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Objective: We report the clinical findings and management of a large retro- and parapharyngeal branchial cyst in a 54-year-old man whose only complaint was a 12-month history of snoring. Method: Case report and a review of the world literature concerning parapharyngeal cysts are presented. Results: On computed tomography (CT) images, a well-marginated cystic mass was observed in the left retro- and parapharyngeal spaces, with displacement of the left internal and common carotid arteries. The cyst contained thick, sterile, yellowish pus, without malignant cells. We performed a transoral resection without any surgical complications. No recurrence was observed 2 years later. Conclusion: Parapharyngeal branchial cysts are rare and often paucisymptomatic. The transoral approach can provide good exposure allowing complete resection without significant post-operative complications or cervical scarring. # 2008 Elsevier Ireland Ltd. All rights reserved.

Using resonant laser ionization, beta-decay studies, and for the first time mass measurements, three beta-decaying states have been unambiguously identified in 70Cu. A mass excess of -62 976.1(1.6) keV and a half-life of 44.5(2) s for the (6-) ground state have been determined. The level energies of the (3-) isomer at 101.1(3) keV with T(1/2)=33(2) s and the 1+ isomer at 242.4(3) keV with T(1/2)=6.6(2) s are confirmed by high-precision mass measurements. The low-lying levels of 70Cu populated in the decay of 70Ni and in transfer reactions compare well with large-scale shell-model calculations, and the wave functions appear to be dominated by one proton-one neutron configurations outside the closed Z=28 shell and N=40 subshell. This does not apply to the 1+ state at 1980 keV which exhibits a particular feeding and deexcitation pattern not reproduced by the shell-model calculations. ispartof: Physical Review Letters vol:92 issue:11 pages:1-4 ispartof: location:United States status: published

Between November, 1970, and December, 1977, 932 consecutive patients received the standard Björk-Shiley prosthesis. Operative mortality was 4.6% for aortic valve replacement (AVR; N = 364), 5.1% for mitral valve replacement (MVR; N = 313); 11.3% for multiple valve replacement (N = 194), and 13.7% for valve replacement combined with coronary artery bypass grafting (CABG; N = 51). Factors influencing hospital mortality included type of valve replacement, age at operation, whether the valve replacement was done as an emergency, and year of implantation. Complete follow-up (mean, 3.7 years) was achieved in 95% of the survivors. Actuarial survival was 82% for AVR patients at 8 years, 83% for MVR patients at 7 years, 72% for multiple valve replacement patients at 7 years, and 76% for those who had valve replacement with CABG at 3 years. No significant difference in late survival was found between patients with mitral insufficiency alone (p greater than 0.2) or aortic insufficiency alone (p greater than 0.9) and those with stenotic lesions only. Thromboembolic complications occurred at an incidence of 1.17% per patient-year, and Dicumarol-induced hemorrhages occurred at an incidence of 2.11% per patient-year. Twelve out of 13 patients survived operation for prosthetic valve thrombosis, indicating that this complication is not as catastrophic as many believe. The incidence of reoperation in anticoagulated patients was 0.63% per patient-year. All of these results are compared with data from the recent literature.