No abstract available.
Arthroplasty* ; Knee*

No abstract available.
Arthroplasty* ; Knee*

The conventional radiologic method for liver segmentation is based on the position of the hepatic and portal veins. However, during surgery, liver segments are resected based on the distribution of hepatic portal blood flow. This discrepancy can lead to a number of problems, such as miscommunication among clinicians, missing the location of the segment with the hepatic mass, and the risk of extended hepatic resection. We suggest a novel method to determine hepatic segments based on portal blood flow, as in the surgical approach, but by using high and low mechanical indexes in contrast-enhanced ultrasonography with Sonazoid. This approach is helpful for preoperatively determining hepatic segments and reducing the risk of missing the location of a hepatic tumor or extended hepatic resection.

Spinal cord stimulation (SCS) in trials involving external stimulation are easily conducted under local anesthesia. However, implantation of a permanent SCS system is painful, and can be intolerable in some patients. Epidural anesthesia can be used to perform the SCS implantation without discomfort if the patient can localize the area of paresthesia. However, little is known about epidural anesthesia for SCS. This paper reports 23 cases of permanent SCS with a cylindrical type lead implanted under the epidural anesthesia. Epidural anesthesia was sufficient in 22 patients without discomfort and significant complications. The remaining patient experienced incomplete epidural anesthesia and required additional analgesics to blunt the pain. All the leads were placed consistent with the patient's report of paresthesia area under epidural anesthesia. Thus, epidural anesthesia is an effective and safe method for the optimal placement of SCS to minimize the discomfort for patients without impairing patients' response to the intraoperative stimulation test.
Analgesics ; Anesthesia, Epidural* ; Anesthesia, Local ; Humans ; Paresthesia ; Spinal Cord Stimulation*

Intrathecal baclofen (ITB) pump implantation can be used to control dystonia and severe pain associated with complex regional pain syndrome (CRPS) with or without a spinal cord stimulator (SCS). A 45-year-old female patient had gotten an SCS to control the pain of CRPS. However, she suffered from chronic intractable pain in her left ankle and foot despite paresthesia in the entire painful area because the effectiveness of the SCS gradually diminished over time. In a trial of intrathecal drug administration, baclofen was superior to morphine for pain relief, had fewer side effects, and was superior in terms of patient satisfaction. To achieve the greatest degree of pain relief from the ITB pump, the tip of the intrathecal catheter was carefully placed in relation to the SCS. Over a one-year follow-up period, the patient experienced mild pain without any adverse effects.
Ankle ; Baclofen* ; Catheters* ; Dystonia ; Female ; Follow-Up Studies ; Foot ; Humans ; Middle Aged ; Morphine ; Pain, Intractable ; Paresthesia ; Patient Satisfaction ; Spinal Cord Stimulation ; Spinal Cord*

BACKGROUND: The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer. METHODS: This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis. RESULTS: Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449–0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028). CONCLUSIONS: Higher occupational sunlight exposure reduces the risk of RCC.
Carcinoma, Renal Cell ; Case-Control Studies ; France ; Humans ; Hypertension ; Incidence ; Kidney Neoplasms ; Logistic Models ; Obesity ; Occupational Groups ; Odds Ratio ; Risk Factors ; Smoke ; Smoking ; Sunlight ; Trichloroethylene