Miniaturized passively Q-switched Nd:YAG/Cr(4+):YAG lasers are promising candidates as spark sources for sophisticated laser ignition. The influence of the complex spatial-temporal pulse profile of ...such lasers on the process of plasma breakdown and on the energy transfer is studied. The developed measurement technique is applied to an open ignition system as well as to prototypes of laser spark plugs. A detected temporal breakdown delay causes an advantageous separation of plasma building phase from energy transfer. In case of fast rising laser pulses, an advantageous reduction of the plasma breakdown delay occurs instead.
According to investigations around 15% of the today's world population is undernourished. The increase of world's population, which is predicted to be around 3 billion people within the next 30 ...years, will strengthen the yet existing population-food imbalance. Besides increase of food supply and limitation of the population growth, drastically reducing the food losses which occur throughout food production, harvest-, post-harvest and marketing seems to be a viable option. The reduction of food losses is particularly a problem for small farmers in developing countries who produce more than 80% of the food. Since the traditional sun drying is a relatively slow process considerable losses can occur. In addition, a reduction in the product quality takes place due to insect infestation, enzymatic reactions, microorganism growth and myctoxin development. The technology used in industrialized countries or even at large scale plantation in developing countries for food preservation is neither technically nor economically feasible for smallholders. In contrast, numerous investigations have shown that solar drying can be an effective means of food preservation since the product is completely protected during drying against rain, dust, insects and animals. But still some obstacles have to be overcome that solar drying will become a technology with a broad dissemination. Although a lot of research work has been conducted during the last decades, only a small number of appropriate solar dryers which can be used by farmers or small scale industries in developing countries are commercially available. Furthermore there is still a lack of knowledge how to process fruits, vegetable, fish, etc. in a proper way to ensure a high quality product and to minimize post-harvest losses.
Ever since Charles Baxter's recommendations the standard regime for burn shock resuscitation remains crystalloid infusion at a rate of 4
ml/kg/% burn in the first 24
h following the thermal injury. A ...growing number of studies on invasive monitoring in burn shock, however, have raised a debate regarding the adequacy of this regime. The purpose of this prospective, randomised study was to compare goal-directed therapy guided by invasive monitoring with standard care (Baxter formula) in patients with burn shock.
Fifty consecutive patients with burns involving more than 20% body surface area were randomly assigned to one of two treatment groups. The control group was resuscitated according to the Baxter formula (4
ml/kg BW/% BSA burn), the thermodilution (TDD) group was treated according to a volumetric preload endpoint (intrathoracic blood volume) obtained by invasive haemodynamic monitoring.
The baseline characteristics of the two treatment groups were similar. Fluid administration in the initial 24
h after burn was significantly higher in the TDD treatment group than in the control group (
P = 0.0001). The results of haemodynamic monitoring showed no significant difference in preload or cardiac output parameters. Signs of significant intravasal hypovolemia as indicated by subnormal values of intrathoracic and total blood volumes were present in both treatment groups. Mortality and morbidity were independent on randomisation.
Burn shock resuscitation due to the Baxter formula leads to significant hypovolemia during the first 48
h following burn. Haemodynamic monitoring results in more aggressive therapeutic strategies and is associated with a significant increase in fluid administration. Increased crystalloid infusion does not improve preload or cardiac output parameters. This may be due to the fact that a pure crystalloid resuscitation is incapable of restoring cardiac preload during the period of burn shock.
Laser-induced fluorescence of indocyanine green (ICG) is a new method for evaluating skin perfusion, which is superior to conventional fluorescein angiography. In a prospective clinical study ICG ...fluorescence video-angiography was used for the intraoperative evaluation of skin-flap perfusion. The results of ICG imaging were compared with clinical outcome 1 week postoperatively. Intraoperative ICG filling defects were always associated with delayed wound healing. In 50% of the patients, the regions of sloughing and epitheliolysis corresponded accurately to the regions of dye-filling deficits. All of the flaps without ICG filling defects healed primarily. These results suggest that ICG fluorescence is a sensitive tool for assessing nutritive blood flow in pedicled skin flaps with and without an axial vessel. Future clinical studies are required to establish critical threshold fluorescence indices that correlate with skin viability in the postoperative course.
Introduction: Hyperglycaemia and insulin resistance are common in severely burned patients, even if they have not previously had diabetes. Conventionally, hyperglycaemia is considered a part of the ...hypermetabolic stress response and blood glucose levels up to 215 mg/dl are tolerated before insulin therapy is initiated. Recent studies suggest that hyperglycaemia and insulin resistance are harmful and that correcting blood glucose to normal levels with insulin might improve the prognosis significantly.
Study objective: The purpose of this clinical study was to evaluate blood glucose levels in severely burned patients with conventional management and to analyse the association between early hyperglycaemia and clinical outcome.
Design: Clinical, prospective, descriptive study.
