Impact of Reconstructing Intercostal Artery on Spinal Cord Circulation During Open Surgery for Thoracoabdominal Aortic Aneurysm

ABSTRACT Introduction: We evaluated the outcomes of the selective intercostal artery reconstruction for preventing spinal cord injury during thoracoabdominal aortic aneurysm repair. Methods: We retrospectively assessed 84 consecutive patients who underwent thoracoabdominal aortic aneurysm repairs between 2004 and 2016. The mean age of the patients was 57.3 years. We performed preoperative multidetector computed tomography in 74 patients (88.0%) to identify the Adamkiewicz artery. Spinal cord injury preventive measures included motor evoked potential monitoring, hypothermia induction, Adamkiewicz artery or other intercostal artery reconstruction, and cerebrospinal fluid drainage. Results: The hospital death rate was 5.9%, and paraplegia occurred in four patients (4.7%). The Adamkiewicz artery or other intercostal arteries were reconstructed selectively in 46 patients (54.7%). Of these patients, 41 underwent postoperative multidetector computed tomography, which revealed occlusion of the reconstructed grafts in 23 patients (56.0%). There was no paraplegia in the patients who underwent reconstruction of the Adamkiewicz artery, which was patent on postoperative multidetector computed tomography. Univariate analysis showed no significant effect of various risk factors on the development of spinal cord injury. Conclusion: Outcome of open surgery for thoracoabdominal aortic aneurysm in our institution regarding spinal cord injury was satisfactory. The benefits of Adamkiewicz artery reconstruction remain inconclusive, and further larger studies are required to identify its validation for spinal cord protection in thoracoabdominal aortic aneurysm repair.</div

Impact of Reconstructing Intercostal Artery on Spinal Cord Circulation During Open Surgery for Thoracoabdominal Aortic Aneurysm

ABSTRACT Introduction: We evaluated the outcomes of the selective intercostal artery reconstruction for preventing spinal cord injury during thoracoabdominal aortic aneurysm repair. Methods: We retrospectively assessed 84 consecutive patients who underwent thoracoabdominal aortic aneurysm repairs between 2004 and 2016. The mean age of the patients was 57.3 years. We performed preoperative multidetector computed tomography in 74 patients (88.0%) to identify the Adamkiewicz artery. Spinal cord injury preventive measures included motor evoked potential monitoring, hypothermia induction, Adamkiewicz artery or other intercostal artery reconstruction, and cerebrospinal fluid drainage. Results: The hospital death rate was 5.9%, and paraplegia occurred in four patients (4.7%). The Adamkiewicz artery or other intercostal arteries were reconstructed selectively in 46 patients (54.7%). Of these patients, 41 underwent postoperative multidetector computed tomography, which revealed occlusion of the reconstructed grafts in 23 patients (56.0%). There was no paraplegia in the patients who underwent reconstruction of the Adamkiewicz artery, which was patent on postoperative multidetector computed tomography. Univariate analysis showed no significant effect of various risk factors on the development of spinal cord injury. Conclusion: Outcome of open surgery for thoracoabdominal aortic aneurysm in our institution regarding spinal cord injury was satisfactory. The benefits of Adamkiewicz artery reconstruction remain inconclusive, and further larger studies are required to identify its validation for spinal cord protection in thoracoabdominal aortic aneurysm repair.</div

Interlayer Resistance and Edge-Specific Charging in Layered Molecular Crystals Revealed by Kelvin-Probe Force Microscopy

