The brachial plexus block has its greatest usefulness in surgery on upper extremities, especially emergency surgical procedure and significant medical problems. There are several techniques at level which the plexus may be block. In 1979, Vongvises and Panijayanond were described on parascalene technique which is safe, simple to perform and reliable in anesthesia the brachial plexus. From May through september 1980, this technique was employed in 53 cases on upper extremities, shoulder joint and distal part of clavicle with immobilization of needle. This technique is a simple and good analgesia but each one case of pneumothorax, Horner's syndrome and recurrent laryngeal nerve paralysis were developed.
Analgesia ; Anesthesia ; Brachial Plexus Block* ; Brachial Plexus* ; Clavicle ; Emergencies ; Horner Syndrome ; Immobilization ; Needles ; Paralysis ; Pneumothorax ; Recurrent Laryngeal Nerve ; Shoulder Joint ; Upper Extremity

Brachial plexus block has been evaluated in 192 cases of surgery of the upper extremities performed during the past 13 years and 9 months. (from Jan. 1958 to Sept. 1971) We have assessed supraclavicular and axillary brachial plexus block using 1% to 2% procaine and lidocaine adding adrenaline case by case. The dosage given was 30 ml to 40 ml in each case There were 142 males and 50 females. In 26 blocks judged unsatisfactory for surgery, we have usually substituted inhalation anesthesia and .2 cases were supplimented with intravenous thiopental sodium, 2.5%, 3 ml to 5 ml intermittently and 4 cases with intravenous thiopental sodium and meperidine. There were 4 cases of complications of supraclavicular brachial plexus block including 2 cases of pneumothorax, one of Horners syndrome only and a cardiac arrest immediately after block. There were no complications in axillary approaches. Therefore in conclusion this brachial plexus block was a simple and useful technic in surgery and treatment of the upper extremities.
Anesthesia, Inhalation ; Brachial Plexus* ; Epinephrine ; Female ; Heart Arrest ; Horner Syndrome ; Humans ; Lidocaine ; Male ; Meperidine ; Pneumothorax ; Procaine ; Thiopental ; Upper Extremity

BACKGROUND/AIMS: The aims of this study were to investigate the prevalence of significant fibrosis in patients with chronic hepatitis B (CHB) virus infections and alanine aminotransferase (ALT) <80 IU/L, and to develop a noninvasive predictive model for significant fibrosis. METHODS: The 136 patients with CHB who underwent liver biopsy were recruited from six tertiary hospitals. The diagnostic value of predictors was judged using multivariate logistic modeling and the area under the receiver operating characteristic (AUROC) curve. RESULTS: Significant fibrosis was diagnosed in 97 patients (71.3%, 95% CI, 63.7~78.9%). In the training set (n = 85), the most important clinical data for predicting significant fibrosis were age and aspartate aminotransferase (AST). The AUROC of this model was 0.86 (95% CI, 0.78~0.94). The validation set (n=51), obtained from another institute, yielded similar results [AUROC: 0.90 (95% CI, 0.78~0.99)]. CONCLUSIONS: A high prevalence of significant fibrosis in CHB patients with ALT <80 IU/L was observed. A simple model that includes age and AST provides an easily applicable tool for physicians to guide the decision-making process regarding the need to perform a liver biopsy in individual patients. However, additional studies are needed to explore the model's performance in larger, independent patient populations.
Alanine Transaminase ; Aspartate Aminotransferases ; Biopsy ; Fibrosis ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Liver ; Logistic Models ; Prevalence ; ROC Curve ; Tertiary Care Centers ; Viruses