ABSTRACT
Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a rare cause of haemoptysis. ABLL may be complicated by massive haemoptysis, heart failure due to left-to-right shunt and infection. We describe a case of this condition presenting in the third trimester of pregnancy. Computed tomography chest angiogram confirmed the diagnosis. A multidisciplinary approach was necessary to determine treatment, which ultimately consisted of elective caesarean section at 36 weeks and 4 days' gestation, followed by transarterial embolisation 9 days postpartum.
ABSTRACT
'Motion dazzle' is the hypothesis that predators may misjudge the speed or direction of moving prey which have high-contrast patterning, such as stripes. However, there is currently little experimental evidence that such patterns cause visual illusions. Here, observers binocularly tracked a Gabor target, moving with a linear trajectory randomly chosen within 18° of the horizontal. This target then became occluded, and observers were asked to judge where they thought it would later cross a vertical line to the side. We found that internal motion of the stripes within the Gabor biased judgements as expected: Gabors with upwards internal stripe motion relative to the overall direction of motion were perceived to be crossing above Gabors with downwards internal stripe movement. However, surprisingly, we found a much stronger effect of the rigid pattern orientation. Patches with oblique stripes pointing upwards relative to the direction of motion were perceived to cross above patches with downward-pointing stripes. This effect occurred only at high speeds, suggesting that it may reflect an orientation-dependent effect in which spatial signals are used in direction judgements. These findings have implications for our understanding of motion dazzle mechanisms and how human motion and form processing interact.
Subject(s)
Illusions , Motion Perception , Humans , Judgment , Movement , Orientation , PsychophysicsABSTRACT
OBJECTIVE: General anesthesia with endobronchial intubation and one-lung positive-pressure ventilation always has been considered mandatory for thoracic surgery. Recently, there has been interest in nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients. The authors' center developed a nonintubated technique with spontaneous ventilation with the patient under general anesthesia using a supraglottic airway device. The authors believe that this was the first study to compare a nonintubated general anesthetic technique with an intubated general anesthetic technique for VATS. DESIGN: Retrospective, observational study. SETTING: Specialist cardiothoracic hospital in the United Kingdom. PARTICIPANTS: All patients who underwent elective minor VATS over 8 months (n = 73). INTERVENTIONS: A nonintubated general anesthetic technique with spontaneous ventilation via a supraglottic airway device was used for minor VATS procedures. This was compared with a case-matched intubated group. MEASUREMENTS AND MAIN RESULTS: Both groups had comparable baseline characteristics and surgical procedures. The anesthetic time was shorter in the nonintubated group (13.6±8.3 v 24.1±10.9 minutes, p<0.001). Surgical operating time and feasibility were similar. Intraoperatively, there were increases in end-tidal carbon dioxide (59.1±12.9 v 41.8±4.6, p<0.001) and respiratory rate (17.8±5.6 v 13.5±2.0, p<0.001) in the nonintubated group. Fewer patients in the nonintubated group had moderate-severe pain during recovery (19.4% v 48.4%, p = 0.02) and pain on discharge to the ward (25.8% v 61.3%, p = 0.004). There was a trend toward shorter recovery times, reduced oxygen requirement, and shorter hospital stays in the nonintubated group. CONCLUSIONS: A nonintubated general anesthetic technique is a feasible alternative to intubated general anesthesia for minor VATS procedures.
