Continuous non-invasive blood pressure monitoring by brachial artery displacement method in high-risk surgical patients

Continuous non-invasive blood pressure (CNBP) measurements were compared to invasive radial artery pressure recordings in 26 patients with cardiac, vascular and/or pulmonary disease. Patients were studied during general anaesthesia (n = 6), regional anaesthesia (n = 10), or combined technique (n = 10) for abdominal or transurethral surgery. CNBP was obtained from a cuff placed around the upper arm and simultaneously compared to invasive pressure from the ipsilateral radial artery. A CNBP device (7001 Cortronic) used intermittent oscillometric measurement for calibration. Through a cuff continuously inflated to a pressure of 20 mmHg, a microprocessor-controlled electro-pneumatic acquisition system sensed displacements of the brachial artery wall. Amplified, digitally converted, filtered and transformed data were displayed as a continuous pulse pressure waveform and digital pressure values on the screen. The CNBP method functioned without disturbances before surgery in all patients. Intra-operative use of electrocautery or a spontaneous occurrence of warning on the screen repeatedly triggered oscillometric recalibration, hence CNBP measurements were discontinued in nine patients. Coefficients of correlation (r) of all invasive and CNBP pairs (n = 1111) were 0.68, 0.58 and 0.70 for systolic, diastolic, and mean blood pressures, respectively. Prediction errors (bias, mean +/- SD) were -13.6 +/- 22.5 mmHg (on average CNBP < invasive pressure) for systolic, +13.0 +/- 12.4 mmHg (CNBP > invasive pressure) for diastolic and +5.0 +/- 13.9 mmHg (CNBP > invasive pressure) for mean CNBP, as compared to radial artery pressure values. Absolute errors (precision) were 25.3 +/- 9.4 mmHg for systolic, 17.4 +/- 4.5 mmHg for diastolic, and 13.9 +/- 4.6 mmHg for mean CNBP. During anaesthesia induction (n = 672) the difference between consecutive measurements (trend of pressure changes) with invasive and CNBP method exceeded 20 mmHg in 90 (13.3%) instances for systolic, in 33 (4.9%) instances for diastolic, and in 45 (6.6%) instances for mean blood pressure. In conclusion, the CNBP method by brachial artery wall displacement failed to measure the blood pressure reliably and to display the trend of pressure changes correctly during anaesthesia induction. In its present form this CNBP method should not replace invasive blood pressure monitoring in high-risk patients neither for anaesthesia induction nor during non-thoracic surgical procedures.     

Realization of a resonant tunneling permeable base transistor withoptimized overgrown GaAs interfaces

A resonant tunneling permeable base transistor has been realized experimentally by overgrowing a tungsten grating placed in direct vicinity to a double barrier heterostructure. In this way, we can directly modulate the tunneling current via an embedded gate. Since the quality of the overgrown interface is critical, special attention is paid to this issue, and the effect of different wet etchants prior to overgrowth is studied both by electrical measurements and by the use of an atomic force microscope. A clear dependence of the electrical properties and the crystal quality on the etchants used is found. This is a key result for the realization of our resonant tunneling device     

Research Needs and Challenges in Application of Computer and Information Sciences for Industrial Engineering

By invitation from the Editor of IIE Transactions, a research forum was established in 1987 to develop and prepare this article. The objective: to write on the directions, needs and challenges for research by the IE com-munity in applying computer and information sciences. The motivation: realizing the major advancements in computer and information sciences in the recent decade and their significant impact on the IE profession, it is vital to examine how IE research activities can respond effectively to current and emerging needs. This article is viewed as a useful contribution to such an examination.

Forum members were invited from academia, government and industry based on their experience in and commitment to research in this area. The forum was chaired by Shimon Y. Nof and the members are the co-authors of this article.

Forum members communicated and deliberated throughout 1987 and met for a review and planning session dur-ing the IIE Conference in Washington, D.C. in May, 1987 (Forum, 1987). The following article summarizes the contributions and recommendations of the forum members, and was reviewed by four guest reviewers. The re-viewers, invited by the Editor, have provided comments that have been incorporated into this article     

Evolution der akustischen Oberflächenwellen-Bauelemente

A selective survey is given on the development of surface acoustic wave (SAW) devices since the 1970’s. Emphasis is put on research and development delivered by the University of Technology Vienna, Austria, in cooperation with the corporate research of Siemens (now EPCOS) Munich, Germany. Future trends of SAW-technology are discussed.     

Banning banking in EU emissions trading?

Admitting banking in emissions trading systems reduces overall compliance costs by allowing for inter-temporal flexibility: cost savings can be traded over time. However, unless individual EU Member States (MS) decide differently, the transfer of unused allowances from the period of 2005–2007 into the first commitment period under the Kyoto Protocol, i.e. 2008–2012, will be prohibited. In this paper, we first explore the implications of such a ban on banking when initial emission targets are lenient. This analysis is based on a simulation which was recently carried out in Germany with companies and with a student control group. The findings suggest that a EU-wide ban on banking would lead to efficiency losses in addition to those losses which arise from the lack of inter-temporal flexibility. Second, we use simple game-theoretic considerations to argue that, under reasonable assumptions, such a EU-wide ban on banking will be the equilibrium outcome. Thus, to avoid a possible prisoners’ dilemma, MS should have co-ordinated their banking decisions.     

Radiation exposure in abdominal radiography with digital luminescence radiography and conventional screen-film system: an experimental animal study]

Progress in the care of the critically ill patient with life-threatening infection has been hampered by inconsistent, often confusing terminology. The clinical syndrome of sepsis-familiar to all yet definable by none-describes a highly heterogeneous group of disorders with different causes and differing prognoses. The imminent availability of mediator-directed therapy has created a sense of urgency to develop better methods for delineating discrete clinical syndromes and to modulate the host response, which may bring both benefit and harm, depending on the clinical circumstances. The term systemic inflammatory response syndrome (SIRS) was introduced several years ago to describe the familiar clinical syndrome of sepsis, independent of its cause. SIRS can result from trauma, pancreatitis, drug reactions, autoimmune disease, and a host of other disorders; when it arises in response to infection, sepsis is said to be present. SIRS describes a dynamic process that has adaptive survival value for the host. The maladaptive consequence of this process in the critically ill patient is the development of progressive but potentially reversible remote organ dysfunction-the multiple organ dysfunction syndrome. The development of cogent conceptual frameworks for classification of the septic response in critically ill patients is more than a question of linguistic pedantry. Optimal therapy presupposes identification of an homogeneous patient population with a characteristic disease process and a predictable response to an intervention. Although progress has been made in identifying such groups of critically ill patients, the disappointing results of clinical trials of agents that so clearly demonstrate efficacy in animal models indicates that considerable work remains.