Topical laryngo-tracheal anesthesia and intraocular pressure in anesthesia for ophthalmic surgery

OBJECTIVE: The reflex response to orotracheal intubation provokes an increase of arterial pressure accompanied by an increase of chorioides volume and a consequent ocular hypertone. There are several methods to reduce the reflex response due to intubation. One of the most effective is topical anaesthesia of larynx and trachea. Experiments were directed to evaluate the efficacy of topical anaesthesia to reduce the intraocular hypertone due to orotracheal intubation. DESIGN: A prospective randomized mask study was conduct on patients undergoing ophthalmologic (anterior segment) surgery at the Eye Clinic of Florence University. METHODS: Intraocular pressure was measured by a Goldman tonometer at four times: T0 = basal, T1 = 2' minutes after induction of general anaesthesia, T2 = 2' minutes after laryngoscopy, T3 = 2' minutes after orotracheal intubation. At the same moments, systolic blood pressure, heart rate, rate pressure pro duct were measured. Patients were randomly divided in two groups: Group L (n = 10) in which was evaluated the efficacy of laryngotracheal topical spray of lidocaine 4% (2 ml) and Group F (n = 10) in which saline was used instead of anesthetic. The filling of the LTA kit (Abbott) was made by a person not involved in the experiments. DATA ANALYSIS: Student's t test for unpaired data. RESULTS: Topical anaesthesia reduces the increase of intraocular pressure, hypertension and rate pressure product due to intubation. The intraocular pressure reduces to 13% less than basal value in Group L and increase to 50% more than basal value in Group F. CONCLUSION: The topical anaesthesia of larynx and trachea is effective to reduce the intraocular hypertension due to the reflex response evoked by orotracheal intubation.     

Magnetic resonance of the encephalon in 17 patients with ocular Beh?et''s disease

OBJECTIVE: To evaluate the relationships between patient and physician pretreatment expectations of pain relief and subsequent pain relief reported by chronic pain patients immediately after treatment. DESIGN: Prospective study of consecutive patients undergoing a procedure in a pain clinic for treatment of chronic pain. Patients rated their current pain level and their expectation of pain relief immediately prior to undergoing a procedure (e.g., intravenous drug infusion, nerve block) for the treatment of chronic pain. Simultaneously and independently, the treating physician completed a similar questionnaire. At completion of the procedure, patients rated their current pain level and degree of pain relief. SETTING: University of Washington Multidisciplinary Pain Center procedure suite. PATIENTS: Forty-six consecutive chronic pain patients. INTERVENTION: Intravenous drug infusions and nerve blocks. OUTCOME MEASURES: Current pain and pain relief ratings. RESULTS: Patients' pain relief expectation ratings were not correlated significantly with their postprocedure pain relief ratings or pre-post procedure changes in pain ratings. However, a statistically significant correlation was found between physician expectations of pain relief and patient pain relief ratings and patient pre-post procedure changes in pain. CONCLUSIONS: The results of this study suggest that physicians are better predictors than are patients of patients responses to these procedures and/or that physicians may somehow subtly communicate their expectations to patients during the procedure, and these expectations then influence patient response. Patient pretreatment expectations may not always play a significant role in nonspecific treatment effects.     

Improved atrial function in bicaval versus standard orthotopic techniques in cardiac transplantation

Atrial geometry is preserved in the bicaval technique of cardiac transplantation. Using Doppler echocardiography, we investigated the impact of this technique on preservation of atrial function and found that echocardiographic indexes of atrial function are improved in bicaval cardiac transplants versus the standard orthotopic transplants.     

