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Background Although minimally invasive surgical techniques have reduced intraoperative bleeding, the risk of transfusion exists. However, few studies have evaluated risk factors for transfusion in radical hysterectomy. We aimed to evaluate the association between preoperative red cell distribution width/albumin ratio (RDW/albumin) and transfusion in cervical cancer patients. Methods We analyzed 907 patients who underwent radical hysterectomy between June 2006 and February 2015. Logistic regression and Cox regression analyses were performed to determine the risk factors for transfusion and mortality at 5-year and overall. Net reclassification improvement (NRI) and integrated identification improvement (IDI) analyses were performed to verify the improvement of the intraoperative transfusion model upon the addition of RDW/albumin. Results RDW/albumin was an independent risk factor for transfusion (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.02–1.77, p = 0.035). Additionally, body mass index, operation time, laparoscopic surgery, total fluids, and synthetic colloid were risk factors for transfusion. RDW/albumin was an independent risk factor for 5-year mortality (hazard ratio [HR]: 1.51, 95% CI: 1.07–2.14, p = 0.020), and overall mortality (HR: 1.48, 95% CI: 1.06–2.07, p = 0.021). NRI and IDI analyses showed the discriminatory power of RDW/albumin for transfusion (p Conclusions RDW/albumin might be a significant factor in transfusion and mortality in cervical cancer patients.

There are few studies between postoperative neutrophil to lymphocyte ratio (NLR) and survival in cervical cancer. We compared postoperative changes in NLR according to surgical methods and analyzed the effect of these changes on 5-year mortality of cervical cancer patients. A total of 929 patients were assigned to either the laparoscopic radical hysterectomy (LRH) (n = 721) or open radical hysterectomy (ORH) (n = 208) group. Propensity score matching analysis compared the postoperative NLR changes between the two groups, and multivariate logistic regression analysis evaluated the association between NLR changes and 5-year mortality. Surgical outcomes between the two groups were also compared. In the LRH group, NLR changes at postoperative day (POD) 0 and POD 1 were significantly lower than in the ORH group after matching (NLR change at POD 0, 10.4 vs. 14.3, p &lt, 0.001, NLR change at POD 1, 3.5 vs. 5.4, p &lt, 0.001). In multivariate logistic regression analysis, postoperative NLR change was not associated with 5-year mortality (2nd quartile: OR 1.55, 95% CI 0.56–4.29, p = 0.401, 3rd quartile: OR 0.90, 95% CI 0.29–2.82, p = 0.869, 4th quartile: OR 1.40, 95% CI 0.48–3.61, p = 0.598), whereas preoperative NLR was associated with 5-year mortality (OR 1.23, 95% CI 1.06–1.43, p = 0.005). After matching, there were no significant differences in surgical outcomes between the two groups. There were significantly fewer postoperative changes of NLR in the LRH group. However, the extent of these NLR changes was not associated with 5-year mortality. By contrast, preoperative NLR was associated with 5-year mortality.

Background Indocyanine green (ICG) video angiography has been widely used in cerebrovascular surgery. ICG injection is generally safe, with a low incidence of complications. ICG-related anaphylactic reactions during neurosurgery have been rarely reported. We report the cases of 2 patients who had experienced anaphylactic shock in response to intravenous ICG injection (DID Indocyanine Green [Dongindang, Inc., Gyeonggi-do, Republic of Korea]) during intracranial aneurysm (IA) surgery. Case Description The first patient, a 69-year-old woman with an unruptured IA, had been undergoing clipping surgery under general anesthesia. Immediately after ICG injection, her blood pressure suddenly decreased from 140/80 mm Hg to 50/30 mm Hg and she developed a skin rash on her abdomen and all extremities. Chest compression was initiated, and her vital signs gradually recovered to their pre-ICG levels within 10 minutes. The second patient was a 58-year-old woman with an unruptured IA who had been undergoing clipping surgery. After ICG injection, her blood pressure had decreased from 130/80 mm Hg to 60/40 mm Hg, and a rash-like skin lesion was observed on her abdomen. After intravenous injection of norepinephrine and dexamethasone, her blood pressure recovered to its pre-ICG level within 30 minutes and remained stable thereafter. The postoperative ICG skin provocation test findings were positive for both patients; however, only 1 patient showed markedly increased serum tryptase levels. Conclusion Despite the rarity of ICG-related anaphylaxis, clinicians should be aware of this unexpected, but potentially life-threatening, drug reaction in patients undergoing cerebrovascular surgery.

