Search

To evaluate if there is a relation between the size of asbestos plaques and the level of past exposure and pulmonary function, we measured the surface of localized pleural plaques found on high-resolution (HR) CT scan, using a computerized video display unit-imaging system, in 73 workers (mean age, 43.5 yr) who had worked from 23 to 27 yr in an asbestos-cement factory. Their estimated cumulative exposure to asbestos ranged from 16.4 to 98.7 fiber-years/ ml (mean, 26.3 fiber-years/ml). Lung function measurements included lung volumes, maximal expiratory flows, and diffusing capacity. A control group of 21 workers was examined by the same procedures. Plaques were detected by CT in 51 (70%) asbestos-exposed subjects and in none of the control subjects. The average calculated plaque surface was 47.9 +/- 61.7 cm2 (median, 22.1 cm2; range, 0 to 278.4 cm2). There was no relation between plaque surface and cumulative asbestos exposure (p = 0.24). In the 51 subjects with pleural plaques, the surface of the pleural lesions was not related to cumulative asbestos exposure, or to smoking history or time since first exposure. Neither the presence nor the extent of the plaques was correlated with lung function parameters.

The exponential increase in the use of the Internet and the consequent growing need for higher bandwidth demand that the telecommu­nications industry expand the laid networks at a much faster rate. Optical fibre is the only transmission medium that has the potential of unlimited bandwidth and the ability to handle very high data rates.

The exponential increase in the use of the Internet and the consequent growing need for higher bandwidth demand that the telecommu­nications industry expand the laid networks at a much faster rate. Optical fibre is the only transmission medium that has the potential of unlimited bandwidth and the ability to handle very high data rates.

The genetic algorithm optimization technique for optical filter design is applied to two starting populations, an inverse Fourier transform population and a random population. The refractive index profiles after convergence, and the transmittance of the filter outside the region of support, are markedly different in the two cases. The Fourier filter has lower sidelobes and fails gracefully outside the region of support whereas the random filter fails catastrophically in this wavelength region. The ripple in the passband is higher for the random filter. Furthermore, the average value of refractive index profile and the excursion in refractive index are much larger for the filter generated with the random starting population. However, most of the drawbacks of the random starting population are eliminated by chromosome manipulation in the spatial frequency domain. The fitter properties after this intervention approximate those of the Fourier filter.

We developed a control system for an electron cyclotron resonance plasma enhanced chemical vapor deposition (ECR-PECVD) reactor for the growth of inhomogeneous dielectric thin films for optical applications. The system supervises the growth of films of a required refractive index profile on different substrates including optical fiber ends. It controls the gas flow rates, microwave power, radio frequency substrate bias, and the ECR and extraction magnet power supplies. The system also adjusts the microwave generator to minimize reflected power during deposition. The characteristics of the ECR-PECVD system and the automation of the deposition process are discussed using the growth of a complex rugate optical filter as an example.

The aim of this study was to determine the correlation between cigarette-smoke-related bronchial disease and air trapping as assessed by expiratory high-resolution CT (HRCT) scans. Thirty healthy subjects (11 non-smokers, 7 ex-smokers for > 2 years, 12 current smokers; age range 35–55 years) with a smoking history between 0 and 28.5 pack-years underwent pulmonary function tests (PFT) and HRCT in inspiration and expiration in supine and prone position. The extent of air trapping was scored in ventral and dorsal aspects of the upper, middle and lower lung portions. In 24 subjects (7 non-smokers, 7 ex-smokers, 10 current smokers) areas of focal air trapping were found, and were present significantly more often in dependent lung portions (p < 0.05) compared with non-dependent portions. No significant differences were found between apical and basal lung zones. Scores of focal air trapping were not significantly different between smokers and ex-smokers, but were significantly lower (p < 0.05) in non-smokers and showed a significant (p < 0.0005) correlation with pack-years. The degree of air trapping was also associated with several lung function tests, especially RV, DLCO, FRC, FEV1 and FEV1/VC. Air trapping is seen in smokers with normal PFT and correlates with the severity of the smoking history, independently of current smoking status.

Silicon–oxygen alloys ranging from amorphous silicon to silicon dioxide have been deposited from electron cyclotron resonance SiH4/O2/Ar plasmas onto radio frequency biased substrates at room temperature. Hundred Watt microwave power, a working pressure of 2 mTorr, a total gas flow rate of 20 sccm, and 13.5 Watt radio frequency bias power were used. Refractive indices of 3.8 to 1.48 were measured by ellipsometry at a wavelength of 632.8 nm. Deposition rates for different SiH4/(SiH4+O2) gas flow ratios were between 4.3 and 7.5 nm min−1. Fourier transform infrared spectroscopy revealed a gradual evolution of the chemical composition of the films from amorphous silicon to silicon dioxide with change in gas phase composition. For silicon dioxide films, the centre frequency of the main Si–O stretching band is 1060 cm−1, whereas full width at half maximum is approximately 94 cm−1. Presence of Si–OH bonds is not detectable for any of the films. The amount of hydrogen in the films is considerably less than that in similar layers deposited by radio frequency plasma enhanced chemical vapour deposition, and for amorphous silicon it does not exceed 1.5×1022 cm−3. The presence of a single band at 486 cm−1 in the Raman spectrum of the a-Si film confirmed its amorphous structure.

