Stable and wavelength-tunable silicon-micro-ring-resonator based erbium-doped fiber laser

In this work, we propose and demonstrate a stable and wavelength-tunable erbium-doped fiber (EDF) ring laser. Here, a silicon-on-insulator (SOI)-based silicon-micro-ring-resonator (SMRR) is used as the wavelength selective element inside the fiber ring cavity. A uniform period grating coupler (GC) is used to couple between the SMRR and single mode fiber (SMF) and serves also as a polarization dependent element in the cavity. The output lasing wavelength of the proposed fiber laser can be tuned at a tuning step of 2 nm (defined by the free spectral range (FSR) of the SMRR) in a bandwidth of 35.2 nm (1532.00 to 1567.20 nm), which is defined by the gain of the EDF. The optical-signal-to-noise-ratio (OSNR) of each lasing wavelength is larger than 42.0 dB. In addition, the output stabilities of power and wavelength are also discussed.

Some like it hot, some like it warm: phenotyping to explore thermotolerance diversity

Plants have evolved overlapping but distinct cellular responses to different aspects of high temperature stress. These responses include basal thermotolerance, short- and long-term acquired thermotolerance, and thermotolerance to moderately high temperatures. This 'thermotolerance diversity' means that multiple phenotypic assays are essential for fully describing the functions of genes involved in heat stress responses. A large number of genes with potential roles in heat stress responses have been identified using genetic screens and genome wide expression studies. We examine the range of phenotypic assays that have been used to characterize thermotolerance phenotypes in both Arabidopsis and crop plants. Three major variables differentiate thermotolerance assays: (1) the heat stress regime used, (2) the developmental stage of the plants being studied, and (3) the actual phenotype which is scored. Consideration of these variables will be essential for deepening our understanding of the molecular genetics of plant thermotolerance.

Timing of gangrene tissue debridement after autologous bone marrow cell implantation in patients with superficial femoral arterial occlusion: preliminary experiences

AIM

Although implantation of bone marrow mononuclear cells (BMI) was shown to improve outcomes in patients with severe peripheral arterial occlusive disease (PAOD), little experience has been reported in patients with an arterial occlusion level above the knee, ischemic gangrene, and high cardiovascular risk. This study sought to investigate the timing of gangrene tissue debridement and the safety of BMI in these patients.

METHODS

Six "no-option" PAOD patients were enrolled with an arterial occlusion level above the knee, ischemic gangrene, and 3 systemic diseases related to a high cardiovascular risk. The ischemic status was evaluated by measuring the ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), and wound healing after BMI.

RESULTS

All patients safely underwent the procedures with intravenous general anesthesia by titrating propofol. Major lower extremity amputation, minor debridement amputation, and debridement surgery were performed in 2 (33.3%), 1 (16.7%), and 2 (33.3%) patients, respectively, 3.1 2.8 months after BMI. Compared to the amputation group (N=3), the salvage group (N=3) had a significantly higher baseline ABI (P=0.02) and a shorter distance between the gangrene site and arterial occlusion site (P=0.01). In the 3 patients who underwent debridement, ABI and TcPO2 significantly improved 1 month after BMI, and gangrenous tissues were debrided 3.8 ± 3.6 (range, 1~8) months after BMI with complete healing within 1 month.

CONCLUSION

Autologous BMI therapy is safe in patients at high cardiovascular risk with an arterial occlusion level above the knee and ischemic gangrene. Effective predictors of BMI include the baseline ABI and distance to the ischemia. Gangrene tissue should be debrided at least 1 month after BMI.

Prostaglandin I2 analogs suppress tumor necrosis factor α production and the maturation of human monocyte-derived dendritic cells

BACKGROUND

Dendritic cells (DCs) are professional antigen-presenting cells and have critical roles in regulating immune responses. Prostaglandin I2 (PGI2) analogs are considered to be potential treatments for asthma. However, the effect of PGI2 analogs on human monocyte-derived DCs (MDDCs) is still not clearly understood.

