scholarly journals THERAPEUTIC PARTICULARITIES OF CHRONIC SUPPURATED CHOLESTEATOMATOUS OTOMASTOIDITIS

2018 ◽  
Vol 1 (2) ◽  
pp. 71-74
Author(s):  
C. Stan ◽  
Andreea Mihaela Enachi ◽  
Doina Vesa
Keyword(s):  
General Anesthesia ◽  
Orotracheal Intubation ◽  
Massive Bleeding ◽  
Point Of View ◽  
Mastoid Process ◽  
General View ◽  
Inflammatory Damage ◽  
Thoracic And Abdominal ◽  
Electric Scalpel ◽  
Congenital Hemangioma

Chronic suppurated otomastoiditis is a chronic inflammatory damage of the middle ear and mastoid process that exceeds 12 weeks and which leads to the permanent perforation of the eardrum’s membrane. There is local damage such as osteitis, osteonecrosis and cholesteatoma, while a general view reveals an  asymptomatic evolution, with a good general state, otorrhea being the only local symptom. This paper brings to light a case resulting from the thorough analysis of case studies run by the ENT Clinic of the Emergency County Hospital "Sf. Apostol Andrei” of Galaţi, through the fact that otomastoiditis progresses given the presence of a congenital hemangioma located on the left half of the cephalic extremity, at a cervical, thoracic and abdominal level. The patient, aged 41, has been suffering from this disease since childhood and has undergone numerous surgeries up to this moment, but none has proven to be adequate for the extent of the lesion due to the malformation and the difficulty in providing general anesthesia with orotracheal intubation, the hemangioma being present in the oropharynx, hypopharynx and larynx. Given the overlapping of the two disorders, the surgical-medical approach to the ear damage has proven insufficient in time due to the risk of massive bleeding, taking into account the fact that the hemangioma was extended to the left ear duct, pharynx and larynx. For this reason, the disease has progressed, leading to extended erosive cholesteatoma with left otomastoiditis. The particularities of the therapeutic approach are presented along with anesthesiologic and surgical problems involved by the hemangioma. Although the risk of hemorrhaging was great, approaching the condition by choosing to provide general anesthesia and making the incisions only with the help of an electric scalpel, the case was eventually solved successfully from a surgical point of view.

scholarly journals I.—The Metamorphosis of the Lizard Gabbros

1886 ◽  
Vol 3 (11) ◽  
pp. 481-489 ◽  
Author(s):  
J. J. H. Teall
Keyword(s):  
Mechanical Energy ◽  
Earth Pressure ◽  
Careful Consideration ◽  
Point Of View ◽  
Igneous Rocks ◽  
General Point ◽  
Present Moment ◽  
General View ◽  
Original Rock ◽  
The Subject

If we take a general view of the present position of geological science, we are struck by the fact that, although there is substantial agreement amongst geologists on matters relating to the origin of the rocks usually designated as aqueous and igneous, the greatest diversity of opinion prevails with regard to the circumstances under which the so-called metamorphic rocks have been produced. Every fragment of evidence calculated to throw light on the origin of these rocks, therefore, deserves the most careful consideration. Of recent years special attention has been directed to the effects of mechanical energy in modifying the mineralogical and structural characters of rocks originally formed by aqueous and igneous agencies; and a suspicion has been aroused that it is in this direction that we must look for a solution of many of the problems connected with the origin of the crystalline schists. A visit to the Lizard Peninsula of Cornwall during the present summer has convinced me of the immense importance of this view so far as that district is concerned. That portion of the peninsula which lies south of a line drawn from Porthalla on the east to Polurrian Cove on the west is formed.partly of igneous rocks—such as gabbro, greenstone, serpentine, and granite—and partly of crystalline schists. The igneous rocks, in certain places, become foliated and sohistose and sometimes show a definite banding due to a variation in the relative proportions of the different constituents. In other words they present characters which are usually regarded as distinctive of the crystalline schists. There is, moreover, evidence to show that these characters are mainly the result of a yielding to earth-pressure subsequent to the consolidation of the original rock. At the present moment, having just returned from the district, I am unable to treat the subject from a general point of view with any prospect of success; but it has occurred to me that some details with regard to one of the rocks may not be without interest to members of the Association.

