Obesity has a negative impact on outcome after colorectal surgery. To further clarify the impact of obesity on surgical outcome, it is recommended that future studies examine grades of obesity and include measures of abdominal obesity.

A new nickel-base superalloy designated as Allvac ® 718Plus ™ has been developed by ATI Allvac to be used at 700°C. For phase characterization, heat treatment selection and structure stability evaluation in high temperature range, the determination of TTT diagram for alloy 718Plus is not only a basic research issue but also an important matter for the alloy application at high temperatures. The conventional alloy 718 has been also studied for comparison. Both alloys were solution treated at 1040°C for full solution of precipitated phases except stable carbide MC. After solution treatment both alloy samples were heat treated at 649 to 954°C for the times from 3-6 minutes till 100 hrs. Phase identification was mainly by means of SEM, XRD and partially TEM and SAD. Hardness test was also conducted on the samples as the indication of γ" and γ' precipitation hardening. The experimentally determined T-T-T diagrams and discussion on the phase formation in alloys 718 and 718Plus are described in this paper.

Randomized controlled trials have shown a benefit for epidurals on postoperative pain relief, and ileus, and possibly respiratory complications. There is no proven benefit with regard to length of stay. There are a number of unresolved issues which further focussed RCT's may help clarify such as effects of epidural on complication rates after colorectal surgery.

We have shown that a multicompartment model accurately predicts end-tidal (ET) sevoflurane (sevo) and isoflurane concentrations. The model has been adapted to use real-time fresh gas flow and vaporizer settings to display a 10-min prediction of ET sevo concentrations. In this study, we evaluated the effect of the predictive display on the speed and accuracy of changes in ET sevo by the anesthesiologist. Fifteen patients were studied in whom sevo-based anesthesia was expected to last more than 2 h. Four step changes of target ET concentration (+0.5, +1.0, -1.0, and -0.5 vol%) were made either unaided or with the prediction display. Fresh gas flow was 1 L/min. Response time, maximum overshoot, and stability in the 5 min after the target was achieved were compared by using two-tailed paired Student's t-tests. Changes were made on average 1.5-2.3 times faster with the predictive display than without it. These differences were statistically significant (P < 0.05) for the +0.5, +1.0, and -0.5 vol% step changes but not for the -1.0 vol% change. There were no differences in the degree of overshoot or stability. These differences are comparable to those seen with an automatic feedback control system. This system may simplify the administration of volatile anesthesia and the use of low-flow anesthesia.

Fresh gas flows used in our department have decreased by 35% over 4 years. Although the absolute change in flow rate is not large, this represents potential annual savings of more than $US130,000. This occurred without specific initiatives, suggesting an evolution in practice towards lower fresh gas flow. Improvements in equipment and monitoring, including a locally developed system, which displays forward predictions of end-tidal and effect-site vapor concentrations, may be factors in this change.