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1

Anesthetic Techniques and Cancer Recurrence after Surgery  

PubMed Central

Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients. PMID:24683330

D'Arrigo, Maria G.; Triolo, Stefania; Mondello, Stefania; La Torre, Domenico

2014-01-01

2

Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm  

PubMed Central

Despite great advancements in the management of aneurysmal subarachnoid hemorrhage (SAH), outcomes following SAH rupture have remained relatively unchanged. In addition, little data exists to guide the anesthetic management of intraoperative aneurysm rupture (IAR), though intraoperative management may have a significant effect on overall neurological outcomes. This review highlights the various controversies related to different anesthetic management related to aneurysm rupture. The first controversy relates to management of preexisting factors that affect risk of IAR. The second controversy relates to diagnostic techniques, particularly neurophysiological monitoring. The third controversy pertains to hemodynamic goals. The neuroprotective effects of various factors, including hypothermia, various anesthetic/pharmacologic agents, and burst suppression, remain poorly understood and have yet to be further elucidated. Different management strategies for IAR during aneurysmal clipping versus coiling also need further attention. PMID:24723946

Petropolis, Andrea; Wilkinson, Marshall; Sandu, Nora; Cappellani, Ronald B.

2014-01-01

3

Anesthetic Management of Hysterosalpingo-oophorectomy in a Case with Severe Idiopathic Dilated Cardiomyopathy  

PubMed Central

Idiopathic dilated cardiomyopathy is a primary myocardial disease with unknown aetiology. This disease follows a prospective course that is characterized by ventricular dilation and impaired myocardial dilation. Congestive heart failure and malignant arrhythmias are the most widespread complications. The incidence of idiopathic dilated cardiomyopathy in the general population is 5-8/100.000. Because of the increased risks of perioperative complications, anesthetic management of this disease requires the application of a specific technique. This case report demonstrates the application of successful regional anesthetic management (thoracic epidural anesthesia) in a patient who had been diagnosed with severe idiopathic dilated cardiomyopathy. PMID:24937943

Kaya, Cengiz; Koksal, Ersin; Ustun, Yasemin Burcu; Semizoglu, Yasemin; Y?lmaz, Nurullah

2014-01-01

4

Anesthetic technique for inferior alveolar nerve block: a new approach  

PubMed Central

Background Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 1329% of cases. Objective Objective: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. Materials and Methods A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition) from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side), and the second following the oclusal plane (left side), a line can be achieved whose projection coincides with the left mandibular foramen. Results The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. Conclusion This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry. PMID:21437463

PALTI, Dafna Geller; de ALMEIDA, Cristiane Machado; RODRIGUES, Antonio de Castro; ANDREO, Jesus Carlos; LIMA, José Eduardo Oliveira

2011-01-01

5

Effect of Opiates, Anesthetic Techniques, and Other Perioperative Factors on Surgical Cancer Patients  

PubMed Central

Background Opioid pharmacotherapy is often used to treat cancer pain. However, morphine and other opioid-like substance use in patients with cancer may have significant adverse consequences, including the suppression of both innate and acquired immune responses. Although studies have examined the possibility that regional anesthesia attenuates the immunosuppressive response of surgery, the effects of morphine and other opioid-related substances on tumor progression remain unknown. Methods This article presents an evidence-based review of the influence of opioids and anesthetic technique on the immune system in the context of cancer recurrence. The review focuses on the field of regional anesthesia and the setting of surgical oncologic procedures. The method for perioperative pain management and the technique of anesthesia chosen for patients in cancer surgery were explored. Results General anesthetics have been indicated to suppress both cell-mediated immunity and humoral immunity. Evidence suggests that intravenous opioids suppress the immune system. However, the mechanisms by which anesthetics and analgesics inhibit the immune system are not understood. Compared with the alternatives, regional analgesia offers reduced blood loss and superior postoperative analgesia. Because of these advantages, the use of regional analgesia has increased in oncologic surgeries. Conclusion Immune responses from all components of the immune system, including both the humoral and cell-mediated components, appear to be suppressed by anesthetics and analgesics. The clinical anesthesiologist should consider these factors in the application of technique, especially in cancer surgery. PMID:24940132

Kaye, Alan David; Patel, Nayan; Bueno, Franklin Rivera; Hymel, Brad; Vadivelu, Nalini; Kodumudi, Gopal; Urman, Richard D.

2014-01-01

6

[Anesthetic management of a neonate with congenital cystic adenomatoid malformation].  

PubMed

We report the anesthetic management of a female neonate with congenital cyst adenoid malformation (CCAM) type III of the lung who underwent the lower right lobe resection 22 days after birth. General anesthesia was induced with propofol and rocuronium. The trachea was intubated with a 3.0 standard tube. Anesthesia was maintained with sevoflurane in an air/oxygen mixture and fentanyl. Intraoperative anesthetic course was uneventful except transient desaturation during lung compression. Immediately, the saturation was restored by interruption of lung compression. One lung ventilation was not necessary in this operation. Postoperative course was uneventful. Patient was discharged home on the 28th postoperative day. PMID:24558943

Tominaga, Hiroki; Hatori, Eiki; Takeda, Junzo; Morisaki, Hiroshi

2014-01-01

7

Anesthetic and dental management of a child with IMAGe syndrome.  

PubMed

IMAGe syndrome (OMIM 300290) is a rare multisystem disorder that has a broad phenotypic presentation. Though variable, this disorder mainly consists of Intrauterine growth retardation, Metaphyseal dysplasia, Adrenal hypoplasia congenita, and Genital abnormalities. Patients with IMAGe syndrome present as an uncommon yet important challenge for dentists and anesthesiologists due to their wide range of dysmorphic facial features, adrenal insufficiency, electrolyte imbalances, and need for steroid replacement. The purpose of this case report is to describe the successful anesthetic management of a pediatric patient diagnosed with IMAGe syndrome who presented for full mouth dental rehabilitation. PMID:25517553

Lindemeyer, Rochelle G; Rashewsky, Stephanie E; Louie, Phillip J; Schleelein, Laura

2014-01-01

8

Congenital lobar emphysema: A modified approach to anesthetic management  

PubMed Central

Congenital lobar emphysema (CLE) is a potentially reversible, though life-threatening cause of respiratory distress in neonates. It is a rare developmental anomaly of the lower respiratory tract. A 10-month-old child presented with fever, cough and difficulty in breathing. Respiratory system examination revealed tachypnea with intercostal retraction, decreased breath sounds over the left upper lobe and room air saturation of 95%. Chest radiograph and computed tomography showed hyperinflated left upper zones with mediastinal shift. Left thoracotomy, followed by left upper lobectomy was performed under general anesthesia with one lung ventilation. Oxygen saturation, blood pressure, electrocardiogram and capnogram were continuously monitored. During anesthesia, conventionally positive pressure ventilation is avoided until the diseased lobe is isolated, however we adopted gentle manual ventilation maintaining the airway pressure before thoracotomy as described by Coté and Payne et al. Successful anesthetic management of CLE can be achieved by proper understanding of pathophysiology, good perioperative monitoring, and adopting novel management strategies. PMID:25624651

Nandihalli, Malathi C.; Thammaiah, Srinivas H.; Kotekar, Nalini; Putran, Prashanth R.

2015-01-01

9

[Anesthetic management for caesarean delivery in a parturient with achondroplasia].  

PubMed

A 27-year-old parturient (height, 130 cm; weight, 43 kg) with achondroplasia, which is characterized by rhizomeric short stature, large head and frontal bossing, was scheduled for elective caesarean section (C/S) because of her contracted pelvis. Her first delivery had been performed by C/S under general anesthesia at a regional hospital 6 years before. Preoperative airway assessment showed normal mouth opening and mobile cervical spine. Since she had anxiety about needle puncture and refused neuraxial blockade and since we considered the trachea could be intubated, we decided to perform C/S under general anesthesia at 37 weeks of gestation. The patient and baby had an uneventful perioperative course. Underdevelopment of bone formation results in characteristic craniofacial and vertebral abnormalities in patients with achondroplasia. Anesthetic management of achondroplastic parturients should be specified to individual basis based on careful preoperative assessment of craniofacial and vertebral deformities. PMID:24979866

Ando, Akira; Hishinuma, Norimasa; Shirotori, Toru; Sasao, Junichi; Tanaka, Satoshi; Kawamata, Mikito

2014-06-01

10

Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report  

PubMed Central

Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist. PMID:25191665

Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza

2014-01-01

11

Management Technique  

NASA Technical Reports Server (NTRS)

Ball Aerospace Systems Division developed a highly efficient management method known as the "total integrated systems approach" a technique developed of necessity for managing extremely complex aerospace programs involving integration of a great many individual systems. These systems, developed at different times by many different companies, must not only work perfectly when separately tested, they must also perform compatibly when integrated into the complete prime system. Systems approach is essentially a carefully considered, painstakingly executed master plan for coordinated design, development and assembly of the multitude of elements that constitute the end product. Intent is to eliminate problems that may occur when specific parts of total functioning system fail to come together to provide the requisite performance of the prime system.

1980-01-01

12

Anesthetic management in a patient with Kindler's syndrome  

PubMed Central

A 35-year-old male with pan-anterior urethral stricture was scheduled to undergo perineal urethrostomy. He was a known case of Kindler's syndrome since infancy. He was having a history of blister formation, extensive poikiloderma and progressive cutaneous atrophy since childhood. He had a tendency of trauma-induced blisters with clear or hemorrhagic contents that healed with scarring. The fingers were sclerodermiform with dystrophic nails and inability to completely clench the fist. Airway examination revealed thyromental distance of 7 cm with limited neck extension, limited mouth opening and mallampatti class III with a fixed large tongue. He was reported as grade IV Cormack and Lehane laryngoscopic on previous anesthesia exposure. We described the anesthetic management of such case on guidelines for epidermolysis bullosa. In the operating room, an 18-G cannula was secured in the right upper limb using Coban™ Wrap. The T-piece of the cannula was than inserted into the slit and the tape was wrapped around the extremity. The ECG electrodes were placed on the limbs and fixed with Coban™. Noninvasive blood pressure cuff was applied over the wrap after wrapping the arm with Webril® cotton. Oral fiberoptic tracheal intubation was done after lubricating the laryngoscope generously with a water-based lubricant with 7-mm endotracheal tube. Surgery proceeded without any complication. After reversing the residual neuromuscular block, trachea was extubated once the patient became awake. He was kept in the postanesthesia care unit for 2 hours and then shifted to urology ward. PMID:22144935

Solanki, Sohan Lal; Jain, Amit; Bhukal, Ishwar; Samanta, Sukhen

2011-01-01

13

Anesthetic management of patients undergoing intracranial bypass procedures.  

PubMed

Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of developing cerebral ischemia. These include patients with moyamoya disease, occlusive cerebrovascular disease, skull base tumors, and complex aneurysms. Our aim in this review is to provide a comprehensive update of both surgical and anesthetic aspects of cerebral revascularization procedures. The anesthetic concerns for most patients presenting for different types of bypass procedures are similar and include the maintenance of adequate cerebral perfusion to prevent cerebral ischemia. Patients with complex aneurysms and tumors have additional considerations related to the surgical treatment of the underlying pathology. PMID:25625262

Chui, Jason; Manninen, Pirjo; Sacho, Raphael H; Venkatraghavan, Lashmi

2015-01-01

14

Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy  

PubMed Central

Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery. PMID:21772690

Chowdhuri, Rajat; Samui, Samarendranath; Kundu, Asim Kumar

2011-01-01

15

Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy.  

PubMed

Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery. PMID:21772690

Chowdhuri, Rajat; Samui, Samarendranath; Kundu, Asim Kumar

2011-04-01

16

Local anesthetic wound infiltration for pain management after periacetabular osteotomy  

PubMed Central

Background and purpose To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postoperative analgesia after PAO. Patients and methods We performed a randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov: NCT00815503) in 53 patients undergoing PAO to evaluate the effect of local anesthetic infiltration on postoperative pain and on postoperative opioid consumption. All subjects received intraoperative infiltration followed by 5 postoperative injections in 10-hour intervals through a multi-holed catheter placed at the surgical site. 26 patients received ropivacaine and 27 received saline. The intervention period was 2 days and the observational period was 4 days. All subjects received patient-controlled opioid analgesia without any restrictions on the total daily dose. Pain was assessed at specific postoperative time points and the daily opioid usage was registered. Results Infiltration with 75 mL (150 mg) of ropivacaine did not reduce postoperative pain or opioid requirements during the first 4 days. Interpretation The clinical importance of ropivacaine as single component in postoperative treatment of pain is questionable, and we are planning further studies to explore the potential of LIA in larger volume—and also a multimodal regimen—to treat pain in this category of patients. PMID:24650022

2014-01-01

17

Ultra-fast-track anesthetic technique facilitates operating room extubation in patients undergoing off-pump coronary revascularization surgery  

Microsoft Academic Search

Objective: To determine if implementation of ultra-fast-track anesthetic (UFTA) technique facilitates operating room extubation in patients undergoing off-pump coronary artery bypass graft (CABG) surgery. Design: Retrospective review. Setting: Referral center for cardiovascular surgery at a university hospital. Participants: Thirty-seven patients undergoing off-pump CABG surgery. Interventions: Two groups represented UFTA (n = 10) and standard anesthetic (controls, n = 27) techniques.

George N Djaiani; Mohamed Ali; Lee Heinrich; Jay Bruce; Jo Carroll; Jacek Karski; R. J Cusimano; Davy C. H Cheng

2001-01-01

18

Anesthetic Concerns of Space Flight  

NASA Technical Reports Server (NTRS)

Anesthesiologists are acutely aware of the fact that, although a given surgical procedure may be relatively simple, the required anesthetic care is, in certain cases, extremely complex. This principle is particularly evident when one ponders the difficulties involved in providing even basic anesthetic care in microgravity. In this issue some of these difficulties through the evaluation of airway management techniques during water immersion are confronted, a simulation of the gravito-inertial conditions of space flight. As prelude for this paper, I would like to outline some of the challenges to be overcome before surgical, anesthetic, and critical care can be delivered beyond our home planet.

Norfleet, William T.

1999-01-01

19

Anesthetic Management of a Patient with Sustained Severe Metabolic Alkalosis and Electrolyte Abnormalities Caused by Ingestion of Baking Soda  

PubMed Central

The use of alternative medicine is prevalent worldwide. However, its effect on intraoperative anesthetic care is underreported. We report the anesthetic management of a patient who underwent an extensive head and neck cancer surgery and presented with a severe intraoperative metabolic alkalosis from the long term ingestion of baking soda and other herbal remedies. PMID:25180100

Lim, Jeffrey

2014-01-01

20

Anesthetic management of a patient with sustained severe metabolic alkalosis and electrolyte abnormalities caused by ingestion of baking soda.  

PubMed

The use of alternative medicine is prevalent worldwide. However, its effect on intraoperative anesthetic care is underreported. We report the anesthetic management of a patient who underwent an extensive head and neck cancer surgery and presented with a severe intraoperative metabolic alkalosis from the long term ingestion of baking soda and other herbal remedies. PMID:25180100

Soliz, Jose; Lim, Jeffrey; Zheng, Gang

2014-01-01

21

[The development of chemical narcotic and related anesthetic techniques in modern times].  

PubMed

Before the 19(th) century, ether and nitrous oxide were synthesized. However, they were just used as a kind of enjoyable things at night gatherings for their hypnotic and analgesic effect. In the 19(th) century, ether and nitrous oxide came into use in clinical anesthesia. Thereafter, more and more chemical narcotics were synthesized and applied to clinical anesthesia. In 1872, chloroform was injected into man's vein for anesthesia. In the 20(th) century, along with many kinds of barbiturates being synthesized, intravenous anesthesia got much development and application. At the same time, related techniques of anesthesia also improved. In the early 19(th) century, open inhalation anesthesia was often used. In 1900, there came a new anesthesia method by blowing into the windpipe through the cut of throat. Later on, the technique of endotracheal anesthesia and artificial respiration anesthesia (1908), the anesthetic instrument of endotracheal intubation and laryngeal mask and laryngoscope were invented. In the mid 19(th) century, the appearance of injection syringe and cocaine made local anesthesia possible. In 1880, local anesthesia also became successful. Thereafter, a variety of local anesthetic drugs were synthesized and applied, companying with various techniques of local anesthesia such as subarachnoid anesthesia (1900), sacral anesthesia (1901), epidural block (1903), plexus block (1902) and so on. In order to control the depth of anesthesia and respiration effectively, people attempted a lot so that anesthesia machine (1910), improved endotracheal anesthesia (1921), cryogenic technique (1902), controlled hypotension (1940s) and artificial hibernation (1950) came into being. PMID:23363851

Zheng, Hui; Zhang, Yan-Rong

2012-11-01

22

Anesthetic considerations and management of a patient with unsuspected carcinoid crisis during hepatic tumor resection.  

PubMed

Anesthetic management for massive blood loss in liver surgery concomitant with hemodynamic instability secondary to carcinoid crisis can be challenging in the perioperative setting. Hypotension, diarrhea, facial flushing, bronchospasm, and tricuspid and pulmonic valvular diseases are the common manifestations of carcinoid syndrome. This report illustrates the importance of early recognition and treatment for signs and symptoms of carcinoid syndrome not only in the preoperative setting but also in the intraoperative phase to prevent undue cardiovascular collapse. PMID:25137869

Choi, Clark K

2014-06-01

23

Anesthetic challenges in managing a case of type III laryngo-tracheo-esophageal cleft  

PubMed Central

Laryngo-tracheo-esophageal cleft (LTEC) is a rare congenital anomaly characterized by failure of fusion of the cricoid cartilage posteriorly and incomplete development of the tracheo-esophageal septum. Securing the airway during anesthesia in patients with LTEC, especially in the severe forms is a challenge. We describe the anesthetic management and the airway challenges in a neonate with type III LTEC who underwent bronchoscopy and repair of LTEC. PMID:23225937

Rajmohan, Nisha; Prakasam, Hassy; Francis, Johny V

2012-01-01

24

Anesthetic challenges in managing a case of type III laryngo-tracheo-esophageal cleft.  

PubMed

Laryngo-tracheo-esophageal cleft (LTEC) is a rare congenital anomaly characterized by failure of fusion of the cricoid cartilage posteriorly and incomplete development of the tracheo-esophageal septum. Securing the airway during anesthesia in patients with LTEC, especially in the severe forms is a challenge. We describe the anesthetic management and the airway challenges in a neonate with type III LTEC who underwent bronchoscopy and repair of LTEC. PMID:23225937

Rajmohan, Nisha; Prakasam, Hassy; Francis, Johny V

2012-10-01

25

Anesthetic management of conjoined twins undergoing one-stage surgical separation: A single center experience  

PubMed Central

Objective: To summarize our experience in the anesthetic management of conjoined twins undergoing one-stage surgical separation. Methodology: Medical records of conjoined twins admitted to our hospital for treatment and considered for surgical separation from 1996 to present were retrospectively reviewed. Four cases of conjoined twins underwent one-stage surgical separation under general anesthesia. Preoperative evaluation was performed to determine the extent of anatomical conjunction and associated anomalies. Anesthesia was simultaneously induced in all conjoined twins. The intubation procedure was successfully performed with the head slightly rotated to each baby’s side, followed by the administration of vecuronium. Anesthetic agents were administered according to the estimated weight of each baby. One case of conjoined twins underwent surgical separation with cardiopulmonary bypass due to shared hearts. Results: All conjoined twins were successfully separated. No significant respiratory or cardiac events occurred during surgery except for one twin, which died after separation because of complicated congenital heart disease. Conclusions : Accurate preoperative evaluation, respiratory and circulatory management, and close cooperation of the multidisciplinary team are important aspects of anesthetic management of conjoined twins surgery. PMID:24353566

Zhong, He-Jiang; Li, Hong; Du, Zhi-Yong; Huan, He; Yang, Tian-De; Qi, Yue-Yong

2013-01-01

26

Anesthetic management of the patient with low ejection fraction.  

PubMed

The number of patients with heart failure presenting for surgery continues to rise, and anesthesiologists are increasingly being called upon to provide quality, safe care in the operating room for patients with low ejection fraction (EF). Perioperative goals in the management of these patients include maintaining forward flow, promoting inotropy without inducing or exacerbating ischemia, and returning patients to their preoperative level of function after surgery. Oftentimes, these goals can be met with pharmacologic support, including the use of calcium channel blockers, phosphodiesterase inhibitors, and novel agents, such as nesiritide and levosimendan. Many patients with diminished EF have implantable cardioverter-defibrillators (ICDs) in place. These devices can be complex to manage, and concern often arises regarding electromagnetic interference from monopolar cautery. Although simply placing a magnet on the device will often disable the antitachycardia interventions of an ICD, this is not always the case. The safest way to manage an ICD in the perioperative period is to interrogate and reprogram the device before and after surgery. Another helpful device in dealing with patients with low EF, particularly those in acute cardiogenic shock, is the intra-aortic balloon pump. These devices can serve a critical role in managing patients who have inadequate responses to pharmacologic therapy or in whom vasopressor and inotropic support are suboptimal because of concerns for increasing myocardial work. With full understanding of available pharmacologic agents, and an appreciation of the capabilities of ICDs and intra-aortic balloon pumps, anesthesiologists will be better equipped to meet the perioperative needs of the patient with low EF. PMID:23344107

Chua, Jason Han; Nguyen, Rudolph

2015-01-01

27

Laparoscopic Cortical Sparing Adrenalectomy for Pediatric Bilateral Pheochromocytoma: Anesthetic Management  

PubMed Central

Introduction: Pheochromocytoma is a catecholamine-secreting tumor, which is seen rarely in children. These tumors predominantly secrete norepinephrine and epinephrine. They might be familial and associated with hereditary tumors such as Von Hippel-Lindau syndrome and multiple endocrine neoplasia type II. Case Presentation: The child might present with a spectrum of clinical manifestation including hypertension, headache, visual disturbances, and behavioral problems. A meticulous preoperative preparation is essential for a stable intraoperative and postoperative outcome Conclusions: We described successful perioperative management of a child who underwent bilateral laparoscopic cortical sparing adrenalectomy and a repeated surgery for the residual tumor removal. PMID:24790902

Rajappa, Geetha Chamanhalli; Anandaswamy, Tejesh Channasandra

2014-01-01

28

Anesthetic management of a pregnant woman with Gorham-Stout disease.  

PubMed

Gorham-Stout disease is a rare disorder of bone loss and proliferation of lymphatic and vascular tissue (lymphangiomatosis). A 30-year-old nulliparous woman with Gorham-Stout disease presented at 8weeks of gestation with a fused cervical spine. At 31weeks she developed basilar invagination and neurological symptoms that were managed with a neck brace. Anesthetic considerations were those of airway compromise, development of severe preeclampsia and Kasabach-Merritt coagulopathy. Elective tracheostomy was declined. She presented two days before a planned cesarean delivery at 35weeks in preterm labor. A semi-urgent cesarean delivery under spinal anesthetic proceeded uneventfully, with an otolaryngologist present in case a surgical airway was required. Mother and baby were discharged home after three days. Maternal postpartum recovery was complicated by episodes of respiratory compromise and critical bone loss in the cervical spine, necessitating further surgical reinforcement. PMID:21111606

Gambling, D R; Catanzarite, V; Fisher, J; Harms, L

2011-01-01

29

Intra-operative post-induction hyperthermia, possibly malignant hyperthermia: Anesthetic implications, challenges and management  

PubMed Central

Malignant Hyperthermia is a pharmacogenetic disorder. Classical manifestations comprise of tachycardia, increase in expired carbon dioxide levels, muscle rigidity, hyperthermia (>38.8°C) and unexpected acidosis. Here we report a case of 16-year-old female patient, ASA-I with chronic rhino-sinusitis and slight strabismus of the left eye posted for functional endoscopic sinus surgery, developing a rise in ETCO2 and temperature immediately following anesthesia induction. She was aggressively managed to an uneventful recovery. We present a case of intra-operative post-induction hyperthermia possibly MH, its anesthetic implications, challenges encountered and its management. PMID:25425784

Gulabani, Michell; Gurha, Pavan; Ahmad, Sabih; Dass, Prashant

2014-01-01

30

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control  

PubMed Central

Background. Hazards of liver surgery have been attenuated by the evolution in methods of hepatic vascular control and the anesthetic management. In this paper, the anesthetic considerations during hepatic vascular occlusion techniques were reviewed. Methods. A Medline literature search using the terms “anesthetic,” “anesthesia,” “liver,” “hepatectomy,” “inflow,” “outflow occlusion,” “Pringle,” “hemodynamic,” “air embolism,” “blood loss,” “transfusion,” “ischemia-reperfusion,” “preconditioning,” was performed. Results. Task-orientated anesthetic management, according to the performed method of hepatic vascular occlusion, ameliorates the surgical outcome and improves the morbidity and mortality rates, following liver surgery. Conclusions. Hepatic vascular occlusion techniques share common anesthetic considerations in terms of preoperative assessment, monitoring, induction, and maintenance of anesthesia. On the other hand, the hemodynamic management, the prevention of vascular air embolism, blood transfusion, and liver injury are plausible when the anesthetic plan is scheduled according to the method of hepatic vascular occlusion performed. PMID:22690040

Tympa, Aliki; Theodoraki, Kassiani; Tsaroucha, Athanassia; Arkadopoulos, Nikolaos; Vassiliou, Ioannis; Smyrniotis, Vassilios

2012-01-01

31

[Anesthetic management of tracheobronchial stent insertion and extracorporeal lung assist (ECLA)].  

PubMed

We experienced eight cases of general anesthesia for tracheobronchial stent insertion. All stents were Ultraflex stent (Boston Scientific, Tokyo), and they were inserted guided by bronchofiberscopy under general anesthesia. Anesthesia was induced with patients under spontaneous breathing, and we inserted a tracheal tube or a laryngeal mask airway. Anesthesia was maintained with propofol and sevoflurane. In four cases with severe tracheobronchial stenosis, we used venovenous extracorporeal lung assist (ECLA) before general anesthesia induction. Oxygenation during stent insertion was well-maintained in all patients. We must evaluate the severity of tracheobronchial stenosis preoperatively. In high risk cases anticipated of airway obstruction, ECLA should be used for safe anesthetic management. PMID:18546898

Nagamine, Yusuke; Harada, Takashi; Asada, Mieko; Sumitomo, Masakazu

2008-06-01

32

[Anesthetic management of laparoscopic cholecystectomy for a patient with Churg-Strauss syndrome: a case report].  

PubMed

Churg-Strauss syndrome (CSS) is an uncommon disease characterized by bronchial asthma, eosinophilia and systemic vasculitis. Many patients with CSS are suffering from cardiovascular disorders, neurological disorders and/or renal disorders which are associated with systemic vasculitis. Cardiac diseases are considered as the main cause of the death in patients with CSS. Steroid administration is the standard pharmacological therapy for CSS. There are very few clinical reports concerning anesthetic management for the patients with CSS. We suppose that precise perioperative managements are required for the patients with CSS, including the appropriate control of bronchial asthma and the careful treatments of disorders in cardiovascular system, neurological system and/or kidney. In addition, we believe that the steroid cover should be considered during the perioperative period of the patients with CSS. Here, we describe an anesthetic management of a 28-year-old man with CSS undergoing laparoscopic cholecystectomy. General anesthesia was induced with midazolam and fentanyl. Rocuronium was administered to facilitate tracheal intubation. After tracheal intubation, anesthesia was maintained with sevoflurane and remifentanil. Prior to the surgery, 100 mg of hydrocortisone was administered for the steroid cover. The surgery was uneventful. The patient emerged from general anesthesia smoothly, and was extubated safely. PMID:25255668

Koda, Kenichiro; Uzawa, Masashi; Kimura, Haruka; Harada, Masaki; Sambe, Norie; Sugano, Takayuki; Ide, Yasuo; Kitamura, Takayuki; Tagami, Megumi

2014-09-01

33

[Anesthetic management for robot assisted off-pump construction of composite graft using the da Vinci surgical system].  

PubMed

Robot-assisted minimally invasive surgery has become common in recent years. We used the da Vinci surgical system and managed anesthesia in 6 cases of bilateral internal mammary artery dissection and construction of a composite graft using the radial artery. To ensure vision inside the thoracic cavity, endoscopic robotic surgery employs the inflation of the thoracic cavity with carbon dioxide, producing a pneumothorax and turning the thoracic cavity into a positive pressure chamber. Thus, marked acidosis and circulatory changes manifest during anesthetic management. Although robotic surgery is considered "minimally invasive, such surgery involves a number of problems in terms of anesthetic management, and these problems must be examined. PMID:20169956

Takanashi, Yoko; Hamano, Hiroko; Miyata, Kazuto; Matsumoto, Shouhei; Isshiki, Atushi

2010-02-01

34

[Anesthetic management of a patient with Maffucci syndrome for removal of a pituitary adenoma].  

PubMed

Maffucci syndrome is a rare syndrome characterized by multiple enchondromas and hemangiomas seen in various tissues and organs. We report anesthetic management of a 33-year-old man with multiple hemangiomas due to Maffucci syndrome undergoing removal of a pituitary adenoma. The preoperative examination revealed multiple hemangiomas in the head, neck, right upper and lower extremities, the tongue and the pharynx. In the operating room, we observed the locations of hemangiomas in the tongue and pharynx in detail using a fiberoptic bronchoscope before induction of anesthesia. Since there was a risk of rupture of a large hemangioma by using a laryngoscope, we planned fiberoptic bronchoscope-guided tracheal intubation without using a laryngoscope. After intravenous administration of propofol and rocuronium, a fiberoptic bronchoscope was orally introduced into the trachea and then the trachea was intubated with a flexible spiral endotracheal tube, preventing contact of the fiber or endotracheal tube with the hemangiomas. In addition, hemangiomas on the body surface were wrapped up with soft dressing to prevent rupture. Surgery was uneventfully completed. The trachea was carefully extubated, and bleeding from hemangiomas was not observed. Since patients with Maffucci syndrome have multiple hemangiomas, it is important to check for the presence of a hemangioma in the upper airway in anesthetic management. PMID:22702097

Imai, Eriko; Kawamata, Tomoyuki; Yamamoto, Katsumi; Mochidome, Mariko; Kawamata, Mikito

2012-05-01

35

Scientometrics of anesthetic drugs and their techniques of administration, 1984–2013  

PubMed Central

The aim of this study was to assess progress in the field of anesthetic drugs over the past 30 years using scientometric indices: popularity indices (general and specific), representing the proportion of articles on a drug relative to all articles in the field of anesthetics (general index) or the subfield of a specific class of anesthetics (specific index); index of change, representing the degree of growth in publications on a topic from one period to the next; index of expectations, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000) biomedical journals covered by PubMed; and index of ultimate success, representing a publication outcome when a new drug takes the place of a common drug previously used for the same purpose. Publications on 58 topics were assessed during six 5-year periods from 1984 to 2013. Our analysis showed that during 2009–2013, out of seven anesthetics with a high general popularity index (?2.0), only two were introduced after 1980, ie, the inhaled anesthetic sevoflurane and the local anesthetic ropivacaine; however, only sevoflurane had a high index of expectations (12.1). Among anesthetic adjuncts, in 2009–2013, only one agent, sugammadex, had both an extremely high index of change (>100) and a high index of expectations (25.0), reflecting the novelty of its mechanism of action. The index of ultimate success was positive with three anesthetics, ie, lidocaine, isoflurane, and propofol, all of which were introduced much longer than 30 years ago. For the past 30 years, there were no new anesthetics that have produced changes in scientometric indices indicating real progress. PMID:25525336

Vlassakov, Kamen V; Kissin, Igor

2014-01-01

36

[Ambulatory pediatric anesthesia: preanesthetic evaluation, anesthetic techniques, and immediate postoperative care].  

PubMed

The advantages of pediatric out-patient surgery are: 1) greater psychological ease; 2) lower rate of infection; 3) less impact on patient habits, and 4) lower cost. Surgery must not involve organs, must have a low rate of complications, and be short. The preanesthetic interview should include clinical history and complementary examinations, information on anesthetic technique, perioperative recommendations and psychological preparation of parents and child. Detailed information reassures parents and improves collaboration; their presence during induction may be useful. At this time complete fasting is not recommended; although solids are not permitted, clear liquids should be taken up to 2-3 hours before anesthesia. In this way the child is less irritable and hypoglycemia and hypotension during inhalational induction are prevented. Low doses of midazolam and ketamine have been used for premedication, which though possibly useful, is not recommended because recovery may be prolonged. Halogenated anesthetics are very useful, with nitrous oxide providing an excellent complement. The potentially toxic effect of halothane on the liver does not keep this agent from being the most popular. Recovery is fast with any of the usual hypnotics (etomidate, propofol, thiopentone). Although thiopentone continues to be the hypnotic drug of reference, propofol's versatility is causing it to gain wider acceptance. The use of atracurium or vecuronium is justified if the dose is adjusted in keeping with type of surgery and duration. Intraoperative analgesics include meperidine, fentanyl and alfentanyl; morphine is not recommended. Should tracheal intubation be necessary, laryngeal edema may be avoided by gentle, cautious laryngoscopy, the use of a tube without a balloon, and 3 h of postanesthetic observation. A laryngeal mask may serve as an alternative to tracheal intubation. Local-regional anesthesia, excepting epidural and spinal anesthesia, offers a number of advantages: blockade of nociceptive stimuli, avoidance of opioid drugs, rapid and pleasant awakening (excellent for postoperative analgesia), and less need for postoperative analgesics. The postoperative complications seen most often are related to respiration or hypertension, making routine postanesthetic pulse oximetry a recommendation. The most frequently used analgesics are paracetamol, magnesium dipyrone, diclofenac, ketorolac, or codeine compounds. Although the incidence of nausea and vomiting is low in children, they are frequently a cause of hospitalization. Inappropriate postoperative care can increase the rate of admissions and medico-legal problems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8372262

García-Pedrajas, F; Monedero, P

1993-01-01

37

Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma: a case report  

PubMed Central

A reninoma is an uncommon, benign, renin-secreting juxtaglomerular cell tumor that causes secondary hypertension in young patients. This hypertension is treated by tumor resection. Except for increased levels of plasma renin and angiotensin I and II, the other physical and laboratory examinations and electrocardiographs were within normal limits upon admission of a 19-year-old woman with a reninoma. For percutaneous computed tomography-guided radiofrequency ablation, general anesthesia was induced by thiopental sodium and rocuronium bromide and maintained with servoflurane (2-4 vol%) and oxygen. The operation ended uneventfully in hemodynamic stability. However, the patient complained of dizziness while sitting 5 hours after the operation, and hypotension was diagnosed. After aggressive normal saline (1 L) infusion over 30 min, the hypotension was corrected and the patient recovered without any other surgical complications. Here, we report the anesthetic management of a patient who underwent percutaneous computed tomography-guided radiofrequency ablation for reninoma destruction, particularly focusing on postoperative hypotension.

Gil, Nam-Su; Han, Jeong Yeol; Ok, Seong-Ho; Shin, Il-Woo; Lee, Heon Keun; Chung, Young-Kyun

2015-01-01

38

A national survey into perioperative anesthetic management of patients with a fractured neck of femur  

PubMed Central

Background We made a survey among Finnish anesthesiologists concerning the current perioperative anesthetic practice of hip fracture patients for further development in patient care. Methods All members of the Finnish Society of Anesthesiologists with a known e-mail address (786) were invited to participate in an internet-based survey. Results The overall response rate was 55% (423 responses); 298 respondents participated in the care of hip fracture patients. Preoperative analgesia was mostly managed with oxycodone and paracetamol; every fifth respondent applied an epidural infusion. Most respondents (98%) employed a spinal block with or without an epidural catheter for intraoperative anesthesia. Midazolam, propofol and/or fentanyl were used for additional sedation. General anesthesia was used rarely. Postoperatively, paracetamol and non-steroidal anti-inflammatory drugs and occasionally peroral oxycodone, were prescribed in addition to epidural analgesia. Conclusions The survey suggests that the impact of more individualised analgesia regimens, both preoperatively and postoperatively, should be investigated in further studies. PMID:22839198

2012-01-01

39

[Anesthetic management of a patient with carnitine palmitoyltransferase deficiency with a history of rhabdomyolysis].  

PubMed

Carnitine palmitoyltransferase (CPT) makes the fatty acids available through beta-oxidation. Deficiency of CPT causes difficulties of muscle cells to metabolize fatty acid. In affected patients, exercise, fast for a prolonged period, and stress, lead to exhaustion of the store of glucose in the body, and rhabdomyolysis may occur, since muscle can not utilize fatty acid as an alternative energy source. Therefore, anesthetic management of CPT deficiency needs infusion of glucose continuously, avoiding the use of the drugs that cause rhabdomyolysis and suppressing the surgical stress. A 67-year-old man, who had previous history of rhabdmyolysis during the postoperative period, and diagnosed CPT deficiency was scheduled for total gastrectomy. General anesthesia was induced with remifentanil, thiamylal and rocuronium after epidural catheter insertion. During surgery, general anesthesia was maintained with remifentanil, sevoflurane, and blood glucose was monitored frequently, with continuous glucose infusion. No complications occurred during anesthesia and perioperative course was uneventful. PMID:23544345

Nakamura, Sayaka; Sugita, Michiko; Nakahara, Eriko; Yamamoto, Tatsuo

2013-03-01

40

Comparison of noninvasive blood pressure measurement techniques via the coccygeal artery in anesthetized cheetahs (Acinonyx jubatus).  

PubMed

Two indirect blood pressure measurement techniques, Doppler (DOP) sphygmomanometry and oscillometry, applied at the ventral coccygeal artery were compared with simultaneous direct blood pressure measurements at the dorsal pedal artery in 10 anesthetized, captive cheetahs (Acinonyx jubatus). The DOP method was moderately accurate, with relatively little bias (mean difference 3.8 mmHg) and 88.6% of the DOP systolic arterial pressure measurements being within 10 mmHg of the direct systolic arterial measurement. With the oscillometric (OM) method, 89.2% of the mean arterial pressure measurements were within 10 mmHg of the direct measurement and had the least bias (mean difference 2.3 mmHg), 80.7% of the systolic measurements were within 10 mmHg of the direct measurement and had the second least bias (mean difference 2.3 mmHg), and 59% of the diastolic measurements were within 10 mmHg of the direct measurement and had significant bias (mean difference 7.3 mmHg). However, DOP showed relatively poor precision (SD 11.2 mmHg) compared with OM systolic (SD 8.0 mmHg), diastolic (SD 8.6 mmHg), and mean (SD 5.7 mmHg). Both techniques showed a linear relationship with the direct technique measurements over a wide range of blood pressures. The DOP method tended to underestimate systolic measurements below 160 mmHg and overestimate systolic measurements above 160 mmHg. The OM method tended to underestimate mean pressures below 160 mm Hg, overestimate mean pressures above 160 mmHg, underestimate systolic pressures below 170 mmHg, overestimate systolic pressures above 170 mmHg, and underestimate diastolic pressures throughout the measured blood pressure range. Indirect blood pressure measurement using the ventral coccygeal artery, particularly when using an OM device for mean and systolic arterial pressure, may be useful in the clinical assessment of cheetahs when monitoring trends over time, but caution should be taken when interpreting individual values. PMID:24450051

Sadler, Ryan A; Hall, Natalie H; Kass, Philip H; Citino, Scott B

2013-12-01

41

[Anesthetic management of a patient with severe subcutaneous and mediastinal emphysema due to pertussis infection].  

PubMed

A 20-month-old girl, with respiratory failure due to severe subcutaneous and mediastinal emphysema, was scheduled to undergo percutaneous drainage of emphysema and induction of extracorporeal membrane oxygenation. Paroxysm, a symptom of the infection of Bordetella pertussis, was the cause of emphysema. In patients with severe neck subcutaneous emphysema, management of difficult airway is the most important safety issue in the practice of anesthesia. Following the American Society of Anesthesiologist (ASA) guidelines for management of difficult airway, we prepared various types of equipment to facilitate intubation and surgeons were beside the patient during induction of anesthesia for emergency invasive airway access. To prevent the progression of emphysema, preservation of spontaneous breathing during the perioperative period was also important. Combined with propofol and midazolam, pethidine was an effective agent for safe anesthetic induction because it produces less respiratory depression compared to other opiate analgesics. In conclusion, this case demonstrates the importance of prediction of and preparation for difficult airway. Furthermore, anesthesiologists should consider the optimization of anesthesia to avoid progression of emphysema. PMID:24979862

Ideno, Satoshi; Miyazawa, Noriko; Ishikawa, Saki; Wakamiya, Rie; Shinto, Atsushi; Mikasa, Hiromi; Yamamoto, Shinichi

2014-06-01

42

[Anesthetic management of a patient with Fontan circulation with pacemaker failure].  

PubMed

We describe the anesthetic management of a 23-year-old female patient with severe bradycardia due to pacemaker lead disconnection. The pacemaker had been placed due to complete AV block following an extracardiac Fontan operation. She was scheduled for lead repair under general anesthesia. The preoperative HR was only 37 beats x min(-1) of idioventricular rhythm. As further bradycardia was a major concern, we prepared a percutaneous cardiac pacemaker and the catheterization laboratory for transatrial cardiac pacing. After placement of transcutaneous cardiac pacing pads on the chest, we administered isoproterenol at 0.01 microg x kg(-1) x min(-1). We confirmed an increase in HR to 50 beats x min(-1) and induced anesthesia, after which isoproterenol was administered at 0.015 microg x kg(-1) x min(-1). No bradycardia was observed perioperatively. Transvenous cardiac pacing, part of the last step in the ACLS bradycardia algorithm, is inappropriate except in patients with anatomic Fontan circulation. Furthermore, in the case of bradycardia, percutaneous or transesophageal cardiac pacing can be used; however, these are not always effective. Transatrial cardiac pacemakers are probably most effective for bradycardia with Fontan circulation but they should be placed by a catheter specialist, and emergency placement can be difficult. As described here, a special management protocol is necessary to control bradycardia in the face of Fontan circulation. PMID:24364280

Kamata, Mineto; Horimoto, Yoh

2013-11-01

43

Evaluation of Common Anesthetic and Analgesic Techniques for Tail Biopsy in Mice  

PubMed Central

Tail biopsy in mice is a common procedure in genetically modified mouse colonies. We evaluated the anesthetic and analgesic effects of various agents commonly used to mitigate pain after tail biopsy. We used a hot-water immersion assay to evaluate the analgesic effects of isoflurane, ice-cold ethanol, ethyl chloride, buprenorphine, and 2-point local nerve blocks before studying their effects on mice receiving tail biopsies. Mice treated with ethyl chloride spray, isoflurane and buprenorphine, and 2-point local nerve blocks demonstrated increased tail-flick latency compared with that of untreated mice. When we evaluated the behavior of adult and preweanling mice after tail biopsy, untreated mice demonstrated behavioral changes immediately after tail biopsy that lasted 30 to 60 min before returning to normal. The use of isoflurane, isoflurane and buprenorphine, buprenorphine, 2-point nerve block, or ethyl chloride spray in adult mice did not significantly improve their behavioral response to tail biopsy. Similarly, the use of buprenorphine and ethyl chloride spray in preweanling mice did not improve their behavioral response to tail biopsy compared with that of the untreated group. However, immersion in bupivacaine for 30 s after tail biopsy decreased tail grooming behavior during the first 30 min after tail biopsy. The anesthetic and analgesic regimens tested provide little benefit in adult and preweanling mice. Given that tail biopsy results in pain that lasts 30 to 60 min, investigators should carefully consider the appropriate anesthetic or analgesic regimen to incorporate into tail-biopsy procedures for mice. PMID:23294888

Jones, Carissa P; Carver, Scott; Kendall, Lon V

2012-01-01

44

Anesthetic management in a pediatric patient with Noonan syndrome, mastocytosis, and von Willebrand disease: a case report.  

PubMed

This case report describes anesthetic considerations for a 6-year-old boy, admitted for adenoidectomy under general anesthesia, who had a complicated medical history, including mastocytosis, Noonan syndrome, and von Willebrand disease. Each affected the anesthetic plan and was addressed preoperatively among all surgical and anesthesia providers. Mastocytosis created a major concern, with its increased numbers of histamine-filled mast cells. Each drug that was added or eliminated from the anesthetic plan, to prevent histamine release by the activation of triggers, was considered. Patient handling and temperature control were also concerns. One of Noonan syndrome's characteristics is heart anomalies. This patient had a history of a patent foramen ovale and pulmonary stenosis; therefore, air was carefully removed from all intravenous lines and syringes. The main concern for bleeding difficulties was attributed to the history of von Willebrand disease, which results in prolonged bleeding time and can lead to delayed bleeding or serious postsurgical hemorrhage. Desmopressin was administered preoperatively to increase platelet aggregation and the von Willebrand factor level. The use of aspirin and other nonsteroidal anti-inflammatory drugs was avoided. We discuss the clinical and anesthetic management of this case with a review of pertinent literature. PMID:17711156

Macksey, Lynn Fitzgerald; White, Beth

2007-08-01

45

Pacific Partnership 2008: the surgical mission, surgical screening process, and the anesthetic management of uncontrolled, untreated hypertensive patients.  

PubMed

United States Armed Forces and nongovernmental agencies on board the USNS Mercy provided humanitarian and civic assistance to over 68,000 patients in five southeastern Asian nations during Pacific Partnership 2008. A commitment to improving the health and well-being of the citizens of these countries along with strengthening diplomatic relationships between the United States and the host nations visited was paramount. This article focuses on surgical mission planning and perioperative anesthetic considerations of providing care for patients with uncontrolled untreated hypertension. Special consideration was required when providing anesthetic care to our patient population. The anesthesia team developed perioperative guidelines for these patients and experienced minimal complications for over 900 surgeries. The purpose herein is to provide guidance for future humanitarian missions regarding management of this clinical problem and to improve mission planning. PMID:20108840

King, Heather Cuniff; Baker, William

2010-01-01

46

Anesthetic dilemmas for dynamic evaluation of the pediatric upper airway.  

PubMed

Sleep cine magnetic resonance imaging and drug-induced sleep endoscopy are currently used to examine the patterns of dynamic airway collapse in children with obstructive sleep apnea. Providing anesthesia that mimics physiologic sleep in these children is a challenge but is critical for accurate interpretation of the airway evaluation. Anesthetic agents might negatively affect the upper airway evaluation. The anesthetic technique in these patients must be tailored to improve patient safety and obtain optimal study. This review focuses on the periprocedural challenges and anesthetic management of children presenting for dynamic evaluation of the upper airway. PMID:25172630

Chatterjee, Debnath; Friedman, Norman; Shott, Sally; Mahmoud, Mohamed

2014-12-01

47

The twin block: a simple technique to block both the masseteric and the anterior deep temporal nerves with one anesthetic injection.  

PubMed

The objective of this article is to describe a new technique to anesthetize the masseter muscle and the temporalis muscle using a single extraoral approach. The block targets both the masseteric and the deep temporal nerves as they leave the infratemporal fossa to innervate the deep surfaces of their respective muscles. PMID:24703404

Quek, Samuel; Young, Andrew; Subramanian, Gayathri

2014-09-01

48

Anesthetic Management for Implantation of the Jarvik 2000??? Left Ventricular Assist System  

Microsoft Academic Search

TheJarvik2000Heart™isaleftventricularassistdevice that produces continuous nonpulsatile axial flow by means of a single, rotating, vaned impeller. Anesthetic and perioperative considerations of the Jarvik 2000 Heart™ differ from those of conventional assist de- vices. The Jarvik 2000 is implanted within the left ven- tricle through a left thoracotomy, which is aided by left lung isolation. A brief period of cardiopulmonary by- pass

Nancy A. Nussmeier; Charles B. Probert; Douglas Hirsch; John R. Cooper; Igor D. Gregoric; Timothy J. Myers; O. H. Frazier

2003-01-01

49

Anesthetic management of an orangutan (Pongo abelii/pygmaeus) undergoing laparoscopic tubal ligation.  

PubMed

An adult hybrid orangutan (Pongo abelii/pygmaeus) was presented to a veterinary teaching hospital for laparoscopic tubal ligation. The orangutan was immobilized with the use of injectable anesthetic agents, then orotracheally intubated. Anesthesia was maintained with the use of isoflurane in oxygen, and positive-pressure ventilation was used to ensure adequate gas exchange. Parameters monitored included arterial blood pressure, ECG, capnometry, and arterial blood gases. Anesthesia was uneventful, and recovery was smooth. PMID:17315439

Hendrix, Paula K

2006-12-01

50

Anesthetic management of comprehensive dental restoration in a child with glutaric aciduria type 1 using volatile sevoflurane.  

PubMed

Glutaric aciduria type 1 (GA1) is a rare, inherited mitochondrial disorder that results from deficiency of mitochondrial glutaryl-CoA dehydrogenase. Most patients develop neurological dysfunction early in life, which leads to severe disabilities. We present a 37-month-old girl with GA1 manifested as macrocephaly and hypotonia who received comprehensive dental restoration surgery under general anesthesia with sevoflurane. She was placed on specialized fluid management during a preoperative fasting period and anesthesia was administered without complications. All the physiological parameters, including glucose and lactate blood levels and arterial blood gas were carefully monitored and maintained within normal range perioperatively. Strategies for anesthetic management should include prevention of pulmonary aspiration, dehydration, hyperthermia and catabolic state, adequate analgesia to minimize surgical stress, and avoidance of prolonged neuromuscular blockade. We administered general anesthesia with sevoflurane uneventfully, which was well tolerated by our patient with GA1. Additionally, communication with a pediatric geneticist and surgeons should be undertaken to formulate a comprehensive anesthetic strategy in these patients. PMID:25107500

Teng, Wei-Nung; Lin, Su-Man; Niu, Dau-Ming; Kuo, Yi-Min; Chan, Kwok-Hon; Sung, Chun-Sung

2014-10-01

51

Anesthetic management of an 8-month-old infant with osteogenesis imperfecta undergoing liver transplantation: a case report  

PubMed Central

Anesthetic management of pediatric liver transplantation in a patient with osteogenesis imperfecta (OI) requires tough decisions and comprehensive considerations of the cascade of effects that may arise and the required monitoring. Total intravenous anesthesia (TIVA) with propofol and remifentanil was chosen as the main anesthetic strategy. Malignant hyperthermia (MH), skeletal fragility, anhepatic phase during liver transplantation, uncertainties of TIVA in children, and propofol infusion syndrome were considered and monitored. There were no adverse events during the operation. Despite meticulous precautions with regard to the risk of MH, there was an episode of high fever (40?) in the ICU a few hours after the operation, which was initially feared as MH. Fortunately, MH was ruled out as the fever subsided soon after hydration and antipyretics were given. Although the delivery of supportive care and the administration of dantrolene are the core principles in the management of MH, perioperative fever does not always mean a MH in patients at risk for MH, and other common causes of fever should also be considered. PMID:25006373

Lee, Jiwon; Kim, Anna; Yoo, Seokha; Shin, Seung-Yeon; Kang, Sun-Hye; Jeong, Jinyoung; Yoo, Yongjae

2014-01-01

52

Anesthetic management of HELLP syndrome complicating primary antiphospholipid syndrome -A case report-  

PubMed Central

Antiphospholipid syndrome (APS) is defined as an autoimmune disorder characterized by recurrent thrombosis or obstetrical morbidity. A 29-year-old woman who was diagnosed with APS underwent emergency cesarean delivery at 23 weeks' gestation. She had a seizure attack and her laboratory findings were: AST/ALT 1459/1108 IU/L, LDH 1424 IU/L, 30% hematocrit, a platelet count of 43 × 103/ml and urine protein (4+). We describe the anesthetic experience of catastrophic HELLP syndrome with antiphospholipid syndrome and we review the relevant literature. PMID:22778897

Jo, Youn Yi; Lee, Kyung Cheon; Kim, Hong Soon; Bae, Hyun Kyung

2012-01-01

53

A comparison of injection pain and postoperative pain of two intraosseous anesthetic techniques.  

