Diffusion of nitrous oxide into the cuff of the endotracheal tube results in an increase in cuff pressure. Excessive endotracheal tube cuff pressure may impair tracheal mucosal perfusion and cause ...tracheal damage and sore throat. Filling the cuff of the endotracheal tube with saline instead of air prevents the increase in cuff pressure due to nitrous oxide diffusion. This method was used to test whether tracheal morbidity is related to excess in tracheal cuff pressure during balanced anesthesia.
Fifty patients with American Society of Anesthesiologists physical status I or II were randomly allocated to two groups with endotracheal tube cuffs initially inflated to 20-30 cm H(2)O with either air (group A) or saline (group S). Anesthesia was maintained with isoflurane and nitrous oxide. At the time of extubation, a fiberoptic examination of the trachea was performed by an independent observer, and abnormalities of tracheal mucosa at the level of the cuff contact area were scored. Patients assessed their symptoms (sore throat, dysphagia, and hoarseness) at the time of discharge from the postanesthesia care unit and 24 h after extubation on a 101-point numerical rating scale.
Cuff pressure increased gradually during anesthesia in group A but remained stable in group S. The incidence of sore throat was greater in group A than in group S in the postanesthesia care unit (76 vs. 20%) and 24 h after extubation (42 vs. 12%; P < 0.05). Tracheal lesions at time of extubation were seen in all patients of group A and in eight patients (32%) of group S (P < 0.05).
Excess in endotracheal tube cuff pressure during balanced anesthesia due to nitrous oxide diffusion into this closed gas space causes sore throat that is related to tracheal mucosal erosion.
The ECRH system of ASDEX Upgrade Leuterer, F; Beckmann, M; Borchegowski, A ...
Fusion engineering and design,
10/2001, Letnik:
56
Journal Article
Recenzirano
The ECRH system of ASDEX Upgrade is now completed. Four gyrotrons generate a total Gaussian beam power of 2 MW/2 s at 140 GHz. The power is transmitted partly quasioptically and partly via corrugated ...HE-11 waveguides. The transmission line losses, determined calorimetrically, are about 12%. The four focused beams lead to a very localised power deposition in the plasma and can be steered in both poloidal and toroidal directions.
The glass-forming region in the Ge–Se–Cd system has been determined, where up to 12 at.% Cd can be introduced into the binary Ge
20Se
80 composition. Specific features in the compositional dependence ...of the density,
d, and microhardness,
H
m, on the average coordination number,
Z, have been found. In particular, two extrema have been observed at
Z=2.4 and
Z=2.68, both in bulk glasses and in amorphous films of the Ge
x
Se
98−
x
Cd
2 family, but the effects are less in the latter case. The same regularities have also been established for the glassy Ge–S–Cd system. The results obtained are compared with those for the previously studied Ge–Se–Fe system. They are discussed on the basis of rigidity percolation concepts and in terms of topological structural transitions in chalcogenide glasses.
Although subjects often report difficulty with swallowing shortly after receiving neuromuscular blocking agents, difficulty with swallowing during recovery from neuromuscular blocking agents appears ...to be infrequent. We have used electromyography to compare onset and recovery at the diaphragm and geniohyoid airway muscles after an intubating dose of mivacurium (0.2 mg kg-1) to determine if the geniohyoid muscles were particularly sensitive to neuromuscular blocking agents. Twelve adults undergoing elective surgery were anaesthetized with propofol and fentanyl and the trachea intubated without neuromuscular blocking agents. The left hypoglossal and right phrenic nerves were stimulated with percutaneous needle electrodes and the electromyogram recorded with surface electrodes. EMG responses were measured after a bolus dose of mivacurium 0.2 mg kg-1. Recordings were also made of the mechanical response of the adductor pollicis to supramaximal ulnar nerve stimulation. There was no difference in the rate of onset of block for geniohyoid muscles and the diaphragm, but recovery to 25% and 90% of the control response was shorter at the diaphragm (median 14.5 (95% confidence limits 12.9-15.3) min and 23.8 (21.7-26) min) than at the geniohyoid muscle (19.4 (15.6-20.1) min and 29.2 (26.3-31.4) min), respectively (P < 0.05). When the train-of-four ratio of the mechanical response of the thumb reached 70%, the diaphragm and geniohyoid muscles had recovered completely in all patients.
New immunoglobulin for treatment of anthrax Borovskoj, D.V; Shevtsov, A.N; Darmov, I.V ...
Žurnal mikrobiologii, ėpidemiologii i immunobiologii,
2009 May-Jun
3
Journal Article
Recenzirano
A new high-effective anti-anthrax gamma-globulin (AAG) has been developed for internal administration produced from human blood plasma for arresting toxemia when epidemics and epizootics occur caused ...by using Bacillus anthracis as striking biological weapons. AAG is a 100% gamma-globulin comprising at least 95% LgG with an antibody titer to protective antigen in EIA being 1:1600, anti-complementary activity 50 units of complements per 1 mg of protein and index of preventive properties of at least 04. The prophylactic and therapeutic efficacy of this preparation has been comparatively studied and currently used equine anti-anthrax immunoglobulin (EAI) for intramuscular administration having side effects. The protective properties of immunoglobulins were comparatively studied on guinea pigs to which AAG and EAI were administered at the same doses. The observation time was 10 days. The efficiency of AAG was 50%, EAI was 60%. It is supposed that the highest prophylactic efficiency of EAI is achieved by great content of specific antibodies in heterogeneous immunoglobulin produced from blood serum of horses hyperimmunized against anthrax. The therapeutic efficiency of the two immunoglobulins as a means for monotherapy for anthrax was 70%. It is concluded that the protective properties of the preparation are comparative to EAI, besides, it is apyrogenic, non-toxic and does not give a serum shock
An optical four-wave mixing (FWM) described by the nonlinear susceptibility
x
(3) (
ω
as = 2
ω
p −
ω
s) is studied in a single crystal of Rochelle salt (NaKC
4H
4O
6·H
2O). In addition to the ...coherent anti-Stokes Raman Scattering (CARS) structure, the FWM spectra consist of nonvibrational (background) components. After analysis of the FWM spectra in the range from 1100 to 1450 cm
−1, the nonresonant (electronic) susceptibility elements
x
el
zzzz
and
x
el
xxxx
of Rochelle salt single crystal are estimated.
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