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PURPOSE: The purpose of this study was to evaluate the effect of the zirconia surface architecturing technique (ZSAT) on the bond strength between veneering porcelain and zirconia ceramic. MATERIALS AND METHODS: 20 sintered zirconia ceramic specimens were used to determine the optimal surface treatment time, and were randomly divided into 4 groups based on treatment times of 0, 1, 2, and 3 hours. After etching with a special solution, the surface was observed under scanning electron microscope, and then the porcelain was veneered for scratch testing. Sixty 3 mol% yttria-stabilized tetragonal zirconia polycrystal ceramic blocks were used for tensile strength testing; 30 of these blocks were surface treated and the rest were not. Statistical analysis was performed using ANOVA, the Tukey post-hoc test, and independent t-test, and the level of significance was set at α=.05. RESULTS: The surface treatment of the zirconia using ZSAT increased the surface roughness, and tensile strength test results showed that the ZSAT group significantly increased the bond strength between zirconia and veneering porcelain compared to the untreated group (36 MPa vs. 30 MPa). Optimal etching time was determined to be 2 hours based on the scratch test results. CONCLUSION: ZSAT increases the surface roughness of zirconia, and this might contribute to the increased interfacial bond strength between zirconia and veneering porcelain.
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BACKGROUND: Preoperative anxiety may differ according to patient temperament. It will be increased when patients are requested to participate in a study involving anesthesia. The purpose of this study was to show that the anxiety felt when patients are requested to participate may differ according to temperament in both patients who agree and disagree to participate. METHODS: Three hundred and twenty-one patients over age 18 with American Society of Anesthesiologists 1 and 2 completed a survey questionnaire. The degree of anxiety was measured according to patient temperament. It was compared on the basis of the State-Trait Anxiety Inventory (STAI) and visual analogue scale (VAS). RESULTS: In the agreed group, the degree of anxiety measured by "usual, present STAI" and VAS in the monitors (those who want to know as much as possible about anesthesia and surgery) was significantly higher than that in the blunters (those who want to know as little as possible) (P = 0.041 for the "usual STAI", 0.017 for "present STAI", and 0.001 for VAS, respectively). Among patients with a lower educational level, the numbers of blunters and monitors were 57 (79%) and 32 (59%), respectively, indicating that the ratio of blunters was significantly higher (P = 0.026). CONCLUSIONS: Both traits of patients in each group were influenced by psychological burdens. The anxiety of the monitors who agreed to participate was significantly higher than that of blunters. In addition to temperament, education level affects participation. Obtaining consent for participation by understanding temperament and considering factors that may reduce the participation rate will be required.
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A 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.
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BACKGROUND: In this study, we assessed the 50% effective concentration (EC50) of sevoflurane for reducing a rocuronium-induced reaction, based on the Dixon's up-and-down method. We also assessed the 50 and 95% effective end-tidal concentration of sevoflurane (ETsev), based on the probit regression curve of the probability of nonwithdrawal reaction. METHODS: We conducted a prospective, double-blind study in 23 males and 24 females. After using 2.5% thiopental sodium (4 mg/kg), anesthesia was induced in the patients. The patients then inhaled sevoflurane with 5 vol% in 6 L/min of oxygen. When the target ETsev was achieved, a nurse injected the intubating dose of rocuronium (0.6 mg/kg) for 5-10 s under the free flow of intravenous fluid. After the nurse evaluated the response, the nurse recorded the maximum heart rate during 30 s and the mean arterial pressure after rocuronium injection. RESULTS: Based on Dixon's up-and-down method, the EC50 of sevoflurane was 2.5 ± 0.5 vol% in males and 2.5 ± 0.3 vol% in females. The probit regression curve of the probability of nonwithdrawal reaction showed that in males the 50% effective ETsev was 2.4 vol% (95% confidence interval [CI], 1.5-3.1 vol%) and the 95% effective ETsev was 3.5 vol% (95% CI, 2.9-11.0 vol%); in females, the 50% effective ETsev was 2.4 vol% (95% CI, 2.1-2.7 vol%) and the 95% effective ETsev was 3.0 vol% (95% CI, 2.7-4.5 vol%). CONCLUSIONS: The inhalation of sevoflurane during the induction period may provide a simple and reliable means of reducing rocuronium-induced reactions without adverse hemodynamic changes. There was no significant difference between males and females.
