Use Of A One-way Flutter Valve Drainage System In The Postoperative Period Following Lung Resection [utilização Da Válvula Unidirecional De Tórax Como Sistema De Drenagem No Pós-operatório De Ressecç ões Pulmonares]

Objective: To evaluate pleural drainage using a one-way flutter valve following elective lung resection. Methods: This was a prospective study, with descriptive analysis, of 39 lung resections performed using a one-way flutter valve to achieve pleural drainage during the postoperative period. Patients less than 12 years of age were excluded, as were those submitted to pneumonectomy or emergency surgery, those who were considered lost to follow-up and those in whom water-seal drainage was used as the initial method of pleural drainage. Lung expansion, duration of the drainage, hospital stay and postoperative complications were noted. Results: A total of 36 patients were included and analyzed in this study. The mean duration of pleural drainage was 3.0 ± 1.6 days. At 30 days after the surgical procedure, chest X-ray results were considered normal for 34 patients (95.2%). Postoperative complications occurred in 8 patients (22.4%) and were related to the drainage system in 3 (8.4%) of those. Conclusions: The use of a one-way flutter valve following elective lung resection was effective, was well tolerated and presented a low rate of complications.348559566Kenyon, J.H., Traumatic Hemothorax: Siphon drainage (1916) Ann Surg, 64, pp. 728-729Lilienthal, H., Resection of the lung for suppurative infections with a report based on 31 operative cases in which resection was done or intended (1922) Ann Surg, 75 (3), pp. 257-320Heimlich, H.J., Valve drainage of the pleural cavity (1968) Dis Chest, 53 (3), pp. 282-287Waller, D.A., Edwards, J.G., Rajesh, P.B., A physiological comparison of flutter valve drainage bags and underwater seal systems for postoperative air leaks (1999) Thorax, 54 (5), pp. 442-443Lima, A.G., Rocha, E.R., Santos, N.A., Seabra, J.C., Mussi, R.K., Santos, J.G., Avalia̧ão do uso da bra̧adeira ou "clamp" na drenagem pleural fechada subaquática. Estudo prospectivo aleatorizado. (2007) J Bras Pneumol, 33 (SUPL 1R), pp. R13Vuorisalo, S., Aarnio, P., Hannukainen, J., Comparison between flutter valve drainage bag and underwater seal device for pleural drainage after lung surgery (2005) Scand J Surg, 94 (1), pp. 56-58Graham, A.N., Cosgrove, A.P., Gibbons, J.R., McGuigan, J.A., Randomised clinical trial of chest drainage systems (1992) Thorax, 47 (6), pp. 461-462Bar-El, Y., Lieberman, Y., Yellin, A., Modified urinary collecting bags for prolonged underwater chest drainage (1992) Ann Thorac Surg, 54 (5), pp. 995-996Ortega, H.A.V., Lima, M.P., Denadai, J.O., Válvula unidirecional aplicada ao tratamento ambulatorial do pneumotórax. (1996) J Pneumol, 22 (4), pp. 177-180Figueiredo Pinto, J.A., Leite, A.G., Cavalet, D., Drenagem torácica: Princípios básicos (2001) Manual de cirurgia torácica, pp. 109-125. , Pinto Filho DR, Cardoso PF, Figueiredo Pinto JA, Scheineider A, editors, Rio de Janeiro: Revinter;Gŕgoire, J., Deslauries, J., Closed drainage and suction systems (2002) Thoracic Surgery, pp. 1281-1297. , Pearson FG, Deslauries J, Ginsberg RJ, Hiebert CA, Mckneally MF, Urschel HC, editors, New York: Churchill Livingstone;Marshall, M.B., Deeb, M.E., Bleier, J.I., Kucharczuk, J.C., Friedberg, J.S., Kaiser, L.R., Suction