Overinflation of the cuff and pressure on the neck reduce the preventive effect of supraglottic airways on pulmonary aspiration: an experimental study in human cadavers.

Background: The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pulmonary aspiration. The aim of this study was to analyse the effects of cuff overinflation and pressure on the neck on the oesophageal leak pressure of seven supraglottic airways.

Minimal Invasive Fixation of Hamate Hook Fractures Through a Dorsal Percutaneous Approach Using a Mini Compression Screw: An Experimental Feasibility Study.

Purpose: Isolated fractures of the hamate hook can be treated by conservative or surgical means. Because nonoperative treatment is associated with high nonunion rates, surgical treatment with open reduction and internal fixation through a palmar approach is often preferred. The aim of this study was to refine surgical treatment of hamate hook fractures using a cannulated mini compression screw through a dorsal percutaneous approach.

Oesophageal seal of the novel supralaryngeal airway device I-Gel in comparison with the laryngeal mask airways Classic and ProSeal using a cadaver model.

Background: Supraglottic airway devices are increasingly used in anaesthesia and emergency medicine. This study was designed to investigate the oesophageal seal of the novel supralaryngeal airway device, I-Gel (I-Gel), in comparison with two of the laryngeal mask airways, Classic (cLMA) and ProSeal (pLMA), in a model of elevated oesophageal pressure.

Methods: The three supralaryngeal airway devices were inserted into eight unfixed cadaver models with exposed oesophagi that had been connected to a water column producing both a slow and a fast oesophageal pressure increase.

A comparison of seal in seven supraglottic airway devices using a cadaver model of elevated esophageal pressure.

Background: Supraglottic airway devices are increasingly important in clinical anesthesia and prehospital emergency medicine, but there are only few data to assess the risk for aspiration. We designed this study to compare the seal of seven supraglottic airway devices in a cadaver model of elevated esophageal pressure.

Methods: The classic laryngeal mask airway, laryngeal mask airway ProSeal, intubating laryngeal mask airway Fastrach, laryngeal tube, laryngeal tube LTS II, Combitube, and Easytube were inserted into unfixed human cadavers with an exposed esophagus that had been connected to a water column of 130 cm height.

[Electrical nerve stimulation for plexus and nerve blocks].

Despite the increasing use of ultrasound, electrical nerve stimulation is commonly used as the standard for both plexus and peripheral nerve blocks. Several recent randomized trials have contributed to a better understanding of physiological and clinical correlations. Traditionally used currents and impulse widths are better defined in relation to the distance between needle tip and nerves.

[Continuing medical education in Aesthetic Medicine: hands--on course on the usage of hyaluronic acids of different particle size on anatomic preparations].

The Division of Evidence Based Medicine (dEBM), Clinic for Dermatology, Venerology and Allergology, Charité--Universitätsmedizin Berlin, offers on a regular basis workshops focusing on different areas of aesthetic medicine. Once a year a joint course is provided in cooperation with the Institute of Anatomy, offering the participants the possibility to improve their injection techniques as well as their knowledge on the facial anatomy. This course is focused on treatment with hyaluronic acids of different particle size.

[Optimization of conventional X-ray images for the detection of hook of hamate fractures].

Fractures of the hook of the hamate are a rare event. The fracture cannot always be detected clinically and standard radiographs do not always provide an overlap-free image of the hook of the hamate, so that fractures can easily be overlooked. The objective of the present study was to examine if the sensitivity of detecting hamulus ossis hamati fractures can further be improved by a modified conventional radiographic projection.

[The hip head-conserving management of traumatic medial cervical hip fractures with big-fragment screws: a biomechanical examination].

Aim: With the growing number of elderly people in the population and the increasing incidence of proximal hip fractures the question of how to manage the medial hip head fracture is of increasing importance. Especially in Hungary and the Scandinavian countries surgeons prefer hip head-conserving therapy although the redislocation of this fracture and necrosis of the hip head opposes this point of view.

Method: Encouraged by two theoretical and mathematical calculations, we tested two different possibilities to screw hip head fractures.

Cribra orbitalia visualized in computed tomography.

Cribra orbitalia are sieve-like lesions of the orbital roof. While common in historic skulls, they have long been absent in those examined in the last decades. Only recently we found low-grade cribra orbitalia in some contemporary cases.

Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study.

Rationale And Objectives: To examine the ability to image fractures of the body and hook of the hamate bone in conventional X-rays and high-resolution computed tomography (HR-CT).

Materials And Methods: In an in vitro experiment using 18 cadaver hands, the hamate bone was fractured at different places. Before and after fracture, conventional X-rays were taken in different planes (anteroposterior, lateral, oblique, and carpal tunnel), and HR-CT was performed with 2-mm layer thickness in the axial, sagittal, and coronal plane.

[The imaging of hamate fractures in the conventional X-ray and CT: experimental results and clinical experiences].

Purpose: Examination of the ability to image fractures of the body and hook of the hamate bone in conventional X-rays and HR-CT.

Material And Methods: In an in vitro experiment on 18 cadaver hands, the hamate bone was fractured at different localisations. Before and after fracture, conventional x-rays were taken in different projectional planes: a.

Activity of acetylcholinesterase and unspecific cholinesterase during differentiation of somites in mouse embryos.

During the development of somites in mouse embryos, widespread activity of unspecific cholinesterase (BuChE) was demonstrated after prolonged incubation. Independent of their position, all somite cells and their derivatives (dermatome, myotome and sclerotome) exhibited enzyme activity in the perinuclear space and in the endoplasmic reticulum. The plasmalemma did not show any enzyme activity.