Objective: The patient population undergoing myocardial revascularization has changed during the last few years. Knowledge of these changes, and of the subsequent influence on morbidity and:or mortality is important, not only for up-dating quality control, but also to support decision-making in financial and economical aspects, and in further research concerning coronary artery surgery. Methods: Pre-, per- and postoperative data of 3834 primary isolated coronary bypass operations, January 1987‐December 1995 were analyzed. The total group was divided into three time cohorts. Group A: 1987‐1989 (n 1292); group B: 1990‐1992 (n1130); and group C: 1993‐1995 (n 1412). Results: Mean age increased from 60.49 9.0 (S.D.) years in group A to 62.999.9 (S.D.) years in group C (PB0.0005). Patients with insulin-dependent diabetic (P 0.005), uro-nefrological (P0.002), pulmonary (PB0.0005)and neurological (P 0.003) pathology increased significantly, and there was a significant increase in the use of arterial grafts (PB0.05). Postoperative, hospital mortality remained stable (9 2.5%). However, there was a significant increasing percentage of patients with pulmonary (P 0.04), neurological (P 0.02) and uro-nefrological (PB 0.0005) problems. Conclusion: During the last few years there has been a trend in myocardial revascularization of older patients, with more coexisting disease. Despite the fact that hospital mortality seems stable, there is an increase in major postoperative morbidity. © 1998 Elsevier Science B.V. All rights reserved.

Zero angle of incidence transmission studies through lamellar gratings on silicon wafers were performed. Gratings with feature sizes of the order of magnitude of the radiation wavelength were fabricated on silicon wafers using micromachining technology. We found that the normal unpolarized light transmission spectra of such grating wafers have an oscillatory behavior, with minima and maxima having transmission values of the order of 0.03 and 0.5, respectively. The two absorption notches at wavelengths 9.06 and 16.39 microns, which appear as dips in the smooth spectra, are diminished in some grating structures. The oscillatory behavior of the spectra proves the existence of coupled electromagnetic modes inside the grating cavities. Theoretical simulation of the spectra based on the S-matrix propagation algorithm are in agreement with the experimental results. The results indicate the possibility of obtaining, with a proper grating design, efficient narrow band filters and mirrors.

Item does not contain fulltext 5 p.

aDepatiment of Medical Oncology, Princess Margaret Hospital, Toronto, Canada bDepartment of Radiation Oncology, Groote Schuur Hospital, South Africa ‘Department of Medicine, Division of Hemoc, SUNY-Health Science Center, Syracuse, New York, USA ‘Department of One-Rad, Medical University, Gdansk, Poland eDepartment of Thoracic and Cardiac Surgery, Nymegen, The Netherlands ‘St. Pierre University Hospital, Brussels, Belgium gUnit~ de Biostatitique, Institute J. Bordet, Belgium h Hospital Erasme, Brussels, Belgium ‘Deparmtent of Radiolo@, Olive V?ew-UCLA Medical Center, Los Angeles, Calgomia, USA iUniversity Hospital, Division of Oncology, Zurich, Switzerland kStatistician, MRC Cancer Trials Of&e, Cambridge, UK

Single-breath carbon monoxide diffusing capacity in the whole lung (DlCO) and per unit alveolar volume (DlCO/VA), as expressed in percentage of normal values, gave discordant results when VA of the patients was abnormal. It was hypothesized that normal reference values were inappropriate to interpret data collected in such patients. To substantiate this hypothesis, DlCO and DlCO/VA were measured in four groups: (1) normal volunteers in whom both indices were measured at five different VA; (2) patients with high VA; (3) emphysematous patients; and (4) patients with diffuse interstitial lung diseases (DILD). In normal subjects, DlCO increased and DlCO/VA decreased with VA. In patients with overinflated lungs, the percentage of DlCO was more increased than DlCO/VA. In the emphysematous patients, both indices were equally decreased. In patients with DILD, DlCO was significantly more decreased than DlCO/VA in those suffering from a restrictive pattern. Theoretical values were re-calculated taking into account their true VA and using the relationships observed between DlCO, DlCO/VA and VA. The divergences between DlCO and DlCO/VA were strongly minimized. Therefore, the authors suggest the need to correct theoretical formulas in the presence of a restrictive pattern.

