Effect of neuromuscular blockade reversal by pyridostigmine on spectral entropy values during recovery from desflurane anesthesia: a prospective, randomized, double-blind, controlled trial.

BACKGROUND: According to several studies investigating the relationship between muscle activity and electroencephalogram results, reversal of neuromuscular blockade (NMB) may affect depth of anesthesia indices. Therefore, we investigated the effect of pyridostigmine on these indices via spectral entropy. METHODS: Fifty-six patients scheduled for thyroidectomy or parotidectomy were included in this study and randomized into two groups. At the start of skin suturing, the desflurane concentration was adjusted to 4.2 vol% in both groups. Following this, the pyridostigmine group (group P, n = 28) was administered pyridostigmine 0.2 mg/kg mixed with glycopyrrolate 0.04 mg/kg, while the control group (group C, n = 28) received normal saline. Entropy values (response entropy [RE] and state entropy [SE]), train of four (TOF) ratio, and end-tidal desflurane concentration were recorded from point of drug administration to 15 minutes post-drug administration. RESULTS: Mean RE values at 15 minutes, when the maximum effect of pyridostigmine was anticipated, showed a statistically significant difference between groups (53.8 ± 10.5 in group P and 48.0 ± 8.8 in group C; P = 0.030). However, mean SE at 15 minutes showed no significant difference between the two groups (P = 0.066). At 15 minutes, there were significant differences in the TOF ratio between the two groups (P < 0.001). CONCLUSIONS: NMB reversal by pyridostigmine significantly increased RE values but not SE values. This finding suggests that spectral entropy may be a useful alternative tool for monitoring anesthetic depth during recovery from anesthesia in the presence of electromyogram activity.

Continuous bioelectricity production and sustainable wastewater treatment in a microbial fuel cell constructed with non-catalyzed granular graphite electrodes and permeable membrane.

Oxygen has been so far addressed as the most preferable terminal electron acceptor in the cathodes of microbial fuel cells (MFCs). However, to reduce the oxygen reduction overpotential at the cathode surface, eco-unfriendly and costly catalysts have been commonly employed. Here, we pursued the possibility of using a high surface area electrode to reduce the cathodic reaction overpotential rather than the utilization of catalyzed materials. A dual chambered MFC reactor was designed with the use of graphite-granule electrodes and a permeable membrane. The performance of the reactor in terms of electricity generation and organic removal rate was examined under a continuous-feed manner. Results showed that the maximum volumetric power of 4.4+/-0.2 W/m(3) net anodic compartment (NAC) was obtained at a current density of 11+/-0.5 A/m(3) NAC. The power output was improved by increasing the electrolyte ionic strength. An acceptable effluent quality was attained when the organic loading rate (OLR) of 2 kgCOD/m(3) NAC d was applied. The organic removal rate seemed to be less affected by shock loading. Our system can be suggested as a promising approach to make MFC-based technology economically viable for wastewater treatment applications. This study shows that current generation can be remarkably improved in comparison with several other studies using a low-surface-area plain graphite electrode.

Analysis of skin movement with respect to flexional bone motion using MR images of a hand.

This study describes the methodology for analyzing skin movement with respect to the predefined flexional motion of the hand. The 3D in vivo geometric data were acquired through magnetic resonance (MR) scanning of multiple hands in various postures. Custom software was developed to segment MR images and to generate polygonal isosurfaces. A new bone coordinate system (BCS) was defined to describe the skin movement measured with the skin-surface markers. The BCS was defined by the surface registration technique, which could minimize the distance among the 3D polygonal surfaces of different postures. MR images of six subjects in the 3 postures were captured with skin-surface markers for the experiment. Skin movement on the second metacarpal bone, which was fixed during the flexional motion, ranged from 1.169 to 10.885 mm. While the distance of the skin movement varied from one subject to another, a common skin movement direction was observed among the six subjects. For the repeatability evaluation of the proposed method, the MR images of the same subject were independently processed 10 times by a trained operator. The standard deviation of the skin movement on the second metacarpal of the index finger with respect to the predefined flexional motion ranged from 0.45 to 0.74 mm.