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BACKGROUND: Although acute tolerance to opioids, especially to remifentanil, has been demonstrated consistently in animal studies, the results of clinical trials in humans are controversial. The aim of this study was to determine whether intraoperative infusions of remifentanil used as an adjuvant in general anesthesia result in acute tolerance, an event manifested by increased postoperative pain and a higher opioid requirement than usual. METHODS: Sixty patients who underwent surgery under general anesthesia for spinal fusion were randomly assigned to receive sevoflurane-nitrous oxide-oxygen (group SO, n = 20), sevoflurane-remifentanil-nitrous oxide-oxygen (group SR, n = 20), or propofol-remifentanil-oxygen (group PR, n = 20) in a double-blinded manner. All patients within 1 hour after induction received PCA (fentanyl 0.4 µg/kg/ml and ondansetron 16 mg) administered intravenously at a basal infusion rate of 1 ml/h, after being intravenously injected with a loading dose of fentanyl (1 µg/kg). Data for fentanyl requirement, verbal Numerical Rating Scale (NRS) pain score at rest, and presence of nausea or vomiting were collected at 1, 24, and 48 hours after surgery. RESULTS: We did not find any significant difference in postoperative PCA fentanyl requirements, NRS or side effects among the groups. CONCLUSIONS: Remifentanil as an adjuvant to sevoflurane or propofol in general anesthesia for adults having surgery for spinal fusion does not appear to cause acute opioid tolerance or hyperalgesia in patients. However, further studies are needed to elucidate whether sevoflurane and propofol exert a clinically significant effect on opioid-induced tolerance or hyperalgesia and whether this effect is related to the age of the patient, the dose and duration of remifentanil given and the intensity of pain experienced postoperatively.
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BACKGROUND: The relatively recently developed I-gel (Intersurgical Ltd., Workingham, England) is a supraglottic airway device designed for single-use that, unlike conventional LMAs, does not require an inflatable cuff. In addition, the I-gel, much like the Proseal LMA (PLMA), has a gastric drainage tube associated with an upper tube for decompression of the stomach, thereby avoiding acid reflux and decreasing the risk of pulmonary absorption. The purpose of this study was to compare PLMA and I-gel devices in patients undergoing gynecological laparoscopy based on sealing pressure before and during pneumoperitoneum, insertion time, and gas exchange. METHODS: Following Institutional Review Board approval and written informed consent, 30 adult patients were randomly allocated to one of two groups (the PLMA or I-gel group). In each case, insertion time and number of attempts were recorded. After successful insertion, airway leak pressure was measured. RESULTS: Successful insertion and mechanical ventilation with both supraglottic airway devices was achieved on the first attempt in all 30 patients, and there were no significant differences with respect to insertion time. Likewise, leak pressure did not vary significantly either between or within groups after CO(2) insufflation. In addition, differences between leak volume and leak fraction between groups were not significant. CONCLUSIONS: The results of our study indicate that the I-gel is a reasonable alternative to the PLMA for controlled ventilation during laparoscopic gynecologic surgery.
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OBJECTIVE: This study was designed to compare the outcomes of two different surgical techniques: conventional transperitoneal laparoscopic varicocele ligation (CTL-VL), and laparoendoscopic single-site varicocele ligation (LESS-VL), using transumbilical home-made single port device. METHODS: Our sample included 82 male patients with 92 clinically palpable varicoceles who underwent varicocelectomy. The patients were randomly allocated to one of two groups according to varicocele ligation technique. Early postoperative complications, hospital stay, time to return to work, degree of satisfaction, and semen parameters were assessed. A visual analogue scale (VAS) pain score that ranged from 0 to 10 and analgesia requirements during the postoperative course were used to evaluate postoperative pain. RESULTS: The operating room time and hospital stay of the two study groups were comparable, but time to return to normal activity was significantly shorter in the LESS group compared with the CTL group (P = 0.025). Both VAS and the postoperative use of analgesics were significantly lower during postoperative days 2 (P = 0.005) and 3 (P = 0.047) in patients who underwent LESS-VL compared with patients who underwent CTL-VL. Significant improvements in sperm count, motility, and morphology were observed in both groups (P < 0.001; at each of the variables in both groups), but the proportion of patients who showed improvement was not significantly different between the two groups. CONCLUSIONS: This relatively small-scale study suggests that LESS-VL is a safe and effective alternative to CTL-VL that provides surgeons with a minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.