Objective: A direct communication between the pulmonary artery and the left atrium is a rare anomaly. On the basis of two cases of our own and a literature review of 49 cases, we focus on clinical presentation, anatomy, diagnosis, and the role of surgery. Methods: Two cases of a fistula between the right pulmonary artery and the left atrium are described in a girl of 4 years and a boy of 15 years. Both presented with unexplained cyanosis. Diagnosis was made on echocardiography and angiography. The fistula was ligated using extracorporeal circulation in the first case and not in the second case. Results: The surgical results were successful with resolution of the cyanosis. Conclusions: In newborns, urgent surgery may be necessary. In other patients, early elective surgical correction should be performed to prevent complications, especially systemic and cerebral emboli, cerebral abscesses, and rupture of aneurysmal fistulas. Complete cure can be achieved by ligation and possible division or by intracardiac repair. © 1997 Elsevier Science B.V.

Polymer dispersed liquid crystal inserted between two multimode optical fiber end faces forms the basis of an electric field probe. This probe has an active volume of about 0.001 mm/sup 3/ and approximates a point measurement. The linear relation between detector output and electric field in the 600 V/cm to 800 V/cm range is adequate for most electric power distribution systems. As the contrast ratio of this transducer is large, it can also be used as a safety on-off detector for high-voltage equipment.

We propose the use of etched optical fibre strain sensors to provide an economical on-board load indicator for minibuses and heavy vehicles. By improving the fabrication process we produced symmetrically etched fibre strain gauges. Manufactured sensors were evaluated experimentally by straining them on a cantilever beam. For strains smaller than 600 microstrain the output of a ten-segment sensor was linear with a typical gauge factor of -57. Bending losses in the fibre sensor became more pronounced for larger strains. This sensor has only two optical components apart from the sensing element. Strain sensors were mounted on the rear axle and on the front torsion bar of a minibus taxi test vehicle. Proper weighting of the outputs of the front and back sensors on the vehicle ensures a monotonic relationship between the sensor output and load. In addition, the reading of the sensor system is virtually independent of the load distribution in the vehicle. Difference-over-sum processing ensures insensitivity to common-mode perturbations such as temperature and source intensity changes.

Objective To evaluate the IVOS (Hamilton Thorne Research Version 2.1 Dimension Program, Beverly, MA) system's ability to predict fertilization in vitro in a prospective study. Design A prospective clirical study. Setting Hospital-based academic ART program. Patients Eighty patients from the IVF-GIFT program were evaluated. The same semen sample was analyzed on a day-to-day basis by both laboratory (manual method) and the computerized system for percentage normal morphology, concentration/mL, motility, and forward progression. Only patients with two or more metaphase II (Mil) oocytes available were allowed into the study and excluded where the male partner had antisperm antibodies or qualified for intracytoplasmic sperm injection ( Statistical Analysis Logistic regression analysis was used to study predictors of fertilization in vitro. Results Three hundred thirty-eight oocytes were obtained from 80 patients of which 239 fertilized. The logistic regression analysis of the manual method (percentage normal morphology) and IVOS indicated that both were predictors of fertilization. Sperm morphology as evaluated by IVOS in patients with 6 motile spermatozoa/mL retrieved after swim-up was a significant predictor of fertilization as was the number of oocytes obtained. Thus, the more oocytes obtained in the lower morphological groups, the better the chance of fertilization. The fertilization rate in the morphology group 0% to 4% normal forms was 45.6% (37/81) and in the group >14% normal forms was 85.2% (69/81). Conclusions It was shown that in patients where ≤10 × 10 6 motile spermatozoa were obtained, the role of morphology (evaluated by IVOS) as well as the number of oocytes were important predictors of fertilization. The computer can assist to identify these patient with a poor prognosis for fertilization.

Background. Atrial fibrillation is a frequently occurring arrhythmia after thoracic operations. Preventive strategies for this complication have been extensively evaluated after cardiac operations. Methods. We performed a prospective, open randomized study, comparing intravenous verapamil and placebo in 199 patients after pneumonectomy or lobectomy at the University Hospital of Leuven. Verapamil was administered as a bolus of 10 mg over 2 minutes followed by a 30-minute infusion of 0.375 mg/min and then 0.125 mg/min for 3 days. The patients were continuously monitored in the postoperative intensive care unit. Results. Atrial fibrillation occurred in 15% of the patients receiving placebo and in 8% of the patients receiving verapamil (difference not significant). The verapamil infusion was interrupted in 9% of the patients because of bradycardia and in 14% because of hypotension. Conclusions. If tolerated, continuous intravenous verapamil infusion showed only a modest prophylactic efficacy for the occurrence of atrial fibrillation after lung operations. In the dose employed the verapamil infusion was accompanied with a high incidence of side effects necessitating interruption of the therapy.