METHODS

Human MDDCs were pretreated with iloprost and treprostinil (2 PGI2 analogs) or forskolin (an adenyl cyclase activator) before lipopolysaccharide (LPS) stimulation. In some cases, I prostanoid (IP) receptor and E prostanoid receptor antagonists were added before the PGI2 analog treatment. tumor necrosis factor α (TNF-α) was measured by enzyme-linked immunosorbent assay. The expression of costimulatory molecules was assessed by flow cytometry. T-cell polarization function was investigated by measuring interferon γ, interleukin 13 (IL-13), and IL-17A production by T cells cocultured with iloprost-treated MDDCs.

RESULTS

Iloprost and treprostinil suppressed LPS-induced TNF-α expression in MDDCs. This effect could be reversed by an IP receptor antagonist, CAY10449, but not by E prostanoid receptor antagonists. Forskolin conferred a similar effect. Iloprost suppressed the LPS-induced expression of costimulatory molecules, including CD80, CD86, CD40, and HLA-DR. Iloprost-treated MDDCs increased IL-17A production by T cells.

CONCLUSIONS

Prostaglandin I2 analogs may exert anti-inflammatory effects by suppressing TNF-α expression via the IP receptor-cyclic adenosine monophosphate pathways and by inhibiting the expression of costimulatory molecules in human MDDCs.

Removal of C.I. Reactive Red 2 from aqueous solutions by chitin: an insight into kinetics, equilibrium, and thermodynamics

In this study, C.I. Reactive Red 2 (RR2) was removed from aqueous solutions by chitin. Exactly how the RR2 concentration, chitin dosage, pH, and temperature affected adsorption of RR2 by chitin was then determined. After reaction for 120 min, the amount of 10 and 20 mg/L RR2 absorbed onto chitin was 5.7 and 7.5 mg/g, respectively. The adsorption percentage increased from 56 to 94% when the chitin dosage was increased from 1.5 to 2.5 g/L. Experimental results indicated that the pseudo-second-order model best represents adsorption kinetics. Adsorption of RR2 increased as the temperature increased; however, it decreased with an increased pH. Experimental results further demonstrated that the Freundlich model is superior to the Langmuir model in fitting experimental isotherms. The ΔH° and ΔS° were 16.34 kJ/mol and 152.10 J/mol K, respectively. ΔH° suggested that adsorption of RR2 onto chitin was via physisorption.

Using adaptive four-band OFDM modulation with 40 Gb/s downstream and 10 Gb/s upstream signals for next generation long-reach PON

In this demonstration, we propose and demonstrate an adaptive long-reach passive optical network (LR-PON) using four-band orthogonal frequency division multiplexed (OFDM) channels. The downstream traffic rates from 6.25 to 40 Gb/s (using fixed quadrature amplitude modulation (QAM) level in the four OFDM bands) and from 9.37 to 40.3 Gb/s (using variable QAM levels in the four OFDM bands) can be achieved adaptively in the optical network units (ONUs) depending on different fiber transmission lengths from 0 to 100 km. For the upstream transmission, a 10 Gb/s 16-QAM OFDM signal with pre-emphasis is experimentally performed by using a 2.5 GHz directly modulated laser (DML). Based on the simulation and experimental results, the proposed adaptive four-band OFDM system could be a promising candidate for the future LR-PON.

Imaging findings in mandibular primitive neuroectodermal tumour: a report of a rare case and review of the literature

Primitive neuroectodermal tumours (PNETs) are aggressive undifferentiated tumours that occur mainly in the central nervous system (CNS). Reviewing the literature, only six cases of primary PNET of the mandible have been reported. These rare tumours are usually overlooked in clinical practice. An 18-year-old woman who presented with dental caries and left cheek swelling was initially diagnosed with facial cellulitis, but the swelling persisted despite adequate intravenous antibiotic therapy. Subsequent ultrasound and MR examinations revealed a tumour originating from the left mandibular ramus. The ultrasonography-guided percutaneous core needle biopsy confirmed the diagnosis of peripheral PNET. The radiographic features of mandibular PNETs are similar to those of PNETs in other regions, except for haemorrhage, necrosis and calcification. In addition, this is the first reported case with sonographic and MR images of this rare tumour, and the first case that was diagnosed based on the ultrasonography-guided percutaneous core needle biopsy. Using these image characteristics, mandibular PNETs can be diagnosed more accurately.

