ABSTRACT
BACKGROUND: We investigated the effect of distal tourniquet to the proximal spread of local anesthetics in the axillary brachial plexus block. METHODS: In this prospective, randomized, controlled trial, 60 patients undergoing elective surgery were divided into two equal groups; Group I (2% mepivacaine 20 ml plus 1% lidocaine 20 ml with 250 mmHg of distal tourniquet) and Group II (2% mepivacaine 20 ml plus 1% lidocaine 20 ml alone). Patients were left for 30 minutes after an axillary brachial plexus block with paresthesia and single injection technique. Sensory blockades were evaluated by pin prick test at each nerve dermatome. RESULTS: There was no significant difference of sensory blockade in radial nerve, but there were significant differences of sensory blockade in ulnar, median, musculocutaneous, medial antebrachial cutaneous, and axillary nerves (P < 0.05). CONCLUSIONS: Our findings suggest that the quality and effect of axillary brachial plexus block in group with distal tourniquet is better than the control group.
Subject(s)
Humans , Anesthetics, Local , Brachial Plexus , Lidocaine , Mepivacaine , Paresthesia , Prospective Studies , Radial Nerve , TourniquetsABSTRACT
Primary hyperhidrosis has been associated with an increased activity of the sympathetic nervous system. Conventional nonsurgical therapies are inconvenient and only temporarily effective. Endoscopic thoracic sympathicotomy (ETS) is a minimal invasive procedure of thoracic sympathetic block and has been used successfully and safely in the treatment of primary palmar and axillary hyperhidrosis. Sympathicotomy results in an initial sympathovagal imbalance with a parasympathetic predominance, which is restored in a long-term basis. ETS is commonly performed to treat hyperhidrosis but there are some rare complications including cardiac arrest. In our hospital, we experienced 2 cases of patients who suffered from sudden cardiac arrest during right ETS, which was performed soon after left ETS. We're going to report these cases and consider about possible causes.
Subject(s)
Humans , Anesthesia, General , Death, Sudden, Cardiac , Heart Arrest , Hyperhidrosis , One-Lung Ventilation , Sympathetic Nervous SystemABSTRACT
Gastroduodenal intussusception is a rare condition and an invagination of a part of the gastric wall through the pyloric canal and into the duodenum. Gastroduodenal intussusception is always caused by a mobile gastric tumor, usually benign. However, gastroduodenal intussusception which was caused by gastric submucosal hemangiomatosis is not documented. We have maneged a case of gastric submucosal tumor leading to gastroduodenal intussusception in 2 years and 10 months old boy. He had a 10 x 5 x 3 cm sized submucosal tumor in posterior wall of gastric antrum. Laparotomy, manual reduction of intussusecption, and wedge resection of posterior gastric wall including the submucosal tumor were performed. Pathologic diagnosis showed a submucosal hemangiomatosis. We report a case of gastric submucosal tumor leading to gastroduodenal intussusception, and review the literature.
Subject(s)
Humans , Infant , Male , Diagnosis , Duodenum , Intussusception , Laparotomy , Pyloric AntrumABSTRACT
In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.