Efficacy of epidural analgesia in minimally invasive direct coronary artery bypass surgery

Minimally invasive direct coronary artery bypass surgery (MIDCAB), coronary bypass grafting with small thoracotomy using no cardiopulmonary bypass (CPB), became popular recently. To attenuate perioperative stress-response, we used epidural analgesia (EPI) with general anesthesia for MIDCAB operation. In this study, we compared retrospectively 11 cases of MIDCAB managed with EPI [ED (+)], and 14 cases of MIDCAB anesthetized without using EPI [ED (-)], concerning extubation time, ICU stay, hospital stay and perioperative complications. The mean time from cessation of general anesthesia to extubation was significantly shorter in ED (+) patients (0.5 hours) when compared to ED (-) patients (18.2 hours). Mean periods of ICU stay and hospital stay were, also, shorter in ED (+) patients (2.1 days, 30.5 days, respectively) when compared to ED (-) (4.3 days, 45.1 days, respectively) patients. We experienced ventricular tachycardia in three patients of ED (-). No major complication occurred in ED (+) patients. These results suggest that EPI shortened extubation time, ICU and hospital stay for MIDCAB patients.     

Ultrasonographic findings of diseases in peripheral lung fields using transtracheobronchial endoscopic ultrasonography (TUS)

Cystic neoplasms of the pancreas constitute about 9% of all cystic lesions of the pancreas and less than 1% of all pancreatic neoplasms. The case of a 70 years-old woman with microcystic cystadenoma is reported. CT-scan of the abdomen diagnosed a 5 cm multilocular septated cyst, with calcifications in the context, localized in the head-uncinate process of the pancreas. The mass was well separated by a sharp cleavage plane with portal vein and superior mesenteric vessels. An ERCP showed cephalic symmetrical stenosis (diameter 3 mm) of the main pancreatic duct (MPD), mildly dilated in the remaining tract (diameter 6 mm). An intraoperative biopsy of the cystic wall was performed. Therefore, it was decided to proceed with a duodenum-preserving resection of the head of the pancreas (DPPHR), including the stenosis tract of the MPD in the surgical specimen. The reconstructive procedure consisted, by i.v. jejunal loop transposition, in a side-to-side pancreatico-jejunostomy, including in the anastomosis both corpocaudal stump and the resection cavity of the pancreatic head, and an end-to-side Roux-en-Y jejuno-jejunostomy. With respect to long-lasting pain relief and preservation of the endocrine and exocrine functions of the pancreas, DPPHR is a highly effective surgical procedure with a low early and late morbidity and mortality due to limited surgical resection. This technique, introduced into surgical practice by Beger, is indicated in patients with chronic pancreatitis with an inflammatory mass in the head of the pancreas. The authors conclude that this procedure can be performed also in case of pancreatic benign tumors, as microcystic cystadenoma. Advantages of this technique makes DPPHR an attractive alternative to Pylorus-Preserving-Pancreatico-Duodenectomy (PPPD).     

An experience of video-assisted thoracoscopic surgery for an intrapulmonary needle under CT-guided marking

A 46-year-old female visited a near hospital, complaining of repeating skin eruption with spontaneous remission. A chest X-ray and CT examinations revealed a needle in the left S6, about 5 mm in length, which was suspected of causing the eruption. She was admitted to our hospital for operation. After CT-guided marking, video-assisted thoracoscopic surgery was performed. Because the needle was too small to be palpable, we decided to respect of it with the lung surrounding the marker and clamped the lung, followed by finding the needle finally. The analysis of the removed needle showed that it contained lead and tin besides iron, nickel and chromium, which are components of stainless steel. Although dermatological examination could not reveal the relation between the needle and the eruption, it has never recurred since the operation. It is thought that CT-guided marking is very useful for resection of an intrapulmonary needle and that a foreign body should be removed for the possibility of being harmful.     

Fabrication of ridge waveguides in LiNbO3 thin film crystal by proton-exchange accelerated etching

A simple fabrication method of adhered LiNbO₃ ridge waveguides by accelerated etching of the proton-exchanged region is proposed and demonstrated. The waveguides were fabricated and tested at 1.55 mum wavelength. Strongly confined guided modes were obtained. The waveguides are suitable for efficient nonlinear-optic wavelength conversion devices.     

Buried annealed/proton-exchanged LiNbO3 waveguides fabricated by direct bonding technique

A new method for fabrication of buried annealed/proton-exchanged LiNbO₃ waveguides using direct bonding technique is demonstrated. The buried waveguides were fabricated and tested at 1.55 m wavelength, and guided modes with excellent symmetry were obtained. The waveguides are suitable for efficient coupling to optical fibres and/or efficient nonlinear-optic wavelength conversion devices.     

Production of eicosapentaenoic acid bySaprolegnia sp. 28YTF-1

Saprolegnia sp. 28YTF-1, isolated from a freshwater sample, is a potent producer of 5,8,11,14,17-cis-eicosapentaenoic acid (EPA). The fungus used various kinds of carbon sources, such as starch, dextrin, sucrose, glucose, and olive oil for growth, and olive oil was the best carbon source for EPA production. The EPA content reached 17 mg/g dry mycelium (0.25 mg/L) when the fungus was grown in a medium that contained 2.5% olive oil and 0.5% yeast extract, at pH 6.0 and 28°C for 6 d with shaking. Accompanying production of arachidonic acid (AA; 3.2 mg/g dry mycelia, EPA/AA = 5.1) and other ω6 polyunsaturated fatty acids was low. Both EPA content and EPA/AA ratio increased in parallel by lowering growth temperature. Triglyceride was the major mycelial lipid (ca. 84%), but EPA comprised only 2.2% of the total fatty acids of this lipid. About 40% of the EPA produced was found in polar lipids, such as phosphatidylethanolamine (EPA content, 28.2%), phosphatidylcholine (13.6%), and phosphatidylserine (21.2%).     

Adsorption and reaction of cyclohexene and 1-hexene on nascent gold surface formed by friction

Adsorption and reaction of cyclohexene, 1-hexene and benzene on nascent gold surface formed by friction were investigated using an adsorption test apparatus in high vacuum at room temperature. Chemisorption of cyclohexene, 1-hexene and benzene was observed during the sliding processes by a quadrupole mass spectrometer. It is found that nascent gold surface has catalytic activity for hydrogenation of cyclohexene and 1-hexene, and for dehydrogenation of the olefins and benzene. The adsorbed cyclohexene and 1-hexene molecules were hydrogenated on the surface to form cyclohexane and hexane, respectively. As dehydrogenation products, hydrogen from all the sample gases, and benzene from cyclohexene desorbed. Adsorption rate of the olefins was higher than that of benzene, and hydrogenation activity of 1-hexene is higher than that of cyclohexene. However, on nascent Pd–Ag alloy surface, the desorption of hydrogenation products was not detected, although adsorption of the sample gases and desorption of the dehydrogenation products were also observed.     

Structural reliability software at the University of California, Berkeley

The paper provides an overview of three software for structural reliability analysis developed at the University of California, Berkeley. These are CalREL, which is a general-purpose structural reliability code written in FORTRAN; FERUM, which is a collection of Matlab^® files that can be used for structural reliability analysis in conjunction with simple finite element models; and OpenSees, which is an object-oriented code for nonlinear structural response simulation with reliability capabilities. Reliability analysis methods featured by these software include FORM, SORM, Monte Carlo simulation, and various importance sampling methods. In addition, variable importance and sensitivity measures are provided.