vs water seal after pulmonary resection: A randomized prospective study (2002) Chest, 121 (3), pp. 831-835McKenna Jr, R.J., Fischel, R.J., Brenner, M., Gelb, A.F., Use of the Heimlich valve to shorten hospital stay after lung reduction surgery for emphysema (1996) Ann Thorac Surg, 61 (4), pp. 1115-1117Okamoto, J., Okamoto, T., Fukuyama, Y., Ushijima, C., Yamaguchi, M., Ichinose, Y., The use of a water seal to manage air leaks after a pulmonary lobectomy: A retrospective study (2006) Ann Thorac Cardiovasc Surg, 12 (4), pp. 242-244Cerfolio, R.J., Bass, C., Katholi, C.R., Prospective randomized trial compares suction versus water seal for air leaks (2001) Ann Thorac Surg, 71 (5), pp. 1613-1617Antanavicius, G., Lamb, J., Papasavas, P., Caushaj, P., Initial chest tube management after pulmonary resection (2005) Am Surg, 71 (5), pp. 416-419Lima, A.G., Contrera Toro, I.F., Tincani, A.J., Barreto, G., A drenagem pleural pré-hospitalar: Apresentação de mecanismo de válvula unidirecional. (2006) Rev Col Bras Cir, 33 (2), pp. 101-106Ponn, R.B., Silverman, H.J., Federico, J.A., Outpatient chest tube management (1997) Ann Thorac Surg, 64 (5), pp. 1437-1440Campisi, P., Voitk, A.J., Outpatient treatment of spontaneous pneumothorax in a community hospital using a Heimlich flutter valve: A case series (1997) J Emerg Med, 15 (1), pp. 115-119Williams, J.G., Riley, T.R., Moody, R.A., Resuscitation experience in the Falkland Islands campaign (1983) Br Med J (Clin Res Ed), 286 (6367), pp. 775-777Schweitzer, E.J., Hauer, J.M., Swan, K.G., Bresch, J.R., Harmon, J.W., Graeber, G.M., Use of the Heimlich valve in a compact autotransfusion device (1987) J Trauma, 27 (5), pp. 537-542Beyruti, R., Villiger, L.E., Campos, J.R., Silva, R.A., Fernandez, A., Jatene, F.B., A válvula de Heimlich no tratamento do pneumotórax. (2002) J Pneumol, 28 (3), pp. 115-119Mainini, S.E., Johnson, F.E., Tension pneumothorax complicating small-caliber chest tube insertion (1990) Chest, 97 (3), pp. 759-760Lodi, R., Stefani, A., A new portable chest drainage device (2000) Ann Thorac Surg, 69 (4), pp. 998-1001Sanches, P.G., Vendrame, G.S., Madke, G.R., Pilla, E.S., Camargo, J.J., Andrade, C.F., (2006) Lobectomy for treating bronchial carcinoma: Analysis of comorbidities and their impact on postoperative morbidity and mortality J Bras Pneumol, 32 (6), pp. 495-504Lang-Lazdunski, L., Chapuis, O., Bonnet, P.M., Pons, F., Jancovici, R., Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: Long-term results (2003) Ann Thorac Surg, 75 (3), pp. 960-965Russo, L., Wiechmann, R.J., Magovern, J.A., Szydlowski, G.W., Mack, M.J., Naunheim, K.S., Early chest tube removal after video-assisted thoracoscopic wedge resection of the lung (1998) Ann Thorac Surg, 66 (5), pp. 1751-1754Watanabe, A., Watanabe, T., Ohsawa, H., Mawatari, T., Ichimiya, Y., Takahashi, N., Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung (2004) Eur J Cardiothorac Surg, 25 (5), pp. 872-876Molins, L., Fibla, J.J., Ṕrez, J., Sierra, A., Vidal, G., Siḿn, C., Outpatient thoracic surgical programme in 300 patients: Clinical results and economic impact (2006) Eur J Cardiothorac Surg, 29 (3), pp. 271-275Tang, A.T., Velissaris, T.J., Weeden, D.F., An evidence-based approach to drainage of the pleural cavity: Evaluation of best practice (2002) J Eval Clin Pract, 8 (3), pp. 333-34