Between 1970 and 1993, 446 patients underwent pneumonectomy. Completion pneumonectomy was performed in 37 patients (8.3%): 34 men and 3 women, with a mean age of 61 years (range 20-78 years). Indications were benign disease in 4 patients and carcinoma in 33. Of the latter, 21 patients underwent resection for metachronous lung cancer, 6 for recurrent lung cancer, 4 for previous incomplete resection, I for primary lung cancer after previous resection for benign disease and 1 patient after previous segmentectomy for metastasis. The mean interval between first operation and completion pneumonectomy was 41 months (range 1-187 months) for the whole group, 30 months for benign disease and 42 months for carcinoma. The overall operative mortality was 6/37 (16.2%); 1/4 patients with benign disease and 5/33 (15.2%) patients with carcinoma. Nine patients (29%) had one or more major non-fatal complication. Actuarial 3- and 5-year survival rates were 41.0% and 24.5% for the entire group, 75% at both times for patients with benign disease, 36.4% and 18.3% for all patients with carcinoma at the time of completion pneumonectomy and 24.3% and 14.5% for patients with metachronous or recurrent lung cancer. For 15 patients with stage I or II metachronous lung cancer, the 3- and 5-year survival rates were 33.9% and 16.9%. All six patients with stage III metachronous cancer died within 18 months. In conclusion, completion pneumonectomy carries a high operative mortality and morbidity. Long-term survival is negatively influenced by stage III lung cancer.

In this paper, an alternative technique for the measurement of roughness of road surfaces is proposed. This noncontact method is based on the scattering of acoustic waves from the road surface and measuring the normalized Fourier spectrum of the scattered wave in the specular direction. Surfaces prepared with different size aggregates ranging from 2.36 mm to 25 mm were analyzed. The roughness parameter of a surface increases linearly with increasing aggregate size. The proposed method can possibly be extended to perform in situ surface roughness measurements from a moving vehicle.

We report on a 27-year-old woman who developed severe arterial hypertension on a background of general malaise within 48 hours after vaginal delivery, suggesting severe acute-onset pre-eclampsia. Concomitant biochemical observations of haemolysis, elevated liver tests and low platelets lead to the diagnosis of (post-partum) HELLP syndrome. Our patient was transferred immediately to the intensive care unit (ICU), where she underwent plasmapheresis in combination with intravenous glucocorticoids, nicardipine and labetalol. Our patient recovered fully after three plasmapheresis sessions. Genetic testing of mutations responsible for complement deficits was negative.

The effects of retrograde and antegrade delivery of cold St. Thomas' Hospital cardioplegia were evaluated and compared in 21 patients who underwent elective myocardial revascularization. The patients were randomly separated into two groups: the antegrade group (n = 10), and the retrograde group (n = 11). Cardiac energy metabolism was monitored by evaluation of arterial and coronary sinus (CS) lactate concentration. There was an increase of the CS lactate concentration during aortic cross-clamp period in both groups. After release of the aortic cross-clamp, there was an increase of the CS lactate concentration in the antegrade group, and a decrease of CS lactate in the retrograde group. Analysis of the patients operated with antegrade delivery of cardioplegia showed an increase of the CS lactate concentration in 9/10 patients after aortic cross-clamp release. In the retrograde group, in 8/11 patients the CS lactate concentration decreased immediately after aortic cross-clamp release. Whereas the differences in the CS lactate concentration were not significantly different, the lactate extaction immediately after aortic cross-clamp release was significantly higher for the retrograde group (p = 0.034). This can be related to a faster reconsolidation of mitochondrial oxidative phosphorylation in the retrograde group. For the other registered parameters, hemodynamic recovery of cardiac function, release of creatine kinase MB isoenzyme, and clinical outcome, there was no significant difference between the groups. Based on this study we conclude that retrograde delivery of a cold non-oxygenated cardioplegic solution results in a better preservation of myocardial energy reserve than antegrade delivery.

Silicon-oxynitride layers were deposited by electron cyclotron resonance plasma enhanced chemical vapour deposition onto silicon and glass substrates. Working pressure ranged from 0.8 to 4 mTorr. Thin films of SiOxNy with different composition were obtained by a change of gas flow ratio under computer control. The optical properties of thin SiOxNy films grown from O 2 Ar , N2 and SiH 4 Ar gas mixtures were determined by optical transmission spectroscopy and Fourier transform infrared spectroscopy. Growth rate was in the range 2–10 nm/min, while refractive index changed from 2.6 to 1.48 with a corresponding change in O 2 ( N 2 + O 2 ) from 0.01 to 0.318 at constant total flow and constant silane flow. The influence of gas flow ratio and substrate bias on refractive index, growth rate and on chemical composition of grown layers was also studied.

