Safety and efficacy of retrograde cerebral perfusion as an adjunct for cerebral protection during surgery on the aortic arch

ObjectiveThe best adjunct for cerebral protection during aortic arch reconstruction remains controversial. Retrograde cerebral perfusion (RCP) as an adjunct to profound hypothermic circulatory arrest (PHCA) extends the tolerable period of brain ischemia by flushing emboli and air from the cerebral circulation while maintaining hypothermia. We examined our experience with RCP to determine its efficacy in patients undergoing complex arch reconstruction.MethodsWe retrospectively evaluated 879 patients undergoing arch reconstruction using RCP from July 1997 to March 2013. Perioperative risk factors were analyzed as predictors of neurologic injury and mortality. Survival for the type of arch reconstruction and for the interval of PHCA was calculated.ResultsOf the 879 patients, 671 underwent hemiarch and 208 total arch replacement. The mean age was 65 ± 13.3 years, and 61.6% were men. The total arch patients had longer mean periods of PHCA (39 vs 21 minutes, P < .001) and RCP (37 vs 19 minutes, P < .001). However, the incidence of transient neurologic dysfunction (3.0% vs 2.4%, P < .813) and permanent neurologic dysfunction (1.3% vs 1.9%, P < .519) was similar for both techniques. Mortality was greater in the hemiarch group (4.8% vs 0.5%, P < .003). Patients requiring >40 minutes of PHCA had outcomes similar to those requiring less. The 1-, 5-, and 10-year survival was similar, regardless of the procedure performed or interval of PHCA.ConclusionsRCP is a safe and effective adjunct for cerebral protection during arch surgery. Patients requiring more extensive arch reconstruction are not at greater risk of permanent neurologic dysfunction or perioperative mortality

An Analysis of English - Indonesian Translation Method Used by Ingrid Dwijani Nimpoeno in Translating Green’s The Fault in Our Stars. Ane Anggraeni 147010040

This research paper entitled “An Analysis of English - Indonesian Translation Me thod Used by Ingrid Dwijani Nimpoeno in Translating Green’s The Fault in Our Stars ” . The objectives of the research are to find out what the translation method mostly used in translating complex sentences and to analyze how the translation result of the most translation method used in translating complex sentences by Ingrid Dwijani Nimpo eno. The writer uses qualitative research method and applied descriptive analysis. The main sources are 63 data or text of complex sentences on the novel entitled The Fault in Our Stars. The result of data analysis showed that the translation mostly used w ere first is communicative translation 31 of 63 data (49,2%), the second is faithful translation 19 of 63 data (30,16%), the third is literal translation 9 of 63 data (14,23%), the fourth is semantic translation 3 of 63 data (4,77%), and the last is word b y word translation 1 of 63 data (1,6%). The conclusion is Ingrid Dwijani Nimpoeno produced the good translation in translating complex sentences, because her translation results are easy to understand, and the messages well delivered. In addition, altho ugh the method mostly used is communicative translation but she still maintained to the source language emphasis . In other side, her translation result is relevant with the classifications of good translation that purposed by some expert. However, the writ er attempted to correct several data which irrelevant, based on the theory. Keywords: Translation Method, Complex Sentenc

γδ T Cells Provide an Early Source of Interferon γ in Tumor Immunity

Interferon (IFN)-γ is necessary for tumor immunity, however, its initial cellular source is unknown. Because γδ T cells primarily produce this cytokine upon activation, we hypothesized that they would provide an important early source of IFN-γ in tumor immunosurveillance. To address this hypothesis, we first demonstrated that γδ T cell–deficient mice had a significantly higher incidence of tumor development after challenge with a chemical carcinogen methylcholanthrene (MCA) or inoculation with the melanoma cell line B16. In wild-type mice, γδ T cells were recruited to the site of tumor as early as day 3 after inoculation, followed by αβ T cells at day 5. We then used bone marrow chimeras and fetal liver reconstitutions to create mice with an intact γδ T cell repertoire but one that was specifically deficient in the capacity to produce IFN-γ. Such mice had a higher incidence of tumor development, induced either with MCA or by inoculation of B16 melanoma cells, compared with mice with IFN-γ–competent γδ T cells. Moreover, genetic deficiency of γδ T cells resulted in impaired IFN-γ production by tumor antigen-triggered αβ T cell upon immunization with tumor lysate. These results demonstrate that γδ T cells can play a necessary role in tumor immunity through provision of an early source of IFN-γ that in turn may regulate the function of tumor-triggered αβ T cells

Characteristics of cardiothoracic surgeons practicing at the top-ranked US institutions

