BACKGROUND The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. MATERIALS AND METHODS Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, 67.2±9.4 years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. RESULTS During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was 59.1±10.3 minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. CONCLUSION Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

Tracheobronchial ruptures (TBR) rarely complicate surgical procedures under general anesthesia. Seemingly uneventful intubations can result in injury to the trachea, which often manifests as hemoptysis and subcutaneous emphysema. We present 2 patients with postintubation TBR who were treated surgically and discuss considerations in the management of this potentially lethal injury.

Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

The vienna-type differential mobility analyzer (DMA) was developed for the measurement of wide-range nm-sized particles under low-pressure conditions (2.9-8 kPa) with the faraday cup electrometer (FCE). The length, inner and outer diameter of DMA are calculated as a function of flow rate, applied voltage, pressure, and particle diameter to avoide breakdown in DMA. The algorithm for the diffusion transfer function of the DMA was successfully developed and verified by comparing the numerical and experimental results. The DMA was calibrated via the tandem DMA (TDMA) method which using two DMA in parallel. The inversion algorithm was applied to the size distribution obtained from the current of the FCE. The calibration experiment was performed with 1% NaCl particles under atmospheric and low-pressure conditions. The calibration result showed that the development of the DMA was successful as it was able to measure 20- to 80-nm paricles under low-pressure conditions with various flow rates (0.1-0.5 l/min).

Recently, many studies have been focused on the development of fiber optic sensor systems for various gases and vapors. In the present study, an intrinsic polymer optical fiber (POF) sensor using graphene is described for the purpose of acetone vapor sensing for the first time. Observations on the continuous measurement of acetone vapor in dehydrated air are presented. The principle of operation of sensor transduction relies on the dependence of the reflectance on the optical and geometric properties of the sensitive over layered when the vapor molecules are adsorbed on the graphene film. For the same purpose the CVD synthesized graphene film was transferred on the POF end. The synthesized graphene film thickness was evaluated using atomic force microscopy (AFM), Raman spectroscopy and transmission electron microscopy (TEM). For the preliminary evaluation using volatile organic compounds, we evaluated the sensor performance for acetone. Upon the interaction of the sensor with acetone vapor, the variation in the reflected light was monitored as a function of the acetone concentration. The sensor response shows a significant change in sensitivity as compared with the POF probe without a graphene coating. The present sensor shows a satisfactory response upon exposure to various concentrations of acetone vapor from 44 ppm to 352 ppm. To the best of our knowledge, the use of graphene film along with POF for the sensing of volatile organic compounds has not previously been reported.

We describe a technique for treating severe functional tricuspid regurgitation (TR) when residual regurgitation cannot be eliminated with ring annuloplasty alone. The anterior leaflet and the anterior half of the posterior leaflet are augmented with an elliptic pericardial patch before implantation of a rigid annuloplasty ring. We successfully performed this procedure in 9 patients with severe TR due to severe leaflet tethering or short coaptation length and achieved complete elimination of TR with sufficient coaptation length in tricuspid valve leaflets for all patients.

Back-to-back hadron pair yields in d+Au and p+p collisions at sqrt[s_{NN}]=200  GeV were measured with the PHENIX detector at the Relativistic Heavy Ion Collider. Rapidity separated hadron pairs were detected with the trigger hadron at pseudorapidity |η|<0.35 and the associated hadron at forward rapidity (deuteron direction, 3.0<η<3.8). Pairs were also detected with both hadrons measured at forward rapidity; in this case, the yield of back-to-back hadron pairs in d+Au collisions with small impact parameters is observed to be suppressed by a factor of 10 relative to p+p collisions. The kinematics of these pairs is expected to probe partons in the Au nucleus with a low fraction x of the nucleon momenta, where the gluon densities rise sharply. The observed suppression as a function of nuclear thickness, p_{T}, and η points to cold nuclear matter effects arising at high parton densities.

We present measurements of J/ψ yields in d+Au collisions at sqrt[s_{NN}]=200  GeV recorded by the PHENIX experiment and compare them with yields in p+p collisions at the same energy per nucleon-nucleon collision. The measurements cover a large kinematic range in J/ψ rapidity (-2.2<y<2.4) with high statistical precision and are compared with two theoretical models: one with nuclear shadowing combined with final state breakup and one with coherent gluon saturation effects. In order to remove model dependent systematic uncertainties we also compare the data to a simple geometric model. The forward rapidity data are inconsistent with nuclear modifications that are linear or exponential in the density weighted longitudinal thickness, such as those from the final state breakup of the bound state.

Purpose: The aim of this study was to evaluate a newly-designed mitral annuloplasty strip (the Mitra-Lift(®) strip) in patients undergoing mitral valve repair for mitral regurgitation (MR).Methods: A total of 30 patients who underwent posterior mitral strip annuloplasty for moderately severe to severe MR were evaluated in this study. The strip annuloplasty (SA) consisted of the use of the newly-designed strip and the suture of the supra-annular atrial wall of 5.0 mm width and the posterior annulus. In addition to SA, six patients (20.0%) with tethered posterior leaflets required posterior leaflet augmentation. Improvement in MR and hemodynamic parameters of the valve with the fixed strip were assessed.Results: After SA, all patients exhibited little or no MR, with no individual exhibiting signs of exacerbation during the follow-up period. A stable coaptation occurred below the strip and the posterior annulus due to forward movement and lifting of the posterior annulus without significant reduction of intercommissural dimension. During the cardiac cycle, the intercommissural dimensions showed considerable changes, which meant a dynamic motion of the anterior leaflet and the commissures.Conclusions: Formation of a stable leaflet coaptation was associated with a dynamic change of the intercommissural dimension during the cardiac cycle and resulted in a reliable, annuloplasty strip, representing a new concept in annuloplasty.