Long-reach radio-over-fiber signal distribution using single-sideband signal generated by a silicon-modulator

The integration of passive optical network (PON) and radio-over-fiber (ROF) networks could provide broadband services for both fixed and mobile users in a single and low-cost platform. Combining the long-reach (LR)-PON (>100 km) and the LR-ROF can further reduce the cost by simplifying the network architecture, sharing the same optical components and extending the coverage of ROF network. However, the transmission and distribution of ROF signal in LR network is very challenging due to the chromatic dispersion generated periodic power fading and code time-shifting effects in the optical fiber. In this work, we propose and experimentally demonstrate a LR-ROF signal distribution using single-sideband (SSB)-ROF signal generated by a silicon ring-modulator. The silicon modulator is compact and has low power consumption. Besides, one unique feature of the silicon ring-modulator is that it only modulates the signal wavelength at the resonant null. This makes it very suitable for the generation of the SSB-ROF signal. Numerical comparison of the SSB-ROF with the double-sideband (DSB)-ROF and optical carrier suppress (OCS)-ROF signals; as well as the fabrication of the silicon ring-modulator will be discussed.

Involvement of the Arabidopsis HIT1/AtVPS53 tethering protein homologue in the acclimation of the plasma membrane to heat stress

Arabidopsis thaliana hit1-1 is a heat-intolerant mutant. The HIT1 gene encodes a protein that is homologous to yeast Vps53p, which is a subunit of the Golgi-associated retrograde protein (GARP) complex that is involved in retrograde membrane trafficking to the Golgi. To investigate the correlation between the cellular role of HIT1 and its protective function in heat tolerance in plants, it was verified that HIT1 was co-localized with AtVPS52 and AtVPS54, the other putative subunits of GARP, in the Golgi and post-Golgi compartments in Arabidopsis protoplasts. A bimolecular fluorescence complementation assay showed that HIT1 interacted with AtVPS52 and AtVPS54, which indicated their assembly into a protein complex in vivo. Under heat stress conditions, the plasma membrane of hit1-1 was less stable than that of the wild type, as determined by an electrolyte leakage assay, and enhanced leakage occurred before peroxidation injury to the membrane. In addition, the ability of hit1-1 to survive heat stress was not influenced by exposure to light, which suggested that the heat intolerance of hit-1 was a direct outcome of reduced membrane thermostability rather than heat-induced oxidative stress. Furthermore, hit1-1 was sensitive to the duration (sustained high temperature stress at 37 °C for 3 d) but not the intensity (heat shock at 44 °C for 30 min) of exposure to heat. Collectively, these results imply that HIT1 functions in the membrane trafficking that is involved in the thermal adaptation of the plasma membrane for tolerance to long-term heat stress in plants.

Analysis of the carrier-suppressed single-sideband modulators used to mitigate Rayleigh backscattering in carrier-distributed PON

By using the carrier-suppressed single-sideband (CS-SSB) modulation, the Rayleigh backscattering (RB) experienced by the uplink signal can be effectively mitigated due to the reduction of the spectral overlap between the uplink signal and the distributed optical carrier. In this work, we first introduce the theoretical analysis of the CS-SSB generation using the dual-drive MZM (DD-MZM)-based and a dual-parallel MZM (DP-MZM)-based optical networking units (ONUs). Due to the different modulation mechanisms of the two CS-SSB modulations, the frequency components of the generated CS-SSB signals are also different. The transmission performance and the dispersion tolerance of the uplink signals generated by the two CS-SSB modulators are also analyzed and discussed.