PubMed Central

The purpose of this prospective, randomized, blinded study was to compare injection pain and postoperative pain of an apical primary X-Tip intraosseous technique to a coronal primary Stabident intraosseous technique in mandibular first molars. Using a repeated-measures design, 41 subjects randomly received 2 primary intraosseous injections at 2 separate appointments. Using a site distal to the mandibular first molar for both injections, the subjects received 1.8 mL of 2% lidocaine with 1: 100,000 epinephrine administered with the X-Tip system using an apical location in alveolar mucosa or 1.8 mL of 2% lidocaine with 1: 100,000 epinephrine administered with the Stabident system using a coronal location in attached gingiva. The pain of infiltration, perforation, needle insertion, solution deposition, mock or actual guide sleeve removal and postoperative pain were recorded on a Heft-Parker visual analogue scale (VAS) scale for the 2 intraosseous systems. The results demonstrated that the apical primary X-Tip intraosseous technique was not statistically different (P > .05) from the coronal primary Stabident technique regarding pain ratings of infiltration, perforation, needle insertion, solution deposition, mock or actual guide sleeve removal and postoperative pain (at the time subjective anesthesia wore off). However, on postoperative days 1 through 3, significantly (P < .05) more males experienced postoperative pain with the X-Tip system than with the Stabident system. Images Figure 1 Figure 2 PMID:14558586

Gallatin, Juliane; Nusstein, John; Reader, Al; Beck, Mike; Weaver, Joel

2003-01-01

54

Anesthetic management of primary hyperparathyroidism: A role rarely noticed and appreciated so far  

PubMed Central

Endocrine surgeries have been on the rise for the last few years. During surgery, endocrine disorders present unique challenges to the endocrinologist and to the attending anesthesiologist. The endocrine, electrolyte and metabolic disturbances resulting from such disorders can have a profound effect on the normal human physiological milieu. Surgery of parathyroid glands is no exception and is associated with a multiple challenges during pre-, intra-, and post-operative period. Pre-op examination and optimization is essential so as to prevent any intra-op or post-op complications. The most striking electrolyte disturbance during parathyroid surgery is the imbalance of calcium levels in the body and the main emphasis during the entire peri-operative period revolves around the maintenance of normal serum calcium levels. The present article review in depth the various anesthetic considerations and implications during parathyroid surgery with an emphasis on pre-op preparation for elective and emergency surgery. PMID:23776894

Bajwa, Sukhminder Jit Singh; Sehgal, Vishal

2013-01-01

55

Anesthetic management for cesarean delivery in a Guillain-Barré syndrome patient -A case report-  

PubMed Central

Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barré syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report a Cesarean delivery in the case of a 32-year old woman who was diagnosed with Guillain-Barré syndrome 18 weeks into gestation. Tracheostomy was performed due to progressive respiratory muscle weakness and respiratory failure, and ventilator support was required in the intensive care unit. The respiratory difficulty was exacerbated by the growth of the fetus, necessitating emergency Cesarean delivery. The delivery was successfully performed under general anesthesia, and the patient recovered without neurological sequelae. PMID:23560196

Kim, Hyunbin; Ryu, Junghee; Do, Sang-Hwan

2013-01-01

56

Aerospace management techniques: Commercial and governmental applications  

NASA Technical Reports Server (NTRS)

A guidebook for managers and administrators is presented as a source of useful information on new management methods in business, industry, and government. The major topics discussed include: actual and potential applications of aerospace management techniques to commercial and governmental organizations; aerospace management techniques and their use within the aerospace sector; and the aerospace sector's application of innovative management techniques.

Milliken, J. G.; Morrison, E. J.

1971-01-01

57

Anesthetic considerations in myofibrillar myopathy.  

PubMed

Myofibrillar myopathy (MFM) is a relatively newly recognized genetic disease that leads to progressive muscle deterioration. MFM has a varied phenotypic presentation and impacts cardiac, skeletal, and smooth muscles. Affected individuals are at increased risk of respiratory failure, significant cardiac conduction abnormalities, cardiomyopathy, and sudden cardiac death. In addition, significant skeletal muscle involvement is common, which may lead to contractures, respiratory insufficiency, and airway compromise as the disease progresses. This study is the first report of anesthetic management of a patient with MFM. We report multiple anesthetic encounters of a child with genetically confirmed BAG3-myopathy, a subtype of MFM with severe childhood disease onset. A review of the anesthetic implications of the disease is provided, with specific exploration of possible susceptibility to malignant hyperthermia, rhabdomyolysis, and sensitivity to other anesthetic agents. PMID:25216331

Latham, Gregory J; Lopez, Grace

2015-03-01

58

Anesthetic management in patients suspected of Creutzfeldt-Jakob disease -A case report-  

PubMed Central

Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disorder in which accumulation of the pathogenic prion protein induces neuronal damage and results in distinct pathologic features. This abnormal prion is an infectious protein and resistant to methods of sterilization currently being used. Therefore, management of definite, or suspected CJD patients requires additional precautions. We report our experience of a patient who had undergone brain biopsy for suspected of CJD. The patient was confirmed to have sporadic CJD. PMID:22025951

In, Chi Bum; Choi, Young Sil; Park, Eun Young; Chang, Dong Jin; Choi, Hyun; Moon, Hyun Soo

2011-01-01

59

Anesthetic management of antiphospholipid syndrome patients who underwent cardiac surgery: three cases report  

PubMed Central

Antiphospholipid syndrome (APS) is a rare disease in which patients display prolonged coagulation test results in vitro, but usually develop thrombotic symptoms in vivo. Patients with APS are at increased risk of valvular heart disease or coronary vascular disease, conditions that often necessitate cardiac surgery via bypass. The management of anticoagulation during cardiopulmonary bypass (CPB) is particularly challenging in these patients because of the unique features of APS. Patients with APS are constantly at risk of arterial and venous thrombotic events. Therefore it is very important to maintain proper anticoagulation perioperatively, especially during CPB. In this paper, we present three successful cases of APS patients who underwent cardiac surgery with CPB. PMID:24624277

Cho, Hyunwook; Hong, Deok Man; Kim, Hyun Joo; Min, Jeong Jin

2014-01-01

60

[Anesthetic management of a patient with moyamoya disease undergoing mitral valve repair].  

PubMed

Moyamoya disease is the result of progressive steno-occlusive changes in the internal carotid arteries followed by formation of bilateral abnormal vascular networks. The disease may present with cerebral ischemia causing cerebral hemorrhage in the perioperative period. There are few reports of cardiac surgeries in patients with moyamoya disease, and the management during cardiopulmonary bypass for moyamoya disease has not been established. We gave general anesthesia for mitral valve plasty in patient with the moyamoya disease. A 52-year-old woman underwent mitral valve plasty. She had been diagnosed with moyamoya disease and during the cardiopulmonary bypass, we used alpha-stat blood gas management with mild hypothermia, and maintained PaCO2 around 40 mmHg. We maintained the perfusion flow of CPB above 3.0 l x min(-1) x m(-2) and the mean perfusion pressure above 70 mmHg. In addition, we used the pulsatile perfusion assist with intraaortic balloon pumping to maintain cerebral circulation. Postoperative course was uneventful without apparent neurologic deficit, and she was discharged from hospital on 10th postoperative day. PMID:24724448

Ishikawa, Saki; Yamada, Tatsuya; Sakaguchi, Ryota; Hatori, Eiki; Morisaki, Hiroshi

2014-03-01

61

Transfusion-free anesthetic management for open heart surgery in a neonate -A case report-  

PubMed Central

In small infants or neonates, open heart surgery without transfusion can have many risks regarding inadequate oxygen delivery and coagulopathy. However, if parents refuse blood transfusion, cardiac surgery without transfusion should be considered. We report a case of bloodless cardiac surgery in a 2.89 kg neonate with Jehovah's Witness parents. Blood conserving strategies were used. Preoperatively, erythropoietin and iron were supplemented to increase the hemoglobin level. Intraoperatively, techniques for minimizing blood loss were used, such as reducing priming volume for cardiopulmonary bypass, a blood salvage system, and modified ultrafiltration. Postoperatively, pharmacologic agents were administered and blood sampling was minimized. PMID:21286425

Lee, Jung Min; Byon, Hyo-Jin; Kim, Hee-Soo; Kim, Chong Sung

2010-01-01

62

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report  

PubMed Central

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis. PMID:25368787

Park, Sang-hee; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

2014-01-01

63

Anesthetic Consideration for Neurointerventional Procedures  

PubMed Central

Interventional neuroradiology (INR) has been a rapidly expanding and advancing clinical area during the past few decades. As the complexity and diversity of INR procedures increases, the demand for anesthesia also increases. Anesthesia for interventional neuroradiology is a challenge for the anesthesiologist due to the unfamiliar working environment which the anesthesiologist must consider, as well as the unique neuro-interventional components. This review provides an overview of the anesthetic options and specific consideration of the anesthesia requirements for each procedure. We also introduce the anesthetic management for interventional neuroradiology performed in our medical institution. PMID:25426301

Joung, Kyung Woon; Yang, Ku Hyun; Shin, Won Jung; Song, Myung Hee; Ham, Kyungdon; Jung, Seung Chul; Lee, Deok Hee

2014-01-01

64

Environmental implications of anesthetic gases.  

PubMed

For several decades, anesthetic gases have greatly enhanced the comfort and outcome for patients during surgery. The benefits of these agents have heavily outweighed the risks. In recent years, the attention towards their overall contribution to global climate change and the environment has increased. Anesthesia providers have a responsibility to minimize unnecessary atmospheric pollution by utilizing techniques that can lessen any adverse effects of these gases on the environment. Moreover, health care facilities that use anesthetic gases are accountable for ensuring that all anesthesia equipment, including the scavenging system, is effective and routinely maintained. Implementing preventive practices and simple strategies can promote the safest and most healthy environment. PMID:23241038

Yasny, Jeffrey S; White, Jennifer

2012-01-01

65

Management Styles and Techniques: People.  

ERIC Educational Resources Information Center

Three articles discuss management of library technical processes personnel. The first article focuses on the employer employee relationship and communication; the second explores management trends, including participative decision making, personnel evaluation, management by objectives, and the collegial system; and the third focuses on the…

DeLoach, Marva L.; And Others

1987-01-01

66

A new technique using fibrin glue in the management of auricular hematoma.  

PubMed

: This study aims to describe a new technique for the management of auricular hematoma using fibrin glue. Five difficult cases of auricular hematoma were managed using this technique, including 2 recurrent and 3 delayed presentations. After skin preparation and local anesthetic, an incision was made, the hematoma was evacuated, and the cavity was washed out with saline. Fibrin glue was applied liberally; a dental roll pressure dressing was applied and secured with a prolene bead suture. The patients were given a course of oral antibiotic and reviewed after 5 days for removal of the external dressing. They were later assessed to exclude re-accumulation of the hematoma. All patients had complete resolution of the hematoma without re-accumulation; they were satisfied with the cosmetic results and experienced no complications. This case series provides evidence that fibrin glue is effective in the management of auricular hematoma. Larger studies may provide further evidence of the effectiveness of this new technique. PMID:24699189

Mohamad, Shwan H; Barnes, Martyn; Jones, Stephen; Mahendran, Suresh

2014-11-01

67

Techniques for integrated water resources management  

NASA Astrophysics Data System (ADS)

The course, Decision Support Techniques for Integrated Water Resources Management, is designed mainly for technical managers and staff of water resources management agencies at the international, national, regional, and local water board level, as well as consultants in other professions working in or interested in the field of water resources development, planning, and operation. It will be held in Wageningen, The Netherlands, June 10-15, 1991.The course objective is to promote better understanding and dissemination of techniques to be applied in “real-world” integrated water resources management. The course offers an introduction to the concepts of decision modeling, plus ample case studies to demonstrate their applicability. It covers decision theory, operations research and simulation methods, as well as certain aspects of law and psychology. Selected multiple objective techniques will be presented, followed by an overview of recent trends in the field. Computer-based techniques will be demonstrated.

68

Anesthetic management of a patient undergoing liver transplantation who had previous coronary artery bypass grafting using an in situ right gastroepiploic artery.  

PubMed

We describe successful anesthetic management during living-donor liver transplantation in a 63-year-old man with previous coronary artery bypass grafting (CABG) that employed an in situ right gastroepiploic artery (RGEA). Anesthesia was maintained with 1.5% isoflurane in air/oxygen and fentanyl. A five-lead electrocardiogram, transesophageal echocardiogram, and pacing pulmonary artery catheter evaluated cardiac function. A pacing wire was inserted through the catheter to prepare for intraoperative severe bradyarrhythmia. Olprinone and nicorandil were continuously infused to prevent decrease in coronary arterial blood flow and the collapse of cardiac function. Avoiding disruption of circulation to coronary arteries through injury or spasm of the RGEA graft and preparing for cardiac insufficiency during liver transplantation of a patient with previous CABG using an in situ RGEA is critical. PMID:20191293

Murata, Hiroaki; Inoue, Haruka; Sumikawa, Koji

2010-04-01

69

Stress Management Techniques for Young Children.  

ERIC Educational Resources Information Center

The director of a not-for-profit nursery school adapted the adult stress management techniques of exercise and relaxation for use with 3- to 5-year-old children. Specifically, children were taught visualization techniques and yoga exercises involving deep breathing. The goal of the practicum was to rechannel children's negative stress-related…

Piper, Francesca M.

70

The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery  

PubMed Central

Purpose. To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects. Methods. Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1), 30?min after tourniquet inflation (t2), immediately before (t3), and 5?min (t4), 15?min (t5), 30?min (t6), 1?h (t7), 2?h (t8), and 6?h (t9) after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9. IMA levels in Group T were significantly lower than those in Group S at t2–t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. Conclusions. TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion. PMID:24701585

Ko?ucu, Müge; Co?kun, ?lker; Eroglu, Ahmet; Kutanis, Dilek; Mente?e, Ahmet; Karahan, S. Caner; Baki, Emre; Kerimo?lu, Servet; Topbas, Murat

2014-01-01

71

Increase Productivity - Implement Energy Management Systems with Project Management Techniques  

E-print Network

INCREASE PRODUCTIVITY IMPLEMENT ENERGY MANAGEMENT SYSTEMS WITH PROJECT MANAGEMENT TECHNIQUES M. Pete Spinner, P.E. Glass Division, Ford Motor Company Detroit, Michigan Lawrence Institute of Technology Southfield, Michigan ABSTRACT... major work items that have to be done to prepare have climbed appreciably (from $0.50 to $1 per the feasibility report. million BTU in 1978 to $4 and $5 in 1982) there has been an abrupt halt in 1983 to escalating This presentation highlights the work...

Spinner, M. P.

1984-01-01

72

Anesthetic management of patient with systemic lupus erythematosus and antiphospholipid antibodies syndrome for laparoscopic nephrectomy and cholecystectomy  

PubMed Central

We report a case of a female having systemic lupus erythematosus and antiphospholipid antibodies syndrome, who was on immunosuppressant therapy. We discussed the preoperative evaluation and perioperative management who underwent nephrectomy and cholecystectomy.

Khokhar, Rashid Saeed; Baaj, Jumana; Al-Saeed, Abdulhamid; Sheraz, Motasim

2015-01-01

73

Anesthetic manipulation in extreme airway stenosis: a case report  

PubMed Central

Introduction Anesthetic management with airway stenosis is challenging. Techniques for maintaining spontaneous respiration are required under sedative and analgesic conditions. Case presentation A 35-year-old Chinese woman presented to our hospital with difficulty breathing. Computerized tomography showed a tumor in the frontal area of her neck, which was causing extreme narrowing of her trachea. She was immediately scheduled for emergency surgery to remove the tumor. Fiberscopic intubation was carefully performed with dexmedetomidine sedation and remifentanil analgesia. Spontaneous respiration was successfully maintained. Conclusion In cases of extreme airway stenosis, intubation can be safely achieved with dexmedetomidine sedation and remifentanil analgesia. PMID:25186092

2014-01-01

74

Neurometric assessment of intraoperative anesthetic  

DOEpatents

The present invention is a method and apparatus for collecting EEG data, reducing the EEG data into coefficients, and correlating those coefficients with a depth of unconsciousness or anesthetic depth, and which obtains a bounded first derivative of anesthetic depth to indicate trends. The present invention provides a developed artificial neural network based method capable of continuously analyzing EEG data to discriminate between awake and anesthetized states in an individual and continuously monitoring anesthetic depth trends in real-time. The present invention enables an anesthesiologist to respond immediately to changes in anesthetic depth of the patient during surgery and to administer the correct amount of anesthetic. 7 figs.

Kangas, L.J.; Keller, P.E.

1998-07-07

75

Neurometric assessment of intraoperative anesthetic  

DOEpatents

The present invention is a method and apparatus for collecting EEG data, reducing the EEG data into coefficients, and correlating those coefficients with a depth of unconsciousness or anesthetic depth, and which obtains a bounded first derivative of anesthetic depth to indicate trends. The present invention provides a developed artificial neural network based method capable of continuously analyzing EEG data to discriminate between awake and anesthetized states in an individual and continuously monitoring anesthetic depth trends in real-time. The present invention enables an anesthesiologist to respond immediately to changes in anesthetic depth of the patient during surgery and to administer the correct amount of anesthetic.

Kangas, Lars J. (West Richland, WA); Keller, Paul E. (Richland., WA)

1998-01-01

76

Anesthetic management of a patient with Henoch-Schonlein purpura for drainage of cervical lymphadenitis: A case report.  

PubMed

Henoch-Schonlein purpura (HSP) is a multisystem disease and immunoglobulin A-mediated vasculitis with a self-limited course affecting the skin, joints, gastrointestinal tract, and kidneys. Severe renal and central nervous system disease may lead to life-threatening conditions, and immunosuppressive agents and plasmapheresis may be needed. We report successful management of a 6-year-old patient with HSP for drainage of cervical lymphadenitis. PMID:24843348

Hasija, Neha; Taxak, Susheela; Bhardwaj, Mamta; Vashist, Kirti

2014-04-01

77

Anesthetic considerations on adrenal gland surgery.  

PubMed

Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues. This review will focus on the endocrine issues, as well as on the above-mentioned aspects of anesthetic management during hormone secreting adrenal gland tumor resection. PMID:25368694

Domi, Rudin; Sula, Hektor; Kaci, Myzafer; Paparisto, Sokol; Bodeci, Artan; Xhemali, Astrit

2015-01-01

78

Anesthetic Considerations on Adrenal Gland Surgery  

PubMed Central

Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues. This review will focus on the endocrine issues, as well as on the above-mentioned aspects of anesthetic management during hormone secreting adrenal gland tumor resection. PMID:25368694

Domi, Rudin; Sula, Hektor; Kaci, Myzafer; Paparisto, Sokol; Bodeci, Artan; Xhemali, Astrit

2015-01-01

79

Management Science Techniques for Consultants (MSTC)  

NSDL National Science Digital Library

Michael Trick, Associate Professor of Industrial Administration at Carnegie-Mellon University, has designed a course to give consultants (and others who want to improve their quantitative skills) an introduction to a variety of useful techniques in management science, with an emphasis on practicality. The course covers sensitivity analysis, solving large problems, integer programming, heuristic decision-making, genetic algorithms/neural networks, relaxations, network models, data envelopment analysis, scenario optimization and multiple objective decision making. In addition to the class notes, the site also contains the homework for the class.

Trick, Michael A.

1998-01-01

80

Management Science Techniques for Consultants (MSTC)  

NSDL National Science Digital Library

Michael Trick, Associate Professor of Industrial Administration at Carnegie-Mellon University, has designed a course to give consultants (and others who want to improve their quantitative skills) an introduction to a variety of useful techniques in management science, with an emphasis on practicality. The course covers sensitivity analysis, solving large problems, integer programming, heuristic decision-making, genetic algorithms/neural networks, relaxations, network models, data envelopment analysis, scenario optimization and multiple objective decision making. In addition to the class notes, the site also contains the homework for the class.

Trick, Michael A.

2005-11-01

81

Highlights of anesthetic considerations for intraoperative neuromonitoring.  

PubMed

Though relatively new, intraoperative neurophysiological monitoring (IONM) has become standard of care for many neurosurgical procedures. The use of IONM has substantially decreased the rate of paralysis after deformity surgery, and has been validated in cervical spine surgery, and thoracic and lumbar laminectomy (1) (2), (3). The main modalities are: somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and electromyography (EMGs). Each test examines a functionally separate area of the spinal cord, which test is chosen depends on the location of the surgery and the patient's preexisting injuries and deficits (6). Inhaled anesthetics decrease the waveform amplitude and increase latency, intravenous anesthetics have the same effect but to a lesser degree. Best anesthetic regimen for surgery involving intraoperative monitoring is controversial. Both inhaled and intravenous agents depress signal attainment, however for equal MAC concentrations inhaled agents cause more depression(11). While studies have shown that halogenated agents and nitrous oxide do in fact depress MEP signals more than total intravenous anesthesia, less is known on the relationship between IONM and patient characteristics. Lo's study documenting MEP attainment with 0.5 MAC was done in an otherwise healthy scoliosis population (12), and no study to date has analyzed signal attainment in correlation with patient characteristics and anesthetic technique. While it is clear that anesthetic technique is extremely important, certain patient characteristics appear to be more common in difficult to monitor patients. The identification of these characteristics would suggest to the anesthesiologist the need for a more stringent technique (TIVA) and avert surgical delay or cancellation due to inability to obtain baseline or worse- loss of intraoperative waveform and need for a Stagnara wake-up test. Our group at Mt. Sinai has retrospectively studied patient characteristics, anesthetic technique and attainment of neuromonitoring signals. Hypertension and diabetes are independent predictors of monitoring failure, and these are preferentially sensitive to inhalational agents. Age and weight are also predictors, but less significant. In summary, neurophysiologic monitoring has evolved to be a consistent part of many procedures. The anesthesiologist should strive to understand the rationale behind monitoring and the basis of its utility. IONM has many implications for anesthetic technique and need for control of the physiologic milieu. With this knowledge the anesthesiologist can work together with the neuromonitoring team and surgeon to ensure patient safety during and after surgery. PMID:20472627

Deiner, Stacie

2010-03-01

82

Hepatotoxicity of Halogenated Inhalational Anesthetics  

PubMed Central

Context: Halogenated inhalational anesthetics are currently the most common drugs used for the induction and maintenance of general anesthesia. Postoperative hepatic injury has been reported after exposure to these agents. Based on much evidence, mechanism of liver toxicity is more likely to be immunoallergic. The objective of this review study was to assess available studies on hepatotoxicity of these anesthetics. Evidence Acquisition: We searched PubMed, Google Scholar, Scopus, Index Copernicus, EBSCO and the Cochrane Database using the following keywords: “inhalational Anesthetics” and “liver injury”; “inhalational anesthetics” and “hepatotoxicity”; “volatile anesthetics” and “liver injury”; “volatile anesthetics” and hepatotoxicity for the period of 1966 to 2013. Fifty two studies were included in this work. Results: All halogenated inhalational anesthetics are associated with liver injury. Halothane, enflurane, isoflurane and desflurane are metabolized through the metabolic pathway involving cytochrome P-450 2E1 (CYP2E1) and produce trifluoroacetylated components; some of which may be immunogenic. The severity of hepatotoxicity is associated with the degree by which they undergo hepatic metabolism by this cytochrome. However, liver toxicity is highly unlikely from sevoflurane as is not metabolized to trifluoroacetyl compounds. Conclusions: Hepatotoxicity of halogenated inhalational anesthetics has been well documented in available literature. Halothane-induced liver injury was extensively acknowledged; however, the next generation halogenated anesthetics have different molecular structures and associated with less hepatotoxicity. Although anesthesia-induced hepatitis is not a common occurrence, we must consider the association between this disorder and the use of halogenated anesthetics.

Safari, Saeid; Motavaf, Mahsa; Seyed Siamdoust, Seyed Alireza; Alavian, Seyed Moayed

2014-01-01

83

Fault Management Techniques in Human Spaceflight Operations  

NASA Technical Reports Server (NTRS)

This paper discusses human spaceflight fault management operations. Fault detection and response capabilities available in current US human spaceflight programs Space Shuttle and International Space Station are described while emphasizing system design impacts on operational techniques and constraints. Preflight and inflight processes along with products used to anticipate, mitigate and respond to failures are introduced. Examples of operational products used to support failure responses are presented. Possible improvements in the state of the art, as well as prioritization and success criteria for their implementation are proposed. This paper describes how the architecture of a command and control system impacts operations in areas such as the required fault response times, automated vs. manual fault responses, use of workarounds, etc. The architecture includes the use of redundancy at the system and software function level, software capabilities, use of intelligent or autonomous systems, number and severity of software defects, etc. This in turn drives which Caution and Warning (C&W) events should be annunciated, C&W event classification, operator display designs, crew training, flight control team training, and procedure development. Other factors impacting operations are the complexity of a system, skills needed to understand and operate a system, and the use of commonality vs. optimized solutions for software and responses. Fault detection, annunciation, safing responses, and recovery capabilities are explored using real examples to uncover underlying philosophies and constraints. These factors directly impact operations in that the crew and flight control team need to understand what happened, why it happened, what the system is doing, and what, if any, corrective actions they need to perform. If a fault results in multiple C&W events, or if several faults occur simultaneously, the root cause(s) of the fault(s), as well as their vehicle-wide impacts, must be determined in order to maintain situational awareness. This allows both automated and manual recovery operations to focus on the real cause of the fault(s). An appropriate balance must be struck between correcting the root cause failure and addressing the impacts of that fault on other vehicle components. Lastly, this paper presents a strategy for using lessons learned to improve the software, displays, and procedures in addition to determining what is a candidate for automation. Enabling technologies and techniques are identified to promote system evolution from one that requires manual fault responses to one that uses automation and autonomy where they are most effective. These considerations include the value in correcting software defects in a timely manner, automation of repetitive tasks, making time critical responses autonomous, etc. The paper recommends the appropriate use of intelligent systems to determine the root causes of faults and correctly identify separate unrelated faults.

O'Hagan, Brian; Crocker, Alan

2006-01-01

84

Application of nanogel systems in the administration of local anesthetics  

PubMed Central

Nanogels are robust nanoparticles that could be used to deliver active drug compounds in controlled drug delivery applications. This review discusses the design, synthesis, loading, and release of local anesthetics using polymeric nanoparticles produced via various types of polymerization techniques. The strategy of using layer-by-layer approach to control the burst release of procaine hydrochloride (PrHy; a local anesthetic drug of the amino ester group) is described and discussed. PMID:22915875

Tan, Jeremy PK; Tan, Maureen BH; Tam, Michael KC

2010-01-01

85

Does the choice of anesthetic technique affect the recovery of bowel function after radical prostatectomy? 1 1 The opinions expressed in this manuscript reflect those of the authors and do not represent official policy of the Uniformed Services University or of the Department of Defense  

Microsoft Academic Search

Objectives. Return of bowel function after radical prostatectomy surgery may be the limiting factor in discharging these patients from the hospital. Recent studies have shown that postoperative epidural infusion of bupivacaine decreases time to return of bowel function compared with intravenous and epidural morphine in patients after abdominal surgery. This study focuses on the role of the intraoperative anesthetic technique

Rom A Stevens; Marianne Mikat-Stevens; Robert Flanigan; W. Bedford Waters; P. A. T Furry; Taqdees Sheikh; Kere Frey; Mary Olson; Bruce Kleinman

1998-01-01

86

Challenges for the cataract surgeon treating people with dementia: a qualitative study exploring anesthetic choices  

PubMed Central

Background In light of the growing number of people with dementia and age-related cataract, as well as changing anesthetic practices for cataract surgery, this study aimed to explore the experiences of cataract surgeons in managing patients with dementia and making anesthetic decisions. Methods This was a qualitative study using semistructured interviews with senior cataract surgeons from two centers in England. Fourteen surgeons were interviewed, and a thematic approach informed by grounded theory was used for the analysis. Results Choice of anesthesia for people with dementia was a central theme arising from the data. Surgeons varied in their thresholds for using general anesthesia. Decisions about suitability for local anesthesia were limited by time constraints and generally made rapidly and based on instinct; dementia was not always apparent at the point of preassessment. Surgeons used a variety of topical, sub-Tenon’s, and sharp needle blocks for people with dementia. Surgeons discussed techniques to help patients tolerate local anesthesia, such as clear communication, a primary nurse, hand-holding, and support from an anesthetist. However, within our sample, some surgeons had had negative experiences of operating on people with dementia, where an incorrect judgment had been made that they could tolerate local anesthetic cataract surgery. Conclusion This study highlights the differing practices of cataract surgeons when making anesthetic choices for people with dementia and the challenges they face. In order to avoid the situation of a patient with dementia becoming distressed during awake surgery, increased time at preassessment and anesthetic support may be beneficial. PMID:25328382

Jefferis, Joanna Mary; Clarke, Michael Patrick; Taylor, John-Paul; Brittain, Katie Rhian

2014-01-01

87

ISWHM: Tools and Techniques for Software and System Health Management  

NASA Technical Reports Server (NTRS)

This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan

2010-01-01

88

Congenital maxillomandibular syngnathia: a new management technique using distraction techniques.  

PubMed

Complex zygomaticomandibular syngnathia is an extremely rare condition with an unknown etiology. The main goal of the surgery is to release the ankylosis, establish good functioning mandible, and prevent reankylosis, if possible. In our case, we offer a new solution to have an adequate oral opening and to prevent reankylosis. After the release of bony syngnathia, we placed a distractor between mandibular segment and maxillozygomatic complex. To our best knowledge, this is the only syngnathia case in the literature treated using distraction techniques. There is a major improvement in the patient's status. Distraction may broaden our horizons in this rare and difficult-to-treat deformity. PMID:25569423

Kona?, Ersoy; Aliyev, Ali; Tunçbilek, Gökhan

2015-01-01

89

General anesthetics and ?-amyloid protein  

PubMed Central

With roughly 234 million people undergoing surgery with anesthesia each year worldwide, it is important to determine whether commonly used anesthetics can induce any neurotoxicity. Alzheimer's disease (AD) is the most common form of age-related dementia, and a rapidly growing health problem. Several studies suggest that anesthesia could be associated with the development of AD. Moreover, studies in cultured cells and animals show that commonly used inhalation anesthetics may induce changes consistent with AD neuropathogenesis, e.g., ?-amyloid protein accumulation. Therefore, in this mini review, we focus on the recent research investigating the effects of commonly used anesthetics including isoflurane, sevoflurane, desflurane, nitrous oxide, and propofol, on A? accumulation in vitro and in vivo. We further discuss the future direction of the research determining the effects of anesthetics on ?-amyloid protein accumulation. PMID:22918033

Xie, Zhongcong; Xu, Zhipeng

2012-01-01

90

Creative Management Techniques in Interscholastic Athletics.  

ERIC Educational Resources Information Center

This text is designed for professional preparation classes in physical education and sports administration and serves as a guide for inservice secondary school athletic directors. Managerial principles are applied to athletic personnel and programs: coaches are depicted as managerial supervisors, the athletic director is middle management, and the…

Fuoss, Donald E.; Troppmann, Robert J.

91

Techniques for Wetlands Construction and Management  

E-print Network

are given in Figure 7. Appendix A contains a list of forbs, grasses, shrubs, trees and vines that are found in wetlands and are benefi cial to wildlife. Submergent Plant Communities ? Manage- ment for submergent plant communities gen- erally... to the transplanting sites as possible. Often plants obtained from locations far away from the transplanting site do not grow well. A selection of desirable submergent plants species includes wild celery, pink smart- weed, sago pondweed, Illinois pondweed, bushy...

Locke, Shawn; Frentress, C.; Cathey, James; Mason, C.; Hirsch, R.; Wagner, M.

2007-09-04

92

Parental acceptance of pediatric dentistry behavior management techniques  

Microsoft Academic Search

The purpose of this study was to assess the attitudes of parents toward behavior management techniques employed in pediatric dentistry. Sixty-seven parents viewed videotaped segments of actual treatment of three- to five-year-old children with whom the following behavior management techniques were used successfully: general anesthesia, Papoose Board ®a , sedation, hand-over- mouth exercise (HOME), physical restraint by the dentist, physical

Marilyn Goodwin Murphy; J. Bernard Machen

1984-01-01

93

Coping Styles as Mediators of Teachers' Classroom Management Techniques  

ERIC Educational Resources Information Center

This study reports the relationships between coping styles of Australian teachers and the classroom based classroom management techniques they use to cope with student misbehaviour. There is great interest internationally in improving educational systems by upgrading the quality of teachers' classroom management. However, the relationship between…

Lewis, Ramon; Roache, Joel; Romi, Shlomo

2011-01-01

94

Visualization techniques of management rules for software development projects  

Microsoft Academic Search

The application of data mining techniques to the managing of software development projects (SDP) is not an uncommon phenomenon, as in any other productive process that generates information in the way of input data and output variables. In this paper, a set of tools developed by the authors, that generate, in a visual way, managing rules suitable to cover minimum

Jacinto Mata; J. L. Alvarez; J. C. Riquelme; I. Ramos; J. S. Aguilar; F. Ferrer

2003-01-01

95

Operations Research Techniques in the Management of Large-Scale  

E-print Network

Operations Research Techniques in the Management of Large-Scale Reforestation Programs Joseph Buongiorno D.E. Teeguarden Abstract: A reforestation planning system for the Douglas-fir region, initial density, reforestation costs, and management constraints. A second model estimates the expected

Standiford, Richard B.

96

Managing difficult polyps: techniques and pitfalls  

PubMed Central

There is no standardized definition of difficult polyps. However, polyps become difficult and challenging to remove endoscopically when they are large in size, flat in nature, situated in a high-risk location and when access to them is very awkward. Recently, an SMSA (Size, Morphology, Site, Access) classification has been proposed that helps to qualify the degree of difficulty by scoring on the above parameters. This article reviews the features that make polyps difficult to remove and provides some practical tips in managing these difficult polyps. We believe that ‘difficult polyp’ is a relative term and each endoscopist should define their own level of difficulty and what they would be able to handle safely. However, in expert trained hands, most difficult polyps can be safely removed by an endoscopic approach. PMID:24714799

Tholoor, Shareef; Tsagkournis, Orestis; Basford, Peter; Bhandari, Pradeep

2013-01-01

97

Anesthetic Management for Lower Limb Fracture in Severe Aortic Valve Stenosis and Fat Embolism: A Case Report and Review of Literature  

PubMed Central

Introduction: Anesthesia in severe aortic stenosis, which describes a valve surface area less than 1 cm2, can result in rapid clinical deterioration and patient mortality. These patients may require treatment for aortic stenosis before any surgical intervention. In suitable patients percutaneous balloon aortic valvutomy appears to carry lower risk, but in emergency situations, it is important to determine which kind of anesthesia technique has the lowest risk for these patients, without any cardiac intervention. Case Presentation: In this case report, we present a patient who had tibia and fibula fractures and a symptomatic severe critical aortic stenosis which was diagnosed during a preoperative visit. The patient had exertional dyspnea, palpitations and fainting history, but he had not received any medical therapy before the present admission. During hospitalization and preoperative evaluation, a fat embolism occurred and the patient was admitted to the intensive care unit. Immediately after his recovery, we successfully managed the tibia and fibula fracture fixation without any cardiac intervention. Conclusions: Our anesthesia method was sciatic and femoral nerve block under double ultrasonic and nerve stimulator guidance. PMID:24910815

Rokhtabnak, Faranak; Zamani, Mohammad Mahdi; Kholdebarin, Alireza; Pournajafian, Alireza; Ghodraty, Mohammad Reza

2014-01-01

98

Dynamic characteristics of the cutaneous vasodilator response to a local external pressure application detected by the laser Doppler flowmetry technique on anesthetized rats  

NASA Astrophysics Data System (ADS)

The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal when a local non-noxious pressure is applied progressively on the skin (11.1 Pa/s). The present work analyses the dynamic characteristics of this vasodilatory reflex response on anaesthetised rats. A de-noising algorithm using wavelets is proposed to obtain accurate values of these dynamic characteristics. The blood flow peak and the time to reach this peak are computed on the de-noised recordings. The results show that the mean time to reach the peak of perfusion is 85.3 s (time t = 0 at the beginning of the pressure application). The mean peak value is 188.3 arbitrary units (a.u.), whereas the mean value of the perfusion before the pressure application is 113.4 a.u. The mean minimum value obtained at the end of the experiment is 60.7 a.u. This latter value is, on the average, reached 841.3 s after the beginning of the pressure application. The comparison of the dynamic characteristics, computed with the de-noising algorithm on signals obtained in other situations, will give a better understanding on some cutaneous lesions such as those present on diabetic people.

Humeau, Anne; Koitka, Audrey; Saumet, Jean-Louis; L'Huillier, Jean-Pierre

2003-10-01

99

A Portable Electronarcosis System for Anesthetizing Salmonids and Other Fish  

Microsoft Academic Search

The physiological responses of fish to continuous (nonpulsed) direct current were first described in the 1960s. One of these responses, electronarcosis (anesthesia, accompanied by muscle relaxation, through electrical inhibition), has been used in fisheries research and management as an anesthetic since the 1970s. We provide details on the assembly and operation of a portable electronarcosis unit for fish anesthesia and

J. Michael Hudson; Jeffrey R. Johnson; Boyd Kynard

2011-01-01

100

An Intelligent Content Discovery Technique for Health Portal Content Management  

PubMed Central

Background Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. Objective This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content Methods A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. Results The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective content management. Conclusions The prevalence of large numbers of online health resources is a key obstacle for domain experts involved in content management of health information portals and websites. The proposed technique has proven successful at search and identification of resources and the measurement of their relevance. It can be used to support the domain expert in content management and thereby ensure the health portal is up-to-date and current. PMID:25654440

2014-01-01

101

Application of optimisation techniques in groundwater quantity and quality management  

Microsoft Academic Search

This paper presents the state-of-the-art on application of optimisation techniques in groundwater quality and quantity management.\\u000a In order to solve optimisation-based groundwater management models, researchers have used various mathematical programming\\u000a techniques such as linear programming (LP), nonlinear programming (NLP), mixed-integer programming (MIP), optimal control\\u000a theory-based mathematical programming, differential dynamic programming (DDP), stochastic programming (SP), combinatorial\\u000a optimisation (CO), and multiple objective

Amlan Das; Bithin Datta

2001-01-01

102

Anesthetic premedication: New horizons of an old practice.  

PubMed

The practice of anesthetic premedication embarked upon soon after ether and chloroform were introduced as general anesthetics in the middle of the 19(th) century. By applying opioids and anticholinergics before surgery, the surgical patients could achieve a less anxious state, and more importantly, they would acquire a smoother course during the tedious and dangerous induction stage. Premedication with opioids and anticholinergics was not a routine practice in the 20(th) century when intravenous anesthetics were primarily used as induction agents that significantly shorten the induction time. The current practice of anesthetic premedication has evolved into a generalized scheme that incorporates several aspects of patient care: decreasing preoperative anxiety, dampening intraoperative noxious stimulus and its associated neuroendocrinological changes, and minimizing postoperative adverse effects of anesthesia and surgery. Rational use of premedication in modern anesthesia practice should be justified by individual needs, the types of surgery, and the anesthetic agents and techniques used. In this article, we will provide our readers with updated information about premedication of surgical patients with a focus on the recent application of second generation serotonin type 3 antagonist, antidepressants, and anticonvulsants. PMID:25304317

Sheen, Michael J; Chang, Fang-Lin; Ho, Shung-Tai

2014-09-01

103

Ondansetron Exhibits the Properties of a Local Anesthetic  

Microsoft Academic Search

PM. The blockade started im- mediately when OND was applied to the cell body us- ing a fast perfusion system, reached a plateau within 15 s, and recovered to the control level within 30 s after washout of the OND-containing solution. Because this is a known property of local anesthetics, we used the tail-flick technique to verify this effect in

Jiang Hong Ye; Wui Chiu Mui; Jun Ren; Thurman E. Hunt; Wen-Hsien Wu; Vlasta K. Zbuzek

1997-01-01

104

Information management and Process Improvement Using Data Mining Techniques  

E-print Network

1 Information management and Process Improvement Using Data Mining Techniques Gibbons, WM, University of Ulster, N.Ireland, mw.gibbons@ulst.ac.uk Ranta, M, Helsinki, University of Technology, Finland University of Technology, Finland, Abstract This paper describes a computer component manufacturing scenario

105

Recent methods and techniques for managing hydrological droughts  

Microsoft Academic Search

SUMMARY - It is largely recognized that shifting from a reactive to a proactive approach is necessary to face successfully hydrological drought risk. Nonetheless, such an change in drought management requires the support of several methods and techniques that can find application both for planning mitigation actions as well as for implementing the measures. In the paper a planning framework

G. Rossi; V. Nicolosi; A. Cancelliere

106

Using Powerpoint Animations to Teach Operations Management Techniques and Concepts  

ERIC Educational Resources Information Center

This article examines the value of using complex animated PowerPoint presentations to teach operations management techniques and concepts. To provide context, literature covering the use of PowerPoint animations in business education is briefly reviewed. The specific animations employed in this study are identified and their expected benefits to…

Treleven, Mark D.; Penlesky, Richard J.; Callarman, Thomas E.; Watts, Charles A.; Bragg, Daniel J.

2014-01-01

107

Power Modeling and Thermal Management Techniques for Manycores  

E-print Network

Power Modeling and Thermal Management Techniques for Manycores Rajib Nath Computer Science number of cores in manycore archi- tectures, along with technology scaling, results in high power in such processors, we need an accurate online estimate of the power consumption. In this paper, we present the first

Simunic, Tajana

108

Nonlethal Techniques for Managing Predation: Primary and Secondary Repellents  

Microsoft Academic Search

Conservation biology requires the development of practical tools and techniques to minimize con- flicts arising from human modification of ecosystems. We applied behavioral theory of primary and secondary repellents to predator management by using aversive stimulus devices (electronic training collars) and dis- ruptive stimulus devices (behavior-contingent audio and visual repellents) in a multipredator ( Canis lupus, Haliaeetus leucocephalus, Ursus spp.)

JOHN A. SHIVIK; ADRIAN TREVES; PEGGY CALLAHAN

2003-01-01

109

Potentiation of Local Anesthetic Activity of Neosaxitoxin with Bupivacaine or Epinephrine: Development of a Long-Acting Pain Blocker  

Microsoft Academic Search

Local anesthetics effectively block and relieve pain, but with a relatively short duration of action, limiting its analgesic\\u000a effectiveness. Therefore, a long-acting local anesthetic would improve the management of pain, but no such agent is yet available\\u000a for clinical use. The aim of this study is to evaluate the potentiation of the anesthetic effect of neosaxitoxin, with bupivacaine\\u000a or epinephrine

Alberto J. Rodriguez-Navarro; Marcelo Lagos; Cristian Figueroa; Carlos Garcia; Pedro Recabal; Pamela Silva; Veronica Iglesias; Nestor Lagos

2009-01-01

110

The worm sheds light on anesthetic mechanisms  

PubMed Central

One hundred and sixty five years have passed since the first documented use of volatile anesthetics to aid in surgery, but we have yet to understand the underlying mechanism of action of these drugs. There is no question that, in vitro, volatile anesthetics can affect the function of numerous neuronal and non-neuronal proteins. In fact, volatile anesthetics are capable of binding such diverse proteins as albumin and bacterial luciferase. The promiscuity of volatile anesthetic binding makes it difficult to determine which proteins are modulated by anesthetics to cause the state of anesthesia. Consequently, despite a great deal of in vitro data, the fundamental physiological process that volatile anesthetics perturb to effect neuronal silencing is not yet identified. Recently, data has increasingly indicated that membrane leak channels may play a role in the anesthetic response. Here we comment on the use of optogenetics to further support such a model. PMID:23730538

Singaram, Vinod K.; Morgan, Philip G.; Sedensky, Margaret M.

2012-01-01

111

Risk Management Techniques and Practice Workshop Workshop Report  

SciTech Connect

At the request of the Department of Energy (DOE) Office of Science (SC), Lawrence Livermore National Laboratory (LLNL) hosted a two-day Risk Management Techniques and Practice (RMTAP) workshop held September 18-19 at the Hotel Nikko in San Francisco. The purpose of the workshop, which was sponsored by the SC/Advanced Scientific Computing Research (ASCR) program and the National Nuclear Security Administration (NNSA)/Advanced Simulation and Computing (ASC) program, was to assess current and emerging techniques, practices, and lessons learned for effectively identifying, understanding, managing, and mitigating the risks associated with acquiring leading-edge computing systems at high-performance computing centers (HPCCs). Representatives from fifteen high-performance computing (HPC) organizations, four HPC vendor partners, and three government agencies attended the workshop. The overall workshop findings were: (1) Standard risk management techniques and tools are in the aggregate applicable to projects at HPCCs and are commonly employed by the HPC community; (2) HPC projects have characteristics that necessitate a tailoring of the standard risk management practices; (3) All HPCC acquisition projects can benefit by employing risk management, but the specific choice of risk management processes and tools is less important to the success of the project; (4) The special relationship between the HPCCs and HPC vendors must be reflected in the risk management strategy; (5) Best practices findings include developing a prioritized risk register with special attention to the top risks, establishing a practice of regular meetings and status updates with the platform partner, supporting regular and open reviews that engage the interests and expertise of a wide range of staff and stakeholders, and documenting and sharing the acquisition/build/deployment experience; and (6) Top risk categories include system scaling issues, request for proposal/contract and acceptance testing, and vendor technical or business problems. HPC, by its very nature, is an exercise in multi-level risk management. Every aspect of stewarding HPCCs into the petascale era, from identification of the program drivers to the details of procurement actions and simulation environment component deployments, represents unprecedented challenges and requires effective risk management. The fundamental purpose of this workshop was to go beyond risk management processes as such and learn how to weave effective risk management practices, techniques, and methods into all aspects of migrating HPCCs into the next generation of leadership computing systems. This workshop was a follow-on to the Petascale System Integration Workshop hosted by Lawrence Berkeley National Laboratory (LBNL)/NERSC last year. It was intended to leverage and extend the risk management experience of the participants by looking for common best practices and unique processes that have been especially successful. This workshop assessed the effectiveness of tools and techniques that are or could be helpful in HPCC risk management, with a special emphasis on how practice meets process. As the saying goes: 'In theory, there is no difference between theory and practice. In practice there is'. Finally, the workshop brought together a network of experts who shared information as technology moves into the petascale era and beyond.

Quinn, T; Zosel, M

2008-12-02

112

Surface Water Quality as Affected by Sugarcane Residue Management Techniques  

Microsoft Academic Search

This study evaluated the impacts of three sugarcane residue management techniques, namely postharvest burning of residue (BR),\\u000a shredding of residue (SR), and full postharvest retention of residue (RR), on the water quality of surface runoff from February\\u000a 2006 to September 2007 in Iberia, LA. Total runoff volumes recorded were 58,418, 57,923, and 46,578 L for the BR, SR, and\\u000a RR treatments,

Theophilus K. Udeigwe; Jim J. Wang; Howard P. Viator; Lewis Gaston

2010-01-01

113

Wetland assessment, monitoring and management in India using geospatial techniques.  

PubMed

Satellite remote sensing and GIS have emerged as the most powerful tools for inventorying, monitoring and management of natural resources and environment. In the special context of wetland ecosystems, remotely sensed data from orbital platforms have been extensively used in India for the inventory, monitoring and preparation of action plans for conservation and management. First scientific inventory of wetlands in India was carried out in 1998 by Space Applications Centre (ISRO), Ahmedabad using indigenous IRS (Indian Remote Sensing Satellite) data of 1992-93 timeframe, which stimulated extensive use of geospatial techniques for wetland conservation and management. Subsequently, with advances in GIS, studies were carried out for development of Wetland Information System for a state (West Bengal) and for Loktak lake wetland (a Ramsar site) as a prelude to National Wetland Information System. Research has also been carried out for preparation of action plans especially for Ramsar sites in the country. In a novel research, use of the geospatial technology has also been demonstrated for biodiversity conservation using landscape ecological metrics. A country-wide estimate of emission of methane, a Green House Gas, from wetlands has also been made using MODIS data. Present article critically reviews the work carried out in India for wetland conservation and management using geospatial techniques. PMID:24486190

Garg, J K

2015-01-15

114

Inhaled Anesthetics Do Not Combine to Produce Synergistic Effects Regarding Minimum Alveolar Anesthetic Concentration in Rats  

Microsoft Academic Search

BACKGROUND: We hypothesized that pairs of inhaled anesthetics having divergent potencies (one acting weakly at minimum alveolar anesthetic concentration (MAC); one acting strongly at MAC) on specific receptors\\/channels might act synergisti- cally, and that such deviations from additivity would support the notion that anesthetics act on multiple sites to produce anesthesia. METHODS: Accordingly, we studied the additivity of MAC for

Edmond I Eger II; Michael Tang; Mark Liao; Michael J. Laster; Ken Solt; Pamela Flood; Andrew Jenkins; Douglas Raines; Jan F. Hendrickx; Steven L. Shafer; Tanifuji Yasumasa; James M. Sonner

2008-01-01

115

Mobility management techniques for the next-generation wireless networks  

NASA Astrophysics Data System (ADS)

The tremendous demands from social market are pushing the booming development of mobile communications faster than ever before, leading to plenty of new advanced techniques emerging. With the converging of mobile and wireless communications with Internet services, the boundary between mobile personal telecommunications and wireless computer networks is disappearing. Wireless networks of the next generation need the support of all the advances on new architectures, standards, and protocols. Mobility management is an important issue in the area of mobile communications, which can be best solved at the network layer. One of the key features of the next generation wireless networks is all-IP infrastructure. This paper discusses the mobility management schemes for the next generation mobile networks through extending IP's functions with mobility support. A global hierarchical framework model for the mobility management of wireless networks is presented, in which the mobility management is divided into two complementary tasks: macro mobility and micro mobility. As the macro mobility solution, a basic principle of Mobile IP is introduced, together with the optimal schemes and the advances in IPv6. The disadvantages of the Mobile IP on solving the micro mobility problem are analyzed, on the basis of which three main proposals are discussed as the micro mobility solutions for mobile communications, including Hierarchical Mobile IP (HMIP), Cellular IP, and Handoff-Aware Wireless Access Internet Infrastructure (HAWAII). A unified model is also described in which the different micro mobility solutions can coexist simultaneously in mobile networks.

