Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
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Randomized Controlled Trial
Effect of bicarbonated Ringer's solution on the acid-base balance in patients undergoing abdominal aortic aneurysm repair.
The present study was designed to assess whether prophylactic use of bicarbonated Ringer's solution ameliorates metabolic acidosis in patients undergoing aortic surgery. ⋯ Aortic cross-clamping leads to the development of metabolic acidosis, with a decrease in pH and BE. The effect of administration of bicarbonated infusion fluid during elective abdominal aortic surgery had not significant compared with that of acetated Ringer's solution with respect to acid-base homeostasis.
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The aim of this study is to report the feasibility of a newly developed intra-abdominal fan retractor system for use in gynecologic laparoscopic surgery. ⋯ The new intra-abdominal fan retractor system is feasible in gynecologic laparoscopic surgery.
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During laparoscopic myomectomy, it is difficult to determine the actual blood loss volume because physiological saline is used for lavaging to detect the bleeding point or to ensure no active bleeding site. We attempted to estimate blood loss by measuring the waste irrigation fluid's hemoglobin (Hb) concentration using HemoCue (HemoCue, Angelholm, Sweden). Twenty-three women enrolled in our study. ⋯ The HemoCue needs only 10 mcl of blood and it takes only about 45 seconds to produce the result. Furthermore, the HemoCue is a reliable device for measurement of blood hemoglobin concentration. Our method is easy and quick to perform, and blood loss estimation and surgeon's experience (subjective method) show accordance.
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The lumbar paraspinal muscles were examined by surface electromyography (EMG) in 22 patients with low back pain and 22 healthy volunteers. Surface electrodes were placed bilaterally on the lumbar multifidus and longissimus muscles at the level of the spinous process of the third lumbar vertebra. Kinesiologic EMG was recorded, in standing resting position, during the following trunk motions: trunk forward flexion and extension, lateral bending and axial rotation. ⋯ In the low back pain group, there was no such time lag. Paraspinal muscle activities restricted lumbar range of motion, and protect from injury for movement. This suggests their role as stabilizers.
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Partial peripheral nerve injury produces a persistent neuropathic pain which is difficult to relieve. In order to determine whether different degrees of peripheral nerve injury are related with the severity of neuropathic pain, we examined pain-related behaviors, histological changes and NGF in the skin in rats treated with different types of spinal nerve injury: tight ligation of the left L5 spinal nerve, incomplete ligation of the left L4 and L5 spinal nerves and incomplete crush of the left L4 and L5 spinal nerves. In all model rats, the thresholds of paw withdrawal in response to mechanical and heat stimuli began to decrease on the injured side 1 day after the operation, and the decreases in the thresholds persisted for more than 1 month. ⋯ Nerve growth factor (NGF) in the skin of the hindpaw on the injured side was accumulated after incomplete ligation and incomplete crush of the left L4 and L5 spinal nerves, but not tight ligation of the left L5 spinal nerve, on day 15 after the operation, possibly due to impairment of transport via unmyelinated primary afferents. Regeneration of the sciatic nerve alleviated the accumulation of NGF in the injured side hindpaw skin on day 32. The present results suggested that the severity of neuropathic pain was related with the degrees of both degeneration and/or regeneration of myelinated fibers and of functional damage of unmyelinated fibers.