239 research outputs found
Transoral, retromolar, para-tonsillar approach to the styloid process in 6 patients with Eagle's syndrome
Objectives: Eagle's syndrome is caused by an elongated or mineralised styloid process and characterised by facial
and pharyngeal pain, odynophagia and dysphagia. Diagnosis is based on clinical findings. However radiologic
imaging, like panoramic radiograph, helps to confirm the diagnosis.
There are different treatments of the Eagle's syndrome. Anti-inflammatory medication (carbamazepime, corticosteroids)
and/or surgical interventions are established. The aim of the different surgical techniques is to resect the
elongated styloid process near the skull base.
Study Design: A transoral, retromolar, para-tonsillar approach was performed to expose and resect the elongated
calcified styloid process in a consecutive series of six patients. The use of different angled ring curettes, generally
used in hypophysis surgery, facilitated the preparation of the styloid process through the surrounding tissue to the
skull base, without a compromise to the surrounding tissue.
Clinical examinations were performed pre- and postoperatively (3 month and after 1 year after surgery) in all
patients.
Results: No intra- or postoperative complications were observed. The hypophysis ring curettes facilitated the
preparation of the styloid process to the skull base.
Conclusions: The transoral, retromolar, para-tonsillar approach is a secure and fast method to resect an elongated
symptomatic styloid process. Side effects of the classical transoral trans-tonsillar approach did not occur
Low temperature transport and evidence for nuclear order in GaAs Quantum Wires
In this thesis we focus on low temperature transport through cleaved edge overgrowth
(CEO) quantum wires. This thesis is motivated by recent theoretical work on one hand
that predicts the formation of a nuclear helimagnet in presence of a Luttinger liquid
(LL) below a critical system temperature [1] and previous measurements on CEO wires
on the other hand that might indicate the onset of such a phase transition [2].
The first task for this thesis was to create suitable measurement conditions to approach
the theoretically predicted strongly correlated state of matter. More precisely,electron
sample temperatures much lower than the predicted ordering temperature of 75mK for
GaAs CEO wires have to be demonstrated. For this purpose, cryogenic microwave filters
with very low cut-off frequency and good thermalization properties were developed
and installed for all measurement cables. With that a minimum electron temperature
of 7.5mK was reached in metallic coulomb blockade thermometers [3],and furthermore,
for the first time in these devices, a deviation from pure electron-phonon cooling is
observed [4].
At low refrigerator temperatures T_R, the CEO (double) wires show pronounced and
completely reproducible conductance oscillations as a function of density. We show
that these oscillations, also present in the zero magnetic field tunneling current
between the parallel quantum wires, emerge as 1D Fabry Perot resonances in the ballistic
CEO wires [5]. We analyze the maximum transmission (T=1) through these wires, i.e
the oscillation maxima, in the single mode regime as a function of temperature. While
the quantum wires approach universal conductance quantization of 2e^2/h for a single
quantum wire only at quite large T_R>15K, we find that the conductance saturates
below T_R=75mK at 1e^2/h [6]. Furthermore, we give strong evidence that the
conductance saturation is not related to insuffcient thermalization, i.e.the CEO wires
cool far beyond the saturation temperature of 75mK. This seems to indicate lifting
of electron spin degeneracy at zero external magnetic field, consistent with the theo-
retically predicted low temperature limit for a clean LL in the ordered helicalstate [1].
We can further exclude other potential mechanisms (temperature dependent contact
resistance, freeze-out of weakly disordered LL, Wigner crystal formation/incoherent
LL), leaving only nuclear spins as candidates for the source of the (possibly) observed
lifted spin degeneracy as spin-orbit coupling is rather weak in GaAs, and the saturation
at 1e^2/h is observed in absence of an external magnetic field. This might resolve
the long-standing mystery of the temperature-dependent (non-universal) conductance
quantization in GaAs cleaved edge overgrowth quantum wires, and furthermore might
give first experimental evidence for a new, strongly correlated state of matter, namely
(helical) nuclear order induced by the strongly interacting electrons via hyperfine
coupling.