Sun, Junzhao; Howie, Douglas P.; Sauvola, Jaakko J.

2001-10-01

116

The management of treatment-resistant biliary calculi using percutaneous endourologic techniques  

PubMed Central

Background Complicated choledocholithiasis cannot always be managed by standard surgical, radiologic or endoscopic methods. One additional approach is to use percutaneous techniques developed by endourologists to treat renal calculi. In this report, we present our experience over the past 10 years with this novel approach. Methods We conducted a retrospective review of all patients who underwent percutaneous, endoscopic treatment of biliary calculi at our institution between January 1997 and August 2007. Primary outcomes of interest were symptom- and stone-free rates, length of stay in hospital and complications. Results Nineteen patients underwent 21 percutaneous treatments for biliary calculi. All were dependent on external drainage for symptom control. The primary indications for treatment were cholangitis, retained stone, biliary colic and jaundice. Seventeen patients (89.5%) had failed prior endoscopic retrograde cholangiopancreatography (ERCP) or open attempts at treatment. The 2 remaining patients (10.5%) were deemed unfit for a general anesthetic. Patients had experienced a mean of 1.8 (standard deviation [SD] 1.0) prior failed attempts at stone removal. We used several treatment modalities, including holmium:yttrium-aluminum-garnet laser (61.9%), electrohydraulic lithotripter (19.0%), ultrasound (9.5%), basket extraction (9.5%) and balloon dilatation of the ampulla (19.0%). Overall, treatment led to successful removal of the biliary drainage tube in 94.7% of patients and 76.2% were stone-free. We performed cholangiograms an average of 21.8 (SD 13.7) days after treatment. The average length of stay in hospital was 1.9 (SD 1.1) days. One patient experienced a perioperative acute coronary syndrome and another experienced prolonged biliary drainage. Both had successful endoscopic treatment of their calculi. There were no cases of treatment-related sepsis, and we observed no other complications. Conclusion Biliary calculi may be successfully treated using standard endourologic methods with high stone-free rates. This technique is generally well-tolerated even among high-risk patients. PMID:19865576

Ray, A. Andrew; Davies, Edward T.; Duvdevani, Mordechai; Razvi, Hassan; Denstedt, John D.

2009-01-01

117

Rehabilitation techniques in ankylosing spondylitis management: a case report  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the musculoskeletal system. Progressive complaints of axial stiffness and restriction in movement may not be addressed by general medical practitioners. While AS has a progressive natural history, chiropractors may play a significant role in early detection, patient education, and management. Early diagnosis and therapy may help to minimize future pain and disability. Chiropractic treatment methods coupled with individualized active rehabilitation techniques should be directed to reduce pain, minimize functional loss and optimize quality of life. ImagesFigure 1Figure 2Figure 3Figure 4

Henderson, Shawn

2003-01-01

118

Application of fisheries-management techniques to assessing impacts  

SciTech Connect

Monitoring methods used in fisheries-management assessments were examined and their potential applicability in confirmatory impact monitoring were evaluated using case studies from selected nuclear power plants. A report on Task I of the project examined the application of Catch-Per-Unit-Effort (CPUE) techniques in monitoring programs at riverine, large lake and ocean sites. Included in this final report is an examination of CPUE data for the Oconee Nuclear Plant on Lake Keowee, a reservoir site. This report also presents a summary of results obtained over the life of the project and guidelines for designing and implementing data collection programs and for data analysis and interpretation. Analysis of monitoring data from Lake Keowee confirmed findings from previous analyses of surveys at nuclear power plants on large lakes, rivers and coastal sites. CPUE techniques as applied to these monitoring programs do not provide data necessary to separate changes induced by plant operation from naturally occurring changes.

McKenzie, D.H.; Simmons, M.A.; Skalski, J.R.

1983-01-01

119

46 CFR 147.105 - Anesthetics, drugs, and medicines.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Anesthetics, drugs, and medicines. 147.105 Section 147.105 Shipping... § 147.105 Anesthetics, drugs, and medicines. Anesthetics, drugs, and medicines must be stowed and dispensed in accordance...

2010-10-01

120

46 CFR 147.105 - Anesthetics, drugs, and medicines.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 false Anesthetics, drugs, and medicines. 147.105 Section 147.105 Shipping... § 147.105 Anesthetics, drugs, and medicines. Anesthetics, drugs, and medicines must be stowed and dispensed in accordance...

2011-10-01

121

Sodium Channels as Targets for Volatile Anesthetics  

PubMed Central

The molecular mechanisms of modern inhaled anesthetics are still poorly understood although they are widely used in clinical settings. Considerable evidence supports effects on membrane proteins including ligand- and voltage-gated ion channels of excitable cells. Na+ channels are crucial to action potential initiation and propagation, and represent potential targets for volatile anesthetic effects on central nervous system depression. Inhibition of presynaptic Na+ channels leads to reduced neurotransmitter release at the synapse and could therefore contribute to the mechanisms by which volatile anesthetics produce their characteristic end points: amnesia, unconsciousness, and immobility. Early studies on crayfish and squid giant axon showed inhibition of Na+ currents by volatile anesthetics at high concentrations. Subsequent studies using native neuronal preparations and heterologous expression systems with various mammalian Na+ channel isoforms implicated inhibition of presynaptic Na+ channels in anesthetic actions at clinical concentrations. Volatile anesthetics reduce peak Na+ current (INa) and shift the voltage of half-maximal steady-state inactivation (h?) toward more negative potentials, thus stabilizing the fast-inactivated state. Furthermore recovery from fast-inactivation is slowed, together with enhanced use-dependent block during pulse train protocols. These effects can depress presynaptic excitability, depolarization and Ca2+ entry, and ultimately reduce transmitter release. This reduction in transmitter release is more potent for glutamatergic compared to GABAergic terminals. Involvement of Na+ channel inhibition in mediating the immobility caused by volatile anesthetics has been demonstrated in animal studies, in which intrathecal infusion of the Na+ channel blocker tetrodotoxin increases volatile anesthetic potency, whereas infusion of the Na+ channels agonist veratridine reduces anesthetic potency. These studies indicate that inhibition of presynaptic Na+ channels by volatile anesthetics is involved in mediating some of their effects. PMID:22479247

Herold, Karl F.; Hemmings Jr., Hugh C.

2012-01-01

122

Managing the Classroom with Technology. On Progress Reports and Online Communications, and How To Manage the Two Different Communication Techniques.  

ERIC Educational Resources Information Center

Describes how one teacher bridged the communications gap among teachers, parents, and students through the use of technology in managing his classroom. Discusses progress reports and online communications and how to manage the two different communication techniques. (JOW)

Kasprowicz, Tim

2002-01-01

123

Using web technique in the managing regulatory requirements of medical equipment for the nursing department  

Microsoft Academic Search

The centralized and information management are in common use technique of modern management. The management of the medical equipment emphasized in the purchase and the maintenance management in early days, and cost down now is import factor for medical equipment management because the health insurance system causes the hospital budget reduced, so in the cost down strategy is to reduce

Chia-Hung Chien; Bao-Hwa Hwang; Thuey-Ru Lin; Cheng-Yi Wang; Fok-Ching Chong

2006-01-01

124

Benzocaine as an anesthetic for striped bass  

USGS Publications Warehouse

Benzocaine was tested as an anesthetic on juvenile and mature adult striped bass (Morone saxatilis ). Concentrations of 55 mg/L at 22 degree C to 80 mg/L at 11 degree C effectively anesthetized fish in about 3 min. Recovery was more rapid as temperature increased. Fish survived concentrations of twice the effective concentration and exposure times up to 60 min at the effective concentration. Striped bass required higher concentrations for anesthetization than had been previously demonstrated for salmonid fishes, but safety margins for both concentration and exposure time were wider than for the salmonids.

Gilderhus, Philip A.; Lemm, Carol A.; Woods, L. Curry, III

1991-01-01

125

Architectural Techniques For Managing Non-volatile Caches  

SciTech Connect

As chip power dissipation becomes a critical challenge in scaling processor performance, computer architects are forced to fundamentally rethink the design of modern processors and hence, the chip-design industry is now at a major inflection point in its hardware roadmap. The high leakage power and low density of SRAM poses serious obstacles in its use for designing large on-chip caches and for this reason, researchers are exploring non-volatile memory (NVM) devices, such as spin torque transfer RAM, phase change RAM and resistive RAM. However, since NVMs are not strictly superior to SRAM, effective architectural techniques are required for making them a universal memory solution. This book discusses techniques for designing processor caches using NVM devices. It presents algorithms and architectures for improving their energy efficiency, performance and lifetime. It also provides both qualitative and quantitative evaluation to help the reader gain insights and motivate them to explore further. This book will be highly useful for beginners as well as veterans in computer architecture, chip designers, product managers and technical marketing professionals.

Mittal, Sparsh [ORNL] ORNL

2013-01-01

126

The role of stereotactic techniques in the management of craniopharyngiomas.  

PubMed

Despite the advances of microsurgery, endocrinology, radiation therapy, and neuroimaging over the last half-century, craniopharyngiomas continue to present neurosurgeons with a therapeutic dilemma. The tumor's histologic benignity belies its aggressive biologic behavior. Although total resection is theoretically curative, the cost in terms of functional disability can be high, especially in light of reports describing long-delayed tumor recurrences ("false cure"). As in other intracranial neoplasms, multimodality therapy is often necessary over the course of a patient's lifetime. Stereotactic techniques (intracystic irradiation, radiosurgery, cyst aspiration, biopsy) have a well-established role in selected cases. To maximize preservation of neurologic, visual, and hypothalamic-pituitary functions, the application of stereotactic, microsurgical, or external irradiation techniques in an individual patient must take into account all of the patient's prior treatments as well as the current status of his or her tumor. Our current recommendation for multimodality treatment of craniopharyngiomas is illustrated in Figure 5. Stereotactic surgery has a definitive role in the life-long management of some patients, and plays an important adjunctive role in many others. PMID:2135965

Coffey, R J; Lunsford, L D

1990-01-01

127

A heuristic risk assessment technique for birdstrike management at airports.  

PubMed

Collisions between birds and aircraft (birdstrikes) have caused the loss of at least 88 aircraft and 243 lives in world civil aviation. Conservative estimates suggest that more routine damage and delays following birdstrikes cost the industry and its insurers US$1.2-1.5 billion per year. The majority of strikes happen close to airports and most countries have regulations that require airport managers to control the birdstrike risk on their property. Birdstrike prevention has, however, lagged behind other aspects of flight safety in the development and implementation of risk assessment protocols, possibly because of the inherent difficulty in quantifying the variability in the populations and behavior of the various bird species involved. This article presents a technique that uses both national and airport-specific data to evaluate risk by creating a simple probability-times-severity matrix. It uses the frequency of strikes reported for different bird species at a given airport over the preceding five years as a measure of strike probability, and the proportion of strikes with each species that result in damage to aircraft, in the national birdstrike database, as a measure of likely severity. Action thresholds for risk levels for particular bird species are then defined, above which the airport should take action to reduce the risk further. The assessment is designed for airports where the reporting and collation of birdstrike events is reasonably consistent over time and where a bird hazard management program of some sort is already in place. This risk assessment is designed to measure risk to the airport as a business rather than risk to the traveling passenger individually. It therefore takes no account of aircraft movement rate in the calculations and is aimed at minimizing the number of damaging incidents rather than concentrating on catastrophic events. Once set up at an airport, the technique is simple to implement for nonexperts, and it allows managers to focus bird control resources on the species causing the greatest risk, hence maximizing the return on investment. This protocol is now being successfully used at major airports in the United Kingdom and elsewhere in the world. PMID:16834629

Allan, John

2006-06-01

128

Anesthetic considerations in acute spinal cord trauma  

PubMed Central

Patients with actual or potential spinal cord injury (SCI) are frequently seen at adult trauma centers, and a large number of these patients require operative intervention. All polytrauma patients should be assumed to have an SCI until proven otherwise. Pre-hospital providers should take adequate measures to immobilize the spine for all trauma patients at the site of the accident. Stabilization of the spine facilitates the treatment of other major injuries both in and outside the hospital. The presiding goal of perioperative management is to prevent iatrogenic deterioration of existing injury and limit the development of secondary injury whilst providing overall organ support, which may be adversely affected by the injury. This review article explores the anesthetic implications of the patient with acute SCI. A comprehensive literature search of Medline, Embase, Cochrane database of systematic reviews, conference proceedings and internet sites for relevant literature was performed. Reference lists of relevant published articles were also examined. Searches were carried out in October 2010 and there were no restrictions by study design or country of origin. Publication date of included studies was limited to 1990–2010. PMID:22096772

Dooney, Neil; Dagal, Armagan

2011-01-01

129

An Authentication Technique Based on Distributed Security Management for the Global Mobility Network  

Microsoft Academic Search

This paper proposes an authentication technique for use in the global mobility network (GLOMONET), which provides a personal communication user with global roaming service. This technique is based on new distributed security management, where authentication management in roaming-service provision is conducted only by the roamed network (the visited network). The original security manager (OSM) administrates the original authentication key (OAK)

Shigefusa Suzuki; Kazuhiko Nakada

1997-01-01

130

The legal status of informed consent for behavior management techniques in pediatric dentistry  

Microsoft Academic Search

The use of various nonpharmacologic behavior management techniques is an integral part of pediatric dental practice. These techniques enjoy broad-based acceptance within the profession, but until recently there has been little syste~natic attempt to ascertain the opinion of parents on the issue of behavior management. New findings suggest that many parents do not approve of the more commonly used management

Patricia P. Hagan; John P. Hagan; J. Bernard Machen

1984-01-01

131

[Anesthesiological management of awake craniotomy : Asleep-awake-asleep technique or without sedation].  

PubMed

Awake craniotomy is indicated in deep brain stimulation (DBS) for treatment of certain movement disorders, such as in Parkinson disease patients or in the surgery of brain tumors in close vicinity to the language area. The standard procedure is the asleep-awake-asleep technique where general anesthesia or analgosedation is intermittently interrupted for neurological testing. In DBS the intraoperative improvement of symptoms, stereotactic navigation and microelectrode reading guide to the optimal position. In brain tumor resection, reversible functional impairments during electrical stimulation on the brain surface (brain mapping) show the exact individual position of eloquent or motoric areas that should be protected.The anesthesiology procedures used are very variable. It is a balancing act between overdosing of anesthetics with impairment of respiration and alertness and underdosing with pain, strain and stress for the patient. For the asleep-awake-asleep technique high acceptance but also frequent and partly severe complications have been reported. The psychological stress for the patient can be immense. Obviously, a feeling of being left alone and being at someone's mercy is not adequately treated by drugs and performance of the neurological tests is undoubtedly better and more reliable with less pharmacological impairment. Cranial nerve blocks can reduce the amount of anesthetics as they provide analgesia of the scalp more efficiently than local infiltration. With these nerve blocks, a strong therapeutic relationship and a specific communication, sedatives can be avoided and the need for opioids markedly reduced or abolished. The suggestive communication promotes for instance dissociation to an inner safe refuge, as well as reframing of disturbing noises and sensations. Each of the methods applied for awake craniotomy can profit from the principles of this awake-awake-awake technique. PMID:25421054

Seemann, M; Zech, N; Graf, B; Hansen, E

2015-02-01

132

Microscopy on anesthetized worms Reagents needed  

E-print Network

Microscopy on anesthetized worms Reagents needed · Vacuum grease syringe · M9 + 5 mM Na Azide (3µl of M9/NaAzide in a watchglass slide 2. Pick 5-10 worms off an NGM plate and into the azide into the square. 6. Pick anesthetized worms onto the slide and gently overlay them with a 22 x 22 mm coverslip. 7

Lamitina, Todd

133

Frequency dependence of capnography in anesthetized rabbits.  

PubMed

Aspirative capnography may be of help to diagnose early childhood asthma, but clinical usefulness in young children is limited by the relatively high respiratory rate. This study aimed to characterize the [Formula: see text] time course during airway constriction in 8 anesthetized rabbits, artificially ventilated at 30, 60 and 80breaths/min. Methacholine was inhaled to double the respiratory resistance measured at 8Hz by the forced oscillation technique. The capnogram shape changed in response to both methacholine and ventilatory frequency. Slope of phase II, the peak of first-order time derivative and trough of the second-order time derivative of the [Formula: see text] signal, were significantly attenuated after methacholine compared with baseline at all breathing rates (p<0.02). Moreover, significant correlations between respiratory reactance and resistance were observed with the phase III slope and the angle described by phase II and phase III (p<0.01). It is concluded that capnography may be useful to identify acute airway changes related to bronchoconstriction, even at high breathing frequencies. PMID:24035836

Ioan, I; Demoulin, B; Duvivier, C; Leblanc, A L; Bonabel, C; Marchal, F; Schweitzer, C; Varechova, S

2014-01-01

134

Age and anesthetic effects on murine electrocardiography.  

PubMed

Murine models offer potential insights regarding human cardiac disease, but efficient and reliable methods for phenotype evaluation are necessary. We employed non-invasive electrocardiography (ECG) in mice, investigating statistical reliability of these parameters with respect to anesthetic and animal age. Mice (C57BL/6, 8 or 48 weeks) were anesthetized by ketamine/xylazine (K/X, 80/10 mg/kg ip) or by inhalation anesthetic (halothane, HAL; sevoflurane, SEV) and 6 lead ECGs were recorded. P wave duration and QT interval was significantly prolonged with K/X compared to HAL and SEV, indicating slowed atrial and ventricular conduction. P-R interval (atrio-ventricular conduction) was significantly increased in aged mice under all anesthetics. Heart rate was inversely correlated to QT interval and P wave duration. We also detected significant age effects with respect to optimal approaches for QT interval corrections. Power analysis showed 4-fold higher number of mice/group, were required for K/X, to achieve identical statistical sensitivity. These data demonstrate the importance of anesthetic selection for relevant and reliable ECG analysis in mice and illustrate the selective influences of anesthetics and age on cardiac conductance in this species. PMID:12639705

Chaves, Alysia A; Dech, Spencer J; Nakayama, Tomohiro; Hamlin, Robert L; Bauer, John Anthony; Carnes, Cynthia A

2003-04-11

135

Percutaneous endoscopic gastrostomy: Indications, technique, complications and management  

PubMed Central

Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system. PMID:24976711

Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

2014-01-01

136

Percutaneous endoscopic gastrostomy: indications, technique, complications and management.  

PubMed

Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the "pull" technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system. PMID:24976711

Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

2014-06-28

137

Effects of Common Anesthetics on Eye Movement and Electroretinogram  

PubMed Central

High-resolution magnetic resonance imaging (MRI) provides non-invasive images of retinal anatomy, physiology and function with depth-resolved laminar resolution. Eye movement and drift, however, could limit high spatial resolution imaging, and anesthetics that minimize eye movement could significantly attenuate retinal function. The aim of this study was to determine the optimal anesthetic preparations to minimize eye movement and maximize visual-evoked retinal response in rats. Eye movements were examined by imaging of the cornea with a charge-coupled device (CCD) camera under isoflurane, urethane, ketamine/xylazine, and propofol anesthesia at typical dosages in rats. Combination of the paralytic pancuronium bromide with isoflurane or ketamine/xylazine anesthesia was also examined for the eye movement studies. Visual-evoked retinal responses were evaluated using full-field electroretinography (ERG) under isoflurane, ketamine/xylazine, urethane, and ketamine/xylazine + pancuronium anesthesia in rats. The degree of eye movement was ranked as follows (from large to small displacement per unit time): i) 1% isoflurane, ii) 2% isoflurane, iii) propofol, iv) ketamine/xylazine, v) urethane, vi) ketamine/xylazine + pancuronium and vii)1% isoflurane + pancuronium. The ketamine/xylazine groups showed larger dark-adapted ERG a- and b-waves than other anesthetics tested. The isoflurane group showed the shortest b-wave implicit times. Photopic ERGs in the ketamine/xylazine groups showed the largest b-waves with the isoflurane group showing slightly shorter implicit times at the higher flash intensities. Oscillatory potentials revealed an early peak in the isoflurane group compared to ketamine/xylazine and urethane groups. Pancuronium did not affect the a- and b-wave, but did increase oscillatory potential amplitudes. Compared to the other anesthetics tested here, ketamine/xylazine + pancuronium was the best combination to minimize eye movement and maximize retinal function. These findings should set the stage for further development and application of high-resolution functional imaging techniques, such as MRI, to study retinal anatomy, physiology and function in anesthetized rats. PMID:21519880

Nair, Govind; Kim, Moon; Nagaoka, Tsukasa; Olson, Darin E.; Thulé, Peter M.; Pardue, Machelle T.; Duong, Timothy Q.

2011-01-01

138

Macroscopic sites of anesthetic action: brain versus spinal cord.  

PubMed

1. General anesthesia is achieved by anesthetic action in the central nervous system (CNS). 2. Whereas amnesia and unconsciousness are due to anesthetic action in the brain, recent evidence suggests that immobility in response to a noxious stimulus is achieved by anesthetic effects in the spinal cord. The putative spinal cord site(s) include dorsal horn cells and motor neurons. 3. The extent to which anesthetic action in the brain influences the spinal cord probably varies among anesthetics. Furthermore, anesthetics can indirectly influence the brain by their actions within the spinal cord, i.e. by modulating ascending transmission of sensory information. PMID:10049180

Antognini, J F; Carstens, E

1998-11-23

139

Leadership and management: techniques and principles for athletic training.  

PubMed

Leadership and management have become topics of recent interest in athletic training. These skills are distinct from each other and are vital to a successful and efficient athletic training room. Leadership is an influence relationship, while management is an authority relationship. Leadership is concerned with knowing yourself, your staff, your profession, and how to apply people skills. Management is concerned with organization, communication, and the development of your athletic training facility's mission. By applying good management and leadership skills, you can implement your mission statement, evaluate your results, and improve the performance of your athletic training facility. PMID:16558296

Nellis, S M

1994-12-01

140

QUIET HOUR 1 A field test of the quiet hour as a time management technique  

E-print Network

QUIET HOUR 1 A field test of the quiet hour as a time management technique Cornelius J. König at European Review of Applied Psychology #12;QUIET HOUR 2 A field test of the quiet hour as a time management and on a behavioral decision-making approach to time management, we argue that establishing quiet hours

Mayberry, Marty

141

Study of systems and techniques for data base management  

NASA Technical Reports Server (NTRS)

Data management areas were studied to identify pertinent problems and issues that will affect future NASA data users in terms of performance and cost. Specific topics discussed include the identifications of potential NASA data users other than those normally discussed, consideration affecting the clustering of minicomputers, low cost computer system for information retrieval and analysis, the testing of minicomputer based data base management systems, ongoing work related to the use of dedicated systems for data base management, and the problems of data interchange among a community of NASA data users.

1976-01-01

142

Effects of Volatile Aromatic Anesthetics on Voltage-Gated Na+ Channels Expressed in Xenopus Oocytes  

PubMed Central

Background Many inhaled anesthetics inhibit voltage-gated sodium channels at clinically relevant concentrations, and suppression of neurotransmitter release by these agents results, at least partly, from decreased presynaptic sodium channel activity. Volatile aromatic anesthetics can inhibit N-methyl-D-aspartate (NMDA) receptor function and enhance ?-amino butyric acid A (GABAA) receptor function, but these effects depend strongly on the chemical properties of the aromatic ompounds. The present study tested whether diverse aromatic anesthetics consistently inhibit sodium channel function. Methods We studied the effect of eight aromatic anesthetics on Nav1.2 sodium channels with ?1 subunits, using whole-cell, two-electrode voltage-clamp techniques in Xenopus oocytes. Results All aromatic anesthetics inhibited INa (sodium currents) at a holding potential which produce half-maximal current (V1/2) (partial depolarization); inhibition was modest with 1,3,5-trifluorobenzene (8 ± 2%), pentafluorobenzene (13 ± 2%), and hexafluorobenzene (13 ± 2%), but greater with benzene (37 ± 2%), fluorobenzene (39 ± 2%), 1,2-difluorobenzene (48 ± 2%), 1,4-difluorobenzene (31 ± 3%), and 1,2,4-trifluorobenzene (33 ± 1%). Such dichotomous effects were noted by others for NMDA and GABAA receptors. Parallel, but much smaller inhibition, was found for INa at a holding potential which produced near maximal current (?90 mV) (VH-90), and hexafluorobenzene caused small (6 ± 1%) potentiation of this current. These changes in sodium channel function were correlated with effectiveness for inhibiting NMDA receptors, with lipid solubility of the compounds, with molecular volume, and with cation-? interactions. Conclusion Aromatic compounds vary in their actions on the kinetics of sodium channel gating and this may underlie their variable inhibition. The range of inhibition produced by MAC concentrations of inhaled anesthetics indicates that sodium channel inhibition may underlie the action of some of these anesthetics but not others. PMID:18931215

Horishita, Takafumi; Eger, Edmond I; Harris, R. Adron

2008-01-01

143

Remote sensing techniques for support of coastal zone resource management.  

NASA Technical Reports Server (NTRS)

Description of remote sensing studies carried out for the purpose of developing and/or demonstrating techniques which can be employed for land use inventory, marsh vegetation classification, and water characteristics surveys. Attention is given to results obtained with (1) photo interpretation techniques and procedures for the development of land use information from high-altitude aircraft and satellite imagery, (2) computer based pattern recognition techniques utilizing multispectral scanner data for marsh vegetation classification, and (3) infrared and microwave techniques for the monitoring and surveying of coastal water temperature and salinity characteristics.

Piland, R. O.

1973-01-01

144

Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review.  

PubMed

Very long-chain acyl-coenzyme A dehydrongenase deficiency (VLCADD) is a rare disorder of fatty acid metabolism that renders sufferers susceptible to hypoglycemia, liver failure, cardiomyopathy, and rhabdomyolysis. The literature about the management of these patients is hugely conflicting, suggesting that both propofol and volatile anesthesia should be avoided. We have reviewed the literature and have concluded that the source papers do not support the statements that volatile anesthetic agents are unsafe. The reports on rhabdomyolysis secondary to anesthesia appear to be due to inadequate supply of carbohydrate not volatile agents. Catabolism must be avoided with minimal fasting, glucose infusions based on age and weight, and attenuation of emotional and physical stress. General anesthesia appears to be protective of stress-induced catabolism and may offer benefits in children and anxious patients over regional anesthesia. Propofol has not been demonstrated to be harmful in VLCADD but is presented in an emulsion containing very long-chain fatty acids which can cause organ lipidosis and itself can inhibit mitochondrial fatty acid metabolism. It is therefore not recommended. Suxamethonium-induced myalgia may mimic symptoms of rhabdomyolysis and cause raised CK therefore should be avoided. Opioids, NSAIDS, regional anesthesia, and local anesthetic techniques have all been used without complication. PMID:25069536

Redshaw, Charlotte; Stewart, Catherine

2014-11-01

145

21 CFR 868.5550 - Anesthetic gas mask.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Anesthetic gas mask. 868.5550 Section 868.5550 Food...Therapeutic Devices § 868.5550 Anesthetic gas mask. (a) Identification. An anesthetic gas mask is a device, usually made of...

2010-04-01

146

21 CFR 868.5550 - Anesthetic gas mask.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Anesthetic gas mask. 868.5550 Section 868.5550 Food...Therapeutic Devices § 868.5550 Anesthetic gas mask. (a) Identification. An anesthetic gas mask is a device, usually made of...

2011-04-01

147

Comparative analysis of tissue reactions to anesthetic solutions: histological analysis in subcutaneous tissue of rats.  

PubMed Central

Postanesthetic pain is a relatively common complication after local anesthesia. This complication may be caused by the anesthetic technique or by the anesthetic solution used. Tissue reactions induced by the anesthetic solutions may be one of the factors resulting in pain after anesthesia. The objective of this study was to comparatively analyze tissue reactions induced by different anesthetic solutions in the subcutaneous tissue of rats. The following solutions were utilized: 2% lidocaine without vasoconstrictor; a 0.5% bupivacaine solution with 1:200,000 adrenaline; a 4% articaine solution and 2% mepivacaine, both with 1:100,000 adrenaline; and a 0.9% sodium chloride solution as a control. Sterilized absorbent paper cones packed inside polyethylene tubes were soaked in the solutions and implanted in the subcutaneous region. The sacrifice periods were 1, 2, 5, and 10 days after surgery. The specimens were prepared and stained with hematoxylin and eosin for histological analysis. The results showed that there is a difference in tissue irritability produced by the local anesthetic solutions. The results also showed that there is no relation between the concentration of the drug and the inflammatory intensity, that the mepivacaine and articaine solutions promoted less inflammatory reaction than the bupivacaine, and that the lidocaine solution produced the least intense inflammation. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 PMID:14959905

Ribeiro, Paulo Domingos; Sanches, Marcio Giampietro; Okamoto, Tetuo

2003-01-01

148

Lidocaine Iontophoresis Versus Eutectic Mixture of Local Anesthetics (EMLA??) for IV Placement in Children  

Microsoft Academic Search

Pain during venipuncture is a major source of concern to children and their caretakers. Iontophoresis is a novel technique that uses an electrical current to facili- tate movement of solute ions (lidocaine) across the stra- tum corneum barrier to provide dermal analgesia. In this study, we compared dermal analgesia provided by lidocaine iontophoresis and eutectic mixture of local anesthetics (EMLA®).

Jeffrey L. Galinkin; John B. Rose; Kathleen Harris; Mehernoor F. Watcha

2002-01-01

149

Comparison of subarachnoid anesthetic effect of emulsified volatile anesthetics in rats  

PubMed Central

Spinal cord is an important target of volatile anesthetics in particular for the effect of immobility. Intrathecal injection of volatile anesthetics has been found to produce subarachnoid anesthesia. The present study was designed to compare spinal anesthetic effects of emulsified volatile anesthetics, and to investigate the correlation between their spinal effects and general effect of immobility. In this study, halothane, isoflurane, enflurane and sevoflurane were emulsified by 30% Intralipid. These emulsified volatile anesthetics were intravenously and intrathecally injected, respectively. ED50 of general anesthesia and EC50 of spinal anesthesia were determined. The durations of general and spinal anesthesia were recorded. Correlation analysis was applied to evaluate the anesthetic potency of volatile anesthetics between their spinal and general effects. ED50 of general anesthesia induced by emulsified halothane, isoflurane, enflurane and sevoflurane were 0.41 ± 0.07, 0.54 ± 0.07, 0.74 ± 0.11 and 0.78 ± 0.08 mmol/kg, respectively, with significant correlation to their inhaled MAC (R2 = 0.8620, P = 0.047). For intrathecal injection, EC50 of spinal anesthesia induced by emulsified halothane, isoflurane, enflurane and sevoflurane were 0.35, 0.27, 0.33 and 0.26 mol/L, respectively, which could be predicted by the product of inhaled MAC and olive oil/gas partition coefficients (R2 = 0.9627, P = 0.013). In conclusion, potency and efficacy of the four emulsified volatile anesthetics in spinal anesthesia were similar and could be predicted by the product of inhaled MAC and olive oil/gas partition coefficients (MAC × olive oil/gas partition coefficients).

Guo, Jiao; Zhou, Cheng; Liang, Peng; Huang, Han; Li, Fengshan; Chen, Xiangdong; Liu, Jin

2014-01-01

150

Magnamosis: a novel technique for the management of rectal atresia.  

PubMed

We report a case of rectal atresia treated using magnets to create a rectal anastomosis. This minimally invasive technique is straightforward and effective for the treatment of rectal atresia in children. PMID:25096648

Russell, Katie W; Rollins, Michael D; Feola, G Peter; Scaife, Eric R

2014-01-01

151

Anesthetic Requirement is Increased in Redheads  

PubMed Central

Background: Age and body temperature alter inhalational anesthetic requirement; however, no human genotype is associated with inhalational anesthetic requirement. There is an anecdotal impression that anesthetic requirement is increased in redheads. Furthermore, red hair results from distinct mutations of the melanocortin-1 receptor. We thus tested the hypothesis that the requirement for the volatile anesthetic desflurane is greater in natural redhead than in dark-haired women. Methods: We studied healthy women with bright red (n=10) or dark (n=10) hair. Blood was sampled for subsequent analyses of melanocortin-1 receptor alleles. Anesthesia was induced with sevoflurane and maintained with desflurane randomly set at an end-tidal concentration between 5.5 and 7.5%. After an equilibration period, a noxious electrical stimulation (100 Hz, 70 mA) was transmitted through bilateral intradermal needles. If the volunteer moved in response to stimulation, desflurane was increased by 0.5%; otherwise it was decreased by 0.5%. This was continued until volunteers “crossed-over” from movement to non-movement (or vice versa) four times. Individual logistic regression curves were used to determine desflurane requirement (P50). Desflurane requirements in the two groups were compared using Mann-Whitney nonparametric two-sample test; P < 0.05 was considered statistically significant. Results: The desflurane requirement in redheads (6.2 volume-percent [95% CI, 5.9 - 6.5]) was significantly greater than in dark-haired women (5.2 volume-percent [4.9 – 5.5], P = 0.0004). Nine of 10 redheads were either homozygous or compound heterozygotes for mutations on the melanocortin-1 receptor gene. Conclusions: Red hair appears to be a distinct phenotype linked to anesthetic requirement in humans that can also be traced to a specific genotype. PMID:15277908

Liem, Edwin B.; Lin, Chun–Ming; Suleman, Mohammad–Irfan; Doufas, Anthony G.; Gregg, Ronald G.; Veauthier, Jacqueline M.; Loyd, Gary

2005-01-01

152

THE MOLECULAR TOOLBOX: GENETIC TECHNIQUES IN WILDLIFE ECOLOGY AND MANAGEMENT  

Microsoft Academic Search

Genetic data can provide a powerful tool for those interested in the ecology and management of wildlife, especially when it is combined with behavioral, demographic, or spatial information. Although the full potential of genetic approaches to the study of wildlife populations has yet to be realized, the application of genetic analyses is becoming increasingly feasible and cost-effective. This is due

RANDY W. DEYOUNG; RODNEY L. HONEYCUTT

2005-01-01

153

Nitrogen Management Modeling Techniques: Assessing Cropping Systems/Landscape Combinations.  

Technology Transfer Automated Retrieval System (TEKTRAN)

Nitrogen use efficiency (NUE) in production agriculture often is too low resulting in losses of excess N to ground water as NO3-N, to gaseous emissions of NH3 and N2O, and to N losses in surface runoff and erosion. Best management practices (BMPs) are needed to improve efficiency levels while maint...

154

Anesthetic considerations in Demons-Meigs’ syndrome: a case report  

PubMed Central

Introduction Demons-Meigs’ syndrome is characterized by the presence of a benign ovarian tumor associated with ascites and a right-sided hydrothorax. Its pathophysiology remains unclear. Anesthesia of this syndrome is a real challenge. Respiratory, hemodynamic, metabolic problems and abdominal hypertension are the main anesthetic risks. Case presentation A 52-year-old African woman with Demons-Meigs’ syndrome was admitted for elective surgery under general anesthesia. An abdominal computed tomography scan showed a tumor mass, with tissue and cystic components associated with abundant ascites and a right pleural effusion of medium abundance. In the operating room after standard monitoring, a crash induction was performed. Just after, her saturation level decreased requiring the use of an alveolar recruitment maneuver followed by the application of positive end-expiratory pressure. Vasoconstrictor and vascular filling were used to correct the hypotension that occurred. Airway pressures remained at 35cm H2O. Maintenance of a slightly proclive position and opening of the abdomen with the progressive removal of 3200ml ascitic fluid allowed a lower thoracic pressure (airway pressures=24cm H2O). Her postoperative course was unremarkable. Clinical evolution after five months was marked by a complete recovery of our patient and no recurrence of effusion or ascites. Conclusions Demons-Meigs’ syndrome is a benign disease with a good prognosis. Respiratory and hemodynamic problems and abdominal hypertension are the main anesthetic risks of this syndrome. Good management of these risks is necessary to preserve the prognosis. PMID:25262179

2014-01-01

155

The Effect of Intravenous Anesthetics on Ischemia-Reperfusion Injury  

PubMed Central

The effects of intravenous anesthetics on ischemia-reperfusion injury (IRI) have been investigated in both animals and clinical studies. The protective effects and the dosages of the intravenous anesthetics on IRI were discussed in this paper. The prevention of the tissue injury after the IRI was demonstrated with intravenous anesthetics in some studies. In the future, the studies should be focused on the dosage of the anesthetics related to diminishing the tissue injuries. Further studies might be required in order to investigate the effects of the anesthetics on molecular levels. PMID:24527458

2014-01-01

156

Advanced neuroimaging techniques in the management of glioblastoma multiforme.  

PubMed

Despite the extensive research efforts over the past century, glioblastoma multiforme (GBM) remains an ominous diagnosis leading fast to progressive disability and death despite the aggressive treatment including microsurgical resection, chemotherapy, radiotherapy and stereotactic radiosurgery. Advanced neuroimaging techniques, such as volumetric acquisitions, spectroscopy, diffusion and perfusion studies added to conventional imaging, provide in selected cases a non-invasive alternative to pathological diagnosis but they are also precious tools to define the boundaries of image-guided microsurgical resection and/or radiosurgical ablation. This paper reviews the role of advanced neuroimaging techniques in the diagnosis and treatment of GBM. PMID:22642424

Colonnese, Claudio; Romanelli, Pantaleo

2012-10-01

157

Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases  

NASA Technical Reports Server (NTRS)

Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed.

Brumfield, J. O. (editor); Schiffman, Y. M. (editor)

1982-01-01

158

Vascular tracers alter hemodynamics and airway pressure in anesthetized sheep  

SciTech Connect

The technique of vascular labeling was developed to mark sites of increased microvascular permeability. We used the vascular labeling technique in anesthetized sheep and found that hemodynamics and airway pressure were adversely affected by intraarterial infusions of two vascular tracers. Monastral blue (nine sheep) immediately caused systemic arterial hypotension, pulmonary arterial hypertension, and bronchoconstriction. All three physiological responses were partially blocked by a cyclooxygenase inhibitor (indomethacin) but not by an H1-antihistamine (chlorpheniramine). Colloidal gold (nine sheep) caused immediate, but less dramatic, pulmonary arterial hypertension which was not attenuated by the blocking agents. We conclude that these two vascular tracers caused detrimental physiological side effects in sheep at the usual doses used to label injured microvessels in other species.

Albertine, K.H.; Staub, N.C.

1986-11-01

159

A GUIDE TO AERATION/CIRCULATION TECHNIQUES FOR LAKE MANAGEMENT  

EPA Science Inventory

The application of aeration/circulation techniques to lakes are reviewed from a theoretical and practical viewpoint. The effect of destratification on algal production is related to the mixed depth with the use of a mathematical model. Procedures are given to determine air requir...

160

Applying Data Mining Techniques to Address Disaster Information Management Challenges on Mobile Devices  

E-print Network

Management and Disaster Recovery techniques are national priorities in the wake of man-made and nature and managing information plays an important role in business recovery efforts after disaster event. With the proliferation of smart phones and wireless tablets, professionals who have an operational responsibility

Chen, Shu-Ching

161

Information Landscaping: Information Mapping, Charting, Querying and Reporting Techniques for Total Quality Knowledge Management.  

ERIC Educational Resources Information Center

Total quality management and knowledge management are merged and used as a conceptual model to direct and develop information landscaping techniques through the coordination of information mapping, charting, querying, and reporting. Goals included: merge citation analysis and data mining, and apply data visualization and information architecture…

Tsai, Bor-sheng

2003-01-01

162

Techniques of Document Management: A Review of Text Retrieval and Related Technologies.  

ERIC Educational Resources Information Center

Reviews present and possible future developments in the techniques of electronic document management, the major ones being text retrieval and scanning and OCR (optical character recognition). Also addresses document acquisition, indexing and thesauri, publishing and dissemination standards, impact of the Internet, and the document management

Veal, D. C.

2001-01-01

163

PDE Estimation Techniques for Advanced Battery Management Systems -Part II: SOH Identification  

E-print Network

PDE Estimation Techniques for Advanced Battery Management Systems - Part II: SOH Identification S and Reinvestment Act (ARRA) of 2009 [3]. As such, battery management systems within these advanced transportation vehi- cles and renewable energy resources is battery energy storage. Advanced battery systems represent

Krstic, Miroslav

164

The Impact of Teachers' Aggressive Management Techniques on Students' Attitudes to Schoolwork  

ERIC Educational Resources Information Center

Previous studies have shown that teachers' aggressive classroom management impacts negatively on students. The authors compared student reaction to teachers' use of aggressive management techniques in Australia, China, and Israel. Reactions included distraction negativity toward teachers and perceptions that teachers' responses were unjustified,…

Romi, Shlomo; Lewis, Ramon; Roache, Joel; Riley, Philip

2011-01-01

165

Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems  

SciTech Connect

Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

Nijs, Els L. F., E-mail: nijs@email.chop.ed [University of Pennsylvania, Department of Clinical Radiology, Children's Hospital of Philadelphia (United States); Cahill, Anne Marie, E-mail: cahill@email.chop.ed [University of Pennsylvania, Department of Radiology, Children's Hospital of Philadelphia (United States)

2010-12-15

166

Novel surgical technique for the management of partial cryptophthalmos  

PubMed Central

We report a case of a 2-month-old baby with bilateral nonsyndromic partial cryptophthalmos presenting with upper eyelid incomplete development and fusion to the cornea with resultant inability to close the eyes. He was managed successfully with bilateral upper lid reconstruction with composite graft using maternal skin and oral mucous membrane, amniotic membrane, and donor scleral graft. After this one stage surgery, lids were well-formed, and the patient was able to close both eyes, thus achieving good anatomical, functional, and cosmetic outcome. PMID:25494255

Murthy, Ramesh; Gupta, Himika

2014-01-01

167

Anesthetic gases and occupationally exposed workers.  

PubMed

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers. The liver blood markers show statistically significant differences in health care workers compared with controls (p<0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p<0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p<0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers. PMID:24374387

Casale, Teodorico; Caciari, Tiziana; Rosati, Maria Valeria; Gioffrè, Pier Agostino; Schifano, Maria Pia; Capozzella, Assunta; Pimpinella, Benedetta; Tomei, Gianfranco; Tomei, Francesco

2014-01-01

168

Local Anesthetics as Pain Therapy in Horses  

Microsoft Academic Search

Local Anesthetics as Pain Therapy in Horses Thomas J. Doherty MVB, MSc, and M. Reza Seddighi DVM, PhD\\u000aDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA\\u000aThis article describes the rationale behind the use of systemically administered lidocaine as an analgesic. The analgesic efficacy of intravenously administered

Seddighi Reza DVM

2010-01-01

169

Management of posterior capsule rupture during phacoemulsification using the dry technique  

Microsoft Academic Search

To manage posterior capsule rupture during phacoemulsification, we use a dry technique in which all procedures are performed without an irrigation\\/aspiration system. The dry technique is characterized by (1) continuous viscoelastic injection instead of fluid irrigation to maintain anterior chamber depth with the posterior capsule and vitreous located posteriorly and (2) static removal of most residual lens material by viscoexpression

Junsuke Akura; Shiro Hatta; Shuzo Kaneda; Mika Ishihara; Kazuki Matsuura; Akihiko Tamai

2001-01-01

170

Investigative and management techniques for cement kiln dust and pulp and paper process wastes  

Microsoft Academic Search

Knowledge of the characteristics of industrial process wastes allows for some innovative and cost savings techniques for investigating and managing these wastes over conventional methods. This paper explores examples of some of these techniques employed on cement kiln dust (CKD) and pulp and paper mill process waste. Similar to Portland Cement, unleached CKD contains free lime and sources of reactive

Christopher S. Peters

1998-01-01

171

Use and efficacy of low-dose ketamine in the management of acute postoperative pain: a review of current techniques and outcomes  

Microsoft Academic Search

Ketamine hydrochloride is a well known general anesthetic and short acting analgesic in use for almost 3 decades. The role of the NMDA receptor in the processing of nociceptive input has led naturally to renewed clinical interest in N-methyl-d-aspartate (NMDA) receptor antagonists such as ketamine. This paper reviews the use and efficacy of low-dose ketamine in the management of acute

Roger L. Schmid; Alan N. Sandler; Joel Katz

1999-01-01

172

Statistical and Economic Techniques for Site-specific Nematode Management.  

PubMed

Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes. PMID:24643451

Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L

2014-03-01

173

Thermal Management Techniques for Oil-Free Turbomachinery Systems  

NASA Technical Reports Server (NTRS)

Tests were performed to evaluate three different methods of utilizing air to provide thermal management control for compliant journal foil air bearings. The effectiveness of the methods was based on bearing bulk temperature and axial thermal gradient reductions during air delivery. The first method utilized direct impingement of air on the inner surface of a hollow test journal during operation. The second, less indirect method achieved heat removal by blowing air inside the test journal to simulate air flowing axially through a hollow, rotating shaft. The third method emulated the most common approach to removing heat by forcing air axially through the bearing s support structure. Internal bearing temperatures were measured with three, type K thermocouples embedded in the bearing that measured general internal temperatures and axial thermal gradients. Testing was performed in a 1 atm, 260 C ambient environment with the bearing operating at 60 krpm and supporting a load of 222 N. Air volumetric flows of 0.06, 0.11, and 0.17 cubic meters per minute at approximately 150 to 200 C were used. The tests indicate that all three methods provide thermal management but at different levels of effectiveness. Axial cooling of the bearing support structure had a greater effect on bulk temperature for each air flow and demonstrated that the thermal gradients could be influenced by the directionality of the air flow. Direct air impingement on the journal's inside surface provided uniform reductions in both bulk temperature and thermal gradients. Similar to the direct method, indirect journal cooling had a uniform cooling effect on both bulk temperatures and thermal gradients but was the least effective of the three methods.

Radil, Kevin; DellaCorte, Chris; Zeszotek, Michelle

2006-01-01

174

Effects of management techniques on the establishment of eucalypt seedlings on farmland: a review  

Microsoft Academic Search

Research into the effects of seven management techniques on survival and growth of eucalypt seedlings planted on farmland\\u000a is reviewed. The techniques include: pre- and post-planting weed control; soil cultivation; fertiliser; mulch; tree guards\\/shelters;\\u000a and irrigation. The initial and ongoing effects of each technique are discussed—including the effects of timing, type and\\u000a quantity. Consideration is given to site, species and

Sonia Graham; Heather M. McGinness; Deborah A. O’Connell

2009-01-01

175

Contemporary pacemaker and ICD lead management: techniques for lead extraction.  

PubMed

With the increasing utilization of cardiac implantable electronic devices, the ability to extract leads using the transvenous approach has become important. Devices that are infected and leads that pose a risk to the patient by causing damage to cardiovascular structures, interference with device function or life-threatening arrhythmias should be removed. While the majority of extractions are performed through the vein of implantation, other approaches, such as the femoral approach, are required in some circumstances. Simple traction may be successful in removing the lead in relatively new (<1 year) implants. Older devices invariably require devices such as locking stylets and simple or powered sheaths. With current techniques, complete lead extraction can be achieved in >90% of cases with a major complication rate of <2% and mortality rate of <1%. Transvenous lead extraction should be performed only by experienced operators with the resources to address life-threatening complications. PMID:22908921

Madhavan, Malini; Swale, Matthew J; Gard, Joseph J; Hayes, David L; Asirvatham, Samuel J

2012-07-01

176

Physiologic and Anesthetic Considerations in Octogenarians Undergoing Laparoscopic Partial Nephrectomy  

PubMed Central

The number of small renal tumors detected is increasing as imaging becomes both more available and advanced, and as the population ages, with a greater proportion of patients in their 80s emerging with small and treatable renal tumors. The technique of laparoscopic partial nephrectomy is emerging and becoming ever more popular in some centers, and is potentially a safer alternative for the elderly due to improved postoperative pain, shorter hospital stay with faster return to preoperative activities, and lower rates of morbidity and mortality. We present a systematic review of the physiologic and anesthetic considerations in octogenarians undergoing the procedure, highlighting special considerations and the need for expertise throughout the multidisciplinary team when dealing with these patients, in order to minimize risk and optimize outcome. PMID:23671402

Todd, Elizabeth; Vasdev, Nikhil; Soomro, Naeem A

2013-01-01

177

Investment, regulation, and uncertainty: managing new plant breeding techniques.  

PubMed

As with any technological innovation, time refines the technology, improving upon the original version of the innovative product. The initial GM crops had single traits for either herbicide tolerance or insect resistance. Current varieties have both of these traits stacked together and in many cases other abiotic and biotic traits have also been stacked. This innovation requires investment. While this is relatively straight forward, certain conditions need to exist such that investments can be facilitated. The principle requirement for investment is that regulatory frameworks render consistent and timely decisions. If the certainty of regulatory outcomes weakens, the potential for changes in investment patterns increases.   This article provides a summary background to the leading plant breeding technologies that are either currently being used to develop new crop varieties or are in the pipeline to be applied to plant breeding within the next few years. Challenges for existing regulatory systems are highlighted. Utilizing an option value approach from investment literature, an assessment of uncertainty regarding the regulatory approval for these varying techniques is undertaken. This research highlights which technology development options have the greatest degree of uncertainty and hence, which ones might be expected to see an investment decline. PMID:24499745

Smyth, Stuart J; McDonald, Jillian; Falck-Zepeda, Jose

2014-01-01

178

Independent Business Owner/Managers. Project TEAMS. (Techniques and Education for Achieving Management Skills).  

ERIC Educational Resources Information Center

Prepared as part of Platte Technical Community College's project to help managers and supervisors develop practical, up-to-date managerial skills in a relatively short time, this instructional workbook provides information and exercises applicable to on-the-job situations encountered by independent business owner/managers. Unit I provides…

Platte Technical Community Coll., Columbus, NE.