Outgrowing nerves in the foreleg of a mouse embryo as viewed by three-dimensional reconstruction from electron micrographs.

Electron micrographs from serial cross-sections of 12-day-old mouse forelegs were digitized and three-dimensional reconstruction of the data was carried out on an Apple Macintosh Quadra 700 computer using a program especially designed for this purpose. Two nerve endings of the palmar net of the median nerve were visualized together with their accompanying Schwann cells and the surrounding processes of fibroblasts. Naked axons invade straightly into the embryonic connective tissue and serve as contact guidance for the Schwann cells to follow.

An abnormal pattern of blood vessels in the retroperitoneal space with a duplicated inferior vena cava in an adult: a case report.

During dissection a duplicated inferior vena cava (IVC) was found in an 82 year-old male. The IVCs were connected with each other by two anastomoses. The course of the other retroperitoneal veins also exhibited some alterations: Just below the diaphragm the azygos and the right ascending lumbar v.

Splenic lesion as a complication of laparoscopy. Case report.

A case of splenic lesion is reported in a 48-year-old female patient who underwent an uneventful diagnostic laparoscopy. Symptoms suggesting massive intraabdominal bleeding occurred 5 hours later. Intraoperatively, a small posterior splenic lesion was found, which could be repaired using fibrin glue.

Specialized cell contacts in the developing nerves of mouse embryos.

In mouse embryos, special focal contacts between axons and Schwann cells, axons and fibroblasts as well as Schwann cells and fibroblasts are visible during the outgrowth of nerves. These rather seldom contacts exhibit a uniform structure. Axons and Schwann cells from small finger-like protrusions projecting into coated pits of Schwann cells and fibroblasts.

Electron microscopic investigations on the growing tip of nerve fibres in the developing distal forelimb of the mouse.

The distal course of the sensory nerve fibres on the palmar side of the hand of 12-day-old mouse embryos was followed by serial ultrathin cross-sections of conventionally fixed tissue. Small nerves fibres are to be found in the space between the layer of the cutaneous blood vessels and the epidermis. A special arrangement of the tissue which is traversed by the nerve fibres is not visible.

Expression of cholinesterase in the Schwann cells of peripheral nerves during development.

In peripheral nerves of mouse embryos Schwann cells exhibit a high activity of unspecific cholinesterase. At first (day 12 of embryonic development) this enzyme occurs in the nuclear envelope and in the granular endoplasmic reticulum. Thus, it is possible to differentiate between Schwann cells and fibroblasts which lack cholinesterase.

Pattern formation of the sensible nerves in the hand of mouse embryos with special reference to the posterior-anterior developmental gradient.

The development of the sensible innervation of the hand was investigated. For this reason normal forelimbs and limb bud cultures from 12- to 14-day-old mouse embryos were stained in toto using the cholinesterase technique. The dorsal side of the hand is mainly innervated by sensible branches of the radial and the musculocutaneous nerve, which penetrate the fascia in the region of the elbow.

[Changes in bones of the foot and development of inserting tendons of the lower leg musculature in tibial aplasia].

Skeleton, muscles and tendons were investigated in 3 lower legs with aplasia of the tibia. The tibiofibular joint appears to be rather a syndesmosis than a diarthrosis. In all 3 cases, talus and calcaneus are connected by a synostosis.

Innervation of the dermatomes in the neck of the mouse.

The dorsal rami of the cervical and thoracic spinal nerves were investigated using both the in situ cholinesterase staining technique and cholinesterase staining on serial sections of plastic-embedded embryos. In most cases only the dorsal rami of the 2nd to 5th cervical spinal nerve possess cutaneous branches. The area innervated by the cutaneous branch of the dorsal ramus of the 5th spinal nerve borders on an area innervated by the cutaneous branch of the dorsal ramus of the 1st thoracic spinal nerve.

On the spatial relationship between fibroblasts and myogenic cells during early development of skeletal muscles.

The spatial relation between fibroblasts and myoblasts as well as myotubes in the extensor muscles of the forearm of mouse embryos was investigated with routine electron microscopic techniques. From day 13 of embryonic development onwards, fibroblasts and myogenic cells may be distinguished by their ultrastructure from each other. Above all the fibroblasts are characterized by their long cell processes.

[Development of connective tissue in mouse skeletal muscle].

The development of the connective tissue in the dorsal forelegs of mouse embryos and sucklings was investigated with the aid of immunofluorescence and electron microscopy. Collagen type III is visible earlier in the muscular connective tissue than collagen type I. However, it seems that collagen does not play a fundamental role in the organization of the muscular tissue.

Development of the vascular supply in rat skeletal muscles.

The vascular development in the extensor muscles of rat forelegs from 12-day-old embryos up to 9-day-old animals was investigated with a light microscope using semithin plastic sections. On late day 12, blood vessels are distributed over the whole cross sectional area of the foreleg. On early day 13, a rearrangement of the blood vessels is visible.

Development of muscles in the dorsal foreleg of rat embryos. A light microscopic study with the in situ cholinesterase staining technique.

The development of muscles from the dorsal side of the forelegs from 13- to 21-day-old rat embryos was investigated under a light microscope. The muscle blastemata and individual muscles were stained in situ with the cholinesterase technique. The first muscle blastemata are visible on the early day 13.