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4 results

  • Chapter 4 - The Marbled Page

  • Helen Williams, Northumbria University, Newcastle
  • Book:
    Laurence Sterne and the Eighteenth-Century Book
    Published online:
    06 April 2021
    Print publication:
    01 April 2021, pp 99-137

  • Summary

    The third volume of Tristram Shandy opens with Tristram’s eventual arrival into the Shandy family, when his nose is crushed during a bungled forceps delivery, causing Walter to throw himself prostrate on the bed. Sterne inserts his most startling innovation, the marbled page, within a volume almost entirely concerned with the publication and collection of medical books. This chapter situates Sterne’s remarkable visual device within a history of colour book illustration dominated by scientific works of the kind treasured by Walter Shandy. It also recounts the history of marbled paper, commonly recognised as book binding material but lesser known as medical packaging for nostrums prescribed to treat wounds and ailments. As a colour illustration in the instalment of Tristram Shandy addressing a wounded nose, for eighteenth-century readers the colour and dimensions of the marbled leaf would have simultaneously recalled colour-illustrated medical books and distinctively packaged branded remedies. The marbled page, therefore, references a full range of paper materials seeking to theorise, diagnose and treat malfunctioning bodies.

  • Optimising endoscopic stapling of pharyngeal pouches

  • A Moore, A Vijendren, R Rajagopal, P Spraggs
  • Journal:
    The Journal of Laryngology & Otology / Volume 126 / Issue 4 / April 2012
    Published online by Cambridge University Press:
    30 January 2012, pp. 407-408
    Print publication:
    April 2012
  • Background:

    Endoscopic hypopharyngeal diverticulotomy is now largely performed using an endoscopic stapling device. A poorly applied endoscopic stapling device can result in incomplete division of the cricopharyngeal bar, necessitating the application of a second set of staples. Applying more than one set of staples is associated with an increased risk of complications and greater cost. Small pharyngeal pouches are difficult to staple because of difficulties engaging the stapling device over the cricopharyngeal bar.

    Method:

    Two pairs of oesophageal forceps are used in conjunction with a 0 degree Hopkins rod to optimise the endoscopic stapling of small and large pharyngeal pouches.

    Results and conclusion:

    Applying grasping forceps to the cricopharyngeal bar improves the accuracy of the stapling procedure, thus reducing the morbidity and cost associated with multiple staple applications.

  • Chapter 12 - Breech Presentation

  • from Part II - INTRAPARTUM AND POSTPARTUM
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 297-321

  • Summary

    This chapter reviews the fundamentals of the techniques for breech delivery and the evaluative process required for appropriate management. Also reviewed are external cephalic version (ECV) and internal podalic version (IPV) and the special needs of the premature breech fetus at delivery. These concepts and approaches are applicable in all breech presentations, independent of the route of delivery. Techniques for delivering the breech fetus are assisted breech delivery, delivering the aftercoming head, and breech extraction. Piper forceps (or alternatively, Simpson or Keilland forceps) can be used for delivering the aftercoming head at the clinician's discretion. The risk that the breech fetus might become acidotic during labor and delivery is marginally greater than for its cephalic counterpart. Once a breech presentation has been diagnosed, the patient and her family can be counseled and instructed about the potential problems that might be encountered.

  • Chapter 18 - Cesarean Delivery and Surgical Sterilization

  • from Part III - SURGICAL PROCEDURES
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 509-607

  • Summary

    This chapter discusses the current practice of cesarean delivery, the indications for the operation, the performance of the surgery, and its potential complications. After forceps and vacuum extraction procedures, symphysiotomy is the principal alternative to the cesarean operation. Epidurals do prolong the second stage of labor and increase the use of oxytocin to maintain progress. As the morbidity associated with cesarean delivery remains low, and the risks associated with elective operations are better appreciated, indications for cesarean operations have progressively increased. The chapter reviews the operative technique for cesarean delivery, cesarean hysterectomy, and the surgical management of acute obstetric hemorrhage. Possible immediate post-operative complications of surgical sterilization include infection, bleeding, intraoperative bowel or bladder injury, thromboembolism, and rarely, death. Sterilization failures are often the result of either mistaken identification of some other intraabdominal structure for the fallopian tube, or of incomplete occlusion of the tubal lumina.