Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention.

BACKGROUND: Therapeutic hypothermia for comatose survivors of out-of-hospital cardiac arrest has demonstrated neurological benefits. Although early cooling during cardiac arrest enhances efficacy in animal studies, few clinical studies are available. METHODS AND RESULTS: The 171 patients who failed to respond to conventional cardiopulmonary resuscitation were studied prospectively. Patients underwent emergency cardiopulmonary bypass (CPB) plus intra-aortic balloon pumping, with subsequent percutaneous coronary intervention (PCI) if needed. Mild hypothermia (34 degrees C for 3 days) was induced during cardiac arrest or after return of spontaneous circulation. Of the 171 patients, 21 (12.3%) had a favorable neurological outcome at hospital discharge. An unadjusted rate of favorable outcome decreased in a stepwise fashion for increasing quartiles of collapse-to-34 degrees C interval (P=0.016). An adjusted odds ratio for favorable outcome after collapse-to-CPB interval was 0.89 (95% confidence interval (CI) 0.82-0.97) and after CPB-to-34 degrees C interval, 0.99 (95%CI 0.98-0.99) when collapse-to-34 degrees C interval was divided into 2 components. Favorable neurological accuracy of a collapse-to-CPB interval at a cutoff of 55.5 min and CPB-to-34 degrees C interval at a cutoff of 21.5 min was 85.4% and 89.5%, respectively. CONCLUSIONS: Early attainment of a core temperature had neurological benefits for patients with out-of-hospital cardiac arrest who underwent CPB and PCI. (Circ J 2010; 74: 77 - 85).

IR sensitivity enhancement of CMOS Image Sensor with diffractive light trapping pixels.

We report on the IR sensitivity enhancement of back-illuminated CMOS Image Sensor (BI-CIS) with 2-dimensional diffractive inverted pyramid array structure (IPA) on crystalline silicon (c-Si) and deep trench isolation (DTI). FDTD simulations of semi-infinite thick c-Si having 2D IPAs on its surface whose pitches over 400 nm shows more than 30% improvement of light absorption at λ = 850 nm and the maximum enhancement of 43% with the 540 nm pitch at the wavelength is confirmed. A prototype BI-CIS sample with pixel size of 1.2 µm square containing 400 nm pitch IPAs shows 80% sensitivity enhancement at λ = 850 nm compared to the reference sample with flat surface. This is due to diffraction with the IPA and total reflection at the pixel boundary. The NIR images taken by the demo camera equip with a C-mount lens show 75% sensitivity enhancement in the λ = 700-1200 nm wavelength range with negligible spatial resolution degradation. Light trapping CIS pixel technology promises to improve NIR sensitivity and appears to be applicable to many different image sensor applications including security camera, personal authentication, and range finding Time-of-Flight camera with IR illuminations.