Background: The present study used the A‐line ARX index, derived from auditory evoked potential measurements, to examine the effect of epidural lidocaine on the end‐tidal concentration of desflurane ...during general anesthesia.
Methods: Thirty ASA I–II patients scheduled for elective colorectal surgery were included and randomized, in a double‐blinded fashion, to receive general anesthesia, and 15 ml of either 2% lidocaine (group GE, n = 15) or normal saline (group GS, n = 15) was administered epidurally with a maintenance infusion rate of 6 ml h−1. After a 10‐min high‐flow oxygen wash‐in period, desflurane was titrated to a target A‐line ARX index (AAI) of 20 ± 5.
Results: Epidural lidocaine reduced the end‐tidal concentration of desflurane required to maintain an adequate clinical effect by 42% compared to general anesthesia alone (2.6% vs. 4.5%, respectively; P < 0.001). The initial mean value of AAI was 87.8 (range 78–99) in group GE and 88.13 (79–99) in group GS before general anesthesia induction, the AAI values were approximately 19.7 (15–25) in group GE and 20.2 (16–25) in group GS during anesthesia maintenance, and returned to 84.53 (77–98) in group GE and 86.87 (79–98) in group GS when the patients regained consciousness in the recovery room. No statistical difference in the AAI values was observed either before, during, or after emergence of anesthesia. No patient reported intraoperative awareness.
Conclusions: Lower‐than‐expected concentrations of volatile anesthetics are sufficient to maintain appropriate a clinical anesthesia effect during combined general‐epidural anesthesia under auditory‐evoked potential monitoring.
To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.
A retrospective chart review of 246 patients with colonic diverticulitis admitted ...between 2000 and 2008 was conducted, and 19 patients received emergent operation were identified and analyzed. Data were collected with regard to age, sex, albumin level on admission, left or right inflammation site, the history of recurrent diverticulitis, preoperative comorbidity, smoking habits, medication, treatment policy, morbidity, and mortality. Preoperative comorbid diseases included cardiovascular disease, diabetes, pulmonary disease, peptic ulcer disease, gouty arthritis, and uremia. Medications in use included non-steroidal anti-inflammatory drugs, acetylsalicylic acid (Aspirin), and corticosteroids. Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.
The mean age of the 246 patients was 69.5 years (range, 24-94 years). Most diverticulitis could be managed with conservative treatment (n = 227, 92.3%), and urgent colectomy was performed in 19 patients (7.7%). There were three deaths in the surgical group and four deaths in the nonsurgical group. The overall mortality rate in the study was 1.7% among patients with conservative treatment and 15.7% among patients undergoing urgent colectomy. Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.
To avoid high mortality and morbidity related to urgent colectomy, we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.
ABSTRACT The potentially hazardous asteroid (185851) 2000 DP107 was the first binary near-Earth asteroid to be imaged. Radar observations in 2000 provided images at 75 m resolution that revealed the ...shape, orbit, and spin-up formation mechanism of the binary. The asteroid made a more favorable flyby of the Earth in 2008, yielding images at 30 m resolution. We used these data to obtain shape models for the two components and to improve the estimates of the mutual orbit, component masses, and spin periods. The primary has a sidereal spin period of 2.7745 0.0007 hr and is roughly spheroidal with an equivalent diameter of 863 m . It has a mass of kg and a density of 1381 244 kg m−3. It exhibits an equatorial ridge similar to the (66391) 1999 KW4 primary; however, the equatorial ridge in this case is not as regular and has a ∼300 m diameter concavity on one side. The secondary has a sidereal spin period of 1.77 0.02 days commensurate with the orbital period. The secondary is slightly elongated and has overall dimensions of m (6% uncertainties). Its mass is kg and its density is 1047 230 kg m−3. The mutual orbit has a semimajor axis of 2.659 0.08 km, an eccentricity of 0.019 0.01, and a period of 1.7556 0.0015 days. The normalized total angular momentum of this system exceeds the amount required for the expected spin-up formation mechanism. An increase of angular momentum from non-gravitational forces after binary formation is a possible explanation. The two components have similar radar reflectivity, suggesting a similar composition consistent with formation by spin-up. The secondary appears to exhibit a larger circular polarization ratio than the primary, suggesting a rougher surface or subsurface at radar wavelength scales.
ABSTRACT We present the results of an all-sky survey made with the Fine Guidance Sensor on the Hubble Space Telescope to search for angularly resolved binary systems among massive stars. The sample ...of 224 stars is comprised mainly of Galactic O- and B-type stars and luminous blue variables, plus a few luminous stars in the Large Magellanic Cloud. The FGS TRANS mode observations are sensitive to the detection of companions with an angular separation between 0 01 and 1 0 and brighter than . The FGS observations resolved 52 binary and 6 triple star systems and detected partially resolved binaries in 7 additional targets (43 of these are new detections). These numbers yield a companion detection frequency of 29% for the FGS survey. We also gathered literature results on the numbers of close spectroscopic binaries and wider astrometric binaries among the sample, and we present estimates of the frequency of multiple systems and the companion frequency for subsets of stars residing in clusters and associations, field stars, and runaway stars. These results confirm the high multiplicity fraction, especially among massive stars in clusters and associations. We show that the period distribution is approximately flat in increments of . We identify a number of systems of potential interest for long-term orbital determinations, and we note the importance of some of these companions for the interpretation of the radial velocities and light curves of close binaries that have third companions.
We present the results of an all sky survey for binary systems among the massive stars that we made with the HST Fine Guidance Sensors. The sample of 225 stars is comprised mainly of Galactic O- and ...B-type stars and Luminous Blue Variables, plus a few luminous stars in the LMC. The FGS TRANS mode observations are sensitive to detection of companions with an angular separation of 0.01–1 arcsec and brighter than △m = 5 mag. The FGS observations resolved 52 binary and 6 triple star systems and detected partially resolved binaries in 7 additional targets, yielding a companion detection frequency of 29%. We also gathered literature results on the numbers of close spectroscopic binaries and wider astrometric binaries among the sample. These results confirm the high multiplicity fraction. The period distribution is essentially flat in increments of log P, although there remains an observational gap in detections for periods of years and decades.
Wnt5a-Ror signaling constitutes a developmental pathway crucial for embryonic tissue morphogenesis, reproduction and adult tissue regeneration, yet the molecular mechanisms by which the Wnt5a-Ror ...pathway mediates these processes are largely unknown. Using a proteomic screen, we identify the kinesin superfamily protein Kif26b as a downstream target of the Wnt5a-Ror pathway. Wnt5a-Ror, through a process independent of the canonical Wnt/β-catenin-dependent pathway, regulates the cellular stability of Kif26b by inducing its degradation via the ubiquitin-proteasome system. Through this mechanism, Kif26b modulates the migratory behavior of cultured mesenchymal cells in a Wnt5a-dependent manner. Genetic perturbation of Kif26b function in vivo caused embryonic axis malformations and depletion of primordial germ cells in the developing gonad, two phenotypes characteristic of disrupted Wnt5a-Ror signaling. These findings indicate that Kif26b links Wnt5a-Ror signaling to the control of morphogenetic cell and tissue behaviors in vertebrates and reveal a new role for regulated proteolysis in noncanonical Wnt5a-Ror signal transduction.
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