Comparison among the Intubation Techniques Employed in the Course of Management of Pan-Facial Trauma

2021 ◽  
Author(s):  
Aravindh RJ
Keyword(s):  
General Anesthesia ◽  
Nasotracheal Intubation ◽  
Functional Results ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Minimal Risk ◽  
Intermaxillary Fixation ◽  
Intubation Technique ◽  
Submental Intubation ◽  
Intraoperative Period

Objective: To find the best method of intubation in patients sustaining pan-facial trauma by comparing the pros and cons of each technique. Materials and methods: Three different types of intubation techniques (nasotracheal intubation, orotracheal intubation, and sub-mental intubation) were considered in this study. The study population involves 9 patients who have undergone treatment for pan-facial trauma under general anesthesia (3 patients per technique) and the variables of clinical outcome of each group were recorded. Results: Nasal intubation is the most common and safest method of intubation. However, it can’t be used in some types of pan-facial trauma. In cases like these, oral intubation is not preferred. As it severely compromises maxillofacial repair because of interference with the placement of intermaxillary fixation [3](IMF), which is used to establish the patient s occlusion in the intraoperative period. Submental intubation is an alternative with minimal risk to tracheostomy when orotracheal or nasotracheal intubation is not appropriate. The submental intubation technique gave an uninterrupted surgical field, unobstructed airway, ease of gaining occlusion in general anesthesia, less intraoperative and postoperative complications and it overcomes the disadvantages of both nasotracheal and orotracheal intubation. Conclusion: Preferred techniques of securing an airway are orotracheal, nasotracheal intubation. However these techniques may not always be applicable, thus a trauma surgeon-anesthetist team should always have alternative techniques in their armamentarium which secures the patient's airways without interfering with occlusion, to gain at most postoperative esthetic and functional results.

scholarly journals Submental method for orotracheal intubation in treating facial trauma

1998 ◽  
Vol 116 (5) ◽  
pp. 1829-1832 ◽  
Author(s):  
Luiz Carlos Manganello-Souza ◽  
Nicolas Tenorio-Cabezas ◽  
Luiz Piccinini Filho
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Surgical Intervention ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Surgical Team ◽  
Visible Scar ◽  
Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

Intermittent General Anesthesia With Controlled Ventilation for Asleep-Awake-Asleep Brain Surgery

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. 764-772 ◽  
Author(s):  
Pauline Deras ◽  
Gérard Moulinié ◽  
Igor Lima Maldonado ◽  
Sylvie Moritz-Gasser ◽  
Hugues Duffau ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Orotracheal Intubation ◽  
Neurosurgical Procedure ◽  
Controlled Ventilation ◽  
Standardized Protocol ◽  
Single Center Study ◽  
Gastric Contents ◽  
Eloquent Area ◽  
Mean Time

Abstract BACKGROUND: Awake brain tumor surgery is a unique opportunity for mapping sensorimotor and cognitive functions, allowing the operator to optimize the resection while preserving the patient's quality of life. During this type of procedure, active participation of the patient is necessary. OBJECTIVE: To assess the efficacy and safety of a method of intermittent general anesthesia with controlled ventilation for performing invasive cerebral mapping. METHODS: We report our prospective and observational single-center study with an asleep-awake-asleep protocol. Aspects of feasibility, airway management, timing of each phase, and occurrence of adverse events were detailed. RESULTS: During a 35-month period, 140 patients underwent resection of a glioma in an eloquent area. During the asleep phases, controlled ventilation with a laryngeal mask was always efficient. Orotracheal intubation was performed for some patients for the second asleep period. The patients remained fully awake for a mean time of 98 minutes. Postural discomfort was reported in 17.8% of cases. There was 1 case of aspiration of gastric contents with a favorable outcome and no mortality. CONCLUSION: Intermittent general anesthesia with controlled ventilation for this type of neurosurgical procedure remains an anesthesiological challenge. However, the results of this study suggest that it may be feasible, reproducible, and relatively safe in the context of a standardized protocol involving members of both anesthesiology and surgery teams. Such a technique has a great potential to improve the surgical results, from both oncological and functional perspectives.

