Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study.

A combined cervical plexus and costoclavicular block provides effective shoulder analgesia without the risk of hemidiaphragmatic paralysis. However, whether this technique can also provide effective anesthesia for shoulder surgery remains unknown. Therefore, this study aimed to assess the feasibility and adverse effects of combined blocks in arthroscopic shoulder surgery. Fifty patients scheduled for arthroscopic shoulder surgery were prospectively enrolled. Intermediate cervical plexus (5 mL of 0.5% ropivacaine) and costoclavicular (20 mL of 0.5% ropivacaine) blocks were administered under ultrasound guidance. The block procedure time, needle pass, patient discomfort, anesthesia quality, onset time, postoperative analgesia quality, adverse events, and patient satisfaction were assessed. Surgical and block success were achieved in 45 (90%; 95% confidence interval [CI], 78-97%) and 44 (88%; 95% CI, 76-95%) patients, respectively. Three patients required local anesthetic supplementation, and two required general anesthesia. The incidence of hemidiaphragmatic paralysis was 12.0% (95% CI, 4.5-24.3%). Postoperative pain control was effective for the first 24 h postoperative. Neurological deficits were not observed. The patients reported a high level of satisfaction. This study revealed that a combined cervical plexus and costoclavicular block provided effective surgical anesthesia for arthroscopic shoulder surgery with a 12% incidence of hemidiaphragmatic paralysis. Further randomized studies comparing this technique with interscalene block are required.

Application of high-flow nasal cannula oxygen therapy in patient with pulmonary edema following cesarean-section under combined spinal-epidural anesthesia: A case report.

BACKGROUND: High-flow nasal cannula (HFNC), which overcomes the disadvantages of the existing low flow mask, is an efficient method that can immediately provide a high volume of heated oxygen to the patient.[1] Therefore, this case reports a case in which HFNC was applied to a pregnant with acute respiratory failure. CASE: A 37-year-old woman pregnant (GA 30 + 5 weeks) with twin was diagnosed with preeclampsia. It was decided to perform an emergency Cesarean-section under combined spinal-epidural technique worsening respiratory failure. After delivery, maternal dyspnea was not alleviated applying of O28 L/min via facial mask. Thus, high-flow nasal cannula (HFNC) oxygen therapy was applied (60 L/min, partial pressure of oxygen (FiO2) 80%) and SpO2 subsequently rose to 98% and the patient's dyspnea was resolved. CONCLUSIONS: HFNC is a safe device that can effectively provide oxygen to pregnant with acute respiratory failure.

Optical Tunneling Mediated Sub-Skin-Depth High Emissivity Tungsten Radiators.

Tailoring the spectrum of thermal radiation at high temperatures is a central issue in the study of thermal radiation harnessed energy resources. Although bulk metals with periodic cavities incorporated into their surfaces provide high emissivity, they require a complicated micron metal etch, thereby precluding reliable, continuous operation. Here, we report thermally stable, highly emissive, ultrathin (<20 nm) tungsten (W) radiators that were prepared in a scalable and cost-effective route. Alumina/W/alumina multiwalled, submicron cavity arrays were fabricated sequentially using nanoimprinting lithography, thin film deposition, and calcination processes. To highlight the practical importance of high-temperature radiators, we developed a thermophotovoltaic (TPV) system equipped with fabricated W radiators and low-bandgap GaSb photovoltaic cells. The TPV system produced electric power reliably during repeated temperature cycling between 500 and 1200 K; the power density at 1200 K was fixed to be approximately 1.0 W/cm2. The temperature-dependent electric power was quantitatively reproduced using a one-dimensional energy conversion model. The symmetric configuration of alumina/W/alumina multiwall together with the presence of a void inside each cavity alleviated thermal stress, which was responsible for the stable TPV performance. The short-current-density (JSC) of developed TPV system was augmented significantly by decreasing the W thickness below its skin depth. A 17 nm thick W radiator yielded a 32% enhancement in JSC compared to a 123 nm thick W radiator. Electromagnetic analysis indicated that subskin-depth W cavity arrays led to suppressed surface reflection due to the mitigated screening effect of free electrons, thereby enhancing the absorption of light within each W wall. Such optical tunneling-mediated absorption or radiation was valid for any metal material and morphology (e.g., planar or patterned).