Increased intra-abdominal pressure with prone positioning for spinal surgery is associated with intraoperative hemodynamic alterations and the potential for postoperative complications. This study investigated the incidence of postoperative acute kidney injury (AKI) in patients undergoing spine surgery on a Jackson spinal table or a Wilson frame.A total of 1374 patients who underwent spine surgery were divided into 2 groups: Jackson spinal table (n = 598) and Wilson frame group (n = 776). After 1:1 propensity score matching, a final analysis was performed on 970 patients. The primary endpoint was a comparison of the incidence of AKI in the 2 groups.After propensity score matching analysis, the mean ± standard deviations of spine surgery invasiveness index were 4.7 ± 3.5 and 2.1 ± 1.4 in patients with the Jackson spinal table and the Wilson frame, respectively (P 0.001). Considering the differences in surgical invasiveness, operative time, estimated blood loss, and administration of packed red blood cells were higher in the Jackson spinal table group than in the Wilson frame group (P0.001). However, the incidence of AKI was less with the Jackson spinal table than with the Wilson frame (1.7% vs. 3.7%, 2.25 [0.978-5.175], P = 0.056), not reaching statistical significance.This analysis showed that postoperative AKI in patients undergoing spine surgery in the prone position was not different with the Wilson frame than in the Jackson spinal table despite higher surgical severity, longer operative times, and more blood loss in the latter group. In spine surgery, the appropriate selection of prone positioning apparatus can potentially be an important consideration in reducing the risk of AKI.

Major laparoscopic pelvic surgery requires steep Trendelenburg position with pneumoperitoneum for a long time. We investigated the effect of Trendelenburg position with pneumoperitoneum on diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery using M-mode sonography. Twenty patients undergoing elective pelviscopic radical hysterectomy were included in this study. Diaphragmatic excursion was measured at the following time points; after sedation, after intubation, 90 minutes after Trendelenburg position with pneumoperitoneum, and after operation with recovery of muscle relaxation. And lung compliance was measured using anesthetic machine under general anesthesia; after the intubation, 90 minutes after Trendelenburg position with pneumoperitoneum and after operation with recovery of muscle relaxation. In order to detect postoperative pulmonary complication, postoperative chest radiography was checked. Static lung compliance, dynamic lung compliance and diaphragmatic excursion were decreased during operation (P < 0.001, respectively). At the end of the operation with recovery of muscle relaxation, reduced diaphragmatic movement was not recovered as its excursion after sedation (P < 0.001). In conclusion, lung compliance was decreased following transiently decreased diaphragmatic excursion during major laparoscopic pelvic surgery.

Cerebral air embolism is a rare but potentially life-threatening complication. We experienced a living-donor liver transplant recipient who presented with unexpected cerebral air embolism and transient neurologic abnormalities that subsequently developed just after the removal of the pulmonary artery catheter from the central venous access device. One day after the initial event, the patient's neurologic status gradually improved. The patient was discharged 30 days after liver transplantation without neurologic sequelae.