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Endoscopía/métodos , Laparoscopía/métodos , Varicocele/cirugía , Adolescente , Adulto , Endoscopía/instrumentación , Diseño de Equipo , Humanos , Laparoscopía/instrumentación , Tiempo de Internación , Ligadura/instrumentación , Ligadura/métodos , Masculino , Dolor Postoperatorio/etiología , Resultado del Tratamiento , Adulto JovenRESUMEN
A deletion 8p syndrome is a relatively uncommon congenital disease characterized by mental retardation associated with multiple malformation that make anesthetic management a challenge. Anesthetic management of a patient with deletion 8p syndrome may pose a serious problem mainly from difficult tracheal intubation, aspiration complication and cardiac malformation. We experienced a case of 10 year-old boy with a deletion 8p syndrome who underwent appendectomy under the general anesthesia. Intubation was performed by video glidescope after unsuccessful attempt with Macintosh laryngoscope. A high arched palate, short neck, poor patient cooperation due to mental retardation and occasional autistic behaviour made airway management difficult. This case should alert anesthesiologists to the greater difficulties of managing patients with deletion 8p syndrome.
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BACKGROUND: The Glidescope® videolaryngoscope is a new device for tracheal intubation that provides an improved view of the larynx. This study was performed to compare the Glidescope with the McGrath videolaryngoscope in terms of time to intubation (TTI) and number of attempts. METHODS: Patients were randomly allocated to one of two groups, Glidescope or McGrath group, by using computer-generated numbers. Tracheal intubation was attempted by an anesthesiologist with extensive experience using these two devices. The operator recorded ease of visualization of glottic structures based on the classification described by Cormack and Lehane. Number of failures, number of attempts and their duration, total intubation time, and events during the whole procedure were recorded. The duration of one attempt was defined as the time elapsed between picking up the endotracheal tube and verification of tracheal intubation with visualization of three expiratory carbon dioxide waveforms. TTI was defined as the sum of the duration of all intubation attempts (as many as three), excluding preoxygenation procedures. RESULTS: TTI was significantly shorter for the Glidescope® compared to the McGrath® laryngoscope (40.5 vs. 53.3 s, respectively, P < 0.05). However, glottic views obtained at intubation were similar between the two groups. Number of intubation attempts was not significantly different between the two groups (1.03 ± 0.19 vs 1.10 ± 0.32, respectively) (mean ± SD). CONCLUSIONS: Study results demonstrated that the Glidescope reduced total intubation time in comparison with the McGrath, in terms of TTI in patients with normal airways.
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BACKGROUND: The greater occipital nerve (GON) block has been frequently used for different types of headache, but performed with rough estimates of anatomic landmarks. Our study presents the values of the anatomic parameters and estimates the effectiveness of the ultrasound-guided GON blockade. METHODS: The GON was detected using ultrasound technique and distance from external occipital protuberance (EOP) to GON, from GON to occipital artery and depth from skin to GON was measured in volunteers. Patients with occipital headache were divided into two groups (ultrasound-guided block: group S, conventional blind block: group B) and GON block was performed. The same parameters were measured on group S and VAS scores were assessed at pretreatment, 1 week and 4 weeks after treatment on both groups. RESULTS: The GON had distance of 23.1 ± 3.4 mm (right) and 20.5 ± 2.8 mm (left) from EOP to GON. Its depth below the skin was 6.8 ± 1.5 mm (right) and 7.0 ± 1.3 mm (left). The distance from GON to occipital artery was 1.5 ± 0.6 mm (right) and 1.2 ± 0.6 mm (left) in volunteers. Initial VAS score of group S and group B patients were 6.4 ± 0.2 and 6.5 ± 0.2. VAS score of 4 weeks after injection were 2.3 ± 0.2 on group S and 3.8 ± 0.3 on group B (P = 0.0003). CONCLUSIONS: The parameters measured in this study should be useful for GON block and ultrasound-guided blockade is likely to be a more effective technique than blind blockade in occipital headache treatment.