Classical and quantum decay of one dimensional finite wells with oscillating walls

To study the time decay laws (tdl) of quasibounded hamiltonian systems we have considered two finite potential wells with oscillating walls filled by non interacting particles. We show that the tdl can be qualitatively different for different movement of the oscillating wall at classical level according to the characteristic of trapped periodic orbits. However, the quantum dynamics do not show such differences.Comment: RevTeX, 15 pages, 14 PostScript figures, submitted to Phys. Rev.

Establishing the relationship between cortical atrophy and semantic deficits in Alzheimer's disease and Mild Cognitive Impairment patients through Voxel-Based Morphometry

The aim of this study was to determine the brain areas responsible for the semantic impairment observed in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) patients. Thirteen AD, 14 MCI patients, and 13 matched healthy older adults were assessed with a test battery aimed to study their semantic competence. Different subtasks were designed to study their semantic knowledge related to objects and faces in the context of semantic retrieval- and semantic association-dependent tasks. Aggregate scores obtained in the different tests were entered into voxel-based regression analyses with grey matter volume values obtained from three-dimensional brain MRI scans. Areas of significant correlation between volume loss and poor semantic scores were restricted to the temporal lobe in the AD group, while in the MCI and control groups significant associations were found with lower grey matter volume values in a widely distributed network of bilateral fronto-temporo-parietal regions. Our results suggest that degradation of partially overlapping and widely distributed neural networks, mainly including temporal regions, subserve semantic deficits related to objects and faces in AD and MCI patients

Conserved charges and supersymmetry in principal chiral and WZW models

Conserved and commuting charges are investigated in both bosonic and supersymmetric classical chiral models, with and without Wess-Zumino terms. In the bosonic theories, there are conserved currents based on symmetric invariant tensors of the underlying algebra, and the construction of infinitely many commuting charges, with spins equal to the exponents of the algebra modulo its Coxeter number, can be carried out irrespective of the coefficient of the Wess-Zumino term. In the supersymmetric models, a different pattern of conserved quantities emerges, based on antisymmetric invariant tensors. The current algebra is much more complicated than in the bosonic case, and it is analysed in some detail. Two families of commuting charges can be constructed, each with finitely many members whose spins are exactly the exponents of the algebra (with no repetition modulo the Coxeter number). The conserved quantities in the bosonic and supersymmetric theories are only indirectly related, except for the special case of the WZW model and its supersymmetric extension.Comment: LaTeX; 49 pages; v2: minor changes and additions to text and ref

Incorporating Precipitation-Induced Variation in Annual Forage Production Into Economic Analyses of Range Improvement Practices.

20 p

Slow relaxation in weakly open vertex-splitting rational polygons

The problem of splitting effects by vertex angles is discussed for nonintegrable rational polygonal billiards. A statistical analysis of the decay dynamics in weakly open polygons is given through the orbit survival probability. Two distinct channels for the late-time relaxation of type 1/t^delta are established. The primary channel, associated with the universal relaxation of ''regular'' orbits, with delta = 1, is common for both the closed and open, chaotic and nonchaotic billiards. The secondary relaxation channel, with delta > 1, is originated from ''irregular'' orbits and is due to the rationality of vertices.Comment: Key words: Dynamics of systems of particles, control of chaos, channels of relaxation. 21 pages, 4 figure

Dynamics near the critical point: the hot renormalization group in quantum field theory