This study was aimed to evaluate the efficiency of a new mesh-type nebulizer for the intrapulmonary delivery of ipratropium bromide in surgical patients under mechanical ventilation. A total of 20 patients were randomly allocated to receive 0.5 mg ipratropium bromide using either a control (Pariboy SX, Pari, Co., Starnberg, Germany, n = 10) or test (NE-SM1 NEPLUS, KTMED INC., Seoul, Korea, n = 10) nebulizer during general anaesthesia. Ipratropium bromide was nebulized continuously for 20 min. in each group. Plasma concentrations of ipratropium bromide were obtained from blood samples at preset intervals. Non-compartmental analysis of ipratropium bromide was performed to compare the efficiency of pulmonary drug delivery in both nebulizers. Population pharmacokinetic analysis of ipratropium bromide was performed. Additionally, the noise level during the nebulizer operation and the aerosol particle size for each device were measured. The dose-normalized AUC(last) was 0.10 min/L for both nebulizers. The pharmacokinetics of nebulized ipratropium bromide can be described best by a one-compartment model with first-order absorption. The apparent volume of distribution and metabolic clearance were 1340 L and 6.78 L/min, respectively. Type of nebulizer was a significant covariate for absorption rate constant. The equivalent sound level and median aerosol particle diameter were 35.0 dB and 4.52 μm for the test nebulizer, and 60.2 dB and 3.85 μm for the control nebulizer, respectively. From the standpoint of the dose-normalized AUC(last) , a new vibrating mesh-type nebulizer shows similar performance in the intrapulmonary delivery of ipratropium bromide to that of a jet-type nebulizer in surgical patients.

The purpose of this study was to detect mind-wandering experienced by pre-service teachers during a video learning lecture on physics. The lecture was videotaped and consisted of a live lecture in a classroom. The lecture was about Gauss's law on physics. We investigated whether oculomotor data and eye movements could be used as a marker to indicate the learner&rsquo, s mind-wandering. Each data was collected in a study in which 24 pre-service teachers (16 females and 8 males) reported mind-wandering experience through self-caught method while learning physics video lecture during 30 minutes. A Tobii Pro Spectrum (sampling rate: 300 Hz) was used to capture their eye-gaze during learning Gauss's law through a course video. After watching the video lecture, we interviewed pre-service teachers about their mind-wandering experience. We first used the self-caught method to capture the mind-wandering timing of pre-service teachers while learning from video lectures. We detected more accurate mind-wandering segments by comparing fixation duration and saccade count. We investigated two types of oculomotor data (blink count, pupil size) and nine eye movements (average peak velocity of saccades, maximum peak velocity of saccades, standard deviation of peak velocity of saccades, average amplitude of saccades, maximum amplitude of saccades, total amplitude of saccades, saccade count/s, fixation duration, fixation dispersion). The result was that the blink count could not be used as a marker for mind-wandering during learning video lectures among them (oculomotor data and eye movements), unlike previous literatures. Based on the results of this study, we identified elements that can be used as mind-wandering markers while learning from video lectures that are similar to real classes, among the oculomotor data and eye movement mentioned in previous literatures. Additionally, we found that most participants focused on past thoughts and felt unpleasant after experiencing mind-wandering through interview analysis.

Background Centipedegrass extract (CGE) is rich in several polyphenolic compounds including C-glycosylflavonoids, such as maysin and its derivatives, and exerts antioxidant, anti-adipogenic and anticancer effects. However, the effect of CGE on the immune system is unclear. Purpose CGE might inhibit NO production induced by lipopolysaccharide (LPS). In this study, we propose a molecular mechanism for regulation of aberrant immune responses by CGE in LPS-stimulated RAW264.7 cells. Study Design We will preparation of Centipedegrass extract and purify partially in rich of maysin and its derivatives. And examine the effect of the CGE on immune system using LPS-induced RAW cells and animals. Methods LPS-induced nitric oxide (NO) and interleukin-6 levels were measured by enzyme-linked immunosorbent assay. The mRNA and protein levels of immune mediators were analyzed by reverse-transcription polymerase chain reaction and immunoblotting, respectively. Results CGE inhibited LPS-induced NO production in a concentration-dependent manner by suppressing inducible nitric oxide synthase (iNOS) expression in LPS-stimulated cells; this effect was mediated by inhibition of the JAK/STAT pathway. However, CGE did not regulate the expression of other factors, including phosphorylated p38, c-jun N-terminal kinase, or extracellular signal-regulated kinase 1/2. In addition, CGE increased T cells percentage in peripheral blood after oral administration. Conclusion These results indicate that CGE suppresses LPS-induced production of NO and expression of iNOS by directly inhibiting JAK2 kinase activity and enhancing effects on the immune system in mice.

