Changing from isoflurane to desflurane toward the end of anesthesia does not accelerate recovery in humans

BACKGROUND: In an attempt to combine the advantage of the lower solubilities of new inhaled anesthetics with the lesser cost of older anesthetics, some clinicians substitute the former for the latter toward the end of anesthesia. The authors tried to determine whether substituting desflurane for isoflurane in the last 30 min of a 120-min anesthetic would accelerate recovery. METHODS: Five volunteers were anesthetized three times for 2 h using a fresh gas inflow of 2 l/min: 1.25 minimum alveolar concentration (MAC) desflurane, 1.25 MAC isoflurane, and 1.25 MAC isoflurane for 90 min followed by 30 min of desflurane concentrations sufficient to achieve a total of 1.25 MAC equivalent ("crossover"). Recovery from anesthesia was assessed by the time to respond to commands, by orientation, and by tests of cognitive function. RESULTS: Compared with isoflurane, the crossover technique did not accelerate early or late recovery (P > 0.05). Recovery from isoflurane or the crossover anesthetic was significantly longer than after desflurane (P < 0.05). Times to response to commands for isoflurane, the crossover anesthetic, and desflurane were 23 +/- 5 min (mean +/- SD), 21 +/- 5 min, and 11 +/- 1 min, respectively, and to orientation the times were 27 +/- 7 min, 25 +/- 5 min, and 13 +/- 2 min, respectively. Cognitive test performance returned to reference values 15-30 min sooner after desflurane than after isoflurane or the crossover anesthetic. Isoflurane cognitive test performance did not differ from that with the crossover anesthetic at any time. CONCLUSIONS: Substituting desflurane for isoflurane during the latter part of anesthesia does not improve recovery, in part because partial rebreathing through a semiclosed circuit limits elimination of isoflurane during the crossover period. Although higher fresh gas flow during the crossover period would speed isoflurane elimination, the amount of desflurane used and, therefore, the cost would increase.     

Purification and characterization of P33 protein of Candida utilis homologous to bgl2p of Saccharomyces cerevisiae; comparative analysis of the role of these proteins in molecular organization of the yeast cell walls

P33 protein was isolated from the cell walls of Candida utilis. Homology between P33 and Bgl2p proteins from the cell walls of Saccharomyces cerevisiae was shown. The important role of these proteins in molecular organization of yeast cell walls was demonstrated using trypsin proteolysis and the "gene disruption" method.     

Single irradiation of the pituitary with a narrow beam of protons having 200 MeV of energy in generalized breast cancer

Eighteen patients with congestive cardiomyopathy were studied by echocardiography and cardiac catheterization. Patients with coronary disease on angiography or primary valvular disease were excluded. Six patients showed mild or no mitral regurgitation; in 12 others the degree of mitral regurgitation was moderate or severe. The echocardiographic features in these patients were: (1) a dilated left ventricle (LV), (2) normal LV wall thickness, (3) reduced LV posterior wall motion, and (4) reduced or absent systolic thickening of the interventricular septum (IVS). IVS motion was reduced in 10 patients, and appeared "normal" or increased in another eight, all of whom showed moderate or severe mitral regurgitation on angiography. It is concluded that an apparent normal or increased motion of the IVS with reduced or absent systolic thickening in congestive cardiomyopathy is evidence for coexistence of significant mitral regurgitation. Reduced or absent systolic thickening can distinguish these patients from those with segmental myocardial disease and normal septa or dilated LV's due to volume overload.     

毫米波探测技术与寻的引信

分析了毫米波传感器(包括毫米波雷达和毫米波辐射计)的特点及工作原理，讨论了基于毫米波传感器的多模复合探测技术，并具体介绍了它们在灵巧弹药寻的引信中的广泛应用，结合现代电子技术和信号处理技术展望了其发展前景。