In the experiments in the present study, electron cyclotron resonance plasma enhanced chemical vapour deposition was used for the deposition of SiOxNy films from O 2 Ar , N2 and SiH 4 Ar mixtures. Optical properties of the films were studied by means of transmission spectroscopy in the wavelength range 200–2600 nm. Refractive indices ranged between 1.5 and 3.5 (measured at 632.8 nm) for different film compositions. The extinction coefficient showed a strong blue shift with decrease of silane content in the gas mixture. Optical interference filters with continuously varying refractive index profiles were designed, and manufactured by our computer controlled electron cyclotron resonance system. Designs which take into account dispersion of refractive index, and absorption in the constituent SiOxNy material, differ only significantly from designs in which it is neglected at wavelengths shorter than 700 nm.

IR normal transmission and angular reflection spectra are studied for lamellar silicon grating-wafer structures. The grating dimensions are comparable with the radiation wavelengths 2.2–22 μm. The spectra were measured using the FTIR system. Numerical simulations of the spectra were carried out using an operator-vector version of rigorous-coupled wave analysis. The theoretical results are in agreement with the measured spectra. The effect of grating structure on the manifestation of two inherent light absorption mechanisms of bulk silicon-interstitial oxygen vibrations and lattice phonons—is discussed. The results indicate the possibility of obtaining a narrow spectral absorber.

A cantilever beam and fiber Bragg grating is used to measure acceleration. The cantilever induces strain on the grating, resulting in a Bragg wavelength modification that is subsequently detected. The output signal is insensitive to temperature variations and for a temperature change from -20/spl deg/C to 40/spl deg/C, the output signal fluctuated less than 5% without any temperature compensation schemes. Because the accelerometer does not utilize expensive and complex demodulation techniques, it is potentially cost effective. For the experimental system, a linear output range of 8 g could be detected.

A cantilever beam and fiber Bragg grating are used to measure acceleration. The output signal is insensitive to temperature variations from −20°C to 40°C, and the output signal fluctuates less than 5% without any temperature compensation schemes. For the experimental system, a linear output range of 8 g can be detected. © 2003 Wiley Periodicals, Inc. Microwave Opt Technol Lett 37: 151–153, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.10852

In 35 patients with pectus excavatum (aged 17.9 ± 5.6 years) pulmonary function and maximal exercise test results were compared before and at 1 year after operation. The lower posteroanterior chest diameter on the lateral x-ray film was significantly smaller than normal (p

A combined retrospective and prospective study describes findings on posteroanterior (PA) chest films and evaluates objective measurements on lateral chest films in pectus excavatum, both before and after surgical correction. Dispiacement of the heart to the left was seen in more than 50%, of patients and was significantly less predominant 1 year after operation, whereas other signs resulting from compression by the anterior chest wall remained unchanged or needed more time to be resolved. In both study groups the lower vertebral index and upper vertebral index in pectus excavatum patients was higher than predicted (P < 0.0001), reflecting smaller PA diameters of the chest. The diameters increased after operation (P < 0.0001), especially the lower. A significant relation was found between clinical severity and radiologic depth of depression. There was no significant relation between clinical operative result and radiologic postoperative changes in chest diameters.

Of 929 consecutive patients who underwent percutaneous transluminal coronary angioplasty over a 36-month period, 32 (3.4%) had emergency coronary artery bypass grafting for angioplasty failure. Twenty-two patients (69%) were hemodynamically stable (stable group), and 10 (31%) were unstable (unstable group) before emergency bypass. In the unstable group, the interval between failed angioplasty and opening of the grafts or end of extracorporeal circulation was significantly shorter (p < 0.001 and p < 0.002, respectively) and significantly more grafts per patient were performed (p < 0.05) than in the stable group. Twenty-seven patients (84%) received at least one internal mammary artery graft, independent of their hemodynamic condition. In 11 culprit left anterior descending arteries, the internal mammary artery graft was supplemented by a saphenous vein graft to the same territory, especially in the unstable group. There were no hospital deaths. Postoperatively, the incidence of myocardial infarction (p < 0.005) and the use of antiarrhythmics (p < 0.0001) were increased and length of stay tended to be longer in the unstable compared with the stable group. The use of a reperfusion catheter had no influence on clinical outcome, except for a significantly reduced postoperative use of antiarrhythmics (p < 0.05). The internal mammary artery can be used in emergency coronary artery bypass grafting after failed percutaneous transluminal coronary angioplasty, without hospital mortality and with acceptable morbidity, especially in hemodynamically stable patients.

Thin films of SiN x were prepared from mixtures of SiH 4 /Ar and N 2 employing a compact 2.45 GHz electron cyclotron resonance plasma source. The composition of these layers as a function of gas flows, extraction magnetic field and substrate bias was studied. Growth rates of 3–4 nm min −1 are typical. The refractive index can be varied from 1.92 to 3.6, depending on experimental conditions. Computer control was implemented to achieve controlled growth of graded refractive index profiles suitable for application in rugate optical interference filters. Rugate filters were grown by the electron cyclotron plasma deposition technique for the first time. Optical reflectance measurements in the 3800–13 000 cm −1 range were used to evaluate characteristics of the rugate filters.

