Persistent cerebrospinal fluid leak.
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Biomedical subjects
Publications and source records attributed to B J Watson.
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Patients undergoing procedures under general anaesthesia as day cases are routinely given a set of instructions regarding activities to avoid in the first 24 h after discharge. Day surgery units generally specify the need for a responsible carer from time of discharge for a period of 24 h. This study looks at the compliance of 240 patients with postoperative instructions. Of the patients studied, 4.1% drove, 1.7% made important decisions, 3.3% drank alcohol, 0.8% took sedatives and 10% cooked, ironed or looked after children. All patients were discharged into the care of a responsible adult. However, 13.3% failed to have a carer with them for 24 h and 1.3% spent the night alone at home. Of our cohort, 25% were unable to comply with the postoperative instructions in full. The majority of non-compliance occurred on the day following surgery, suggesting that patients may feel that the advice is excessively cautious.
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We have investigated the effect of four doses of remifentanil on the incidence of respiratory depression and somatic response at incision. Remifentanil was administered as a loading dose of 0.125, 0.25, 0.375 or 0.5 microgram kg-1 and at a maintenance infusion rate of 0.025, 0.05, 0.075 or 0.1 microgram kg-1 min-1, respectively, with an infusion of propofol 6 mg kg-1 h-1. Responses occurred in 88% of patients with remifentanil 0.025 microgram kg-1 min-1 compared with 30-40% in the other groups. Respiratory depression after incision increased from 6% with remifentanil 0.025 microgram kg-1 min-1 to 73% with 0.1 microgram kg-1 min-1. Increases in propofol infusion rate to 7.2-8.4 mg kg-1 h-1 produced adequate maintenance of anaesthesia. Reductions in remifentanil doses to 0.025-0.05 microgram kg-1 min-1 resulted in adequate respiration at the end of surgery in 88% of patients. Maintenance infusions of the two drugs for spontaneous ventilation are likely to be in these ranges. However, the ideal loading doses and infusion rates for induction remain to be established.
The muskrat is an aquatic rodent of moderate size and possesses dramatic respiratory and cardiovascular behaviors in response to submersion, stimulation of the upper respiratory tract, or environmental cues. This report provides a stereotaxic atlas of the muskrat's brainstem in the transverse plane to facilitate studies requiring an accurate localization of discrete brain structures. Plates are presented of brainstem sections between the obex and superior colliculus separated by 450 microns. Each figure shows a Nissl stained hemisection complemented by a line drawing. Our data shows mature muskrats have relatively uniform craniometric dimensions promoting their use for stereotaxic placements in their brains.
Muskrats are aquatic rodents of moderate size which are plentiful throughout North America, but are not used commonly in the laboratory. Recently, we tested the feasibility of muskrats as experimental models and have found them to be acquired and cared for easily in conventional laboratory animal facilities. Some of their natural characteristics and diseases are described. The husbandry techniques that we used are presented and form a base for the preparation of future guidelines for the maintenance and use of feral animals in research. The results of some initial experiments testing the muskrat's utility for investigations of cardiorespiratory control mechanisms also are presented. Our data show that even anesthetized muskrats possess brisk and dramatic cardiovascular and respiratory reflexes. Our findings that their brains possess the cytoarchitectural and myeloarchitectural features comparable to other mammals, combined with their relative uniformity in size, has allowed us to locate specific neuronal loci stereotaxically. We suggest that the muskrat be considered as an experimental animal model for studies of the neural control of cardiorespiratory systems.
Preservation and usefulness of human gross temporal bones that have been dissected or drilled have always been a problem. This article describes application of the technique of plastination developed by von Hagens to the temporal bone. The use of this technique permits development of a collection of both anatomically dissected and surgically drilled temporal bones which can be studied by the otolaryngologist at any level. The procedure involves impregnation of the specimen with uncured polymers--a silicone rubber of medium viscosity followed by curing in a vapor bath. The advantages of this technique are that the plastinated temporal bone can be studied and handled without any unpleasant odor and there is no need for liquid preservation. The potential problem of the specimen drying out and becoming useless is thus avoided.