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The position of the Gemeric Superunit within the Western Carpathians is unique due to the occurrence of the Lower Palaeozoic basement rocks together with the autochthonous Upper Palaeozoic cover. The Gemeric granites play one of the most important roles in the framework of the tectonic evolution of this mountain range. They can be observed in several small intrusions outcropping in the western and south-eastern parts of the Gemeric Superunit. Moreover, these granites are particularly interesting in terms of their mineralogy, petrology and ages. The comprehensive geological and geophysical research of the Gemeric granites can help us to better understand structures and tectonic evolution of the Western Carpathians. Therefore, a new and original 3D density model of the Gemeric granites was created by using the interactive geophysical program IGMAS. The results show clearly that the Gemeric granites represent the most significant upper crustal anomalous low-density body in the structure of the Gemeric Superunit. Their average thickness varies in the range of 5–8 km. The upper boundary of the Gemeric granites is much more rugged in comparison with the lower boundary. There are areas, where the granite body outcrops and/or is very close to the surface and places in which its upper boundary is deeper (on average 1 km in the north and 4–5 km in the south). While the depth of the lower boundary varies from 5–7 km in the north to 9–10 km in the south. The northern boundary of the Gemeric granites along the tectonic contact with the Rakovec and Klátov Groups (North Gemeric Units) was interpreted as very steep (almost vertical). The results of the 3D modelling show that the whole structure of the Gemeric Unit, not only the Gemeric granite itself, has an Alpine north-vergent nappe structure. Also, the model suggests that the Silicicum–Turnaicum and Meliaticum nappe units have been overthrusted onto the Golčatov Group.

Introduction: In response to a perceived high incidence of acute kidney injury following cardiopulmonary bypass at our institution, a quality improvement initiative consisting of a systematic change to a delivered oxygen (DO 2 ) goal-directed perfusion practice was implemented. We sought to maintain DO 2  > 270 mL/min/m 2 to reduce the incidence of acute kidney injury., Methods: 'The study population included all patients receiving isolated, non-emergent, on-pump coronary artery bypass grafting from January 2015 through December 2018, excluding patients requiring preoperative hemodialysis. DO 2 goal-directed perfusion was instituted in February 2017. Acute kidney injury was defined using Acute Kidney Injury Network criteria., Results: The pre-goal-directed perfusion cohort included 257 patients, and the post-goal-directed perfusion cohort included 226 patients. The DO 2 was significantly higher in the post-goal-directed perfusion group (p < 0.001). Postoperative change in serum creatinine and incidence of acute kidney injury were significantly lower in the post-goal-directed perfusion group (p < 0.001, p = 0.001, respectively). Estimation with probit and ordered probit models support these findings., Conclusion: This initiative confirms previous assertions that DO 2 is a critical intraoperative parameter and should direct perfusion intervention accordingly.

In patients with alveolar-to-pleural air leak due to recent surgery or trauma, clinicians tend to manage chest tubes with suction therapy. Nonsuction therapy is associated with shorter chest tube duration but also a higher risk of pneumothorax. We sought to develop an intrapleural electrical impedance sensor for continuous, real-time monitoring of pneumothorax development in a porcine model of air leak as a means of promoting nonsuction therapy. Using thoracoscopy, 2 chest tubes and the pleural impedance sensor were introduced into the pleural space of 3 pigs. Continuous air leak was introduced through 1 chest tube by carbon dioxide insufflation. The second chest tube was placed to suction then transitioned to no suction at increasingly higher air leaks until pneumothorax developed. Simultaneously, real-time impedance measurements were obtained from the pleural sensor. Fluoroscopy spot images were captured to verify the presence or absence of pneumothorax. Statistical Analysis Software was used throughout. With the chest tube on suction, a fully expanded lung was identified by a distinct pleural electrical impedance respiratory waveform. With transition of the chest tube to water seal, loss of contact of the sensor with the lung resulted in an immediate measurement of infinite electrical impedance. Pneumothorax resolution by restoring suction therapy was detected in real time by a return of the normal respiratory impedance waveform. Pleural electrical impedance monitoring detected pneumothorax development and resolution in real time. This simple technology has the potential to improve the safety and quality of chest tube management., (Copyright © 2019 Elsevier Inc. All rights reserved.)