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Diabetic Ketoacidosis Associated with Guillain-Barre Syndromewith
CASE REPORT Diabetic Ketoacidosis Associated with Guillain-Barre Syndromewith AutonomicDysfunction Setsuko Fujiwara, Hiroyuki Oshika, Kenzo Motoki, Kenji Kubo*, Yukiaki Ryujin*, Masahiro Shinozaki**, Takuzo Hano*** and Ichiro Nishio*** Abstract Case Report A37-year-old womanwas admitted in a comatosestate, In March 1996, a 37-year-old womanwas admitted to Koyo after exhibiting fever and diarrhea. Diabetic ketoacidosis Hospital in a comatose state after fever, diarrhea and vomiting was diagnosed due to an increased blood glucose level (672 of 1-week duration. Diabetes mellitus was diagnosed in 1990, mg/dl), metabolic addosis, and positive urinary ketone bod- and the patient had taken anti-diabetic drugs for five years, but ies. On the fifth hospital day, despite recovery from the criti- follow-up was discontinued in 1995. She had no episodes of cal state of ketoacidosis, the patient suffered from dyspha- neurological deficit or fainting and was workingas a nurse. gia, hypesthesia and motor weakness, followed by respira- On admission, Kussmaul's breathing, blood pressure of 96/ tory failure. Cerebrospinal fluid analysis was suggestive of 56 mmHg,and a heart rate of 122/min were observed. DKA Guillain-Barre syndrome (GBS). Autonomic dysfunction was diagnosed on the basis of an increased blood glucose level was manifested as tachycardia and mild hypertension in (672 mg/dl), severe metabolic acidosis (arterial blood gas analy- the acute stage. Marked orthostatic hypotension persisted sis: pH 6.703, PCO2 13.8 mmHg, PO2 281.4 mmHg, HCO3 1.7 long after paresis was improved, indicating an atypical clini- jjmol//, BE -36.3 jimol//) and urinary ketone bodies. Other labo- cal course of GBS. -
Macroscopic Anatomy of the Nasal Cavity and Paranasal Sinuses of the Domestic Pig (Sus Scrofa Domestica) Daniel John Hillmann Iowa State University
Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1971 Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica) Daniel John Hillmann Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Animal Structures Commons, and the Veterinary Anatomy Commons Recommended Citation Hillmann, Daniel John, "Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica)" (1971). Retrospective Theses and Dissertations. 4460. https://lib.dr.iastate.edu/rtd/4460 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. 72-5208 HILLMANN, Daniel John, 1938- MACROSCOPIC ANATOMY OF THE NASAL CAVITY AND PARANASAL SINUSES OF THE DOMESTIC PIG (SUS SCROFA DOMESTICA). Iowa State University, Ph.D., 1971 Anatomy I University Microfilms, A XEROX Company, Ann Arbor. Michigan I , THIS DISSERTATION HAS BEEN MICROFILMED EXACTLY AS RECEIVED Macroscopic anatomy of the nasal cavity and paranasal sinuses of the domestic pig (Sus scrofa domestica) by Daniel John Hillmann A Dissertation Submitted to the Graduate Faculty in Partial Fulfillment of The Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Subject: Veterinary Anatomy Approved: Signature was redacted for privacy. h Charge of -^lajoï^ Wor Signature was redacted for privacy. For/the Major Department For the Graduate College Iowa State University Ames/ Iowa 19 71 PLEASE NOTE: Some Pages have indistinct print. -
Caudal Septoplasty: Efficacy of a Surgical Technique-Preliminnary Report
Braz J Otorhinolaryngol. 2011;77(2):178-84. ORIGINAL ARTICLE BJORL.org Caudal septoplasty: efficacy of a surgical technique-preliminnary report Leonardo Bomediano Sousa Garcia1, Pedro Wey de Oliveira2, Tatiana de Aguiar Vidigal3, Vinicius de Magalhães Suguri4, Rodrigo de Paula Santos5, Luis Carlos Gregório6 Keywords: Abstract nasal cartilages, questionnaires, lthough not being the most frequent nasal septal deviations, those of the caudal septum account rhinometry, acoustic, A for many complaints. The correction of such defects has always been the subject of much controversy, nasal septum, and several different operative techniques have been described. prospective studies. Aim: To assess the efficacy of a surgical technique for correcting caudal septal deviations. Materials and Methods: Prospective study with preliminary reports of 10 patients who answered a standardized, specific questionnaire (the Nasal Obstruction Symptom Evaluation, or NOSE), underwent acoustic rhinometry and had their noses photographed. Caudal deviations were then corrected through a surgical technique whereby the entire deviated portion is removed and a straight cartilage segment is placed between the medial crura of the alar cartilages, through a retrograde approach, to support the nasal tip. Sixty days after all patients were reassessed. Results: As for the NOSE questionnaire, mean pre-operative and post-operative scores were 82.39 and 7.39 respectively (p<0.001). Pre-operative acoustic rhinometry showed mean minimum cross- sectional area (MCA) values of 0.352 and 0.431 cm2, whereas mean post-operative values were 0.657 and 0.711 cm2(p<0.0001). Conclusions: The study results prove, both subjectively (patient satisfaction as measured with a standardized questionnaire) and objectively (acoustic rhinometry findings), that the proposed technique for correction of caudal septal deviation is safe and effective. -