scholarly journals Representação e ciências sociais

2016 ◽  
Vol 1 (1) ◽  
pp. 109-126
Author(s):  
Drance Elias da Silva
Keyword(s):  
Social Sciences ◽  
Knowledge Representation ◽  
Human Life ◽  
Point Of View ◽  
General View ◽  
Dominant Culture ◽  
The Real ◽  
The Social ◽  
Long Time ◽  
Expression Form

This Article may be situated within the rapport field between Philosophy and Social Sciences, at the search regarding to the concept concerning the Representation. Regarding to Philosophy, under a general view, the concept, concerning Representation, has been, since a long time, understood as a trail which one would get througl reaching to the real and true ones. Representation, as the thought contents expression form had not been known departing from Philosophy as a barrier against the objectivity concerning the knowledge. Representation, in its source, has been constituting itself a cognictive, inmanent reflection, related to the conscience inner subjectivity. But departing from the episthemological point of view, it has been not so easy for the campus concerning the Culture Sciences as a totality. In the theory regarding to knowledge, the Social Sciences campus and, more specifically, in the human life Symbolic dimension constitutive aspects, it has been, often, accepted negatively as an entry door for the histotical social reality. Nowadays, one may conclude that the contents concerning the Culture are deeply rooted within the histotical reality, which may present new dimension the reading regarding to the Symbolical side concerning the human life, under the view regarding to the unseen aspect, such as the intellectualistic Western dominant Culture allows understanding the way which could be in.

Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage

2021 ◽  
pp. 105566562110366
Author(s):  
Yong Bae Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Han Gyu Cha ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
General Anesthesia ◽  
Retrospective Review ◽  
Costal Cartilage ◽  
Point Of View ◽  
Nasal Reconstruction ◽  
Open Rhinoplasty ◽  
Frontonasal Dysplasia ◽  
Congenital Condition

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.

Morphological Change

2017 ◽  
Author(s):  
Carola Trips
Keyword(s):  
Morphological Change ◽  
Point Of View ◽  
General View ◽  
Inflectional Morphology ◽  
Linguistic Change ◽  
Morphological Theory ◽  
History Of ◽  
Abstract Level ◽  
Types Of Change

Morphological change refers to change(s) in the structure of words. Since morphology is interrelated with phonology, syntax, and semantics, changes affecting the structure and properties of words should be seen as changes at the respective interfaces of grammar. On a more abstract level, this point relates to linguistic theory. Looking at the history of morphological theory, mainly from a generative perspective, it becomes evident that despite a number of papers that have contributed to a better understanding of the role of morphology in grammar, both from a synchronic and diachronic point of view, it is still seen as a “Cinderella subject” today. So there is still a need for further research in this area. Generally, the field of diachronic morphology has been dealing with the identification of the main types of change, their mechanisms as well as the causes of morphological change, the latter of which are traditionally categorized as internal and external change. Some authors take a more general view and state the locus of change can be seen in the transmission of grammar from one generation to the next (abductive change). Concerning the main types of change, we can say that many of them occur at the interfaces with morphology: changes on the phonology–morphology interface like i-mutation, changes on the syntax–morphology interface like the rise of inflectional morphology, and changes on the semantics–morphology like the rise of derivational suffixes. Examples from the history of English (which in this article are sometimes complemented with examples from German and the Romance languages) illustrate that sometimes changes indeed cross component boundaries, at least once (the history of the linking-s in German has even become a prosodic phenomenon). Apart from these interface phenomena, it is common lore to assume morphology-internal changes, analogy being the most prominent example. A phenomenon regularly discussed in the context of morphological change is grammaticalization. Some authors have posed the question of whether such special types of change really exist or whether they are, after all, general processes of change that should be modeled in a general theory of linguistic change. Apart from this pressing question, further aspects that need to be addressed in the future are the modularity of grammar and the place of morphology.

