A consecutive series of 11 patients presenting with obstructing laryngeal neoplasms over an 8-month period have been treated by laser debulking of the tumour in order to avoid a tracheotomy. Providing that all members of the team are experienced in microlaryngeal laser surgery, this technique can be safely and effectively used in the management of obstructing laryngeal neoplasms.

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A propsective analysis oj 100 successive intubations with Robertshaw tubes in patients submitted jor routine thoracic surgery is presented. Clinical guidelines jor intubation were used as the protocol. Tube position was judged on clinical assessment only and not confirmed with jibreoptic bronchoscopy. In approximately 60% oj cases the tubes were judged to be correctly placed on initial introduction. In 20-30% oj cases, minor and simple adjustments were required to achieve suitable conditions jor one lung anaesthesia. In no case did it prove impossible to achieve conditions adequate jor surgery. Common problems related to the endobronchial portion oj tubes entering the wrong bronchus, being inserted too jar, or not jar enough. Two oj six episodes oj hypoxaemia related to minor problems with tubes and were easily corrected. The experience is compared with that oj other workers. The pertinence and implications oj the experience and the data to the training oj personnel in the techniques oj one-lung ventilation and the juture oj Robertshaw tubes are discussed. It is concluded that the good practical results achieved are specifically related to the Robertshaw design and the material oj manujacture.

A neonate whose mother had recently taken amitriptyline developed fixed dilated pupils after a modest dose of intravenous atropine. Interaction of atropine with neonatal amitriptyline levels is suggested and evidence of neonatal effects from maternal antidepressant use is examined. There were no neurological sequelae, and the neonate's pupils became reactive again after 7 h.