Most cardiac centers performed aortic root surgery in small volumes. The unadjusted operative mortality was greater for patients >80 years old and those with aortic stenosis, regardless of age. Valve sparing root surgery was associated with the lowest mortality. A trend was seen toward an increased use of stented tissue valves from 2004 to 2009.

In this paper, we present a "green" and size-controlled seed-mediated growth method by which differently sized palladium (Pd) nanoparticles, spanning from 3.4 to 7.6 nm, with an increment of 1.4 nm, were synthesized. Monodisperse Pd nanoparticles (ca. 3.4 nm, standard deviation = 0.7 nm) were first synthesized and stabilized in an aqueous solution at 95 degrees C using nontoxic ascorbic acid and sodium carboxymethyl cellulose (CMC) as reducing agent and capping agent, respectively. These Pd nanoparticles were subsequently employed as seeds on the surface of which fresh Pd (2+) ions were reduced by the weak reducing agent ascorbic acid. Optimal conditions were determined that favored the homogeneous and sequential accumulation of Pd atoms on the surface of the Pd seeds, rather than the formation of new nucleation sites in the bulk growth solution, thereby achieving atomic-level control over particle sizes. The adsorbed CMC molecules did not inhibit the addition of Pd atoms onto the seeds during the growth but provided stabilization of the Pd nanoparticles in aqueous solution after the growth. Potential mechanisms that underpin this seed-mediated growth process are provided and discussed. One advantage of this seed growth process is that it provides stoichiometric control over the size of the Pd nanoparticles by simply varying Pd(2+) added during the growth stage. Furthermore, the use of ecologically friendly reagents, such as water (solvent), CMC (capping agent), and ascorbic acid (reducing agent), in both the seed synthesis and subsequent seed-mediated growth provides both "green" and economic attributes to this process.

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Objective Compensatory hyperhidrosis is a common devastating adverse effect following endoscopic thoracic sympathectomy for patients undergoing surgical treatment of primary hyperhidrosis. We sought to determine if there was a correlation in our patient population between the level and extent of sympathetic chain resection and the subsequent development of compensatory hyperhidrosis. Methods All patients undergoing endoscopic thoracic sympathectomy in the T2-3, T2-4, T2-5, or T2-6 levels for palmar or axillary hyperhidrosis at the University of Iowa Hospital and Clinics (n=97) between January 2004 and January 2013 were retrospectively reviewed. Results Differences in preoperative patient characteristics were not statistically significant between patients receiving either T2-3, T2-4, T2-5, or T2-6 level resections. Of the ninety-seven patients included in this study, twenty-eight patients (29%) experienced transient compensatory hyperhidrosis and four patients (4%) complained of severe compensatory hyperhidrosis and required further treatment. There were no operative mortalities and morbidity was similar amongst the groups. Conclusions Most patients had successful outcomes after undergoing extensive resection without change in incidence of compensatory hyperhidrosis. Therefore, we recommend performing a complete and adequate resection for relief of symptoms in patients with primary hyperhidrosis.

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