Patients: Thirty seven severely burned adults (>25% total body surface area).
Interventions: Hyperglycaemia was treated according to conventional clinical practice. This included the infusion of insulin based on a blood glucose level >215 mg/dl and the maintenance of the glucose level between 180 and 200 mg/dl.
Measurements and results: Measurements of whole-blood glucose were performed at 8, 16, 24, 36 and 48 h after the thermal injury. Additional measurements were performed if indicated. A total of 185 measurements were obtained and significant elevations of blood glucose levels (>140 mg/dl) were found in 108 (64%) of the measurements. Peak blood glucose values exceeded 140 mg/dl in all but three of the patients; however, only 17 patients received insulin treatment during the shock period. The inadequacy of the insulin treatment is shown by the mean glucose values, which exceeded 200 mg/dl in 27% of the patients. Despite a non-significant difference in the extent of burn (
P=0.055), patients who died showed significantly higher maximum glucose values than patients who survived the thermal injury (
P<0.05). Even though not statistically significant, blood glucose control was poorer in patients who later developed sepsis or acute renal failure (
P>0.05). No correlation was found between burned surface area (TBSA) and mean plasma glucose levels during the first 48 h of resuscitation (
r=0.12).
Conclusion: Hyperglycaemia is very frequent during the resuscitation period of thermal injury and current guidelines for insulin therapy are inadequate to correct plasma glucose to normal levels. As an association between early hyperglycaemia and subsequent mortality seems to exist, more aggressive manoeuvres to reduce blood glucose may be warranted in this group of patients.
Introdução: Hiperglicemia e resistência à insulina são comuns em grandes queimados mesmo em não diabéticos. Convencionalmente a hiperglicemia é considerada como fazendo parte da resposta metabólica ao stress e são tolerados nı́veis de glicose até 215 mg/dL antes do inı́cio de insulina. Estudos recentes sugerem que a hiperglicemia e a resistência à insulina são prejudiciais e que a correcção com insulina da glicemia para nı́veis normais pode melhorar significativamente o prognóstico.
Objectivo do estudo: Avaliar os nı́veis de glicemia, com abordagem convencional, em grandes queimados e analisar a associação entre hiperglicemia precoce e o resultado clı́nico.
Desenho:Estudo clı́nico descritivo e prospectivo.
Doentes: Trinta e sete adultos, grandes queimados (>25% da área de superfı́cie corporal total).
Intervenções: A hiperglicemia foi tratada de acordo com a prática clı́nica convencional. Isto incluiu a perfusão de insulina com base numa glicemia >215
mg/dL e na manutenção de glicemias entre 180 e 200
mg/dL.
Resultados: As glicemias foram avaliadas no sangue total às 8, 16, 24, 36 e 48 horas após a lesão térmica. Efectuaram-se medições adicionais quando indicadas. Foram obtidas 185 medições e encontradas elevações significativas dos nı́veis de glicemia (>140
mg/dL) em 108 (64%) das medições. Os valores máximos de glicemia excederam 140
mg/dL em todos, excepto 3 doentes contudo, apenas 17 doentes receberam tratamento com insulina durante o perı́odo de choque hemodinâmico. A inadequação do tratamento com insulina é demonstrado pelos valores médios de glicemia, que excederam 200
mg/dL em 27% dos doentes. Apesar da diferença não ser significativa quanto à extensão das queimaduras (P=0,055), os doentes falecidos apresentaram nı́veis máximos de glicemia significativamente maiores do que os doentes que sobreviveram às queimaduras (P<0,05). Embora sem significado estatı́stico, o controle da glicemia foi pior nos doentes que desenvolveram sépsis ou insuficiência renal aguda mais tarde (P>0,05). Não foi encontrada correlação entre a área de superfı́cie queimada (TBSA) e os nı́veis médios de glicemia plasmática durante as primeiras 48 horas de ressuscitação (r=0,12).
Conclusão: A hiperglicemia é muito frequente durante o perı́odo de ressuscitação de queimados e as recomendações actuais para o tratamento com insulina são inadequadas para corrigir a glicemia a nı́veis normais. Como parece existir uma associação entre hiperglicemia precoce e mortalidade subsequente, podem ser necessárias medidas mais agressivas para reduzir a glicemia neste grupo de doentes.
Introducción: La Hiperglicemia y la resistencia a la insulina son comunes en pacientes severamente quemados, aun si no han sido diabéticos previamente. Convencionalmente, la hiperglicemia es considerada una parte de la respuesta hipermetabólica de stress y los niveles de glucosa suben a 215
mg/dl son tolerados antes de iniciar terapia con insulina. Estudios recientes sugieren que la Hiperglicemia y la resistencia a la insulina son dañinas y que la corrección del nivel de glucosa en sangre hasta niveles normales con insulina podrı́a mejorar significativamente el pronóstico.