scholarly journals Two Decades of Global Progress in Authorized Advanced Therapy Medicinal Products: An Emerging Revolution in Therapeutic Strategies

2020 ◽  
Vol 8 ◽  
Author(s):  
Roya Ramezankhani ◽  
Shukoofeh Torabi ◽  
Neda Minaei ◽  
Hoda Madani ◽  
Siamak Rezaeiani ◽  
...  
Keyword(s):  
Point Of View ◽  
Market Size ◽  
Published Data ◽  
General View ◽  
Medicinal Products ◽  
Clinical Practices ◽  
Advanced Therapy Medicinal Products ◽  
Safety Issues ◽  
Advanced Therapy ◽  
Product Description

The introduction of advanced therapy medicinal products (ATMPs) to the global pharma market has been revolutionizing the pharmaceutical industry and has opened new routes for treating various types of cancers and incurable diseases. In the past two decades, a noticeable part of clinical practices has been devoting progressively to these products. The first step to develop such an ATMP product is to be familiar with other approved products to obtain a general view about this industry trend. The present paper depicts an overall perspective of approved ATMPs in different countries, while reflecting the degree of their success in a clinical point of view and highlighting their main safety issues and also related market size as a whole. In this regard, published articles regarding safety, efficacy, and market size of approved ATMPs were reviewed using the search engines PubMed, Scopus, and Google Scholar. For some products which the related papers were not available, data on the relevant company website were referenced. In this descriptive study, we have introduced and classified approved cell, gene, and tissue engineering-based products by different regulatory agencies, along with their characteristics, manufacturer, indication, approval date, related regulatory agency, dosage, product description, price and published data about their safety and efficacy. In addition, to gain insights about the commercial situation of each product, we have gathered accessible sale reports and market size information that pertain to some of these products.

scholarly journals Transient Unilateral Hypoglossal Nerve Palsy After Orotracheal Intubation for General Anesthesia

2009 ◽  
Vol 47 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Nan-Kai Hung ◽  
Chian-Her Lee ◽  
Shun-Ming Chan ◽  
Chung-Chang Yeh ◽  
Chen-Hwan Cherng ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Orotracheal Intubation ◽  
Hypoglossal Nerve Palsy

scholarly journals Hemodynamic Response to Massive Bleeding in a Patient with Congenital Insensitivity to Pain with Anhidrosis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yuki Sugiyama ◽  
Sayako Gotoh ◽  
Masatoshi Urasawa ◽  
Mikito Kawamata ◽  
Koichi Nakajima
Keyword(s):  
General Anesthesia ◽  
Adrenal Glands ◽  
Stress Hormones ◽  
Massive Bleeding ◽  
Hemodynamic Changes ◽  
Compensatory Response ◽  
Congenital Insensitivity ◽  
Autonomic Disturbance ◽  
Congenital Insensitivity To Pain ◽  
Insensitivity To Pain

A patient with congenital insensitivity to pain with anhidrosis (CIPA) underwent revision of total hip arthroplasty under general anesthesia with only propofol. During surgery, neither elevation of stress hormones nor hemodynamic changes associated with pain occurred; however, when blood was rapidly lost, compensatory tachycardia was observed. Although patients with CIPA are complicated with autonomic disturbance due to dysfunction of postganglionic sympathetic fibers, this compensatory response indicated that the adrenal glands in patients with CIPA secrete catecholamine as part of a compensatory response during bleeding under general anesthesia.

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