Use of orange peel as a raw material for bioethanol production requires removal of its limonene content, which inhibits fermentation. Orange peel was pretreated using electron beam or gamma ray irradiation. Limonene content decreased in a dose-dependent manner, with approximately 60% reduction compared to the control after gamma irradiation at a dose of 800 kGy. However, electron beam irradiation did not demonstrate the same effectiveness. Therefore, gamma irradiation was deduced to be a promising pretreatment method for removing limonene from orange peel.

Pneumothorax during general anesthesia is more difficult to diagnose compared with that of non-anesthetized patient. Furthermore, the early diagnosis of pneumothorax is to some extent difficult due to CO2-pneumoperitoneum during laparoscopic surgery. The use of ultrasonography to diagnose pneumothorax has increased in a variety of situations, demonstrating a better diagnostic rate than conventional chest radiography. Here, we report two cases of intraoperative capnothorax that were confirmed using the M-mode "lung point" sign. However, the insertion of a chest tube could have been avoided because the spontaneous resolution of capnothorax was quickly identified using bedside lung ultrasonography.

This study was to investigated the effects of the bee venom on inhibition of cell growth via upregulation of death receptor expression in the A549 human lung cancer cells. Bee venom(1-5 μg/ml) inhibited the growth of A549 lung cancer cells by the induction of apoptotic cell death in a dose dependent manner. Consistent with apoptotic cell death, expression of TNFR1, Fas, death receptors(DR) 3, 4 and 6 was increased in the cells. Expression of DR downstream pro-apoptotic proteins including caspase-3, -9 and Bax was concomitantly increased, but the expression of Bcl-2, NF-kB were inhibited by treatment with bee venom in A549 cells. Moreover, deletion of DR3, DR4 by small interfering RNA significantly reversed bee venom-induced cell growth inhibitory effect, whereas Apo3L strengthened anti-proliferative effect of bee venom through enhancement of DR3 expression. These results suggest that bee venom should exert anti-tumor effect through induction of apoptotic cell death in lung cancer cells via enhancement of death receptor expression, and that bee venom could be a promising agent for preventing and treating lung cancer.

Ternary electroless nickel, NiXP, films were produced by adding salts of Mo, Re, Tl, Cu, W, Co, Fe, Zn, and Mn to conventional electroless Ni baths and subsequently reacted with Sn-3.5Ag solder. From the full width at the half maximum (FWHM) data, as-plated NiXP films can be categorized into two groups: one is close to the FWHM value of nanocrystalline Ni5P film and the other is close to amorphous Ni9P film. Alloying elements in the electrolessly plated under-bump metallurgy that effectively suppressed intermetallic compound (IMC) spalling were Mn, Zn, Re, Fe, and W, whereas Tl exacerbated spalling. The roles of Cu, Mo, and Co were less clear due to a lack of data. Based on scanning electron microscopy observations, a spalling map was presented, which showed elemental demarcation lines of IMC spalling in the X-P coordinates.

Effects of tungsten (W) addition to the electroless Ni(P) under bump metallization (UBM) on the solder joint reliability were investigated by preparing Ni–xW–5P and Ni–xW–9P films. Characteristics of the NiWP films, interfacial reaction with Sn–3.5Ag solder, and the impact resistance of solder joints was investigated by conducting differential scanning calorimetry, x-ray diffraction, scanning electron microscopy, transmission electron microscopy (TEM), and drop tests. Tungsten increased the thermal stability of the film and raised the crystallization temperature, but the crystallinity decreased with the W content in the film. The drop impact resistance of the Sn–3.5Ag/Ni–xW–9P joints was improved remarkably with the W content in the UBM, which was a direct consequence of the elimination of Ni3Sn4 spalling from the UBM. Additions of W up to 16 wt.% did not suppress intermetallic compound (IMC) spalling completely, but 22 wt.% W did up to 4 reflows, which increased the number of drops to failure (Nf) from 50 to over 300. TEM study showed the presence of an amorphous (Ni,W)3P layer between Ni3Sn4 and the original Ni–22W–9P UBM.