Lung cancer without distant metastasis often requires an invasive surgical procedure to document inoperability. In order to determine how often puncture biopsy was a valid substitute for a surgical procedure, we investigated the performance of endoscopic staging by means of transcarinal needle aspiration biopsy during rigid bronchoscopy. Eighty lung cancer patients with subcarinal lymph nodes visible on computed tomography (CT) scan were studied. Specimens were of histological quality (i.e. lymph node tissue) in 59 out of 80 (74%) patients, and showed malignant invasion of this lymph node tissue in 43 cases. Specimens of cytological quality (i.e. lymph node cells) were obtained in 13 out of 80 (16%) patients, and showed malignancy in 7 cases. Therefore, adequate evaluation of the subcarinal lymph nodes was possible in 72 out of 80 (90%) patients. In 50 of these 72, malignant mediastinal spread was proven, and further invasive surgical staging could be avoided. Subgroup analysis showed that this outcome tended to be more likely in patients with abnormal endoscopic appearance of the main carina, with locally extensive tumours, and with nonsquamous histology. These results indicate that transbronchial needle aspiration biopsy of subcarinal lymph nodes can be a valuable alternative to more invasive surgical staging in patients selected by CT scan.

PROBLEM: We investigated the lymphocyte subpopulations in peripheral blood (PB) and peritoneal fluid (PF) of women with and without endometriosis to evaluate if the decreased natural killer (NK)-mediated cytotoxicity in women with endometriosis was due to a quantitative defect or not. METHOD: The PB and PF mononuclear cells of 59 women undergoing a diagnostic laparoscopy for pain and/or infertility were analyzed by flow cytometry. RESULTS: The number and concentration of PF mononuclear cells (MC) was increased in women with endometriosis compared to women without endometriosis. The monocyte/macrophage marker (CD14) was expressed on 70.3 and 66.9% of PFMC of women with and without endometriosis, respectively. The CD4/CD8 ratio was inverted in the PF, and this was more pronounced in women with endometriosis. In the PF of women with endometriosis, 41.3% of the lymphocytes were CD8 positive, compared to 34.3% in women without endometriosis. The percentage of NK positive lymphocytes in PF, using three different monoclonal antibodies directed against NK cell markers (CD57, CD 16, and CD56) were not different between women with and without endometriosis. In women with endometriosis, 12.7,9.5, and 28.8% of lymphocytes were CD57, CD16, and CD56 positive, respectively. CONCLUSION: PFMC consisted mainly of phagocytic and human leukocyte antigen (HLA)-restricted or HLA unrestricted cytotoxic cells capable of reacting to various antigens entering the cavity from the lower genital tractus. Furthermore, the decreased NK activity reported in PB and PF of women with endometriosis was not likely to be caused by a quantitative defect, since the percentage of NK positive lymphocytes was not different between women with and without endometriosis.

Myocardial protection is the cornerstone of cardiac surgery especially in coronary reoperation, where the most striking problem is perioperative myocardial infarction. Use of retrograde delivery of cardioplegic solution may be preferable in coronary reoperation. Experience is described with retrograde cardioplegia in 48 reoperations for myocardial revascularization, and the advantages and limitations of this technique discussed.

A new equivalent circuit describing the frequency response of porous aluminium oxide with absorbed water vapour is presented. The basic model for an almost dry porous structure consists of four passive elements, two resistors and two capacitors. Additional series combinations of a resistor and a capacitor are added in parallel to the equivalent circuit to account for the frequency response of the material containing various amounts of adsorbed and free water. Excellent agreement between measured and calculated capacitance values is achieved. The agreement in the case of the resistance values is satisfactory. By using estimated values of capacitance and resistance, relaxation times of the mixed dielectric as a function of relative humidity were determined. These relaxation times are discrete representations of the continuous spectrum of relaxation phenomena occurring in the material.

A total of 44 patients undergoing isolated aortic valve replacement received either anterograde (20 patients) or retrograde (24 patients), cold St Thomas's Hospital cardioplegia. The patients were similar with respect to age, sex, left ventricular ejection fraction, left ventricular-aortic pressure gradient, cross-clamping time and mean dose of cardioplegia. After surgery, there were no differences in enzyme release, low cardiac output syndrome, rhythm disturbances or clinical outcome between the two groups. Analysis of the postoperative haemodynamic data, however, suggests better preservation of left ventricular contractility with retrograde delivery of cardioplegic solution.

