Hemodynamic changes during laparoscopic cholecystectomy

Hemodynamics during laparoscopic cholecystectomy under general anesthesia (isoflurane in N2O/O2 (50%)) were investigated in 15 nonobese ASA Class I patients by using invasive hemodynamic monitoring including a flow-directed pulmonary artery catheter. During surgery, intraabdominal pressure was maintained automatically at 14 mm Hg by a CO2 insufflator, and minute ventilation was controlled and adjusted to avoid hypercapnia. Hemodynamics were measured before anesthesia, after the induction of anesthesia, after tilting into 10 degrees head-up position, 5 min, 15 min, and 30 min after peritoneal insufflation, and 30 min after exsufflation. Induction of anesthesia decreased significantly mean arterial pressure and cardiac index (CI). Tilting the patient to the head-up position reduced cardiac preload and caused further reduction of CI. Peritoneal insufflation resulted in a significant increase (+/- 35%) of mean arterial pressure, a significant reduction (+/- 20%) of CI, and a significant increase of systemic (+/- 65%) and pulmonary (+/- 90%) vascular resistances. The combined effect of anesthesia, head-up tilt, and peritoneal insufflation produced a 50% decrease in CI. Administration of increasing concentrations of isoflurane, via its vasodilatory activity, may have partially blunted these hemodynamic changes. These results demonstrate that laparoscopy for cholecystectomy in head-up position results in significant hemodynamic changes in healthy patients, particularly at the induction of pneumoperitoneum.     

Study of the interaction of fish myosin with the products of lipid oxidation: The case of aldehydes

The aim of this study was to assess the modifications of fish myosin induced by interactions with four aldehydes: hexanal, 2-hexenal, 2,4-hexadienal, and 2,6-nonadienal. These compounds are generated during lipid oxidation and are known to have an impact on the functional properties of proteins.     

Instrumental avoidance conditioning in the spinal rat

Spinal rats exposed to an instrumental avoidance routine in a counterbalanced Horridge paradigm were able to achieve successively higher criteria. Both experimental and yoked control animals were capable of instrumental avoidance conditioning to incremental criteria; experimental animals exhibited retention of the task when tested. During acquisition, naive experimental animals were superior in performance to previous control animals. Due to the use of a counterbalanced Horridge paradigm, the effectsof sensitization and response variability are probably not sufficient to explain all of the results of this experiment. The data suggest that both graded acquisition and retention occur at the spinal level.     

Telemonitoring of patients at home: a software agent approach

To address the issue of the increasing social, economical and medical needs of maintaining at home people in loss of autonomy while preserving privacy and quality of life, the authors present a software agent based telemonitoring and alarm raising system. The article describes the overall architecture, the various components of the model, and the methodology that has been used. It specifically addresses the issue of reflecting in the object oriented model of the system various dimensions including: the physical world of in-home bio-signal sensors, the numerical world of software agents and Internet-related technologies, and the medical and social worlds of patients, physicians and caregivers. In the model, the main stream of information goes from the biophysical world of patients at home to the socio-medical world of carers through a chain of devices including in-home sensors, local area network, home computer, remote server, and carers' computers. Each device hosts software agents with different levels of knowledge and complexity. Internet and Java technologies provide the building blocks of the designed telemonitoring software. Laboratory experiments have been realized using a fully equipped 'smart' demonstration home for telecare. The study takes place into a more general research project on 'smart' homes for telecare conducted at the Hospital Centre of Grenoble, France.     

Possible in vivo tolerance of human polymorphonuclear neutrophil to low-grade exercise-induced endotoxaemia

Splenic injury is the most common abdominal organ injury in children who sustain blunt trauma and may result from apparently minor injuries. We present two cases of delayed diagnosis of splenic injury in children who fell from a moderate height of less than 10 feet. Careful physical examination and close follow-up with reevaluation are necessary to identify children with possible splenic injury after relatively minor blunt trauma.     

Loss of HLA molecules in B lymphomas is associated with an aggressive clinical course

Studies that show laparoscopic lumbar fusion to decrease cost or time of hospitalization or to increase the speed or incidence of return to activities are not currently available. Laparoscopic fusion of the lumbar spine appears to be a potentially attractive approach to treating axial back pain secondary to different causes. Although the technique is attractive because of its minimally invasive nature and marketing allure, it has yet to be established as to what the true clinical efficacy of this procedure will be. Further clinical study of these techniques with longer follow-up, and case-controlled studies should help clinicians to know the best fusion technique to offer patients.     

Parameterized complexity of firefighting

The Firefighter problem is to place firefighters on the vertices of a graph to prevent a fire with known starting point from lighting up the entire graph. In each time step, a firefighter may be placed on an unburned vertex, permanently protecting it, and the fire spreads to all neighboring unprotected vertices of burning vertices. The goal is to let as few vertices burn as possible. In this paper, we consider a generalization of this problem, where at each time step b?1$b?1$ firefighters can be deployed. Our results answer several open questions raised by Cai et al. [8]. We show that this problem is W[1]-hard when parameterized by the number of saved vertices, protected vertices, and burned vertices. We also investigate several combined parameterizations for which the problem is fixed-parameter tractable. Some of our algorithms improve on previously known algorithms. We also establish lower bounds to polynomial kernelization.     

Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study.

This meta-analysis of 172 studies (N = 2,263 anxious,N = 1,768 nonanxious) examined the boundary conditions of threat-related attentional biases in anxiety. Overall, the results show that the bias is reliably demonstrated with different experimental paradigms and under a variety of experimental conditions, but that it is only an effect size of d = 0.45. Although processes requiring conscious perception of threat contribute to the bias, a significant bias is also observed with stimuli outside awareness. The bias is of comparable magnitude across different types of anxious populations (individuals with different clinical disorders, high-anxious nonclinical individuals, anxious children and adults) and is not observed in nonanxious individuals. Empirical and clinical implications as well as future directions for research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coalescence of single-walled carbon nanotubes and formation of multi-walled carbon nanotubes under high-temperature treatments

Electric arc-discharge single-wall carbon nanotubes are annealed between 1600 and 2800 °C under argon flow. Their stability and evolution are studied by coupling TEM, X-ray diffraction and Raman spectroscopy. The first modifications appear at 1800 °C with a significant decrease of the crystalline order. It is due to SWNTs coalescence leading to smaller bundles but with an increase of the tube diameters from 2 to 4 nm. From 2200 °C, SWNTs progressively disappear to the benefit of MWNTs having at first two to three carbon layers then reaching 7 nm external diameter. The possible mechanisms responsible for the SWNTs coalescence and instability and their transformation in MWNTs are discussed.