The Experts below are selected from a list of 66 Experts worldwide ranked by ideXlab platform
A. Czerniak - One of the best experts on this subject based on the ideXlab platform.
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A rare complication of the use of a Finger Cot to protect the cuff of a tracheal tube during nasotracheal intubation
Intensive Care Medicine, 1993Co-Authors: J. P. Barras, P. Bigler, A. CzerniakAbstract:Some anesthetists in Swirzerland and elsewhere use a Finger Cot to protect the cuff of the endotracheal tube during nasotracheal intubation. In the presented report the Finger cut was lost during the procedure and the patient presented 3 months later with a lateral neck mass. The Finger Cot was found within that mass at exploration. Apart from the other potential risks of this manoeuvre, this severe complication should incite caution against the practice described above.
J. P. Barras - One of the best experts on this subject based on the ideXlab platform.
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A rare complication of the use of a Finger Cot to protect the cuff of a tracheal tube during nasotracheal intubation
Intensive Care Medicine, 1993Co-Authors: J. P. Barras, P. Bigler, A. CzerniakAbstract:Some anesthetists in Swirzerland and elsewhere use a Finger Cot to protect the cuff of the endotracheal tube during nasotracheal intubation. In the presented report the Finger cut was lost during the procedure and the patient presented 3 months later with a lateral neck mass. The Finger Cot was found within that mass at exploration. Apart from the other potential risks of this manoeuvre, this severe complication should incite caution against the practice described above.
Pei Zhong - One of the best experts on this subject based on the ideXlab platform.
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effect of lithotripter focal width on stone comminution in shock wave lithotripsy
Journal of the Acoustical Society of America, 2010Co-Authors: Neal W Simmons, Georgy Sankin, Pei ZhongAbstract:Using a reflector insert, the original HM-3 lithotripter field at 20 kV was altered significantly with the peak positive pressure (p+) in the focal plane increased from 49 to 87 MPa while the −6 dB focal width decreased concomitantly from 11 to 4 mm. Using the original reflector, p+ of 33 MPa with a −6 dB focal width of 18 mm were measured in a pre-focal plane 15-mm proximal to the lithotripter focus. However, the acoustic pulse energy delivered to a 28-mm diameter area around the lithotripter axis was comparable (∼120 mJ). For all three exposure conditions, similar stone comminution (∼70%) was produced in a mesh holder of 15 mm after 250 shocks. In contrast, stone comminution produced by the modified reflector either in a 15-mm Finger Cot (45%) or in a 30-mm membrane holder (14%) was significantly reduced from the corresponding values (56% and 26%) produced by the original reflector (no statistically significant differences were observed between the focal and pre-focal planes). These observations suggest...
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Comparison of Stone Comminution Produced by Two Different Reflector Configurations in an HM-3 Lithotripter
Volume 2: Biomedical and Biotechnology Engineering, 2007Co-Authors: W. Neal Simmons, Pei ZhongAbstract:Clinical experience has demonstrated that the performance of the 2nd and 3rd generation shock wave lithotripters in terms of stone comminution has become inferior to the 1st generation Dornier HM-3 lithotripter. A primary change in the design of the newer generation lithotripters is the enlarged aperture of the shock source, leading to a higher peak pressure with a smaller focal area. To evaluate the effect of beam size on stone comminution in the same lithotripter, we developed a reflector insert for the HM-3 that can substantially increase the peak pressure while concomitantly tightening the beam size of the lithotripter field. Using a light spot hydrophone, we have characterized the acoustic fields produced by the two reflector configurations at 20 kV. The peak positive pressure and the −6dB beam size were found to be 87 MPa and 4 mm for the HM-3 with the reflector insert, which are significantly different than the corresponding values (51 MPa and 13 mm) for the original reflector. In contrast, the peak tensile pressure and the total acoustic energy of the lithotripter pulse were found to be similar (−12 MPa and 59 mJ with the reflector insert, −11 MPa and 52 mJ for the original reflector). Stone comminution was evaluated in four different holders in order to determine the effect of lateral spreading of residual fragments on lithotripsy outcome. After 250 shocks, the results of stone comminution in a mesh holder of D = 15 mm (63% vs. 61%) were similar. However, the corresponding values produced by the HM-3 with reflector insert in a Finger Cot of D = 15 mm (45%) and in a membrane holder of D = 30 mm (14%) were significantly lower than those produced by the original reflector (56% and 26%). Further, the efficiencies of stone comminution in both the mesh holder and the Finger Cot were much higher than that in the membrane holder. These results suggest that a wide beam size in the original HM-3 may increase stone comminution efficiency when the fragments are spread out to a large area during lithotripsy. In contrast, when the fragments are confined during lithotripsy the beam size may not influence significantly the treatment outcome.Copyright © 2007 by ASME
P. Bigler - One of the best experts on this subject based on the ideXlab platform.
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A rare complication of the use of a Finger Cot to protect the cuff of a tracheal tube during nasotracheal intubation
Intensive Care Medicine, 1993Co-Authors: J. P. Barras, P. Bigler, A. CzerniakAbstract:Some anesthetists in Swirzerland and elsewhere use a Finger Cot to protect the cuff of the endotracheal tube during nasotracheal intubation. In the presented report the Finger cut was lost during the procedure and the patient presented 3 months later with a lateral neck mass. The Finger Cot was found within that mass at exploration. Apart from the other potential risks of this manoeuvre, this severe complication should incite caution against the practice described above.
Achim M. Loske - One of the best experts on this subject based on the ideXlab platform.
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The importance of an expansion chamber during standard and tandem extracorporeal shock wave lithotripsy.
Journal of Endourology, 2009Co-Authors: Francisco Fernández, Gilberto Fernández, Achim M. LoskeAbstract:Abstract Background and Purpose: It is known that extracorporeal shock wave lithotripsy (SWL) may be improved by increasing cavitation using tandem shock waves. However, fluid is needed for the cavitation to work. The purpose of this research was to evaluate the importance of a fluid-filled expansion chamber in enhancing stone fragmentation during standard and tandem SWL. Materials and Methods: A piezoelectric lithotripter was modified to generate tandem shock waves. Artificial kidney stones inserted in vitro into the parenchyma of a pig kidney were exposed to either standard or tandem shock waves. Stones in one group were placed inside a small Finger Cot filled with water before they were introduced into the kidney. Stone fragments were strained through a mesh, dried, and weighed. Results: Water surrounding the stones always improved stone fragmentation. The best results were achieved using tandem shock waves at a delay of 250 μs. Conclusions: A fluid-filled chamber surrounding the stone is essential for...