Influence of Pleural Drain Insertion in Lung Function of Patients Undergoing Coronary Artery Bypass Grafting

Background and objectives: Longitudinal, prospective, randomized, blinded Trial to assess the influence of pleural drain (non-toxic PVC) site of insertion on lung function and postoperative pain of patients undergoing coronary artery bypass grafting in the first three days post-surgery and immediately after chest tube removal. Method: Thirty six patients scheduled for elective myocardial revascularization with cardiopulmonary bypass (CPB) were randomly allocated into two groups: SX group (subxiphoid) and IC group (intercostal drain). Spirometry, arterial blood gases, and pain tests were recorded. Results: Thirty one patients were selected, 16 in SX group and 15 in IC group. Postoperative (PO) spirometric values were higher in SX than in IC group (p < 0.05), showing less influence of pleural drain location on breathing. PaO2 on the second PO increased significantly in SX group compared with IC group (p < 0.0188). The intensity of pain before and after spirometry was lower in SX group than in IC group (p < 0.005). Spirometric values were significantly increased in both groups after chest tube removal. Conclusion: Drain with insertion in the subxiphoid region causes less change in lung function and discomfort, allowing better recovery of respiratory parameters.

Hydration and anomalous solubility of the Bell-Lavis model as solvent

We address the investigation of the solvation properties of the minimal orientational model for water originally proposed by [Bell and Lavis, J. Phys. A 3, 568 (1970)]. The model presents two liquid phases separated by a critical line. The difference between the two phases is the presence of structure in the liquid of lower density, described through the orientational order of particles. We have considered the effect of a small concentration of inert solute on the solvent thermodynamic phases. Solute stabilizes the structure of solvent by the organization of solvent particles around solute particles at low temperatures. Thus, even at very high densities, the solution presents clusters of structured water particles surrounding solute inert particles, in a region in which pure solvent would be free of structure. Solute intercalates with solvent, a feature which has been suggested by experimental and atomistic simulation data. Examination of solute solubility has yielded a minimum in that property, which may be associated with the minimum found for noble gases. We have obtained a line of minimum solubility (TmS) across the phase diagram, accompanying the line of maximum density. This coincidence is easily explained for noninteracting solute and it is in agreement with earlier results in the literature. We give a simple argument which suggests that interacting solute would dislocate TmS to higher temperatures.

Endonasal endoscopic exposure of the internal carotid artery: An anatomical study

Objectives/Hypothesis: The aim of this work was to define the anatomical landmarks, limitations, and difficulties of obtaining internal carotid artery (ICA) exposure via endonasal endoscopic approaches (EEA).

Origin of the heavy elements in HD 140283 Measurement of europium abundance

Context. HD 140283 is a nearby (V = 7.7) subgiant metal-poor star, extensively analysed in the literature. Although many spectra have been obtained for this star, none showed a signal-to-noise (S/N) ratio high enough to enable a very accurate derivation of abundances from weak lines. Aims. The detection of europium proves that the neutron-capture elements in this star originate in the r-process, and not in the s-process, as recently claimed in the literature. Methods. Based on the OSMARCS 1D LTE atmospheric model and with a consistent approach based on the spectrum synthesis code Turbospectrum, we measured the europium lines at 4129 angstrom and 4205 angstrom, taking into account the hyperfine structure of the transitions. The spectrum, obtained with a long exposure time of seven hours at the Canada-France-Hawaii Telescope (CFHT), has a resolving power of 81 000 and a S/N ratio of 800 at 4100 angstrom. Results. We were able to determine the abundance A(Eu) = -2.35 +/- 0.07 dex, compatible with the value predicted for the europium from the r-process. The abundance ratio [Eu/Ba] = +0.58 +/- 0.15 dex agrees with the trend observed in metal-poor stars and is also compatible with a strong r-process contribution to the origin of the neutron-capture elements in HD 140283.

On the Origin of the Trigger-Angle Dependence of the Ridge Structure

The origin of the trigger-angle dependence of the ridge structure in two-hadron long-range correlations, as observed at RHIC, is discussed as due to an interplay between the elliptic flow caused by the initial state global geometry and flow produced by fluctuations.