Heterogeneous radio-over-fiber passive access network architecture to mitigate Rayleigh backscattering interferometric beat noise

We propose and experimentally demonstrate a hybrid radio-over-fiber (ROF) wavelength division multiplexed and time division multiplexed passive optical network (WDM-TDM PON) architecture to mitigate Rayleigh backscattering (RB) interferometric beat noises. Here, only a single wavelength is needed at the central office (CO) to generate the downstream baseband data for optical wired application and optical millimeter-wave (mm-wave) signal for wireless application. The upstream signal is produced by remodulating the downstream signal. No optical filter is required at the optical network unit/remote antenna unit (ONU/RAU) to separate the optical wired and optical mm-wave signals. In the proposed network, 10 Gb/s differential phase shift keying (DPSK) signal is used for the downstream optical wired application and 2.5 Gb/s on-off keying (OOK) signal on 20 GHz carrier is used for the optical mm-wave signal. In each ONU, a reflective optical semiconductor amplifier (RSOA) is used to remodulate and produce a 2.5 Gb/s OOK format for upstream traffic. As the back-refection produced by the downstream DPSK signal and the upstream OOK signal is traveling in different fiber path, RB noise at the CO can be completely mitigated.

Mitigation of Rayleigh backscattering in 10-Gb/s downstream and 2.5-Gb/s upstream DWDM 100-km long-reach PONs

Long-reach passive optical network (LR-PON) is considered as a promising technology towards higher capacity and extended coverage optical system. We propose and demonstrate a LR-PON with the capability of Rayleigh backscattering (RB) noise mitigation. By using the upstream signal wavelength-transition generated by a dual-parallel Mach-Zehnder modulator (DP-MZM) based colorless optical networking unit (ONU), the spectral overlap among the upstream signal and the RB noises can be minimized. Hence, due to the achievement of effective RB mitigation, a 100 km LR-PON with a high split-ratio of 512 is demonstrated using 10 Gb/s non-return-to-zero (NRZ) downstream and 2.5 Gb/s NRZ upstream signals. Detail analysis of the wavelength-transition generation is presented.

40-Gb/s downstream DPSK and 40-Gb/s upstream OOK signal remodulation PON using reduced modulation index

As different high speed signal-remodulation wavelength division multiplexed--passive optical network (WDM-PON) solutions up to 10 Gb/s have been proposed, researchers are going to further increase the data rate of PON towards 40 Gb/s or higher. However, scaling up from 10 Gb/s/wavelength to 40 Gb/s/wavelength PON is very challenging. Although many studies have been performed on upgrading the exiting 10 Gb/s network to 40 Gb/s, the study of the 40 Gb/s signal-remodulation network is very little. In this work, we will first study the chromatic dispersion effect on the signal-remodulation PON. Then, we will propose and demonstrate a signal-remodulation PON using 40-Gb/s downstream differential-phase shift keying (DPSK) and 40-Gb/s upstream on-off keying (OOK) signals. By using the reduced modulation index (RMI) of the downstream DPSK signal, the tolerance to the residual chromatic dispersion of the whole system can be greatly enhanced. Due to the reduced impact of the accumulated chromatic dispersion, the quality of the upstream remodulated OOK signal can be significantly improved. Besides, by detecting the downstream demodulated DPSK signal at the destructive output port of the demodulator, good quality of the demodulated DPSK signal can still be achieved.

A 9 bp cis-element in the promoters of class I small heat shock protein genes on chromosome 3 in rice mediates L-azetidine-2-carboxylic acid and heat shock responses

