Complete Laryngotracheal Separation Following Attempted Hanging

Laryngotracheal separation (LTS) is the most immediately life-threatening airway injury. LTS is so rare that very few otolaryngologists have experience with it. LTS is one of the diagnostic and therapeutic challenges in airway diseases and its management remains to be established. We experienced a patient with complete LTS after attempted hanging. A high index of suspicion, adequate imaging, prompt airway establishment and early surgical repair are the most vital factors in managing a patient with LTS

Psychiatric understanding and treatment of patients with amputations

Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient’s adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful

Dense Iron Ejecta and Core-collapse Supernova Explosion in the Young Supernova Remnant G11.2-0.3

We present the results of near-infrared spectroscopic observations of dense (\simgt 10$^3$ cm$^{-3}$) iron ejecta in the young core-collapse supernova remnant G11.2-0.3. Five ejecta knots projected to be close to its center show a large dispersion in their Doppler shifts: two knots in the east are blueshifted by more than 1,000 \kms, while three western knots have relatively small blueshifts of 20-60 \kms. This velocity discrepancy may indicate that the western knots have been significantly decelerated or that there exists a systematic velocity difference among the knots. One ejecta filament in the northwestern boundary, on the other hand, is redshifted by \simgt 200 \kms, while opposite filament in the southeastern boundary shows a negligible radial motion. Some of the knots and filaments have secondary velocity components, and one knot shows a bow shock-like feature in the velocity structure. The iron ejecta appear to be devoid of strong emission from other heavy elements, such as S, which may attest to the alpha-rich freezeout process in the explosive nucleosynthesis of the core-collapse supernova explosion close to its center. The prominent bipolar distribution of the Fe ejecta in the northwestern and southeastern direction, along with the elongation of the central pulsar wind nebula in the perpendicular direction, is consistent with the interpretation that the supernova exploded primarily along the northwestern and southeastern direction.Comment: To appear in ApJ Letter