Linking origin of the electric field-assisted beta-PbF2 crystallization in lead oxyfluoroborate glasses below T (g) to simultaneous cathode/anode-compensated electrochemical reactions

Full validation of the electrochemical mechanisms so far postulated as driving force of electric field-assisted non-spontaneous crystallization development in given glasses has suffered experimental restrictions. In this work, we looked into origin of this phenomenon in lead oxyfluoroborate glasses, resulting in beta-PbF2 growth even below the corresponding glass transition temperatures, through achieving a systematic study of not only Pt,Ag/Glass/Ag,Pt- but also Pt,Ag/Glass/YSZ:PbF2/Ag,Pt-type cells, where YSZ:PbF2 represents a two-phase system (formed by Y2O3-doped ZrO2 and PbF2). It is demonstrated that crystallization induction in these glasses involves Pb2+ ions reduction at the cathode, the phenomenon being, however, confirmed only when the F- ions were simultaneously also able to reach the anode for oxidation, after assuring either a direct glass-anode contact or percolation pathways for free fluoride migration across the YSZ:PbF2 mixtures. A further support of this account is that the electrochemically induced beta-PbF2 phase crystallizes showing ramified-like microstructure morphology that arises, accordingly, from development of electroconvective diffusion processes under electric field action.

Origin of the heavy elements in HD 140283: measurement of europium abundance

Context. HD140283 is a nearby (V = 7:7) subgiant metal-poor star, extensively analysed in the literature. Although many spectra have been obtained for this star, none showed a signal-to-noise (S/N) ratio high enough to enable a very accurate derivation of abundances from weak lines. Aims. The detection of europium proves that the neutron-capture elements in this star originate in the r-process, and not in the s-process, as recently claimed in the literature. Methods. Based on the OSMARCS 1D LTE atmospheric model and with a consistent approach based on the spectrum synthesis code Turbospectrum, we measured the europium lines at 4129 Å and 4205 Å, taking into account the hyperfine structure of the transitions. The spectrum, obtained with a long exposure time of seven hours at the Canada-France-Hawaii Telescope (CFHT), has a resolving power of 81 000 and a S/N ratio of 800 at 4100 Å. Results. We were able to determine the abundance A(Eu) =

Initial experience with Pomerantzeff's technique for reduction of the size of giant left atrium

Introduction: The most common indication for surgical correction of giant left atrium is associated with mitral valve insufficiency with or without atrial fibrillation. Several techniques for this purpose are already described with varying results. Objective: To present the initial experience with the tangential triangular resection technique (Pomerantzeff). Methods: From 2002 to 2010, four patients underwent mitral valve operation with reduction of left atrial volume by the technique of triangular resection tangential in our service. Three patients were female. The age ranged from 21 to 51 years old. The four patients presented with atrial fibrillation. Ejection fraction of left ventricle preoperatively ranged from 38% to 62%. The left atrial diameter ranged from 78mm to 140mm. After treatment of mitral dysfunction, the left atrium was reduced by resecting triangular tangential posterior wall between the pulmonary veins to avoid anatomic distortion of the mitral valve or pulmonary veins, reducing tension in the suture line. Results: Average hospital stay was 21.5 +/- 6.5 days. The mean cardiopulmonary bypass time was 130 +/- 30 minutes. There was no surgical bleeding or mortality in the postoperative period. All patients had sinus rhythm restored in the output of cardiopulmonary bypass, maintaining this rate postoperatively. The average diameter of the left atrium was reduced by 50.5% +/- 19.5%. The left ventricular ejection fraction improved in all patients. Conclusion: Initial results with this technique have shown effective reduction of the left atrium.

Petrogenesis of Cenozoic volcanic rocks in the NW sector of the Gharyan volcanic field, Libya

