Summary We compared the McGrath® Series 5 videolaryngoscope with the Macintosh laryngoscope in a simulated difficult airway, using manual in‐line stabilisation in 88 anaesthestised patients of ASA physical status 1‐2. The primary outcome was laryngoscopic view. Secondary outcomes included rates of successful tracheal intubation and complications. A Cormack and Lehane grade‐1 or ‐2 view was found in all patients when using the McGrath compared with 45 (51%, p < 0.0001) using the Macintosh laryngoscopes. The mean (SD) percentage of glottic opening was 82 (23)% using the McGrath compared with 13 (23)% using the Macintosh (p < 0.0001). In 66 out of 88 patients (75%), the McGrath improved the glottic view by one to three grades compared with the Macintosh (p < 0.001). Intubation of the trachea was successful in all patients using the McGrath, while the Macintosh was successful in 26 (59%, p < 0.001). There was no significant difference in the complication rates between the devices.

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In simulated difficult pediatric airway, using the GlideScope resulted in a significantly declined view to the glottic entrance. This result is in contrast to studies in children with difficult airway anatomy due to an anterior larynx, where the GlideScope resulted in improved views.

Background: Abdominal aortic aneurysm (AAA) rupture has an associated mortality of 90%. AAAs are repaired when they meet size criteria, become symptomatic, or rupture. Use of aortic diameter as the primary criterion in the decision to intervene fails to take into consideration that AAAs rupture at sizes below operative thresholds or reach extreme size without rupture. We have previously shown that AAAs rupture at sites of low wall shear stress (WSS) where flow recirculation and intraluminal thrombus (ILT) tend to be more abundant. This study examined the fate of ILT deposition in AAA growth. We hypothesized that AAA expansion would be associated with increasing ILT deposition in sites of flow recirculation. Methods: A total of six patients with serial images of AAA growth over three time points were studied. Aortic measurements and sites of ILT deposition were recorded. Three-dimensional AAA geometry was generated from computed tomography angiography images. Predicted aortic blood flow velocity, localized pressure variation, and WSS profiles were correlated with AAA growth and ILT deposition. This study was carried out with biomedical ethics approval. Results: AAA growth was associated with increasing ILT deposition in most cases. The site of maximal ILT deposition strongly correlated with regions of flow recirculation and low WSS but did not correlate with the region of maximal aortic expansion. Interestingly, in some cases, the recirculation zone changed location with AAA growth, and this was associated with similar change in location of ILT deposition. Conclusions: This study has shown that ILT increases with increasing AAA size in most aneurysms and that deposition of ILT occurs at sites with low WSS and flow recirculation. An understanding of the alterations in WSS in pulsatile flow and its effect on vascular endothelium will lead to a better understanding of AAA development and growth and may ultimately lead to better prediction of AAA rupture potential.

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constituted the SVF. For ASC amplification, the SVF was then resuspended in growth medium and kept under standard cell culture conditions for at least one week. We transplanted laparoscopically metanephroi from rabbit embryos in 3 groups: a) combined treatment with 105 cells of either mononuclear cells from the SVF or b) combined with ASC and c) control suspended in 5 ml of growth medium to test in vivo host integration and function. Then we transplant every metanephros by a laparoscopic procedure and documented the growth (weight, morphologically and histomorphometric of glomeruli) and the renin and erythropoietin transcript expression by qRT-PCR RESULTS: Four weeks after transplantation, kidney graft explants were recovered and examined. In total, 3/6 SVF metanephroi, 4/6 ASC metanephroi and 3/6 control metanephroi were successfully grown. However, in the ASC group, the organ weights increased significantly (0.5AE0.06 g vs 0.2AE0.08 g and 0.3AE0.08 g for ASC vs SVF and control group, respectively p < 0.05). In all of groups, kidney graft explants developed mature glomeruli whose histomorphometry analysis showed a similar area and perimeter of renal corpuscle and glomerulus and glomerular tuft cellularity. In addition, the expression profile of renin and erythropoietin transcript, and consistent with the expression in host kidneys CONCLUSIONS: Taken together, our results demonstrated that embryonic kidney in combined treatment with adipose derived stem cells, enable the generation of kidney graft explants with higher weights after laparoscopic transplantation into syngeneic non-immunosuppressed host

Background: Ruptured middle colic artery aneurysm is extremely uncommon. Diagnosis can be challenging, as symptomatology can be attributed to more common abdominal pathologies. Due to the rarity of this condition, only case reports are available to inform management. Case Presentation: We present the case of a 72-year-old woman with a ruptured middle colic artery aneurysm presenting with signs and symptoms more suggestive of acute calculous cholecystitis. Her co-existing bleed was confirmed on CT angiogram. Coil embolization was initially attempted unsuccessfully. She underwent laparotomy, a middle colic artery ligation, and extended right hemicolectomy with intra-aortic balloon placement for emergency proximal vascular control. Post-operatively, she had a re-bleed that was successfully managed with covered stent placement in the proximal superior mesenteric artery after an unsuccessful re-attempt at coil embolization. Her apparent associated cholecystitis was managed with antibiotics and resolved uneventfully. Conclusion:A middle colic artery aneurysm can be challenging to diagnose and treat. Management options include endovascular techniques, open surgery, or a combination approach. Intra-aortic balloon placement for emergency vascular control is a novel approach that could avoid hemorrhage when intra-abdominal vascular access is challenging.