The perturbative approach to the description of long wavelength excitations at high temperature breaks down near the critical point of a second order phase transition. We study the \emph{dynamics} of these excitations in a relativistic scalar field theory at and near the critical point via a renormalization group approach at high temperature and an $\epsilon$ expansion in $d=5-\epsilon$ space-time dimensions. The long wavelength physics is determined by a non-trivial fixed point of the renormalization group. At the critical point we find that the dispersion relation and width of quasiparticles of momentum $p$ is $\omega_p \sim p^{z}$ and $\Gamma_p \sim (z-1) \omega_p$ respectively, the group velocity of quasiparticles $v_g \sim p^{z-1}$ vanishes in the long wavelength limit at the critical point. Away from the critical point for $T\gtrsim T_c$ we find $\omega_p \sim \xi^{-z}[1+(p \xi)^{2z}]^{{1/2}}$ and $\Gamma_p \sim (z-1) \omega_p \frac{(p \xi)^{2z}}{1+(p \xi)^{2z}}$ with $\xi$ the finite temperature correlation length $\xi \propto |T-T_c|^{-\nu}$. The new \emph{dynamical} exponent $z$ results from anisotropic renormalization in the spatial and time directions. For a theory with O(N) symmetry we find $z=1+ \epsilon \frac{N+2}{(N+8)^2}+\mathcal{O}(\epsilon^2)$. Critical slowing down, i.e, a vanishing width in the long-wavelength limit, and the validity of the quasiparticle picture emerge naturally from this analysis.Comment: Discussion on new dynamical universality class. To appear in Phys. Rev.

Relaxation and Metastability in the RandomWalkSAT search procedure

An analysis of the average properties of a local search resolution procedure for the satisfaction of random Boolean constraints is presented. Depending on the ratio alpha of constraints per variable, resolution takes a time T_res growing linearly (T_res \sim tau(alpha) N, alpha < alpha_d) or exponentially (T_res \sim exp(N zeta(alpha)), alpha > alpha_d) with the size N of the instance. The relaxation time tau(alpha) in the linear phase is calculated through a systematic expansion scheme based on a quantum formulation of the evolution operator. For alpha > alpha_d, the system is trapped in some metastable state, and resolution occurs from escape from this state through crossing of a large barrier. An annealed calculation of the height zeta(alpha) of this barrier is proposed. The polynomial/exponentiel cross-over alpha_d is not related to the onset of clustering among solutions.Comment: 23 pages, 11 figures. A mistake in sec. IV.B has been correcte

Exact diagonalization of the generalized supersymmetric t-J model with boundaries

We study the generalized supersymmetric $t-J$ model with boundaries in three different gradings: FFB, BFF and FBF. Starting from the trigonometric R-matrix, and in the framework of the graded quantum inverse scattering method (QISM), we solve the eigenvalue problems for the supersymmetric $t-J$ model. A detailed calculations are presented to obtain the eigenvalues and Bethe ansatz equations of the supersymmetric $t-J$ model with boundaries in three different backgrounds.Comment: Latex file, 32 page

Semiclassical relativistic strings in S^5 and long coherent operators in N=4 SYM theory

We consider the low energy effective action corresponding to the 1-loop, planar, dilatation operator in the scalar sector of N=4 SU(N) SYM theory. For a general class of non-holomorphic ``long'' operators, of bare dimension L>>1, it is a sigma model action with 8-dimensional target space and agrees with a limit of the phase-space string sigma model action describing generic fast-moving strings in the S^5 part of AdS_5 x S^5. The limit of the string action is taken in a way that allows for a systematic expansion to higher orders in the effective coupling $\lambda/L^2$. This extends previous work on rigid rotating strings in S^5 (dual to operators in the SU(3) sector of the dilatation operator) to the case when string oscillations or pulsations in S^5 are allowed. We establish a map between the profile of the leading order string solution and the structure of the corresponding coherent, ``locally BPS'', SYM scalar operator. As an application, we explicitly determine the form of the non-holomorphic operators dual to the pulsating strings. Using action--angle variables, we also directly compute the energy of pulsating solutions, simplifying previous treatments.Comment: LaTeX, 50 pages, 1 figure. v2: References added, minor corrections. 54 pages. v3: Few changes. One paragraph added at the end of section 3. 55 page