The Effects of Changing from Isoflurane to Desflurane on the Recovery Profile during the Latter Part of Anesthesia

It is not known whether changing from isoflurane to desflurane during the latter part of anesthesia shows early emergence and recovery in long surgery. We therefore evaluated the effects of changing isoflurane to desflurane on emergence and recovery. Eighty-two patients were randomly assigned to receive isoflurane (Group I) or desflurane (Group D) or to change from isoflurane to desflurane anesthesia (Group X). At the point when there was an hour until the operation would end, isoflurane was replaced with 1 MAC of desflurane in Group X, and isoflurane and desflurane were maintained at 1 MAC in Groups I and D. When the operation ended, we compared the emergence and recovery characteristics among the 3 groups. Compared with Group I, Group X showed faster emergence and recovery. Group X and Group D showed similar emergence and recovery. In conclusion, changing isoflurane to desflurane during the latter part of anesthesia improves emergence and recovery

Total intravenous anesthesia with propofol and remifentanil in a patient with MELAS syndrome -A case report-

A 23-year-old woman with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) underwent a laparoscopy-assisted appendectomy. MELAS syndrome is a multisystemic disease caused by mitochondrial dysfunction. General anesthesia has several potential hazards to patients with MELAS syndrome, such as malignant hyperthermia, hypothermia, and metabolic acidosis. In this case, anesthesia was performed with propofol, remifentanil TCI, and atracurium without any surgical or anesthetic complications. We discuss the anesthetic effects of MELAS syndrome

A Nationwide Survey of Lymphangioleiomyomatosis in Korea: Recent Increase in Newly Diagnosed Patients

In 2007, the Korean Interstitial Lung Disease Society had collected clinical data of patients who have diagnosed as Lymphangioleiomyomatosis (LAM) since 1990 through nationwide survey, which showed that LAM patients had increased sharply after 2004. The present study was performed to show the clinical features of Korean patients with LAM, and to establish the reason for the recent increase in the diagnosis. All 63 patients were women and the mean age at diagnosis was 36 yr. The most common presenting symptom was dyspnea and 8 patients had tuberous sclerosis complex. The survival rate at 5 yr after diagnosis was 84%. Compared with patients diagnosed after 2004 (n=34), the patients diagnosed before 2004 (n=29) complained with dyspnea more (P=0.016) and had lower FEV1% predicted (P=0.003), and DLco% predicted (P=0.042). The higher proportion of patients diagnosed after 2004 showed the normal chest radiography, and they were detected by routine chest CT screening (P=0.016). This study showed that clinical features of Korean patients with LAM were not different from those reported elsewhere. It is concluded that the reason for the increase of newly diagnosed patients is the result of increase in detection of the early stage LAM by the widespread use of chest CT screening

Spectroscopic Mass and Host-star Metallicity Measurements for Newly Discovered Microlensing Planet OGLE-2018-BLG-0740Lb

We report the discovery of the microlensing planet OGLE-2018-BLG-0740Lb. The planet is detected with a very strong signal of $\Delta\chi^2\sim 4630$, but the interpretation of the signal suffers from two types of degeneracies. One type is caused by the previously known close/wide degeneracy, and the other is caused by an ambiguity between two solutions, in which one solution requires to incorporate finite-source effects, while the other solution is consistent with a point-source interpretation. Although difficult to be firmly resolved based on only the photometric data, the degeneracy is resolved in strong favor of the point-source solution with the additional external information obtained from astrometric and spectroscopic observations. The small astrometric offset between the source and baseline object supports that the blend is the lens and this interpretation is further secured by the consistency of the spectroscopic distance estimate of the blend with the lensing parameters of the point-source solution. The estimated mass of the host is $1.0\pm 0.1~M_\odot$ and the mass of the planet is $4.5\pm 0.6~M_{\rm J}$ (close solution) or $4.8\pm 0.6~M_{\rm J}$ (wide solution) and the lens is located at a distance of $3.2\pm 0.5$~kpc. The bright nature of the lens, with $I\sim 17.1$ ($V\sim 18.2$), combined with its dominance of the observed flux suggest that radial-velocity (RV) follow-up observations of the lens can be done using high-resolution spectrometers mounted on large telescopes, e.g., VLT/ESPRESSO, and this can potentially not only measure the period and eccentricity of the planet but also probe for close-in planets. We estimate that the expected RV amplitude would be $\sim 60\sin i ~{\rm m~s}^{-1}$.Comment: 12 pages, 11 figures, 4 table

Candidate Brown-dwarf Microlensing Events with Very Short Timescales and Small Angular Einstein Radii

Short-timescale microlensing events are likely to be produced by substellar brown dwarfs (BDs), but it is difficult to securely identify BD lenses based on only event timescales t_E because short-timescale events can also be produced by stellar lenses with high relative lens-source proper motions. In this paper, we report three strong candidate BD-lens events found from the search for lensing events not only with short timescales (t_E ≲ 6 days) but also with very small angular Einstein radii (θ_E ≲ 0.05 mas) among the events that have been found in the 2016–2019 observing seasons. These events include MOA-2017-BLG-147, MOA-2017-BLG-241, and MOA-2019-BLG-256, in which the first two events are produced by single lenses and the last event is produced by a binary lens. From the Monte Carlo simulations of Galactic events conducted with the combined t_E and θ_E constraint, it is estimated that the lens masses of the individual events are 0.051^(+0.100)_(−0.027) M⊙, 0.044^(+0.090)_(−0.023) M⊙, and 0.046^(+0.067)_(−0.023) M⊙/0.038^(+0.056)_(−0.019) M⊙ and the probability of the lens mass smaller than the lower limit of stars is ~80% for all events. We point out that routine lens mass measurements of short-timescale lensing events require survey-mode space-based observations

OGLE-2018-BLG-0022: First Prediction of an Astrometric Microlensing Signal from a Photometric Microlensing Event

In this work, we present the analysis of the binary microlensing event OGLE-2018-BLG-0022 that is detected toward the Galactic bulge field. The dense and continuous coverage with the high-quality photometry data from ground-based observations combined with the space-based {\it Spitzer} observations of this long time-scale event enables us to uniquely determine the masses $M_1=0.40 \pm 0.05~M_\odot$ and $M_2=0.13\pm 0.01~M_\odot$ of the individual lens components. Because the lens-source relative parallax and the vector lens-source relative proper motion are unambiguously determined, we can likewise unambiguously predict the astrometric offset between the light centroid of the magnified images (as observed by the {\it Gaia} satellite) and the true position of the source. This prediction can be tested when the individual-epoch {\it Gaia} astrometric measurements are released.Comment: 10 pages, 10 figures, 4 table