High-Yield Neuroanatomy
LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page i Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page ii Aptara Inc. LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iii Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION James D. Fix, PhD Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia With Contributions by Jennifer K. Brueckner, PhD Associate Professor Assistant Dean for Student Affairs Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington, Kentucky LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelley Squazzo Marketing Manager: Emilie Moyer Designer: Terry Mallon Compositor: Aptara Fourth Edition Copyright © 2009, 2005, 2000, 1995 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at http://www.lww.com (products and services). -
Immobilization and Anaesthesia in Asiatic Lions (Panthera Leo Persica)
Advances in Animal and Veterinary Sciences Research Article Immobilization and Anaesthesia in Asiatic Lions (Panthera leo persica) 1 2 1 MURUGAN BHARATHIDASAN , BENJAMIN JUSTIN WILLIAM *, RAMAMURTHY JAYAPRAKASH , THANDAVAN 2 3 1 ARTHANARI KANNAN , RAJARTHANAM THIRUMURUGAN , RAVI SUNDAR GEORGE 1Department of Veterinary Surgery and Radiology, Tamil Nadu Veterinary and Animal Sciences University, India; 2Centre for Stem Cell Research and Regenerative Medicine, Madras Veterinary College, Chennai – 600007, Tamil Nadu, India; 3Veterinary Assistant Surgeon, Arignar Anna Zoological Park, Chennai, India. Abstract | A total of 12 trials were conducted in 8 Asiatic and hybrid lions (Panthera leo persica) for diagnostic and surgical procedures. All the lions were immobilized with a combination of xylazine and ketamine at the rate of 1.00 mg/kg and 2.00 mg/kg body weight, respectively, using darts based on assumed body weight. Ketamine and propofol intravenously were used as induction agents sufficiently to achieve deep plane of anaesthesia and good jaw muscle relaxation in six trials each of treatment I and II. The commercially available large animal endotracheal tubes and cus- tom made silicon medical grade tubes were used for intubation either by direct visualization or by digital palpation of glottis. Anaesthesia was maintained with isoflurane. The study revealed that the young lions required 1.08±0.10 and 2.70±0.26 mg/kg and adult required 1.06±0.30 and 2.64±0.08 mg/kg body weight of xylazine and ketamine, respec- tively for immobilization. Ear flick reflex was taken as an indicator for safe and appropriate time for approaching the lion after immobilization, which was completely abolished only after 1.37 and 2.01 minutes after recumbency in young and adult lions, respectively. -
Deviated Nasal Septum Multimedia Health Education
Deviated Nasal Septum Multimedia Health Education Disclaimer This movie is an educational resource only and should not be used to manage deviated nasal septum. All decisions about the management of deviated nasal septum must be made in conjunction with your Physician or a licensed healthcare provider. Deviated Nasal Septum Multimedia Health Education MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1 . Normal Nose Anatomy a. Introduction b. Normal Nose Anatomy 2 . Overview of Deviated Nasal Septum a. What is a Deviated Nasal Septum? b. Symptoms c. Causes and Risk Factors 3 . Treatment Options a. Diagnosis b. Conservative Treatment c. Surgical Treatment Introduction d. Septoplasty e. Post Operative Precautions f. Risks and Complications Deviated Nasal Septum Multimedia Health Education INTRODUCTION The nasal septum is the cartilage which divides the nose into two breathing channels. It is the wall separating the nostrils. Deviated nasal septum is a common physical disorder of the nose involving displacement of the nasal septum. To learn more about deviated nasal septum, it helps to understand the normal anatomy of the nose. Deviated Nasal Septum Multimedia Health Education Unit 1: Normal Nose Anatomy Normal Nose Anatomy External Nose: The nose is the most prominent structure of the face. It not only adds beauty to the face it also plays an important role in breathing and smell. The nasal passages serve as an entrance to the respiratory tract and contain the olfactory organs of smell. Our nose acts as an air conditioner of the body responsible for warming and saturating inspired air, removing bacteria, particles and debris, as (Fig.1) well as conserving heat and moisture from expired air. -
