The Tohoku journal of experimental medicine
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The neurolytic celiac plexus block (NCPB) has been recommended for pain relief in patients with upper abdominal cancer by the WHO Cancer Pain Relief Program. In this article, we review the indications, techniques, and adverse effects of NCPB based on the previous findings in the literature and our own experience of 142 NCPBs during the past 11 years. No well-validated indication criteria for the NCPB have been available from invasive trials or non-invasive pain evaluations. ⋯ The diarrhea may counteract the morphine-induced constipation. NCPB relieves visceral pain in upper abdominal cancer with no serious adverse effects. We recommend this procedure to improve the quality of life of the patients suffering from abdominal cancer pain.
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Tohoku J. Exp. Med. · Sep 2000
Comparative StudyComparison of wiring techniques for bone fracture fixation in total hip arthroplasty.
The objective of this study was to investigate the effect of cerclage wire position and determine the number of wires necessary to prevent crack opening and stem subsidence following a proximal femoral fracture in cementless total hip arthroplasty. A cementless femoral stem one size larger than the templated size was inserted into each femur to initiate a proximal crack. A cerclage wire was wrapped around the fracture in one of two orientations: 1) parallel to the osteotomy (PO) and 2) normal to the fracture line (NF). ⋯ The mechanical evaluation of stem subsidence were verified by various computer simulations even using four wires. We have found that placement of the cerclage wires normal to the fracture line prevents stem subsidence and crack opening better than placement of the wires parallel to the osteotomy. Three cerclage wires, placed normal to the fracture line at three locations: 1) adjacent to the superior of the lesser trochanter, 2) adjacent to the inferior of the lesser trochanter and 3) 10 mm distal to the bottom of the lesser trochanter were necessary to achieve stability under higher loads.