Journal of medical and dental sciences
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Vocal cord paralysis (VCP) is one of the postoperative complications after radical esophagectomy. VCP may also lead to serious morbidities such as respiratory distress and aspiration pneumonia. Therefore, an early diagnosis of VCP is meaningful in the postoperative management of patients undergoing esophagectomy. We evaluated a new practical method for diagnosing postoperative VCP. ⋯ The VCP during orotracheal intubation is assessable by transnasal endoscopy.
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Chronic subdural hematoma (CSDH) is prevalent among elderly populations worldwide, and its mysterious pathogenesis has been discussed in the literature for decades. The issues remaining to be solved in regard to CSDH include the initiating events; the bleeding into the subdural space and the formation of the outer and inner membranes, its development; increase and liquefaction of hematoma, the optimal treatments, and the natural history. The pathophysiology is becoming more clear due to recent findings from computed tomography studies and human models of CSDH. In this work, we review previous studies on CSDH and present a new integrated concept about the development of this common condition after head injuries.
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This study was conducted to characterize the distribution of epithelial regeneration in lungs with diffuse alveolar damage (DAD) and to ascertain whether epithelial regeneration is associated with the underlying disease and/or DAD stage. ⋯ Epithelial regeneration was not associated with the underlying disease. This study revealed that regenerative epithelial cells appeared at day 6 during the exudative stage and that the number of type Ⅱ pneumocytes increased significantly during the proliferative stage.
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Randomized Controlled Trial Comparative Study
New method of chest compression for infants in a single rescuer situation: thumb-index finger technique.
We introduce a new method of external chest compression (ECC), an essential part of cardiopulmonary resuscitation, using a thumb and index finger method (TIFM) on infants, and compares, this with two standard methods of the two finger method (TFM) and the two-thumb encircling hands method (TTEM). Sixty trained PALS (Pediatric Advanced Life Support) providers were randomly assigned into three groups and provided one-rescuer ECC for a period of five continuous minutes. Results without coaching or feedback were recorded on a recording CPR simulator (Laerdal, Inc). ⋯ The same parameters in the TTEM and new TIFM groups during this study were in accordance with the parameters recommended by the guidelines. Thus, our new TIFM technique of chest compression, in infants was shown to be better than the currently TFM, especially for achieving adequate compression depth and avoiding fatigue, and is equally as effective as the TTEM. We propose this new method (TIFM) should be considered as the method of choice in single rescuer situations.
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Cerebral blood flow (CBF) measurements during mild hypothermia therapy were made in 30 adult patients with severe head injuries (Glasgow Coma Scale score < or =18), by xenon enhanced computed tomography (Xe-CT). All patients but one underwent removal of hematomas and decompressive craniectomy. Immediately after surgery, hypothermia was induced by surface cooling, and a brain temperature of 32-35 degrees C was maintained for 3 days. ⋯ Nineteen patients (63%) showed good outcomes (GOS score of 4 or 5) and 11 (37%) showed poor outcomes (GOS score of 1, 2, or 3). Statistically significant differences were obtained for the mean global CBF and CMRO2 values between the good and poor outcome groups. In this study, we demonstrated that CBF measurement may be useful to predict neurological outcomes following severe traumatic brain injury in patients undergoing hypothermia as well as to identify those who might not likely benefit from hypothermia therapy.