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A Hundt

Publications and source records attributed to A Hundt.

5 recordsLinked to original sources
PubMed2003

[Comparison of different laryngeal mask airways in a resuscitation model].

OBJECTIVE: The standard laryngeal mask airway LMA-Classic is recommended in the ILCOR guidelines as alternative to facemask and tracheal tube during cardiopulmonary resuscitation. LMA-Unique, LMA-Fastrach and LMA-ProSeal are additional variants that are compared with the standard LMA in a resuscitation model. METHODS: Tidal volumes, chest compressions and signs of gastric inflation are measured in a standardized resuscitation model (Ambu Cardiac Care Trainer with notebook and thumper). Ten 3-minute resuscitation cycles were performed with facemask and all LMAs (Classic, Unique, Fastrach, ProSeal, all size 4) with a ventilation : compression ratio of 2:15. To allow comparison with tracheal tube and to judge safety margins, another ten resuscitation cycles were performed with tracheal tube and all laryngeal masks with continuous chest compressions after two initial ventilations. The bag-valve device used for ventilation was replaced by an automatic transport ventilator in a third series with continuous chest compressions. Cuff pressures were set at 80 cm H2O. RESULTS: During interrupted chest compressions, adequate ventilation was possible with all devices. Tidal volumes for facemask, LMA-Fastrach and LMA-ProSeal were significantly (p < 0.001) higher than with LMA- Classic and LMA-Unique. During continuous chest compressions, significant differences (p < 0.001) occurred when comparing tracheal tube, Fastrach and ProSeal with the other two laryngeal mask airways, which did not reach recommended tidal volumes. During ventilation with the automatic transport ventilator, values for all devices except LMA-ProSeal dropped significantly, adequate ventilation was possible with tracheal tube, Fastrach and ProSeal. Signs of gastric inflation were found during ventilation with facemask and - to a lesser extent - with LMA-Classic. CONCLUSION: In the resuscitation model chosen, all laryngeal mask airways are possible alternatives for ventilation during cardiopulmonary resuscitation. The new LMA-ProSeal and also the LMA-Fastrach allow higher tidal volumes even during elevated intrathoracic pressures caused by continuous chest compressions, performing superior to the standard laryngeal mask airway. For inclusion of these devices in the ILCOR guidelines, further research in patients is warranted.

Cardiopulmonary Resuscitation↗
PubMed2001

Photon beats from a single semiconductor quantum dot.

Single-photon interference is observed on the ultranarrow long-term stable exciton resonance of an individual semiconductor quantum dot. This interference is related to the fine-structure splitting and allows direct conclusions about the coherence properties of the exciton. When selectively addressing a particular dot by quasiresonant phonon-assisted excitation, despite a rapid orientation relaxation on a 1-ps time scale, coherence is partly maintained. No significant further decoherence occurs when the ground state is reached until the exciton recombines radiatively (approximately 300 ps).

Journal Article↗
PubMed2001

Neoadjuvant radio-chemotherapy of adenocarcinoma of the oesophagogastric junction.

BACKGROUND: Recently, neoadjuvant radio-chemotherapy has been demonstrated to induce tumour remission and to prolong survival of patients with locally advanced adenocarcinoma of the oesophagogastric junction.The present study was performed to re-evaluate these data. PATIENTS AND METHOD: A non-randomised trial of multimodal treatment was conducted in order to investigate histopathologic response and survival of patients with adenocarcinoma of the oesophagogastric junction. Treatment consisted of 2 courses of combined chemotherapy with 15 mg/kg 5-fluorouracil on days 1-5 and 75 mg/m(2) cisplatin on day 8 and simultaneous radiation (40 Gy), and a second course starting on day 36, followed by surgery. Abdomino-thoracic oesophagectomy and systematic 2-field lymphadenectomy were performed in patients with Barrett's carcinoma. D2-gastrectomy was performed in patients with type 2 or 3 cancer of the oesophagogastric junction according to the Siewert classification. Probability of survival was estimated using the Kaplan-Meier method. RESULTS: 16 patients with a mean age of 57 years were enrolled in this study. Surgery was performed in 14 of these patients. Response to treatment was evident in 10 patients, but none of these patients had complete histopathologic response. Toxicity related to radiochemotherapy was mild to moderate (37.5%). Perioperative complications, both medical and surgical, occurred in 71.4% of patients. 2 patients had fatal complications. 30-day mortality was 25.4%. The probability of survival at 2 years after surgery was 61.2%. CONCLUSION: Neoadjuvant radio-chemotherapy followed by surgery for cancer of the oesophagogastric junction is associated with a considerable rate of complications. Histopathologic response to radio-chemotherapy is poor. In consequence of these preliminary results, the present study was terminated and the protocol of a future study was modified.

Adenocarcinoma↗
PubMedDate not supplied

The impact of health care market changes on local decision making and STD care: experience in three counties.

INTRODUCTION: In 1993 health care reform including universal coverage appeared imminent. Some county health departments elected to discontinue provision of direct services including sexually transmitted disease (STD) care. County A moved in this direction with final clinic closure in 1996. Coincidentally, two other counties elected to continue their STD treatment services. These events have created a "natural experiment" in which to evaluate the contrasting strategies among three counties. METHODS: This report describes the changes in local delivery over a three-year period (1993-1995). Measurements were carried out in three counties in two states. STD program capacity, service delivery, and morbidity rates for STDs (chlamydia and gonorrhea) were monitored in each study county. Quantitative data were complemented by a qualitative patient survey at each site. RESULTS: Capacity changed dramatically in County A as compared with the other two over the three-year period. Major declines in STD clinic visits (-43%) and laboratory testing (-46%) occurred. A major drop in reported STD incidence (-23% for chlamydia and -49% for gonorrhea) also occurred, including a drop in public provider reporting. CONCLUSIONS: In County A, a decision to end delivery of personal health services led to a divestiture in STD service delivery and a decline in all measured parameters. Etiology of concurrent declined in reported STDs is unclear. Possibly decreased public services led to a spurious decline in reporting. Alternatively, an overall strategy of shifting care to private providers has succeeded in reducing disease. Public health surveillance may be less accurate in such settings.

Adult↗