Organic field-effect transistors (OFETs) having an active channel of solution-processed 2,7-dioctyl[1]­benzothieno­[3,2-<i>b</i>]­[1]­benzothiophene (C₈–BTBT) were investigated by Kelvin-probe force microscopy (KFM). We found step-like potential distributions in a channel region, suggesting that the interlayer resistance between the conjugated BTBT core layers is quite high and each conjugated layer is electrically isolated from one another by insulating alkyl chain layers. We also found a noticeable positive charging in the channel region especially at the step edges after the device operation. The observed charging was explained by long-lived positive charges on the trap sites, and the trap density at the step edge was estimated to be on the order of 10¹¹ cm^–2. The KFM measurements suggest that the device performance of the staggered C₈–BTBT OFETs could deteriorate due to the considerably high access resistance, which stems from the high interlayer resistance and/or by the site-specific charge trapping at the contact/semiconductor interface which originates from step edge structures

A feasibility study of predictable and unpredictable surf-like sounds for tinnitus therapy using personal music players

<p><b>Objective:</b> To evaluate the feasibility of predictable or unpredictable amplitude-modulated sounds for tinnitus therapy.</p> <p><b>Design:</b> The study consisted of two parts. (1) An adaptation experiment. Loudness level matches and rating scales (10-point) for loudness and distress were obtained at a silent baseline and at the end of three counterbalanced 30-min exposures (silence, predictable and unpredictable). (2) A qualitative 2-week sound therapy feasibility trial. Participants took home a personal music player (PMP).</p> <p><b>Study sample:</b> Part 1: 23 individuals with chronic tinnitus and part 2: seven individuals randomly selected from Part 1.</p> <p><b>Results:</b> Self-reported tinnitus loudness and annoyance were significantly lower than baseline ratings after acute unpredictable sound exposure. Tinnitus annoyance ratings were also significantly lower than the baseline but the effect was small. The feasibility trial identified that participant preferences for sounds varied. Three participants did not obtain any benefit from either sound. Three participants preferred unpredictable compared to predictable sounds. Some participants had difficulty using the PMP, the average self-report hours of use were low (less <1 h/day).</p> <p><b>Conclusions:</b> Unpredictable surf-like sounds played using a PMP is a feasible tinnitus treatment. Further work is required to improve the acceptance of the sound and ease of PMP use.</p

One-Pot Construction of Pyrazoles and Isoxazoles with Palladium-Catalyzed Four-Component Coupling

Four-component coupling of a terminal alkyne, hydrazine (hydroxylamine), carbon monoxide, and an aryl iodide furnishes pyrazole or isoxazole derivatives in the presence of a palladium catalyst. The reaction proceeds at room temperature and an ambient pressure of carbon monoxide in an aqueous solvent system

Investigation of Molecular Chain Orientation Change of Polymer Crystals in Phase Transitions by Friction Anisotropy Measurement

Direct observation of the molecular orientation change in polymer crystals provides us visible information for understanding their structural phase-transition mechanisms. In this letter, we successfully identified the main-chain orientation of poly(vinylidenefluoride-trifluoroethylene) (P(VDF-TrFE)) crystals over all directions using friction anisotropy measured by lateral-modulation friction force microscopy (LM-FFM). This technique made possible our investigation of molecular orientation changes caused by a ferroelectric phase transition and also a fabrication process for artificial nanometer-scale structures. These results give us visual information that is directly connected to the transition mechanisms

Atomic-Scale Three-Dimensional Local Solvation Structures of Ionic Liquids

Room-temperature ionic liquids are promising media for next-generation energy devices because of their various superior characteristics. Because device performance is often dictated by the solvation structures at the solid–liquid interfaces, particularly at the local reactive sites, their atomistic pictures are in great demand. However, there has been no experimental technique for their three-dimensional solvation structures. Here, we first demonstrate the measurement of the atomic-scale ionic liquids using a recently established ultralow-noise three-dimensional frequency-modulation atomic force microscopy technique supported by molecular dynamics simulations. We conducted the experiments in protic and aprotic aqueous solutions and reveal that the aprotic solvation structure exhibits the higher site specificity, which resolves atomic-scale surface charge distribution on mica because of the absence of the H-bonding network. Our methodology is also applicable to pure liquids and would be a breakthrough for expanding their future applications