Acute upper airway failure and mediastinal emphysema following a wire-guided percutaneous cricothyrotomy in a patient with severe maxillofacial trauma

Contains fulltext : 69538.pdf (publisher's version ) (Open Access)BACKGROUND: In the presence of severe maxillofacial trauma, management of the airway is important because this condition poses a significant threat to airway patency. That securing the airway is not always straightforward is described and illustrated in this paper. CASE: We present the case of a 23-year-old patient who sustained severe maxillofacial injury for which airway control was necessary. A wire-guided percutaneous dilation cricothyrotomy was performed, which was most probably the cause of an acute loss of airway patency. The literature regarding the role of percutaneous techniques in an elective and emergency setting is reviewed

PSEUDO-RANDOM AMPLITUDE OR TONE BURST MODULATION COMBINED WITH CAVITY-ENHANCED DETECTION

Author Institution: Southwest Sciences Ohio Operations, Cincinnati OH 45244 ; Southwest Sciences, Santa Fe NM 87505Combining pseudo random-modulation techniques with cavity enhanced spectroscopy allows the estimation of both optical path length and absorption while using a cw diode laser as the light source. Two pseudo-random modulation approaches are described, in each case combined with an off-axis cavity consisting of two cylindrical mirrors oriented to produce a dense pattern of cavity modes. In one approach, the amplitude of the laser is modulated; deconvolution results in an exponential ring-down decay curve. In the second approach, tone bursts that modulate the laser frequency are switched on and off with a pseudo-random code. Deconvolution yields the first derivative of an exponential whose amplitude is proportional to absorbance. With either approach the dynamic range of the transmitted intensity is much smaller than for a ring-down experiment, allowing high gain before the signal is digitized. Initial experimental results measuring carbon monoxide are presented, and the dependence of detection sensitivity on experimental parameters such as pseudo-random clock rate is discussed

Predictors of future growth of sporadic vestibular schwannomas obtained by history and radiologic assessment of the tumor.

Contains fulltext : 81894timmer.pdf (publisher's version ) (Closed access)Management of a sporadic vestibular schwannoma (VS) is still a subject of controversy, mainly due to distinct and unpredictable growth patterns. To embark on an appropriate therapy it is necessary to dispose of a reliable prediction about tumor progression. This study aims to design a risk profile with predictors for VS growth. A total of 234 VS patients who were managed conservatively were included. Data concerning (duration of) symptoms and localization of VS were analyzed with Cox proportional hazards regression models. Predictors for growth are unsteadiness/vertigo, no sudden onset of hearing loss and short duration of hearing loss. High-risk patients have (1) VS with an extrameatal localization, short duration of hearing loss and at least one of the two other predictors (unsteadiness/vertigo or no sudden sensorineural hearing loss) or (2) VS with an intrameatal localization and all three other predictors. Low-risk patients have (1) VS with an extrameatal component and no other predictor or (2) VS with an intrameatal localization and at most one other predictor. High-risk patients have a risk of growth of 36.9% in the first year and 64.6% in the second year. For patients with a low risk this is 2.5 and 12.7%, respectively. Simple data gathered at the moment of diagnosis may provide useful information since they may lead to a risk profile for growth