The north-western sector of the Gharyan volcanic field (northern Libya) consists of trachytic-phonolitic domes emplaced between similar to 41 and 38 Ma, and small-volume mafic alkaline volcanic centres (basanites, tephrites. alkali basalts. hawaiites and rare benmoreites) of Middle Miocene-Pliocene age (similar to 12-2 Ma). Two types of trachytes and phonolites have been recognized on the basis of petrography, mineralogy and geochemistry. Type-1 trachytes and phonolites display a smooth spoon-shaped REE pattern without negative Europium anomalies. Type-2 trachytes and phonolites show a remarkable Eu negative anomaly, higher concentration in HFSE (Nb-Ta-Zr-Hf), REE and Ti than Type-1 rocks. The origin of Type-1 trachytes and phonolites is compatible with removal of clinopyroxene, plagioclase, alkali feldspar, amphibole. magnetite and titanite starting from benmoreitic magmas. found in the same outcrops. Type-2 trachytes and phonolites could be the result of extensive fractional crystallization starting from mafic alkaline magma, without removal of titanite. In primitive mantle-normalized diagrams, the mafic rocks (Mg#= 62-68, Cr up to 514 ppm, Ni up to 425 ppm) show peaks at Nb and Ta and troughs at K. These characteristics, coupled with low Sr-87/Sr-86(i) (0.7033-0.7038) and positive epsilon(Nd) (from +4.2 to + 5.3) features typical of the mafic anorogenic magmas of the northern African plate and of HIMU-OIB-like magma in general. The origin of the mafic rocks is compatible from a derivation from low degree partial melting (3-9%) shallow mantle sources in the spinel/gamet facies. placed just below the rigid plate in the uppermost low-velocity zone. The origin of the igneous activity is considered linked to passive lithospheric thinning related to the development of continental rifts like those of Sicily Channel (e.g.. Pantelleria and Linosa) and Sardinia (e.g., Campidano Graben) in the Central-Western Mediterranean Sea. (C) 2012 Elsevier B.V. All rights reserved.

Analysis of the NMDA in Focal Cerebral Ischemia in Rats

NMDAR (N-methyl-D-aspartate receptor) is one subtype of ionotrophic glutamate receptor which is extensively distributed in the central nervous system (CNS). In the mammalian CNS, NMDAR serves prominent roles in the pathophysiologic process of cerebral ischemia. This study aimed to investigate the pattern of expression of protein and gene of the excitatory neurotransmitter NMDAR in experimental focal cerebral ischemia and the hole of neuroprotection with hypothermia and ketoprofen. 120 rats were randomly divided into 6 groups (20 animals each): control - no surgery; sham - simulation of surgery; ischemic - focal ischemia for 1 hour, without reperfusion; ischemic + intraischemic hypothermia; ischemic + previous intravenous ketoprofen, and ischemic + hypothermia and ketoprofen. Ten animals from each experimental group were used to establish the volume of infarct. Transient focal cerebral ischemia was obtained in rats by occlusion of the middle cerebral artery with an intraluminal suture. The infarct volume was measured using morphometric analysis of infarct areas defined by triphenyl tetrazolium chloride and the patterns of expression of the protein and gene NMDA were evaluated by immunohistochemistry and quantitative real-time PCR, respectively. Increases in the protein and gene NMDA receptor in the ischemics areas were observed and these increases were reduced by hypothermia and ketoprofen. The increase in the NMDA receptor protein and gene expression observed in the ischemic animals was reduced by neuroprotection (hypothermia and ketoprofen). The NMDA receptor increases in the ischemic area suggests that the NMDA mediated neuroexcitotoxicity plays an important role in cell death and that the neuroprotective effect of both, hypothermia and ketoprofen is directly involved with the NMDA.

Electrocardiographic manifestation of the middle fibers/septal fascicle block: a consensus report

There are fibers in the left ventricle (LV) (LV middle network) that in around one third of cases may be considered a true septal fascicle that arises from the common left bundle. Its presence and the evidence that there are 3 points of activation onset in the LV favor the quadrifascicular theory of the intravantricular activation of both ventricles. Since the 70s, different authors have suggested that the block of the left middle fibers (MS)/left septal fascicle may explain different electrocardiographic (ECG) patterns. The 2 hypothetically based criteria that are in some sense contradictory include: a) the lack of septal "q" wave due to first left and later posteriorly shifting of the horizontal plane loop and b) the presence of RS in lead V-2 (V-1-V-2) due to some anterior shifting of the horizontal plane vectorcardiogram loop. However, there are many evidence that the lack of septal q waves can be also explained by predivisional first-degree left bundle-branch block and that the RS pattern in the right precordial leads may be also explained by first-degree right bundle-branch block. The transient nature of these patterns favor the concept that some type of intraventricular conduction disturbance exists but a doubt remains about its location. Furthermore, the RS pattern could be explained by many different normal variants. To improve our understanding whether these patterns are due to MF/left septal fascicle block or other ventricular conduction disturbances (or both), it would be advisable: 1) To perform more histologic studies (heart transplant and necropsy) of the ventricular conduction system; 2) To repeat prior experimental studies using new methodology/technology to isolate the MF; and 3) To change the paradigm: do not try to demonstrate if the block of the fibers produces an ECG change but to study with new electroanatomical imaging techniques, if these ECG criteria previously described correlate or not with a delay of activation in the zone of the LV that receives the activation through these fibers or in other zones. (C) 2012 Elsevier Inc. All rights reserved.