In rice, the class I small heat shock protein (sHSP-CI) genes were found to be selectively induced by L-azetidine-2-carboxylic acid (AZC) on chromosome 3 but not chromosome 1. Here it is shown that a novel cis-responsive element contributed to the differential regulation. By serial deletion and computational analysis, a 9 bp putative AZC-responsive element (AZRE), GTCCTGGAC, located between nucleotides -186 and -178 relative to the transcription initiation site of Oshsp17.3 was revealed. Deletion of this putative AZRE from the promoter abolished its ability to be induced by AZC. Moreover, electrophoretic mobility shift assay (EMSA) revealed that the AZRE interacted specifically with nuclear proteins from AZC-treated rice seedlings. Two AZRE-protein complexes were detected by EMSA, one of which could be competed out by a canonical heat shock element (HSE). Deletion of the AZRE also affected the HS response. Furthermore, transient co-expression of the heat shock factor OsHsfA4b with the AZRE in the promoter of Oshsp17.3 was effective. The requirement for the putative AZRE for AZC and HS responses in transgenic Arabidopsis was also shown. Thus, AZRE represents an alternative form of heat HSE, and its interaction with canonical HSEs through heat shock factors may be required to respond to HS and AZC.

Isolation and characterization of the Arabidopsis heat-intolerant 2 (hit2) mutant reveal the essential role of the nuclear export receptor EXPORTIN1A (XPO1A) in plant heat tolerance

*The Arabidopsis heat-intolerant 2 (hit2) mutant was isolated on the basis of its impaired ability to withstand moderate heat stress (37 degrees C). Determination of the genetic mutation that underlies the hit2 thermosensitive phenotype allowed better understanding of the mechanisms by which plants cope with heat stress. *Genetic analysis revealed that hit2 is a single recessive mutation. Map-based cloning was used to identify the hit2 locus. The response of hit2 to other types of heat stress was also investigated to characterize the protective role of HIT2. *hit2 was defective in basal but not in acquired thermotolerance. hit2 was sensitive to methyl viologen-induced oxidative stress, and the survival of hit2 seedlings in response to heat stress was affected by light conditions. The mutated locus was located at the EXPORTIN1A (XPO1A) gene, which encodes a nuclear transport receptor. Two T-DNA insertion lines, xpo1a-1 and xpo1a-3, exhibited the same phenotypes as hit2. *The results provide evidence that Arabidopsis XPO1A is dispensable for normal plant growth and development but is essential for thermotolerance, in part by mediating the protection of plants against heat-induced oxidative stress.

A DEAD-box protein, AtRH36, is essential for female gametophyte development and is involved in rRNA biogenesis in Arabidopsis

DEAD-box RNA helicases are involved in RNA metabolism, including pre-mRNA splicing, ribosome biogenesis, RNA decay and gene expression. In this study, we identified a homolog of the RH36 gene, AtRH36, which encodes a DEAD-box protein in Arabidopsis thaliana. The gene was expressed ubiquitously throughout the plant. The AtRH36 fused to green fluorescent protein was localized in the nucleus. Homozygosity for the Arabidopsis atrh36 mutants, atrh36-1 and atrh36-2, could not be obtained. Progeny of selfed Arabidopsis atrh36 heterozygote plants were obtained at a heterozygote to wild-type ratio of 1 : 1, which suggested that the AtRH36 gene was involved in gametogenesis. Therefore, we performed a reciprocal cross to determine whether AtRH36 was involved in female gametophyte development. Female gametogenesis was delayed in atrh36-1, and asynchronous development of the female gametophytes was found within a single pistil. Knock-down of AtRH36 gave a pleiotropic phenotype and led to the accumulation of unprocessed 18S pre-rRNA. These results suggest that AtRH36 is essential for mitotic division during female gametogenesis and plays an important role in rRNA biogenesis in Arabidopsis.

Increase of plasma insulin by racecadotril, an inhibitor of enkephalinase, in Wistar rats

