Search PubMed⌕ Search

Biomedical subjects

I Preis

Publications and source records attributed to I Preis.

8 recordsLinked to original sources
PubMed2001

Removal of the connector on the laryngeal mask airway provides a useful alternative to the intubating laryngeal mask.

PURPOSE: We describe two cases in which fiberoptic intubation through the standard laryngeal mask airway (LMA) was successful with large-bore tracheal tubes (TTs) when an intubating LMA (ILMA) could not be used. CLINICAL FEATURES: Patient # 1, with obstructive sleep apnea, underwent elective surgical repair. His mouth opening was just under 25 mm, but difficult intubation was not anticipated. We induced general anesthesia, easily ventilated the patient by mask, and established neuromuscular blockade. Direct laryngoscopy and attempts to insert either a #5 or a #4 ILMA into the mouth failed. A standard #4 LMA, with the connector removed, was inserted, through which a 7.0 mm nasal RAE TT, fiberoptically guided, passed into the trachea at the first attempt. Patient #2, with a loosened implant after left hip arthroplasty, underwent revision prosthesis. Her neck movement was limited. We thus planned awake securing of the airway, but the patient refused. We induced anesthesia and established bag-mask-valve ventilation. The limited neck movement prevented direct laryngoscopy. Visualizing the laryngeal inlet with the fiberoptic bronchoscope (FOB) proved impossible as bloody secretions obscured the FOB's tip. Ventilation by mask was easy. As an ILMA was not available, we removed a #5 LMAs connector and passed an 8.0 mm nasal RAE TT through the LMA. Fiberoptic-guided intubation was easy. In both cases, the remainder of the intraoperative course was uneventful. CONCLUSION: A standard LMA whose connector has been removed to allow passage of TTs of >6.0 mm internal diameter may be substituted for the ILMA when necessary.

Apnea↗
PubMed2001

A systematic approach to provider based disability management.

Tacit within the treatment goals of every workers' compensation case is timely return of the worker to pre-injury status. Assigned disability status must truly reflect the extent of medical impairment and functional limitations affecting return to his/her customary job. Permanent Partial Disability (PPD) awards with associated legal involvement are widely acknowledged as a major cost driver within the Workers' Compensation system. Medical providers are encouraged to become pro-active disability management specialists for each workers' compensation case. Provider review of critical process checkpoints and integration of medical treatment with disability guidelines maximize benefits to the injured employee and the employer. This in turn enhances providers' control of patient care with less emphasis on external case managers.

Disability Evaluation↗
PubMed2000

Variations in ILMA external diameters: another cause of device failure.

PURPOSE: To report failure of insertion of #5 and #4 intubating laryngeal mask airways (ILMAs) in a patient with a mouth opening of just under 25 mm, and the variances among same-size ILMAs. CLINICAL FEATURES: A 53-yr-old man with obstructive sleep apnea underwent elective ENT surgical repair. His mouth opening was just under 25 mm. Ventilation by mask was easy. Direct laryngoscopy failed after induction of anesthesia and neuromuscular block. Neither a #5 nor a #4 ILMA could be passed between the patient's teeth, despite different twisting maneuvres. A #4 LMA was thus prepared as a conduit for fibreoptic intubation. Placement of the LMA was easy, as was fibreoptic-guided intubation. The LMA was removed over the tracheal tube (TT) to enable ENT surgery, and the further course was uneventful. Manual examination showed that, unlike others of the same type, the failed ILMAs were not sufficiently compressible either to allow insertion in this patient or to the 20 mm reported as the maximal outer dimension of the device. Radiological examination revealed that, at the point of the device where it is intended to be compressible, the silicone layer was thicker in the failed devices than in stock compressible ILMAs, and the end of the steel tube was not so sharply beveled. CONCLUSION: Our inability to insert an ILMA in a patient with an interdental distance of just under 25 mm was because the device was not sufficiently compressible although the manufacturer states the maximal outer dimension to be 20 mm.

Anesthesia↗
PubMed1998

Autoclaving impairs the connector-tube bond of the laryngeal mask airway but not its airtightness.

The general-purpose laryngeal mask airway (LMA) is re-usable when undamaged, and cleaned and autoclaved correctly. We had found weakening of the silicone adhesive that bonds the connector of the LMA to the tube. We report that repeated autoclaving damaged the adhesive such that the connector could be rotated in the tube after the 12th autoclave cycle in almost all of the LMA tested. The damage to the adhesive did not affect the airtightness of the junction, which appears to be maintained by the material properties of the connector and tube and by the shape of the join.

Adhesives↗
PubMed1991

[Diagnosis of malignant hyperthermia. The platelet test versus the in vitro contracture test].

An eight-year-old boy was scheduled for an orthopaedic operation with a clinically abortive reaction of malignant hyperthermia and a positive platelet test result. Since there has been no validation for this platelet test, we performed a muscle biopsy and the caffeine- halothane-contracture test (CHCT). The young patient was found to be negative (MHN) in CHCT. Furthermore, the valence and the validity of the used platelet test are discussed for diagnostic purposes. With regard to resulting consequences, first of all in respect of possibly false negative results, we suggest to investigate all patients classified by this platelet test with the accepted and established CHCT.

Blood Platelets↗
PubMed1979

A single-step immunization by sustained antigen release.

An inert polymer pellet less than 1 mm in diameter, implanted subcutaneously in mice, releases free antigen continuously and enhances antibody formation for over 6 months. The immune response stimulated by sustained antigen delivery is comparable to the secondary response induced by the same total dose of antigen emulsified in complete Freund's adjuvant. The sustained release polymer implants, using antigens over a wide molecular weight range, proved effective in eliciting prolonged antibody formation. The antigens tested included bovine serum albumin, gamma-globulin, and ribonuclease. Superior biocompatibility and release characteristics make the ethylene-vinyl acetate copolymer a promising method for the single-step induction of immunity.

Adjuvants, Immunologic↗
PubMed1977

Inhibition of neovascularization by an extract derived from vitreous.

An extract of the vitreous body, inhibited the growth of new blood vessels induced by tumors in the rabbit cornea. This extract was delivered by an inert, continuously releasing polymer. The average vessel growth rate in the region surrounding the polymer was 32% less in corneas containing the inhibitory substance than in control corneas.

Animals↗