Snowboard traumatology: an epidemiological study

OBJECTIVE: To estimate the frequency of perioperative morbidities in patients who underwent anesthesia and a surgical procedure with no preoperative laboratory testing. MATERIAL AND METHODS: We conducted an electronic database search of medical records of 56,119 patients who underwent surgical or diagnostic procedures and anesthesia at Mayo Clinic Rochester in 1994 and found 5,120 who had no laboratory tests done within 90 days before the procedure. From this group, we randomly selected 1,044 patients (87 from each month) to document the absence of preoperative tests, the presence of preexisting disease (by organ system), the type of anesthetic agent, and the outcomes and tests intraoperatively and postoperatively. RESULTS: The 1,044 patients ranged in age from 0 to 95 years (median age, 21). No deaths or major perioperative morbidities occurred (0.0%; exact 95% confidence interval, 0.00 to 0.35%). Although 10 patients underwent blood typing and screening for antibodies immediately preoperatively, no blood transfusions were necessary. Intraoperatively, 17 laboratory tests and 1 electrocardiogram were obtained, and 3 results were abnormal. Postoperatively, 42 blood tests and 2 electrocardiographic procedures were performed. Five of the 42 blood tests showed abnormal results (hemoglobin levels in 3, serum sodium in 1, and arterial blood gases in 1). One electrocardiogram showed normal findings, and the other revealed normal results except for premature ventricular contractions. No laboratory test done intraoperatively or postoperatively was found to change surgical or medical management substantially. One patient who had unanticipated blood loss during an outpatient procedure was admitted to the hospital for observation. CONCLUSION: All 1,044 patients, 97% of whom were relatively healthy, with no recent laboratory testing safely underwent anesthesia and an operation. We conclude that patients who have been assessed by history and physical examination and determined to have no preoperative indication for laboratory tests can safely undergo anesthesia and operation with tests obtained only as indicated intraoperatively and post-operatively. Current anesthetic and medical practices rapidly identify perioperative indications for laboratory evaluation as they arise.     

佛山市中心组团桥梁群对河道影响的数值分析

在不同频率流量和阻水程度条件下,采用一维明渠非恒定流网河数学模型,分析规划中的佛山市桥梁群对区间河道洪季行洪、枯季水环境的影响,计算洪季不同频率洪峰流量下规划桥梁群对区间河道行洪洪水位、分流比的影响,枯季时规划桥梁群对区间河道过流量、分流比的影响,结果表明,利用一维网河数学模型计算佛山市中心组团规划桥梁群对区间河道断面平均水位、流量和流速的影响,结果有足够的数值精度,是可信的。     

Doped silicon and NIS junctions for bolometer applications

We discuss the performance, of a normal metal hot electron bolometer (NHEB) that we have measured at 0.3 K. We found that the noise equivalent power was limited by the amplifier noise. To improve the NHEB power response and to make it more robust and reliable we propose to substitute the normal metal with heavily doped silicon. The heavily doped silicon behaves like a metal with lower carrier concentration and has a smaller electron–phonon thermal coupling. We have fabricated superconductor-doped silicon-superconductor contacts (S-Sm-S) and we have used them as thermometers and coolers.     

Inorganic–organic hybrid materials with zirconium oxoclusters as protective coatings on aluminium alloys

Inorganic–organic hybrid materials are attracting a strong scientific interest mainly for their outstanding inherent mechanical and thermal properties, which can be traced back to the intimate coupling of both inorganic and organic components. By carefully choosing the experimental parameters used for their synthesis, chemically and thermally stable acrylate-based hybrid material embedding the zirconium oxocluster Zr₄O₄(OMc)₁₂, where OMcCH₂C(CH₃)C(O)O, can be deposited as UV-cured films on aluminium alloys.

In particular, the molar ratios between the oxocluster and the monomer, the polymerisation time, the amount of photo-initiator and the deposition conditions, by using an home-made spray-coating equipment, were optimised in order to obtain the best performing layers in terms of transparency and hardness to coat aluminium alloy (AA1050, AA6060 and AA2024) sheets. Furthermore, it was also evaluated whether the hybrid coatings behave as barrier to corrosion.

Several coated samples were prepared and characterised. Environmental scanning electronic microscopy (ESEM) and scratch test were used to investigate the morphology of the films and to evaluate their scratch resistance, respectively. Electrochemical impedance spectroscopy (EIS) was performed in order to evaluate if the coatings actually protect the metallic substrate from corrosion.

In order to measure shear storage modulus (G′) and loss modulus (G″) of the materials used for coatings, bulk samples were also obtained by UV-curing of the precursors solution. Dynamical mechanical thermal analysis (DMTA) was performed in shear mode on cured disks of both the hybrid materials and pristine polymer for comparison. The values of T_g were read off as the temperatures of peak of loss modulus. The length and mass of all the samples were measured before and after the DMTA analysis, so that the shrinkage of the materials in that temperature range was exactly evaluated.     

Effect of Bonder at Skin/Core Interface on the Mechanical Performances of Sandwich Structures Used in Marine Industry

The present work is aimed to extend the knowledge of mechanical properties of sandwich structures used for marine applications focusing on the possibility to increase the performances of such structures by adding a bonder at the skin/core interface. Therefore, three sandwich structures that are utilised in different structural components of a yacht were realised by manual lay-up. The mechanical characterisation was performed by flatwise compressive, edgewise compressive and three point flexural tests. The tests execution has allowed both to determine the mechanical performances and to understand the fracture mechanisms that take place when the bonder is added in the stacking sequence of the samples.