179

Effects of general anesthetics on visceral pain transmission in the spinal cord  

PubMed Central

Current evidence suggests an analgesic role for the spinal cord action of general anesthetics; however, the cellular population and intracellular mechanisms underlying anti-visceral pain by general anesthetics still remain unclear. It is known that visceral nociceptive signals are transmited via post-synaptic dorsal column (PSDC) and spinothalamic tract (STT) neuronal pathways and that the PSDC pathway plays a major role in visceral nociception. Animal studies report that persistent changes including nociception-associated molecular expression (e.g. neurokinin-1 (NK-1) receptors) and activation of signal transduction cascades (such as the protein kinase A [PKA]-c-AMP-responsive element binding [CREB] cascade)-in spinal PSDC neurons are observed following visceral pain stimulation. The clinical practice of interruption of the spinal PSDC pathway in patients with cancer pain further supports a role of this group of neurons in the development and maintenance of visceral pain. We propose the hypothesis that general anesthetics might affect critical molecular targets such as NK-1 and glutamate receptors, as well as intracellular signaling by CaM kinase II, protein kinase C (PKC), PKA, and MAP kinase cascades in PSDC neurons, which contribute to the neurotransmission of visceral pain signaling. This would help elucidate the mechanism of antivisceral nociception by general anesthetics at the cellular and molecular levels and aid in development of novel therapeutic strategies to improve clinical management of visceral pain. PMID:18973669

Wang, Yun; Wu, Jing; Lin, Qing; Nauta, HJ; Yue, Yun; Fang, Li

2008-01-01

180

Anesthetic Diffusion Through Lipid Membranes Depends on the Protonation Rate  

PubMed Central

Hundreds of substances possess anesthetic action. However, despite decades of research and tests, a golden rule is required to reconcile the diverse hypothesis behind anesthesia. What makes an anesthetic to be local or general in the first place? The specific targets on proteins, the solubility in lipids, the diffusivity, potency, action time? Here we show that there could be a new player equally or even more important to disentangle the riddle: the protonation rate. Indeed, such rate modulates the diffusion speed of anesthetics into lipid membranes; low protonation rates enhance the diffusion for local anesthetics while high ones reduce it. We show also that there is a pH and membrane phase dependence on the local anesthetic diffusion across multiple lipid bilayers. Based on our findings we incorporate a new clue that may advance our understanding of the anesthetic phenomenon. PMID:25520016

Pérez-Isidoro, Rosendo; Sierra-Valdez, F. J.; Ruiz-Suárez, J. C.

2014-01-01

181

The relationship among brain, spinal cord and anesthetic requirements.  

PubMed

The spinal cord is a crucial site wherein anesthetics suppress movement in response to noxious stimuli. The balance of excitatory and inhibitory influences on the spinal cord likely determines the extent of motor response, and is thus important to anesthetic requirements. When the volatile anesthetic isoflurane is selectively delivered to the in situ goat brain (with low concentrations in the torso), anesthetic requirements increase dramatically, but when low isoflurane concentrations are delivered to the brain, anesthetic requirements decrease in the torso. When high, supraclinical concentrations of isoflurane (6-10%) are delivered to the brain and not to the torso, spontaneous movement occurs. These results are best explained by a differential effect of anesthetics on spinal cord neurons and cerebral neurons (midbrain reticular formation). Examination of neurons in the dorsal horn and midbrain reticular formation, and the electromyogram, during differential delivery of isoflurane to brain and spinal cord, will test this hypothesis. PMID:9049994

Antognini, J F

1997-01-01

182

Anesthetic experience of a patient with relapsing polychondritis -A case report-  

PubMed Central

Relapsing polychondritis is a rare disease characterized by progressive inflammation and destruction of cartilaginous structures such as ears, nose, and tracheolaryngeal structures. As a result, tracheolaryngeal involvement makes anesthetic management a challenge. Anesthetic management of a patient with relapsing polychondritis may encounter airway problems caused by severe tracheal stenosis. We present the case of a 60-year-old woman with relapsing polychondritis who underwent wedge resection of the stomach under epidural analgesia. Thoracic epidural blockade of the T4-10 dermatome was achieved by epidural injection of 7 ml of 0.75% ropivacaine and 50 µg of fentanyl. The patient was tolerable during the operation. We suggest that epidural analgesia may be an alternative to general anesthesia for patients with relapsing polychondritis undergoing upper abdominal surgery. PMID:23198044

Kim, In Ki; Kim, Min Soo; Shin, Yang-Sik

2012-01-01

183

Mimosa pudica, Dionaea muscipula and anesthetics.  

PubMed

Some studies showed that anesthetics reduce the response of physical stimuli in Mimosa pudica and in Venus Flytrap (Dionaea muscipula), peculiar plants that have the ability to respond to touch stimuli. In this research we tested the effects of ketamine, lidocaine, diethyl ether, and amlodipine on the movements of Mimosa pudica and Venus Flytrap. With a literature review, we tried to bring elements to theorize about the interaction of these substances with these plants. The angular displacement in Mimosa´s petiole and in Dionaea leaves is what was measured to compare the drugs group with control groups. PMID:22899087

De Luccia, Thiago Paes de Barros

2012-09-01

184

A Security Event Management Framework Using Wavelet and Data-Mining Technique  

Microsoft Academic Search

As the rapid increase of network security events, network security monitoring and management on network behavior become more and more focused in the fields of computer science. This paper develops a kind of network security management framework using collection, analysis and integration, event-correlation and scenario-analysis technique to process the raw data gathered from hybrid network. Data-mining and wavelet technology are

Lan Liu; Zhitang Li; Ling Xu; Huajun Chen

2006-01-01

185

Current role of modern radiotherapy techniques in the management of breast cancer  

PubMed Central

Breast cancer is the most common type of malignancy in females. Advances in systemic therapies and radiotherapy (RT) provided long survival rates in breast cancer patients. RT has a major role in the management of breast cancer. During the past 15 years several developments took place in the field of imaging and irradiation techniques, intensity modulated RT, hypofractionation and partial-breast irradiation. Currently, improvements in the RT technology allow us a subsequent decrease in the treatment-related complications such as fibrosis and long-term cardiac toxicity while improving the loco-regional control rates and cosmetic results. Thus, it is crucial that modern radiotherapy techniques should be carried out with maximum care and efficiency. Several randomized trials provided evidence for the feasibility of modern radiotherapy techniques in the management of breast cancer. However, the role of modern radiotherapy techniques in the management of breast cancer will continue to be defined by the mature results of randomized trials. Current review will provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer. PMID:25114857

Ozyigit, Gokhan; Gultekin, Melis

2014-01-01

186

Networkcentric healthcare: applying the tools, techniques and strategies of knowledge management to create superior healthcare operations.  

PubMed

The proliferation of Information Computer and Communication Technologies (IC2T) throughout the business environment has led to exponentially increasing amounts of data and information. Although these technologies were implemented to enhance and facilitate superior decision-making, the reality is information overload. Knowledge Management (KM) is a recent management technique designed to make sense of this information chaos. Critical to knowledge management is the application of IC2T. This paper discusses how effective and efficient healthcare operations can ensue through the adoption of a networkcentric healthcare perspective that is grounded in process-oriented knowledge generation and enabled through World Healthcare Information Grid (WHIG). PMID:18048258

von Lubitz, Dag; Wickramasinghe, Nilmini

2006-01-01

187

Development of parameter based fault detection and diagnosis technique for energy efficient building management system  

Microsoft Academic Search

This paper presents a complete methodology for detection and diagnosis of faults in variable air volume air handling units. Three cases are considered: (a) an off-line fault detection technique for existing buildings, (b) an automatic on-line fault detection technique for integration in building management systems (BMSs) of upcoming not very complex buildings and (c) an automatic on-line fault detection as

Sanjay Kumar; S. Sinha; T. Kojima; H. Yoshida

2001-01-01

188

Interventional Techniques: Evidence-based Practice Guidelines in the Management of Chronic Spinal Pain  

Microsoft Academic Search

Background: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation of

Mark V. Boswell; Andrea M. Trescot; Sukdeb Datta; David M. Schultz; Hans C. Hansen; Salahadin Abdi; Nalini Sehgal; Rinoo V. Shah; Vijay Singh; Ramsin M. Benyamin; Vikram B. Patel; Ricardo M. Buenaventura; James D. Colson; Harold J. Cordner; Richard S. Epter; Joseph F. Jasper; Elmer E. Dunbar; Sairam L. Atluri; Richard C. Bowman; Timothy R. Deer; John Swicegood; Peter S. Staats; Howard S. Smith; Allen W. Burton; David S. Kloth; James Giordano; Laxmaiah Manchikanti

2007-01-01

189

Local anesthetics reduce the inhibitory neurotransmitter-induced current in dissociated hippocampal neurons of the rat  

Microsoft Academic Search

The effects of local anesthetics on amino acid-induced currents were examined using the whole-cell configuration of the patch clamp technique in dissociated hippocampal pyramidal neurons of the rat. Lidocaine (3 mM) decreased the glycine-induced Cl? current (Gly-ICl) more potently (to 46% of the control value) than the ?-aminobutyric acid-induced Cl? current (GABA-ICl; to 75%), whereas the agent had little effect

Manami Hara; Yoshihisa Kai; Yoshimi Ikemoto

1995-01-01

190

Solubility of volatile anesthetics in plasma substitutes, albumin, intravenous fat emulsions, perfluorochemical emulsion, and aqueous solutions  

Microsoft Academic Search

Using the gas chromatographic headspace sampling technique, we determined the solubility of volatile anesthetics (halothane,\\u000a enflurane, isoflurane, and sevoflurane) in plasma substitutes, albumin solution, intravenous fat emulsions, perfluorochemical\\u000a FC-43 emulsion, and aqueous solutions at 37°C. The order of magnitude of ? value (liquid\\/gas partition coefficients) was halothane\\u000a >enflurane>isoflurane> sevoflurane in all the parenteral infusion fluids except the perfluorochemical emulsion (FC-43).

Jaes Chol Shim; Yoshiroh Kaminoh; Chikara Tashiro; Yoshikazu Miyamoto; Hee Koo Yoo

1996-01-01

191

Two Student Self-Management Techniques Applied to Data-Based Program Modification.  

ERIC Educational Resources Information Center

Two student self-management techniques, student charting and student selection of instructional activities, were applied to ongoing data-based program modification. Forty-two elementary school resource room students were assigned randomly (within teacher) to one of three treatment conditions: Teacher Chart-Teacher Select Instructional Activities…

Wesson, Caren

192

The role of magnetic resonance techniques in understanding and managing multiple sclerosis  

Microsoft Academic Search

Summary Magnetic resonance (MR) techniques have had a major impact in the last 10-15 years in understanding and managing multiple sclerosis. This review summarizes the current uses of MR in multiple sclerosis, based on the proceedings of a recent international workshop, under four headings: (i) technical issues; (ii) role in diagnosis; (iii) natural history studies in understanding the disease; (iv)

D. H. Miller; R. I. Grossman; S. C. Reingold; H. F. McFarland

1998-01-01

193

LOCALIZATION AND FUEL MANAGEMENT TECHNIQUES FOR THE NTUA SPACE SERVICER EMULATOR SYSTEM  

E-print Network

LOCALIZATION AND FUEL MANAGEMENT TECHNIQUES FOR THE NTUA SPACE SERVICER EMULATOR SYSTEM Thaleia. A planar space emulator has been developed to emulate the operation of free-flying robotic servicers. The last two issues are important to both emulators and space robots, and correlate directly to realistic

Papadopoulos, Evangelos

194

Current trends in behavior management techniques as they relate to new standards concerning informed consent  

Microsoft Academic Search

Standards governing informed consent are changing across the United States, and these changes have potential impact on the techniques of behavior management used by pediatric dentists. The purpose of this study was to determine pediatric dentists' azoareness of standards of informed con- sent in the state in which they practice, as well as the i~npact of the professional com~nunity standard

Barrie B. Choate; N. Sue Seale; Warren A. Parker; Carolyn F. G. Wilson

1990-01-01

195

Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies  

ERIC Educational Resources Information Center

This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

Brunton, Margaret Ann; Jeffrey, Lynn Maud

2010-01-01

196

Cultural Variations in Mothers' Acceptance of and Intent to Use Behavioral Child Management Techniques  

ERIC Educational Resources Information Center

We examined cultural differences in mothers' acceptance of and intent to use behavioral parenting techniques for managing disruptive child behavior, and the possible roles of parenting styles and implicit theories in explaining these cultural differences. A community sample of 117 Euro-Canadian and Chinese-immigrant mothers of boys aged 4- to…

Mah, Janet W. T.; Johnston, Charlotte

2012-01-01

197

Virtual memory is a technique for managing the resource of physical memory. It  

E-print Network

60 Virtual memory is a technique for managing the resource of physical memory. It gives an application the illusion of a very large amount of memory, typically much larger than what is actually of process­ es partially resident in memory. Only the most recently used portions of a process's address

Mudge, Trevor

198

Virtual memory is a technique for managing the resource of physical memory. It  

E-print Network

60 Virtual memory is a technique for managing the resource of physical memory. It gives an application the illusion of a very large amount of memory, typically much larger than what is actually of process- es partially resident in memory. Only the most recently used portions of a process's address

Mudge, Trevor

199

PDE Estimation Techniques for Advanced Battery Management Systems -Part I: SOC Estimation  

E-print Network

This paper investigates a Li-ion battery state-of-charge (SOC) estimation algorithm based uponPDE Estimation Techniques for Advanced Battery Management Systems - Part I: SOC Estimation S. J- cles and renewable energy resources is battery energy storage. Advanced battery systems represent

Krstic, Miroslav

200

Management of Giant Cell Tumour Radius in a Three Year old Child with an Improvised Technique  

PubMed Central

Giant cell tumours of immature skeleton have a very low incidence and epi-metaphyseal location. We are presenting giant cell tumour distal radius in a skeletally immature patient; an uncontained defect with a large soft tissue component which was managed by wide excision and reconstruction with an improvised technique. PMID:25654002

Puri, Ajay; Gulia, Ashish; Sharma, Seema; Verma, Amit K

2014-01-01

201

New management techniques and restructuring for accountability in Australian police organisations  

Microsoft Academic Search

This paper examines the implementation of new management techniques in Australian police services since the late 1980s, within an international context of demands for greater public sector efficiencies and accountability. Through an examination of police organisations in Queensland and New South Wales, the paper demonstrates that the impetus for organisational change, particularly in the context of employment practices has largely

Jenny Fleming; George Lafferty

2000-01-01

202

Advances in grid-based numerical modeling techniques for improving gas management in coal mines  

Microsoft Academic Search

Effective gas management in coal mines, as well as proper ventilation design, is very important for maintaining the safety of underground coal miners. Advances in numerical modeling techniques have enabled evaluations of the coal mining environment using advanced grid designs and computed gas distributions through detailed mathematical models. These models help engineers to \\

C. Ö. Karacan

203

In-Situ Leachate Management in a Tropical Landfill by Storage and Recirculation Operation Techniques  

Microsoft Academic Search

This paper presents the application of storage and recirculation techniques to leachate management in tropical climate. Four pilot-scale landfill lysimeters were operated under different operational mode, i.e. 1) conventional landfill operation (control) 2) leachate re- circulation 3) internal storage with recirculation and 4) internal storage without recirculation. The experiment was carried out to quantify the amount and characteristics of leachate

Chart Chiemchaisri; Wilai Chiemchaisri; Salinee Sittichoktum; Taweesak Tantichanthakarun; Sunya Tangsri

204

Resistance Management Techniques of Milton H. Erickson, M.D.: An Application to Nonhypnotic Mental Health Counseling.  

ERIC Educational Resources Information Center

Delineates five selected hypnotically based techniques of client resistance management pioneered by Milton H. Erickson: acceptance; paradoxical encouragement; reframing; displacement; dissociation. Explains how techniques can be applied to nonhypnotic mental health counseling. Discusses relevant clinical, theoretical, and empirical issues related…

Otani, Akira

1989-01-01

205

A Novel Surgical Pre-suturing Technique for the Management of Ankyloglossia  

PubMed Central

Ankyloglossia or “tongue-tie” is a congenital anomaly caused by tight lingual frenulum that abnormally connects the tongue base to the floor of the mouth. Ankyloglossia can results in difficulty during speech and deglutition. This case series presents a novel surgical technique in the management of ankyloglossia in using presuturing technique in which different sets of sutures are given on lingual frenum before severing it. This results in reduced opening of the wound, minimal bleeding, pain and discomfort. Two male patients with severe ankyloglossia had been managed with this technique and after 2 years of follow-up of these cases showed satisfactory protrusive and lateral movement of the tongue with minimal scarring and discomfort.

Khairnar, Mayur; Pawar, Babita; Khairnar, Darshana

2014-01-01

206

Liquid general anesthetics lower critical temperatures in plasma membrane vesicles  

E-print Network

A large and diverse array of small hydrophobic molecules induce general anesthesia. Their efficacy as anesthetics has been shown to correlate both with their affinity for a hydrophobic environment and with their potency in inhibiting certain ligand gated ion channels. Here we explore the effects that n-alcohols and other liquid anesthetics have on the two-dimensional miscibility critical point observed in cell derived giant plasma membrane vesicles (GPMVs). We show that anesthetics depress the critical temperature (Tc) of these GPMVs without strongly altering the ratio of the two liquid phases found below Tc. The magnitude of this affect is consistent across n-alcohols when their concentration is rescaled by the median anesthetic concentration (AC50) for tadpole anesthesia, but not when plotted against the overall concentration in solution. At AC50 we see a 4{\\deg}C downward shift in Tc, much larger than is typically seen in the main chain transition at these anesthetic concentrations. GPMV miscibility critical temperatures are also lowered to a similar extent by propofol, phenylethanol, and isopropanol when added at anesthetic concentrations, but not by tetradecanol or 2,6 diterbutylphenol, two structural analogs of general anesthetics that are hydrophobic but have no anesthetic potency. We propose that liquid general anesthetics provide an experimental tool for lowering critical temperatures in plasma membranes of intact cells, which we predict will reduce lipid-mediated heterogeneity in a way that is complimentary to increasing or decreasing cholesterol. Also, several possible implications of our results are discussed in the context of current models of anesthetic action on ligand gated ion channels.

Ellyn Gray; Joshua Karslake; Benjamin B. Machta; Sarah L. Veatch

2013-09-10

207

Liquid General Anesthetics Lower Critical Temperatures in Plasma Membrane Vesicles  

PubMed Central

A large and diverse array of small hydrophobic molecules induce general anesthesia. Their efficacy as anesthetics has been shown to correlate both with their affinity for a hydrophobic environment and with their potency in inhibiting certain ligand-gated ion channels. In this study we explore the effects that n-alcohols and other liquid anesthetics have on the two-dimensional miscibility critical point observed in cell-derived giant plasma membrane vesicles (GPMVs). We show that anesthetics depress the critical temperature (Tc) of these GPMVs without strongly altering the ratio of the two liquid phases found below Tc. The magnitude of this affect is consistent across n-alcohols when their concentration is rescaled by the median anesthetic concentration (AC50) for tadpole anesthesia, but not when plotted against the overall concentration in solution. At AC50 we see a 4°C downward shift in Tc, much larger than is typically seen in the main chain transition at these anesthetic concentrations. GPMV miscibility critical temperatures are also lowered to a similar extent by propofol, phenylethanol, and isopropanol when added at anesthetic concentrations, but not by tetradecanol or 2,6 diterbutylphenol, two structural analogs of general anesthetics that are hydrophobic but have no anesthetic potency. We propose that liquid general anesthetics provide an experimental tool for lowering critical temperatures in plasma membranes of intact cells, which we predict will reduce lipid-mediated heterogeneity in a way that is complimentary to increasing or decreasing cholesterol. Also, several possible implications of our results are discussed in the context of current models of anesthetic action on ligand-gated ion channels. PMID:24359747

Gray, Ellyn; Karslake, Joshua; Machta, Benjamin B.; Veatch, Sarah L.

2013-01-01

208

Inhaled anesthetics and immobility: mechanisms, mysteries, and minimum alveolar anesthetic concentration.  

PubMed

Studies using molecular modeling, genetic engineering, neurophysiology/pharmacology, and whole animals have advanced our understanding of where and how inhaled anesthetics act to produce immobility (minimum alveolar anesthetic concentration; MAC) by actions on the spinal cord. Numerous ligand- and voltage-gated channels might plausibly mediate MAC, and specific amino acid sites in certain receptors present likely candidates for mediation. However, in vivo studies to date suggest that several channels or receptors may not be mediators (e.g., gamma-aminobutyric acid A, acetylcholine, potassium, 5-hydroxytryptamine-3, opioids, and alpha(2)-adrenergic), whereas other receptors/channels (e.g., glycine, N-methyl-D-aspartate, and sodium) remain credible candidates. PMID:12933393

Sonner, James M; Antognini, Joseph F; Dutton, Robert C; Flood, Pamela; Gray, Andrew T; Harris, R Adron; Homanics, Gregg E; Kendig, Joan; Orser, Beverley; Raines, Douglas E; Rampil, Ira J; Trudell, James; Vissel, Bryce; Eger, Edmond I

2003-09-01

209

Airway management in patients with subglottic stenosis: experience at an academic institution.  

PubMed

We describe a pilot study investigating the airway techniques used in the anesthetic management of subglottic stenosis. We searched the electronic clinical information database of the University of Michigan Health System for cases of subglottic stenosis in patients undergoing surgery. Demographics, airway techniques, incidence of hypoxemia, and technique failure were extracted from 159 records. A lower incidence of hypoxemia was found between the 4 most commonly used techniques and the less common techniques. We detected no difference in outcome between individual techniques. This study suggests a larger prospective multicenter study is required to further investigate these outcomes in patients with subglottic stenosis. PMID:24257385

Knights, Richard M; Clements, Stephan; Jewell, Elizabeth; Tremper, Kevin; Healy, David

2013-12-01

210

Implementation of quality improvement techniques for management and technical processes in the ACRV project  

NASA Technical Reports Server (NTRS)

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Raiman, Laura B.

1992-01-01

211

Volatile anesthetics constrict pulmonary artery in rabbit lung perfusion model.  

PubMed

Volatile anesthetics are generally considered to possess a vasodilator action. Some of their actions on pulmonary vessels, however, are not clearly understood. We examined the effects of various volatile anesthetics on pulmonary vessels using an in situ rabbit isolated-lung perfusion model. We prepared a rabbit constant-flow lung-perfusion model by sending blood to the pulmonary artery and removing blood from the left atrium, and observed the changes in pulmonary arterial perfusion pressure caused by inhalation of 0.5, 1, 2, and 3 minimum alveolar concentration (MAC) volatile anesthetics: halothane, enflurane, isoflurane, and sevoflurane, in random order. These volatile anesthetics increased pulmonary arterial perfusion pressure in a dose-dependent manner and caused the pulmonary arteries to constrict. In particular, halothane at all concentrations induced significantly greater pulmonary vasoconstriction than the other volatile anesthetics. Therefore, it is suggested that volatile inhalation anesthetics induce the pulmonary arteries to constrict, and halothane exhibits the most potent pulmonary vasoconstrictor effect among the volatile anesthetics tested. PMID:16261478

Takemura, Mitsuhiro; Shiokawa, Yasuhiro; Okamoto, Shinji; Uno, Hiroshi; Futagawa, Koichi; Koga, Yoshihisa

2005-01-01

212

Investigative and management techniques for cement kiln dust and pulp and paper process wastes  

SciTech Connect

Knowledge of the characteristics of industrial process wastes allows for some innovative and cost savings techniques for investigating and managing these wastes over conventional methods. This paper explores examples of some of these techniques employed on cement kiln dust (CKD) and pulp and paper mill process waste. Similar to Portland Cement, unleached CKD contains free lime and sources of reactive silica and/or alumina. Thus, it can set up in the presence of water. Properly moisture-conditioned CKD has been successfully used in Michigan as a landfill liner and cover material on closures of old CKD piles and newly permitted fills. However, CKD also contains high concentrations of soluble salts and when improperly managed can generate a leachate with high total dissolved solid concentrations. Surface and downhole geophysical methods employing electromagnetic conductivity have proven effective in delineating the horizontal and vertical extent of groundwater plumes caused by releases of CKD leachate.

Peters, C.S. [RMT, Inc., Okemos, MI (United States)

1998-12-31

213

Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine  

NASA Technical Reports Server (NTRS)

On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

2015-01-01

214

Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques  

NASA Technical Reports Server (NTRS)

Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

Saha, Bhaskar; Goebel, kai

2007-01-01

215

Interaction of Local Anesthetics with Biomembranes Consisting of Phospholipids and Cholesterol: Mechanistic and Clinical Implications for Anesthetic and Cardiotoxic Effects  

PubMed Central

Despite a long history in medical and dental application, the molecular mechanism and precise site of action are still arguable for local anesthetics. Their effects are considered to be induced by acting on functional proteins, on membrane lipids, or on both. Local anesthetics primarily interact with sodium channels embedded in cell membranes to reduce the excitability of nerve cells and cardiomyocytes or produce a malfunction of the cardiovascular system. However, the membrane protein-interacting theory cannot explain all of the pharmacological and toxicological features of local anesthetics. The administered drug molecules must diffuse through the lipid barriers of nerve sheaths and penetrate into or across the lipid bilayers of cell membranes to reach the acting site on transmembrane proteins. Amphiphilic local anesthetics interact hydrophobically and electrostatically with lipid bilayers and modify their physicochemical property, with the direct inhibition of membrane functions, and with the resultant alteration of the membrane lipid environments surrounding transmembrane proteins and the subsequent protein conformational change, leading to the inhibition of channel functions. We review recent studies on the interaction of local anesthetics with biomembranes consisting of phospholipids and cholesterol. Understanding the membrane interactivity of local anesthetics would provide novel insights into their anesthetic and cardiotoxic effects. PMID:24174934

2013-01-01

216

Innovative Techniques for Estimating Illegal Activities in a Human-Wildlife-Management Conflict  

PubMed Central

Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles) is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB) in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT); projective questioning (PQ); brief implicit association test (BIAT)) for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management. PMID:23341973

Cross, Paul; St. John, Freya A. V.; Khan, Saira; Petroczi, Andrea

2013-01-01

217

Management of postthoracotomy pain: acute and chronic.  

PubMed

Given the discomfort of thoracic surgical incisions, thoracic surgeons must understand and use contemporary multimodality pain treatments. Acute postthoracotomy pain not only causes psychologic distress to the patient but also has detrimental effects on pulmonary function and postoperative mobility, leading to increased morbidity. By choosing the most appropriate and least traumatic surgical incision, adhering to meticulous surgical techniques, and avoiding intercostal nerve injury or rib fractures, surgeons can minimize postoperative pain. Aggressive perioperative and postoperative pain management is best accomplished with use of an epidural anesthetic and covering breakthrough pain with an IV-PCA. Alternatively, an infusion system for continuous administration of local anesthetics directly in the subpleural plane, posterior to the intercostal incision, also provides excellent pain control. Again, use of an IV-PCA as adjuvant therapy is recommended. With careful planning, severe pain and its negative impact on thoracic surgical patients can be prevented. PMID:17004557

Koehler, Richard P; Keenan, Robert J

2006-08-01

218

A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report  

PubMed Central

ABSTRACT Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204. PMID:25206223

Kumaresan, Ramesh; Mohammed, Faraz; Thapasum Fairozekhan, Arishiya

2013-01-01

219

A novel technique for the management of blandin-nuhn mucocele: a case report.  

PubMed

Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204. PMID:25206223

Kumaresan, Ramesh; Karthikeyan, Priyadarshini; Mohammed, Faraz; Thapasum Fairozekhan, Arishiya

2013-09-01

220

Top-down mechanisms of anesthetic-induced unconsciousness  

PubMed Central

The question of how structurally and pharmacologically diverse general anesthetics disrupt consciousness has persisted since the nineteenth century. There has traditionally been a significant focus on “bottom-up” mechanisms of anesthetic action, in terms of sensory processing, arousal systems, and structural scales. However, recent evidence suggests that the neural mechanisms of anesthetic-induced unconsciousness may involve a “top-down” process, which parallels current perspectives on the neurobiology of conscious experience itself. This article considers various arguments for top-down mechanisms of anesthetic-induced unconsciousness, with a focus on sensory processing and sleep-wake networks. Furthermore, recent theoretical work is discussed to highlight the possibility that top-down explanations may be causally sufficient, even assuming critical bottom-up events. PMID:25002838

Mashour, George A.

2014-01-01

221

Cardiovascular toxicity of palytoxin in anesthetized dogs.  

PubMed

Cardiovascular toxicity of palytoxin (PTX), isolated from Palythoa tuberculosa, was examined in pentobarbital-anesthetized dogs. In intact dogs, PTX at doses below 0.05 microgram/kg i.v. caused a sustained rise in arterial pressure. PTX at doses above 0.06 microgram/kg i.v. caused a transient rise in arterial pressure followed by rapid hypotension and resulting in death within 5 min. In open-chest dogs, a sublethal dose of PTX caused constriction of coronary, femoral and renal arteries. Renal blood flow was interrupted by a sublethal dose of PTX. PTX at a dose of 0.04 microgram/kg, which was lethal for this preparation, caused a rapid interruption of renal and coronary blood flows. Total peripheral resistance increased and cardiac output fell abruptly at this dose. It is suggested that PTX exerts its toxic action through intense vasoconstriction in the whole body, particularly in the coronary and renal vascular beds, and through depression of the cardiac function. PMID:6127986

Ito, K; Urakawa, N; Koike, H

1982-07-01

222

[Severe local anesthetic intoxication in an infant undergoing circumcision.  

PubMed

Local anesthetic intoxication is an uncommon complication of regional anesthesia. We report the case of a 4-month-old infant who presented with generalized tonic-clonic seizure complicated by cardiac arrest secondary to a severe intoxication to local anesthesia. These complications were observed after a bilateral dorsal penile nerve block with lidocaine for circumcision in a non-hospital setting. This report emphasizes the potential risk of local anesthetic systemic toxicity in such circumstances and describes its treatment. PMID:25482996

Doye, E; Desgranges, F-P; Stamm, D; de Queiroz, M; Valla, F V; Javouhey, E

2014-11-15

223

Tissue Injury from Tricyclic Antidepressants Used as Local Anesthetics  

Microsoft Academic Search

Neurotoxicity has been reported with tricyclic anti- depressants (TCAs) used as local anesthetics. We ex- amined the hypothesis that TCAs cause tissue injury, particularly myotoxicity, as occurs with many local anesthetics. Animals were given sciatic nerve injec- tions with 0-80 mM doxepin, amitriptyline, or bu- pivacaine (1.5 mL for histological studies, 0.3 mL for neurobehavioral studies). Four days after injection,

Caryn S. Barnet; David N. Louis; Daniel S. Kohane

2005-01-01

224

Ionic mechanism of action of a spin-labeled local anesthetic on squid axon membranes.  

PubMed

The ionic mechanism of action of a spin-labeled local anesthetic (SLA), 2-[N-methyl-N-(2,2,6,6-tetramethylpiperidonooxyl)]-ethyl 4-ethoxylbenzoate, was studied by means of voltage clamp technique with squid giant axons in comparison with the parent compound without spin label moiety, 2-(N,N-dimethyl)ethyl 4-ethoxylbenzoate (GS-01). Like other local anesthetics, they suppressed both sodium and potassium conductance increases. However, three remarkable differences have been noted between SLA and GS-01: (1) SLA is more effective than GS-01 in suppressing the sodium and potassium conductance increases; (2) SLA induces a potassium inactivation, whereas GS-01 is lacking this ability; (3) SLA has no effect on the time to peak sodium current, whereas GS-01 prolongs it. GS-01 resembles procaine with respect to (2) and (3) above. SLA will become a useful probe for the study of the molecular mechanism of local anesthetic aciton and of ionic channel function. PMID:1235802

Yeh, J Z; Takeno, K; Rosen, G M; Narahashi, T

225

General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture  

PubMed Central

Background Reduction of nasal bone fracture can be performed under general or local anesthesia. The aim of this study was to compare general anesthesia (GA) and monitored anesthetic care (MAC) with dexmedetomidine based on intraoperative vital signs, comfort of patients, surgeons and nurses and the adverse effects after closed reduction of nasal bone fractures. Methods Sixty patients with American Society of Anesthesiologists physical status I or II were divided into a GA group (n = 30) or MAC group (n = 30). Standard monitorings were applied. In the GA group, general anesthesia was carried out with propofol-sevoflurane-N2O. In the MAC group, dexmedetomidine and local anesthetics were administered for sedation and analgesia. Intraoperative vital signs, postoperative pain scores by visual analog scale and postoperative nausea and vomiting (PONV) were compared between the groups. Results Intraoperatively, systolic blood pressures were significantly higher, and heart rates were lower in the MAC group compared to the GA group. There were no differences between the groups in the patient, nurse and surgeon's satisfaction, postoperative pain scores and incidence of PONV. Conclusions MAC with dexmedetomidine resulted in comparable satisfaction in the patients, nurses and surgeons compared to general anesthesia. The incidence of postoperative adverse effects and severity of postoperative pain were also similar between the two groups. Therefore, both anesthetic techniques can be used during the reduction of nasal bone fractures based on a patient%s preference and medical condition. PMID:24101954

Lee, Kyoungkyun; Yon, Jun Heum; Kim, Kye-Min; Kim, Mun-Cheol; Lee, Woo Yong; Lee, Sangseok; Lim, Yun-Hee; Nam, Sang Hyun; Choi, Young Woong; Kim, Hoon

2013-01-01

226

Effects of anesthetic compounds on responses of earthworms to electrostimulation.  

PubMed

Earthworms play an important role in biomedical research, and some surgical procedures require anesthesia. Anesthetic treatments used so far usually induce convulsive body movements connected with extrusion of coelomocyte-containing coelomic fluid that may affect experimental results. Extensive movements connected with the expulsion of coelomic fluid are exploited by immunologists as a method of harvesting immunocompetent coelomocytes from worms subjected to mild electrostimulation (4.5V). The aim of the investigations was to find anesthetic drugs without unintentional coelomocyte depletion. Experiments were performed on adult specimens of Dendrobaena veneta, the coelomocytes of which consist of amoebocytes and riboflavin-storing eleocytes. Earthworm mobility was filmed and extrusion of coelomocytes was quantified by detection of eleocyte-derived riboflavin in immersion fluid. Treatments included earthworms (1) immersed either in physiological saline (controls) or in a solution of one of the tested anesthetic drugs; (2) electrostimulated immediately after anesthesia, and (3) electrostimulated a second time after a 1-hour recovery period. The well-established fish and amphibian anesthetic agent MS-222 induced coelomocyte expulsion. In contrast, solutions of the mammalian local anesthetic drug, prilocaine hydrochloride (0.25-0.5%, 5-10 min) caused temporal earthworm immobilization followed by recovery, thus showing utility as an efficient earthworm anesthetic. PMID:25134346

Podolak-Machowska, Agnieszka; Kostecka, Joanna; Librowski, Tadeusz; Santocki, Michal; Bigaj, Janusz; Plytycz, Barbara

2014-01-01

227

Comparative efficacy of 16 anesthetic chemicals on rainbow trout  

USGS Publications Warehouse

Presently there are no legally registered fish anesthetics that allow for the release of fish or use of the fish for food soon after they have been anesthetized. MS-222 (tricaine), the only anesthetic registered for use on fish in the United States, cannot be used within 21 d of harvesting the fish for food. As the start in a search for an anesthetic that can be used with little or no withdrawal period, we tested the efficacy of 16 chemicals as anesthetics on rainbow trout Salmo gairdneri. Efficacy was defined by the fish (1) becoming handleable (quiet enough to be manipulated and handled readily) in 3 min or less, (2) recovering in 10 min or less, and (3) showing no mortality after 15 min in the anesthetic solution. Four chemicals--MS-222, quinaldine sulfate, benzocaine, and 2-phenoxyethanol--met these criteria for efficacy. Chemicals that yielded excessive induction or recovery times or caused excessive mortality were methylpentynol, chlorobutanol, etomidate, metomidate, Piscaine, propanidid, carbon dioxide, nicotine, salt, Halothane, Metofane, and Biotal. Because carbon dioxide leaves no residues and requires no withdrawal period, it may be an acceptable alternative for fishery workers who can tolerate somewhat shallower anesthesia and longer induction and recovery times.

Gilderhus, P.A.; Marking, L.L.

1987-01-01

228

Remotely sensed data assimilation technique to develop machine learning models for use in water management  

NASA Astrophysics Data System (ADS)

Increasing population and water conflicts are making water management one of the most important issues of the present world. It has become absolutely necessary to find ways to manage water more efficiently. Technological advancement has introduced various techniques for data acquisition and analysis, and these tools can be used to address some of the critical issues that challenge water resource management. This research used learning machine techniques and information acquired through remote sensing, to solve problems related to soil moisture estimation and crop identification on large spatial scales. In this dissertation, solutions were proposed in three problem areas that can be important in the decision making process related to water management in irrigated systems. A data assimilation technique was used to build a learning machine model that generated soil moisture estimates commensurate with the scale of the data. The research was taken further by developing a multivariate machine learning algorithm to predict root zone soil moisture both in space and time. Further, a model was developed for supervised classification of multi-spectral reflectance data using a multi-class machine learning algorithm. The procedure was designed for classifying crops but the model is data dependent and can be used with other datasets and hence can be applied to other landcover classification problems. The dissertation compared the performance of relevance vector and the support vector machines in estimating soil moisture. A multivariate relevance vector machine algorithm was tested in the spatio-temporal prediction of soil moisture, and the multi-class relevance vector machine model was used for classifying different crop types. It was concluded that the classification scheme may uncover important data patterns contributing greatly to knowledge bases, and to scientific and medical research. The results for the soil moisture models would give a rough idea to farmers/irrigators about the moisture status of their fields and also about the productivity. The models are part of the framework which is devised in an attempt to provide tools to support irrigation system operational decisions. This information could help in the overall improvement of agricultural water management practices for large irrigation systems. Conclusions were reached based on the performance of these machines in estimating soil moisture using remotely sensed data, forecasting spatial and temporal variation of soil moisture and data classification. These solutions provide a new perspective to problem-solving techniques by introducing new methods that have never been previously attempted.

Zaman, Bushra

229

Low level waste management: a compilation of models and monitoring techniques. Volume 1  

SciTech Connect

In support of the National Low-Level Waste (LLW) Management Research and Development Program being carried out at Oak Ridge National Laboratory, Science Applications, Inc., conducted a survey of models and monitoring techniques associated with the transport of radionuclides and other chemical species from LLW burial sites. As a result of this survey, approximately 350 models were identified. For each model the purpose and a brief description are presented. To the extent possible, a point of contact and reference material are identified. The models are organized into six technical categories: atmospheric transport, dosimetry, food chain, groundwater transport, soil transport, and surface water transport. About 4% of the models identified covered other aspects of LLW management and are placed in a miscellaneous category. A preliminary assessment of all these models was performed to determine their ability to analyze the transport of other chemical species. The models that appeared to be applicable are identified. A brief survey of the state-of-the-art techniques employed to monitor LLW burial sites is also presented, along with a very brief discussion of up-to-date burial techniques.

Mosier, J.E.; Fowler, J.R.; Barton, C.J. (comps.)

1980-04-01

230

Linking Spatial Variations in Water Quality with Water and Land Management using Multivariate Techniques.  

PubMed

Most studies using multivariate techniques for pollution source evaluation are conducted in free-flowing rivers with distinct point and nonpoint sources. This study expanded on previous research to a managed "canal" system discharging into the Indian River Lagoon, Florida, where water and land management is the single most important anthropogenic factor influencing water quality. Hydrometric and land use data of four drainage basins were uniquely integrated into the analysis of 25 yr of monthly water quality data collected at seven stations to determine the impact of water and land management on the spatial variability of water quality. Cluster analysis (CA) classified seven monitoring stations into four groups (CA groups). All water quality parameters identified by discriminant analysis showed distinct spatial patterns among the four CA groups. Two-step principal component analysis/factor analysis (PCA/FA) was conducted with (i) water quality data alone and (ii) water quality data in conjunction with rainfall, flow, and land use data. The results indicated that PCA/FA of water quality data alone was unable to identify factors associated with management activities. The addition of hydrometric and land use data into PCA/FA revealed close associations of nutrients and color with land management and storm-water retention in pasture and citrus lands; total suspended solids, turbidity, and NO + NO with flow and Lake Okeechobee releases; specific conductivity with supplemental irrigation supply; and dissolved O with wetland preservation. The practical implication emphasizes the importance of basin-specific land and water management for ongoing pollutant loading reduction and ecosystem restoration programs. PMID:25602661

Wan, Yongshan; Qian, Yun; Migliaccio, Kati White; Li, Yuncong; Conrad, Cecilia

2014-03-01

231

Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System  

NASA Astrophysics Data System (ADS)

This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

Ram Prabhakar, J.; Ragavan, K.

2013-07-01

232

Management strategies for infected total hip arthroplasty. A critical appreciation of problems and techniques.  

PubMed

Infection is a devastating complication of total hip arthroplasty (THA). Risk factors have been recognised and prevention is possible. The nature of the disease is heterogeneous and for satisfactory management one has to weigh factors related to pathogen, host, local soft tissue, bone stock, surgeon experience and financial resources. Available data in the current literature is of poor quality and there is a lack of data comparing different techniques. Referral of patients to dedicated departments with the appropriate facilities may be more appropriate. PMID:25329980

Karachalios, Theofilos; Koutalos, Antonios; Komnos, George

2014-01-01

233

Considerations and techniques for incorporating remotely sensed imagery into the land resource management process.  

NASA Technical Reports Server (NTRS)

Development of a scheme for utilizing remote sensing technology in an operational program for regional land use planning and land resource management program applications. The scheme utilizes remote sensing imagery as one of several potential inputs to derive desired and necessary data, and considers several alternative approaches to the expansion and/or reduction and analysis of data, using automated data handling techniques. Within this scheme is a five-stage program development which includes: (1) preliminary coordination, (2) interpretation and encoding, (3) creation of data base files, (4) data analysis and generation of desired products, and (5) applications.

Brooner, W. G.; Nichols, D. A.

1972-01-01

234

Incorporating Piaget's theories into behavior management techniques for the child dental patient.  

PubMed

This presentation reviews psychologist Jean Piaget's contributions to knowledge of cognitive development in children, relating it to behavior management techniques. Piaget theorized that children's knowledge about reality is realized by touching and observing; he termed this constructivism. He recognized that there are stages of development in knowledge acquisition. Practitioners should try to stimulate these needs to develop a positive dental experience. Another Piaget model is egocentrism, wherein a child views the world subjectively. The dentist should let the child patient know what's going on and have an active part in treatment. PMID:11199558

Delitala, G

2000-01-01

235

Novel technique in managing bronchobiliary fistula in adults: Endobronchial embolization using silicone spigots in 2 cases  

PubMed Central

Bronchobiliary fistula (BBF) can complicate most hepatic pathologies. This is a challenging group of patients, especially when surgery is precluded. The bronchoscopic application of silicon spigots is a recognized technique for the treatment of massive hemoptysis and the management of patients with bronchopleural fistula following lung resection. Their role in the treatment of BBF has never been described. In this paper we report the successful embolization using silicon spigots in two patients with BBF secondary to malignant disease, when all surgical options were exhausted. PMID:25593611

Kostopanagiotou, Kostas; George, Robert S.; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

2015-01-01

236

Immediate implant placement: surgical techniques for prevention and management of complications.  

PubMed

Loss of soft and hard tissue is common after tooth extraction. Substantial resorption of alveolar bone compromises esthetics and may result in prosthetic and surgical limitations. Immediate implant placement at the time of tooth extraction is used to maintain alveolar ridge dimensions. Clinical studies support the successful outcome of immediate placement of dental implants in fresh extraction sockets; comparative clinical studies have found that implant survival rates after immediate placement are similar to those after delayed placement. This article addresses surgical techniques for immediate implant placement and the prevention and the management of complications associated with this procedure. PMID:25434560

Al-Sabbagh, Mohanad; Kutkut, Ahmad

2015-01-01

237

Trimanual Anterior Vitrectomy: A Novel Technique to Manage Vitreous Loss during Phacoemulsification.  

PubMed

We report 2 cases illustrating the use of a new technique to manage vitreous loss during phacoemulsification, which we have termed 'trimanual' anterior vitrectomy. In each case, after recognizing posterior capsule tear, the remaining nuclear pieces were removed with low-parameter phacoemulsification. The remaining cortical material was then removed using bimanual irrigation and aspiration handpieces while the assistant surgeon inserted the vitrectomy probe through a separate 1-mm limbal incision. The vitrectomy probe was held below the plane of the posterior capsule tear, used to cut the vitreous and to provide a mechanical blockade to potentially descending lens material. While this technique involves the potentially awkward simultaneous use of 3 intraocular instruments, we believe that there are several advantages over standard bimanual anterior vitrectomy. PMID:25520653

Taggart, Michael G; Morshedi, R Grant; Ambati, Balamurali K

2014-09-01

238

Trimanual Anterior Vitrectomy: A Novel Technique to Manage Vitreous Loss during Phacoemulsification  

PubMed Central

We report 2 cases illustrating the use of a new technique to manage vitreous loss during phacoemulsification, which we have termed ‘trimanual’ anterior vitrectomy. In each case, after recognizing posterior capsule tear, the remaining nuclear pieces were removed with low-parameter phacoemulsification. The remaining cortical material was then removed using bimanual irrigation and aspiration handpieces while the assistant surgeon inserted the vitrectomy probe through a separate 1-mm limbal incision. The vitrectomy probe was held below the plane of the posterior capsule tear, used to cut the vitreous and to provide a mechanical blockade to potentially descending lens material. While this technique involves the potentially awkward simultaneous use of 3 intraocular instruments, we believe that there are several advantages over standard bimanual anterior vitrectomy. PMID:25520653

Taggart, Michael G.; Morshedi, R. Grant; Ambati, Balamurali K.

2014-01-01

239

Body piercing and airway management: photo guide to tongue jewelry removal techniques.  

PubMed

Body modification has been practiced in cultures around the world for thousands of years. The ramifications of body piercing on anesthesia practice and airway management have become more evident in recent years. This article reviews the techniques for removal of tongue jewelry and options for maintaining oral piercing patency. To remove or not to remove...that is the question. In the emergency medicine and anesthesia literature, there are arguments both for and against the routine removal of oral jewelry for intubation. Some practitioners feel that if people can eat, drink, talk, and sleep with the jewelry in place, they probably can be intubated safely without removing it. Most case reports present the opinion that tongue jewelry should be removed before oral intubation to minimize jewelry aspiration, bleeding, and medical-legal risks to the anesthetist. This article's focus is to illustrate suggested tongue jewelry removal techniques for awake and unconscious patients from the health practitioner's and body piercer's perspectives. PMID:18323315

DeBoer, Scott; McNeil, Michelle; Amundson, Troy

2008-02-01

240

Drivers for change in the management of prostate cancer - guidelines and new treatment techniques.  

PubMed

Clinical practice guidelines and new treatment techniques are of particular importance for the effective management of prostate cancer. In Europe, the European Association of Urology guidelines offer a regularly updated evidence-based source of recommendations for the optimal treatment of prostate cancer. This review examines recent changes to guidelines highlighting developments in diagnosis, hormonal therapy in advanced and metastatic disease, bone protection, the definition of new terminology such as castrate-resistant prostate cancer, treatment of relapse after hormonal therapy, and cytotoxic therapy for castrate-resistant prostate cancer. The review also examines new surgical and radiotherapeutic developments in prostate cancer. This includes minimally invasive techniques such as robot-assisted radical prostatectomy, which is becoming the surgical gold standard for clinically localized disease in many countries. Other promising techniques reviewed include cryosurgical ablation of the prostate, laser-induced interstitial thermotherapy, vascular-targeted photodynamic therapy, and high-intensity focused ultrasound; with the exception of cryotherapy, these approaches are not currently recommended for routine clinical use. Finally, we will review the evidence supporting intensity modulated radiotherapy, an optimized high-precision form of three-dimensional conformal radiotherapy which aims to allow homogeneously increased radiation doses, without increased toxicity to healthy at-risk organs. Novel techniques such as proton beam or carbon ion radiotherapy, which may offer improved and more localized dose distribution with reduced damage to normal tissue, are also examined. PMID:22672123

Wolff, J M; Mason, M

2012-06-01

241

Obtaining a contact lens acquired electroretinogram in the presence of topical anesthetic hypersensitivity.  

PubMed

Clinical circumstances often demand flexibility in electrodiagnostic procedures. We present a clinical case that required alteration of our routine full-field electroretinography technique. The patient presented with reports of allergy to Xylocaine (lidocaine) and refused the use of any type of topical anesthetic drops. This conflicted with our routine ERG method that combines the use of the Henkes Lovac hard contact lens and the topical anesthetic Alcaine (proparacaine hydrochloride). We acquired a successful electroretinogram without topical anesthesia by using a "piggy-back" system involving the interposition of a soft hydrophilic contact lens between the cornea and the recording hard lens. The procedure yielded excellent ERG recordings and was well tolerated. This non-routine technique was also compared to our standard ERG technique using a normal volunteer. It appears that this proposed "piggy-back" technique is a useful alternative to routine ERG procedure in cases of refusal/allergy to ophthalmic solutions and also potentially in cases where additional corneal protection is needed. PMID:17985164

Parkinson, Joan; Tremblay, Francois

2008-05-01

242

Anesthetic management of a case of armored brain  

PubMed Central

Armored brain is condition, which occurs due to calcification in a chronic subdural hematoma (SDH). Here, we are reporting a case of armored brain due to chronic SDH as a complication of vetriculoperitoneal shunt (VP shunt). Patient had undergone major surgery for removal of calcified hematoma. VP shunt is a simple surgery, but can lead to catastrophic complications like this. In this report, we had described this condition and its aspects. PMID:25558206

Gupta, Surender Kumar; Pandia, Mihir Prakash

2015-01-01

243

Anesthetic management of a patient with isovaleric acidemia.  

PubMed

A 3-year-old male with isovaleric acidemia presented for dental rehabilitation under general anesthesia. In times of stress, such as in the perioperative period, patients with isovaleric acidemia are at greater risk for morbidity and mortality from disordered metabolism, including glucose disturbances, hyperammonemia, hypocalcemia, and non-anion gap metabolic acidosis. Communication between the anesthesiology, dental, and endocrine teams allowed for safe and successful care of the patient. PMID:25642957

Lam, Humphrey; Kiberenge, Roy; Nguyen, Thanh; Sobey, Jenna Helmer; Austin, Thomas

2015-02-01

244

On neural network techniques in the secure management of communication systems through improving and quality assessing pseudorandom stream generators  

Microsoft Academic Search

Random components play an especially important role in the management of secure communication systems, with emphasis on the key management of cryptographic protocols. For this reason, the existence of strong pseudo random number generators is highly required. This paper presents novel techniques, which rely on Artificial Neural Network (ANN) architectures, to strengthen traditional generators such as IDEA and ANSI X.9

Dimitris A. Karras; Vasilios Zorkadis

2003-01-01

245

Name: Molina Question: In patients who are pregnant and need dental treatment, will using an anesthetic, as compared to  

E-print Network

: no anesthesia O: effect on mother/fetus Question Type: prognosis Search Strategy: pregnancy AND anesthetics an anesthetic, as compared to no anesthetic, result in adverse outcomes to the mother or fetus? PICO fetus, and neonate involving local anesthetics. The available literature on the use of local anesthetics

Goldman, Steven A.