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STUDY OBJECTIVE: To determine the most suitable effect-site concentration of remifentanil during lightwand intubation when administered with a target-controlled infusion (TCI) of propofol at 4.0 µg/mL without neuromuscular blockade. DESIGN: Prospective study using a modified Dixon's up-and-down method. SETTING: Operating room of an academic hospital. PATIENTS: 28 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for minor elective surgery. INTERVENTIONS: Anesthesia was induced by TCI propofol effect-site concentration to 4.0 µg/mL, and the dose of remifentanil given to each patient was determined by the response of the previously tested patient using 0.2 ng/mL as a step size. The first patient was tested at a target effect-site concentration of 4.0 ng/mL of remifentanil. If intubation was successful, the remifentanil dose was decreased by 0.2 ng/mL; if it failed, the remifentanil dose was increased by 0.2 ng/mL. Successful intubation was defined as excellent or good intubating conditions. MEASUREMENTS AND MAIN RESULTS: The remifentanil effect-site concentration was measured. The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction using 2% propofol target effect-site concentration to 4 µg/mL was 2.16 ± 0.19 ng/mL. From probit analysis, the effect-site concentration of remifentanil required for successful lightwand intubation in 50% (EC50) and 95% (EC95) of adults was 2.11 ng/mL (95% CI 1.16-2.37 ng/mL) and 2.44 ng/mL (95% CI 2.20-3.79 ng/mL), respectively. CONCLUSION: A remifentanil effect-site concentration of 2.16 ± 0.19 ng/mL given before a propofol effect-site concentration of 4 µg/mL allowed lightwand intubation without muscle relaxant.
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Anestésicos Intravenosos/farmacocinética , Intubación Intratraqueal/métodos , Piperidinas/farmacocinética , Propofol/farmacocinética , Adulto , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/uso terapéutico , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Piperidinas/administración & dosificación , Piperidinas/uso terapéutico , Propofol/administración & dosificación , Propofol/uso terapéutico , Estudios Prospectivos , RemifentaniloRESUMEN
Catalytic wet air oxidation (CWAO) is one of the most economical and environmental-friendly advanced oxidation process. It makes a promising technology for the treatment of refractory organic pollutants in industrial wastewaters. Various heterogeneous catalysts including noble metals and metal oxides have been extensively studied to enhance the efficiency of CWAO. The present review is concerned about the literatures published in this regard. Phenolics, carboxylic acids, and nitrogen-containing compounds were taken as model pollutants in most cases, and noble metals such as Ru, Rh, Pd, Ir, and Pt as well as oxides of Cr, Mn, Fe, Co, Ni, Cu, Zn, Mo, and Ce were applied as heterogeneous catalysts. Reports on their characterization and catalytic performances for the CWAO of aqueous pollutants are reviewed. Discussions are also made on the reaction mechanisms and kinetics proposed for heterogeneous CWAO and also on the typical catalyst deactivations in heterogeneous CWAO, i.e. carbonaceous deposits and metal leaching.
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Compuestos Orgánicos/química , Contaminantes del Agua/química , Catálisis , Oxidación-ReducciónRESUMEN
OBJECTIVE: There is no definite adjustment protocol for patients shunted with programmable valves. Therefore, we attempted to find an appropriate method to adjust the valve, initial valve-opening pressure, adjustment scale, adjustment time interval, and final valve-opening pressure of a programmable valve. METHODS: Seventy patients with hydrocephalus of various etiologies were shunted with programmable shunting devices (Micro Valve with RICKHAM(R) Reservoir). The most common initial diseases were subarachnoid hemorrhage (SAH) and head trauma. Sixty-six patients had a communicating type of hydrocephalus, and 4 had an obstructive type of hydrocephalus. Fifty-one patients had normal pressure-type hydrocephalus and 19 patients had high pressure-type hydrocephalus. We set the initial valve pressure to 10-30 mmH(2)O, which is lower than the preoperative lumbar tapping pressure or the intraoperative ventricular tapping pressure, conducted brain computerized tomographic (CT) scans every 2 to 3 weeks, correlated results with clinical symptoms, and reset valve-opening pressures. RESULTS: Initial valve-opening pressures varied from 30 to 180 mmH(2)O (mean, 102 +/- 27.5 mmH(2)O). In high pressure-type hydrocephalus patients, we have set the initial valve-opening pressure from 100 to 180 mmH(2)O. We decreased the valve-opening pressure 20-30 mmH(2)O at every 2- or 3-week interval, until hydrocephalus-related symptoms improved and the size of the ventricle was normalized. There were 154 adjustments in 81 operations (mean, 1.9 times). In 19 high pressure-type patients, final valve-opening pressures were 30-160 mmH(2)O, and 16 (84%) patients' symptoms had nearly improved completely. However, in 51 normal pressure-type patients, only 31 (61%) had improved. Surprisingly, in 22 of the 31 normal pressure-type improved patients, final valve-opening pressures were 30 mmH(2)O (16 patients) and 40 mmH(2)O (6 patients). Furthermore, when final valve-opening pressures were adjusted to 30 mmH(2)O, 14 patients symptom was improved just at the point. There were 18 (22%) major complications : 7 subdural hygroma, 6 shunt obstructions, and 5 shunt infections. CONCLUSION: In normal pressure-type hydrocephalus, most patients improved when the final valve-opening pressure was 30 mmH(2)O. We suggest that all normal pressure-type hydrocephalus patients be shunted with programmable valves, and their initial valve-opening pressures set to 10-30 mmH(2)O below their preoperative cerebrospinal fluid (CSF) pressures. If final valve-opening pressures are lowered in 20 or 30 mmH(2)O scale at 2- or 3-week intervals, reaching a final pressure of 30 mmH(2)O, we believe that there is a low risk of overdrainage syndromes.
