Mechanical ventilation support and diaphragm pacing has improved the prognosis of patients with idiopathic congenital central hypoventilation syndrome (CCHS; Ondine's curse). However, severe bradyarrhythmias may occur. This report is about a patient who was supplied with a bilateral diaphragm pacing system at early childhood. At the age of 17 years, he experienced multiple syncopes due to sinus...

We encountered cardiac arrest induced by 0.375 % ropivacaine 7 ml administered via a catheter for continuous thoracic paravertebral block (TPVB) in a 6-year-old female who underwent pacemaker implantation for sick sinus syndrome (SSS). She was successfully resuscitated with adrenaline and lipid emulsion. Plasma concentration of ropivacaine was 5.2 μg/ml, suggesting intravascular administration ...

conclusions surgeons should consider the possibility of existence of other mucoceles when they find a large downstream sinus mucocele obstructing the ostia of upstream sinuses on computed tomography scans. introduction mucoceles of the paranasal sinuses are relatively rare. a very busy otolaryngology department does not have more than a few cases each year. bilateral, multiple, and multiloculat...

purpose : to report a patient with sphenoid sinus mucocele (ssm) case report : the patient is a 19-year-old man who was referred to khatam-al-anbia eye center as retrobulbar optic neuritis. brain and orbital ct scan and mri revealed ssm. the patient underwent endoscopic sinus surgery and visual acuity (va) improved from no light perception (nlp) to 2 meter counting fingers. conclusion : ssm may...

In the March 2017 issue of Critical Care, Tagami et al. [1] emphasized that amiodarone, lidocaine, and nifekalant similarly improve survival at hospital admission for out-of-hospital cardiac arrest (OHCA) patients due to refractory ventricular fibrillation (VF). However, neither amiodarone nor lidocaine has been shown to improve long-term survival or neurologic recovery [2]. During resuscitatio...

some otolaryngologists administer topical phenylephrine for bleeding control in adenoidectomy surgery. absorption of this drug from surgical site can lead to increase in blood pressure due to vasoconstriction and then bradycardia related to baroreceptore reflex.  our case was an intraoperative arrest of a 9-yrs-old girl related to administration of topical phenylephrine during adenoidectomy how...

The carotid sinus syndrome and carotid sinus hypersensitivity (CSH) are closely related disorders. The first is characterized by syncope triggered by manipulation of the carotid sinus in daily life (e.g. shaving). According to the current European Society of Cardiology guidelines, CSH is diagnosed when carotid sinus massage elicits ≥3 s asystole, a fall in systolic blood pressure of ≥50 mmHg, o...