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Profound trigeminocardiac reflex from lingual nerve stimulation: a case report
Allen Champion,John Masi 대한치과마취과학회 2022 Journal of Dental Anesthesia and Pain Medicine Vol.22 No.1
Trigeminocardiac reflex (TCR) is a well-known brainstem reflex that manifests as hypotension, bradycardia, dysrhythmia, and asystole when stimulation is applied to a branch of the trigeminal nerve. Most commonly associated with ophthalmic, orbital, and neurologic surgeries, mandibular division and oral cavity variants occur far less frequently. Here, we describe a case of asystolic TCR elicited by lingual nerve stimulation. This case highlights the role of specific anesthetic medications in modulating this phenomenon and reinforces the need for early recognition and clear communication in case of its occurrence. Anesthesia providers must consider discontinuing or avoiding certain medications when clinically appropriate, even during low TCR-risk procedures.
“Flesh of my Flesh”: City Affect and Spirit of Place in D. H. Lawrence’s Women in Love
( Margret Gunnarsdóttir Champion ) 한국로렌스학회 2018 D.H. 로렌스 연구 Vol.26 No.2
Less celebratory about modern city life than Virginia Woolf and James Joyce, D. H. Lawrence nonetheless often depicts metropolitan awareness as a determining influence on individuals’ perceptions and behaviour. Drawing on Georg Simmel’s early twentieth-century study of the urban psyche as well as on recent developments in affect theory, this essay examines the challenges Women in Love poses to the modernized, blase sensibilities of the major protagonists. In Parables of the Virtual, Brian Massumi understands affect as an autonomous subtext to encounters, expressed both as concrete experience and as residual excess. Thus, participants in an exchange undergo shocks of perceptions which may enable a widening horizon of self-expression or, if curbed, restrain, and even decimate, growth. As metonym of the modern urban personality, Gudrun Brangwen, despite her susceptibility to the challenging encounters with art and nature, “won’t give herself away,” in Birkin’s description, often regressing into nostalgia, anger, envy and cruelty. On the other hand, a critic of the constraining discourse of modern capitalism, Rupert Birkin benefits from the virtual “other centers” the novel envisions as future alternatives. Thus, instead of becoming trapped in romantic nostalgia, Birkin taps into a non-binary understanding of primitive art as well as a potentially non-anthropomorphic love of nature. The affective education in the novel can be seen to culminate in Birkin’s and Ursula’s sexual encounter in the chapter “Excurse,” where the micro-perceptions of the human body are celebrated in tandem with the cosmic flows of non-human place.