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BACKGROUND: The use of remifentanil before propofol administration facilitates the insertion of the Laryngeal Mask Airway. We designed the present study to determine whether remifentanil would also create more suitable conditions for providing Cobra Perilaryngeal airway (CobraPLA) insertion when administered with propofol. METHODS: Both remifentanil and propofol were given as effect-site target-controlled infusions. There were four groups of 25 patients each. The propofol effect-site concentration was set at 6 microg/mL in all groups. Group R1 received a target effect-site remifentanil concentration of 1 ng/mL, Group R2 received remifentanil at 2 ng/mL, Group R3 received remifentanil at 3 ng/mL, and Group R4 received remifentanil at 4 ng/mL before the induction of anesthesia with propofol. The ease of insertion of CobraPLA was graded by the following 3-point scale: Grade 1, excellent, no response to CobraPLA insertion; Grade 2, acceptable, gagging or swallowing with insertion of CobraPLA; Grade 3, poor, unable to open mouth or biting upon insertion of CobraPLA. RESULTS: The most patients ranked as excellent for the first CobraPLA insertion (Grade 1) were found in Group R4, which was significantly higher than Groups R1 and R2 (P < 0.01), whereas no significant difference was found when compared with Group R3. The duration of apnea showed a significant dose-related increase (P < 0.01), especially between Group R2 (median 2.95 min) and R3 (median 7.9 min), but there was no significant difference between Groups R3 and R4. The incidence of hypotension in Group R4 within 1 min after insertion of CobraPLA was significantly more than for Groups R1 and R2 (P < 0.01). No significant differences could be found between the incidence of hypotension between Group R3 and the other groups. The incidence of hypertension at 1 min postinsertion was significantly more common in Groups R1 and R2 than Groups R3 and R4 (P < 0.01). CONCLUSION: An effect-site concentration of remifentanil of 2 ng/mL provides excellent conditions for insertion of the CobraPLA on the first attempt with minimal hemodynamic perturbations and a shorter duration of apnea.
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Anestesia General , Anestésicos Combinados/administración & dosificación , Anestésicos Intravenosos/administración & dosificación , Máscaras Laríngeas , Piperidinas/administración & dosificación , Propofol/administración & dosificación , Respiración Artificial/instrumentación , Adulto , Anestésicos Combinados/efectos adversos , Anestésicos Intravenosos/efectos adversos , Apnea/etiología , Apnea/prevención & control , Presión Sanguínea/efectos de los fármacos , Diseño de Equipo , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Piperidinas/efectos adversos , Propofol/efectos adversos , Remifentanilo , Respiración Artificial/efectos adversos , Factores de TiempoRESUMEN
The mixed oxide (Ce(0.65)Zr(0.35)O(2)) prepared by supercritical synthesis was applied as a support of transition metal (Mn, Fe, Co, Ni, and Cu) oxide catalysts for catalytic wet oxidation (CWO) of phenol in view of their higher thermal stability, better oxygen storage capacity, and higher surface area. The prepared catalysts showed an enhanced catalytic activity for CWO of phenol due to the excellent redox properties of ceria-zirconia mixed oxide. Among the prepared catalysts, the CuO(x)/Ce(0.65)Zr(0.35)O(2) was the most effective catalyst in view of catalytic activity and CO(2) selectivity. The leached copper ions seem to contribute to the higher conversion of phenol over the CuO(x)/Ce(0.65)Zr(0.35)O(2) via homogeneous catalysis. The characterization with XPS, XANES, and TPR experiments confirmed that the active copper species in the CuO(x)/Ce(0.65)Zr(0.35)O(2) is highly dispersed Cu(2+) clusters. Although the MnO(x)/Ce(0.65)Zr(0.35)O(2) showed a high conversion of phenol and TOC, the converted phenol was mainly changed to carbon deposits on the surface of catalyst resulting in catalyst deactivation.
