Ulstrasonic monitoring for early diagnosis of air embolism during neurosurgical procedures (author's transl)

The sitting position of the patient offers many advantages to the neurosurgeon for operations at the posterior fossa, the upper cervical region, the Gasserian ganglion and the retroganglionic trigeminal root. Air embolism is however one of the greatest dangers during operations in this position. Air emboli occur more frequently than it is generally recognized. Most monitoring systems indicate the entrance of air at a late stage only. But early diagnosis and immediate therapy are of utmost importance. The use of an ultrasonic monitoring device for early diagnosis and the preoperative insertion of a right artrial catheter for immediate aspiration of the air are recommended.     

Quantitative analysis of the in situ Fourier transform infrared absorption and emission spectrum of gas-phase SiO (Deltav = 1 and 2) produced in Si-N-O fiber growth

The in situ Fourier transform infrared (FT-IR) spectrum of gasphase SiO produced in silicon oxynitride fiber growth has been quantitatively analyzed. Both absorption and emission FT-IR spectra at a spectral resolution of 0.5 cm(-1) were produced from the reaction zone at 1450 degrees C. The fundamental and hot bands were observed with vibrational levels up to v = 7. For the purposes of quantitative analysis the individual vibration-rotation integrated line strengths for the three main isotopes,( 28)SiO,( 29)SiO, and( 30)SiO, were calculated based on ab initio quantum chemical calculations of the electric dipole moment function and the transition moment. Vibrational anharmonicity and Hermann-Wallis correction factors were also incorporated. From the line strengths at specific temperatures and the known Dunham coefficients, the absorbance spectrum was simulated with best fits giving the averaged SiO concentration in the 400 mm reaction zone of 1.0 x 10(17) molecules/cm(3). Such quantitative measurements demonstrate the power of in situ infrared (IR) spectroscopy combined with quantum chemical calculations. The rapid determination of synthetic calibration datasets for chemometric analysis can thus lead to correlation of gas-phase species concentrations with fiber growth properties and subsequently to real-time process control.     

Noise and machine failures: determining factors in the acceptance and behavior of O2 concentrator. The Asturias project

Whether a sulfonylurea may be used together with insulin for treating NIDDM has been controversial. One view, based on older studies, has been that the additional benefit is too small or the level of glucose control achieved usually too poor to recommend this method. More recent studies of a more specific way of combining a sulfonylurea with insulin are more supportive. When a single injection of insulin taken in the evening is added to a sulfonylurea at the time of secondary failure of the sulfonylurea alone, glycemic control is quite simply and consistently restored to acceptable levels. At this time in the natural history of NIDDM, evening insulin combined therapy is more effective than a single injection of insulin alone, and just as effective as a more complex multiple-injection regimen without an oral agent. A recent multicenter trial of a new sulfonylurea, glimepiride, in combination with a single injection of 70/30 insulin before dinner has confirmed that this approach is safe and more consistently effective than insulin alone for obese patients beginning insulin in a setting resembling clinical practice. The available evidence suggests this form of combined therapy is suitable for routine use.     

The organization and postnatal development of the commissural projection of the rat somatic sensory cortex

Anterograde and retrograde tracing experiments have been used to demonstrate the origin and terminal distribution of commissural fibers in the first somatosensory cortex (SI) of the rat. The commissural fibers originate from pyramidal cells of all layers, but predominantly from layers III and V. The fibers terminate in a series of approximately vertical bands. In each of these there are concentrations of terminals extending from the inner portion of the molecular layer to the deep portion of layer III as well as in the superficial part of layer V, and in layer VI. Discrete vertical bands of cortex are reciprocally connected across the midline to give both the origin and terminal regions of the projection a patchy or "columnar" appearance. The commissural fibers arise from and terminate in areas of the cortex that lie between and alongside the aggregations of granule cells that distinguish SI of the rat. No commissural fibers terminate within the aggregations of layer IV cells themselves but the more superficial terminal ramifications may come to overlie these aggregations. A heterotopic projection to the contralateral second somatosensory cortex has been observed and is similar in form to the homotopic projection to SI. Many commissural fibers have crossed the midline in the corpus callosum by the day of birth but lie in the underlying white matter and do not enter the cortical plate until at least the third postnatal day. During the first postnatal week these fibers grow somewhat diffusely into the maturing cortex and their topographic and laminar pattern of distribution attains its adult characteristics by the end of the first week. Commissural axons, thus, arise from immature cells but the maturation of cell form seems to precede the ingrowth of these axons and the acquisition of commissural synapses.     