246

Reliability and Efficacy of Water Use Estimation Techniques and their Impact on Water Management and Policy  

NASA Astrophysics Data System (ADS)

Estimating how much water is being used by various water users is key to effective management and optimal utilization of groundwater resources. This is especially true for aquifers like the Ogallala that are severely stressed and display depleting trends over the last many years. The High Plains Underground Water Conservation District (HPWD) is the largest and oldest of the Texas water conservation districts, and oversees approximately 1.7 million irrigated acres. Water users within the 16 counties that comprise the HPWD draw from the Ogallala extensively. The HPWD has recently proposed flow-meters as well as various 'alternative methods' for water users to report water usage. Alternative methods include using a) site specific energy conversion factors to convert total amount of energy used (for pumping stations) to water pumped, b) reporting nozzle package (on center pivot irrigation systems) specifications and hours of usage, and c) reporting concentrated animal feeding operations (CAFOs). The focus of this project was to evaluate the reliability and effectiveness for each of these water use estimation techniques for regulatory purposes. Reliability and effectiveness of direct flow-metering devices was also addressed. Findings indicate that due to site-specific variability and hydrogeologic heterogeneity, alternative methods for estimating water use can have significant uncertainties associated with water use estimates. The impact of these uncertainties on overall water usage, conservation, and management was also evaluated. The findings were communicated to the Stakeholder Advisory Group and the Water Conservation District with guidelines and recommendations on how best to implement the various techniques.

Singh, A.; Deeds, N.; Kelley, V.

2012-12-01

247

Anesthetic-dependent pial arteriolar response to ethanol.  

PubMed

Anesthetic agents are often administered in the presence of ethyl alcohol, both in research and in the clinical setting. The authors tested the hypothesis that anesthetic agents may affect cerebrovascular responses to ethanol. A closed cranial window preparation in the rat was used to compare the response of pial arterioles to topically applied ethanol (0.01% to 1% vol/vol) in the presence of alpha-chloralose/urethane (50 and 600 mg/kg, respectively) or halothane (0.5% to 1%) anesthesia. Heart rate, mean arterial blood pressure, and blood gas levels were maintained stable and within the physiological range throughout each experiment. Ethanol induced significant vasoconstriction in alpha-chloralose/urethane-anesthetized animals (multivariate analysis of variance (MANOVA), p = 0.039); conversely, ethanol induced significant vasodilation of the pial arterioles in halothane-anesthetized animals (MANOVA, p = 0.017). These responses were significantly different from one another (MANOVA, p = 0.001). Thus, the choice of anesthetic agent alters the cerebrovascular response to ethanol, and care should be taken to ascertain the influence of anesthesia in both research and clinical settings. PMID:7472557

Gordon, E L; Meno, J R; Ngai, A C; Lam, A M; Winn, H R

1995-11-01

248

Liquid general anesthetics lower critical temperatures in plasma membrane vesicles  

E-print Network

A large and diverse array of small hydrophobic molecules induce general anesthesia. Their efficacy as anesthetics has been shown to correlate both with their affinity for a hydrophobic environment and with their potency in inhibiting certain ligand gated ion channels. Here we explore the effects that n-alcohols and other liquid anesthetics have on the two-dimensional miscibility critical point observed in cell derived giant plasma membrane vesicles (GPMVs). We show that anesthetics depress the critical temperature (Tc) of these GPMVs without strongly altering the ratio of the two liquid phases found below Tc. The magnitude of this affect is consistent across n-alcohols when their concentration is rescaled by the median anesthetic concentration (AC50) for tadpole anesthesia, but not when plotted against the overall concentration in solution. At AC50 we see a 4{\\deg}C downward shift in Tc, much larger than is typically seen in the main chain transition at these anesthetic concentrations. GPMV miscibility critic...

Gray, Ellyn; Machta, Benjamin B; Veatch, Sarah L

2013-01-01

249

Advances in dental local anesthesia techniques and devices: An update  

PubMed Central

Although local anesthesia remains the backbone of pain control in dentistry, researches are going to seek new and better means of managing the pain. Most of the researches are focused on improvement in the area of anesthetic agents, delivery devices and technique involved. Newer technologies have been developed that can assist the dentist in providing enhanced pain relief with reduced injection pain and fewer adverse effects. This overview will enlighten the practicing dentists regarding newer devices and methods of rendering pain control comparing these with the earlier used ones on the basis of research and clinical studies available. PMID:24163548

Saxena, Payal; Gupta, Saurabh K.; Newaskar, Vilas; Chandra, Anil

2013-01-01

250

Guanfacine enhances cardiac acetylcholine release with little effect on norepinephrine release in anesthetized rabbits.  

PubMed

An ?2A-adrenergic agonist guanfacine improves autonomic imbalance in attention-deficit hyperactivity disorder, suggesting that it may be useful to correct autonomic imbalance in chronic heart failure (CHF) patients. To investigate the effects of guanfacine on cardiac autonomic nerve activities, a microdialysis technique was applied to anesthetized rabbit heart. Acetylcholine (ACh) and norepinephrine (NE) concentrations in atrial dialysates were measured as indices of cardiac autonomic nerve activities. Guanfacine at a dose of 100?g/kg significantly decreased heart rate and increased dialysate ACh concentration without decreasing sympathetic NE release. Guanfacine may be useful for vagal activation therapy in CHF patients. PMID:25498385

Shimizu, Shuji; Kawada, Toru; Akiyama, Tsuyoshi; Turner, Michael James; Shishido, Toshiaki; Kamiya, Atsunori; Shirai, Mikiyasu; Sugimachi, Masaru

2015-01-01

251

A importância da técnica de aspiração prévia ao bloqueio anestésico do nervo alveolar inferior The importance of the aspiration technique prior to inferior alveolar nerve block  

Microsoft Academic Search

In view of a dental surgeon's frequent use of anesthetic techniques and the fact that their misuse can cause accidents and complications in daily practice, technical, anatomical and pharmacological knowledge, in addition to professional training, are factors crucial to the success of the anesthetic procedure. Because inferior alveolar nerve block is the most widely used anesthetic procedure in dentistry, aspiration

Belmiro Cavalcanti; Egito Vasconcelos; Renata de Albuquerque; Cavalcanti Almeida; Herika de Arruda Mauricio

252

Project planning and management techniques of the fast-paced TMX-Upgrade construction  

SciTech Connect

The Tandem Mirror Experiment-Upgrade (TMX-Upgrade) construction will be completed in 18 months at a total cost of $14.5 million. This paper describes the project planning and the management techniques used to complete the TMX-Upgrade within its allocated cost and schedule. In the planning stages of a project, before approval of the proposal, we define major project objectives, create a work breakdown structure (WBS), detail a technical description for each level of the WBS, and provide detailed bottoms-up cost estimates and summary schedules. In the operating phase, which continues throughout the project, we establish budget and schedule baselines. The reporting phase includes The Department of Energy (DOE) reviews of project status at monthly, quarterly, and semiannual intervals. These reports include cost, schedule, manpower, major procurement, and technical status information.

Seberger, C.D.; Chargin, A.K.

1981-10-26

253

75 FR 876 - Anesthetic and Life Support Drugs Advisory Committee; Cancellation  

Federal Register 2010, 2011, 2012, 2013, 2014

...Administration [Docket No. FDA-2009-N-0664] Anesthetic and Life Support Drugs Advisory Committee; Cancellation AGENCY: Food...SUMMARY: The meeting of the Anesthetic and Life Support Drugs Advisory Committee scheduled for January 28,...

2010-01-06

254

Bilateral dorsal foot pain in a young tennis player managed by neurodynamic treatment techniques.  

PubMed

Exercise-related lower limb pain represents one of the most common presentations in sports medicine practice. This is usually caused by musculoskeletal overuse injuries but not uncommonly, a neuropathic cause may be suspected. A review of the literature revealed that peripheral neuropathic pain has never been documented in a child. It is possible that peripheral neuropathic pain of spinal origin may be more prevalent in children than previously recognized. This case report describes the presentation of a 12 year old tennis player with bilateral dorsal foot pain, who presented with positive findings of peripheral nerve sensitization which was successfully managed using neurodynamic treatment techniques. Differential diagnoses are considered and treatment and management described. A discussion of the clinical reasoning which led to the patient's diagnosis is included. This case report suggests the effectiveness of neurodynamic treatment in a child with bilateral foot pain who fulfilled published criteria for peripheral nerve sensitization. However, the single case methodology employed in this study limits generalization of its findings. Further studies are warranted to investigate the role of neurodynamics in musculoskeletal pain disorders in children. PMID:21376654

Nelson, Rebecca; Hall, Toby

2011-12-01

255

Educating the Business Process Managers of the Future: The Six Sigma Techniques  

NSDL National Science Digital Library

Six Sigma is a strategy designed to improve efficiency in manufacturing and business processes. Its basic focus is to decrease defect, improve overall quality, reduce cost and increase profit in production. Modern operations managers recognize the tremendous advantage of applying innovative and advanced techniques that would increase productivity and customer satisfaction. Tomorrows managers are being educated at universities today. Implementing business processes analysis and improvement methodologies should be considered an important component of this education. Six Sigma methodology offers a comprehensive body of knowledge to aid with such process improvements.This paper suggests a road map for implementation of a graduate course in Six Sigma. Students would start by acquiring the basic cognitive skills and mastering the necessary underlying concepts and theories. These theories are then put into practice through a project selection and execution. Finally, students would be prepared to offer recommendations and suggestions for the selected business on manufacturing processes.As with any instructional and curriculum material, a course in Six Sigma methodology should also provide a means of assessing outcomes and student learning. This paper will present and discuss these issues and should be of great interest to those educators who wish to offer instructions on this topic.

Stephens, Matthew P.; Torres, Patricio A.

2010-03-19

256

Assessment of frequent cutting as a plant-community management technique in power-line corridors  

NASA Astrophysics Data System (ADS)

Repeated cutting of vegetation at or near ground level in power-line corridors is a common practice for inhibiting tree growth and regeneration. However, few data exist on long-term community responses. In this study, we sampled 20 northern Kentucky power-line corridors and compared their seedling and sapling communities to the edges and interiors of adjacent undisturbed forests. Mean seedling and sapling density in corridors was roughly twice that of adjacent undisturbed forest interiors, suggesting that repeated cutting is not a viable method of inhibiting tree regeneration. Corridor communities were dominated by Robinia pseudoacacia (black locust) and Fraxinus americana (white ash), but ordinations indicated strong similaritties among communities in corridors and adjacent forests. Many of the tree species found in adjacent forests, with the exception of a few shade-tolerant species, had highest seedling and sapling densities in corridors. Stump or root sprouting by many species appears to regenerate forests quickly after cutting. However, disturbed soil and detritus accumulations caused by management crews and their equipment may also create a large variety of microsites for seedling establishment. Because repeated cutting selects for dominance by species with highest sprout growth rates, it should not be used as the sole management technique. It may instead be used to alter the vigor, stature, and stored reserves of trees so that herbicides or other methods of tree control can be used more efficiently.

Luken, James O.; Hinton, Andrew C.; Baker, Douglas G.

1991-05-01

257

Assessment of the best available wastewater management techniques for a textile mill: cost and benefit analysis.  

PubMed

In the present study, several water recovery and end-of-pipe wastewater treatment alternatives were evaluated towards the evaluation of Best Available Techniques (BATs) for the management of wastewaters from a denim textile mill in accordance with the European Union's Integrated Pollution Prevention and Control (IPPC) Directive. For this purpose, an assessment that translates the key environmental aspects into a quantitative measure of environmental performance and also financial analysis was performed for each of the alternatives. The alternatives considered for water recovery from dyeing wastewaters were nanofiltration (NF) with coagulation and/or microfiltration (MF) pre-treatment, ozonation or peroxone and Fenton oxidation. On the other hand, for the end-of-pipe treatment of the mill's mixed wastewater, ozonation, Fenton oxidation, membrane bioreactor (MBR) and activated sludge (AS) process followed by membrane filtration technologies were evaluated. The results have indicated that membrane filtration process with the least environmental impacts is the BAT for water recovery. On the other side, MBR technology has appeared as the BAT for the end-of-pipe treatment of the mill's mixed wastewater. A technical and financial comparison of these two BAT alternatives revealed that water recovery via membrane filtration from dyeing wastewaters is selected as the BAT for the water and wastewater management in the mill. PMID:20182075

Dogan, Bugce; Kerestecioglu, Merih; Yetis, Ulku

2010-01-01

258

The Limits of Corporate Social Responsibility: Techniques of Neutralization, Stakeholder Management and Political CSR.  

PubMed

Since scholarly interest in corporate social responsibility (CSR) has primarily focused on the synergies between social and economic performance, our understanding of how (and the conditions under which) companies use CSR to produce policy outcomes that work against public welfare has remained comparatively under-developed. In particular, little is known about how corporate decision-makers privately reconcile the conflicts between public and private interests, even though this is likely to be relevant to understanding the limitations of CSR as a means of aligning business activity with the broader public interest. This study addresses this issue using internal tobacco industry documents to explore British-American Tobacco's (BAT) thinking on CSR and its effects on the company's CSR Programme. The article presents a three-stage model of CSR development, based on Sykes and Matza's theory of techniques of neutralization, which links together: how BAT managers made sense of the company's declining political authority in the mid-1990s; how they subsequently justified the use of CSR as a tool of stakeholder management aimed at diffusing the political impact of public health advocates by breaking up political constituencies working towards evidence-based tobacco regulation; and how CSR works ideologically to shape stakeholders' perceptions of the relative merits of competing approaches to tobacco control. Our analysis has three implications for research and practice. First, it underlines the importance of approaching corporate managers' public comments on CSR critically and situating them in their economic, political and historical contexts. Second, it illustrates the importance of focusing on the political aims and effects of CSR. Third, by showing how CSR practices are used to stymie evidence-based government regulation, the article underlines the importance of highlighting and developing matrices to assess the negative social impacts of CSR. PMID:23997379

Fooks, Gary; Gilmore, Anna; Collin, Jeff; Holden, Chris; Lee, Kelley

2013-01-01

259

Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies  

SciTech Connect

As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

2011-11-15

260

The Limits of Corporate Social Responsibility: Techniques of Neutralization, Stakeholder Management and Political CSR  

PubMed Central

Since scholarly interest in corporate social responsibility (CSR) has primarily focused on the synergies between social and economic performance, our understanding of how (and the conditions under which) companies use CSR to produce policy outcomes that work against public welfare has remained comparatively under-developed. In particular, little is known about how corporate decision-makers privately reconcile the conflicts between public and private interests, even though this is likely to be relevant to understanding the limitations of CSR as a means of aligning business activity with the broader public interest. This study addresses this issue using internal tobacco industry documents to explore British-American Tobacco’s (BAT) thinking on CSR and its effects on the company’s CSR Programme. The article presents a three-stage model of CSR development, based on Sykes and Matza’s theory of techniques of neutralization, which links together: how BAT managers made sense of the company’s declining political authority in the mid-1990s; how they subsequently justified the use of CSR as a tool of stakeholder management aimed at diffusing the political impact of public health advocates by breaking up political constituencies working towards evidence-based tobacco regulation; and how CSR works ideologically to shape stakeholders’ perceptions of the relative merits of competing approaches to tobacco control. Our analysis has three implications for research and practice. First, it underlines the importance of approaching corporate managers’ public comments on CSR critically and situating them in their economic, political and historical contexts. Second, it illustrates the importance of focusing on the political aims and effects of CSR. Third, by showing how CSR practices are used to stymie evidence-based government regulation, the article underlines the importance of highlighting and developing matrices to assess the negative social impacts of CSR. PMID:23997379

Gilmore, Anna; Collin, Jeff; Holden, Chris; Lee, Kelley

2013-01-01

261

Managing complex processing of medical image sequences by program supervision techniques  

NASA Astrophysics Data System (ADS)

Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

1997-05-01

262

Effective management of medical information through a novel blind watermarking technique.  

PubMed

Medical Data Management (MDM) domain consists of various issues of medical information like authentication, security, privacy, retrieval and storage etc. Medical Image Watermarking (MIW) techniques have recently emerged as a leading technology to solve the problems associated with MDM. This paper proposes a blind, Contourlet Transform (CNT) based MIW scheme, robust to high JPEG and JPEG2000 compression and simultaneously capable of addressing a range of MDM issues like medical information security, content authentication, safe archiving and controlled access retrieval etc. It also provides a way for effective data communication along with automated medical personnel teaching. The original medical image is first decomposed by CNT. The Low pass subband is used to embed the watermark in such a way that enables the proposed method to extract the embedded watermark in a blind manner. Inverse CNT is then applied to get the watermarked image. Extensive experiments were carried out and the performance of the proposed scheme is evaluated through both subjective and quantitative measures. The experimental results and comparisons, confirm the effectiveness and efficiency of the proposed technique in the MDM paradigm. PMID:22327385

Das, Sudeb; Kundu, Malay Kumar

2012-10-01

263

Effects of some anesthetic agents on skin microcirculation evaluated by laser Doppler perfusion imaging in mice  

PubMed Central

Background Anesthetic agents alter microcirculation, influencing tissue oxygenation and delivery of vital substrates. Laser Doppler perfusion imaging is a widespread technique in the field of microvascular research that can evaluate noninvasively and in real time the effects of environmental conditions, physical manipulations, diseases and treatments on peripheral perfusion. This study aims to evaluate laser Doppler perfusion imaging as a means to detect changes in skin microcirculation induced by some popular anesthetic agents in a murine model. Twenty-four age- and gender-matched healthy CD1 mice were examined by laser Doppler perfusion imaging. The skin microcirculatory response was measured at the level of plantar surfaces during isoflurane anesthesia with or without subsequent dexmedetomidine or acepromazine. At the end of the procedure, dexmedetomidine was reversed by atipamezole administration. Results In all mice, skin blood flow under isoflurane anesthesia did not show significant differences over time (P = 0.1). The serial perfusion pattern and values following acepromazine or dexmedetomidine administration differed significantly (P < 0.05). Conclusions We standardized a reliable laser Doppler perfusion imaging protocol to non-invasively assess changes in skin microcirculation induced by anesthesia in mice, considering the advantages and drawbacks of this technique and its translational value. PMID:24341447

2013-01-01

264

Human Placental Lactogen Decreases Regional Blood Flow in Anesthetized Pigs  

Microsoft Academic Search

In 22 pigs anesthetized with sodium pentobarbitone, changes in blood flow caused by infusion of human placental lactogen into the left renal, external iliac, and anterior descending coronary arteries were assessed using electromagnetic flowmeters. In 17 pigs, infusion of human placental lactogen whilst keeping the heart rate and arterial pressure constant decreased coronary, renal and iliac flow. In 5 additional

E. Grossini; C. Molinari; A. Battaglia; D. A. S. G. Mary; F. Ribichini; N. Surico; G. Vacca

2006-01-01

265

Anesthetic effect of 4-styrylpyridine on lamprey and fish  

USGS Publications Warehouse

The anestheticp roperty of 4-styrylpyridine (4-SP) on fish and lamprey was first noticed during chemical screening search of a selective toxicant for larval lamprey (Applegate, Howell, Hall, and Smith, 1957). To assess the possible value of the compound as an anesthetic, we later conducted the experiments reviewed in this report.

Howell, John H.; Thomas, Paul M.

1964-01-01

266

Respiratory phase locking during mechanical ventilation in anesthetized human subjects  

E-print Network

Respiratory phase locking during mechanical ventilation in anesthetized human subjects CARL GRAVES, Canada GRAVES, CARL, LEON GLASS, DONALD LAPORTA, ROGER MELOCHE, AND ALEX GRASSINO.Respiratory phase of these results. entrainment; respiratory reflexes; control of breathing PERIODIC INPUTS HAVE POWERFUL effects

Glass, Leon

267

Does warming local anesthetic reduce the pain of subcutaneous injection?  

Microsoft Academic Search

The most frequent complaint noted with the use of lidocaine (or other amide local anesthetic) is stinging or burning pain associated with subcutaneous infiltration. The purpose of this study was to evaluate the efficacy of warming buffered lidocaine for reducing the pain of infiltration. Forty adult volunteers were entered into a randomized, crossover study conducted at a community teaching hospital.

Stacy Martin; Jeffrey S Jones; Barbara N Wynn

1996-01-01

268

Minimally Painful Local Anesthetic Injection for Cleft Lip/Nasal Repair in Grown Patients  

PubMed Central

Introduction: There has been a recent interest in injecting large body and face areas with local anesthetic in a minimally painful manner. The method includes adherence to minimal pain injection details as well feedback from the patient who counts the number of times he feels pain during the injection process. This article describes the successes and limitations of this technique as applied to primary cleft lip/nasal repair in grown patients. Methods: Thirty-two primary cleft lip patients were injected with local anesthesia by 3 surgeons and then underwent surgical correction of their deformity. At the beginning of the injection of the local anesthetic, patients were instructed to clearly inform the injector each and every time they felt pain during the entire injection process. Results: The average patient felt pain only 1.6 times during the injection process. This included the first sting of the first 27-gauge needle poke. The only pain that 51% of the patients felt was that first poke of the first needle; 24% of the patients only felt pain twice during the whole injection process. The worst pain score occurred in a patient who felt pain 6 times during the injection process. Ninety-one percent of the patients felt no pain at all after the injection of the local anesthetic and did not require a top-up. Conclusion: It is possible to successfully and reliably inject local anesthesia in a minimally painful manner for cleft lip and nasal repair in the fully grown cleft patient. PMID:25289364

Price, Christopher; Wong, Alison L.; Chokotho, Tilinde

2014-01-01

269

Spinal Osteotomy Techniques in Management of Severe Pediatric Spinal Deformity and Analysis of Postoperative Complications.  

PubMed

Study Design. Retrospective analysis.Objective. To compare radiographic analysis and clinical outcomes of spinal osteotomy techniques, including Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR), and analyze the relationship between preoperative evaluation and postoperative complication incidence.Summary of Background Data. These three techniques have been extensively reported previously, while, few literatures are available on comparing these three techniques in management of severe pediatric spinal deformity.Methods. In all of these 34 pediatric patients, 14 were treated with SPO, 12 were treated with PSO and 8 were treated with VCR. All operations were performed by the senior author beteen 2005 and 2009 in our institute. Preoperative Halo-gravity traction was applied for 2 weeks in all patients, patients were evaluated by standing radiographs taken before and after traction and post operation and a prospectively collected database with ourcomes questionnaires. The postoperative complications and its relationship to preoperative assessment were also analyzed in this study.Results. All these 34 patient were diagnosed as severe pediatric spinal deformity (22 females and 12 males), with an average age of 11.97 years (range, 6-17 years) and an average follow-up of 66.38 months (range, 48-97 months). The mean preoperative major curve for each group was 103.43° in SPO group, 108.08° in PSO group and 117.00° in VCR group, and was corrected to 15.21°, 16.83° and 25.88°, respectively. The apical vertebral translation was corrected by 73.29% by SPO, 73.35% by PSO and 59.71% by VCR. The coronal balance were improved from 16.57 mm to 1.50 mm in SPO group, 17.33 mm to 3.83 mm in PSO group and 29.38 mm to 3.63 mm in VCR group. The mean correction of the kyphotic angle for single SPO was 19.00°, for those with two and three SPOs, the average correction was 34.40° and 47.5°, and 33.83° for the PSO group, 47.38° for VCR group. There were significant improvements in the overall clinical outcomes. The overall complication rate was 35.3%. Complication rate was high in patients with respiratory insufficiency and rigid spine.Conclusion. There was no significant difference in coronal correction among these three techniques, while, the average corrections in the sagittal plane were progressively higher from single SPO to two SPOs or PSO to three SPOs or VCR. Preoperative respiratory insufficiency and rigidity of the spinal deformity are associated with high complication rate. PMID:25494310

Xia, Lei; Li, Peng; Wang, Dan; Bao, Deming; Xu, Jinglei

2014-12-01

270

Estimation of the effect of the acidosis and alkalosis on the anesthetic potency of local anesthetics by biopartitioning micellar chromatography and micellar electrokinetic chromatography  

Microsoft Academic Search

Local anesthetics are hydrophobic compounds and weak bases with protonation constants ranged between 7.5 and 8.8. These drugs block reversibly nerve conduction near their site of application or injection and thus produce temporary loss of feeling or sensation in a limited area of the body. The efficacy of anesthetic blockade of local anesthetics depends on the charged\\/uncharged form ratio and

N. Canós-Rius; Y. Martín-Biosca; S. Sagrado; R. M. Villanueva-Camañas; M. J. Medina-Hernández

2005-01-01

271

Minimally Invasive Techniques for Management of the Ureterocele and Ectopic Ureter: Upper Tract Versus Lower Tract Approach.  

PubMed

The optimal management approach for children with ureterocele and complete pyeloureteral duplication, especially in the setting of high-grade ipsilateral vesicoureteral reflux, remains unclear. Trends in surgical management reflect a shift from single-stage open reconstruction toward conservative management and minimally invasive approaches. This article reviews lower tract approaches (endoscopic ureterocele incision and ipsilateral ureteroureterostomy), and upper tract approaches (ureterocele moiety heminephrectomy) in terms of selected operative techniques, patient selection, published outcomes, postoperative care, and follow-up. Current data support endoscopic puncture as a safe and effective treatment of symptomatic children with single-system intravesical ureteroceles. PMID:25455173

Timberlake, Matthew D; Corbett, Sean T

2015-02-01

272

How to treat a difficult-to-anesthetize patient. Twelve alternatives to the traditional inferior alveolar nerve block.  

PubMed

In the case of the difficult-to-anesthetize patient, the inferior alveolar nerve can be particularly challenging In those patients, other approaches may be necessary to achieve profound anesthesia. This article presents techniques that may be used in those efforts. The clinician can change his target slightly, or increase the dosage of anesthetic. Accessory innervation by lingual and mylohyoid nerves sometimes needs to be addressed. Some standard alternative approaches are Gow-Gates and Varizani-Akinosi injections. Intraosseous and intraligamentary injections should be considered. For lower anteriors, infiltration and incisive nerve blocks can be effective. Slight changes in armamentarium, such as increasing the needle gauge, can be helpful. Twelve approaches that can be used instead of or as an adjunct to, the traditional Halstead injection are described. PMID:20583494

Forbes, William C

2010-01-01

273

Assessment of alternative management techniques of tank bottom petroleum sludge in Oman.  

PubMed

This paper investigated several options for environmentally acceptable management techniques of tank bottom oily sludge. In particular, we tested the applicability of managing the sludge by three options: (1) as a fuel supplement; (2) in solidification; (3) as a road material. Environmental testing included determination of heavy metals concentration; toxic organics concentration and radiological properties. The assessment of tank bottom sludge as a fuel supplement included various properties such as proximate analysis, ultimate analysis and energy content. Solidified sludge mixtures and road application sludge mixtures were subjected to leaching using the toxicity characteristic leaching procedure (TCLP). Tank bottom sludge was characterized as having higher concentrations of lead, zinc, and mercury, but lower concentrations of nickel, copper and chromium in comparison with values reported in the literature. Natural occurring radioactive minerals (NORM) activity values obtained on different sludge samples were very low or negligible compared to a NORM standard value of 100Bq/g. The fuel assessment results indicate that the heating values, the carbon content and the ash content of the sludge samples are comparable with bituminous coal, sewage sludge, meat and bone meal and petroleum coke/coal mixture, but lower than those in car tyres and petroleum coke. The nitrogen content is lower than those fuels mentioned above, while the sulfur content seems comparable with bituminous coal, petroleum coke and a petroleum coke/coal mixture. The apparent lack of leachability of metals from solidification and road material sludge applications suggests that toxic metals and organics introduced to these applications are not readily attacked by weak acid solutions and would not be expected to migrate or dissolved into the water. Thus, in-terms of trace metals and organics, the suggested sludge applications would not be considered hazardous as defined by the TCLP leaching procedure. PMID:16959405

Al-Futaisi, Ahmed; Jamrah, Ahmad; Yaghi, Basma; Taha, Ramzi

2007-03-22

274

New Tools, New Times: Strategic Planning. A Seminar Focusing on Proactive Management Techniques (Chapel Hill, North Carolina, June 17-19, 1991).  

ERIC Educational Resources Information Center

This handbook was designed to accompany a three-day workshop for senior administrators in higher education on proactive management techniques in higher education. Proactive management allows for anticipating change and managing uncertainty in place of crisis management or reactive actions. The workshop covered: (1) strategic thinking; (2)…

Morrison, James L.; Ashley, William C.

275

Investigative and management techniques for cement kiln dust and pulp and paper mill process wastes  

SciTech Connect

Knowledge of the characteristics of industrial process wastes allows for some innovative and cost savings techniques for investigating and managing these wastes over conventional methods. This paper explores examples of some of these techniques employed on cement kiln dust (CKD) and pulp and paper mill process waste. Similar to Portland Cement, unleached CKD contains free lime and sources of reactive silica and/or alumina. Thus, it can set up in the presence of water. Properly moisture conditioned CKD has been successfully used in Michigan as a landfill liner and cover material on closures of old CKD piles and newly permitted fills. In addition to its pozzolanic properties, CKD contains high concentrations of soluble salts, generating a leachate with high total dissolved solids concentrations. Surface and downhole geophysical methods employing electromagnetic conductivity have proven effective in delineating the horizontal and vertical extent of groundwater plumes. At one paper mill in Alabama where dewatered filter cake had been placed in a lined solid waste facility, liquids that had migrated to the surface due to excessive gas pressures caused unstable working conditions at the surface. Large, vertical french drains and a horizontal drainage blanket consisting of geogrid and sand constructed over the existing waste resulted in dewatering and a substantial increase in waste stability, allowing a vertical expansion to proceed. At a kraft mill in the southeastern US, a geotechnical investigation of a lime mud pond revealed that the stability of the unit would increase by construction of an overlying dike, thereby allowing a vertical expansion to proceed. Finally, laboratory testing and modeling of the behavior of paper mill sludges indicates that they can be used as a landfill cover with permeabilities equivalent to or better than compacted clay.

Peters, C.S. [RMT, Inc., Okemos, MI (United States)

1997-12-31

276

Airway Management and Endoscopic Treatment of Subglottic and Tracheal Stenosis: The Laryngeal Mask Airway Technique  

PubMed Central

Objectives The objective is to present clinical outcomes of subglottic and tracheal stenosis treated by flexible bronchoscopic delivery of carbon dioxide (CO2) laser via laryngeal mask airway (LMA). Methods All consecutive, nontracheotomy dependent cases of subglottic and tracheal stenosis treated endoscopically over a 4-year period were retrospectively reviewed. The surgical approach consisted of radial incisions using a flexible fiber-based CO2 laser, balloon dilation, and topical application of mitomycin C. Ventilation during the procedure occurred through the LMA, and the CO2 laser fiber was delivered through the working channel of a flexible bronchoscope passed through the LMA. Number of dilations, period between dilations, and operative times were reviewed. Results Eleven patients who underwent airway intervention during the study period were identified. Average follow-up was 28 months. Etiologies of airway stenosis included intubation injury (6), idiopathic (4), or autoimmune disease (1), requiring an average of 1.3, 1.5, and 3 dilations, respectively. Average operative time was 67 minutes. Autoimmune etiology correlated with more frequent dilations. Conclusion LMA is an effective way to manage ventilation while simultaneously allowing unencumbered flexible bronchoscopic access for laser surgery, balloon dilation, and mitomycin C application for airway stenosis. Long-term success in treating stenosis is achievable using this technique. PMID:24671485

Vorasubin, Nopawan; Vira, Darshni; Jamal, Nausheen; Chhetri, Dinesh K.

2015-01-01

277

Enhancing Learning Management Systems Utility for Blind Students: A Task-Oriented, User-Centered, Multi-Method Evaluation Technique  

ERIC Educational Resources Information Center

This paper presents a novel task-oriented, user-centered, multi-method evaluation (TUME) technique and shows how it is useful in providing a more complete, practical and solution-oriented assessment of the accessibility and usability of Learning Management Systems (LMS) for blind and visually impaired (BVI) students. Novel components of TUME…

Babu, Rakesh; Singh, Rahul

2013-01-01

278

A model for performance management in real properties using statistical techniques  

E-print Network

Within Real Property Portfolio Management. there is a conscious search for new methodologies to improve building management practice, particularly for facilities in use. An approach in this direction is realized by the ...

Deolalikar, Jyoti

1989-01-01

279

Anesthetic Efficacy of Bupivacaine Solutions in Inferior Alveolar Nerve Block  

PubMed Central

The purpose of this study was to compare the anesthetic efficacy of 2 bupivacaine solutions. Twenty-two volunteers randomly received in a crossover, double-blinded manner 2 inferior alveolar nerve blocks with 1.8 mL of racemic bupivacaine and a mixture of 75% levobupivacaine and 25% dextrobupivacaine, both 0.5% and with 1 : 200,000 epinephrine. Before and after the injection, the first mandibular pre-molar was evaluated every 2 minutes until no response to the maximal output (80 reading) of the pulp tester and then again every 20 minutes. Data were analyzed using the Wilcoxon paired test and the paired t test. No differences were found between the solutions for onset and duration of pulpal anesthesia and duration of soft tissue anesthesia (P > .05). It was concluded that the solutions have similar anesthetic efficacy. PMID:16596912

Volpato, Maria Cristina; Ranali, José; Ramacciato, Juliana Cama; de Oliveira, Patrícia Cristine; Ambrosano, Glaúcia Maria Bovi; Groppo, Francisco Carlos

2005-01-01

280

Etomidate is Still a Valid Anesthetic for Electroconvulsive Therapy.  

PubMed

Komatsu et al have recently written that the use of etomidate as an anesthetic induction agent for surgery is associated with increased 30-day mortality and cardiovascular morbidity, compared with propofol. Etomidate has long been recognized as suppressing adrenocortical function and, as an infusion over days, has been indicted in increasing intensive care unit patient mortality. Even in single doses, etomidate causes a reduction in cortisol production, although recovery from single-dose suppression is generally prompt. In prospectively evaluating etomidate as an anesthetic for electroconvulsive therapy, Lebowitz et al, in a pilot study, found that 3 times per week, etomidate did not cause adrenocortical suppression that lasted until the following treatment. The steroid responses did not differ from those of methohexital, and no patient demonstrated evidence of cortisol deficiency. Consequently, concerns raised by Komatsu et al about etomidate's safety seem unwarranted when used for electroconvulsive therapy, and their study's conclusions likely relate to issues with their retrospective methodology. PMID:25010029

Lebowitz, Philip

2014-12-01

281

Effect of certain anesthetic agents on mallard ducks  

USGS Publications Warehouse

Four anesthetic agents used in human or veterinary medicine and 3 experimental anesthetic preparations were evaluated for effectiveness in inducing narcosis when administered orally to game-farm mallard ducks (Anas platyrhynchos).Tribromoethanol was the only compound to satisfy criteria of initial tests. Mean duration of the induction, immobilization, and recovery periods was 2.4 minutes, 8.7 minutes, and 1.3 hours, respectively, at the median effective dosage for immobilization (ED50; 100 mg./kg. of body weight). The median lethal dosage (LD50) was 400 mg./kg. of body weight.Tribromoethanol was also tested on mallards during the reproductive season. Effects on the hatchability of eggs or the survival of young were not detected.

Cline, D.R.; Greenwood, R.J.

1972-01-01

282

Carborane-Derived Local Anesthetics are Isomer Dependent.  

PubMed

Clinically there is a need for local anesthetics with a greater specificity of action on target cells and longer duration. We have synthesized a series of local anesthetic derivatives we call boronicaines in which the aromatic phenyl ring of lidocaine was replaced with ortho-, meta-, C,C'-dimethyl meta- and para-carborane clusters. The boronicaine derivatives were tested for their analgesic activity and compared with lidocaine using standard procedures in mice following a plantar injection. The compounds differed in their analgesic activity in the following order: ortho-carborane = C,C'-dimethyl meta-carborane > para-carborane > lidocaine > meta-carborane derivative. Both ortho-boronicaine and C,C'-dimethyl meta-boronicaine had longer durations of analgesia than lidocaine. Differences in analgesic efficacies are rationalized by variations in chemical structure and protein binding characteristics. PMID:25420874

Kracke, George R; VanGordon, Monika R; Sevryugina, Yulia V; Kueffer, Peter J; Kabytaev, Kuanysh; Jalisatgi, Satish S; Hawthorne, M Frederick

2015-01-01

283

Local Anesthetics Induce Apoptosis in Human Thyroid Cancer Cells through the Mitogen-Activated Protein Kinase Pathway  

PubMed Central

Local anesthetics are frequently used in fine-needle aspiration of thyroid lesions and locoregional control of persistent or recurrent thyroid cancer. Recent evidence suggests that local anesthetics have a broad spectrum of effects including inhibition of cell proliferation and induction of apoptosis in neuronal and other types of cells. In this study, we demonstrated that treatment with lidocaine and bupivacaine resulted in decreased cell viability and colony formation of both 8505C and K1 cells in a dose-dependent manner. Lidocaine and bupivacaine induced apoptosis, and necrosis in high concentrations, as determined by flow cytometry. Lidocaine and bupivacaine caused disruption of mitochondrial membrane potential and release of cytochrome c, accompanied by activation of caspase 3 and 7, PARP cleavage, and induction of a higher ratio of Bax/Bcl-2. Based on microarray and pathway analysis, apoptosis is the prominent transcriptional change common to lidocaine and bupivacaine treatment. Furthermore, lidocaine and bupivacaine attenuated extracellular signal-regulated kinase 1/2 (ERK1/2) activity and induced activation of p38 mitogen-activated protein kinase (MAPK) and c-jun N-terminal kinase. Pharmacological inhibitors of MAPK/ERK kinase and p38 MAPK suppressed caspase 3 activation and PARP cleavage. Taken together, our results for the first time demonstrate the cytotoxic effects of local anesthetics on thyroid cancer cells and implicate the MAPK pathways as an important mechanism. Our findings have potential clinical relevance in that the use of local anesthetics may confer previously unrecognized benefits in the management of patients with thyroid cancer. PMID:24586874

Chang, Yuan-Ching; Hsu, Yi-Chiung; Liu, Chien-Liang; Huang, Shih-Yuan; Hu, Meng-Chun; Cheng, Shih-Ping

2014-01-01

284

Cardiovascular responses to intrathecal administration of endomorphins in anesthetized rats  

Microsoft Academic Search

Endomorphins (EMs), the endogenous, potent and selective ?-opioid receptor agonists, have been shown to decrease systemic arterial pressure (SAP) in rats after intravenous (i.v.) administration. In the present study, cardiovascular responses to intrathecal (i.t.) injection of EMs were investigated in urethane-anesthetized rats. It is noteworthy that EMs elicited decreases in SAP and heart rate (HR) in a dose-dependent manner; 10–300nmol\\/kg

Chang-Lin Wang; Ye Yu; Lu-Hao Lai; Yun Cui; Xiang Wang; Rui Wang

2007-01-01

285

Enhanced local anesthetic action of mepivacaine from the bioadhesive gels.  

PubMed

Mepivacaine, an amide-type local anesthetic, has been used to relieve local pain. Among the many drug delivery systems, transdermal drug delivery has some advantages, as it provides controlled drug delivery for an extended period of time. To develop new gel formulations that have suitable bioadhesion, the bioadhesive force of hydroxypropyl methylcellulose (HPMC) was assessed using an auto-peeling tester. The effect of drug concentration on drug release from 2% HPMC gel was studied using synthetic cellulose membrane at 37±0.5°C. The drug concentrations tested were 0.5, 1, 1.5, 2, and 2.5%. The effect of temperature on drug release from the 2% drug gel was evaluated at 27, 32, 37 and 42°C. To increase the skin permeation of mepivacaine from HPMC gel, enhancers such as saturated and unsaturated fatty acids, pyrrolidones, propylene glycol derivatives, glycerides, and non-ionic surfactants were incorporated into the mepivacaine-HPMC gels. The enhancing effect of the enhancer on drug permeation was then examined in the modified Keshary-Chien cell. For the efficacy study, the anesthetic action of the formulated mepivacaine gel containing enhancer and vasoconstrictor was evaluated with the tail-flick analgesimeter. Among the various kinds of HPMC, HPMC-K100M gel showed the highest viscosity and bioadhesive force. As the viscosity of the HPMC gels increased, the bioadhesive forces increased. Increasing the drug concentration or temperature increased the drug release rate. Among the enhancers used, polyoxyethylene 2-oleyl ether showed the greatest enhancement of permeation. Based on the area under the efficacy curve of the rat tail flick test curve, mepivacaine gel containing polyoxyethylene 2-oleyl ether and tetrahydrozoline showed prolonged and increased local anesthetic action compared to the control. For bioadhesive mepivacaine gels with enhanced local anesthetic action, mepivacaine gels containing penetration enhancer and vasoconstrictor could be developed with the bioadhesive polymer, HPMC. PMID:21190925

Cho, Cheong-Weon; Choi, Jun-Shik; Shin, Sang-Chul

2011-01-01

286

Interactions of Local Anesthetics with Voltage-gated Na + Channels  

Microsoft Academic Search

Voltage-gated Na+ channels are dynamic transmembrane proteins responsible for the rising phase of the action potential in excitable membranes. Local anesthetics (LAs) and structurally related antiarrhythmic and anticonvulsant compounds target specific sites in voltage-gated Na+ channels to block Na+ currents, thus reducing excitability in neuronal, cardiac, or central nervous tissue. A high-affinity LA block is produced by binding to open

C. Nau; G. K. Wang

2004-01-01

287

Rhabdomyolysis following accidental intra-arterial injection of local anesthetic.  

PubMed

Drug-induced myopathy, also named Nicolau syndrome, is a well-known phenomenon following intramuscular injection of certain agents, most commonly reported with penicillin or diclofenac. The mechanism responsible for the pathology is proposed to be incidental administration of the drug into the small arterioles. In this report, we present a Nicolau syndrome-like case that developed following accidental injection of a local anesthetic agent into the femoral artery during coronary angiography. PMID:18388104

Selimoglu, Ozer; Basaran, Murat; Ugurlucan, Murat; Ogus, Temucin Noyan

2009-01-01

288

Using palaeoecological techniques to inform contemporary hydrological management of a peatland  

NASA Astrophysics Data System (ADS)

Realization of the economic and environmental value of upland peatlands has led both public and private organizations to implement 'restoration' schemes. The word 'restore' implies that we seek to reverse adverse effects that have occurred and return the ecosystem to a pre-disturbance state. Restoration schemes in UK upland peatlands focus on the objectives of raising the water table through blocking drainage channels and gullies and re-vegetating bare areas of peat that are prone to erosion. The target is often the reinstatement of Sphagnum as a significant part of the peatland flora as this will produce an accumulating peat system. Restoration of a peatland implies that we have knowledge of its previous ecological history from which we can attain a restoration blueprint but restoration schemes often take little, if any, account of the ecological history of the site. This study is an example of how palaeoecological techniques have been employed at a UK upland catchment with findings to support the peatland restoration schemes. The study combined an extensive stratigraphic survey of the catchment and a detailed core-based analysis. Macrofossil, testate amoebae, humification and charcoal analysis were employed to determine the historical representation of Sphagnum at the site, the changes in water-table level, the degree of decomposition and also burning history. Stratigraphic survey and core results show that Sphagnum has played a significant role in parts but not all of the catchment, persisting in the main core until late 19th century. They also demonstrate that the loss of Sphagnum and subsequent abundance of Calluna vulgaris is coincident with evidence of wildfire. Continued absence of Sphagnum and abundance of Calluna vulgaris is coincident with further, less intense, burning likely due to grouse moor management. The 3000 year old record from the main core demonstrates the importance of historical climate change in changing water-table levels, vegetation, and degree of decomposition. There is little doubt that when faced with designing and implementing a 'restoration' plan for a site land managers will be able to make much more informed decisions if the ecological history of the site is investigated. At this site encouraging Sphagnum growth is shown to be valid. If this restoration aim is to be successful the removal of prescribed burning is probably required.

Blundell, Antony; Holden, Joseph

2014-05-01

289

Anesthetic keratopathy presenting as bilateral Mooren-like ulcers  

PubMed Central

This observational case report describes the development of bilateral Mooren-like ulcers in a patient with anesthetic keratopathy. A 42-year-old man with a recent history of minor eye trauma and pain self-treated with tetracaine eye drops presented with complaints of acutely worsening vision and severe pain bilaterally. His visual acuity at presentation was limited to hand motion. Slit-lamp examination revealed bilateral epithelial defects at the center of the cornea, and an area of stromal infiltration and thinning with an undermining leading edge resembling a Mooren’s ulcer in both eyes. Corneal haze and hypopyon were visible. Anesthetic use was halted immediately and the patient was started on prednisolone and mycophenolate mofetil (Cellcept®), after which visual acuity gradually improved and pain decreased. Despite improvement of symptoms, residual epithelial defects remained, and the patient was ultimately treated with keratoplasty for recovery of vision. We suggest that anesthetic keratopathy should be included in the differential diagnosis for any patient presenting with ring-shaped stromal infiltrates or nonhealing epithelial defects. PMID:23118524

Khakshoor, Hamid; Moshirfar, Majid; Simpson, Rachel G; Gharaee, Hamid; Vejdani, Amir H; Christiansen, Steven M; Edmonds, Jason N; Behunin, Nicholas L

2012-01-01

290

Interactions of anesthetics with the membrane-water interface  

NASA Technical Reports Server (NTRS)

Although the potency of conventional anesthetics correlates with lipophilicity, an affinity to water also is essential. It was recently found that compounds with very low affinities to water do not produce anesthesia regardless of their lipophilicity. This finding implies that clinical anesthesia might arise because of interactions at molecular sites near the interface of neuronal membranes with the aqueous environment and, therefore, might require increased concentrations of anesthetic molecules at membrane interfaces. As an initial test of this hypothesis, we calculated in molecular dynamics simulations the free energy profiles for the transfer of anesthetic 1,1,2-trifluoroethane and nonanesthetic perfluoroethane across water-membrane and water-hexane interfaces. Consistent with the hypothesis, it was found that trifluoroethane, but not perfluoroethane, exhibits a free energy minimum and, therefore, increased concentrations at both interfaces. The transfer of trifluoroethane from water to the nonpolar hexane or interior of the membrane is accompanied by a considerable, solvent-induced shift in the conformational equilibrium around the C-C bond.

Pohorille, A.; Cieplak, P.; Wilson, M. A.

1996-01-01

291

Albumin extravasation rates in tissues of anesthetized and unanesthetized rats  

SciTech Connect

Bovine serum albumin (BSA) labeled with /sup 131/I was injected intravenously in chronically prepared, unanesthetized rats and into pentobarbital-anesthetized rats that had received 2 ml 5% BSA to help sustain plasma volume. Initial uptake rates (clearances) in skin, skeletal muscles, diaphragm, and heart (left ventricle) were measured over 1 h. BSA labeled with /sup 125/I was injected terminally to correct for intravascular /sup 131/I-BSA. Observed clearances were in the following order in both groups of animals: heart much greater than diaphragm approximately equal to skin greater than resting skeletal muscles. Differences between unanesthetized and anesthetized animals were small and inconsistently directed. Our results suggest that the lower albumin clearances reported in the literature for anesthetized rats are not the result of their immobility or any direct effect of anesthesia on albumin transport in these tissues. The lower transport rates appear to result indirectly from changes produced by anesthesia and/or surgery in controllable parameters such as plasma volume and intravascular protein mass.

Renkin, E.M.; Joyner, W.L.; Gustafson-Sgro, M.; Plopper, G.; Sibley, L.

1989-05-01

292

Analysis of Efficacy Differences between Caudal and Lumbar Interlaminar Epidural Injections in Chronic Lumbar Axial Discogenic Pain: Local Anesthetic Alone vs. Local Combined with Steroids  

PubMed Central

Study Design: Comparative assessment of randomized controlled trials of caudal and lumbar interlaminar epidural injections in chronic lumbar discogenic pain. Objective: To assess the comparative efficacy of caudal and lumbar interlaminar approaches of epidural injections in managing axial or discogenic low back pain. Summary of Background Data: Epidural injections are commonly performed utilizing either a caudal or lumbar interlaminar approach to treat chronic lumbar axial or discogenic pain, which is pain exclusive of that associated with a herniated intervertebral disc, or that is due to degeneration of the zygapophyseal joints, or due to dysfunction of the sacroiliac joints, respectively. The literature on the efficacy of epidural injections in managing chronic axial lumbar pain of presumed discogenic origin is limited. Methods: The present analysis is based on 2 randomized controlled trials of chronic axial low back pain not caused by disc herniation, radiculitis, or facet joint pain, utilizing either a caudal or lumbar interlaminar approach, with a total of 240 patients studied, and a 24-month follow-up. Patients were assigned to receive either local anesthetic only or local anesthetic with a steroid in each 60 patient group. Results: The primary outcome measure was significant improvement, defined as pain relief and functional status improvement of at least 50% from baseline, which was reported at 24-month follow-ups in 72% who received local anesthetic only with a lumbar interlaminar approach and 54% who received local anesthetic only with a caudal approach. In patients receiving local anesthetic with a steroid, the response rate was 67% for those who had a lumbar interlaminar approach and 68% for those who had a caudal approach at 12 months. The response was significantly better in the lumbar interlaminar group who received local anesthetic only, 77% versus 56% at 12 months and 72% versus 54% at 24 months. Conclusion: This assessment shows that in patients with axial or discogenic pain in the lumbar spine after excluding facet joint and SI Joint pain, epidural injections of local anesthetic by the caudal or lumbar interlaminar approach may be effective in managing chronic low back pain with a potential superiority for a lumbar interlaminar approach over a caudal approach.

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Benyamin, Ramsin M.; Boswell, Mark V.

2015-01-01

293

Optical imaging of the propagation patterns of neural responses in the rat sensory cortex: Comparison under two different anesthetic conditions.  

