scholarly journals Closing an Intractable Tracheoesophageal Fistula Caused by a Tracheoesophageal Shunt Using a Myocutaneous Flap and a Hinged Flap With Skin Graft in a Two-Step Procedure

Cureus ◽  
2021 ◽  
Author(s):  
Yasuyuki Morimatsu ◽  
Koichiro Yonezawa ◽  
Hidetoshi Matsui ◽  
Shigemichi Iwae ◽  
Shunsuke Sakakibara
Keyword(s):  
Skin Graft ◽  
Tracheoesophageal Fistula ◽  
Myocutaneous Flap ◽  
Step Procedure ◽  
Tracheoesophageal Shunt

scholarly journals Platysma myocutaneous flap interposition in surgical management of large acquired post-traumatic tracheoesophageal fistula: A case report

2014 ◽  
Vol 5 (5) ◽  
pp. 282-286 ◽  
Author(s):  
Thawatchai Akaraviputh ◽  
Chotirot Angkurawaranon ◽  
Teerawit Phanchaipetch ◽  
Visnu Lohsiriwat ◽  
Thanyadej Nimmanwudipong ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Tracheoesophageal Fistula ◽  
Myocutaneous Flap ◽  
Post Traumatic

scholarly journals Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis

2009 ◽  
Vol 24 (2) ◽  
pp. 14-18
Author(s):  
Jeanne O. Madrid ◽  
Celso V. Ureta
Keyword(s):  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Public Hospital ◽  
Sound Production ◽  
Myocutaneous Flap ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Voice Production ◽  
Alaryngeal Speech

Objective:  To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique Methods:        Design: Cross-Sectional Study Setting: Tertiary Public Hospital        Subjects: Twenty alaryngeal patients Results:  Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen.  Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave.  Pharyngoesophageal vibration was noted in two thirds of patients.  It was associated with a strong mucosal wave, regular vibration and a longer open phase. Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction.    Keywords:  larynx, total laryngectomy, voice reconstruction, tracheoesophageal (te) fistula speech, alaryngeal voice, alaryngeal speech, videostrobe    

Scanning Tunneling Microscopy of Amorphous Carbon Films

1990 ◽  
Vol 48 (1) ◽  
pp. 318-319
Author(s):  
Mircea Fotino ◽  
D.C. Parks
Keyword(s):  
Scanning Tunneling Microscopy ◽  
Amorphous Carbon ◽  
Carbon Films ◽  
Atomic Scale ◽  
Scanning Tunneling ◽  
Tunneling Microscopy ◽  
Amorphous Carbon Films ◽  
Image Optimization ◽  
Step Procedure ◽  
Stm Images

In the last few years scanning tunneling microscopy (STM) has made it possible and easily accessible to visualize surfaces of conducting specimens at the atomic scale. Such performance allows the detailed characterization of surface morphology in an increasing spectrum of applications in a wide variety of fields. Because the basic imaging process in STM differs fundamentally from its equivalent in other well-established microscopies, good understanding of the imaging mechanism in STM enables one to grasp the correct information content in STM images. It thus appears appropriate to explore by STM the structure of amorphous carbon films because they are used in many applications, in particular in the investigation of delicate biological specimens that may be altered through the preparation procedures.All STM images in the present study were obtained with the commercial instrument Nanoscope II (Digital Instruments, Inc., Santa Barbara, California). Since the importance of the scanning tip for image optimization and artifact reduction cannot be sufficiently emphasized, as stressed by early analyses of STM image formation, great attention has been directed toward adopting the most satisfactory tip geometry. The tips used here consisted either of mechanically sheared Pt/Ir wire (90:10, 0.010" diameter) or of etched W wire (0.030" diameter). The latter were eventually preferred after a two-step procedure for etching in NaOH was found to produce routinely tips with one or more short whiskers that are essentially rigid, uniform and sharp (Fig. 1) . Under these circumstances, atomic-resolution images of cleaved highly-ordered pyro-lytic graphite (HOPG) were reproducibly and readily attained as a standard criterion for easily recognizable and satisfactory performance (Fig. 2).

Procedure for Maximizing Phonological Information from Single-Word Responses

1984 ◽  
Vol 15 (4) ◽  
pp. 267-274 ◽  
Author(s):  
Harriet B. Klein
Keyword(s):  
Phonological Information ◽  
Single Word ◽  
Preliminary Assessment ◽  
Target Attainment ◽  
Phonological Processes ◽  
Step Procedure ◽  
Yield Information ◽  
Assessment Measure ◽  
Busy Clinician ◽  
Planning Intervention

Formal articulation test responses are often used by the busy clinician as a basis for planning intervention goals. This article describes a 6-step procedure for using efficiently the single-word responses elicited with an articulation test. This procedure involves the assessment of all consonants within a word rather than only test-target consonants. Responses are organized within a Model and Replica chart to yield information about an individual's (a) articulation ability, (b) frequency of target attainment, substitutions, and deletions, (c) variability in production, and (d) phonological processes. This procedure is recommended as a preliminary assessment measure. It is advised that more detailed analysis of continuous speech be undertaken in conjunction with early treatment sessions.

Plasminogen-Activator in Human Early Milk: Its Partial Purification and Characterization

1981 ◽  
Vol 45 (02) ◽  
pp. 121-126 ◽  
Author(s):  
Utako Okamoto ◽  
Noboru Horie ◽  
Yoko Nagamatsu ◽  
Jun-Ichiro Yamamoto
Keyword(s):  
Plasminogen Activator ◽  
Polyacrylamide Gel Electrophoresis ◽  
Gel Filtration ◽  
Partial Purification ◽  
Order Kinetic ◽  
Diisopropyl Fluorophosphate ◽  
Step Procedure ◽  
Activity Band ◽  
C 50 ◽  
Gel Isoelectric Focusing

SummaryMilk plasminogen-activator was partially purified from human transitional milk collected at about 10 days after delivery, by a five-step procedure involving chloroform treatment, ammonium sulfate precipitation, and column chromatography on Sephadex G-150, CM Sephadex C-50 and DEAE Sephadex A-50. This gave milk-activator with a maximum purification factor of about 2,400-fold with respect to the skimmed milk. The CM Sephadex-step preparation showed, on polyacrylamide gel electrophoresis, a single plasminogen-activator activity band located between the bands of albumin and prealbumin of human serum. This preparation exhibited no kinin forming activity. The activator hydrolyzed acetyl-glycyl-L-lysine methyl ester with similar order kinetic constants to urokinase, and was inhibited strongly by diisopropyl-fluorophosphate. The molecular weight of the activator as estimated by gel filtration was approximately 86,000, the isoelectric points as estimated by gel isoelectric focusing were pH 7.2, 6.9 and 6.6, and the activator activity was not quenched by antiurokinase globulin, indicating that the milk-activator is a different entity from urokinase.

CLOSURE OF TRACHEOESOPHAGEAL FISTULA USING ENDOSCOPIC SUTURING

2020 ◽  
Author(s):  
A Benson ◽  
D Hakimian ◽  
H Jacob ◽  
I Boškoski
Keyword(s):  
Tracheoesophageal Fistula ◽  
Endoscopic Suturing

Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

2020 ◽  
Author(s):  
Domenico Pagliara ◽  
Maria Lucia Mangialardi ◽  
Stefano Vitagliano ◽  
Valentina Pino ◽  
Marzia Salgarello
Keyword(s):  
Comparative Study ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Tactile Sensitivity ◽  
Aesthetic Outcome ◽  
Propeller Flap ◽  
Thickness Skin ◽  
Anterolateral Thigh ◽  
Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

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