Pathophysiologie des Kapnoperitoneums: Implikationen für Beatmung und Hämodynamik

Zusammenfassung: Die laparoskopische Chirurgie wurde Anfang der 50er Jahre für gynäkologische Eingriffe eingeführt. Mit verbesserter Technik erweiterte sich das Spektrum in den letzten Jahrzehnten beträchtlich. Es wurden zunehmend komplexere und länger dauernde Operationen durchgeführt. Als Vorteile gegenüber offener Chirurgie wurden eine Reduktion der postoperativen Schmerzen, bessere kosmetische Ergebnisse, raschere Erholung und die Verkürzung der Krankenhausverweildauer angeführt. Infolgedessen wird die Laparoskopie mittlerweile auch bei immer älteren Patienten mit entsprechenden pulmonalen sowie kardiovaskulären Komorbiditäten und in der Chirurgie für adipöse Patienten eingesetzt. Eine sichere Anästhesieführung setzt detaillierte Kenntnisse der Pathophysiologie des Kapnoperitoneums voraus, insbesondere im Hinblick auf dessen respiratorische und hämodynamische Konsequenzen. Der Übersichtsartikel diskutiert die wichtigsten Effekte des Kapnoperitoneums und stellt aktuelle Forschungsergebnisse sowie deren Umsetzungsmöglichkeiten in der klinischen Praxis da

Development and operation of a pixel segmented liquid-filled linear array for radiotherapy quality assurance

A liquid isooctane (C$_{8}$H$_{18}$) filled ionization linear array for radiotherapy quality assurance has been designed, built and tested. The detector consists of 128 pixels, each of them with an area of 1.7 mm $\times$ 1.7 mm and a gap of 0.5 mm. The small pixel size makes the detector ideal for high gradient beam profiles like those present in Intensity Modulated Radiation Therapy (IMRT) and radiosurgery. As read-out electronics we use the X-Ray Data Acquisition System (XDAS) with the Xchip developed by the CCLRC. Studies concerning the collection efficiency dependence on the polarization voltage and on the dose rate have been made in order to optimize the device operation. In the first tests we have studied dose rate and energy dependences, and signal reproducibility. Dose rate dependence was found lower than 2.5 % up to 5 Gy min$^{-1}$, and energy dependence lower than 2.1 % up to 20 cm depth in solid water. Output factors and penumbras for several rectangular fields have been measured with the linear array and were compared with the results obtained with a 0.125 cm$^{3}$ air ionization chamber and radiographic film, respectively. Finally, we have acquired profiles for an IMRT field and for a virtual wedge. These profiles have also been compared with radiographic film measurements. All the comparisons show a good correspondence. Signal reproducibility was within a 2% during the test period (around three months). The device has proved its capability to verify on-line therapy beams with good spatial resolution and signal to noise ratio.Comment: 16 pages, 12 figures Submitted to Phys. Med. Bio

Quantum-sl(2) action on a divided-power quantum plane at even roots of unity

We describe a nonstandard version of the quantum plane, the one in the basis of divided powers at an even root of unity $q=e^{i\pi/p}$. It can be regarded as an extension of the "nearly commutative" algebra $C[X,Y]$ with $X Y =(-1)^p Y X$ by nilpotents. For this quantum plane, we construct a Wess--Zumino-type de Rham complex and find its decomposition into representations of the $2p^3$-dimensional quantum group $U_q sl(2)$ and its Lusztig extension; the quantum group action is also defined on the algebra of quantum differential operators on the quantum plane.Comment: 18 pages, amsart++, xy, times. V2: a reference and related comments adde

Factorizable ribbon quantum groups in logarithmic conformal field theories

We review the properties of quantum groups occurring as Kazhdan--Lusztig dual to logarithmic conformal field theory models. These quantum groups at even roots of unity are not quasitriangular but are factorizable and have a ribbon structure; the modular group representation on their center coincides with the representation on generalized characters of the chiral algebra in logarithmic conformal field models.Comment: 27pp., amsart++, xy. v2: references added, some other minor addition

Quantum Zeno Effect and Light-Dark Periods for a Single Atom

The quantum Zeno effect (QZE) predicts a slow-down of the time development of a system under rapidly repeated ideal measurements, and experimentally this was tested for an ensemble of atoms using short laser pulses for non-selective state measurements. Here we consider such pulses for selective measurements on a single system. Each probe pulse will cause a burst of fluorescence or no fluorescence. If the probe pulses were strictly ideal measurements, the QZE would predict periods of fluorescence bursts alternating with periods of no fluorescence (light and dark periods) which would become longer and longer with increasing frequency of the measurements. The non-ideal character of the measurements is taken into account by incorporating the laser pulses in the interaction, and this is used to determine the corrections to the ideal case. In the limit, when the time between the laser pulses goes to zero, no freezing occurs but instead we show convergence to the familiar macroscopic light and dark periods of the continuously driven Dehmelt system. An experiment of this type should be feasible for a single atom or ion in a trapComment: 16 pages, LaTeX, a4.sty; to appear in J. Phys.

W-Extended Fusion Algebra of Critical Percolation

Two-dimensional critical percolation is the member LM(2,3) of the infinite series of Yang-Baxter integrable logarithmic minimal models LM(p,p'). We consider the continuum scaling limit of this lattice model as a `rational' logarithmic conformal field theory with extended W=W_{2,3} symmetry and use a lattice approach on a strip to study the fundamental fusion rules in this extended picture. We find that the representation content of the ensuing closed fusion algebra contains 26 W-indecomposable representations with 8 rank-1 representations, 14 rank-2 representations and 4 rank-3 representations. We identify these representations with suitable limits of Yang-Baxter integrable boundary conditions on the lattice and obtain their associated W-extended characters. The latter decompose as finite non-negative sums of W-irreducible characters of which 13 are required. Implementation of fusion on the lattice allows us to read off the fusion rules governing the fusion algebra of the 26 representations and to construct an explicit Cayley table. The closure of these representations among themselves under fusion is remarkable confirmation of the proposed extended symmetry.Comment: 30 page