A Dictionary of Neurological Signs
FM.qxd 9/28/05 11:10 PM Page i A DICTIONARY OF NEUROLOGICAL SIGNS SECOND EDITION FM.qxd 9/28/05 11:10 PM Page iii A DICTIONARY OF NEUROLOGICAL SIGNS SECOND EDITION A.J. LARNER MA, MD, MRCP(UK), DHMSA Consultant Neurologist Walton Centre for Neurology and Neurosurgery, Liverpool Honorary Lecturer in Neuroscience, University of Liverpool Society of Apothecaries’ Honorary Lecturer in the History of Medicine, University of Liverpool Liverpool, U.K. FM.qxd 9/28/05 11:10 PM Page iv A.J. Larner, MA, MD, MRCP(UK), DHMSA Walton Centre for Neurology and Neurosurgery Liverpool, UK Library of Congress Control Number: 2005927413 ISBN-10: 0-387-26214-8 ISBN-13: 978-0387-26214-7 Printed on acid-free paper. © 2006, 2001 Springer Science+Business Media, Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dis- similar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to propri- etary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omis- sions that may be made. -
Percutaneous Suspension Sutures to Change the Nasal Tip
Chapter 5 Percutaneous Suspension Sutures to Change the Nasal Tip M. B. Des Fernandes Additional information is available at the end of the chapter http://dx.doi.org/10.5772/56249 1. Introduction Although a number of procedures have been described for placement of “shaping sutures” during open and closed rhinoplasty, scant attention is given to the possibility of percutaneous placement of sutures without dissection of the skin envelop. Periodically patients will present who want minimal changes to their nose because the tip is too bulky, not well defined and the nose is longer than ideal. Many of these patients have no concerns about the bridge width and do not have a dorsal hump. This is the perfect patient to consider using the operation that will be described. Many other patients have had an attractive straight nose when they were young and as they have aged, the nose has become coarser, broader and tends to lengthen and lose support from the septum and then droops into becoming a hooked nose. The operation that will be described specifically addresses these changes and with this surprisingly simple operation, the nose can be restored to much closer to the original. Other patients who have had a corrective rhinoplasty develop a typical “polly-beak” deformity. By elevating and rotating the nasal cartilages one can restore a normal nasal tip projection and a straight bridge. 2. Methods and instruments The following instruments and materials are required: 1. 11 or 15 blade scalpel 2. 18 gauge (green) needle or a 22 (yellow) spinal needle. 3. Sharp pointed fine scissors 4. -
High-Yield Neuroanatomy, FOURTH EDITION
LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page i Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page ii Aptara Inc. LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iii Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION James D. Fix, PhD Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia With Contributions by Jennifer K. Brueckner, PhD Associate Professor Assistant Dean for Student Affairs Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington, Kentucky LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelley Squazzo Marketing Manager: Emilie Moyer Designer: Terry Mallon Compositor: Aptara Fourth Edition Copyright © 2009, 2005, 2000, 1995 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at http://www.lww.com (products and services). -
The Human Nervous System S Tructure and Function