Of 111 patients with non-small cell lung cancer without clinically evident N2 disease 95 underwent mediastinoscopy between 1975 and 1985. In 63 cases mediastinoscopy was positive and in 32 negative. The patients with a positive mediastinoscopy were considered to have inoperable disease. Their 3- and 5-year survival rates were 5% and 0%, respectively. The patients with a negative mediastinoscopy and 16 patients in whom no mediastinoscopy was performed because of a peripheral tumor underwent operation. They underwent complete tumor resection and mediastinal lymph node dissection. Unsuspected N2 disease was found. Their 3- and 5-year survival rates were 19% and 10%, respectively. The better survival rate in the operated group was statistically significant and mainly due to a better survival of the lobectomy group. Multiple regression analysis showed no favorable prognostic factors in the nonoperated group, but in the operated group lobectomy and central location of the tumor significantly improved the prognosis. We conclude that patients with unsuspected stage IIIa non-small cell lung cancer discovered at thoracotomy benefit from complete tumor resection and mediastinal lymph node dissection, especially if the resection can be confined to lobectomy and if the tumor is located centrally.

A substrate heater using a 900-W tungsten lamp and a proportional-integral controller is presented. The externally generated radiation is directed onto a substrate in the target chamber. The temperature of the substrate is controlled to within +or-1 degrees C of the set temperature with a typical rise time of 5 s for a 430 degrees C change in temperature. This is achieved with negligible overshoot. >

Ion‐implanted GaAs is investigated by means of a fast nondestructive optical technique. We analyzed the implanted substrates by performing a simple bilinear transformation of the experimental infrared reflectance followed by a Fourier spectral analysis. Three cases are analyzed in this paper: (i) Cr‐doped, semi‐insulating

The effects of retrograde and antegrade delivery of cardioplegic solution on myocardial function were evaluated and compared in 60 patients who underwent myocardial revascularization. All patients had three-vessel coronary artery disease, and the revascularization was done with extensive use of the internal mammary artery. Seventy-five percent of the distal anastomoses were performed with the internal mammary artery. Myocardial protection consisted of St. Thomas' Hospital cardioplegic solution, topical slushed ice, and systemic hypothermia (28 degrees C). The patients were randomly separated into two groups: group A (n = 30), who received antegrade cardioplegia, and group B (n = 30), who received retrograde cardioplegia. With the exception of the total dose of cardioplegic solution (p = 0.02), there was no significant difference between the two groups that concerned septal myocardial temperature at the moment of asystole and after infusion of the total dose of cardioplegic solution. Cardiac function was assessed before and after the patient was weaned from cardiopulmonary bypass. In the immediate postoperative period there was a significant increase in right atrial pressure of the patients who underwent antegrade cardioplegia. For the other registered parameters there was no significant difference either in the immediate postoperative period or 6 hours later. Release of creatine kinase MB isoenzyme was the same in the two groups. Clinical outcome in terms of mortality, prevalence of perioperative infarction, prevalence of low cardiac output, and rhythm and conduction disturbances was similar in both groups. Technical problems related to cannulation and decannulation of the coronary sinus were not encountered. Multivariate analysis showed that occlusion of the left anterior descending coronary artery (p = 0.012) is an essential contraindication of antegrade delivery of cardioplegic solution. Analysis of the patients with an occlusion of the left anterior descending coronary artery who underwent antegrade (n = 9) and retrograde (n = 10) cardioplegia showed a significant difference in the total dose of cardioplegic solution (p = 0.02) and septal myocardial temperature at the moment of asystole (p = 0.008) and after infusion of the total dose of cardioplegic solution (p = 0.015). The mean arterial systolic blood pressure in the antegrade group was significantly lower than in the retrograde group (p = 0.003). Preservation of the left ventricular stroke work index was significantly better in the retrograde group (namely, 85% of its initial value versus 71% in the antegrade group, p = 0.0116).(ABSTRACT TRUNCATED AT 400 WORDS)

A computerized in situ optical reflectivity measurement system for the quantitative determination of material parameter changes of a substrate during the process of ion implantation is presented. These changes are related to the extent and nature of the induced crystal disorder in the substrate. The system consists of an optical reflectometer, with data acquisition and signal processing capabilities. For each sample a case history of the implant is obtained in the form of a continuous graph of reflectivity vs. a desired implantation parameter (e.g. dose). Examples regarding the implantation of /sup 31/P/sup +/, /sup 40/Ar/sup +/, and /sup 14/N/sup +/ are presented. Additional suggestions for further system development and applications are made. Among the advantages of in situ measurements are the time-effort-expense. savings, a higher yield of experimental data per sample, higher accuracy, repeatability, and various possibilities of process control. >