PubMed

Although many studies have reported the influence of anesthetics on the shape of somatic evoked potential, none has evaluated the influence on the spatio-temporal pattern of neural activity in detail. It is practically impossible to analyze neural activities spatially, using conventional electrophysiological methods. Applying our multiple-site optical recording technique for measuring membrane potential from multiple-sites with a high time resolution, we compared the spatio-temporal pattern of the evoked activity under two different anesthetic conditions induced by urethane or ?-chloralose. The somatic cortical response was evoked by electrical stimulation of the hindlimb, and the optical signals were recorded from the rat sensorimotor cortex stained with a voltage-sensitive dye (RH414). The evoked activity emerged in a restricted area and propagated in a concentric manner. The spatio-temporal pattern of the evoked activity was analyzed using isochrone maps. There were significant differences in the latency and propagation velocity of the evoked activity, as well as the full width at half maximum of optical signal between the two anesthetic conditions. Differences in the amplitude and the slope of the rising phase were not significant. PMID:25301752

Hama, N; Ito, S-I; Hirota, A

2015-01-22

294

Advanced InSAR techniques for the management and characterization of geothermal resources  

NASA Astrophysics Data System (ADS)

InSAR is a remote sensing tool that has applications in both geothermal exploitation and in the management of producing fields. The technique has developed rapidly in recent years and the most evolved algorithms, now capable of providing precise ground movement measurements with unprecedented spatial density over large areas, allow the monitoring of the effects of fluid injection and extraction on surface deformation and the detection of active faults. Multi-interferogram approaches have been used at several geothermal sites in different stages of development. SqueeSAR™, which represents the latest breakthrough in InSAR technology, provides a significant increase in the spatial density of measurement points by exploiting signal returns from both point-like and distributed scatterers. Furthermore, recent satellite radar sensors have a higher spatial resolution (down to 1 m), as well as a higher temporal frequency of image acquisitions (down to a few days). The coupling of the new algorithm with this new generation of satellites provides a valuable tool for monitoring the different phases of geothermal production and in support of the decision making process. Some examples from the US are presented here: the first case study involves the use of InSAR within a suite of tools for exploration of the San Emidio geothermal field in Nevada. This project aimed to develop geophysical techniques to identify and map large aperture fractures for the placement of new production/exploration wells. The second and third examples examine two zones in California: the Salton Sea area, where multi-interferogram InSAR provided an overview of surface deformation at a producing geothermal reservoir. Surface deformation in this area was complex, and the added detail provided insight into the interplay of tectonics and production activities. Additional InSAR studies have also been carried out at the Geysers field in order to evaluate the behavior of an Enhanced Geothermal System (EGS) in response to high rates of water injection, with a strong interest in researching induced seismicity and ground deformation. These studies, along with the continuing developments in radar satellite technology and in the field of InSAR, show considerable promise for the future monitoring of geothermal production facilities.

Bellotti, F.; Falorni, G.; Morgan, J.; Rucci, A.; Ferretti, A.

2012-04-01

295

Management of complex intracranial aneurysms with bypass surgery: a technique application and experience in 93 patients.  

PubMed

Despite advances in microsurgery and the development of new endovascular techniques, the treatment of complex intracranial aneurysms remains a daunting challenge for neurosurgeons. In the present study, we retrospectively reviewed our experience of bypass surgery in the treatment of 93 cases of complex intracranial aneurysms. A series of 93 consecutive cases of complex intracranial aneurysms were treated with bypass surgery between April 2004 and July 2013. Radial artery (RA) grafts were used in 58 cases, saphenous vein (SV) grafts in 16 cases, and occipital artery (OA) grafts in 6 cases, while the remaining 13 cases were managed with superficial temporal artery (STA) grafts. In this series, the aneurysms were excised after trapping in 32 cases with mass effect and neural compression. Proximal occlusion of the parent artery was performed in 22 cases of fusiform or giant dissecting aneurysms with subsequent retrograde flow to avoid compromise of the perforators nearby. Trapping was performed after bypass surgery in the remaining 39 cases. Postoperative angiographies were performed in 91 patients and patency of the bypass graft and obliteration of the aneurysms were confirmed in 89 patients. Patency of the bypass could not be confirmed in the remaining two patients, of which one presented with cerebral infarction due to graft occlusion, and the other remained asymptomatic. Within 1 month after surgery, 88 patients had good outcome, four patients needed assistance for daily living, and one death occurred due to brainstem infarction. In 77 patients with a mean follow-up of 3.0 years, 72 patients had good outcome, 4 patients needed assistance for daily living, and 1 death occurred unrelated to surgery. Complex intracranial aneurysms present unique therapeutic challenges that require thorough surgical planning, individualized treatment strategies, and refined neurovascular techniques for successful outcome. Proper use of bypass surgery is imperative in preserving the parent artery and its major perforators. The internal maxillary artery, used as a donor in a bypass, is an effective method due to its shorter distance from the recipient vessels and relatively large diameter with resulting higher flow rate. PMID:25154436

Shi, Xiangen; Qian, Hai; Fang, Tie; Zhang, Yongli; Sun, Yuming; Liu, Fangjun

2014-08-26

296

Quality management systems for fruit fly (Diptera: Tephritidae) sterile insect technique  

SciTech Connect

The papers presented in this issue are focused on developing and validating procedures to improve the overall quality of sterile fruit flies for use in area-wide integrated pest management (AW-IPM) programs with a sterile insect technique (SIT) component. The group was coordinated and partially funded by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Vienna, Austria, under a five-year Coordinated Research Project (CRP) on 'Quality Assurance in Mass-Reared and Released Fruit Flies for Use in SIT Programmes'. Participants in the CRP from 16 countries came from both basic and applied fields of expertise to ensure that appropriate and relevant procedures were developed. A variety of studies was undertaken to develop protocols to assess strain compatibility and to improve colonization procedures and strain management. Specific studies addressed issues related to insect nutrition, irradiation protocols, field dispersal and survival, field cage behavior assessments, and enhancement of mating competitiveness. The main objective was to increase the efficiency of operational fruit fly programs using sterile insects and to reduce their cost. Many of the protocols developed or improved during the CRP will be incorporated into the international quality control manual for sterile tephritid fruit flies, standardizing key components of the production, sterilization, shipment, handling, and release of sterile insects. (author) [Spanish] Los articulos presentados en este numero se enfocan en el desarrollo y la validacion de procedimientos para mejorar la calidad total de moscas de las frutas esteriles para su uso en programas de manejo integrado de plagas en donde la tecnica del insecto esteril (TIE) es uno de los componentes clave. El grupo fue coordinado y parcialmente financiado por la Division Conjunta de Tecnicas Nucleares para la Alimentacion y la Agricultura de la FAO/OIEA, Viena, Austria, por un periodo de cinco anos bajo el proyecto de Investigacion Coordinada (PIC) sobre 'el Aseguramiento de la Calidad de Moscas de las Frutas Criadas y Liberadas para su Uso en Programas de TIE'. Los participantes en el PIC representan 16 paises con experiencia en campos de investigacion basica y aplicada. Para asegurar que los procedimientos desarrollados fueran apropiados y pertinentes, se realizaron una variedad de estudios para el desarrollo de protocolos para evaluar la compatibilidad y para mejorar los procedimientos de colonizacion y manejo de cepas salvajes. Estudios especificos trataron asuntos relacionados con la nutricion de insectos, los protocolos de irradiacion, la dispersion y supervivencia en el campo, evaluacion del comportamiento en jaulas de campo, y el mejoramiento de la competitividad sexual. Los objetivos fundamentales fueron el aumentar la eficiencia y reducir los costos de los programas operacionales de control de moscas de las frutas donde TIE es utilizada. Muchos de los protocolos desarrollados o mejorados durante el PIC seran incorporados en el Manual Internacional de Control de Calidad para Moscas Estriles de la familia Tephritidae, para estandarizar componentes claves como la produccion, esterilizacion, envio, manejo y liberacion de insectos esteriles. (author)

Caceres, C.; Robinson, A. [Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Agency's Laboratories, A-2444 Seibersdorf (Austria); McInnis, D. [USDA-ARS USPBARC, 2727 Woodlawn Drive, Honolulu, HI 96720 (United States); Shelly, T. [USDA/APHIS/CPHST, 41-650 Ahiki St. Waimanalo, HI 96795 (United States); Jang, E. [USDA-ARS USPBARC, P.O. Box 4459, Hilo, HI 96720 (United States); Hendrichs, J. [Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Wagramerstrasse 5. P.O. Box 100, A-1400 Vienna (Austria)

2007-03-15

297

Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus  

PubMed Central

AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature. METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria. RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included: (1) when available, urea breath and stool antigen test (HpSA) should be used for non-invasive diagnosis; (2) detect and eradicate Helicobacter pylori (H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer; (3) further investigate implementation issues and health outcomes of H. pylori eradication for primary prevention of gastric cancer in high-risk populations; (4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment; (5) routinely assess eradication success post-treatment in clinical settings; and (6) select second- and third-line therapies according to antibiotic susceptibility testing. CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes. PMID:25152601

Rollan, Antonio; Arab, Juan Pablo; Camargo, M Constanza; Candia, Roberto; Harris, Paul; Ferreccio, Catterina; Rabkin, Charles S; Gana, Juan Cristóbal; Cortés, Pablo; Herrero, Rolando; Durán, Luisa; García, Apolinaria; Toledo, Claudio; Espino, Alberto; Lustig, Nicole; Sarfatis, Alberto; Figueroa, Catalina; Torres, Javier; Riquelme, Arnoldo

2014-01-01

298

An in vivo method for recording single unit activity in lumbar spinal cord in mice anesthetized with a volatile anesthetic.  

PubMed

We describe a method to record single unit neuronal activity from mouse spinal cord using volatile anesthesia. The small size of the mouse can complicate usual methods that are used for single-unit recording in rats, but simple modifications can significantly increase the number of successful recordings. Stabilization of the vertebral column is particularly important, as are adequate ventilation of the animal, control of body temperature and accurate determination of anesthetic concentrations in respiratory gas samples. PMID:15171995

Cuellar, Jason M; Antognini, Joseph F; Carstens, Earl

2004-06-01

299

Comparison of Different Final Impression Techniques for Management of Resorbed Mandibular Ridge: A Case Report  

PubMed Central

The history of complete denture impression procedures has been influenced largely by the development of impression materials from which new techniques and ideas arose. The purpose of this study was to compare the retention of complete dentures made by using different impression techniques like conventional, admixed, all green, and functional techniques. The results showed that there was significant difference in retention between the six techniques where functional technique showed the highest mean value of retention followed by elastomeric, all green, and admixed, while cocktail and green stick compound showed the lowest mean value. However, on clinical examination, the retention produced by the six techniques was satisfactory. PMID:25180105

Yadav, Bhupender; Jayna, Manisha; Yadav, Harish; Suri, Shrey; Phogat, Shefali; Madan, Reshu

2014-01-01

300

[Perioperative management for esophagectomy].  

PubMed

Esophagetomy is considered as one of the most invasive surgical procedures. Despite marked advances in surgical techniques, anesthetic management and intensive care, the morbidity and mortality remain still high compared with the other types of surgery. Excessive inflammatory response after surgery induces over-production of inflammatory cytokines, leading to the development of vital organ failures. Anesthesiologists should pay much attention to perioperative management of patients undergoing esophagectomy since they are potentially at high risks of respiratory and cardiovascular complications caused by excessive stress with cervical, thoracic and abdominal procedures. During surgery, many interventions such as effective epidural anesthesia, restrictive fluid management, lung protective strategy, maintenance of hemodynamic stability and steroid therapy should be considered. Perioperative respiratory management including early extubation, intensive physical therapy, early mobilization and rehabilitation with enteral nutrition are all important to prevent postoperative complications and to shorten the length of hospital stay. However, some patients need longer-term mechanical ventilation due to preoperative respiratory dysfunction and reduced cough reflex by surgical manipulations. A multimodal treatment is warranted to improve the outcomes after esophagectomy. PMID:24864570

Suzuki, Takeshi; Morisaki, Hiroshi

2014-05-01

301

Xenon and Other Volatile Anesthetics Change Domain Structure in Model Lipid Raft Membranes  

PubMed Central

Inhalation anesthetics have been in clinical use for over 160 years, but the molecular mechanisms of action continue to be investigated. Direct interactions with ion channels received much attention after it was found that anesthetics do not change the structure of homogeneous model membranes. However, it was recently found that halothane, a prototypical anesthetic, changes domain structure of a binary lipid membrane. The noble gas xenon is an excellent anesthetic and provides a pivotal test of the generality of this finding, extended to ternary lipid raft mixtures. We report that xenon and conventional anesthetics change the domain equilibrium in two canonical ternary lipid raft mixtures. These findings demonstrate a membrane-mediated mechanism whereby inhalation anesthetics can affect the lipid environment of trans-membrane proteins. PMID:24299622

Weinrich, Michael; Worcester, David L.

2014-01-01

302

Ventral inlay buccal mucosal graft urethroplasty: A novel surgical technique for the management of urethral stricture disease  

PubMed Central

To describe the novel technique of ventral inlay substitution urethroplasty for the management of male anterior urethral stricture disease. A 58-year-old gentleman with multifocal bulbar stricture disease measuring 7 cm in length was treated using a ventral inlay substitution urethroplasty. A dorsal urethrotomy was created, and the ventral urethral plated was incised. The edges of the urethral plate were mobilized without violation of the ventral corpus spongiosum. A buccal mucosa graft was harvested and affixed as a ventral inlay to augment the caliber of the urethra. The dorsal urethrotomy was closed over a foley catheter. No intraoperative or postoperative complications occurred. Postoperative imaging demonstrated a widely patent urethra. After three years of follow-up, the patient continues to do well with no voiding complaints and low postvoid residuals. Ventral inlay substitution urethroplasty appears to be a safe and feasible technique for the management of bulbar urethral strictures. PMID:25685305

Terlecki, Ryan Patrick

2015-01-01

303

Posterior Sternoclavicular Dislocations: A Brief Review and Technique for Closed Management of a Rare But Serious Injury  

PubMed Central

Posterior sternoclavicular dislocations are rare but serious injuries. The proximity of the medial clavicle to the vital structures of the mediastinum warrants caution with management of the injury. Radiographs are the initial imaging test, though computed tomography and magnetic resonance imaging are essential for diagnosis and preoperative planning. This paper presents an efficient diagnostic approach and effective technique of closed reduction of posterior sternoclavicular dislocations with a brief review of open and closed reduction procedures. PMID:24744842

Deren, Matthew E.; Behrens, Steve B.; Vopat, Bryan G.; Blaine, Theodore A.

2014-01-01

304

Chondrotoxicity of Low pH, Epinephrine, and Preservatives Found in Local Anesthetics Containing Epinephrine  

Microsoft Academic Search

Background: Recent clinical and basic science investigations have revealed the chondrotoxicity of local anesthetics, especially those containing epinephrine, administered via an intra-articular pain pump. However, the exact mechanism of toxicity is unknown. This study evaluates the chondrotoxicity of low pH, epinephrine, and preservatives found in commonly used local anesthetics.Hypothesis: The chondrotoxicity of local anesthetics containing epinephrine is due to low

Jason L. Dragoo; Tatiana Korotkova; Hyeon Joo Kim; Anubhav Jagadish

2010-01-01

305

The Effects of Clonidine Premedication on Sevoflurane Requirements and Anesthetic Induction Time  

Microsoft Academic Search

We assessed the effects of oral clonidine preanesthetic medication (4.5 mg\\/kg) on the vital capacity rapid- inhalation anesthetic induction time (VCRII time) and minimum alveolar anesthetic concentration (MAC) to prevent a response to a verbal command in 50% of pa- tients (MAC-Awake) by its hypnotic effect, and on MAC-Skin incision for the analgesic effect in patients anesthetized with sevoflurane. We

Shinichi Inomata; Yuichi Yaguchi; Hidenori Toyooka

1999-01-01

306

Comprehensive Magnetic Resonance Enterography of Crohn?s Disease in the Pediatric Population: Technique, Interpretation, and Management.  

PubMed

Magnetic resonance enterography (MRE) plays a critical role in the management of Crohn?s disease in the pediatric population. The ability to provide dynamic assessment of disease burden, complications, and therapeutic response without ionizing radiation makes it an ideal tool for younger patients requiring frequent follow-up. With a growing array of available treatment options, a sound understanding of MRE is critical in directing management aimed at curbing the physical and emotional morbidity associated with the lifelong condition. The goal of this article is to provide a practical overview of MRE in the pediatric population. This includes a review of our technique, approach to interpretation, pictorial collection of findings, and discussion of the role MRE plays in management. PMID:25155516

Chehab, Monzer; Hlubocky, James; Olariu, Elena; Bloom, David; Nandalur, Kiran

2014-08-21

307

Surgical Technique for Treatment of Recalcitrant Adductor Longus Tendinopathy  

PubMed Central

Chronic groin pain in the athlete can be a difficult problem to manage. Adductor dysfunction is the most common cause of groin pain in athletes, with the adductor longus being the tendon most commonly involved. The most reproducible finding for adductor longus tendinopathy is tenderness along the tendon with passive abduction and resisted hip adduction in extension. Magnetic resonance imaging and injection of a corticosteroid and anesthetic into the proximal muscle-tendon junction are both helpful in confirming the diagnosis. Nonoperative treatment may consist of protected weight bearing, ice application, ultrasonography, electrical stimulation, and gentle stretching with progressive strengthening. However, nonoperative management is not always successful. In these instances, surgical treatment can be quite effective. We present the indications, surgical technique, and rehabilitation protocol of adductor tenotomy for chronic tendinopathy. This can prove a useful tool for the treatment of recalcitrant groin pain attributable to the adductor longus. PMID:24904780

Gill, Thomas J.; Carroll, Kaitlin M.; Makani, Amun; Wall, Andrew J.; Dumont, Guillaume D.; Cohn, Randy M.

2014-01-01

308

Topical anesthetic preparations for rigid and flexible endoscopy: a meta-analysis.  

PubMed

Transnasal endoscopy can cause pain or discomfort for the patient. Topical anesthetic has been used in an attempt to reduce this. However, there is no consensus on whether topical anesthetic is effective in optimizing patient experience during the procedure. The goal of this study was to perform a systematic review with meta-analysis of the efficacy of topical anesthetic on pain and comfort outcomes during endoscopy. Two authors independently searched the databases from inception to September 2013. Studies comparing topical anesthetic with placebo where the outcomes of interest were pain, comfort, or side effect outcomes were included. Sufficient data for meta-analysis were retrieved for ten trials with a total of 837 patients. The evidence suggests that local anesthetic alone or in combination with a vasoconstrictor is beneficial to patients' pain [standardized mean difference (SMD) = -0.21; p = 0.045] and comfort (SMD = -0.51; p < 0.001) outcomes when performing transnasal endoscopy. However, the topical anesthetic caused unpleasant sensation with respect to an unpleasant taste (SMD = 0.77; p < 0.001). In addition, there was no significant difference between a topical anesthetic spray and cotton type in pain and discomfort values. Applying topical anesthetic during transnasal endoscopy could reduce pain and discomfort. The spray and cotton type methods of topical anesthetic preparation showed no significant difference in terms of pain and discomfort during the procedure. However, further trials with good research methodology should be conducted to confirm our results. PMID:24682602

Hwang, Se Hwan; Park, Chan-Soon; Kim, Byung Guk; Cho, Jin Hee; Kang, Jun Myung

2015-02-01

309

Critical role of water in the binding of volatile anesthetics to proteins.  

PubMed

Numerous small molecules exhibit drug-like properties by low-affinity binding to proteins. Such binding is known to be influenced by water, the detailed picture of which, however, remains unclear. One particular example is the controversial role of water in the binding of general anesthetics to proteins as an essential step in general anesthesia. Here we demonstrate that a critical amount of hydration water is a prerequisite for anesthetic-protein binding. Using nuclear magnetic resonance, the concurrent adsorption of hydration water and bound anesthetics on model proteins are simultaneously measured. Halothane binding on proteins can only take place after protein hydration reaches a threshold hydration level of ?0.31 g of water/g of proteins at the relative water vapor pressure of ?0.95. Similar dependence on hydration is also observed for several other anesthetics. The ratio of anesthetic partial pressures at which two different anesthetics reach the same fractional load is correlated with the anesthetic potency. The binding of nonimmobilizers, which are structurally similar to known anesthetics but unable to produce anesthesia, does not occur even after the proteins are fully hydrated. Our results provide the first unambiguous experimental evidence that water is absolutely required to enable anesthetic-protein interactions, shedding new light on the general mechanism of molecular recognition and binding. PMID:24050264

Wang, Hai-Jing; Kleinhammes, Alfred; Tang, Pei; Xu, Yan; Wu, Yue

2013-10-10

310

The Timing of Acupuncture Stimulation Does Not Influence Anesthetic Requirement  

PubMed Central

Studies suggest that acupuncture is more effective when induced before induction of general anesthesia than afterwards. We tested the hypothesis that electro-acupuncture initiated 30 minutes before induction reduces anesthetic requirement more than acupuncture initiated after induction. Seven volunteers were each anesthetized with desflurane on 3 study days. Needles were inserted percutaneously at 4 acupuncture points thought to produce analgesia in the upper abdominal area and provide generalized sedative and analgesic effects: Zusanli (St36), Sanyinjiao (Sp6), Liangqiu (St34), and Hegu (LI4). Needles were stimulated at 2-Hz and 10-Hz, with frequencies alternating at two-second intervals. On Preinduction day, electro-acupuncture was started 30 minutes before induction of anesthesia and maintained throughout the study. On At-induction day, needles were positioned before induction of anesthesia, but electro-acupuncture stimulation was not initiated until after induction. On Control day, electrodes were positioned near the acupoints, but needles were not inserted. Noxious electrical stimulation was administered via 25-G needles on the upper abdomen (70 mA, 100 Hz, 10 seconds). Desflurane concentration was increased 0.5% when movement occurred and decreased 0.5% when it did not. These up-and-down sequences continued until volunteers crossed from movement to no-movement 4 times. The P50 of logistic regression identified desflurane requirement. Desflurane requirement was similar on the Control (5.2±0.6%, mean±SD), Preinduction (5.0±0.8%), and At-induction (4.7±0.3%, P=0.125) days. This type of acupuncture is thus unlikely to facilitate general anesthesia or decrease the need for anesthetic drugs. PMID:15673863

Chernyak, Grigory; Sengupta, Papiya; Lenhardt, Rainer; Liem, Edwin; Doufas, Anthony G.; Sessler, Daniel I.; Akça, Ozan

2005-01-01

311

Late pharmacologic conditioning with volatile anesthetics after cardiac surgery  

PubMed Central

Introduction The aim of this randomized controlled trial was to investigate whether volatile anesthetics used for postoperative sedation have any beneficial effects on myocardial injury in cardiac surgery patients after on-pump valve replacement. Methods Anesthesia was performed with propofol. After arrival in the intensive care unit (ICU), 117 patients were randomized to be sedated for at least 4 hours with either propofol or sevoflurane. Sevoflurane was administered by using the anesthetic-conserving device. Troponin T, creatine kinase, creatine kinase from heart muscle tissue, myoglobin, and oxygenation index were determined on arrival at the ICU, 4 hours after sedation, and in the morning of the first postoperative day (POD1). Primary end points were cardiac injury markers on POD1. As secondary end points oxygenation, postoperative pulmonary complications, and ICU and hospital stay were documented. Results Fifty-six patients were analyzed in the propofol arm, and 46 patients in the sevoflurane arm. Treatment groups were comparable with regard to patient demographics and intraoperative characteristics. Concentration of troponin T as the most sensitive marker for myocardial injury at POD1 was significantly lower in the sevoflurane group compared with the propofol group (unadjusted difference, -0.4; 95% CI, -0.7 to -0.1; P < 0.01; adjusted difference, -0.2; 95% CI, -0.4 to -0.02; P = 0.03, respectively). Conclusions The data presented in this investigation indicate that late postconditioning with the volatile anesthetic sevoflurane might mediate cardiac protection, even with a late, brief, and low-dose application. Trial registration ClinicalTrials.gov: NCT00924222. PMID:23062276

2012-01-01

312

A method for recording single unit activity in lumbar spinal cord in rats anesthetized with nitrous oxide in a hyperbaric chamber.  

PubMed

The limited potency of nitrous oxide mandates the use of a hyperbaric chamber to produce anesthesia. Use of a hyperbaric chamber complicates anesthetic delivery, ventilation, and electrophysiological recording. We constructed a hyperbaric acrylic-aluminum chamber allowing recording of single unit activity in spinal cord of rats anesthetized only with N(2)O. Large aluminum plates secured to each other by rods that span the length of the chamber close each end of the chamber. The 122 cm long, 33 cm wide chamber housed ventilator, intravenous infusion pumps, recording headstage, including hydraulic microdrive and stepper motors (controlled by external computers). Electrical pass-throughs in the plates permitted electrical current or signals to enter or leave the chamber. In rats anesthetized only with N(2)O we recorded extracellular action potentials with a high signal-to-noise ratio. We also recorded electroencephalographic activity. This technique is well-suited to study actions of weak anesthetics such as N(2)O and Xe at working pressures of 4-5 atm or greater. The safety of such pressures depends on the wall thickness and chamber diameter. PMID:17045342

Antognini, Joseph F; Atherley, Richard J; Laster, Michael J; Carstens, Earl; Dutton, Robert C; Eger, Edmond I

2007-03-15

313

3D Geographic Reconstruction and Visualization Techniques Applied to Land Resource Management  

Microsoft Academic Search

Optimized land resource management depends on reliable and detailed information describing the spatial distribution of soils, geology, topography, and land use. Soil- landscapes are three-dimensional (3D) systems commonly represented using 2D maps utilizing geographic information systems. Addressing 3D soil-landscape reality is crucial for land resource management in terms of crop growth and transport processes (e.g. nitrate leaching) that are driving

Sabine Grunwald; Phillip Barak

2003-01-01

314

A QoS Management Technique of Urgent Information Provision in ITS Services Using DSRC for Autonomous Base Stations  

NASA Astrophysics Data System (ADS)

A QoS management technique based on an autonomous decentralized mobility system, which is an autonomous decentralized system enhanced to provide mobile stations with information about urgent roadway situations, is proposed in this paper. This technique enables urgent messages to be flexibly and quickly transmitted to mobile stations by multiple decentralized base stations using dedicated short range communication. It also supports the easy addition of additional base stations. Each station autonomously creates information-delivery communities based on the urgency of the messages it receives through the roadside network and the distances between the senders and receivers. Each station dynamically determines the urgency of messages according to the message content and the speed of the mobile stations. Evaluation of this technique applied to the Smart Gateway system, which provides driving-assistance services to mobile stations through dedicated short-range communication, demonstrated its effectiveness and that it is suitable for actual systems.

Shimura, Akitoshi; Aizono, Takeiki; Hiraiwa, Masashi; Sugano, Shigeki

315

43 CFR 10005.15 - Planning and management techniques applicable to the plan.  

Code of Federal Regulations, 2011 CFR

...techniques applicable to the plan. 10005.15 Section...MITIGATION AND CONSERVATION PLAN § 10005.15 Planning...techniques applicable to the plan. The Commission...Commission will consider projects that make use...purposes. (b) Physical restoration of ecological functions and...

2011-10-01

316

43 CFR 10005.15 - Planning and management techniques applicable to the plan.  

Code of Federal Regulations, 2014 CFR

...techniques applicable to the plan. 10005.15 Section...MITIGATION AND CONSERVATION PLAN § 10005.15 Planning...techniques applicable to the plan. The Commission...Commission will consider projects that make use...purposes. (b) Physical restoration of ecological functions and...

2014-10-01

317

43 CFR 10005.15 - Planning and management techniques applicable to the plan.  

Code of Federal Regulations, 2013 CFR

...techniques applicable to the plan. 10005.15 Section...MITIGATION AND CONSERVATION PLAN § 10005.15 Planning...techniques applicable to the plan. The Commission...Commission will consider projects that make use...purposes. (b) Physical restoration of ecological functions and...

2013-10-01

318

Classical Deception Techniques and Perception Management vs. the Four Strategies of Information Warfare  

Microsoft Academic Search

The use of deception techniques for intelligence operations, strategic and tactical deception in war, politics, business and media manipulation is well established and well documented. This paper analyses established deception techniques in the context of the four canonical strategies of Information Warfare, to establish an information theoretical and game theoretical framework for future modelling and analysis.

C. Kopp

319

Comparison of stapling techniques and management of the mesoappendix in laparoscopic appendectomy.  

PubMed

Many techniques for laparoscopic appendectomy have been proposed with few comparative studies. We performed a retrospective review of all patients undergoing laparoscopic appendectomy for uncomplicated appendicitis from 2006 to 2011. Techniques were: (1) transection of the mesoappendix and appendix with a single staple line (SSL); (2) transection of the mesoappendix and appendix with multiple staple lines (MSL); and (3) transection of the mesoappendix with ultrasonic shears and the appendix with a single staple line (USSL). A total of 565 cases were reviewed (149 SSL, 259 MSL, and 157 USSL). Patients treated with the SSL technique had decreased operative duration (P<0.001) and length of stay (P=0.003) despite equivalent disease presentations. Multivariate analysis demonstrated decreased operative duration with the SSL technique (P=0.001). Use of a SSL for transection of the mesoappendix and appendix is both a safe and efficient technique that results in reduced operative duration with excellent surgical outcomes. PMID:24752160

Wright, G Paul; Mitchell, Eric J; McClure, Amanda M; Onesti, Jill K; Moyo, Steven C; Brown, Alexander R; Peshkepija, Andi; Scott, Geoffrey L; Chung, Mathew H

2015-02-01

320

Effects of insulin on coronary blood flow in anesthetized pigs.  

PubMed

Insulin can influence the vasculature by a sympathetically mediated vasoconstriction and a vasodilatation; the latter effect predominates in the renal circulation of anesthetized pigs. We determined the effect of intravenous infusion of insulin on coronary blood flow in pentobarbitone-anesthetized pigs at constant heart rate, arterial pressure and blood levels of glucose and potassium. In 6 pigs, infusion of 0.004 IU kg(-1) min(-1) of insulin decreased coronary flow despite increasing left ventricular dP dT(max)(-1); when the latter was abolished by propranolol, the coronary flow response was augmented. The mechanisms of this response were examined in 22 pigs given propranolol. Phentolamine changed coronary flow response to an increase (6 pigs) and this was abolished by intracoronary injection of N(omega)-nitro-L-arginine methyl ester (L-NAME; 5 pigs). L-NAME augmented coronary flow response (6 pigs) and this was abolished by phentolamine (5 pigs). In 18 pigs given propranolol, three incremental doses of insulin caused graded coronary flow decreases whether L-NAME was given (6 pigs) or not (6 pigs) beforehand, and caused graded coronary flow increases after phentolamine (6 pigs). Thus insulin caused a coronary vasoconstriction mediated by sympathetic alpha-adrenergic effects and a vasodilatation related to the release of nitric oxide. The net effect was a coronary vasoconstriction. PMID:12566976

Molinari, C; Battaglia, A; Grossini, E; Mary, D A S G; Bona, G; Scott, E; Vacca, G

2002-01-01

321

The effect of different anesthetics on neurovascular coupling  

PubMed Central

To date, the majority of neurovascular coupling studies focused on the thalamic afferents' activity in layer IV and the corresponding large spiking activity as responsible for functional hyperemia. This paper highlights the role of the secondary and late cortico-cortical transmission in neurovascular coupling. Simultaneous scalp electroencephalography (EEG) and diffuse optical imaging (DOI) measurements were obtained during multiple conditions of event-related electrical forepaw stimulation in 33 male Sprague-Dawley rats divided into 6 groups depending on the maintaining anesthetic - alpha-chloralose, pentobarbital, ketamine-xylazine, fentanyl-droperidol, isoflurane, or propofol. The somatosensory evoked potentials (SEP) were decomposed into four components and the question of which best predicts the hemodynamic responses was investigated. Results of the linear regression analysis show that the hemodynamic response is best correlated with the secondary and late cortico-cortical transmissions and not with the initial thalamic input activity in layer IV. Baseline cerebral blood flow (CBF) interacts with neural activity and influences the evoked hemodynamic responses. Finally, neurovascular coupling appears to be the same across all anesthetics used. PMID:20350606

Franceschini, Maria Angela; Radhakrishnan, Harsha; Thakur, Kiran; Wu, Weicheng; Ruvinskaya, Svetlana; Carp, Stefan; Boas, David A.

2010-01-01

322

Formulation of an antispasmodic drug as a topical local anesthetic.  

PubMed

Mebeverine hydrochloride, a spasmolytic agent on GIT smooth muscles, was reported to have a local anesthetic effect. Thus, it was desired in this study to formulate mebeverine HCl into a gel that could be used locally in the treatment of different oral painful conditions. Poloxamer 407 (P-407) was used as the base for this gel. Different additives were used to enhance drug release from the preparation while others were used to enhance the residence time for the preparation. Different formulae were characterized in terms of drug release and mucoadhesion. The formula which has shown the best compromise between the aforementioned parameters was selected for clinical evaluation in comparison to Lidocaine HCl gel and rheologically examined. The best drug release enhancer was cetrimide (0.005%, w/w), while hydroxypropylcellulose (0.5%, w/w) as a mucoadhesive additive has shown the best compromise between fast drug release and mucoadhesion. The gel formula (G) has shown a better pain reduction efficiency (p=0.0078) and longer duration (p=0.0313) than Lidocaine HCl gel. Histopathological examination has shown no change in the inflammatory cells count of rat oral mucosa. Therefore, it could be concluded that (G) is very promising as a local anesthetic preparation for the treatment of different oral painful conditions. PMID:16935442

Abdel-Hamid, Sameh M; Abdel-Hady, S E; El-Shamy, A A; El-Dessouky, H F

2006-12-01

323

Cardiovascular effects of Adonis aestivalis in anesthetized sheep  

PubMed Central

Adonis aestivalis (summer pheasant-eye) is an annual plant with a crimson flower, distributed in southern Europe and Asia. The plant has large buttercup-like blossoms and soft, fern-like leaves. It blooms in spring and is often found as a weed in cereal fields. Like other Adonis spp., the plant produces cardiac glycosides. It is used in remedies for mild weakness of the heart, especially when accompanied by nervous complaints. Cardiovascular and toxic effects of a hydroalcoholic extract from the aerial parts of A. aestivalis were investigated in sheep and mice. Six male sheep were anesthetized with sodium pentobarbital and arterial blood pressure was measured with a transducer connected to the left femoral artery. Heart rate and electrocardiogram (ECG) were registered from lead base-apex ECG derivatives connected to a Powerlab recorder. Three successive equal doses (75 mg kg-1) of the hydroalcoholic extract of A. aestivalis intravenously administered to anesthetized sheep. Adonis aestivalis extract induced a significant bradycardia and hypotension in sheep. Various ECG abnormalities in sheep included sinus arrhythmia, shortened and depressed S-T interval, and absence of P wave and flattened or inverted T wave. In addition, ventricular arrhythmias, bradyarrhythmias, atrioventricular block, ventricular premature beats, ventricular tachycardia and ventricular fibrillation have also been observed. The acute intraperitoneal toxicity (LD50) of the extract in mice was 2150 mg kg-1. In conclusion, bradycardia and ECG alterations induced by the extract could explain the justification of traditional use of the of Adonis aestivalis in treating cardiovascular insufficiency.

Maham, Masoud; Sarrafzadeh-Rezaei, Farshid

2014-01-01

324

Evaluation of exposures of hospital employees to anesthetic gases  

SciTech Connect

Hospital employees who work in hospital operating and recovery rooms are often exposed to a number of anesthetic gases. There is evidence to support the belief that such exposures have led to higher rates of miscarriages and spontaneous abortions of pregnancies among women directly exposed to these gases than among women not exposed. Most of the studies assessing exposure levels were conducted prior to the widespread use of scavenging systems. Air sampling was conducted in hospital operatories and recovery rooms of three large hospitals to assess the current exposure levels in these areas and determine the effectiveness of these systems in reducing exposures to fluoride-containing anesthetic gases. It was determined that recovery-room personnel are exposed to levels of anesthesia gases that often approach and exceed the recommended Threshold Limit Value-Time Weighted Average (TLV-TWA) of 2.0 ppm. Recovery-room personnel do not have the protection from exposure provided by scavenging systems in operating rooms. Operating-room personnel were exposed to anesthesia gas levels above the TLV-TWA only when patients were masked, or connected and disconnected from the scavenging systems. Recovery-room personnel also need to be protected from exposure to anesthesia gases by a scavenging system.

Lambeth, J.D.

1988-01-01

325

Management of total femoral bone loss using a hybrid cement spacer surgical technique.  

PubMed

Standard treatment for an infected total hip arthroplasty is 2-stage revision. Bone loss in infected total hip arthroplasty presents specific challenges during the first stage. This is especially the case when there is massive or complete loss of the femoral bone stock. We describe a technique successfully used in the setting of total femoral bone loss using a hybrid cement spacer. We describe 2 cases illustrating the technique and perioperative course. This technique is a potential solution for total femoral bone loss that allows the individual to maintain mobility before definitive surgery. PMID:22749006

Cassar Gheiti, Adrian J; Baker, Joseph F; Brown, Thomas E; Mulhall, Kevin J

2013-02-01

326

Is transverse abdominis plane block effective following local anesthetic infiltration in laparoscopic totally extraperitoneal hernia repair?  

PubMed Central

Background Transverse abdominis plane (TAP) block can be recommended as a multimodal method to reduce postoperative pain in laparoscopic abdominal surgery. However, it is unclear whether TAP block following local anesthetic infiltration is effective. We planned this study to evaluate the effectiveness of the latter technique in laparoscopic totally extraperitoneal hernia repair (TEP). Methods We randomly divided patients into two groups: the control group (n = 37) and TAP group (n = 37). Following the induction of general anesthesia, as a preemptive method, all of the patients were subjected to local anesthetic infiltration at the trocar sites, and the TAP group was subjected to ultrasound-guided bilateral TAP block with 30 ml of 0.375% ropivacaine in addition before TEP. Pain was assessed in the recovery room and post-surgery at 4, 8, and 24 h. Additionally, during the postoperative 24 h, the total injected dose of analgesics and incidence of nausea were recorded. Results: On arrival in the recovery room, the pain score of the TAP group (4.33 ± 1.83) was found to be significantly lower than that of the control group (5.73 ± 2.04). However, the pain score was not significantly different between the TAP group and control group at 4, 8, and 24 h post-surgery. The total amounts of analgesics used in the TAP group were significantly less than in the control group. No significant difference was found in the incidence of nausea between the two groups. Conclusions TAP block following local infiltration had a clinical advantage only in the recovery room.

Kim, Mun Gyu; Ok, Si Young; Kim, Sang Ho; Lee, Se-Jin; Park, Sun Young; Yoo, Jae-Hwa; Cho, Ana; Hur, Kyung Yul; Kim, Myung Jin

2014-01-01

327

Ultrasound-guided breast interventions: accuracy of biopsy techniques and applications in patient management.  

PubMed

Ultrasound (US) provides a versatile approach for guiding biopsies and other breast interventions. The wide availability, real-time capability, technical improvements, and increasing user experience have greatly expanded the role of US-guided interventions in the diagnosis and management of breast disease. This article reviews the accuracy of US-guided fine-needle aspiration biopsy, automated core biopsy, and vacuum-assisted biopsy. Some of the more specialized procedures that reflect the growing role of US-guided interventions in patient management will also be discussed. PMID:16915998

Shulman, Suzanne G; March, David E

2006-08-01

328

Endovascular Management of Visceral Artery Pseudoaneurysms: Transcatheter Coil Embolization Using the Isolation Technique  

SciTech Connect

PurposeTo describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter coil embolization using an isolation technique and to propose indications for treating VAPA with this method.Materials and MethodsWe treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm.ResultsTranscatheter coil embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter coil embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up.ConclusionTranscatheter coil embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with coil embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

Ikeda, Osamu, E-mail: osamu-3643ik@do9.enjoy.ne.jp; Nakasone, Yutaka; Tamura, Yoshitaka; Yamashita, Yasuyuki [Kumamoto University, Graduate School of Medical and Pharmaceutical Sciences, Department of Diagnostic Radiology (Japan)

2010-12-15

329

The effect of stress management training on stress and depression in women with depression disorders: Using cognitive-behavioral techniques  

PubMed Central

Background: The present study aimed to investigate the effect of stress management training through cognitive-behavioral techniques on stress, social adaptability and depression in women with depression disorders. Materials and Methods: In this study, 40 patients diagnosed with depression who had referred to psychiatry and consultation clinics of Isfahan were randomly selected and assigned to intervention and control groups (20 patients in each group). The intervention group received eight 90-min sessions of stress training through cognitive–behavioral techniques. Data collection tools included Cooper's stress questionnaire, Bell's social adaptability questionnaire and Hamilton's depression scale questionnaire. The participants completed the questionnaires before the intervention and 1 month after the same. Data analysis was performed using covariance analysis. Results: Based on the results, considering variables of stress, social adaptability and depression, the equal variance hypothesis was confirmed. The relationship between pre- and post-test scores on stress, social adaptability and depression was statistically significant (P < 0.001). The modified mean difference was F = 12.45, P < 0.001 on stress; F = 6.88, P < 0.01 on social adaptability; and F = 5.36, P < 0.02 on depression, all of which were significant. Conclusion: Stress management training through cognitive behavioral techniques can play a main role in depression reduction and development of social adaptability through modifying inappropriate social information-processing patterns. PMID:25077163

Abbasian, Farahzad; Najimi, Arash; Meftagh, Sayyed Davood; Ghasemi, Gholamreza; Afshar, Hamid

2014-01-01

330

Administration of anesthetic and analgesic prevent the suppression of many leukocyte responses following surgical castration and physical dehorning.  

PubMed

The objectives of the current research were to determine the physiological effects and responses of many leukocytes following surgical castration and/(or) physical dehorning and the influence of anesthetics and analgesics in 3-month-old calves. Eighty 3-month-old Holstein bull calves were completely randomized to treatments in a 2 × 2 × 2 factorial arrangement with castration, dehorning, and anesthetic/analgesic as the main effects. Peripheral blood samples were collected just before (0) and 0.5, 1.5, 2.5, 4, 6, 24, and 72 h after the respective procedure(s) and analyzed for total leukocyte and differential counts, as well as plasma cortisol and haptoglobin concentrations. Blood from the 0, 0.5 and 24h collections were analyzed for many ex vivo leukocyte responses. Data were analyzed using a repeated measures analysis of variance with the fixed effects of treatment, time, and the interaction of treatment × time. Pre-planned contrasts were performed to determine the effect of (1) management procedure (castration and/(or) dehorning), (2) anesthetic/analgesic, and (3) were the management procedures additive. There were treatment × time interactions (P<0.05) on plasma cortisol and haptoglobin concentrations as well as for total leukocyte and neutrophil concentrations in blood. Castration and dehorning increased cortisol concentrations and the effect of the procedures was additive (P<0.02). Dehorning alone elicited a greater (P<0.05) cortisol response than castration alone. In contrast, the leukocytosis and neutrophilia was greater (P<0.01) among castrated calves. In addition, haptoglobin concentrations at 24h after castration were elevated (P<0.01) in calves that were castrated. Both castration and dehorning suppressed (P=0.04) many leukocyte responses including the secretion of tumor necrosis factor-? when whole blood cultures were stimulated with lipopolysaccharide, surface expression of L-selectin on peripheral blood neutrophils, and the oxidative burst intensity of peripheral blood neutrophils when co-cultured with an Escherichia coli. The effects of castration and dehorning on blood leukocyte counts or any of the leukocyte responses were not additive (P>0.23). Castration and dehorning effects of plasma haptoglobin concentrations tended (P=0.10) to be additive at 72 h after the procedure(s). Prior administration of local anesthetic and a systemic analgesic attenuated (P<0.001) the cortisol response and prevented (P=0.03) the observed leukocytosis, neutrophilia, and leukocyte suppression. These data suggest that calves should be castrated and dehorned on the same day rather than spreading them out across two days and calves should be administered pain relief prior to performing either procedure. PMID:23270586

Ballou, M A; Sutherland, M A; Brooks, T A; Hulbert, L E; Davis, B L; Cobb, C J

2013-02-15

331

Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques  

ERIC Educational Resources Information Center

This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

2006-01-01

332

Implementing Bottleneck Management Techniques and Establishing Quality of Sort Relationships to Improve Terminal Processing Capacity  

E-print Network

of network operations from freight car utilization to service reliability. The acceptance of scheduled, railroads need to harness as much capacity as possible from existing infrastructure. It is estimated of a terminal system can be gained by adopting a manufacturing systems management approach. This enables use

Barkan, Christopher P.L.

333

Window-Masked Segmented Digital Clock Manager-FPGA-Based Digital Pulsewidth Modulator Technique  

Microsoft Academic Search

This paper presents a new digital pulsewidth modulator (DPWM) architecture for field programmable gate array (FPGA)-based systems. The design of the proposed DPWM architecture is based on fully utilizing the digital clock manager (DCM) resources available on new FPGA boards. Furthermore, this architecture will also window-mask the DCM operation to only a portion of the switching period in order to

Majd Ghazi Batarseh; Wisam Al-Hoor; Lilly Huang; Chris Iannello; Issa Batarseh

2009-01-01

334

Managing Construction Operations Visually: 3-D Techniques for Complex Topography and Restricted Visibility  

ERIC Educational Resources Information Center

Visual information is vital in planning and managing construction operations, particularly, where there is complex terrain topography and salvage operations with limited accessibility and visibility. From visually-assessing site operations and preventing equipment collisions to simulating material handling activities to supervising remotes sites…

Rodriguez, Walter; Opdenbosh, Augusto; Santamaria, Juan Carlos

2006-01-01

335

75 FR 14604 - Guidance for Industry on Anesthetics for Companion Animals; Availability  

Federal Register 2010, 2011, 2012, 2013, 2014

...Anesthetics for Companion Animals.'' This guidance document...inhalational) for use in companion animals (dogs, cats, and horses...Anesthetics for Companion Animals'' which gave interested persons...does not create or confer any rights for or on any person and...

2010-03-26

336

A Comparison of the Electrocardiographic Cardiotoxic Effects of Racemic Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Swine  

Microsoft Academic Search

We sought, in this observer-blinded study, to deter- mine the lethal dose for each of the local anesthetics levobupivacaine (L), racemic bupivacaine (B), and ropi- vacaine (R), and to compare their respective effects on the QRS interval of the precordial electrocardiograph after intracoronary injection. Anesthetized swine were instrumented with a left anterior descending artery cor- onary angiography catheter and injected

Stuart G. Morrison; Javier J. Dominguez; Philippe Frascarolo; Sebastian Reiz

2000-01-01

337

Effects of Intravenous and Intracerebroventricular Theophylline on Hypoxic Ventilatory Depression in Anesthetized Cats  

Microsoft Academic Search

Objective: The present study was undertaken to investigate the ventilatory response due to sustained isocapnic moderate hypoxia and the possible role of adenosine in hypoxic depression in anesthetized cats. Materials and Methods: Cats anesthetized with pentothal sodium (30 mg kg–1 i.p.) were divided into two groups: treated (n = 11) and control (n = 15). Respiratory frequency (f), tidal volume

N. K. Yelmen; G. Turgut; T. Oruç

2004-01-01

338

Web based collaborative decision making in flood risk management: Application of TOPSIS and visualisation techniques for ranking of alternatives  

NASA Astrophysics Data System (ADS)

Development of flood risk management (FRM) plans is ideally carried out in a participatory process with relevant stakeholders. Integrating stakeholders knowledge and information in the decision making process creates trust amongst decision makers and stakeholders that often leads to a successful implementation of measures. Stakeholder participation however does not come without challenges and hindrances (e.g. limitation of resources, spatial distribution and interest to participate). The most challenging type of participation is Collaborative decision making (CDM). A web-based mobile or computer-aided environment offers an innovative approach to address these challenges and hindrances. Moreover, this also enhances participation. Different phases or steps of a CDM process are addressing relevant management objectives, identify scenarios and sets of proposed alternatives, individually rank these alternatives in order of preference and present an aggregated rank to view the groups position. In individual ranking, formulation of judgement should combine scientific facts with stakeholders' beliefs and attitudes. This paper presents a developed web-based CDM framework and its implementation, highlighting the application of a Muti-Criteria Decision Making (MCDM) method for individual ranking of alternative, the method Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) with Fuzzy logic. Moreover, an innovative visualisation technique for stakeholders' group ranking is also presented. Case studies are the Alster catchment (Hamburg, Germany) and Cranbrook catchment, (London, UK). A series of stakeholders' workshops was done to test and evaluate the environments. It shows that the TOPSIS method provides a close representation of the stakeholders' preferences regarding the measures and alternatives. Overall the evaluation shows that web-based environments can address the challenges and hindrances and it enhances participation in flood risk management. The web-based environment was developed within the DIANE-CM project (Decentralised Integrated Analysis and Enhancement of Awareness through Collaborative Modelling and Management of Flood Risk) of the 2nd ERANET CRUE funding initiative.

Evers, Mariele; Almoradie, Adrian; Jonoski, Andreja

2014-05-01

339

75 FR 70932 - Joint Meeting of the Anesthetic and Life Support Drugs Advisory Committee and the Drug Safety and...  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2010-N-0001] Joint Meeting of the Anesthetic and Life Support Drugs Advisory Committee and the Drug Safety and Risk...SUMMARY: The Joint Meeting of the Anesthetic and Life Support Drugs Advisory Committee and the Drug Safety and...

2010-11-19

340

Thoracic outlet syndrome: diagnosis and management with a new surgical technique.  

