ABSTRACT
BACKGROUND: The hemodynamic changes associated with orotracheal intubation may result from direct laryngoscopy and the endotracheal intubation. This study evaluated and compared the cardiovascular changes after either Bonfils intubation fibrescope or conventional laryngoscopic endotracheal intubation. METHODS: Sixty patients, aged 20 to 30 years, were randomly allocated into two groups, the Bonfils intubation fibrescope group (BF group, n = 30) and conventional intubation using a rigid laryngoscope (LS group, n = 30). Bonfils intubation fibrescope or laryngoscopic oral endotracheal intubation was performed after inducing anesthesia. The systolic and diastolic arterial pressures, heart rate, peripheral oxygen saturation and intubation time were recorded before and after orotracheal intubation. RESULTS: In both groups, the systolic and diastolic arterial pressures increased significantly after endotracheal intubation. The heart rate increased significantly after the induction of anesthesia in both groups. However, the arterial blood pressure, heart rate and intubation time were similar in both groups. CONCLUSIONS: The use of a Bonfils intubation fibrescope does not modify the hemodynamic response associated with endotracheal intubation compared with conventional laryngoscopy.
Subject(s)
Humans , Anesthesia , Arterial Pressure , Heart Rate , Hemodynamics , Intubation , Intubation, Intratracheal , Laryngoscopes , Laryngoscopy , OxygenABSTRACT
Congenital middle ear cholesteatoma is a keratinizing squamous epithelial cyst that classically presents as a white "pearl" in either the anterosuperior or posterosuperior quadrants behind an intact tympanic membrane. The presenting features of congenital cholesteatoma depend upon the initial site of the disease. The most common presentation of this disease is a conductive hearing loss or a facial palsy of gradual onset. Other presentations include incapacitating vertigo with nystagmus, a feeling of fullness in the ear, frequent otalgia, an abnormal eardrum noted at physical examination for an unrelated condition and meningitis. Recently, we experienced a case of congenital cholesteatoma that was presented as a post-auricular fistula. In considering the management of such a fistula, it would be important to recognize the possibility that the disease may present in this way.
Subject(s)
Cholesteatoma , Cholesteatoma, Middle Ear , Ear , Earache , Facial Paralysis , Fistula , Hearing Loss, Conductive , Meningitis , Physical Examination , Tympanic Membrane , VertigoABSTRACT
BACKGROUND AND OBJECTIVES:Dizziness is a vague symptom of disease. Dizziness of cardiovascular origin is associated with decreased cardiac output and usually presented as light-headed sensation of an impending faint. This study aims to provide the clinician with a logical approach to identifying the cardiovascular causes of dizziness. MATERIALS AND METHOD:From February 2002 to June 2004, we sampled the 30 dizzy patients who complained light-headed sensation of an impending faint with underlying disease of arrhythmia or abnormal blood pressure. The 11 patients with arrhythmia were monitored by 24 hr ambulatory ECG monitoring and all were examined with Schellong test. RESULTS:Among the 11 patients with arrhythmia, 7 patients were diagnosed as cardiovascular origin dizziness by 24hr ambulatory ECG monitoring and 10 patients as orthostatic hypotension by Schellong test. CONCLUSION:The results of this study indicated that 24hr ambulatory ECG monitoring and Schellong test had efficacy for the diagnosis of dizzy patients who complained light-headed sensation of an impending faint with underlying disease of arrhythmia or abnormal blood pressure
Subject(s)
Humans , Arrhythmias, Cardiac , Blood Pressure , Cardiac Output , Diagnosis , Dizziness , Electrocardiography , Electrocardiography, Ambulatory , Hypotension, Orthostatic , Logic , SensationABSTRACT
Pilomatricomas are rare, usually benign and solitary, asymptomatic, calcifying tumors of the hair matrix cell, which mostly appear in the first and second decade of life. However, they may occur in adulthood. The most prevalent sites of pilomatricomas in children are the head and neck but they may occur anywhere. The typical presentation is a firm, slowly enlarging, freely mobile, well-circumscribed subcutaneous nodule, measuring 0.5 to 3 cm in diameter. The tumors are generally solitary, often adherent to overlying skin. Multiple pilomatricoma is relatively rare. Spontaneous regression is never observed, complete surgical excision is a treatment of choice. We present two cases of pilomatricoma arising from the right posterior auricle and the left posterior neck, which were treated with simple excision.
Subject(s)
Child , Humans , Hair , Head , Neck , Pilomatrixoma , SkinABSTRACT
In the past, the treatments for acute dacryocystitis with abscess formation were warm compression, systemic and topical antibiotics, and drainage of the abscess, if fluctuation occurs. Acute dacryocystitis with abscess formation is rarely primary, but often secondary to distal obstruction or extension of contiguous inflammation. After resolution of acute infection, evaluation and treatment of the underlying cause should be initiated. Recent reports have demonstrated that endoscopic dacryocystorhinostomy is an effective treatment for acute dacryocystitis associated with nasolacrimal duct obstruction. We experienced a case of acute dacryocystitis with lacrimal sac abscess formation. Drainage of lacrimal sac abscess was safely accomplished with endoscopic dacryocystorhinostomy. The patient had an excellent postoperative course without recurrence.