Processing of electronic materials often produces graded refractive index profiles near the surface, as for instance in ion-implanted and diffused semiconductors. Analysis of these materials by means of optical reflectance and transmittance measurements, simulations, and least-squares fits is prevalent, but cumbersome. In order to facilitate the nondestructive characterization of materials containing inhomogeneous layers, we developed new theoretical solutions in integral form for the reflectance and transmittance. Two special cases are emphasized in this paper: a buried Gaussian refractive index profile, and a transition region described by a half Gaussian. The analytical study of Gaussian profiles provides us with new methods for the direct estimation of the average depth xp and the standard deviation σ from optical reflectance data. Our estimates of these parameters, derived from experimental reflectance data of ion-implanted silicon, germanium, and GaAs, agree well with the values estimated by means of elaborate curve-fitting procedures. Simulations performed by means of the well-known matrix method and our theory, not only show excellent agreement but also prove that our method is very time efficient. Therefore, this technique could be used advantageously as a diagnostic tool as well as in process controllers in the semiconductor manufacturing industry.

The assumption of material homogeneity in the analysis of optical reflectance or transmittance data is often invalid, as, for example, in ion-implanted and diffused semiconductors. A new closed-form solution in integral form for the reflectance of material with an inhomogeneous refractive index profile is presented. Practical examples such as a buried Gaussian refractive index profile and a gradual transition region described by half a Gaussian are discussed. Estimates of the standard deviation σ and average depth x p of a Gaussian profile are obtained directly from optical reflectance data. There is good agreement between our theory, experimental data and simulations pertaining to ion-implanted material.

A previously healthy 22-year-old female was diagnosed with new-onset grade III renovascular hypertension. CT angiography showed a single 9 mm long filiform segment at the origin of the right renal artery (figure 1A, arrow). Blood pressure dropped after percutaneous angioplasty with stenting (figure 1B) and remained normal without any need for antihypertensive therapy for more than 2 years, when the patient was referred again …

In recent years, use of the internal mammary artery (IMA) as first graft of choice has been expanded with bilateral and sequential grafts in primary myocardial revascularization. The use of bilateral IMA grafts in reoperation has seldom been reported. The experience and early results with bilateral IMA grafting in 47 patients undergoing coronary reoperation are described. Hospital mortality was 6.3%. Four patients had postoperative signs of low cardiac output, and 4 had a perioperative myocardial infarction. At follow-up (18 ± 18 months), 2 cardiac-related, late deaths were noted. Thirteen patients (29%) improved 1 New York Heart Association class, and 28 (63%) improved >1 class. In 1 of 44 surviving patients, operation did not result in a decrease in angina. On the basis of the early results, the bilateral use of the IMA in coronary reoperation appears justified.

A new method for the characterization of ion-implanted silicon is proposed. It is based on analysis of the Fourier spectrum of bilinearly transformed infrared reflectance versus wavenumber data of ion-implanted samples. This non-destructive technique has been applied to previously published infrared reflectance data of 〈111〉 and 〈100〉 oriented Si samples which had been implanted with 2.7 MeV phosphorus and 380 keV silicon ions, respectively, and annealed at 500° C for various lengths of time. The refractive index and thickness of the amorphous layer of the as-implanted samples can be measured directly by means of this technique. The position of boundaries between the amorphous, recrystallized and substrate zones, as well as the position of the carrier concentration peak can be determined for the various annealing times. Depending on the annealing time, the recrystallized layer in 〈111〉 silicon has a refractive index which is between 2% and 4% higher than the substrate refractive index, while the difference in refractive index between the amorphous and recrystallized layers is in the order of 5%. In contrast to these results, the presence of the substrate/recrystallized material interface could not be detected in partially recrystallized 〈100〉 silicon by this method, implying that the refractive index step at the substrate/recrystallized material interface is less than 1%. The step in refractive index at the crystalline/amorphous interface in 〈100〉 silicon implanted with a dose of 0.5 x 1016 cm−2 silicon ions, was measured to be 12%, and it is reduced to 8% after partial regrowth has occurred. These results confirm the data obtained by a model-based least-squares analysis.

The problem of the efficacy of right-ventricular protection with retrograde coronary sinus cardioplegia is studied. Sixty patients undergoing myocardial revascularization were prospectively assigned to receive cold St. Thomas' Hospital cardioplegia into the aortic root (30 patients) or retrogradely in the coronary sinus (30 patients). The two groups were similar concerning preoperative and operative data. The hemodynamic recovery postoperatively was good in both groups, the increase of the heart rate, the decrease of the mean aortic pressure and the right-ventricular stroke-work index were not significantly different in the two groups. However, right atrial pressure increased significantly (p less than 0.001) in patients who received cardioplegia anterogradely and decreased, but not significantly, in the retrograde group. The data suggest that the decrease of the right-ventricular stroke-work index in the anterograde group is related to a depressed contractility and in the group with retrograde delivery of cardioplegia to a decreased preload. There were no differences between the groups with respect to clinical outcome. We conclude that retrograde delivery of cardioplegia results in an excellent protection of the right-ventricular function in elective myocardial revascularization.