PubMed

In 71 patients with thoracic outlet syndrome, the signs and symptoms of which (Table 1) were assessed revealing several findings previously not reported in association with this condition, 119 surgical procedures were performed according to a newly-developed technique described in this paper. As compared with a substantial number of unsuccessful early and late outcomes rendered through first-rib resection or scalenectomy, the new technique, scalenotomy, led to excellent results in 100% of all cases (Table 2). No complications were seen and no recurrences were observed during an average follow-up period of one year. An additional finding was that, on use of the new technique, even in the presence of a symptomatic cervical rib or hypoplastic first thoracic rib, resection was not necessary to provide the patients with complete recovery from the syndrome. PMID:6706285

Fernandez Noda, E I; Lopez, S

1984-02-01

341

A Less-Invasive Technique for Capsular Management During Hip Arthroscopy for Femoroacetabular Impingement  

PubMed Central

The aim of this work is to describe a new arthroscopic technique for the treatment of femoroacetabular impingement that allows a complete articular joint view with maximum protection of the capsuloligamentous complex. This arthroscopic technique avoids injury to the capsuloligamentous complex, preventing the risk of postoperative instability. The diagnosis of femoroacetabular impingement was based on clinical and radiographic grounds. An alpha angle greater than 50° was considered pathologic. In this technique, the use of intra-articular devices (retractors) allows us to separate the capsular tissue from the femoral head-neck junction and mobilize the capsule, achieving an adequate joint view without performing a capsulotomy and, consequently, avoiding the complications of capsular damage. PMID:25264505

Fiz, Nicolás; Sánchez, Mikel; Pérez, Juan Carlos; Guadilla, Jorge; Delgado, Diego; Azofra, Juan; Aizpurua, Beatriz

2014-01-01

342

Intraspinal techniques for pain management in cancer patients: a systematic review  

Microsoft Academic Search

Purpose  This systematic review outlines current evidence regarding the effectiveness of intraspinal techniques for cancer pain and\\u000a addresses practical implementation issues.\\u000a \\u000a \\u000a \\u000a Methods  A search of electronic databases identified systematic reviews and randomized controlled trials (RCTs) evaluating the effectiveness\\u000a of intraspinal techniques in the setting of cancer pain. An environmental scan was completed via the internet to identify\\u000a practice guidelines and resource documents

Jeff Myers; Vincent Chan; Virginia Jarvis; Cindy Walker-Dilks

2010-01-01

343

The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months  

Microsoft Academic Search

Background  Scotland has high levels of untreated dental caries in primary teeth. The Hall Technique is a simplified method of managing\\u000a carious primary molars using preformed metal crowns (PMCs) cemented with no local anaesthesia, caries removal or tooth preparation.\\u000a This study compared the acceptability of the Hall Technique for children, their carers, and dentists, and clinical outcomes\\u000a for the technique, with

Nicola P Innes; Dafydd JP Evans; David R Stirrups

2007-01-01

344

Effects of Anesthetics on the Renal Sympathetic Response to Anaphylactic Hypotension in Rats  

PubMed Central

The autonomic nervous system plays an important role in rat anaphylactic hypotension. It is well known that sympathetic nerve activity and cardiovascular function are affected by anesthetics. However, the effects of different types of anesthesia on the efferent renal sympathetic nerve activity (RSNA) during anaphylactic hypotension remain unknown. Therefore, we determined the renal sympathetic responses to anaphylactic hypotension in anesthetized and conscious rats and the roles of baroreceptors in these responses. Sprague-Dawley rats were randomly allocated to anesthetic groups that were given pentobarbital, urethane, or ketamine-xylazine and to a conscious group. The rats were sensitized using subcutaneously injected ovalbumin. The systemic arterial pressure (SAP), RSNA and heart rate (HR) were measured. The effects of sinoaortic baroreceptor denervation on RSNA during anaphylaxis were determined in pentobarbital-anesthetized and conscious rats. In all of the sensitized rats, the RSNA increased and SAP decreased after antigen injection. At the early phase within 35 min of the antigen injection, the antigen-induced sympathoexcitation in the conscious rats was significantly greater than that in the anesthetized rats. Anaphylactic hypotension was attenuated in the conscious rats compared to the anesthetized rats. The anesthetic-induced suppression of SAP and RSNA was greater in the order ketamine-xylazine >urethane?=?pentobarbital. Indeed, in the rats treated with ketamine-xylazine, RSNA did not increase until 40 min, and SAP remained at low levels after the antigen injection. The baroreceptor reflex, as evaluated by increases in RSNA and HR in response to the decrease in SAP induced by sodium nitroprusside (SNP), was suppressed in the anesthetized rats compared with the conscious rats. Consistent with this finding, baroreceptor denervation attenuated the excitatory responses of RSNA to anaphylaxis in the conscious rats but not in the pentobarbital-anesthetized rats. RSNA was increased markedly in conscious rats during anaphylactic hypotension. Anesthetics attenuated this antigen-induced renal sympathoexcitation through the suppression of baroreceptor function. PMID:25423366

Wang, Mofei; Kuda, Yuhichi; Kurata, Yasutaka; Shibamoto, Toshishige

2014-01-01

345

Tools and Techniques for Evaluating the Effects of Maintenance Resource Management (MRM) in Air Safety  

NASA Technical Reports Server (NTRS)

This research project was designed as part of a larger effort to help Human Factors (HF) implementers, and others in the aviation maintenance community, understand, evaluate, and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions; on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2001, three issues were addressed. First a prototype process for measuring performance was developed and used. Second an automated calculator was developed to aid the HF implementer user in analyzing and evaluating local survey data. These results include being automatically compared with the experience from all MRM programs studied since 1991. Third the core survey (the Maintenance Resource Management Technical Operations Questionnaire, or 'MRM/TOQ') was further developed and tested to include topics of added relevance to the industry.

Taylor, James C.

2002-01-01

346

A novel tracer technique for the assessment of fine sediment dynamics in urban water management systems.  

PubMed

Urban storm water run off can reduce the quality of receiving waters due to high sediment load and associated sediment-bound contaminants. Consequently, urban water management systems, such as detention ponds, that both modify water quantity through storage and improve water quality through sediment retention are frequently-used best management practices. To manage such systems effectively and to improve their efficiency, there is a need to understand the dynamics (transport and settling) of sediment, and in particular the fine sediment fraction (<63 ?m) and its associated contaminants within urban storm water management systems. This can be difficult to achieve, as modelling the transport behaviour of fine-grained and cohesive sediment is problematic and field-based measurements can be costly, time-consuming and unrepresentative. The aim of this study was to test the application of a novel cohesive sediment tracer and to determine fine sediment transport dynamics within a storm water detention pond. The cohesive sediment tracer used was a holmium labelled montmorillonite clay which flocculated and had similar size and settling velocity to the natural pond sediment it was intended to mimic. The tracer demonstrated that fine sediment was deposited across the entire pond, with the presence of reed beds and water depth being important factors for maximising sediment retention. The results of the sediment tracer experiment were in good agreement with those of a mathematical sediment transport model. Here, the deposited sediment tracer was sampled by collecting and analysing surface pond sediments for holmium. However, analysis and sampling of the three dimensional suspended tracer 'cloud' may provide more accurate information regarding internal pond sediment dynamics. PMID:21420140

Spencer, K L; Droppo, I G; He, C; Grapentine, L; Exall, K

2011-04-01

347

Adoption of Pollution Prevention Techniques: The Role of Management Systems and Regulatory Pressures  

Microsoft Academic Search

This paper investigates the extent to which firm level technological change that reduces unregulated emissions is driven by\\u000a regulatory pressures, and firms’ technological and organizational capabilities. Using a treatment effects model with panel\\u000a data for a sample of S&P 500 firms over the period 1994–1996, we find that organizational change in the form of Total Quality\\u000a Environmental Management leads firms

Madhu Khanna; George Deltas; Donna Ramirez Harrington

2009-01-01

348

A review of fault management techniques used in safety-critical avionic systems  

NASA Astrophysics Data System (ADS)

In order to achieve high integrity levels in complex, real-time, safety-critical systems, it is necessary to detect failures and take appropriate fault recovery action, to maintain safe system operation or fail to a safe state. It may also be necessary to alert the operator of the failure. In order to take appropriate maintenance action it is also necessary to isolate the failed component. This process is termed fault management. Airline experience with modern avionic systems is that, despite the apparent sophistication of the Built-In Test Equipment and Centralised Maintenance Systems, spurious fault detection is unacceptably high. Fault detection coverage is not uniformly good and fault isolation is often inaccurate or imprecise. This paper presents a critical analysis of the methods currently used in fault management, in the light of personal experience of safety critical systems development within the aircraft industry and work by other researchers. It makes recommendations about the use of the various approaches and attempts to highlight areas where future research could be most usefully directed. It also assesses the impact that new avionics architectures may have on the utility of the various approaches to fault management in future aircraft systems.

Johnson, David M.

1996-10-01

349

Yoga Breathing Techniques: Implications for Stress Management, Health, and Psychophysiological Research  

Microsoft Academic Search

Understanding and application of various respiratory practices are impeded by the many interacting physiological and psychological variables. Yoga techniques may offer insights into useful breathing practices and control of important variables. This review integrates relevant data from (a) the psychophysiological\\/psychological literature, (b) the physiological\\/medical literature, and (c) studies of yoga. The available data indicate that yogic slow breathing practices promote

James E. Kennedy

350

The pouch and tunnel technique for management of multiple gingival recession defects  

PubMed Central

The desire for improved esthetics has increased tremendously over the years. Periodontal plastic surgery deals with regenerative procedures designed to restore form, function and enhance esthetics. The aim of this study was to evaluate the effectiveness of subepithelial connective tissue graft using pouch and tunnel technique as root coverage procedure. Three patients corresponding to a total of 8 sites participated in the study. Maxillary teeth with miller's class I gingival recession were included in the study. All the sites were treated using subepithelial connective tissue graft using pouch and tunneling technique. Patients were followed up for a period of 6 months and 1 year. All the treated teeth showed 100% root coverage at the end of 6 months and 1 year. Gingival recession is a common occurrence and its prevalence increases with age. It can lead to clinical problems, diminished cosmetic appeal and hence esthetic concern. There are various techniques for root coverage. Subepithelial connective tissue graft has shown the best predictability (95%) of root coverage in Millers class I & II cases. This technique preserves the intermediate papilla, accelerates the initial wound healing & also applies less traction. Due to minimal trauma at the recipient site, this procedure may be advantageous in treatment of recession as compared to other treatment modalities.

Dani, Sneha; Dhage, Aditi; Gundannavar, Gayatri

2014-01-01

351

A technique for remote management of instrumentation based on Web Service  

Microsoft Academic Search

In the paper the authors propose an original solution to perform the remote control of measurement instrumentation, with the aim of realizing the experimental section of an E-Learning portal of Electrical and Electronic Measurement courses, based on Web Services implemented in Visual Basic.Net. The .Net technology proves to overcome drawbacks typically affecting most of the techniques for remote instrument control

Pasquale Daponte; Claudio De Capua; Annalisa Liccardo; Bosco Lucarelli; Piazza Roma

352

Evaluation of Segmentation Techniques for Inventory Management in Large Scale Multi-Item Inventory Systems1  

E-print Network

-Item Inventory Systems1 Manuel D. Rossetti2 , Ph. D., P. E. Department of Industrial Engineering University techniques such as ABC analysis are often limited to using demand and cost when segmenting the inventory segmentation, clustering. 1 Accepted for publication in the International Journal of Logistics Systems

Rossetti, Manuel D.

353

Humor As a Management Technique: Its Impact on School Culture and Climate.  

ERIC Educational Resources Information Center

Ways in which humor is used as an administrative technique are explored in this paper, with a focus on its impact on school culture. Case study methodology is based on interviews with two principals and five staff members at a Tennessee high school. Following a review of transcript excerpts, the principal's use of humor is viewed through four…

Williams, Ronny A.; Clouse, R. Wilburn

354

Digital compensation of cross-phase modulation distortions using perturbation technique for dispersion-managed fiber-optic systems.  

PubMed

A digital compensation scheme based on a perturbation theory for mitigation of cross-phase modulation (XPM) distortions is developed for dispersion-managed fiber-optic communication systems. It is a receiver-side scheme that uses a hard-decision unit to estimate data for the calculation of XPM fields using the perturbation technique. The intra-channel nonlinear distortions are removed by intra-channel digital backward propagation (DBP) based on split-step Fourier scheme before the hard-decision unit. The perturbation technique is shown to be effective in mitigating XPM distortions. However, wrong estimations in the hard-decision unit result in performance degradation. A hard-decision correction method is proposed to correct the wrong estimations. Numerical simulations show that the hybrid compensation scheme with DBP for dispersion and intra-channel nonlinear impairments compensation and the perturbation technique for XPM compensation brings up to 3.7 dBQ and 1.7 dBQ improvements as compared with the schemes of linear compensation only and intra-channel DBP, respectively. The perturbation technique for XPM compensation requires only one-stage (or two-stage when hard-decision correction is applied) compensation and symbol-rate signal processing. PMID:25321268

Liang, Xiaojun; Kumar, Shiva; Shao, Jing; Malekiha, Mahdi; Plant, David V

2014-08-25

355

Modulation of the general anesthetic sensitivity of a protein: a transition between two forms of firefly luciferase.  

PubMed Central

The activities of most proteins are relatively insensitive to general anesthetics. A notable exception is firefly luciferase, whose sensitivity to a wide range of anesthetic agents closely parallels that of whole animals. We have now found that this sensitivity can be controlled by ATP. The enzyme is insensitive at low (microM) concentrations of ATP and very sensitive at high (mM) concentrations. The differential sensitivity varies from anesthetic to anesthetic, being greatest (about a 100-fold difference) for molecules with large apolar segments. This suggests that anesthetic sensitivity is modulated by changes in the hydrophobicity of the anesthetic-binding pocket. Parallel changes in the binding of the substrate firefly luciferin, for which anesthetics compete, indicate that anesthetics bind at the same site as the luciferin substrate. These changes in the nature of the binding pocket modify not only the sensitivity to anesthetics but also the position of the "cutoff" in the homologous series of primary alcohol anesthetics; the cutoff position can vary from octanol to pentadecanol, depending upon the concentration of ATP. Our results suggest that particularly sensitive anesthetic target sites in the central nervous system may possess anesthetic-binding pockets whose polarities are regulated by neuromodulatory agents. PMID:1986359

Moss, G W; Franks, N P; Lieb, W R

1991-01-01

356

I, S, T, and J Grading Techniques for Es, Ns, Fs, and Ps: Insights from the MBTI on Managing the Grading Process  

ERIC Educational Resources Information Center

Most instructors at least occasionally experience grading student work as a frustrating, time-consuming task. The Myers-Briggs Type Indicator (MBTI) instrument can be a powerful self-awareness tool for management educators seeking to enhance their grading techniques. Evidence suggests that many management professors prefer Extraversion (E),…

Fornaciari, Charles J.; Lund Dean, Kathy

2013-01-01

357

Irrigation Management with Remote Sensing Techniques. Crop Water Requirements and Biophysical Indicators  

NASA Astrophysics Data System (ADS)

Saving water in irrigated agriculture is increasingly relevant, as the irrigation sector is in many regions the biggest water consumer, but must be a sustainable activity. Therefore, the need urges for water use control methods and water resources planning. In irrigated agriculture, the right way for saving water is constituted by the increase of efficiency in water management. This work validates procedures and methodologies with remote sensing to determine the water availability in the soil at each moment and therefore the opportunity for the application of the water volume strictly necessary to optimize crop growth (irrigation opportunity and irrigation amount). The analysis applied to the Irrigation District of Divor, Évora, having used 7 experiment plots, which are areas watered by center-pivot systems, cultivated to corn. Data were determined from multispectral and infrared images of the cultivated surface obtained by satellite or by flying unmanned platform and integrated with parameters of the atmosphere and of the crops for calculating biophysical indicators and indices of water stress in the vegetation (NDVI, Kc, Kcb, CWSI). Therefore, evapotranspiration (ETc) was estimated, with which crop water requirement was calculated, with the opportunity and the amount of irrigation water to allocate. As this information is geographic referenced, maps can be prepared with GIS technology, describing water situation and the opportunity for watering crops. If the remote images are available with enough high spatial and temporal resolution, the frequent availability of maps can serve as a basis for a farmers irrigation advice system and for the regional irrigation authority to make decisions on the irrigation management at the regional scale. This can be a significant contribute to an efficient water management technology and a sustainable irrigated agriculture. Key-Words: Remote Sensing, Vegetation Index, Crop Coefficients, Water Balance

Toureiro, Célia; Serralheiro, Ricardo

2013-04-01

358

Job stress management protocol using a merge between cognitive-behavioral techniques and ergonomic tools.  

PubMed

This paper presents a protocol for work distress assessment. Work distress is defined as a merge between nonergonomic related aspects, in tasks or environment, and adversely conditions perceived for a worker, in a certain work situation. This frame requires an approach that can treat individuals and organizational factors in the same way, at the same time. For this, we elaborate a psycho-ergonomics method, associating concepts and practices from cognitive-behavioral techniques and work ergonomic analysis, which we named CEWAT - Cognitive-Behavioral Work Analysis Technique. This paper presents CEWAT's foundations and structure, in steps. An application to a complex and dangerous system illustrates its benefits in the ergonomics action. PMID:22317142

Viola, Elaine; Vidal, Mario Cesar

2012-01-01

359

Advances in the understanding of the pathophysiology and management of aortic stenosis: role of novel imaging techniques.  

PubMed

The management of asymptomatic patients with aortic stenosis (AS) is controversial and the mechanisms leading to symptom generation and adverse outcome are not fully understood. Novel imaging techniques offer a noninvasive tool for in vivo assessment of AS and its pathophysiological consequences on the myocardium. Exercise echocardiography provides insight into the mechanisms responsible for exercise limitation and symptom generation. Speckle tracking allows the detection of reduced myocardial strain, which is associated with adverse events in asymptomatic patients. Computed tomography scanning can accurately quantify valve calcification and is associated with disease severity. Positron emission tomography/computed tomography imaging has the potential to monitor disease activity (inflammation and microcalcification) for the first time. Cardiac magnetic resonance (CMR) imaging uniquely allows tissue characterization with identification of fibrosis, a key characteristic of failing myocardium. T1 mapping allows estimation of diffuse interstitial fibrosis and late gadolinium enhancement demonstrates focal fibrosis/scarring. Myocardial steatosis, assessed using CMR spectroscopy, is increased in severe AS and might contribute to myocardial dysfunction. Positron emission tomography and CMR imaging can quantify myocardial blood flow and assess microvascular dysfunction, which might contribute to symptom development and myocardial remodelling. These novel imaging techniques are now being assessed in prospective prognostic studies that will clarify their utility in risk stratification in AS, and lead to improved management and outcomes for these patients. PMID:25015690

Singh, Anvesha; Steadman, Christopher D; McCann, Gerry P

2014-09-01

360

Novel technique for tracking manpower and work packages: a useful tool for the team and management  

NASA Astrophysics Data System (ADS)

In these times of austerity it is becoming more and more important to justify the need for manpower to management. Additionally, with the fast pace of today's projects the need for tools that facilitate teams to not only plan, but also track their work, are essential. The practice of planning work packages and the associated manpower has been about for a while but little is done to really cross-check that planning against reality. In this paper these elements are brought together through a number of tools that make up the end to end process of planning, tracking and reporting of work package progress and manpower usage.

Gill, R.; Gracia, G.; Lupton, R. H.; O'Mullane, W.

2014-08-01

361

Applications notice. [application of space techniques to earth resources, environment management, and space processing  

NASA Technical Reports Server (NTRS)

The discipline programs of the Space and Terrestrial (S&T) Applications Program are described and examples of research areas of current interest are given. Application of space techniques to improve conditions on earth are summarized. Discipline programs discussed include: resource observations; environmental observations; communications; materials processing in space; and applications systems/information systems. Format information on submission of unsolicited proposals for research related to the S&T Applications Program are given.

1978-01-01

362

Anesthesia and perioperative management of colorectal surgical patients – A clinical review (Part 1)  

PubMed Central

Colorectal surgery is commonly performed for colorectal cancer and other pathology such as diverticular and inflammatory bowel disease. Despite significant advances, such as laparoscopic techniques and multidisciplinary recovery programs, morbidity and mortality remain high and vary among surgical centers. The use of scoring systems and assessment of functional capacity may help in identifying high-risk patients and predicting complications. An understanding of perioperative factors affecting colon blood flow and oxygenation, suppression of stress response, optimal fluid therapy, and multimodal pain management are essential. These fundamental principles are more important than any specific choice of anesthetic agents. Anesthesiologists can significantly contribute to enhance recovery and improve the quality of perioperative care. PMID:22557737

Patel, Santosh; Lutz, Jan M; Panchagnula, Umakanth; Bansal, Sujesh

2012-01-01

363

Pelvic fractures: part 2. Contemporary indications and techniques for definitive surgical management.  

PubMed

Once the patient with pelvic fracture is resuscitated and stabilized, definitive surgical management and anatomic restoration of the pelvic ring become the goal. Understanding injury pattern by stress examination with the patient under anesthesia helps elucidate the instability. Early fixation of the unstable pelvis is important for mobilization, pain control, and prevention of chronic instability or deformity. Current pelvic fracture management employs a substantial amount of percutaneous reduction and fixation, with less emphasis placed on pelvic reconstruction proceeding from posterior to anterior, and most reduction and fixation of unstable pelvic fractures done with the patient supine. Compared with control subjects with acetabular fracture or pelvic fracture alone, patients with combined injury have a significantly higher Injury Severity Score, lower systolic blood pressure, and higher mortality rates; they are also transfused more packed red blood cells. Even with anatomic restoration of the pelvis, long-term outcomes after severe pelvic trauma are below population norms. The most common chronic problems relate to sexual dysfunction and pain. Regardless of fracture type, neurologic injury is a universal harbinger of poor outcome. PMID:23908252

Langford, Joshua R; Burgess, Andrew R; Liporace, Frank A; Haidukewych, George J

2013-08-01

364

Measurements of pulmonary arterial pressure in anesthetized male broilers at two to seven weeks of age.  

PubMed

Pulmonary hypertension (an elevated pulmonary arterial pressure) is the defining symptom of the pathophysiological progression leading to pulmonary hypertension syndrome (ascites) in broilers. Previously, closed-thorax techniques had not been reported for measuring the pulmonary arterial pressure in young (<5 wk of age) broilers. The objective of this research was to evaluate continuous pulmonary arterial pressure in anesthetized male broilers at weekly intervals (2 to 7 wk of age) by inserting a cannula directly into the pulmonary artery. Body weights, heart rates, and the right:total ventricular weight ratio were also recorded. Clinically healthy individuals were selected from two separate hatches without prior assessment of electrocardiograms or the percentage of saturation of hemoglobin with oxygen. The pulmonary arterial pressure increased (P < or = 0.05) from 20 to 25 mm Hg between Weeks 2 and 3, remained at approximately 25 mm Hg during Weeks 4 and 5, and then returned to 19 mm Hg during Weeks 6 to 7. Body weight increased with age, the heart rate and body weight-normalized right and total ventricular weights remained constant through Week 5, and the right:total ventricular weight ratio remained constant through Week 7. This technique is useful for determining age-related changes in pulmonary arterial pressure that may contribute to a mismatch between pulmonary vascular capacity and cardiac output in apparently healthy broilers during the pathogenesis of pulmonary hypertension syndrome. PMID:11092340

Forman, M F; Wideman, R F

2000-11-01

365

Anaesthetic management of a case of dilated cardiomyopathy for emergency appendectomy  

PubMed Central

The anesthetic management of a patient with dilated cardiomyopathy (DCM) undergoing non-cardiac surgery poses a challenge for anesthesiologist either due to pre-existing or a risk of precipitating congestive heart failure. We report a successful use of combined spinal epidural for emergency appendicectomy in a patient of DCM. Different anesthetic concerns and agents, some recent advances are also discussed.

Raj, Ravi; Kumar, Mritunjay; Batra, Meenu

2014-01-01

366

Anesthetic Effects of a Three-Drugs Mixture-Comparison of Administrative Routes and Antagonistic Effects of Atipamezole in Mice.  

PubMed

The anesthetic mixture of medetomidine (MED), midazolam (MID) and butorphanol (BUT) produced anesthetic duration of around 40 mins (min) in ICR mice. We reported that this anesthetic mixture produced almost the same anesthetic effects in both male and female BALB/c and C57BL/6J strains. Intraperitoneal (IP) administration of drugs has been widely used in mice. However, various injectable routes of the anesthetic mixture may cause different anesthetic effects. First, we examined effects of the anesthetic mixture by subcutaneous (SC) and intravenous (IV) injection compared to IP injection. After injection of the anesthetic mixture, administration of atipamezole (ATI) induced mice recovery from anesthesia. Secondly, we examined how different dosage and optimum injection timing of ATI affected mice recovery from anesthesia. We used an anesthetic score to measure anesthetic duration and a pulse oximeter to monitor vital signs under anesthesia. Usually, drugs from SC injection work more weakly than IP or IV injection. However, we found no significant differences of anesthetic duration among the three different injection routes. Antagonistic effects of ATI (0.3 mg/kg and 1.5 mg/kg) worked equally when administered at 30 min after injection of the anesthetic mixture. Antagonistic effects of ATI (1.5 mg/kg) were stronger than ATI (0.3 mg/kg) at 10 min after injection of the anesthetic mixture. The anesthetic mixture is a useful drug to induce nearly the same anesthetic effects by different injection routes and has an antagonist of ATI which helps mice quickly recover from anesthesia. These results may contribute to the welfare of laboratory animals. PMID:25223384

Kirihara, Yumiko; Takechi, Mayumi; Kurosaki, Kaoru; Kobayashi, Yuta; Saito, Yoji; Takeuchi, Takashi

2014-09-12

367

Anesthetic effects of a three-drugs mixture —comparison of administrative routes and antagonistic effects of atipamezole in mice—  

PubMed Central

The anesthetic mixture of medetomidine (MED), midazolam (MID) and butorphanol (BUT) produced anesthetic duration of around 40 minutes (min) in ICR mice. We reported that this anesthetic mixture produced almost the same anesthetic effects in both male and female BALB/c and C57BL/6J strains. Intraperitoneal (IP) administration of drugs has been widely used in mice. However, various injectable routes of the anesthetic mixture may cause different anesthetic effects. First, we examined effects of the anesthetic mixture by subcutaneous (SC) and intravenous (IV) injection compared to IP injection. After injection of the anesthetic mixture, administration of atipamezole (ATI) induced mice recovery from anesthesia. Secondly, we examined how different dosage and optimum injection timing of ATI affected mice recovery from anesthesia. We used an anesthetic score to measure anesthetic duration and a pulse oximeter to monitor vital signs under anesthesia. Usually, drugs from SC injection work more weakly than IP or IV injection. However, we found no significant differences of anesthetic duration among the three different injection routes. Antagonistic effects of ATI (0.3 mg/kg and 1.5 mg/kg) worked equally when administered at 30 min after injection of the anesthetic mixture. Antagonistic effects of ATI (1.5 mg/kg) were stronger than ATI (0.3 mg/kg) at 10 min after injection of the anesthetic mixture. The anesthetic mixture is a useful drug to induce nearly the same anesthetic effects by different injection routes and has an antagonist of ATI which helps mice quickly recover from anesthesia. These results may contribute to the welfare of laboratory animals.

KIRIHARA, Yumiko; TAKECHI, Mayumi; KUROSAKI, Kaoru; KOBAYASHI, Yuta; SAITO, Yoji; TAKEUCHI, Takashi

2014-01-01

368

Overview movement as an index of anesthetic depth in humans and experimental animals.  

PubMed

Anesthesia is used widely in animal research, but there are diverse opinions regarding acceptable anesthetic depth. Excessive anesthesia is associated with increased morbidity and mortality. Traditionally, researchers have been taught that animal movement during surgical and experimental procedures indicates that the animal is 'underanesthetized.' Complex movement, however, can be initiated and propagated within the spinal cord, with little input from supraspinal structures. For example, frogs with high spinal-cord transections still maintain the wiping reflex, whereby the hindlimb can move to the forelimb to wipe away a noxious stimulus. Rats that have been decerebrated can perform complex tasks, such as grooming. Brain-dead humans can have spontaneous movement of the arms, legs, and head. Consistent with these phenomena, emerging evidence suggests that, in anesthetized animals, movement in response to noxious stimulation is abolished primarily via anesthetic action in the spinal cord. When isoflurane, halothane, or thiopental is delivered selectively to the brain circulation in goats, substantially greater anesthetic concentrations in brain are needed to ablate movement, as compared with those required upon delivery of anesthetic to the entire body. Rats that have had a precollicular decerebration require the same isoflurane concentrations to prevent movement as compared to intact rats. Furthermore, data from both humans and animals indicate that memory and awareness are ablated at anesthetic concentrations that are < 50% of those needed to abolish movement. Collectively, these data indicate that animals can be anesthetized at depths that, although they do not abolish movement, still produce unconsciousness and amnesia. PMID:16270896

Antognini, Joseph F; Barter, Linda; Carstens, Earl

2005-10-01

369

Microsensor and microdialysis technology. Advanced techniques in the management of severe head injury.  

PubMed

Neuroscientists continue the search for the "magic bullet" that will prevent the deleterious effects of primary and secondary brain injury. Indirect measurement of the effects of primary and secondary brain injury through the study of ICP- or CPP-directed management, CBF monitoring, Sjo2 monitoring, and TCD monitoring has led to improved care of persons with brain injury. Although the findings from brain injury research using microsensor and microdialysis technology are only preliminary and extensive research is still needed, these technologies have dramatically expanded knowledge about brain injury at the cellular level. Extended neuromonitoring is poised to enter a new and exciting phase because of the growth in knowledge regarding the cellular events associated with brain injury. The recent approval of NeuroTrend by the FDA will further promote this growth. Applications of the technology have already expanded to include uses beyond the management of traumatic brain injury. Microsensor and microdialysis technology is being used intraoperatively to determine "safe" temporary clipping times for aneurysm surgery and is also being used within the critical care setting to improve the monitoring and management of subarachnoid hemorrhage patients who are experiencing vasospasm. The ultimate application of this new technology is to improve long-term outcomes for patients with brain injury through the reduction of secondary brain injury. If that goal is to be accomplished, then it will be important for nurses caring for patients with brain injury to become immersed in this exciting new phase in brain injury monitoring. Nurses must obtain a comprehensive knowledge base of brain injury pathophysiology and how extended neuromonitoring can lead to improved outcomes. Technical proficiency will also be important to ensure that treatment and research conclusions are based on accurate data. Finally and perhaps most importantly, it will be critical for nurses to participate in and develop research studies that explore the impact of interventions, especially nursing care activities, on the injured brain if these exciting new advances are to be translated into tangible benefits for brain-injured patients. PMID:11855247

Haselman, M; Fox, S

2000-12-01

370

Motoneuronal TASK channels contribute to immobilizing effects of inhalational general anesthetics.  

PubMed

General anesthetics cause sedation, hypnosis, and immobilization via CNS mechanisms that remain incompletely understood; contributions of particular anesthetic targets in specific neural pathways remain largely unexplored. Among potential molecular targets for mediating anesthetic actions, members of the TASK subgroup [TASK-1 (K2P3.1) and TASK-3 (K2P9.1)] of background K(+) channels are appealing candidates since they are expressed in CNS sites relevant to anesthetic actions and activated by clinically relevant concentrations of inhaled anesthetics. Here, we used global and conditional TASK channel single and double subunit knock-out mice to demonstrate definitively that TASK channels account for motoneuronal, anesthetic-activated K(+) currents and to test their contributions to sedative, hypnotic, and immobilizing anesthetic actions. In motoneurons from all knock-out mice lines, TASK-like currents were reduced and cells were less sensitive to hyperpolarizing effects of halothane and isoflurane. In an immobilization assay, higher concentrations of both halothane and isoflurane were required to render TASK knock-out animals unresponsive to a tail pinch; in assays of sedation (loss of movement) and hypnosis (loss-of-righting reflex), TASK knock-out mice showed a modest decrease in sensitivity, and only for halothane. In conditional knock-out mice, with TASK channel deletion restricted to cholinergic neurons, immobilizing actions of the inhaled anesthetics and sedative effects of halothane were reduced to the same extent as in global knock-out lines. These data indicate that TASK channels in cholinergic neurons are molecular substrates for select actions of inhaled anesthetics; for immobilization, which is spinally mediated, these data implicate motoneurons as the likely neuronal substrates. PMID:20519544

Lazarenko, Roman M; Willcox, Sarah C; Shu, Shaofang; Berg, Allison P; Jevtovic-Todorovic, Vesna; Talley, Edmund M; Chen, Xiangdong; Bayliss, Douglas A

2010-06-01

371

FaceTime(®) for teaching ultrasound-guided anesthetic procedures in remote place.  

PubMed

In isolated area in Japan, only one anesthesiologist must often do new anesthetic techniques such as ultrasound-guided procedures without receiving any teaching. One solution to this problem may involve teleanesthesia, by which experienced anesthesiologists teach novices in remote places, by utilizing information communication technologies. FaceTime™ (Apple, USA), which provides 120p of the resolution and 30 frames per second (fps) is an application of free visual communications using iPod Touch™, iPhone™ or iPad™ (Apple, USA). We investigated the delay time, the loss of the frames and the picture quality of iPad (as the device in the teaching site) in combination with iPod Touch, iPhone4 or iPhone5 (as the device in the isolated site) during FaceTime. At the operating rooms in Sado General Hospital (SGH) located in Sado Island (population; approximately 60,000), Japan, an anesthesiologist prepared 3 mobile devices (iPod Touch, iPhone4 or iPhone5). He called the other anesthesiologist at Yokohama City University Hospital (YCUH; approximately 300 km apart) by FaceTime using 1 of 3 mobile devices. The anesthesiologist at YCUH received the FaceTime call using iPad. After the connection was established, the display of the same cervical ultrasound image at SGH was sent to YCUH to evaluate the distinctness visually. Then we measured the delay time of every second (n = 60) and the loss of the frames (total frames = 30 fps × 60 s = 1,800) in each device for a minute. P < 0.01 was statistically significant. The quality of the pictures on the iPad display sent from iPhone5 was distinctly the best visually. The delay time of iPhone5 was significantly longer than the others (iPod Touch; 0.14 ± 0.02 s, iPhone4; 0.13 ± 0.02 s, iPhone5; 0.19 ± 0.03 s), but clinically acceptable. The loss of the frames of iPhone5 (20; 1.1%) was significantly less than the others (iPhone4; 900, 50.0%, iPod Touch; 902, 50.1%). To teach anesthetic techniques in remote place by FaceTime, iPhone5 as the devise in isolate site was optimum compared with iPod Touch and iPhone4. PMID:24222344

Miyashita, Tetsuya; Iketani, Yasuhiro; Nagamine, Yusuke; Goto, Takahisa

2014-04-01

372

Usability Evaluation of an Online, Tailored Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients Incorporating Behavior Change Techniques  

PubMed Central

Background An eHealth intervention using computer tailored technology including several behavior change techniques was developed to support the self-management of chronic obstructive pulmonary disease patients. Objective The goal of this study was to evaluate and improve the usability of the eHealth intervention. Methods We conducted a usability evaluation with 8 chronic obstructive pulmonary disease patients, with a mixed methods design. We improved the usability through iterative cycles of evaluation and adaptation. Participants were asked to think aloud during the evaluation sessions. Participants then completed a semi-structured interview. The sessions were observed and recorded. Descriptive statistics and content analysis were used to uncover usability issues. Results Areas for improvement were layout, navigation, and content. Most issues could be solved within 3 iterations of improvement. Overall, participants found the program easy to use. The length of the program urged us to further analyze the appreciation of behavior change techniques. Some were perceived as helpful and easy to use, while others evoked frustration. Conclusions The usability study identified several issues for improvement, confirming the need for usability evaluation during the development of eHealth interventions. The uncovered strengths and limitations of behavior change techniques may lead to optimization of eHealth interventions, but further insight is needed. PMID:23612363

Moser, Albine; van der Weijden, Trudy; Nagykaldi, Zsolt; de Vries, Hein; Tange, Huibert

2013-01-01

373

Visceral Artery Aneurysms and Pseudoaneurysms—Should They All be Managed by Endovascular Techniques?  

PubMed Central

Visceral artery aneurysms (VAA) and pseudoaneurysms (VAPA) can be life-threatening conditions with high incidence of rupture and hemorrhage. Greater availability and increased use of advanced imaging technology has led to the increased incidental detection of asymptomatic visceral aneurysms. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic pseudoaneurysms. Due to this, both VAA and VAPA have become an increasingly frequent diagnosis confronting the vascular surgeon. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular occlusive and aneurysmal disease. All VAA and VAPA can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting, particularly in patients who are poor surgical candidates due to their comorbidities or who present a hostile abdomen. However, in the emergent setting it may carry a higher morbidity and mortality. We review the literature about open and endovascular approach for the treatment of VAA and VAPA both in the elective and emergent setting. PMID:24386016

2013-01-01

374

Development of minimally invasive techniques for management of medically-complicated obesity  

PubMed Central

The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal interventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss. PMID:25309074

Rashti, Farzin; Gupta, Ekta; Ebrahimi, Suzan; Shope, Timothy R; Koch, Timothy R; Gostout, Christopher J

2014-01-01

375

Diagnostic strategies for heart disease in women: an update on imaging techniques for optimal management.  

PubMed

Significant progress has been made toward increasing awareness of the risks of heart disease in women and in the area of sex-specific cardiovascular research. Yet, coronary artery disease remains the leading cause of death of women in the western world. Over the last decade, the increased research focus of women at risk for ischemic heart disease has helped in defining and delineating some of the sex-specific factors, which have adversely affected the accuracy of imaging techniques in women. A focused body of clinical research has been published over the last few years, and there now exists a growing body of evidence on the diagnostic and prognostic accuracy of contemporary cardiovascular imaging techniques in women. Recent publications specifically addressing this issue [namely the 2005 American Heart Association Statement on Cardiac Imaging in Women, and the 2006 Women's Ischemia Syndrome Evaluation (WISE) study] are now changing the existing paradigm of ischemic heart disease from one representing a "man's disease," to one including sex-specific algorithms. In this article we review the literature regarding the diagnostic and prognostic evaluation of coronary artery disease in women with respect to imaging. PMID:18090062

Makaryus, Amgad N; Shaw, Leslee J; Mieres, Jennifer H

2007-01-01

376

Local anesthetic activity of mixtures of cis- and trans-(2-dimethylaminomethylcycloheptyl)-2-alkoxyphenylcarbamates.  

PubMed

In a previous study, we synthesized two homologous series of racemic stereoisomeric cis- and trans-(2-dimethylaminomethylcycloheptyl)-2-alkoxyphenylcarbamates with alkyl chain lengths ranging from C1 to C8 and analyzed their local anesthetic activity. Here, we show that the local anesthetic activities of mixtures of cis-1 and trans-1 stereoisomers are higher than the sum of activities calculated for the individual stereoisomers at all molar fractions. We conclude that an appropriate ratio of cis- and trans-stereoisomers is necessary to achieve the maximum anesthetic activity of the studied stereoisomeric carbamates. PMID:25272940

Gregan, F; Gregan, J; Skorsepa, M

2014-09-01

377

Signaling epicenters: The role of caveolae and caveolins in volatile anesthetic induced cardiac protection  

PubMed Central

Caveolae are flask-like invaginations of the cell surface that have been identified as signaling epicenters. Within these microdomains, caveolins are structural proteins of caveolae, which are able to interact with numerous signaling molecules affecting temporal and spatial dimensions required in cardiac protection. This complex moiety is essential to the mechanisms involved in volatile anesthetics. In this review, we will outline a general overview of caveolae and caveolins and their role in protective signaling, with a focus on the effects of volatile anesthetics. These recent developments have allowed us to better understand the mechanistic effect of volatile anesthetics and their potential in cardiac protection. PMID:24502576

Horikawa, Yousuke T.; Tsutsumi, Yasuo M.; Patel, Hemal H.; Roth, David M.

2014-01-01

378

Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques.  

PubMed

We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms. PMID:23323015

Wang, Mao-Qiang; Liu, Feng-Yong; Duan, Feng

2012-12-21

379

Symposium on the management of inguinal hernias: 4. The Shouldice technique: a canon in hernia repair  

PubMed Central

Controversy exists on the merits of the various approaches to inguinal repair. Evolution of the classic open repair has culminated in the Shouldice repair. Challenges from newcomers, namely, tension-free repair and laparoscopy, are being examined. These two techniques have a number of disadvantages: the presence of foreign bodies (prostheses) and their implication in cases of infection; the cost of prosthetic material, which is no longer negligible (particularly with expanded polytetrafluoroethylene); and problems of safety in that the laparoscopic approach is no longer a dependable asset except in the hands of a highly specialized and dextrous operator. Still, complications occur with laparoscopic repair that should not be associated with a surgical procedure that is considered benign, safe and cost-effective. Surgeons must recognize the pertinent facts and decide according to their conscience which method of repair to use. PMID:9194781

Bendavid, Robert

1997-01-01

380

Laparoscopic surgical technique to facilitate management of high anorectal malformations – report of seven cases  

PubMed Central

Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

Murawski, Maciej; ?osin, Marcin; Królak, Marek; Czauderna, Piotr

2011-01-01

381

Laparoscopic surgical technique to facilitate management of high anorectal malformations - report of seven cases.  

PubMed

Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

Go??biewski, Andrzej; Murawski, Maciej; Losin, Marcin; Królak, Marek; Czauderna, Piotr

2011-09-01

382

Actions of Bupivacaine, a Widely Used Local Anesthetic, on NMDA Receptor Responses.  

PubMed

NMDA receptors mediate excitatory neurotransmission in brain and spinal cord and play a pivotal role in the neurological disease state of chronic pain, which is caused by central sensitization. Bupivacaine is the indicated local anesthetic in caudal, epidural, and spinal anesthesia and is widely used clinically to manage acute and chronic pain. In addition to blocking Na(+) channels, bupivacaine affects the activity of many other channels, including NMDA receptors. Importantly, bupivacaine inhibits NMDA receptor-mediated synaptic transmission in the dorsal horn of the spinal cord, an area critically involved in central sensitization. We used recombinant NMDA receptors expressed in HEK293 cells and found that increasing concentrations of bupivacaine decreased channel open probability in GluN2 subunit- and pH-independent manner by increasing the mean duration of closures and decreasing the mean duration of openings. Using kinetic modeling of one-channel currents, we attributed the observed current decrease to two main mechanisms: a voltage-dependent "foot-in-the-door" pore block and an allosteric gating effect. Further, the inhibition was state-independent because it occurred to the same degree whether the drug was applied before or after glutamate stimulation and was mediated by extracellular and intracellular inhibitory sites, via hydrophilic and hydrophobic pathways. These results predict that clinical doses of bupivacaine would decrease the peak and accelerate the decay of synaptic NMDA receptor currents during normal synaptic transmission. These quantitative predictions inform possible applications of bupivacaine as preventative and therapeutic approaches in chronic pain. PMID:25589775

Paganelli, Meaghan A; Popescu, Gabriela K

2015-01-14

383

Testbed for the evaluation of battlefield information management techniques applied to a low-bandwidth tactical wireless communications environment  

NASA Astrophysics Data System (ADS)

Mobile communication is an important military requirement. Voice communication still occupy a pre-eminent place in Army operations. Present-generation digital data communications at the tactical level are often accomplished using radio system designed primarily with voice in mind. Data throughput tends to be very limited and highly variable. If one regards the wireless communication network as a data pipeline, there are essentially three possible ways of improving the situation: (1) increase the size of the pipeline; (2) optimize transmission through the pipeline; or (3) be as smart and efficient as possible about what is put into the pipeline. The potential of the third approach is often overlooked. This paper describes a testbed being developed to study the impact of information management techniques, applied at the level of the application database in each participating node of a simulated tactical radio network on the quality and timeliness of information distribution across nodes.

Gibb, Allan W.; St-Jacques, Jean-Claude

1999-07-01

384

Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause.  

PubMed

Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may also sometimes be helpful in women with abnormal vaginal bleeding before the menopause. In this chapter, I present ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas, including submucous myomas and leiomyosarcoma, and describe ultrasound-based triage of women with postmenopausal bleeding. PMID:24834911

Valentin, Lil

2014-07-01

385

Geospatial Techniques for Efficient Conservation and Management of Surface Water for Irrigation in Joganbedi Village, Khargone District, Madhya Pradesh, India  

NASA Astrophysics Data System (ADS)

The study aimed at developing improved methods based on remote sensing and GIS techniques to increase cultivated area under irrigation. Landuse / landcover mapping was considered as the key component to prioritize locations for constructing appropriate recharge structures. Joganbedi scheme was proposed for this study. Joganbedi is situated 13 km. from Khargone, district Khargone, Madhya Pradesh, India. Command area of the proposed scheme lies in Beda sub-basin which is a tributary of the Narmada River. This area is of hard rock terrain and is occupied by the Deccan basalt. The main objective of the study was surface water conservation and management via multi-spectral information resulting from remotely sensed data to increase irrigation. High resolution GeoEye1 stereo images were used for generation of DEM, contour, landuse/landcover mapping, lineaments and drainage mapping. DEM was used for canal alignment. and further, contours were used to determine catchment, submergence /FRL, and command areas. Landuse/landcover statistics of submergence area helped to identify different land classes within the study area. These parameters are required for scheme planning. Additionally, rainfall data, maximum drawdown level, and dam height were collected as supporting parameters. The study concludes that landuse/landcover mapping is useful in identification of surface water conservation and management plan for irrigation purpose. It also proves that implementation of Joganbedi scheme will increase the cultivated area under irrigation, facilitate the farmers for multi season cropping and help in improving their economic condition.

Singh, A. M.; Chauhan, A. S.; Aggarwal, D.

2014-11-01

386

[An experimental study of the computer-controlled equipment for delivering volatile anesthetic agent].  

PubMed

Our newly-designed computer-controlled equipment for delivering volatile anesthetic agent uses the subminiature singlechip processor as the central controlling unit. The variables, such as anesthesia method, anesthetic agent, the volume of respiratory loop, age of patient, sex, height, weight, environment temperature and the grade of ASA are all input from the keyboard. The anesthetic dosage, calculated by the singlechip processor, is converted into the signals controlling the pump to accurately deliver anesthetic agent into respiratory loop. We have designed an electrocircuit for the equipment to detect the status of the pump's operation, so we can assure of the safety and the stability of the equipment. The output precision of the equipment, with a good anti-jamming capability, is 1-2% for high flow anesthesia and 1-5% for closed-circuit anesthesia and its self-detecting working is reliable. PMID:12583263

Sun, B; Li, W Z; Yue, Y; Jiang, C W; Xiao, L Y

2001-11-01

387

Anticonvulsant and anesthetic effects of a fluorescent neurosteroid analog activated by visible light  

E-print Network

Anticonvulsant and anesthetic effects of a fluorescent neurosteroid analog activated by visible are potent and efficacious endogenous potentia- tors of GABAA receptor activity. As exogenous drugs depress electrical activity in targeted brain regions for experimental or clinical purposes. Conventional

Cai, Long

388

ENHANCED SUSCEPTIBILITY TO KINDLING BY CHLORDIMEFORM MAY BE MEDIATED BY ALOCAL ANESTHETIC ACTION  

EPA Science Inventory

The formamidine pesticides amitraz and chlordimeform have recently been shown to be potent proconvulsants (Gilbert 1988). wo main neuroactive prosperities have been identified as mediators of formamidine neurotoxicity, -2 adrenergic agonism and local anesthetic actions. hese two ...

389

The Extended Posterior Circumferential Decompression Technique in the Management of Tubercular Spondylitis with and without Paraplegia  

PubMed Central

Study Design Retrospective clinical series. Purpose To study the clinical, functional and radiological results of patients with tuberculous spondylitis with and without paraplegia, treated surgically using the "Extended Posterior Circumferential Decompression (EPCD)" technique. Overview of Literature With the increasing possibility of addressing all three columns by a single approach, posterior and posterolateral approaches are gaining acceptance. A single exposure for cases with neurological deficit and kyphotic deformity requiring circumferential decompression, anterior column reconstruction and posterior instrumentation is helpful. Methods Forty-one patients with dorsal/dorsolumbar/lumbar tubercular spondylitis who were operated using the EPCD approach between 2006 to 2009 were included. Postoperatively, patients were started on nine-month anti-tuberculous treatment. They were serially followed up to thirty-six months and both clinical measures (including pain, neurological status and ambulatory status) and radiological measures (including kyphotic angle correction, loss of correction and healing status) were used for assessment. Results Disease-healing with bony fusion (interbody fusion) was seen in 97.5% of cases. Average deformity (kyphosis) correction was 54.6% in dorsal spine and 207.3% in lumbar spine. Corresponding loss of correction was 3.6 degrees in dorsal spine and 1.9 degrees in the lumbar spine. Neurological recovery in Frankel B and C paraplegia was 85.7% and 62.5%, respectively. Conclusions The EPCD approach permits all the advantages of a single or dual session anterior and posterior surgery, with significant benefits in terms of decreased operative time, reduced hospital stay and better kyphotic angle correction.

Rathinavelu, Barani; Krishnan, Venkatesh; Amritanand, Rohit; Sundararaj, Gabriel David

2014-01-01

390

Goalpha regulates volatile anesthetic action in Caenorhabditis elegans.  

PubMed Central

To identify genes controlling volatile anesthetic (VA) action, we have screened through existing Caenorhabditis elegans mutants and found that strains with a reduction in Go signaling are VA resistant. Loss-of-function mutants of the gene goa-1, which codes for the alpha-subunit of Go, have EC(50)s for the VA isoflurane of 1.7- to 2.4-fold that of wild type. Strains overexpressing egl-10, which codes for an RGS protein negatively regulating goa-1, are also isoflurane resistant. However, sensitivity to halothane, a structurally distinct VA, is differentially affected by Go pathway mutants. The RGS overexpressing strains, a goa-1 missense mutant found to carry a novel mutation near the GTP-binding domain, and eat-16(rf) mutants, which suppress goa-1(gf) mutations, are all halothane resistant; goa-1(null) mutants have wild-type sensitivities. Double mutant strains carrying mutations in both goa-1 and unc-64, which codes for a neuronal syntaxin previously found to regulate VA sensitivity, show that the syntaxin mutant phenotypes depend in part on goa-1 expression. Pharmacological assays using the cholinesterase inhibitor aldicarb suggest that VAs and GOA-1 similarly downregulate cholinergic neurotransmitter release in C. elegans. Thus, the mechanism of action of VAs in C. elegans is regulated by Goalpha, and presynaptic Goalpha-effectors are candidate VA molecular targets. PMID:11404329

van Swinderen, B; Metz, L B; Shebester, L D; Mendel, J E; Sternberg, P W; Crowder, C M

2001-01-01

391

Measurement of nasal patency in anesthetized and conscious dogs.  

PubMed

Experiments were undertaken to characterize a noninvasive chronic, model of nasal congestion in which nasal patency is measured using acoustic rhinometry. Compound 48/80 was administered intranasally to elicit nasal congestion in five beagle dogs either by syringe (0.5 ml) in thiopental sodium-anesthetized animals or as a mist (0.25 ml) in the same animals in the conscious state. Effects of mast cell degranulation on nasal cavity volume as well as on minimal cross-sectional area (A(min)) and intranasal distance to A(min) (D(min)) were studied. Compound 48/80 caused a dose-related decrease in nasal cavity volume and A(min) together with a variable increase in D(min). Maximal responses were seen at 90-120 min. Compound 48/80 was less effective in producing nasal congestion in conscious animals, which also had significantly larger basal nasal cavity volumes. These results demonstrate the utility of using acoustic rhinometry to measure parameters of nasal patency in dogs and suggest that this model may prove useful in studies of the actions of decongestant drugs. PMID:11796672

Koss, Michael C; Yu, Yongxin; Hey, John A; McLeod, Robbie L

2002-02-01

392

Central administration of nicotine suppresses tracheobronchial cough in anesthetized cats.  

