The importance of phrenic nerve preservation and its effect on long-term postoperative lung function after pneumonectomy

OBJECTIVES The importance of phrenic nerve preservation during pneumonectomy remains controversial. We previously demonstrated that preservation of the phrenic nerve in the immediate postoperative period preserved lung function by 3-5% but little is known about its long-term effects. We, therefore, decided to investigate the effect of temporary ipsilateral cervical phrenic nerve block on dynamic lung volumes in mid- to long-term pneumonectomy patients. METHODS We investigated 14 patients after a median of 9 years post pneumonectomy (range: 1-15 years). Lung function testing (spirometry) and fluoroscopic and/or sonographic assessment of diaphragmatic motion on the pneumonectomy side were performed before and after ultrasonographic-guided ipsilateral cervical phrenic nerve block by infiltration with lidocaine. RESULTS Ipsilateral phrenic nerve block was successfully achieved in 12 patients (86%). In the remaining 2 patients, diaphragmatic motion was already paradoxical before the nerve block. We found no significant difference on dynamic lung function values (FEV1 'before' 1.39 ± 0.44 vs FEV1 'after' 1.38 ± 0.40; P = 0.81). CONCLUSIONS Induction of a temporary diaphragmatic palsy did not significantly influence dynamic lung volumes in mid- to long-term pneumonectomy patients, suggesting that preservation of the phrenic nerve is of greater importance in the immediate postoperative period after pneumonectomy.

EACTS expert consensus statement for surgical management of pleural empyema

Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce hospital costs, morbidity and mortality. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research. The European Association for Cardio-Thoracic Surgery (EACTS) Thoracic Domain and the EACTS Pleural Diseases Working Group established a team of thoracic surgeons to produce a comprehensive review of available scientific evidence with the aim to cover all aspects of surgical practice related to its treatment, in particular focusing on: surgical treatment of empyema in adults; surgical treatment of empyema in children; and surgical treatment of post-pneumonectomy empyema (PPE). In the management of Stage 1 empyema, prompt pleural space chest tube drainage is required. In patients with Stage 2 or 3 empyema who are fit enough to undergo an operative procedure, there is a demonstrated benefit of surgical debridement or decortication [possibly by video-assisted thoracoscopic surgery (VATS)] over tube thoracostomy alone in terms of treatment success and reduction in hospital stay. In children, a primary operative approach is an effective management strategy, associated with a lower mortality rate and a reduction of tube thoracostomy duration, length of antibiotic therapy, reintervention rate and hospital stay. Intrapleural fibrinolytic therapy is a reasonable alternative to primary operative management. Uncomplicated PPE [without bronchopleural fistula (BPF)] can be effectively managed with minimally invasive techniques, including fenestration, pleural space irrigation and VATS debridement. PPE associated with BPF can be effectively managed with individualized open surgical techniques, including direct repair, myoplastic and thoracoplastic techniques. Intrathoracic vacuum-assisted closure may be considered as an adjunct to the standard treatment. The current literature cements the role of VATS in the management of pleural empyema, even if the choice of surgical approach relies on the individual surgeon's preference.

Age, Growth and Population Structure of Jumbo Flying Squid, Dosidicus Gigas, Based on Statolith Microstructure Off the Exclusive Economic Zone of Chilean Waters

The jumbo flying squid, Dosidicus gigas, support an important squid fishery off the Exclusive Economic Zone of Chilean waters. However, we only have limited information about their biology. In this study, age, growth and population structure of D. gigas were studied using statoliths from 333 specimens (386 females and 147 males) randomly sampled in the Chinese squid jigging surveys from 2007 to 2008 off the Exclusive Economic Zone of Chile. Mantle lengths (MLs) of the sample ranged from 206 to 702 mm, and their ages were estimated from 150 to 307 days for females and from 127 to 302 days for males. At least two spawning groups were identified, the main spawning peak tended to occur between August and November (austral spring group), and the secondary peak appeared during March to June (austral autumn group). The ML-age relationship was best modelled by a linear function for the austral spring group and a power function for the austral autumn group, and the body weight (BW)-age relationship was best described by an exponential function for both the groups. Instantaneous relative growth rates and absolute growth rates for ML and BW did not differ significantly between the two groups. The growth rate of D. gigas tended to be high at young stages, and then decreased after the sub-adult stage (>180 days old). This study suggests large spatial and temporal variability in key life history parameters of D. gigas, calling for the collection of more data with fine spatial and temporal scales to further improve our understanding of the fishery biology of D. gigas.

Tackling Copyright in the Digital Age: An Initiative of the University of Connecticut Libraries

From 2005 to 2007, the University of Connecticut Libraries Copyright Project Team engaged in a wide range of activities to fulfill its charge and to raise awareness of copyright issues in the library and across the university. This article highlights some of the primary activities and tools used by the team to involve stakeholders, to provide educational opportunities, and to stay current on copyright issues in higher education. Among other activities, the team developed a new copyright web site for use by library staff and the broader university community.

Freshman Friendship and University Connection

The purpose of this study is to understand better the support systems available to freshmen students at the University of Connecticut and how those support systems impact their connection to the university. The study involves two questionnaires, one distributed at the beginning of their first semester and a second follow-up questionnaire at the end of that same semester. Two main research questions are the focus of this study. The first question is whether freshmen who make friends on campus feel more connected than freshmen who report having fewer friends. The second question concerns whether freshmen who feel more connected to the university report stronger feelings of support than freshmen who do not feel connected to the university. This study has found that support at the university level needs to be more focused on individual students because freshmen who make friends at the university report experiencing greater levels of support. Parents, faculty, and counselors need to reexamine the way in which they provide support in order to reach those students who are not connecting with friends. The First Year Experience Program could better serve freshmen students by focusing on the relationship between students, instructor, and mentor to build friendships within the FYE class, which will foster friendships and support.

The Effect of Broadleaf Canopies on Survey-grade Horizontal GPS/GLONASS Measurements

A study was conducted to empirically determine the degradation of survey-grade GPS horizontal position measurements due to the effects of broadleaf forest canopies. The measurements were taken using GPS/GLONASS-capable receivers measuring C/A and P-codes, and carrier phase. Fourteen survey markers were chosen in central Connecticut to serve as reference markers for the study. These markers had varying degrees of sky obstruction due to overhanging tree canopies. Sky obstruction was measured by photographing the sky with a 35mm reflex camera fitted with a hemispherical lens. The negative was scanned and the image mapped using an equal- area projection to remove the distortion caused by the lens. The resulting digital image was thresholded to produce a black-and-white image in which a count of the black pixels is a measure of sky-area obstruction. The locations of the markers were determined independently before the study. During the study, each marker was occupied for four 20-minute sessions over the period of one week in mid-July, 1999. The location of the study markers produced relatively long baselines, as compared with similar studies. We compared the accuracy of GPS-only vs. GPS&GLONASS as a function of sky obstruction. Based on our results, GLONASS observations did not improve or degrade the accuracy of the position measurements. There is a loss of 2mm of accuracy per percent of sky obstruction for both GPS only and GPS&GLONASS.

Volume 13, Number 1: February/March 2007

Page 2 – The Vice Provost for University Libraries examines how the libraries are responding to 21st century student learning. Page 3 - Children’s author and donor to the Northeast Children’s Literature Collection Susan Bivin Aller is featured. Page 5 - In a guest column on diversity issues, Theo. Van Alst describes the events sponsored by Native American Cultural Society Office.