1.Reduction of the incidence of development of venous thromboembolism by ultrasound-guided femoral nerve block in total knee arthroplasty.
Yusuke ASAKURA ; Hiroki TSUCHIYA ; Hisatake MORI ; Takashi YANO ; Yasuhide KANAYAMA ; Hideki TAKAGI
Korean Journal of Anesthesiology 2011;61(5):382-387
BACKGROUND: Venous thromboembolism (VTE) and the subsequent development of pulmonary embolism (PE) is a major cause of post-operative mortality in total knee arthroplasty (TKA). We evaluated whether the addition of an ultrasound-guided femoral nerve block with general anesthesia affected the incidence in the development of VTE following TKA. METHODS: This was a retrospective non-randomized comparative study with patients assigned to groups based on the surgery date (pre-femoral nerve block versus post-femoral nerve block periods). All anesthesia and medical records of the patients who had undergone computer-navigated TKA in our facility between January 2009 and March 2010 were retrospectively reviewed. RESULTS: Forty patients were identified; 15 patients underwent computer-navigated TKA under general anesthesia alone (Group G) and 25 patients underwent surgery under general anesthesia combined with ultrasound-guided femoral nerve block (Group F). The incidence of development of VTE post-operatively was significantly lower in Group F (P = 0.037). Logistic regression analysis identified the use of a femoral nerve block as the most significant variable correlating with the incidence of post-operative development of VTE, and the odds ratio for VTE development in Group G was 3.12 (95% CI, 0.57-20.56). CONCLUSIONS: We suggest the possibility that the addition of a femoral nerve block on general anesthesia may reduce the incidence of the development of VTE following TKA.
Anesthesia
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Anesthesia, General
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Arthroplasty
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Femoral Nerve
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Humans
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Incidence
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Knee
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Logistic Models
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Medical Records
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Nerve Block
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Odds Ratio
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Pulmonary Embolism
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Retrospective Studies
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Venous Thromboembolism
2.High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy.
Hee Chul PARK ; Shinichi SHIMIZU ; Akio YONESAKA ; Kazuhiko TSUCHIYA ; Yasuhiko EBINA ; Hiroshi TAGUCHI ; Norio KATOH ; Rumiko KINOSHITA ; Masayori ISHIKAWA ; Noriaki SAKURAGI ; Hiroki SHIRATO
Yonsei Medical Journal 2010;51(1):93-99
PURPOSE: The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients. MATERIALS AND METHODS: Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy. RESULTS: All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient. CONCLUSION: The use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.
Adult
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Aged
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*Brachytherapy
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Female
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Humans
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Middle Aged
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Radiotherapy Planning, Computer-Assisted/adverse effects/*methods
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Treatment Outcome
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Uterine Cervical Neoplasms/mortality/pathology/*radiotherapy
3.Subacute effects of deep-sea water from the Japan Sea on blood examination values in mice.
Yasuo TSUCHIYA ; Kazutoshi NAKAMURA ; Hiroho SEKIKAWA ; Hiroki KAWAMURA ; Kunio MIYANISHI ; Teiji ISHIZU ; Masaharu YAMAMOTO
Environmental Health and Preventive Medicine 2002;7(5):189-192
OBJECTIVESTo clarify the characteristics of deep-sea water (DSW), we investigated the hematological, immunological and biochemical effects of DSW, specifically the so-called Japan Sea Proper Water (JSPW), samples of which we collected from the Japan Sea at a depth of about 300 meters.
METHODSFive groups of five mice each were orally administered,ad libitum for 12 weeks, one of the following: 1.2% DSW, 12% DSW, 1.2% surface-sea water (SSW), 12% SSW, or purified water (control)
RESULTSAmong these groups, no significant differences were observed in the average reduction of water intake, food consumption or body weight. The mean corpuscular volume, however, was significantly lower (p<0.05) in the 1.2% DSW group than in the control group. Moreover, serum immunoglobulin G and A values were significantly higher (p<0.05) in the 12% DSW and the 12% SSW groups, respectively, compared with the control group. In addition, the serum glucose value in the 12% DSW group was significantly higher (p<0.05) than in the control group
CONCLUSIONSThe findings of the present study suggested the presence of some toxic components in DSW. Before a final answer is reached about whether DSW, and specifically JSPW, is bad for human health, the pathophysiology of findings such as the decreased mean corpuscular volume, the higher immunoglobulin G value and the higher glucose value should be investigated.