Objetivo del estudio: El propósito de este estudio clı́nico fue evaluar los niveles de glicemia en pacientes severamente quemados con manejo convencional y analizar la asociación entre hiperglicemia temprana y resultado clı́nico.
Diseño: Estudio clı́nico descriptivo prospectivo.
Pacientes: Treinta y siete adultos severamente quemados (>25% superficie corporal).
Intervenciones: Se trató la hiperglicemia de acuerdo con práctica clı́nica convencional. Esto incluyó la infusión de insulina basada en glicemia>215
mg/dl y mantención de glicemia entre 180 y 200
mg/dl.
Mediciones y resultados: Se realizaron mediciones de glicemia 8, 16, 24,36 y 48 horas después de la lesión térmica. Se realizaron mediciones adicionales cuando estaban indicadas. Se obtuvieron un total de 185 mediciones y se encontraron glicemias significativamente elevadas (> 140
mg/dl) en 108 (64%) de la mediciones. La máxima elevación de glicemia excedió los 140 mg/dl en todos salvo en tres pacientes; sin embargo, solamente 17 pacientes recibieron tratamiento con insulina durante el perı́odo de shock. Lo inadecuado de un tratamiento con insulina es mostrado por los valores promedio de glicemia, que excedı́an los 200
mg/dl en 27% de los pacientes. Pese a no haber diferencia significativa en la extensión de la quemadura (
P=0.055), los pacientes que murieron mostraron niveles máximos de glicemia significativamente mayores que en pacientes que sobrevivieron la lesión térmica (
P<0.05). El control de glicemia fue mas pobre, aunque no estadı́sticamente significativo, en pacientes que posteriormente desarrollaron una sepsis o falla renal aguda (
P<0.05). No se encontró correlación entre superficie total quemada (TBSA) y niveles promedio de glucosa plasmática durante las primeras 48 horas de resucitación.(
r=0.12).
Conclusión: La hiperglicemia es muy frecuente durante el perı́odo de resucitación de lesiones térmicas y las actuales guı́as para terapia con insulina son inadecuadas para corregir la glicemia hasta niveles normales. Parece existir una asociación entre glicemia temprana y mortalidad , en este grupo de pacientes pueden garantizarse maniobras mas agresivas para reducir la glicemia.
The equilibrium moisture contents of longan were determined experimentally using the dynamic method at temperatures ranging from 30 to 50°C and water activity ranging from 11 to 97%. The sorption ...isotherm curves of longan were sigmoidal in shape and decreased with increased temperature at constant relative humidity. Five selected isotherm models were tested to fit the experimental isotherm data of longan. The GAB model fitted the best to the experimental data of longan and the modified Oswin model was the next to the GAB model. The agreement between the best-fitted models and experimental data was excellent. The isosteric heats of sorption, determined from equilibrium data using the Clausius-Clapeyron equation, were found to be a function of moisture content.
Eyelid bags are the result of relaxation of lid structures like the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudo herniation of intraorbital fat contents. ...The logical treatment of baggy upper and lower eyelids should therefore include repositioning the herniated fat into the orbit and strengthening the attenuated septum in the form of a septorhaphy as a hernia repair. The preservation of orbital fat results in a more youthful appearance. The operative technique of the orbital septorhaphy is demonstrated for the upper and lower eyelid. A prospective series of 60 patients (50 upper and 90 lower blepharoplasties) with a maximum follow-up of 17 months were analyzed. Pleasing results were achieved in 56 patients. A partial recurrence was noted in 3 patients and widening of the palpebral fissure in 1 patient. Orbital septorhaphy for baggy eyelids is a rational, reliable procedure to correct the herniation of orbital fat in the upper and lower eyelids. Tightening of the orbicularis muscle and skin may be added as usual. The procedure is technically simple and without trauma to the orbital contents. The morbidity is minimal, the rate of complications is low, and the results are pleasing and reliable.
High investments, high dumping costs and high electrical energy consumption turn waste water treatment in small sewage plants an expensive process. Therefore, the University of Hohenheim and the ...company Thermo-System have developed a fully automatic low temperature solar drying plant allowing further stabilization and volume reduction of sewage sludge by continuous mixing and aerating. To test the potential of the technology, the drying process was investigated in a commercially operated municipal sewage treatment plant with aerobic sludge digestion. During experiments, the changes of the dry solids concentration and the volatile solids, the climatic conditions and the energy consumption were constantly measured and documented. It was found, that the sludge could be dried from a dry solids concentration of 3 to 93% w/w in 64 (flocculated) or 83 days (non-flocculated). At the same time, the volatile solids content was reduced from 65 to 34% w/w, respectively. The electrical energy consumption was only 22 to 28 kWh per ton of evaporated water, compared to 70 to 110 kWh required for conventional drying processes. The thermal energy for evaporation was fully covered by solar energy.
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