The inability to perform the "liftoff" test has been attributed to a subscapularis muscle or tendon injury. The goals of this study were to evaluate the activity of the glenohumeral muscles during performance of the "liftoff" maneuver and to identify the most effective initial upper extremity placement that isolates the subscapularis musculotendinous unit. In the first phase of this study 15 subjects accomplished four proposed versions to the "liftoff" test while their intramuscular electromyographic activity in select glenohumeral muscles was recorded. The second phase of this study assessed the ability of five subjects with a nonfunctional subscapularis musculotendinous unit to perform the same proposed versions. On the basis of electromyographic data none of the proposed versions to the "liftoff" maneuver isolated the upper and lower subscapularis muscle from either the teres major, latissimus dorsi, posterior deltoid, or rhomboid muscles (p > 0.05). In the presence of a nonfunctional subscapularis musculotendinous unit, the subjects were able to perform all of the proposed versions of the "liftoff" maneuver except one: elevation of the dorsum of the hand from the posterior-inferior border of the scapula (maximum internal rotation test). Although significant electromyographic activity was generated in the potentially confounding shoulder girdle muscles during the maximum internal rotation "liftoff" test, a successful test appears to be dependent on the isolated glenohumeral internal rotation function of the subscapularis muscle.

Adult↗

PubMedDate not supplied

A new silicone elastomer tube for use during microsurgery on the larynx.

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Humans↗

PubMedDate not supplied

Large tracheal papillomas: A difficult anesthetic problem and an apparent cure. A case report.

Summary--A six-year-old female with papillomatosis of the trachea causing respiratory embarrassment was operated upon under general anesthesia. Utilizing a specially designed anesthetic technique to fit the problem and utilizing a cryoprobe followed by electrodessication, the lesions were removed. Furthermore, simple operative procedures and the use of bovine wart vaccine has, over the course of seven months, resulted in an apparent cure.

Anesthesia, Inhalation↗

PubMedDate not supplied

Special new low resistance to flow tube and endotracheal tube adapter for use during fiberoptic bronchoscopy.

This paper describes endotracheal tubes and adapters which are designed specially for fiberoptic bronchoscopy; the tubes are designed in such a way that they are wide at the upper part but are narrow and thin walled in the part of the tube which goes through and below the cords. By designing tubes in this manner, the resistance to flow of gas through the tube when the fiberoptic bronchoscope is in place is very much reduced and the safety of the whole precedure is enhanced. A special adapter for use under these circumstances is also described which utilizes a commercially available swivel tracheostomy adapter with a special silicone diaphragm fitted onto the top to enable the fiberoptic bronchoscope to be placed through the diaphragm and keep a sealed system. A plug is available for the hole in the diaphragm when the fiberoptic bronchoscope is not being used. Clinical and laboratory data show that these pieces of equipment perform the function for which they were designed.

Adult↗

PubMedDate not supplied

Percutaneous jet ventilation.

A method of ventilation utilizing an S-shaped cannula placed through the cricothyroid membrane and hooked up to a conventional jetting system is described. Its advantages are reduced morbidity, better ventilation, and an unobstructed view of the operating site for the surgeon. The system allows ventilation of the patient with oxygen prior to the induction, or at the end of anesthesia if necessary, and allows the surgeon to perform a tracheostomy in the usual manner if it is indicated. The system is not proposed as a routine method of ventilation during anesthesia for laryngeal surgery but is reserved for cases in which other methods would not perform adequately.

Aged↗