Surgical management of aortic root disease in Marfan syndrome and other congenital disorders associated with aortic root aneurysms

Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR can be performed irrespective of aortic dimensions and a mechanical replacement valve is a secure and near certain means of correcting aortic valve regurgitation but has thromboembolic and bleeding risks. VSRR offers freedom from anticoagulation and attendant risks of bleeding but reoperation for aortic regurgitation runs at 1.3% per annum. A prospective multi-institutional study has found this to be an underestimate of the true rate of valve-related adverse events. PEARS conserves the aortic root anatomy and optimises the chance of maintaining valve function but average follow-up is under 5 years and so the long-term results are yet to be determined. Patients are on average in their 30s and so the cumulative lifetime need for reoperation, and of any valve-related complications, are consequently substantial. With lowering surgical risk of prophylactic root replacement, the threshold for intervention has reduced progressively over 30 years to 4.5 cm and so an increasing number of patients who are not destined to have a dissection are now having root replacement. In evaluation of these three forms of surgery, the number needed to treat to prevent dissection and the balance of net benefit and harm in future patients must be considered

Alumina fiber strength improvement

The effective fiber strength of alumina fibers in an aluminum composite was increased to 173,000 psi. A high temperature heat treatment, combined with a glassy carbon surface coating, was used to prevent degradation and improve fiber tensile strength. Attempts to achieve chemical strengthening of the alumina fiber by chromium oxide and boron oxide coatings proved unsuccessful. A major problem encountered on the program was the low and inconsistent strength of the Dupont Fiber FP used for the investigation

ATLS: Catheter and tube placement

The specific objectives of this experiment are: to evaluate the rack mounted equipment and medical supplies necessary for medical procedures; to evaluate the attachments, mounting points, and inner drawer assemblies for the medical supplies; and to evaluate the procedures for performing medical scenarios. The resources available in the HMF miniracks to accomplish medical scenarios and/or procedures include: medical equipment mounted in the racks; a patch panel with places to attach tubing and catheters; self contained drawers full of critical care medical supplies; and an ALS 'backpack' for deploying supplies. The attachment lines, tubing and associated medical supplies will be deployed and used with the equipment and a patient mannequin. Data collection is provided by direct observations by the inflight experimenters, and analysis of still and video photography

Spin-dependent transport in a quasiballistic quantum wire

We describe the transport properties of a 5 $\mu$m long one-dimensional (1D) quantum wire. Reduction of conductance plateaux due to the introduction of weakly disorder scattering are observed. In an in-plane magnetic field, we observe spin-splitting of the reduced conductance steps. Our experimental results provide evidence that deviation from conductance quantisation is very small for electrons with spin parallel and is about 1/3 for electrons with spin anti-parallel. Moreover, in a high in-plane magnetic field, a spin-polarised 1D channel shows a plateau-like structure close to $0.3 \times e^2/h$ which strengthens with {\em increasing} temperatures. It is suggested that these results arise from the combination of disorder and the electron-electron interactions in the 1D electron gas.Comment: 4 pages, 5 figures, latex to be published in Phys. Rev. B (15/3/2000

Activation mechanisms in sodium-doped Silicon MOSFETs

We have studied the temperature dependence of the conductivity of a silicon MOSFET containing sodium ions in the oxide above 20 K. We find the impurity band resulting from the presence of charges at the silicon-oxide interface is split into a lower and an upper band. We have observed activation of electrons from the upper band to the conduction band edge as well as from the lower to the upper band. A possible explanation implying the presence of Hubbard bands is given.Comment: published in J. Phys. : Condens. Matte