We also measure real-time tunneling in a GaAs few electron double quantum dot (DQD)
by means of an adjacent quantum dot as charge sensor. At low temperatures, in the
limit of negligible interdot tunneling and low tunnel rates to source and drain, we
observe metastable charge state switching. The metastability only occurs within diamond
shaped regions that are centered between associated triple points of the charge stability
diagram (CSD). We show that these charge fluctuations arise as an intrinsic property
in DQDs, and take place via fast intermediate states that include an electron exchange
with the leads [7]. Due to the geometrical shape of the diamond (in very good agreement
with our model of thermally activated electron exchange with the leads), its large
energy scale (>1.7K) and due to its visibility even at charge sensor bias voltages as
small as 5ÂľV, we exclude extrinsic effects such as phonon or photon assisted tunneling.
Furthermore, the simultaneous observation of the diamond shaped region of metastable
charge state switching at various points in the CSD and its pinning to associated triple
points upon reshaping the DQD, make charge traps and other defects a very unlikely
explanation
Psychosocial and socioeconomically aspects of mothers having a child with cleft lip and/or palate (CL/P) : a pilot-study during the first year of life
The emotional impact on parents at the birth of their new-born with cleft lip and/or palate (CL/P) can be traumatic for parents, especially mothers, and affect the sensitive early parent-child relationship. Unlike many other congenital malformations facial deformities are visible to all. The uncommon facial appearance creates feelings and reactions in the mother, families and other people. Only few studies deal with this psychosocial burden of these mothers. This pilot-study deals with mothers? early experiences (n=84) having a child with CL/P. Mothers were asked to complete a questionnaire at diagnosis, birth and after lip surgery. The questions were focused on the social background of the mother (educational degree, marital status, lifestyle and prenatal care), the medical information at diagnosis and the following reaction. The surveys were administrated from 01/2014 ? 12/2016. 84 mothers of affected children (CL/P) replied the completed questionnaire (84/103, 81.5%). At diagnosis 65 mothers (77%) lived in a solid partnership and 44% worked full-time (40h). The diagnosis caused fear among the mothers (60.7%, p?0.01), despair (27.4%, p?0.01), grief (17.9%, p?0.01) and guilt (16.7%, p?0.01). Despite the emotional stress after the diagnosis only 5 mothers asked for psychological support (6.0%). The medical information by the gynecologist (41.6%) or maxillofacial surgeon (32.2%) was rated as ?good? (n=26) or ?very good? (n=26) in 60.2%. A lack of medical information and care was rated with ?insufficient? (11.9%) or ?poor? (14.3%). There are only few studies about mothers? early feelings and emotions having a child with a CL/P. We found high parental stress, physical and emotional strain among the mothers after diagnosis, mostly caused due to insufficient information?s. This stress was not correlated with the educational level and CLP appearance showed no relation about the socioeconomic status
The UN Sustainable Development Goals as innovation drivers for local sustainability governance? Examples from Germany
Local governments are highly relevant for the just-starting socio-ecological transformation. Living up to this role requires new or adapted forms of governance. The German case provides a vivid example of how the UN Sustainable Development Goals (SDGs) provide a useful framework for this transformation. In our policy-oriented contribution, we focus on the question whether the SDGs themselves are innovation drivers in local sustainability governance. We motivate this idea with the theoretical framework of public sector innovation and provide comprehensive examples of the most prevalent current approaches to SDG-related innovations at the German local government level, covering local government sustainability reporting, strategies, budgets, and financing. Our central finding is that a small group of early-innovating German local governments has already begun to govern sustainability with the help of SDG-driven innovations and that this became possible because of publicly funded support projects and accessible pre-defined localised SDGs
Cuff overinflation and endotracheal tube obstruction: case report and experimental study
Background: Initiated by a clinical case of critical endotracheal tube (ETT) obstruction, we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. Methods: Five different disposable ETTs (6.0, 7.0, and 8.0 mm inner diameter) were exposed to ambient outside temperature for 13 months. In addition, every second of these tubes was mechanically stressed by clamping its cuffed end between the covers of a metal emergency case for 10 min. Then, all tubes were heated up to normal body temperature, placed within the cock of a syringe, followed by stepwise inflation of their cuffs to pressures of 3 kPa and >=12 kPa, respectively. The inner lumen of the ETT was checked with the naked eye for any obstruction caused by the external cuff pressure. Results: Neither in tubes that were exposed to ambient temperature (range: -12°C to +44°C) nor in those that were also clamped, visible obstruction by inflated cuffs was detected at any of the two cuff pressure levels. Conclusions: We could not demonstrate a critical obstruction of an ETT by its inflated cuff, neither when the cuff was over-inflated to a pressure of 12 kPa or higher, nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress
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