Grain boundary (GB) in multicrystalline silicon (mc-Si) degrades a conversion efficiency of mc-Si solar cell. To reduce the GB effect, we investigated various parameters such as the preferential GB etch, etch time, tin-doped indium-oxide (ITO) electrode, heat treatment, and emitter layer effect. Among various preferential etchants such as Sirtl, Yang, Secco, and Schimmel, a Schimmel etchant illustrated an excellent preferential etching property. We used RF magnetron sputter grown ITO film as a top contact metal. ITO films served as a top electrode as well as an effective AR coating layer. With well-fabricated mc-Si solar cells, we were able to achieve conversion efficiency as high as 16.6% at the input power of 20 mW/cm2.

Rotation thromboelastometry (ROTEM®) is increasingly used in liver transplantation (LT). Of the ROTEM® parameters, maximum clot firmness (MCF) of EXTEM (MCFEXT) and INTEM (MCFINT) are influenced by both platelet count (PLT) and fibrinogen concentration (FIB), whereas MCF of FIBTEM (MCFFIB) is solely influenced by FIB. We aimed to determine whether using MCFs of thromboelastometry could reliably predict both PLT and FIB and to evaluate their relations in patients with thrombocytopenia and hypofibrinogenemia during LT.A total of 4100 retrospective ROTEM® assays with simultaneous standard laboratory tests performed during LT were analyzed in 295 patients. The optimal cut-off values of PLT and FIB according to the ROTEM® transfusion guideline were determined by area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis.MCFEXT and MCFINT showed good correlation with platelet count (r = 0.79 and 0.80, respectively, P.001) and with fibrinogen concentration (r = 0.67 and 0.66, respectively, P.001). MCFFIB and fibrinogen concentration were highly correlated (r = 0.84, P.001). Additionally, PLT and FIB were calculated mathematically: PLT (/μL) = 14827 + 3.93 (MCFEXT)(2.5); FIB (mg/dL) = 63 + 0.00082 (MCFEXT)(3.0); FIB (mg/dL) = 29 + 13.3 MCFFIB. MCFEXT35 mm predicted PLT of 43 × 10(3)/μL (AUC = 0.89) and FIB of 91 mg/dL (AUC = 0.78), whereas MCFEXT45 mm predicted PLT of 52 × 10(3)/μL (AUC = 0.89) and FIB of 121 mg/dL (AUC = 0.86), MCFFIB8 mm predicted FIB of 128 mg/dL (AUC = 0.94). MCFINT showed almost the same cut-off values as MCFEXT.Both PLT and FIB can be reliably quantified by MCFs of thromboelastometry, reducing the needs for additional laboratory tests to know values of thrombocytopenia and hypofibrinogenemia in patients undergoing LT.

Background Centipedegrass extract (CGE) is mainly composed of maysin and its derivatives, which are recognized internationally as natural compounds. Compared to other flavonoids, maysin has a unique structure in that mannose is bound to the flavonoid backbone. CGE exhibits some biological properties in that it can function as an anti-oxidant, anti-inflammatory, anti-adipogenic, and insecticidal. Whether CGE has other biological functions, such as anti-cancer activity, is unknown. Methods B16F1 (mouse) and SKMEL-5 (human) cells were treated with CGE, and their subsequent survival was determined using MTT assay. We performed a cell cycle analysis using propidium iodide (PI), and detected apoptosis using double staining with annexin V-FITC/PI. In addition, we examined mitochondrial membrane potentials using flow cytometry, as well as signaling mechanisms with an immunoblotting analysis. Results CGE inhibited skin cancer cell growth by arresting the cell cycle in the G2/M phase, and increased both early and late apoptotic cell populations without affecting normal cells. Furthermore, we observed mitochondrial transmembrane depolarization, increased cytochrome-c release, caspase-3 and caspase-7 activation, and increased poly ADP-ribose polymerase degradation. CGE also downregulated activation of p-AKT, p-glycogen synthase kinase-3β (GSK-3β), and p-BAD in a time-dependent manner. LY294002 inhibition of phosphoinositide 3-kinase (PI3K) significantly sensitized skin cancer cells, which led to an increase in CGE-induced apoptosis. Conclusions CGE controlled skin cancer cell growth by inhibiting the PI3K/AKT/GSK-3β signaling pathway and activating the effector caspases. This study is the first to demonstrate anti-cancer properties for CGE, and that CGE may be an effective therapeutic agent for treating skin cancer.

