Materials and Methods: From 1980 to 2009, 660 partial nephrectomies were performed at 4 centers for tumor in a solitary functioning kidney under cold (300) or warm (360) ischemia. Data were collected in institutional review board approved registries and followup averaged 4.5 years. Preoperative and postoperative glomerular

Selleckchem PF-6463922 filtration rates were estimated via the Chronic Kidney Disease-Epidemiology Study equation.

Results: At 3 months after partial nephrectomy median glomerular filtration rate decreased by equivalent amounts with cold or warm ischemia (21% vs 22%, respectively, p = 0.7), although median cold ischemic times were much longer (45 vs 22 minutes respectively, p <0.001). On multivariable analyses increasing age, larger tumor size, lower

preoperative glomerular filtration rate and longer ischemia time were associated with decreased postoperative glomerular filtration rate (p <0.05). When percentage of parenchyma spared was incorporated into the analysis, this factor and preoperative glomerular filtration rate proved to be the primary determinants of ultimate renal function, and duration of ischemia Wortmannin research buy lost statistical significance.

Conclusions: This nonrandomized, comparative study suggests that within the relatively strict parameters of conventional practice, ie predominantly short ischemic intervals and liberal use of hypothermia, ischemia time was not an independent predictor of ultimate renal function after partial nephrectomy. Long-term renal function after partial nephrectomy is determined primarily by the quantity and quality of renal parenchyma preserved, although type and duration of ischemia remain the most important modifiable factors, and warrant further study.”
“When an acoustic stimulus

that is sufficiently intense to elicit a startle response is delivered in conjunction with else the “”go”" signal in a simple reaction time (RT) task, RT is greatly reduced. It has been suggested that this effect is due to the startle interacting with voluntary response channels to directly trigger the preprogrammed action. Alternatively, it may be that the startling stimulus simply increases activation along the sensory and motor pathways allowing for faster stimulus-response processing. In the present study a startling acoustic stimulus (SAS) was presented in addition to a visual or an auditory imperative stimulus (IS) in a simple RT task. Results showed that the pre-programmed response was initiated much faster when participants were startled. However, while differences in RT due to IS modality were observed in control trials, this difference was absent for startle trials. This result indicates that the SAS does not simply speed processing along the normal stimulus-response channels, but acts to release the pre-planned movement via a separate, faster neural pathway. (C) 2011 Elsevier Ireland Ltd. All rights reserved.