Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump

AbstractObjectives: The purpose of this study was to investigate how the inflow cannulation site of the left ventricular assist system with a centrifugal pump would influence cardiac function on failing heart models. Methods: In 10 sheep, a left ventricular assist system was instituted by an outflow cannula in the descending aorta, two inflow cannulas in the left atrium and the left ventricle, and connecting those cannulas to a magnetically suspended centrifugal pump. A conductance catheter and a tipped micromanometer for monitoring the pressure-volume loop were also inserted into the left ventricle. Myocardial oxygen consumption was directly measured. Heart failure was induced by injection of microspheres into the left main coronary artery. The assist rate was varied from 0% to 100% at each inflow cannulation site. Results: The pump flow with left ventricular cannulation increased during the systolic phase and decreased during the diastolic phase, whereas it was constant with left atrial cannulation. Ejection fraction with left atrial cannulation decreased as the assist rate increased, whereas that with left ventricular cannulation was maintained up to 75% assist. The external work with left atrial cannulation decreased gradually as the assist rate increased, whereas the external work with left ventricular cannulation did not decrease until the assist rate reached 75%. The myocardial oxygen consumption in both cannulations decreased proportionally as the assist rate increased; they were significantly less with left ventricular cannulation at the 100% assist rate than with left atrial cannulation. Conclusion: Left ventricular cannulation during left ventricular assistance maintains ejection fraction and effectively reduces oxygen consumption.J Thorac Cardiovasc Surg 2003;125:353-6

Hot electron and ion spectra on blow-off plasma free target in GXII-LFEX direct fast ignition experiment

Polystyrene deuteride shell targets with two holes were imploded by the Gekko XII laser and additionally heated by the LFEX laser in a direct fast ignition experiment. In general, when an ultra-intense laser is injected into a blow-off plasma created by the imploding laser, electrons are generated far from the target core and the energies of electrons increase because the electron acceleration distance has been extended. The blow-off plasma moves not only to the vertical direction but to the lateral direction against the target surface. In a shell target with holes, a lower effective electron temperature can be realized by reducing the inflow of the implosion plasma onto the LFEX path, and high coupling efficiency can be expected. The energies of hot electrons and ions absorbed into the target core were calculated from the energy spectra using three electron energy spectrometers and a neutron time-of-flight measurement system, Mandala. The ions have a large contribution of 74% (electron heating of 4.9 J and ion heating of 14.1 J) to target heating in direct fast ignition

Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis

<p>Abstract</p> <p>Background</p> <p>Hepatectomy is recommended as the most effective therapy for liver metastasis from colorectal cancer (CRCLM). It is crucial to elucidate the prognostic clinicopathological factors.</p> <p>Methods</p> <p>Eighty-three patients undergoing initial hepatectomy for CRCLM were retrospectively analyzed with respect to characteristics of primary colorectal and metastatic hepatic tumors, operation details and prognosis.</p> <p>Results</p> <p>The overall 5-year survival rate after initial hepatectomy for CRCLM was 57.5%, and the median survival time was 25 months. Univariate analysis clarified that the significant prognostic factors for poor survival were depth of primary colorectal cancer (≥ serosal invasion), hepatic resection margin (< 5 mm), presence of portal vein invasion of CRCLM, and the presence of intra- and extrahepatic recurrence. Multivariate analysis indicated the presence of intra- and extrahepatic recurrence as independent predictive factors for poor prognosis. Risk factors for intrahepatic recurrence were resection margin (< 5 mm) of CRCLM, while no risk factors for extrahepatic recurrence were noted. In the subgroup with synchronous CRCLM, the combination of surgery and adjuvant chemotherapy controlled intrahepatic recurrence and improved the prognosis significantly.</p> <p>Conclusions</p> <p>Optimal surgical strategies in conjunction with effective chemotherapeutic regimens need to be established in patients with risk factors for recurrence and poor outcomes as listed above.</p

Direct fast heating efficiency of a counter-imploded core plasma employing a laser for fast ignition experiments (LFEX)

Fast heating efficiency when a pre-imploded core is directly heated with an ultraintense laser (heating laser) was investigated. \u27Direct heating\u27 means that a heating laser hits a pre-imploded core without applying either a laser guiding cone or an external field. The efficiency, η, is defined as the increase in the internal core energy divided by the energy of the heating laser. Six beams (output of 1.6 kJ) from the GEKKO XII (GXII) green laser system at the Institute of Laser Engineering (ILE), Osaka University were applied to implode a spherical deuterated polystyrene (CD) shell target to form a dense core. The DD-reacted protons and the core x-ray emissions showed a core density of 2.8 ± 0.7 g cm−3, or 2.6 times the solid density. Furthermore, DD-reacted thermal neutrons were utilized to estimate the core temperature between 600 and 750 eV. Thereafter, the core was directly heated by a laser for fast-ignition experiments (LFEX, an extremely energetic ultrashort pulse laser) at ILE with its axis lying along or perpendicular to the GXII bundle axis, respectively. The former and latter laser configurations were termed \u27axial\u27 and \u27transverse modes\u27, respectively. The η was estimated from three independent methods: (1) the core x-ray emission, (2) the thermal neutron yield, and (3) the runaway hot electron spectra. For the axial mode, 0.8%< η <2.1% at low power (low LFEX energy) and 0.4%< η <2.5% at high power (high LFEX energy). For the transverse mode, 2.6%< η <7% at low power and 1.5%< η <7.7% at high power. Their efficiencies were compared with that in the uniform implosion mode using 12 GXII beams, 6% < η <12%, which appeared near to the η for the transverse mode, except that the error bar is very large