For high density and performance of microelectronic devices, the 3-D system in package (SiP) has been considered as a superb microelectronic packaging system. The development and evaluation of stacked chip type 3-D SiP with vertically interconnected TSV are reported. The process includes; 55 mum-diameter via holes by reactive ion etching (RIE), SiO2 dielectric layer by thermal oxidation, Ta and Cu seed layers by ionized metal plasma (IMP), Cu via filling by electroplating, Cu/Sn bump for multi-chip stacking and finally chip-to-PCB bonding with Sn-3.0Ag-0.5Cu solder and ENIG pad. A prototype 3-D SiP with 10 stacked chips was successfully fabricated. High frequency electrical model of the TSV was proposed and the model parameters were extracted from the measured S-parameters. The proposed model was verified by TDR/TDT (time domain reflectometry/time domain transmission) and eye-diagram measurement. And then, contact resistances of Cu via and bump joint were discussed.

Percutaneous radiofrequency ablation (RFA) is a useful and safe procedure for treating hepatic neoplasm. However, liver RFA causes severe pain, which thereby increases the demand for monitored anesthesia care (MAC). Here, we compared the efficacy and safety of propofol and dexmedetomidine, which are commonly administered during MAC when performing RFA to assess hepatic neoplasm.In this randomized controlled trial, 40 patients were randomly allocated to 2 groups for elective RFA. Patients received either dexmedetomidine (group D) or propofol (group P). Both groups received the continuous infusion of remifentanil for pain control. The primary outcomes were opioid consumption and differences in partial pressure of arterial carbon dioxide (PaCO2) between pre- and postprocedure RFA. In addition, hemodynamic parameters, patient satisfaction, and interventional radiologist satisfaction were determined.There were significant differences in opioid consumption (50.1 ± 16.8 ng/kg/min [group D] vs 71.2 ± 18.7 ng/kg/min [group P]; P = 0.001) and delta PaCO2 (10.4 ± 6.4 mm Hg vs 17.2 ± 9.2 mm Hg, respectively; P = 0.016). Moreover, respiratory rates were significantly different between groups during RFA (P

System in package (SiP) is a superb candidate to enhance the area efficiency and performance of electronic packaging. Here, recent work on stacked chip type 3D SiP with vertically interconnected through hole vias are reported. The process includes; formation of 50um-diameter via holes, conformal deposition of SiO2 dielectric layer, deposition of Ta and Cu barrier layers, via filling by Cu electroplating, Cu/Sn bump formation for multi-chip stacking, and finally chip-to-PCB bonding using Sn-3.0Ag-0.5Cu solder and ENIG pad. A prototype 3D SiP stacked up to 10 layers was successfully fabricated.A high frequency electrical model of the through hole via was proposed and the model parameters were extracted from measured S-parameters. The proposed model was verified by TDR/TDT (time domain reflectometry/time domain transmission) and eye-diagram measurement. Contact resistances of Cu via and bump joint were presented.