BACKGROUND: We aimed to determine which factors distinguish cardiothoracic (CT) surgeons practicing at the top-ranked US institutions from their peers. METHODS: Using online resources, we collected demographics, training information and academic metrics of 694 cardiac (n=489; 70%) and thoracic (n=205; 30%) surgeons practicing at 57 preeminent US institutions, including those with the highest US News & World Report ranking ("top CT centers"). RESULTS: Two hundred and ninety-nine (43.1%) CT surgeons were practicing at the 18 "top CT centers" and had higher academic productivity (publications, citations) than their peers. While there was no difference in the proportion of international medical graduates (IMGs) (21.4% overall) or of surgeons with a PhD degree (9.4% overall) across institutions, the "top CT centers" had a higher proportion of faculty who received their entire CT training abroad (10.4% vs. 5.8%; P=0.038) or at highly-ranked US institutions. Those who published more during their early career years (residency, fellowship and first 5 years as faculty) were more likely to attain academic (professorship) and institutional leadership (division/department chair) positions and to practice at the "top CT centers". Women represented a minority (7.3% overall; 5.1% of cardiac vs. 12.7% of thoracic surgeons, P<0.001), but with growing prevalence among younger faculty and without differences across institutions. CONCLUSIONS: CT surgeons of the best US centers have a more international background and received their training at highly-ranked institutions. Early academic productivity is associated with life-long career achievements, with special importance of the first 5 years as faculty. Women represent a growing proportion of the CT surgical workforce

Explaining the Praesepe blue straggler HD 73666

The blue straggler phenomenon is not yet well explained by current theory; however, evolutionary models of star clusters call for a good knowledge of it. Here we try to understand the possible formation scenario of HD 73666, a blue straggler member of the Praesepe cluster. We compile the known physical properties of HD 73666 found in the literature, focusing in particular on possible binarity and the abundance pattern. HD 73666 appears to be slowly rotating, has no detectable magnetic field, and has normal abundances, thereby excluding close binary evolution and mass transfer processes. There is no evidence of a hot radiation source. With the use of theoretical results on blue straggler formation present in literature, we are able to conclude that HD 73666 was probably formed by physical collision involving at least one binary system, between 5 and 350 Myr (50 Myr if the star is an intrinsic slow rotator) ago.Comment: Accepted for publication on Astronomy and Astrophysic

Biological solutions to aortic root replacement: valve-sparing versus bioprosthetic conduit‡

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Pre-main-sequence stars in the young open cluster NGC 1893: II. Evidence for triggered massive star formation

(Abridged) The open cluster NGC 1893, illuminating the HII region IC410, contains a moderately large population of O-type stars and is one of the youngest clusters observable in the optical range. We have probed the stellar population of NGC 1893 in an attempt to determine its size and extent. We classify a large sample of cluster members with new intermediate resolution spectroscopy. We use H-alpha slitless spectroscopy of the field to search for emission line objects, identifying 18 emission-line PMS stars. We then combine existing optical photometry with 2MASS JHKs photometry to detect stars with infrared excesses, finding close to 20 more PMS candidates. While almost all stars earlier than B2 indicate standard reddening, all later cluster members show strong deviations from a standard reddening law, which we interpret in terms of infrared excess emission. Emission-line stars and IR-excess objects show the same spatial distribution, concentrating around two localised areas, the immediate vicinity of the pennant nebulae Sim 129 and Sim 130 and the area close to the cluster core where the rim of the molecular cloud associated with IC 410 is illuminated by the nearby O-type stars. In and around the emission nebula Sim 130 we find three Herbig Be stars with spectral types in the B1-4 range and several other fainter emission-line stars. We obtain a complete census of B-type stars by combining Stroemgren, Johnson and 2MASS photometry and find a deficit of intermediate mass stars compared to massive stars. We observe a relatively extended halo of massive stars surrounding the cluster without an accompanying population of intermediate-mass stars. The overall picture of star formation in NGC 1893 suggests a very complex process.Comment: Acepted for publication in Astronomy & Astrophysics, 11 figures, uses new aa macro. For a version with full resolution figures (Fig. 7 and 8 in colour) use http://www.dfists.ua.es/~ignacio/download/aa6654.pd

The first year of SN 2004dj in NGC 2403

New BVRI photometry and optical spectroscopy of the Type IIp supernova 2004dj in NGC 2403, obtained during the first year since discovery, are presented. The progenitor cluster, Sandage 96, is also detected on pre-explosion frames. The light curve indicates that the explosion occured about 30 days before discovery, and the plateau phase lasted about +110 \pm 20 days after that. The plateau-phase spectra have been modelled with the SYNOW spectral synthesis code using H, NaI, TiII, ScII, FeII and BaII lines. The SN distance is inferred from the Expanding Photosphere Method and the Standard Candle Method applicable for SNe IIp. They resulted in distances that are consistent with each other as well as earlier Cepheid- and Tully-Fisher distances. The average distance, D = 3.47 \pm 0.29 Mpc is proposed for SN 2004dj and NGC 2403. The nickel mass produced by the explosion is estimated as 0.02 \pm 0.01 M_o. The SED of the progenitor cluster is reanalysed by fitting population synthesis models to our observed BVRI data supplemented by U and JKH magnitudes from the literature. The chi^2-minimization revealed a possible "young" solution with cluster age T_{cl} = 8 Myr, and an "old" solution with T_{cl} = 20 - 30 Myr. The "young" solution would imply a progenitor mass M > 20 M_o, which is higher than the previously detected progenitor masses for Type II SNe.Comment: 19 pages, accepted in MNRA