The refractive index of human skin tissues is an important parameter in characterizing the optical response of the skin. We extended a previously developed method of coherent reflectance curve measurement to determine the in vitro values of the complex refractive indices of epidermal and dermal tissues from fresh human skin samples at eight wavelengths between 325 and 1557 nm. Based on these results, dispersion relations of the real refractive index have been obtained and compared in the same spectral region.

Over the past 15 years, repair techniques, improved prostheses, retrograde cardioplegia, and enhanced exposure collectitvely have led to impressive advances in mitral valve surgery. Just as minimally invasive coronary surgery appears efficacious, cardiac valve operations using similar techniques are promising. Recently, Kaneko and associates 1 reported videoscopic examination of the mitral valve during a commissurotomy done via a sternotomyo Early this year, port-access mitral replacements were done in Malaysia by the Stanford team using new aortic balloon occlusive technology. On February 26, 1996, Carpentier successfully performed the first video-assisted mitral valve repair through a minithoracotomy during ventriculai fibrillation. 2 On May 26, 1996, our group performed a direct vision "micro-mitral" valve repair with antegrade cardioplegic arrest through a 2.4-inch incision. Two days later we replaced a rheumatic mitral valve using a video-assisted minimally invasive approach, and this case is the subject of this report.The patient was a 43-year-old man with diabetes and long-standing mitral insufficiency that had progressed to class III heart failure and recent-onset atrial fibrillation. Cardiac catheterization showed normal coronary arteries and a 0.45 ventricular ejection fraction. Transthoracic echocardiography showed an immobile posterior leaflet with type III severe mitral insufficiency. Intraoperative transesophageal echocardiography confirmed the transthoracic study. The patient was intubated with a double-lumen endotracheal tube for single lung ventilation and positioned with the right side of the chest elevated 45 degrees and the pelvis nearly flat. A 2-inch incision was made in the midaxillary line over the fifth rib and a small section was removed. A custom retractor was used to provide operative exposure (Snowden-Pencer Inc.). The pericardium was opened just anterior to the phrenic nerve with thoracoscopy scissors. Specialized instruments were used throughout the operation: however, video access was established by means of standard thoracoscopic techniques. A 10 mm thoracoscopic port was placed posterior and cephalad to the main incision, and a three-chip lighted camera (Linvatec Inc.) was inserted to visualize the limited surgical field.Peripheral cardiopulmonary support (28 ° C

Objective The virtual interview for residency and fellowship applicants has previously been utilized preliminarily in their respective processes. The COVID-19 pandemic forced many programs to switch to a virtual interview process on short notice. In the independent plastic surgery process, which was underway when the pandemic started, applicants had a heterogeneous experience of in-person and virtual interviews. The purpose of this study was to assess if applicants prefer a virtual interview experience to an in-person interview as well as determine if virtual interview applicants had a different opinion of a program compared to the in-person interview applicants. Design/Setting/Participants The 2019 to 2020 applicants who interviewed at the Indiana University Independent Plastic Surgery program were administered an anonymous online survey about their interview experience at our program. Results Our survey response was 60% (18/30). The in-person interview group ( n = 10) rated their overall interview experience higher than the virtual interview group ( n = 8) 8.8 vs 7.5 (p = 0.0314). The in-person interview group felt they became more acquainted with the program, the faculty, and the residents more than the virtual group (4.7 vs 3.25, p < 0.0001) (4.3 vs 3.25, p = 0.0194) (4.3 vs 2.75, p < 0.0001). The majority of applicants favored in-person interviews (16/18, 88.9%). The in-person interview group spent significantly more money on their interview at our program compared to the virtual interview group ($587 vs $0, p < 0.0001). Conclusion Our study demonstrated that the virtual interview process was an efficient process for applicants from both a financial and time perspective. However, the virtual interview process left applicants less satisfied with their interview experience. The applicants felt they did not become as acquainted with the program as their in-person counterparts. The virtual interview process may play a large role in residency and fellowship applications in the future, and programs should spend time on how to improve the process.

A comparative study of skin incision healing using a standard "bovie" and a new design electroscalpel, Utah Medical Products Epitome Electrode (Midvale, UT), was conducted in a porcine model. Wounds were evaluated objectively at 14 and 28 days after surgery using wound bursting strength measurements and histologic wound scoring. Each electrosurgical device was compared with wound healing of cold scalpel incisions as the gold standard using the same criteria. Statistical differences of healing between the bovie and the Epitome indicating preferential healing for the Epitome wounds were demonstrated for bursting strength at 14 days (p = 0.002). Comparisons of the measured "zone of coagulation necrosis" produced by the electroscalpels demonstrated significantly decreased thermal tissue damage favoring the Epitome (p = 0.0003). Greater differences in wound healing favoring the cold scalpel occurred in comparisons of bovie with cold scalpel than Epitome with cold scalpel, and overall results demonstrated healing for the Epitome wounds closely approximated that for cold scalpel. The authors conclude that this new generation electroscalpel provides measurable improvements in incisional wound healing compared to established electrosurgical technology.

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