Racecadotril is known as an inhibitor of enkephalinase. Increase of plasma insulin by racecadotril has been observed in rats while the mechanism of the action remains obscure. In the present study, intravenous injection of male Wistar rats with racecadotril significantly decreased blood glucose levels. However, this effect of racecadotril was not modified by naloxone at the dose sufficient to block opioid receptors. Thus, the blood glucose-lowering action of racecadotril might be through an endogenous opioid independent mechanism. Otherwise, we found that C-peptide content was also raised by racecadotril in parallel with the increase of insulin in Wistar rats. Thus, the blood glucose-lowering action of racecadotril was related to insulin secretion, but not through the inhibition of plasma insulin degradation. In addition, racecadotril showed no direct effect on insulin secretion in isolated islets or cultured HIT-T15 beta cells. The increase of plasma insulin and blood glucose-lowering action induced by racecadotril were reduced by pretreatment with atropine and enhanced by physotigmine. Direct inhibition of cholinesterase was not observed in brain homogenates treated with racecadotril. Moreover, actions of racecadotril were significantly reduced in rats receiving hemicholinium-3 at a sufficient dose to decrease endogenous acetylcholine. Activation of cholinergic tone is possibly involved in the blood glucose-lowering effect of racecadotril. Our results suggested that racecadotril increased insulin secretion to lower blood glucose mainly via regulation of parasympathetic tone in Wistar rats.

100 GHz ultra-wideband (UWB) fiber-to-the-antenna (FTTA) system for in-building and in-home networks

Fiber-to-the-antenna (FTTA) system can be a cost-effective technique for distributing high frequency signals from the head-end office to a number of remote antenna units via passive optical splitter and propagating through low-loss and low-cost optical fibers. Here, we experimentally demonstrate an optical ultra-wideband (UWB) - impulse radio (IR) FTTA system for in-building and in-home applications. The optical UWB-IR wireless link is operated in the W-band (75 GHz - 110 GHz) using our developed near-ballistic unitraveling-carrier photodiode based photonic transmitter (PT) and a 10 GHz mode-locked laser. 2.5 Gb/s UWB-IR FTTA systems with 1,024 high split-ratio and transmission over 300 m optical fiber are demonstrated using direct PT modulation.

Decrease of bone morphogenetic protein-7 (BMP-7) and its type II receptor (BMP-RII) in kidney of type 1-like diabetic rats

Bone morphogenetic protein-7 (BMP-7) expression is known to be protective for renal damage during diabetic nephropathy and disappears early during the progression of diabetic nephropathy. However, changes in expression of BMP-7 and BMP-7 type II receptor (BMP-RII) during kidney nephropathy response to high glucose-induced oxidative stress remain unclear. In this study, we used streptozotocin-induced diabetic rats with diabetic nephropathy and treated them with insulin, phloridzin, or antioxidant tiron. The insulin, phloridzin, or tiron treatment improved the renal function and decreased fibronectin expression in the streptozotocin-induced diabetic rats. Both insulin and phloridzin could reverse the attenuation effects of hyperglycemia on BMP-7 and BMP-RII expressions in the kidneys of streptozotocin-induced diabetic rats through the correction of hyperglycemia. However, the decrease of BMP-7 and BMP-RII expressions in kidney of streptozotocin-induced diabetic rats could be reversed by tiron through decreasing the high glucose-induced oxidative stress but not through changing the levels of glucose. We further confirmed the effect on reversing the BMP-7 and BMP-RII expressions through decreasing oxidative stress by tiron treatment in high glucose exposed mesangial cells. Thus, we suggest that a decrease in oxidative stress is responsible for the improvement of renal function and recovery of renal BMP-7 and BMP-RII expression in streptozotocin-induced diabetic rats.

MR imaging of primary spinal germinoma: a case report and review of the literature

Germinomas in the central nervous system (CNS) are uncommon tumors and occur usually in the pineal or suprasellar regions. Primary spinal germinoma is extremely rare. Here we reported a rare case of an extramedullary germinoma in a young adult who presented with progressive paraparesis and retention of stool and urine. The MR image features with their differential diagnoses were discussed along with literature review of all previously reported 22 cases.

Predictive factors for faecal incontinence after third or fourth degree obstetric tears: a clinico-physiologic study

OBJECTIVE

This is a prospective study to review the natural history of anorectal dysfunction after primary repair for third or fourth degree obstetric tear and to identify the predictive factors for significant faecal incontinence.