PubMed

We tested the hypothesis that nicotine, which acts peripherally to promote coughing, might inhibit reflex cough at a central site. Nicotine was administered via the vertebral artery [intra-arterial (ia)] to the brain stem circulation and by microinjections into a restricted area of the caudal ventral respiratory column in 33 pentobarbital anesthetized, spontaneously breathing cats. The number of coughs induced by mechanical stimulation of the tracheobronchial airways; amplitudes of the diaphragm, abdominal muscle, and laryngeal muscles EMGs; and several temporal characteristics of cough were analyzed after administration of nicotine and compared with those during control and recovery period. (-)Nicotine (ia) reduced cough number, cough expiratory efforts, blood pressure, and heart rate in a dose-dependent manner. (-)Nicotine did not alter temporal characteristics of the cough motor pattern. Pretreatment with mecamylamine prevented the effect of (-)nicotine on blood pressure and heart rate, but did not block the antitussive action of this drug. (+)Nicotine was less potent than (-)nicotine for inhibition of cough. Microinjections of (-)nicotine into the caudal ventral respiratory column produced similar inhibitory effects on cough as administration of this isomer by the ia route. Mecamylamine microinjected in the region just before nicotine did not significantly reduce the cough suppressant effect of nicotine. Nicotinic acetylcholine receptors significantly modulate functions of brain stem and in particular caudal ventral respiratory column neurons involved in expression of the tracheobronchial cough reflex by a mecamylamine-insensitive mechanism. PMID:25477349

Poliacek, I; Rose, M J; Pitts, T E; Mortensen, A; Corrie, L W; Davenport, P W; Bolser, D C

2015-02-01

393

Human placental lactogen decreases regional blood flow in anesthetized pigs.  

PubMed

In 22 pigs anesthetized with sodium pentobarbitone, changes in blood flow caused by infusion of human placental lactogen into the left renal, external iliac, and anterior descending coronary arteries were assessed using electromagnetic flowmeters. In 17 pigs, infusion of human placental lactogen whilst keeping the heart rate and arterial pressure constant decreased coronary, renal and iliac flow. In 5 additional pigs, increasing the dose of human placental lactogen produced a dose-related decrease in regional blood flow. The mechanisms of the above response were studied in 15 of the 17 pigs by repeating the experiment of infusion. The human placental lactogen-induced decrease in regional blood flow was not affected by blockade of cholinergic receptors (5 pigs) or of alpha-adrenergic receptors (5 pigs), but it was abolished by blockade of beta2-adrenergic receptors (5 pigs). The present study showed that intra-arterial infusion of human placental lactogen primarily decreased coronary, renal and iliac blood flow. The mechanism of this response was shown to be due to the inhibition of a vasodilatory beta2-adrenergic receptor-mediated effect. PMID:16410683

Grossini, E; Molinari, C; Battaglia, A; Mary, D A S G; Ribichini, F; Surico, N; Vacca, G

2006-01-01

394

Dynamic resting state functional connectivity in awake and anesthetized rodents.  

PubMed

Since its introduction, resting-state functional magnetic resonance imaging (rsfMRI) has been a powerful tool for investigating functional neural networks in both normal and pathological conditions. When measuring resting-state functional connectivity (RSFC), most rsfMRI approaches do not consider its temporal variations and thus only provide the averaged RSFC over the scan time. Recently, there has been a surge of interest to investigate the dynamic characteristics of RSFC in humans, and promising results have been yielded. However, our knowledge regarding the dynamic RSFC in animals remains sparse. In the present study we utilized the single-volume co-activation method to systematically study the dynamic properties of RSFC within the networks of infralimbic cortex (IL) and primary somatosensory cortex (S1) in both awake and anesthetized rats. Our data showed that both IL and S1 networks could be decomposed into several spatially reproducible but temporally changing co-activation patterns (CAPs), suggesting that dynamic RSFC was indeed a characteristic feature in rodents. In addition, we demonstrated that anesthesia profoundly impacted the dynamic RSFC of neural circuits subserving cognitive and emotional functions but had less effects on sensorimotor systems. Finally, we examined the temporal characteristics of each CAP, and found that individual CAPs exhibited consistent temporal evolution patterns. Together, these results suggest that dynamic RSFC might be a general phenomenon in vertebrate animals. In addition, this study has paved the way for further understanding the alterations of dynamic RSFC in animal models of brain disorders. PMID:25315787

Liang, Zhifeng; Liu, Xiao; Zhang, Nanyin

2015-01-01

395

Sensitivity to thermal stimulation in prairie rattlesnakes (Crotalus viridis) after bilateral anesthetization of the facial pits  

SciTech Connect

Six yearling prairie rattlesnakes (Crotalus viridis) were exposed to thermal stimuli prior to and after bilateral anesthetization of their facial pits with 2% xylocaine solution. This treatment eliminates trigeminally mediated electrophysiological responses of the pits to thermal stimulation. Nevertheless, the rattlesnakes continued to exhibit behavioral responses to thermal cues after anesthetization of the pits. An auxiliary infrared-sensitive system, nociceptors, or the common temperature sense could be responsible for these findings.

Chiszar, D.; Dickman, D.; Colton, J.

1986-01-01

396

Increase in permeability of Escherichia coli outer membrane by local anesthetics and penetration of antibiotics.  

PubMed Central

The MICs of several antibiotics (both hydrophobic and hydrophilic) which penetrate very poorly into intact Escherichia coli cells were found to be 2- to 10-fold decreased in the presence of low doses of various local anesthetics (procaine, dibucaine, tetracaine, chlorpromazine, and quinine). The concentrations of anesthetics necessary for this effect have no adverse effect on cell growth and are markedly lower than those concentrations used clinically. PMID:3279905

Labedan, B

1988-01-01

397

Halogenated Anesthetics Inhibit Pseudomonas aeruginosa Growth in Culture Conditions Reproducing the Alveolar Environment  

Microsoft Academic Search

We assessed the effects of halogenated anesthetics on Pseudomonas aruginosa growth in a liquid nutrient broth. Sterile Petri dishes (3.5-cm diameter) were filled with a 1-mL suspension of a Pseudomonas aeruginosa strain and incubated at 37°C. Exposure of bacterial plates to halothane, isoflurane, and enflurane adminis- tered at 1 and 2 minimum alveolar anesthetic concen- tration (MAC) were studied for

Serge Molliex; Philippe Montravers; Bertrand Dureuil; Jean-Marie Desmonts

1998-01-01

398

A hypothesis on the origin and evolution of the response to inhaled anesthetics.  

PubMed

In this article, I present an evolutionary explanation for why organisms respond to inhaled anesthetics. It is conjectured that organisms today respond to inhaled anesthetics owing to the sensitivity of ion channels to inhaled anesthetics, which in turn has arisen by common descent from ancestral, anesthetic-sensitive ion channels in one-celled organisms (i.e., that the response to anesthetics did not arise as an adaptation of the nervous system, but rather of ion channels that preceded the origin of multicellularity). This sensitivity may have been refined by continuing selection at synapses in multicellular organisms. In particular, it is hypothesized that 1) the beneficial trait that was selected for in one-celled organisms was the coordinated response of ion channels to compounds that were present in the environment, which influenced the conformational equilibrium of ion channels; 2) this coordinated response prevented the deleterious consequences of entry of positive charges into the cell, thereby increasing the fitness of the organism; and 3) these compounds (which may have included organic anions, cations, and zwitterions as well as uncharged compounds) mimicked inhaled anesthetics in that they were interfacially active, and modulated ion channel function by altering bilayer properties coupled to channel function. The proposed hypothesis is consistent with known properties of inhaled anesthetics. In addition, it leads to testable experimental predictions of nonvolatile compounds having anesthetic-like modulatory effects on ion channels and in animals, including endogenous compounds that may modulate ion channel function in health and disease. The latter included metabolites that are increased in some types of end-stage organ failure, and genetic metabolic diseases. Several of these predictions have been tested and proved to be correct. PMID:18713893

Sonner, James M

2008-09-01

399

The challenge of evaluating pain and a pre-incisional local anesthetic block  

PubMed Central

Background. Our objective was to test the effectiveness of a local anesthetic line block administered before surgery in reducing postoperative pain scores in dogs undergoing ovariohysterectomy (OVHX). Methods. This study is a prospective, randomized, blinded, clinical trial involving 59 healthy female dogs. An algometric pressure-measuring device was used to determine nociceptive threshold, and compared to three subjective pain scales. Group L/B received a line block of lidocaine (4 mg/kg) and bupivacaine (1 mg/kg) subcutaneously in the area of the incision site and saline subcutaneously as premedication; group L/BM (positive control) received a similar block and morphine (0.5 mg/kg) subcutaneously for premedication; and group SS (negative control) received a saline line block and saline premedication. Criteria for rescue analgesia were defined before the study. Dogs were assessed prior to surgery, at extubation (time 0) and at 2, 4, 6, 8 and 24 h post-recovery. The data were analyzed with one-way ANOVA, and a Split Plot Repeated Measures ANOVA with one grouping factor and one repeat factor (time). P < 0.05 was considered statistically significant. Results. Approximately 33% of dogs required rescue analgesia at some point during the study, with no significant difference between groups. There was no significant difference between treatment groups with any assessment method. Conclusions. As there were no statistically significant differences between positive and negative controls, the outcome of this technique cannot be proven. PMID:24765575

Pascoe, Peter J.; Lascelles, B. Duncan X.; Kass, Philip H.

2014-01-01

400

Multiple sclerosis: basic knowledge and new insights in perioperative management.  

PubMed

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting young adults that may lead to significant disability. The clinical course varies among the types of the disease as well as among individuals. Herein we provide a brief review of the recent data concerning the clinical presentation, diagnosis, causes, and pathogenesis of MS as well as medication used, followed by the anesthetic considerations of patients diagnosed with the disease. To accomplish this, we conducted a systematic PubMed literature search for articles, using the terms multiple sclerosis, anesthesia, general, regional, perioperative, and preoperative, and we then manually reviewed the references from each pertinent article. Because randomized controlled trials on the field are rare, most information is derived by case reports and case series. We concluded that the disease itself as well as the treatment modalities may have several implications in the conduct of anesthesia and perioperative management of MS patients. General and regional anesthetic techniques have been successfully used. With thorough preoperative evaluation and in depth knowledge of the disease and its complications, the MS patients can be managed safely. PMID:23963466

Makris, Alexandros; Piperopoulos, Alexandros; Karmaniolou, Iosifina

2014-04-01

401

Secondhand management of "spaghetti wrist": do not hesitate to explore.  

PubMed

"Spaghetti wrist" consists of the severance of at least three structures, of which one is the median nerve or the ulnar nerve, and it is one of the most devastating injuries of the hand. Close follow-up and appropriate rehabilitation are mandatory for management; however, this is not easy in patients whose previous treatment was accomplished elsewhere. The authors explored 28 patients with spaghetti wrist injuries who were previously operated. The study included those with areas of the hand, innervated by the injured nerve, that were partially or completely anesthetic. Limited sensorial return was also uniform and partial anesthetic sites were usually limited to only a finger or either side of a finger. When explored, six nerves had a normal appearance and 18 nerves had neuroma-in-continuity on their repair sites. The median nerves of the remaining five patients had been repaired not to their original proximal or distal stumps, but to adjacent tendons. A nerve tissue bridge from the proximal to the distal stump developed in all these patients. The authors conclude that hand surgeons should explore the previous repair sites if they have any suspicions regarding the technique performed and the success of previous management of spaghetti wrist. Any partial sensorial return to a limited area may be the result of axonal secondary pathways; thus, early exploration during the critical period can protect these patients from paralyzing sequelae of the injured nerves. PMID:12439018

Yüksel, Fuat; Peker, Fatih; Açikel, Cengiz; CelIköz, Bahattin

2002-11-01

402

A Robust Decision-Making Technique for Water Management under Decadal Scale Climate Variability  

NASA Astrophysics Data System (ADS)

Robust decision making, a flexible and dynamic approach to managing water resources in light of deep uncertainties associated with climate variability at inter-annual to decadal time scales, is an analytical framework that detects when a system is in or approaching a vulnerable state. It provides decision makers the opportunity to implement strategies that both address the vulnerabilities and perform well over a wide range of plausible future scenarios. A strategy that performs acceptably over a wide range of possible future states is not likely to be optimal with respect to the actual future state. The degree of success--the ability to avoid vulnerable states and operate efficiently--thus depends on the skill in projecting future states and the ability to select the most efficient strategies to address vulnerabilities. This research develops a robust decision making framework that incorporates new methods of decadal scale projections with selection of efficient strategies. Previous approaches to water resources planning under inter-annual climate variability combining skillful seasonal flow forecasts with climatology for subsequent years are not skillful for medium term (i.e. decadal scale) projections as decision makers are not able to plan adequately to avoid vulnerabilities. We address this need by integrating skillful decadal scale streamflow projections into the robust decision making framework and making the probability distribution of this projection available to the decision making logic. The range of possible future hydrologic scenarios can be defined using a variety of nonparametric methods. Once defined, an ensemble projection of decadal flow scenarios are generated from a wavelet-based spectral K-nearest-neighbor resampling approach using historical and paleo-reconstructed data. This method has been shown to generate skillful medium term projections with a rich variety of natural variability. The current state of the system in combination with the probability distribution of the projected flow ensembles enables the selection of appropriate decision options. This process is repeated for each year of the planning horizon--resulting in system outcomes that can be evaluated on their performance and resiliency. The research utilizes the RiverSMART suite of software modeling and analysis tools developed under the Bureau of Reclamation's WaterSMART initiative and built around the RiverWare modeling environment. A case study is developed for the Gunnison and Upper Colorado River Basins. The ability to mitigate vulnerability using the framework is gauged by system performance indicators that measure the ability of the system to meet various water demands (i.e. agriculture, environmental flows, hydropower etc.). Options and strategies for addressing vulnerabilities include measures such as conservation, reallocation and adjustments to operational policy. In addition to being able to mitigate vulnerabilities, options and strategies are evaluated based on benefits, costs and reliability. Flow ensembles are also simulated to incorporate mean and variance from climate change projections for the planning horizon and the above robust decision-making framework is applied to evaluate its performance under changing climate.

Callihan, L.; Zagona, E. A.; Rajagopalan, B.

2013-12-01

403

Biogeosystem technique - the fundamental base of modern Water Policy and Management  

NASA Astrophysics Data System (ADS)

Freshwater conservation is the problem of world water strategy. Water is intended not only for human consumption but also for functions of the biosphere - the only place where humanity can exist. To maintain the quality of biosphere is very relevant. An important property of biosphere is ability of soil to provide the synthesis of fresh living biological material by plants. There are few places in the world where exists a natural high level of biological production. Therefore, irrigation widely applies. Irrigation provides an increase of crops, but the imitating gravitational frontal isotropic-continual irrigation paradigm has the adverse effects on soils and landscapes. So irrigation in the past history of humanity was one of the causes for civilization's downfall, Sumer in particular, now irrigation causes a humanitarian catastrophe in Central Asia. Irrigation is the world main consumer of water. Leading cause of negative results of irrigation in biosphere is the irrigation paradigm defect. By artificial watering is imitated a natural hydrological regime of the land. The water flows down into soil through the soil surface. Or groundwater flows up through the soil bottom. In either case, a natural or standard artificial soil moisturizing amplifies the mass transfer in soil continuum. At initial soil stage the mass transfer in soil continuum plays positive role. Adverse substances are leached, in particular soluble salts. Fine material and organic particles determining soil fertility are accumulating. However, after a soil genesis initial stage the mass transfer through soil continuum plays negative role. Irrigation excess water flow into soil reduces the productivity of cultivated plants as compared to the optimum soil solution conditions. The excess soil moisture leads to excess transpiration, evaporation, infiltration, destroys the soil disperse system composition, forms inactive dead-end pores, leaches useful biological and other substances synthesized in soil out from active biosphere stage to vadose zone. These substances are entering the undesired stage of sedimentation and lithogenesis. Such adverse events are enhanced by irrigation. As a result, up to 80-90% of the fresh water taken for irrigation from lakes, rivers, storage reservoirs, desalinators are lost useless entailing economic losses. As a result of irrigation the quality of water is deteriorated as well as the quality of soil and landscape. A quality of human environment and a quality of biosphere as a whole is reduced. It is much more dangerous than economic losses. The irrigation paradigm shift is essential for successful water policy and water management in modern world. In a framework of Biogeosystem technics the new intrasoil pulse continuous-discrete paradigm of irrigation is developed. Water is supplied by small discrete portions into individual volumes of a soil continuum without excess soil mass transfer, transpiration, evaporation and seepage. New paradigm of irrigation optimizes plant growth, reduces consumption of water per unit of biological product, the yield increases. It provides the soil and landscape conservation, fresh water - the global deficit - saving up to 10-20 times, biological productivity and sustainability of biosphere. Intrasoil pulse continuous-discrete robotic irrigation technologies match the nowadays noosphere technological platform.

Kalinitchenko, Valery; Batukaev, Abdulmalik; Minkina, Tatiana; Solntseva, Natalia; Skovpen, Andrey; Zarmaev, Ali; Jusupov, Vaha; Lohmanova, Olga

2014-05-01

404

Volatile general anesthetic sensing with organic field-effect transistors integrating phospholipid membranes.  

PubMed

The detailed action mechanism of volatile general anesthetics is still unknown despite their effect has been clinically exploited for more than a century. Long ago it was also assessed that the potency of an anesthetic molecule well correlates with its lipophilicity and phospholipids were eventually identified as mediators. As yet, the direct effect of volatile anesthetics at physiological relevant concentrations on membranes is still under scrutiny. Organic field-effect transistors (OFETs) integrating a phospholipid (PL) functional bio inter-layer (FBI) are here proposed for the electronic detection of archetypal volatile anesthetic molecules such as diethyl ether and halothane. This technology allows to directly interface a PL layer to an electronic transistor channel, and directly probe subtle changes occurring in the bio-layer. Repeatable responses of PL FBI-OFET to anesthetics are produced in a concentration range that reaches few percent, namely the clinically relevant regime. The PL FBI-OFET is also shown to deliver a comparably weaker response to a non-anesthetic volatile molecule such as acetone. PMID:22921091

Daniela Angione, Maria; Magliulo, Maria; Cotrone, Serafina; Mallardi, Antonia; Altamura, Davide; Giannini, Cinzia; Cioffi, Nicola; Sabbatini, Luigia; Gobeljic, Danka; Scamarcio, Gaetano; Palazzo, Gerardo; Torsi, Luisa

2013-02-15

405

New procedure to synthesize silver nanoparticles and their interaction with local anesthetics  

PubMed Central

Silver nanoparticles (AgNPs) were prepared in aqueous colloid dispersions by the reduction of Ag+ with glucose in alkaline medium. Tetraethyl orthosilicate and L-asparagine were added as stabilizers of NPs. The AgNPs were characterized, and their interaction with three local anesthetics (procaine, dibucaine, or tetracaine) was investigated. Optical spectra show the characteristic absorption band of AgNPs, due to surface plasmon resonance. Modifications in the position and shape of this band reflect the self-assembly of metal NPs mediated by anesthetic molecules and the progress in time of the aggregation process. Zeta-potential measuring was applied in order to characterize the electrostatic stability of the NPs. The size and shape of the AgNPs, as well as the features of the assemblies formed by their association in the presence of anesthetics, were evidenced by transmission electron microscopy images. Atomic force microscopy images showed the characteristics of the films of AgNPs deposited on glass support. The effect of the anesthetics could be described in terms of electrostatic forces between the negatively charged AgNPs and the anesthetic molecules, existing also in their cationic form at the working pH. But also hydrophobic and hydrogen bonding interactions between the coated nanoparticles and anesthetics molecular species should be considered. PMID:24143090

Mocanu, Aurora; Pasca, Roxana Diana; Tomoaia, Gheorghe; Garbo, Corina; Frangopol, Petre T; Horovitz, Ossi; Tomoaia-Cotisel, Maria

2013-01-01

406

Different distribution of fluorinated anesthetics and nonanesthetics in model membrane: a 19F NMR study.  

PubMed Central

Despite their structural resemblance, a pair of cyclic halogenated compounds, 1-chloro-1,2,2-trifluorocyclobutane (F3) and 1,2-dichlorohexafluorocyclobutane (F6), exhibit completely different anesthetic properties. Whereas the former is a potent general anesthetic, the latter produces no anesthesia. Two linear compounds, isoflurane and 2,3-dichlorooctofluorobutane (F8), although not a structural pair, also show the same anesthetic discrepancy. Using 19F nuclear magnetic spectroscopy, we investigated the time-averaged submolecular distribution of these compounds in a vesicle suspension of phosphatidylcholine lipids. A two-site exchange model was used to interpret the observed changes in resonance frequencies as a function of the solubilization of these compounds in membrane and in water. At clinically relevant concentrations, the anesthetics F3 and isoflurane distributed preferentially to regions of the membrane that permit easy contact with water. The frequency changes of these two anesthetics can be well characterized by the two-site exchange model. In contrast, the nonanesthetics F6 and F8 solubilized deeply into the lipid core, and their frequency change significantly deviated from the prediction of the model. It is concluded that although anesthetics and nonanesthetics may show similar hydrophobicity in bulk solvents such as olive oil, their distributions in various regions in biomembranes, and hence their effective concentrations at different submolecular sites, may differ significantly. PMID:9083671

Tang, P; Yan, B; Xu, Y

1997-01-01

407

Effects of local anesthetics on monoamine oxidase, and their membrane effects.  

PubMed

The effects of various local anesthetics on rat brain and liver monoamine oxidase (MAO) and their antihemolytic and local anesthetic effects were studied. All local anesthetics tested at 1 x 10(-7) M to 1 x 10(-3) M inhibited MAO activity in rat liver mitochondria with 5-hydroxytryptamine (5-HT) as substrate. The order of potency was tetracaine>procaine>dibucaine>lidocaine>prilocaine. Tetracaine and procaine inhibited 5-HT oxidation much more than beta-phenylethylamine (PEA) oxidation. Dibucaine inhibited PEA oxidation as much as 5-HT oxidation. Inhibition of MAO by local anesthetics other than dibucaine was reversible. Tetracaine and procaine inhibited 5-HT oxidation competitively, whereas dibucaine inhibited it non-competitively. Antihemolytic effects were observed with dibucaine and tetracaine at concentrations of 6 x 10(-5) M and 1 x 10(-4), respectively. The order of surface anesthetic potencies was dibucaine>tetracaine>prilocaine>lidocaine>procaine. These results suggest that the inhibition of MAO activities by local anesthetics depends on both electrostatic and hydrophobic interactions between these drugs and enzyme-associated phospholipids or the hydrophobic regions of proteins. PMID:6285048

Yasuhara, H; Wada, I; Sakamoto, K; Kamijo, K

1982-04-01

408

Pain Management in Newborns.  

PubMed

As a standard of care for preterm/term newborns effective pain management may improve their clinical and neurodevelopmental outcomes. Neonatal pain is assessed using context-specific, validated, and objective pain methods, despite the limitations of currently available tools. Therapeutic approaches reducing invasive procedures and using pharmacologic, behavioral, or environmental measures are used to manage neonatal pain. Nonpharmacologic approaches like kangaroo care, facilitated tucking, non-nutritive sucking, sucrose, and others can be used for procedural pain or adjunctive therapy. Local/topical anesthetics, opioids, NSAIDs/acetaminophen and other sedative/anesthetic agents can be incorporated into NICU protocols for managing moderate/severe pain or distress in all newborns. PMID:25459780

Hall, Richard W; Anand, Kanwaljeet J S

2014-12-01

409

Specificity of stimulus-evoked fMRI responses in the mouse: the influence of systemic physiological changes associated with innocuous stimulation under four different anesthetics.  

PubMed

Functional magnetic resonance (fMRI) in mice has become an attractive tool for mechanistic studies, for characterizing models of human disease, and for evaluation of novel therapies. Yet, controlling the physiological state of mice is challenging, but nevertheless important as changes in cardiovascular parameters might affect the hemodynamic readout which constitutes the basics of the fMRI signal. In contrast to rats, fMRI studies in mice report less robust brain activation of rather widespread character to innocuous sensory stimulation. Anesthesia is known to influence the characteristics of the fMRI signal. To evaluate modulatory effects imposed by the anesthesia on stimulus-evoked fMRI responses, we compared blood oxygenation level dependent (BOLD) and cerebral blood volume (CBV) signal changes to electrical hindpaw stimulation using the four commonly used anesthetics isoflurane, medetomidine, propofol and urethane. fMRI measurements were complemented by assessing systemic physiological parameters throughout the experiment. Unilateral stimulation of the hindpaw elicited widespread fMRI responses in the mouse brain displaying a bilateral pattern irrespective of the anesthetic used. Analysis of magnitude and temporal profile of BOLD and CBV signals indicated anesthesia-specific modulation of cerebral hemodynamic responses and differences observed for the four anesthetics could be largely explained by their known effects on animal physiology. Strikingly, independent of the anesthetic used our results reveal that fMRI responses are influenced by stimulus-induced cardiovascular changes, which indicate an arousal response, even to innocuous stimulation. This may mask specific fMRI signal associated to the stimulus. Hence, studying the processing of peripheral input in mice using fMRI techniques constitutes a major challenge and adapted paradigms and/or alternative fMRI readouts should also be considered when studying sensory processing in mice. PMID:24495809

Schroeter, Aileen; Schlegel, Felix; Seuwen, Aline; Grandjean, Joanes; Rudin, Markus

2014-07-01

410

Anesthetic efficacy of metomidate and comparison of plasma cortisol responses to tricaine methanesulfonate, quinaldine and clove oil anesthetized channel catfish Ictalurus punctatus  

Microsoft Academic Search

The present experiments were designed to determine the efficacy of metomidate hydrochloride as an alternative anesthetic with potential cortisol blocking properties for channel catfish Ictalurus punctatus. Channel catfish (75 g) were exposed to concentrations of metomidate ranging from 0.5 to 16 ppm for a period of 60 min. At 16-ppm metomidate, mortality occurred in 65% of the catfish. No mortalities

Brian C Small

2003-01-01

411

Intracoronary ghrelin infusion decreases coronary blood flow in anesthetized pigs.  

PubMed

The peptide ghrelin has been linked to the atherosclerotic process and coronary artery disease. We planned to study, for the first time, the primary effects of ghrelin on the intact coronary circulation and determine the mechanisms involved. In 24 sodium pentobarbitone-anesthetized pigs, changes in anterior descending coronary blood flow caused by intracoronary infusion of ghrelin at constant heart rate and arterial pressure were assessed using electromagnetic flowmeters. In 20 pigs, intracoronary infusion of ghrelin decreased coronary blood flow without affecting left ventricular maximum rate of change of left ventricular systolic pressure (dP/dt(max)), filling pressures of the heart or plasma levels of GH. In four pigs, this decrease was graded by step increments of infused dose of the hormone. The mechanisms of the above response were studied in the 20 pigs by repeating the experiment after coronary flow had returned to the control values observed before infusion. The ghrelin-induced coronary vasoconstriction was not affected by iv atropine (five pigs) or phentolamine (five pigs). This response was abolished by iv butoxamine (five pigs) and intracoronary N(omega)-nitro-l-arginine methyl ester (five pigs), even after reversing the increase in arterial pressure and coronary vascular resistance caused by the two blocking agents with iv infusion of papaverine. The present study showed that intracoronary infusion of ghrelin primarily caused coronary vasoconstriction. The mechanisms of this response were shown to involve the inhibition of a vasodilatory beta(2)-adrenergic receptor-mediated effect related to the release of nitric oxide. PMID:17110424

Grossini, Elena; Molinari, Claudio; Mary, David A S G; Ghigo, Ezio; Bona, Gianni; Vacca, Giovanni

2007-02-01

412

Intravenous anesthetic propofol suppresses leukotriene production in murine dendritic cells.  

PubMed

Leukotrienes, divided into cysteinyl leukotrienes (CysLTs), which are important mediators of asthmatic responses, and leukotriene B4 (LTB4), a chemotactic and chemokinetic agent for leukocytes, are potent lipid mediators generated from arachidonic acid by 5-lipoxygenase (5-LO). Leukotrienes are also considered to have immunoregulatory and pro-inflammatory actions. Propofol is an intravenous anesthetic widely used for anesthesia and sedation that is alleged to possess anti-inflammatory properties. The present study examined the effect of propofol on leukotriene production by dendritic cells (DC). In murine bone marrow-derived DC, propofol significantly suppressed CysLT and LTB4 production after short-term stimulation with zymosan. The protein levels of cytosolic phospholipase A2 and 5-LO, or arachidonic acid release from plasma membranes, were not affected by the presence of propofol. Although zymosan treatment induced or enhanced the phosphorylation of ERK1/2, p-38 MAPK, and JNK, which presumably up-regulates the activity of 5-LO, the presence of propofol had no additional effect on the phosphorylation status of any of these MAPKs. Similarly, zymosan significantly increased the concentration of intracellular calcium, which is the most crucial activator of 5-LO, but no additional concentration changes were observed with the addition of propofol. Lastly, in an in-vitro cell-free ferrous oxidation-xylenol orange assay, propofol significantly inhibited the 5-LO activity of purified human recombinant 5-LO enzyme with an IC50 of ~7.5 µM. Thus, propofol's inhibition of 5-LO is not likely restricted to the circumstances surrounding the production of leukotrienes from DC, but applicable to other types of immune and non-immune cells that produce leukotrienes. The 5-LO-inhibiting activity of propofol may, at least in part, contribute to the well-known anti-inflammatory activity of propofol. PMID:22953970

Inada, Takefumi; Ueshima, Hironobu; Shingu, Koh

2013-01-01

413

Dynamic longitudinal investigation of individual nerve endings in the skin of anesthetized mice using in vivo two-photon microscopy  

NASA Astrophysics Data System (ADS)

Visualization of individual cutaneous nerve endings has previously relied on laborious procedures of tissue excision, fixation, sectioning and staining for light or electron microscopy. We present a method for non-invasive, longitudinal two-photon microscopy of single nerve endings within the skin of anesthetized transgenic mice. Besides excellent signal-to-background ratio and nanometer-scale spatial resolution, this method offers time-lapse ``movies'' of pathophysiological changes in nerve fine structure over minutes, hours, days or weeks. Structure of keratinocytes and dermal matrix is visualized simultaneously with nerve endings, providing clear landmarks for longitudinal analysis. We further demonstrate feasibility of dissecting individual nerve fibers with infra-red laser and monitoring their degradation and regeneration. In summary, our excision-free optical biopsy technique is ideal for longitudinal microscopic analysis of animal skin and skin innervations in vivo and can be applied widely in preclinical models of chronic pain, allergies, skin cancers and a variety of dermatological disorders.

Yuryev, Mikhail; Khiroug, Leonard

2012-04-01

414

The AmeriFlux Data Activity and Data System: An Evolving Collection of Data Management Techniques, Tools, Products and Services  

SciTech Connect

The Carbon Dioxide Information Analysis Center (CDIAC) at Oak Ridge National Laboratory (ORNL), USA has provided scientific data management support for the U.S. Department of Energy and international climate change science since 1982. Over this period, climate change science has expanded from research focusing on basic understanding of geochemical cycles, particularly the carbon cycle, to integrated research addressing climate change impacts, vulnerability, adaptation, and mitigation. Interests in climate change data and information worldwide have grown remarkably and, as a result, so have demands and expectations for CDIAC s data systems. To meet the growing demands, CDIAC s strategy has been to design flexible data systems using proven technologies blended with new, evolving technologies and standards. CDIAC development teams are multidisciplinary and include computer science and information technology expertise, but also scientific expertise necessary to address data quality and documentation issues and to identify data products and system capabilities needed by climate change scientists. CDIAC has learned there is rarely a single commercial tool or product readily available to satisfy long-term scientific data system requirements (i.e., one size does not fit all and the breadth and diversity of environmental data are often too complex for easy use with commercial products) and typically deploys a variety of tools and data products in an effort to provide credible data freely to users worldwide. Like many scientific data management applications, CDIAC s data systems are highly customized to satisfy specific scientific usage requirements (e.g., developing data products specific for model use) but are also designed to be flexible and interoperable to take advantage of new software engineering techniques, standards (e.g., metadata standards) and tools and to support future Earth system data efforts (e.g., ocean acidification). CDIAC has provided data management support for numerous long-term measurement projects crucial to climate change science. One current example is the AmeriFlux measurement network. AmeriFlux provides continuous measurements from forests, grasslands, wetlands, and croplands in North, Central, and South America and offers important insight about carbon cycling in terrestrial ecosystems. We share our approaches in satisfying the challenges of delivering AmeriFlux data worldwide to benefit others with similar challenges handling climate change data, further heighten awareness and use of an outstanding ecological data resource, and highlight expanded software engineering applications being used for climate change measurement data.

Boden, Thomas A [ORNL; Krassovski, Misha B [ORNL; Yang, Bai [ORNL

2013-01-01

415

Diversity in soil bacterial communities structure in four high-altitude vineyards cultivated using different soil management techniques  

NASA Astrophysics Data System (ADS)

Some of the major wine producing countries are located in the Mediterranean regions, where viticulture represents one of the most widespread cultivations with economic and social importance. The area devoted to vineyards can also expand to mountain and steep slope zones, often characterized by small-scale high quality wine production, where viticulture contributes to the sustainable development from the ecological and environmental point of view. Farming practices adopted in sloping vineyards have the purpose to improve the soil physicochemical but also biological properties to avoid the degradation of the soil characteristics and resulting problems such as soil erosion and organic matter losses. A preliminary study was conducted during 2013 in four commercial vineyards located in Aosta Valley (north-western Italy), within a small area located in the adjacent municipalities of Chambave and Saint-Denis in order to minimize soil variability. Two sites have been identified on the lower (about 600 m asl) and higher (about 750 m asl) zone of the slope, each of which consist of two vineyards managed since at least ten years with different soil management techniques: grass cover and chemical weed control. The four experimental soils had a sandy loam texture with abundant skeleton, and were characterized by a slightly alkaline reaction. The organic matter content was greater in the lower zone (2.4%) than in the upper (1.5%), without specific differences between treatments. The low values of the C:N ratio reported (on average 6.2) reveal the increased organic matter mineralization; furthermore the CEC values were rather low, typical of loose soils. Soil microbiota are critical for the maintenance of soil health and quality, playing an important role in agricultural soil ecosystems. A 16S rDNA pyrosequencing approach was used for investigating differences, abundance and diversity in bacterial community structure of the four studied vineyards. Data from pyrosequencing detected, after removing low-quality sequences, a total of 40900 sequences with 10000 on average per vineyard location. Most abundant bacterial phyla were Proteobacteria (36%), followed by Actinobacteria (26%) and Acidobacteria (15%), with a trend to have higher Proteobacteria or Actinobacteria levels in the higher and lower zone of the slope, respectively and higher number of Acidobacteria when herbicide was used to control the weeds. Results from ? diversity and ? diversity indices indicated that there are differences in bacterial structure among the sampled altitudes and between the tested soil management systems, in that order. Multivariate analyses are being conducted to identify soil physicochemical factors that could be used, with additional data that will be collected and analyzed in the following year, as an indicator of the different vineyards management systems and which specific microbial groups, if any, could be correlated with those managements.

Opsi, Francesca; Landa, Blanca; Zecca, Odoardo; Biddoccu, Marcella; Barmaz, Andrea; Cavallo, Eugenio

2014-05-01

416

Efficacy and Safety of 5 Anesthetics in Adult Zebrafish (Danio rerio)  

PubMed Central

Although the safety and efficacy of tricaine methanesulfonate (MS222) for anesthesia of fish are well established, other anesthetics used less commonly in fish have been less extensively evaluated. Therefore, we compared gradual cooling, lidocaine hydrochloride (300, 325, and 350 mg/L), metomidate hydrochloride (2, 4, 6, 8, and 10 mg/L), and isoflurane (0.5 mL/L) with MS222 (150 mg/L) for anesthesia of adult zebrafish. The efficacy and safety of each agent was evaluated by observing loss of equilibrium, slowing of opercular movement, response to tail-fin pinch, recovery time, and anesthesia-associated mortality rates. At 15 min after anesthetic recovery, we used a novel-tank test to evaluate whether anesthetic exposure influenced short-term anxiety-like behavior. Behavioral parameters measured included latency to enter and number of transitions to the upper half of the tank, number of erratic movements, and number of freezing bouts. Behavior after anesthesia was unaltered regardless of the anesthetic used. Efficacy and safety differed among the anesthetics evaluated. Gradual cooling was useful for short procedures requiring immobilization only, but all instrumentation and surfaces that come in contact with fish must be maintained at approximately 10 °C. MS222 and lidocaine hydrochloride at 325 mg/L were effective as anesthetic agents for surgical procedures in adult zebrafish, but isoflurane and high-dose lidocaine hydrochloride were unsuitable as sole anesthetic agents due to high (30%) mortality rates. Although MS222 remains the best choice for generating a surgical plane of anesthesia, metomidate hydrochloride and gradual cooling were useful for sedation and immobilization for nonpainful procedures. PMID:24602548

Collymore, Chereen; Tolwani, Angela; Lieggi, Christine; Rasmussen, Skye

2014-01-01

417

Hypnotic Hypersensitivity to Volatile Anesthetics and Dexmedetomidine in Dopamine ?-Hydroxylase Knockout Mice  

PubMed Central

BACKGROUND Multiple lines of evidence suggest that the adrenergic system can modulate sensitivity to anesthetic-induced immobility and anesthetic-induced hypnosis as well. However, several considerations prevent the conclusion that the endogenous adrenergic ligands norepinephrine and epinephrine alter anesthetic sensitivity. METHODS Using dopamine ?-hydroxylase (Dbh?/?) mice genetically engineered to lack the adrenergic ligands and their siblings with normal adrenergic levels, we test the contribution of the adrenergic ligands upon volatile anesthetic induction and emergence. Moreover, we investigate the effects of intravenous dexmedetomidine in adrenergic-deficient mice and their siblings using both righting reflex and processed electroencephalographic measures of anesthetic hypnosis. RESULTS We demonstrate that the loss of norepinephrine and epinephrine and not other neuromodulators copackaged in adrenergic neurons is sufficient to cause hypersensitivity to induction of volatile anesthesia. However, the most profound effect of adrenergic deficiency is retarding emergence from anesthesia, which takes two to three times as long in Dbh?/? mice for sevoflurane, isoflurane, and halothane. Having shown that Dbh?/? mice are hypersensitive to volatile anesthetics, we further demonstrate that their hypnotic hypersensitivity persists at multiple doses of dexmedetomidine. Dbh?/? mice exhibit up to 67% shorter latencies to loss of righting reflex and up to 545% longer durations of dexmedetomidine-induced general anesthesia. Central rescue of adrenergic signaling restores control-like dexmedetomidine sensitivity. A novel continuous electroencephalographic analysis illustrates that the longer duration of dexmedetomidine-induced hypnosis is not due to a motor confound, but occurs because of impaired anesthetic emergence. CONCLUSIONS Adrenergic signaling is essential for normal emergence from general anesthesia. Dexmedetomidine-induced general anesthesia does not depend upon inhibition of adrenergic neurotransmission. PMID:23042227

Hu, Frances Y.; Hanna, George M.; Han, Wei; Mardini, Feras; Thomas, Steven A.; Wyner, Abraham J.; Kelz, Max B.

2012-01-01

418

NMR resolved multiple anesthetic binding sites in the TM domains of the ?4?2 nAChR.  

PubMed

The ?4?2 nicotinic acetylcholine receptor (nAChR) has significant roles in nervous system function and disease. It is also a molecular target of general anesthetics. Anesthetics inhibit the ?4?2 nAChR at clinically relevant concentrations, but their binding sites in ?4?2 remain unclear. The recently determined NMR structures of the ?4?2 nAChR transmembrane (TM) domains provide valuable frameworks for identifying the binding sites. In this study, we performed solution NMR experiments on the ?4?2 TM domains in the absence and presence of halothane and ketamine. Both anesthetics were found in an intra-subunit cavity near the extracellular end of the ?2 transmembrane helices, homologous to a common anesthetic binding site observed in X-ray structures of anesthetic-bound GLIC (Nury et al., [32]). Halothane, but not ketamine, was also found in cavities adjacent to the common anesthetic site at the interface of ?4 and ?2. In addition, both anesthetics bound to cavities near the ion selectivity filter at the intracellular end of the TM domains. Anesthetic binding induced profound changes in protein conformational exchanges. A number of residues, close to or remote from the binding sites, showed resonance signal splitting from single to double peaks, signifying that anesthetics decreased conformation exchange rates. It was also evident that anesthetics shifted population of two conformations. Altogether, the study comprehensively resolved anesthetic binding sites in the ?4?2 nAChR. Furthermore, the study provided compelling experimental evidence of anesthetic-induced changes in protein dynamics, especially near regions of the hydrophobic gate and ion selectivity filter that directly regulate channel functions. PMID:23000369

Bondarenko, Vasyl; Mowrey, David; Liu, Lu Tian; Xu, Yan; Tang, Pei

2013-02-01

419

Anesthetic considerations for orthognathic surgery with evaluation of difficult intubation and technique for hypotensive anesthesia.  

PubMed Central

Orthognathic surgery is carried out to improve facial appearance and/or to improve malocclusion. Usually, patients are young and healthy. However, they may have airway problems. Reinforced silicone low-pressure, high-volume endotracheal tubes and p-xylometazoline (Otrivin) for nasal vasoconstriction reduces problems due to the endotracheal tubes. A head-up position with ventilator and monitoring equipment at the foot end helps the surgeons as well as the surgery. Surgeons may be the cause of endotracheal tube problems. Bleeding is a major problem that may be encountered and is reduced by induced hypotension. During osteotomies, severe bradycardia may occur and may even lead to cardiac arrest. In the early postoperative period, bleeding may be a problem. Later ulceration at the tip of the nose and on the buttocks may be seen if preventive measures are not carried out. PMID:11432182

Rodrigo, C.

2000-01-01

420

Process Management and Exception Handling in Multiprocessor Operating Systems Using Object-Oriented Design Techniques. Revised Sep. 1988  

NASA Technical Reports Server (NTRS)

The programming of the interrupt handling mechanisms, process switching primitives, scheduling mechanism, and synchronization primitives of an operating system for a multiprocessor require both efficient code in order to support the needs of high- performance or real-time applications and careful organization to facilitate maintenance. Although many advantages have been claimed for object-oriented class hierarchical languages and their corresponding design methodologies, the application of these techniques to the design of the primitives within an operating system has not been widely demonstrated. To investigate the role of class hierarchical design in systems programming, the authors have constructed the Choices multiprocessor operating system architecture the C++ programming language. During the implementation, it was found that many operating system design concerns can be represented advantageously using a class hierarchical approach, including: the separation of mechanism and policy; the organization of an operating system into layers, each of which represents an abstract machine; and the notions of process and exception management. In this paper, we discuss an implementation of the low-level primitives of this system and outline the strategy by which we developed our solution.

Russo, Vincent; Johnston, Gary; Campbell, Roy

1988-01-01

421

A Critical Review of the Effectiveness of "Teach-Back" Technique in Teaching COPD Patients Self-Management Using Respiratory Inhalers  

ERIC Educational Resources Information Center

Objective: To examine and discuss the evidence base behind the effectiveness of the "teach-back" technique as an educational intervention for chronic obstructive pulmonary disease (COPD) patient self-management using respiratory inhalers. Design: A systematic literature review Method: A search was conducted through Medline, CINAHL…

Dantic, Dennis Emralino

2014-01-01

422

Conference Report Regional seminar on the application of remote sensing techniques to coastal zone management and environmental monitoring, Dhaka, Bangladesh, 18-26 November 1986  

Microsoft Academic Search

A regional seminar on the application of remote sensing techniques to coastal zone management and environmental monitoring was held in Dhaka, Bangladesh, from 18 to 26 November 1986. The seminar was jointly organized by the UNDP\\/ESCAP Regional Remote Sensing Programme and the Bangladesh Space Research and Remote Sensing Organization (SPARRSO). The purpose of the seminar was to exchange information and

M. A. H. PRAMANIK; ANWAR ALI; D. A. QUADIR; ATIAR RAHMAN; M. A. SHAHID; M. D. HOSSAIN

1987-01-01

423

Guidelines for the use of mathematics in operational area-wide integrated pest management programs using the sterile insect technique with a special focus on Tephritid Fruit Flies  

Technology Transfer Automated Retrieval System (TEKTRAN)

Pest control managers can benefit from using mathematical approaches, particularly models, when implementing area-wide pest control programs that include sterile insect technique (SIT), especially when these are used to calculate required rates of sterile releases to result in suppression or eradica...

424

Cellular signaling pathways and molecular mechanisms involving inhalational anesthetics-induced organoprotection.  

PubMed

Inhalational anesthetics-induced organoprotection has received much research interest and has been consistently demonstrated in different models of organ damage, in particular, ischemia-reperfusion injury, which features prominently in the perioperative period and in cardiovascular events. The cellular mechanisms accountable for effective organoprotection over heart, brain, kidneys, and other vital organs have been elucidated in turn in the past two decades, including receptor stimulations, second-messenger signal relay and amplification, end-effector activation, and transcriptional modification. This review summarizes the signaling pathways and the molecular participants in inhalational anesthetics-mediated organ protection published in the current literature, comparing and contrasting the 'preconditioning' and 'postconditioning' phenomena, and the similarities and differences in mechanisms between organs. The salubrious effects of inhalational anesthetics on vital organs, if reproducible in human subjects in clinical settings, would be of exceptional clinical importance, but clinical studies with better design and execution are prerequisites for valid conclusions to be made. Xenon as the emerging inhalational anesthetic, and its organoprotective efficacy, mechanism, and relative advantages over other anesthetics, are also discussed. PMID:24610035

Wu, Lingzhi; Zhao, Hailin; Wang, Tianlong; Pac-Soo, Chen; Ma, Daqing

2014-10-01

425

Physical therapy and anesthetic blockage for treating temporomandibular disorders: A clinical trial  

PubMed Central

Purpose: the aim of this study was to evaluate the use of physical therapy and anesthetic blockage of the auriculotemporal nerve as a treatment for temporomandibular joint disorders. Methods: the sample comprised of twenty patients with a diagnosis of disc displacement with/ without reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis I Group IIa, IIb and IIIa). Ten patients (group 1) underwent a cycle of eight anesthetic blockages of the auriculotemporal nerve with injections (1 per week) of 1 ml of bupivacaine 0.5% without vasoconstrictor for 8 weeks. The other 10 patients (group 2) received anesthetic blockage and physical therapy (massage and muscular stretching exercises). After the end of treatment all patients were evaluated at baseline, 1st week, 4th week and 2 months. The t-Student and F (ANOVA) tests were used for statistical analysis, with a significance rate of 5%. Results: there was a significant difference when both groups were compared according to VAS score (p=0.027). There was no significant difference for the other variables: MMO and jaw protrusion. Conclusion: the anesthetic blockage and physical therapy, when used together, are effective in the reduction of pain in patients with TMD. Key words:Temporomandibular joint disorders, physical therapy, physiotherapy and nerve block, local anesthetic, bupivacaine. PMID:23229236

Nascimento, Mirella M.; Porto, Gabriela G.; Ferdinanda, Greiciane; Nogueira, Cyntia M.; Raimundo, Ronaldo C.

2013-01-01

426

Impact of Anesthetics on Immune Functions in a Rat Model of Vagus Nerve Stimulation  

PubMed Central

Vagus nerve stimulation (VNS) has been successfully performed in animals for the treatment of different experimental models of inflammation. The anti-inflammatory effect of VNS involves the release of acetylcholine by vagus nerve efferent fibers inhibiting pro-inflammatory cytokines (e.g. TNF-?) produced by macrophages. Moreover, it has recently been demonstrated that splenic lymphocytic populations may also be involved. As anesthetics can modulate the inflammatory response, the current study evaluated the effect of two different anesthetics, isoflurane and pentobarbital, on splenic cellular and molecular parameters in a VNS rat model. Spleens were collected for the characterization of lymphocytes sub-populations by flow cytometry and quantification of cytokines secretion after in vitro activation. Different results were observed depending on the anesthetic used. The use of isoflurane displayed a non-specific effect of VNS characterized by a decrease of most splenic lymphocytes sub-populations studied, and also led to a significantly lower TNF-? secretion by splenocytes. However, the use of pentobarbital brought to light immune modifications in non-stimulated animals that were not observed with isoflurane, and also revealed a specific effect of VNS, notably at the level of T lymphocytes’ activation. These differences between the two anesthetics could be related to the anti-inflammatory properties of isoflurane. In conclusion, pentobarbital is more adapted than isoflurane in the study of the anti-inflammatory effect of VNS on an anesthetized rat model in that it allows more accurate monitoring of subtle immunomodulatory processes. PMID:23840592

Picq, Chloé A.; Clarençon, Didier; Sinniger, Valérie E.; Bonaz, Bruno L.; Mayol, Jean-François S.

2013-01-01

427

The effect of a topical anesthetic on the sensitivity of calf dehorning wounds.  

PubMed

The objective was to determine the effect of a topical local anesthetic on the sensitivity of dehorning wounds in calves. Thirty 2-mo-old Holstein-Friesian calves were randomly allocated to sham dehorning control (CON), scoop dehorning without treatment with topical anesthetic (SnoTA), or scoop dehorning with an application of a topical anesthetic (STA). Sensitivity was measured by providing mechanical stimulation to the dehorned wound and peri-wound area using von Frey monofilaments calibrated at 10 and 300 g. Calf responses were categorized as absent, minor, moderate, or severe. Sensitivity measurements were performed before treatment and at various time points up to 24h posttreatment. Sham dehorned calves displayed unchanging absent or minor responses to stimulation. Regardless of whether topical anesthetic was applied, scoop dehorned calves were more likely to display minor, moderate, or severe responses than sham dehorned control calves, and responses tended to be most extreme at 4h postdehorning. Calves in the STA group tended to be less likely to display minor, moderate, or severe responses than calves in the SnoTA group at most time points (exception at 4h postdehorning). Responses were significantly more likely to be less severe in STA calves than in SnoTA calves at 40 min and 1.5h following dehorning. Thus, the use of the topical anesthetic for calves reduced the short-term sensitivity of scoop dehorning wounds. PMID:23477817

Espinoza, C; Lomax, S; Windsor, P

2013-05-01

428

A comparison of the pain perceived during intravenous catheter insertion after injection with various local anesthetics.  

PubMed

This study compared 4 local anesthetics, 1% lidocaine, 1% lidocaine with sodium bicarbonate, 2% chloroprocaine, and 0.5% bupivacaine, in a double-blinded manner for pain on intradermal injection and pain during subsequent intravenous (IV) cannulation with an 18-gauge catheter. The subjects rated their pain, using 100-mm visual analog scales, related to the local injection itself and again after the IV catheter was inserted. No statistical differences were noted in pain scores after the injection of the local anesthetic (P = . 134) or on insertion of the IV catheter itself (P = .394). However, there was a low correlation between the pain perceived during the injection of local anesthetic and insertion of the IV catheter (r = 0.483; P = .001). We found that there were no differences in pain produced by 1% lidocaine, 1% lidocaine with sodium bicarbonate, 2% chloroprocaine, and 0.5% bupivacaine during intradermal injection. There were also no differences in pain produced by an 18-gauge IV catheter being inserted after administration of any of these local anesthetics. Thus, any of these 4 local anesthetics may be used, and the choice may be based on other factors such as price and convenience. PMID:22403968

Beck, Ryan M; Zbierajewski, Frank J; Barber, Melissa K; Engoren, Milo; Thomas, Robert

2011-08-01