Microstructured void gratings for outcoupling deep-trap guided modes.

Breaking the total internal reflection far above a critical angle (i.e., outcoupling deep-trap guided modes) can dramatically improve existing light-emitting devices. Here, we report a deep-trap guided modes outcoupler using densely arranged microstructured hollow cavities. Measurements of the leaky mode dispersions of hollow-cavity gratings accurately quantify the wavelength-dependent outcoupling strength above a critical angle, which is progressively improved over the full visible spectrum by increasing the packing density. Comparing hollow- and filled-cavity gratings, which have identical morphologies except for their inner materials (void vs. solid sapphire), reveals the effectiveness of using the hollow-cavity grating to outcouple deep-trap guided modes, which results from its enhanced transmittance at near-horizontal incidence. Scattering analysis shows that the outcoupling characteristics of a cavity array are dictated by the forward scattering characteristics of their individual cavities, suggesting the importance of a rationally designed single cavity. We believe that a hollow-cavity array tailored for different structures and spectra will lead to a technological breakthrough in any type of light-emitting device.

Quick, large-area assembly of a single-crystal monolayer of spherical particles by unidirectional rubbing.

Rubbing a dry powder of particles in one direction between two rubbery substrates is found to be a quick and highly reproducible, yet inexpensive fabrication technique for assembling particle monolayers with perfect spatial registry on flat or curved surfaces. The optimum rubbing conditions - pressure and speed - for a single-crystal monolayer are shown to depend on particle size. Potential applications are in biosensors, photovoltaics, and light manipulators.

Mode tunable p-type Si nanowire transistor based zero drive load logic inverter.

A design platform for a zero drive load logic inverter consisting of p-channel Si nanowire based transistors, which controlled their operating mode through an implantation into a gate dielectric layer was demonstrated. As a result, a nanowire based class D inverter having a 4.6 gain value at V(DD) of -20 V was successfully fabricated on a substrate.

One-dimensional semiconductor nanostructure based thin-film partial composite formed by transfer implantation for high-performance flexible and printable electronics at low temperature.

Having high bending stability and effective gate coupling, the one-dimensional semiconductor nanostructures (ODSNs)-based thin-film partial composite was demonstrated, and its feasibility was confirmed through fabricating the Si NW thin-film partial composite on the poly(4-vinylphenol) (PVP) layer, obtaining uniform and high-performance flexible field-effect transistors (FETs). With the thin-film partial composite optimized by controlling the key steps consisting of the two-dimensional random dispersion on the hydrophilic substrate of ODSNs and the pressure-induced transfer implantation of them into the uncured thin dielectric polymer layer, the multinanowire (NW) FET devices were simply fabricated. As the NW density increases, the on-current of NW FETs increases linearly, implying that uniform NW distribution can be obtained with random directions over the entire region of the substrate despite the simplicity of the drop-casting method. The implantation of NWs by mechanical transfer printing onto the PVP layer enhanced the gate coupling and bending stability. As a result, the enhancements of the field-effect mobility and subthreshold swing and the stable device operation up to a 2.5 mm radius bending situation were achieved without an additional top passivation.

Secretory phospholipase A2 induces apoptosis through TNF-alpha and cytochrome c-mediated caspase cascade in murine macrophage RAW 264.7 cells.

Phospholipase A2 (PLA2) is an esterase that cleaves the sn-2 ester bond in glycerophospholipids, thereby releasing free fatty acids and lysophospholipids. In addition to the apoptotic activity of cytosolic PLA2 and Ca2+-independent PLA2, recent studies showed that secretory PLA2 (sPLA2) also play a role in apoptosis. However, the details of molecular mechanism have not been fully elucidated. Our data demonstrated that group IB PLA (IB PLA2)-exposed murine macrophage 264.7 cells showed characteristic features of apoptosis such as morphological changes, DNA laddering, staining positive for propidium iodide (PI) as well as Annexin V and activation of caspases and subsequent cleavage of poly (ADP-ribose) polymerase (PARP) in dose- and time-dependent manner. Moreover, IB PLA2 was found to elicit tumor necrosis factor (TNF)-alpha production and release of cytochrome c, suggesting that IB PLA2 exerts its apoptotic activity via the induction of TNF-alpha production and cytochrome c release, which results in triggering the activation of caspase cascade and PARP cleavage.