METHOD

From January 2003 to December 2005, 121 consecutive women (mean age 29.9 +/- 4.7) who sustained third or fourth degree obstetric tears were assessed. All had primary repair by obstetricians. They were assessed using anorectal physiology testing and endoanal ultrasound. Short-term (3-month postpartum) and medium-term (mean 18.8 +/- 7.7 months) Wexner's continence scores were obtained.

RESULTS

Among the 121 women, seven were excluded because of incomplete follow-up. At short-term assessment, 25 out of 114 women were incontinent. One of them underwent another sphincter repair for significant faecal incontinence. Twenty-one and three patients respectively, had mild (Wexner's score 1-4) and moderate (Wexner's score 5-8) symptoms. At medium-term assessment, 24 patients remained incontinent; of these, 20 had mild symptoms (Wexner's score 1-4) and four had moderate incontinence (Wexner's score 5-8). The parity (P = 0.04), degree of obstetric tear (P = 0.036) and short-term Wexner's scores at 3 months postpartum (P < 0.0001) were significantly related to the change in Wexner's scores at medium-term assessment. However, the short-term Wexner's score was the only identifiable predictive factor for significant faecal incontinence.

CONCLUSION

Most women suffering from third or fourth degree obstetric tear were continent or mildly incontinent. Poor Wexner's score at short-term assessment at 3 months postpartum was predictive of faecal incontinence in the medium-term.

A self-protected colorless WDM-PON with 2.5 Gb/s upstream signal based on RSOA

In this investigation, we propose and demonstrate a colorless wavelength division multiplexed passive optical network (WDM-PON) at 2.5 Gb/s using reflective semiconductor optical amplifier (RSOA)-based optical networking units (ONUs); together with a self-protected architecture against fiber fault. In the optical line terminal (OLT), we use an array of self-seeding Fabry-Perot laser diodes (FP-LDs) to provide single-longitudinal-mode (SLM) continuous wave (CW) optical sources for the external injection to the RSOA-based ONUs. The self-survivable function for protecting the fiber fault in the distributed fibers and the proposed network performance are investigated and discussed.

Prospective, case-matched study of heated and humidified carbon dioxide insufflation in laparoscopic colorectal surgery

PURPOSE

Laparoscopic colorectal surgery is often prolonged and may cause hypothermia. It is uncertain if heated and humidified carbon dioxide (CO(2)) in laparoscopic colorectal surgery is beneficial. This is a prospective case-matched study on the use of heated and humidified CO(2) in patients undergoing laparoscopic colorectal surgery.

METHOD

Twenty consecutive patients undergoing laparoscopic colorectal surgery with heated (36 degrees C) and humidified (95%) CO(2) were compared with 20 consecutive patients using standard CO(2) (30.2 degrees C). All procedures were performed by a single surgeon in an institution. The changes in core temperature during surgery, visual quality of images and the short-term clinical outcome were documented.

RESULTS

The core temperature fell during surgery in both groups. Although the fall of core temperature was more in the control group, it was not statistically significant (P > 0.05). The passage of flatus was more delayed in heated and humidified group (P = 0.004), but it did not affect the hospital discharge. All the other parameters, including the quality of visual images and the postoperative pain, were similar in both groups.

CONCLUSIONS

Despite better temperature maintenance (nonsignificant), pneumoperitoneum using heated and humidified CO(2) gas did not appear to have any clinical benefits in laparoscopic colorectal surgery.

[Nurse practitioner development: from the perspective of the author]

The role of nurse practitioner (NP) has had 20 years of development in Taiwan, with most NPs today being trained in hospitals. The Department of Health, together with leaders from medical and nursing disciplines, has in recent years implemented laws to help ensure that NP system development remains on track. Numerous research studies conducted overseas verify the effectiveness of NP in clinical care and demonstrate that expectations of NP differ from country to country. As a pioneer in advanced NP training in Taiwan's higher education system, I believe the efficacy of NP training programs as currently organized in Taiwan to be equivocal. This is especially so in NP's core competency. This paper introduces the development of NP in Taiwan to provide better insight into the role and contribution of the NP training system to medical care in Taiwan.