Prospective randomized study evaluating an absorbable cyanoacrylate for use in vascular reconstructions

BackgroundAn easy-to-use vascular sealant with good safety and efficacy is needed to prevent anastomotic bleeding in vascular surgery. This study evaluated the safety and efficacy of cyanoacrylate surgical sealant in establishing hemostasis of expanded polytetrafluoroethylene to arterial vascular anastomoses in arteriovenous (AV) grafts and femoral bypass grafts.MethodsThis multicenter, randomized, controlled, open-label study was conducted in a hospital setting at 12 sites: 10 in the United States and 2 in Europe. A total of 151 patients undergoing femoral bypass procedures or AV shunt procedures for hemodialysis access using expanded polytetrafluoroethylene grafts were randomized 2:1 to receive cyanoacrylate surgical sealant or the control (oxidized cellulose) between April 26, 2004, and January 18, 2005. Randomization was stratified by clinical site and type of procedure. After the anastomosis, cyanoacrylate surgical sealant or the control was applied to all anastomosis sites for patients undergoing femoral bypass procedures and to only the arterial anastomosis sites for patients undergoing AV shunt procedures. The primary end point was the elapsed time from clamp release to hemostasis. Secondary end points were the proportion of patients achieving hemostasis at t = 0 (immediate), 1, 5, or 10 minutes after clamp release, use of additional adjunctive measures to achieve hemostasis, and occurrence of adverse events.ResultsBaseline demographics and clinical characteristics showed that the two treatment groups were similar at baseline. The mean time from clamp release to hemostasis was 119.3 seconds with cyanoacrylate surgical sealant vs 403.8 seconds with the control (P < .001). Immediate hemostasis was achieved in 54.5% of patients receiving cyanoacrylate surgical sealant and in 10% of those receiving the control. The proportion of patients requiring additional adjunctive measures was lower with cyanoacrylate surgical sealant, and the occurrence of adverse events was similar in both groups.ConclusionsThis study demonstrates that cyanoacrylate surgical sealant is effective at reducing the time to hemostasis and achieving immediate hemostasis in AV shunt and femoral bypass procedures and that it is safe for internal use. Cyanoacrylate surgical sealant is an easy-to-use vascular sealant with good safety and efficacy that significantly decreases anastomotic bleeding in vascular surgery

Neural development - One year on

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Near-infrared integral field spectroscopy of Massive Young Stellar Objects

We present medium resolution ($R\approx5300$) $K$-band integral field spectroscopy of six MYSOs. The targets are selected from the RMS survey, and we used the NIFS on the Gemini North telescope. The data show various spectral line features including Br$\gamma$, CO, H$_2$, and \mbox{He\,{\sc i}}. The Br$\gamma$ line is detected in emission in all objects with $v_\mathrm{FWHM}\sim100$ -- 200 kms$^{-1}$. V645 Cyg shows a high-velocity P-Cygni profile between -800 kms$^{-1}$ and -300 kms$^{-1}$. We performed three-dimensional spectroastrometry to diagnose the circumstellar environment in the vicinity of the central stars using the Br$\gamma$ line. We measured the centroids of the velocity components with sub-mas precision. The centroids allow us to discriminate the blueshifted and redshifted components in a roughly east--west direction in both IRAS 18151--1208 and S106 in Br$\gamma$. This lies almost perpendicular to observed larger scale outflows. We conclude, given the widths of the lines and the orientation of the spectroastrometric signature, that our results trace a disc wind in both IRAS 18151--1208 and S106. The CO $\nu=2-0$ absorption lines at low $J$ transitions are detected in IRAS 18151--1208 and AFGL 2136. We analysed the velocity structure of the neutral gas discs. In IRAS 18151--1208, the absorption centroids of the blueshifted and redshifted components are separated in a direction of north-east to south-west, nearly perpendicular to that of the larger scale $H_2$ jet. The position-velocity relations of these objects can be reproduced with central masses of 30 M_{\sun} for IRAS 18151--1208 and 20 M_{\sun} for AFGL 2136. We also detect CO $\nu=2-0$ bandhead emission in IRAS 18151--1208, S106 and V645 Cyg. The results can be fitted reasonably with a Keplerian rotation model, with masses of 15, 20 and 20 M_{\sun} respectively.Comment: 17 pages, 10 figures, accepted by MNRA

Singlet-triplet dispersion reveals additional frustration in the triangular dimer compound Ba3_3Mn2_2O8_8

We present single crystal inelastic neutron scattering measurements of the S=1 dimerized quasi-two-dimensional antiferromagnet Ba$_3$Mn$_2$O$_8$. The singlet-triplet dispersion reveals nearest-neighbor and next-nearest-neighbor ferromagnetic interactions between adjacent bilayers that compete against each other. Although the inter-bilayer exchange is comparable to the intra-bilayer exchange, this additional frustration reduces the effective coupling along the c-axis and leads to a quasi-two dimensional behavior. In addition, the obtained exchange values are able to reproduce the four critical fields in the phase diagram.Comment: 4 pages, 3 color figures, submitted to an APS physical review journa

The RMS Survey: The Bolometric Fluxes and Luminosity Distributions of Young Massive Stars

Context: The Red MSX Source (RMS) survey is returning a large sample of massive young stellar objects (MYSOs) and ultra-compact (UC) \HII{} regions using follow-up observations of colour-selected candidates from the MSX point source catalogue. Aims: To obtain the bolometric fluxes and, using kinematic distance information, the luminosities for young RMS sources with far-infrared fluxes. Methods: We use a model spectral energy distribution (SED) fitter to obtain the bolometric flux for our sources, given flux data from our work and the literature. The inputs to the model fitter were optimised by a series of investigations designed to reveal the effect varying these inputs had on the resulting bolometric flux. Kinematic distances derived from molecular line observations were then used to calculate the luminosity of each source. Results: Bolometric fluxes are obtained for 1173 young RMS sources, of which 1069 have uniquely constrained kinematic distances and good SED fits. A comparison of the bolometric fluxes obtained using SED fitting with trapezium rule integration and two component greybody fits was also undertaken, and showed that both produce considerable scatter compared to the method used here. Conclusions: The bolometric flux results allowed us to obtain the luminosity distributions of YSOs and UC\HII{} regions in the RMS sample, which we find to be different. We also find that there are few MYSOs with L $\geq$ 10$^{5}$\lsol{}, despite finding many MYSOs with 10$^{4}$\lsol{} $\geq$ L $\geq$ 10$^{5}$\lsol{}.Comment: 12 pages, 12 figures, 3 tables, accepted to A&A. The full versions of tables 1 and 2 will be available via the CDS upon publicatio

Dispersive magnetic excitations in the S=1 antiferromagnet Ba3_3Mn2_2O8_8

We present powder inelastic neutron scattering measurements of the S=1 dimerized antiferromagnet Ba$_3$Mn$_2$O$_8$. The $T=1.4$ K magnetic spectrum exhibits a spin-gap of $\Delta \approx 1.0$ meV and a dispersive spectrum with a bandwidth of approximately 1.5 meV. Comparison to coupled dimer models describe the dispersion and scattering intensity accurately and determine the exchange constants in Ba$_3$Mn$_2$O$_8$. The wave vector dependent scattering intensity confirms the proposed S=1 dimer bond. Temperature dependent measurements of the magnetic excitations indicate the presence of both singlet-triplet and thermally activated triplet-quintet excitations.Comment: 8 pages, 8 figures, Submitted to Physical Review B, Resubmited versio