The Tokai journal of experimental and clinical medicine
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Tokai J. Exp. Clin. Med. · Jul 2014
Visibility of ultrasound-guided echogenic needle and its potential in clinical delivery of regional anesthesia.
Ultrasound-guided regional anesthesia is recommended for nerve block due to its safety and reliability. Needle visualization is important when inserting needles into tissues in close proximity to target nerves. For safety reasons, the tip of the standard-type needle for application of nerve block is thinner than that of an interventional needle for insertion into intra-abdominal organs, and this makes it harder to determine its precise position. The purpose of this study was to evaluate the performance of an insulated echogenic needle under ultrasound guidance in phantoms and in the routine anesthetic management of patients undergoing elective surgery. ⋯ The better visibility of the tip of CCR indicates that it is superior to S in the clinical delivery of peripheral nerve block.
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Tokai J. Exp. Clin. Med. · Apr 2014
Case ReportsCase of Wenckebach-type atrioventricular block caused by administration of indigo carmine.
We report a case of first-degree atrioventricular (A-V) block progressing to second-degree (Wenckebach-type) A-V block after administration of indigo carmine in a patient undergoing hysterectomy under general anesthesia. We believe that the onset of Wenckebach-type A-V block may have been induced by one or more of three factors: 1) preoperative first-degree A-V block, 2) the anesthetics used (propofol and remifentanil), and 3) administration of indigo carmine.
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Tokai J. Exp. Clin. Med. · Dec 2013
Case ReportsLobectomy of pulmonary metastasis of endometrial stromal sarcoma.
Pulmonary metastasis of low-grade endometrial stromal sarcoma is rare. A 61-year-old woman visited our hospital due to an abnormal chest shadow. Computed tomograhy showed a mass that was composed of a cystic and solid lesion, in the right lower lobe. ⋯ To avoid possible dissemination, the tumor was resected not using video-assisted thoracic surgery but using thoracotomy. The pathologic diagnosis was pulmonary metastasis of the low-grade endometrial stromal sarcoma. Now, medroxyprogesterone acetate is being administered, and no signs of recurrence have been detected in the 24 months since the lung resection.
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Tokai J. Exp. Clin. Med. · Sep 2013
Case ReportsDelayed hemothorax superimposed on extrapleural hematoma after blunt chest injury: a case report.
We report a case showing delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury. The patient was a 56-year-old man with a medical history of alcoholic hepatopathy who presented with a chief complaint of dyspnea on exertion. One month prior to presentation, he had sustained a fall that had resulted in left simple rib fracture. ⋯ When the inside of the thorax was observed, what had been presumed to be the septi of a multilocular fluid collection was found to be actually the parietal pleura, and a hematoma was confirmed inside the extrapleural cavity. The hematoma inside the extrapleural cavity was managed with lavage and drainage, and drainage tubes were placed inside both the thoracic cavity and extrapleural cavity at the end of the procedure. The patient's postoperative course was uneventful, and he was discharged on postoperative day 4.
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Tokai J. Exp. Clin. Med. · Jul 2013
Case ReportsRare variant of inguinal hernia, interparietal hernia and ipsilateral abdominal ectopic testis, mimicking a spiegelian hernia. Case report.
We report a case in which the combination of an interparietal inguinal hernia and ipsilateral ectopic testicle mimicked a spigelian hernia. The patient was a 22-day-old boy who presented with a reducible mass that extended from the right lumbar region to the iliac fossa region. The right testis was palpable in the right lumbar region. ⋯ Traditional inguinal herniorrhaphy and traditional orchidopexy were performed, and the postoperative course was uneventful. It is difficult to understand the surgical anatomy of interparietal hernias, but once the surgical anatomy is understood, surgical repair is simple. We report the case with a review of the literature and also emphasize that laparoscopic exploration is helpful during surgery.