The Human Nervous System S tructure and Function S ixth Ed ition The Human Nervous System Structure and Function S ixth Edition Charles R. Noback, PhD Professor Emeritus Department of Anatomy and Cell Biology College of Physicians and Surgeons Columbia University, New York, NY Norman L. Strominger, PhD Professor Center for Neuropharmacology and Neuroscience Department of Surgery (Otolaryngology) The Albany Medical College Adjunct Professor, Division of Biomedical Science University at Albany Institute for Health and the Environment Albany, NY Robert J. Demarest Director Emeritus Department of Medical Illustration College of Physicians and Surgeons Columbia University, New York, NY David A. Ruggiero, MA, MPhil, PhD Professor Departments of Psychiatry and Anatomy and Cell Biology Columbia University College of Physicians and Surgeons New York, NY © 2005 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapress.com All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. All papers, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. This publication is printed on acid-free paper. h ANSI Z39.48-1984 (American Standards Institute) Permanence of Paper for Printed Library Materials. Production Editor: Tracy Catanese Cover design by Patricia F. Cleary Cover Illustration: The cover illustration, by Robert J. Demarest, highlights synapses, synaptic activity, and synaptic-derived proteins, which are critical elements in enabling the nervous system to perform its role. -
Electrophysiological Evaluation of Oropharyngeal Swallowing in Myotonic Dystrophy
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.70.3.363 on 1 March 2001. Downloaded from J Neurol Neurosurg Psychiatry 2001;70:363–371 363 Electrophysiological evaluation of oropharyngeal swallowing in myotonic dystrophy C Ertekin, N Yüceyar,~ I Aydog˘du, H Karasoy Abstract Myotonic dystrophy (MyD) is the most Objective—Oropharyngeal dysphagia is a common adult form of muscular dystrophy common feature of patients with myotonic and pneumonia was reported to be the most dystrophy and is not usually perceived due common cause of death in these patients.1 to their emotional deficits and lack of Pneumonia in MyD results from a multiplicity interest. The aim was to show the existence of problems. Oropharyngeal dysphagia and and frequency of subclinical electrophysi- oesophageal motility disorders were found to ological abnormalities in oropharyngeal be the most important reasons causing aspira- swallowing and to clarify the mechanisms tion pneumonia.2–6 Dysphagia may be even a of dysphagia in myotonic dystrophy. more prominent problem when the swallowing Methods—Eighteen patients with myot- disorder seems to be present early in the course onic dystrophy were examined for of disease but is not usually subjectively oropharyngeal phase of swallowing by perceived until the advanced stages of disease clinical and electrophysiological methods. are reached.6 Ten patients had dysphagia whereas 11 Patients with MyD often exhibit disorders of patients had signs and symptoms reflect- personality and impairment of intellectual and ing CNS involvement. Four patients with cognitive functions, especially lack of interest in myotonia congenita and 30 healthy volun- their disease.7 This might play a part in the teers served as controls. -
Neural Control of Swallowing
AG-2018-48 REVIEW dx.doi.org/10.1590/S0004-2803.201800000-45 Neural control of swallowing Milton Melciades Barbosa COSTA Received 11/4/2018 Accepted 9/5/2018 ABSTRACT – Background – Swallowing is a motor process with several discordances and a very difficult neurophysiological study. Maybe that is the reason for the scarcity of papers about it. Objective – It is to describe the chewing neural control and oral bolus qualification. A review the cranial nerves involved with swallowing and their relationship with the brainstem, cerebellum, base nuclei and cortex was made. Methods – From the reviewed literature including personal researches and new observations, a consistent and necessary revision of concepts was made, not rarely conflicting. Re- sults and Conclusion – Five different possibilities of the swallowing oral phase are described: nutritional voluntary, primary cortical, semiautomatic, subsequent gulps, and spontaneous. In relation to the neural control of the swallowing pharyngeal phase, the stimulus that triggers the pharyngeal phase is not the pharyngeal contact produced by the bolus passage, but the pharyngeal pressure distension, with or without contents. In nutritional swallowing, food and pressure are transferred, but in the primary cortical oral phase, only pressure is transferred, and the pharyngeal response is similar. The pharyngeal phase incorporates, as its functional part, the oral phase dynamics already in course. The pharyngeal phase starts by action of the pharyngeal plexus, composed of the glossopharyngeal (IX), vagus (X) and accessory (XI) nerves, with involvement of the trigeminal (V), facial (VII), glossopharyngeal (IX) and the hypoglossal (XII) nerves. The cervical plexus (C1, C2) and the hypoglossal nerve on each side form the ansa cervicalis, from where a pathway of cervical origin goes to the geniohyoid muscle, which acts in the elevation of the hyoid-laryngeal complex.