Chang Gung medical journal
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Review Case Reports
Idiopathic spinal epidural lipomatosis - two cases report and review of literature.
Spinal epidural lipomatosis (SEL), an abnormal localized or tumor-like accumulation of fat in the epidural space, is an infrequent complication of chronic steroid usage and an uncommon cause of spinal cord compression. During the period of 1990 to 2006, we have two cases of medically heath SEL patients without history of steroid administration. Their initial clinical manifestations were low back pain, progressive lower extremities weakness, numbness, followed by rapid deterioration of neurogenic intermittent claudication. ⋯ These 2 patients all underwent laminectomy and removal of epidural fat. Postoperatively, they both showed improvement. We reviewed the literature and discussed the current concept in the management of SEL.
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de Quervain's disease is a condition in which there is pain in the radial styloid process caused by stenosing tenosynovitis of the abductor pollicis longus (APL) or/and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist. In this study we studied variations in the tendons of the EPB in the first extensor compartment and its site of insertion. ⋯ Variation in the number of EPB tendons and site of insertion should be taken into consideration by clinicians and surgeons when performing surgical decompression of the first extensor compartment of the wrist in de Quervain's syndrome. Surgical failure may occur due to overlooking variations in EPB tendons or septation of the first extensor compartment.
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Randomized Controlled Trial
Effect of warm lidocaine on the sensory onset of epidural anesthesia: a randomized trial.
Administration of local anesthetics at body temperature has been reported to shorten the onset time of regional block; however, studies examining the effects of warmed lidocaine on the onset of epidural anesthesia are limited. Here, we ascertain whether warming lidocaine solution to body temperature shortens the time to onset of epidural anesthesia. ⋯ Administration of lidocaine at BT compared to RT shortens the onset time of sensory block in epidural anesthesia with no associated adverse effects.