Although nasogastric tube insertion is routinely indicated in patients undergoing abdominal surgery, insertion of a nasogastric tube in anesthetized and intubated patients is associated with a failure rate of ~50% during the first attempt and has been the cause of delays in beginning surgery [1,2]. In this respect, various techniques had traditionally been proposed to facilitate nasogastric tube insertion, including the use of a slit endotracheal tube, lateral neck pressure, head flexion, gloved finger steering, and the use of Magill forceps. More recently, esophageal guidewires and visualization-aided modalities such as the GlideScope were suggested to facilitate nasogastric tube insertion [2,3]. However, these instruments are not always available in the operating room. We suggest that a semi-rigid esophageal stethoscope with a temperature sensor, which is always available in all operating rooms, can safely and effectively aid nasogastric tube placement. In our method, the 18 Fr nasogastric tube is inserted via the nostril and pulled out via the mouth. The nasogastric tube can then be introduced with the assistance of an 18 Fr esophageal stethoscope (Sewoon Medical, Cheonan, Korea) tied to the tip of the nasogastric tube with a 75 cm surgical suture (size 3-0) by a slipknot, such as the highwayman's hitch [4]. When the nasogastric tube is inserted into the esophagus as deeply as possible, the slipknot can be spontaneously untied with a light tug. We believe that this novel and easy-to-learn method will allow for the successful, safe, and rapid placement of nasogastric tubes in anesthetized patients.

In this paper we investigated a feasibility of Y2O3 films as a buffer layer of MFIS (metal ferroelectric insulator semiconductor) type capacitor. Buffer layers were prepared by two-step process of a low temperature film growth and subsequent RTA treatment. Investigated parameters are given as substrate temperature, O2 partial pressure, post-annealing temperature, and suppression method of interfacial SiO2layer generation. By employing an ultra thin Y pre-metal layer, unwanted SiO2 layer generation was successfully suppressed at an interface between the buffer layer and Si substrate. By using two-step process, we improved the leakage current density of Y2O3 films by 2 orders and the Dit as low as 8.72×1010 cm−2eV−1. For a substrate temperature above 400°C and O2 partial pressure of 20%, we observed cubic Y2O3 phase domination in XRD spectra. We achieved 1.75% lattice mismatch between Y2O3 film and silicon substrate. Y2O3 buffer layer for a single transistor FRAM exhibited optimal properties when it was grown at 400°C with 20% O2 partial pressure then RTA treatment at 900°C in oxygen ambient.

A 56 year old female patient was transferred to the operating room for the repair of anterior cruciate ligament under general anesthesia. Initial vital sign was stable, but there was gradual decreases of the blood pressure and end-tidal CO2 after femur tourniquet application. We suspected the pulmonary thromboembolism, and started massive treatment of using ventilator with 100% O2, various invasive monitors and many vasopressors. Because the patient's vital sign was so unstable, we finally made a decision of using emergency bypass system (Capiox EBS ® , Terumo, Japan) by femoral artery and vein. After that, we transferred the patient to intensive care unit, and continued vigorous treatment. The patient was diagnosed as pulmonary thromboembolism by CT scan. We treated her with infusion of heparin and maintained ACT above 200 second. The 4th day at the intensive care unit, we removed the emergency bypass system. We transferred her to general ward without any complication after 12th day postoperatively. (Korean J Anesthesiol 2007; 53: 391～4)

Background: Local anesthetics can reduece excitotoxic neuronal injury from ischemia. We investigated neuroprotective effects of intrathecally administered bupivacaine and hypothermia in rat model of transient spinal cord ischemia. Methods: A PE-10 intrathecal catheter was implanted into thirty six male Sprague-Dawley rats through L4-5 interlaminar space. Animals of normothermia (N) and hypothermia (H) groups were administered 15l of normal saline, and 15l of 0.5% bupivacaine for bupivacaine (B) and bupivacaine-hypothermia (BH) groups. Transient spinal cord ischemia was induced by inflation of a 2 F Fogarty catheter placed into aortic arch for 12 minutes. During ischemia, rectal temperature was maintained to 37.0 0.5 for N and B groups, 34.5 0.5 for H and BH groups. Motor and sensory deficit score were assessed 2 and 24 hour after reperfusion. Lumbar spinal cords were harvested for histopathology, and for immunoreactivity of heat shock protein 70 (HSP70). Results: The motor and sensory deficit score of N and B group was significantly higher than H group (P