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Óxidos/química , Fenol/química , Elementos de Transición/química , Catálisis , Cerio , Oxidación-Reducción , Agua , CirconioRESUMEN
BACKGROUND: We hypothesized that pressure control ventilation allows a more even distribution in the lung and better maintenance of the mean airway pressure than is achieved with volume control ventilation. We try to compare the effect of pressure control ventilation (PC) with that of volume control ventilation without an end-inspiratory pause (VC) during one-lung ventilation (OLV) in an anesthetized, paralyzed patient for performing thoracopic bullectomy of the lung. METHODS: We ventilated 20 patients with VC and PC after the insertion of a thoracoscope in continual order for, at least for 15 minutes, for each, VC and PC procedure. At the end of VC and PC, the respiratory mechanics, gasometrics, and hemodynamic parameters were measured and collected. RESULTS: We found no significant differences between VC and PC except for the peak inspiratory airway pressure (PIP), the mean airway pressure and the arterial oxygen partial pressure (PaO2). The PIP was significantly decreased from 27.0 +/- 6.0 cmH2O (VC) to 21.8 +/- 5.4 cmH2O (PC). The mean airway pressure was significantly increased from 8.6 +/- 1.6 cmH2O (VC) to 9.4 +/- 2.0 cmH2O (PC), and the PaO2 was significantly increased from 252.9 +/- 97.3 mmHg (VC) to 285.2 +/- 103.8 mmHg (PC). CONCLUSIONS: If PC allows mechanical ventilation with the same tidal volume and respiratory rate as VC during OLV, then PC significantly increases the PaO2 but this is not clinically significant, and the PC significantly decreases the PIP, which induces barotrauma or volutrauma when the PIP is excessively high.
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Awareness with recall after general anesthesia is a relatively infrequent occurrence and this awareness is often associated with significant adverse psychological sequelae, including posttraumatic stress disorder. The occurrence of awareness is often the consequence of the light anesthetic techniques with using minor anesthetic agents. Because the locking lever of the Penlon Sigma Delta Anesthetic vaporizer (sevoflurane) was at the unlock position, disconnection happened between the anesthetic machine and the vaporizer (the Selectatec(R) vaporizing system). In our two cases, the inhalation agents were not supplied and awareness with recall was identified after surgery. We recommend to check the concentration of the inhalation agents by monitoring the concentration of using endtidal inhalation agents and to measure the hypnotic level of anesthesia via the bispectral index (BIS) and the auditory evoked potential (AEP).
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Various techniques have been used to characterize the CuO(x)/TiO(2) catalysts with different copper loading. Surface area, pore volume and pore size distribution of the prepared catalysts were estimated from nitrogen adsorption isotherm. Temperature programmed reduction (TPR), X-ray diffraction (XRD), electron spin resonance (ESR), X-ray photoelectron spectroscopy (XPS) and X-ray absorption near edge structure (XANES) experiments were performed to investigate the chemical state of the copper species. The chemical state of copper in the CuO(x)/TiO(2) catalysts varied with copper loading (1-25wt.%): highly dispersed Cu(2+) cluster for 1 and 5wt.%, and bulk CuO for 7-25wt.%. The activity and mineralization selectivity of the CuO(x)/TiO(2) catalysts increased with copper loading up to 20wt.%, and remained almost constant for higher copper loading. The optimum copper loading was 20wt.% for the wet air oxidation of phenol over the CuO(x)/TiO(2) catalysts in this work. The stability of the CuO(x)/TiO(2) catalysts with different copper loading was also studied with respect to carbonaceous deposits and copper leaching.