Testosterone and testosterone precursors in the spermatic vein and in the testicular tissue of old men. Reduced oxygen supply may explain the relative increase of testicular progesterone and 17 alpha-hydroxyprogesterone content and production in old age

Testosterone and the testosterone precursors pregnenolone, progesterone, 17 alpha-hydroxyprogesterone, 17 alpha-hydroxypregnenolone, androstenedione, androstenediol and dehydroepiandrosterone were measured in the spermatic vein plasma and in the testicular tissue of young and old men. Testosterone and its precursors decreased in the testicular tissue of old men. However, progesterone and 17 alpha-hydroxyprogesterone increased in relation to testosterone in the testicular tissue and in the spermatic vein of old men. It is assumed that these age-dependent changes are caused by an impaired oxygen supply of the ageing testes. This hypothesis is supported by the observation that the same changes in steroid pattern seen in old age can be observed under reduced oxygen supply in in vitro incubation experiments with testicular tissue.     

T2 ACSR conductors: lessons learned

Electric utilities are under increasing pressure to provide better quality service to the customer. In the information age, even momentary interruptions are now unacceptable. The Central Iowa Power Cooperative (USA) has 10 years of experience using variable cross-section ACSR conductor (T2) in an attempt to improve line performance. This article presents a summary of the lessons learned during that time     

Interim report on the radiosurgical treatment of cerebral arteriovenous malformations. The influence of size, dose, time, and technical factors on obliteration rate

During the authors' initial 4-year experience with radiosurgery using the Leksell cobalt-60 gamma unit, they treated 121 patients with cerebral arteriovenous malformations (AVMs). The radiosurgical dose to the margin of the nidus was 20 Gy for lesions less than 2.0 cm in diameter (volume < or = 4.2 cm3); 18 Gy for malformations 2.1 to 3.0 cm in diameter (volume 4.2-14.1 cm3); and 16 Gy for malformations greater than 3.0 cm (volume > 14.1 cm3). Fifty-one patients underwent follow-up angiography between 1 and 3 years after treatment, and complete obliteration of the nidus was confirmed in 38 (74.5%) of these patients. Thirty-two (74.4%) of 43 AVMs with volumes of 10 cm3 or less and six (75%) of eight larger AVMs (volume 11-30 cm3) showed complete obliteration. Analysis of the time course of AVM nidus shrinkage and obliteration showed that most of the radiosurgically induced effect had occurred by 36 months after treatment. Retrospective analysis of the dose plans for 10 AVMs that were not obliterated by 36 months after gamma knife radiosurgery at the authors' institution (eight cases) or elsewhere (two cases) revealed that six AVMs had not been covered completely by the prescribed isodose. Six (5%) of the 121 patients developed neurological deficits as a direct result of radiosurgical treatment. The authors infer from these data that malformations up to 30 cm3 in volume (approximately 4.0 cm in average diameter) can be treated effectively with an acceptably low complication rate using a radiosurgical dose of 16 Gy to the margin of the nidus. The obliteration rate for the larger malformations that were treated with a dose of 16 to 18 Gy appears to be similar to that for smaller ones treated with 18 to 20 Gy. As more experience accrues using radiosurgery to treat AVMs, patient selection criteria and the variables associated with successful obliteration of the nidus should become more clearly defined.     

T cell response to two immunodominant proteolipid protein (PLP) peptides in multiple sclerosis patients and healthy controls

Despite the fact that the neuroleptic drugs have been widely used for more than 40 years, one of their most common side-effects, akathisia, has been relatively neglected. There are still no universally agreed diagnostic criteria for akathisia, particularly chronic akathisia, and in this review article, we discuss the controversies surrounding the voluntary nature of its motor features and the importance of the dysphoric component. We also review the published epidemiological studies to show the great variation in frequency of occurrence. Finally, we discuss the possible neurotransmitters involved in the pathophysiology and treatment of this condition.