THE FIRST DETERMINATION OF THE VISCOSITY PARAMETER IN THE CIRCUMSTELLAR DISK OF A Be STAR

Be stars possess gaseous circumstellar decretion disks, which are well described using standard alpha-disk theory. The Be star 28 CMa recently underwent a long outburst followed by a long period of quiescence, during which the disk dissipated. Here we present the first time-dependent models of the dissipation of a viscous decretion disk. By modeling the rate of decline of the V-band excess, we determine that the viscosity parameter alpha = 1.0 +/- 0.2, corresponding to a mass injection rate (M) over dot = (3.5 +/- 1.3) x 10(-8) M-circle dot yr(-1). Such a large value of a suggests that the origin of the turbulent viscosity is an instability in the disk whose growth is limited by shock dissipation. The mass injection rate is more than an order of magnitude larger than the wind mass-loss rate inferred from UV observations, implying that the mass injection mechanism most likely is not the stellar wind, but some other mechanism.

The protective effect of cilostazol on isolated rabbit femoral arteries under conditions of ischemia and reperfusion: the role of the nitric oxide pathway

OBJECTIVES: The clinical significance of ischemia/reperfusion of the lower extremities demands further investigation to enable the development of more effective therapeutic alternatives. This study investigated the changes in the vascular reactivity of the rabbit femoral artery and nitric oxide metabolites under partial ischemia/reperfusion conditions following cilostazol administration. METHODS: Ischemia was induced using infrarenal aortic clamping. The animals were randomly divided into seven groups: Control 90 minutes, Ischemia/Reperfusion 90/60 minutes, Control 120 minutes, Ischemia/Reperfusion 120/90 minutes, Cilostazol, Cilostazol before Ischemia/Reperfusion 120/90 minutes, and Ischemia 120 minutes/Cilostazol/Reperfusion 90 minutes. Dose-response curves for sodium nitroprusside, acetylcholine, and the calcium ionophore A23187 were obtained in isolated femoral arteries. The levels of nitrites and nitrates in the plasma and skeletal muscle were determined using chemiluminescence. RESULTS: Acetylcholine- and A23187-induced relaxation was reduced in the Ischemia/Reperfusion 120/90 group, and treatment with cilostazol partially prevented this ischemia/reperfusion-induced endothelium impairment. Only cilostazol treatment increased plasma levels of nitrites and nitrates. An elevation in the levels of nitrites and nitrates was observed in muscle tissues in the Ischemia/Reperfusion 120/90, Cilostazol/Ischemia/Reperfusion, and Ischemia/Cilostazol/Reperfusion groups. CONCLUSION: Hind limb ischemia/reperfusion yielded an impaired endothelium-dependent relaxation of the femoral artery. Furthermore, cilostazol administration prior to ischemia exerted a protective effect on endothelium-dependent vascular reactivity under ischemia/reperfusion conditions.

New measurement of the B-11(p,alpha(0))Be-8 bare-nucleus S(E) factor via the Trojan horse method

A new measurement of the B-11(p,alpha(0))Be-8 has been performed applying the Trojan horse method (THM) to the H-2(B-11,alpha Be-8(0))n quasi-free reaction induced at a laboratory energy of 27 MeV. The astrophysical S(E) factor has been extracted from similar to 600 keV down to zero energy by means of an improved data analysis technique and it has been compared with direct data available in the literature. The range investigated here overlaps with the energy region of the light element LiBeB stellar burning and with that of future aneutronic fusion power plants using the B-11+p fuel cycle. The new investigation described here confirms the preliminary results obtained in the recent TH works. The origin of the discrepancy between the direct estimate of the B-11(p,alpha(0))Be-8 S(E)-factor at zero energy and that from a previous THM investigation is quantitatively corroborated. The results obtained here support, within the experimental uncertainties, the low-energy S(E)-factor extrapolation and the value of the electron screening potential deduced from direct measurements.