Epidural analgesia is considered by many to be the best method of pain relief after major surgery. It is used routinely in many thoracic surgery centres. Although effective, side-effects include hypotension, urinary retention, incomplete (or failed) block, and, in rare cases, paraplegia. Paravertebral block (PVB) is an alternative technique that may offer comparable analgesic effectiveness and ...

Plasma Cell neoplasms result from monoclonal proliferation of plasma cells. Solitary extramedullary plasmacytomas (SEMPs) are rare and constitute 5% of all plasma cell disorders. SEMPs most commonly involve upper aerodigestive tract. Isolated spinal epidural space involvement by SEMPs is extremely rare and to best of our knowledge only 7 such cases have been reported previously in available Eng...

CONTEXTS CD154 (commonly referred to as CD40-ligand) is a critical T cell factor that participates in the pathogenesis of autoimmune and is over-expressed in rheumatoid arthritis (RA). TNF-α blockade treatment had dramatic efficacy in RA. OBJECTIVE To investigate whether TNF-α blockade treatment can inhibit CD154 expression in RA. METHODS Blood samples were collected from 33 patients with r...

The structural organization of the epidural lymphatics and lymphatic drainage of the cerebrospinal fluid from spinal meninges was studied in Japanese monkeys (Macaca fuscata) by an enzyme-histochemical method. The spinal meninges were examined at various intervals from 1 to 48 h, as well as at 30 days, following an injection of ultrafine carbon particles into the subarachnoidal space (cisterna ...

Objective: To assess and compare the consequences of different approaches of epidural and combined spinal, epidural analgesia on the umbilical and uterine artery flow velocity waveform indices, maternal haemodynamics and neonatal outcome in normal term labour. Design: A prospective, observational, randomised study. Settings: El-Hussien Hospital and Kuwait Maternity Hospital. Subjects and Method...

Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% 12% of all cases of vertebral vascular malformation. Most of these are of vertebral origin, and cases that are non-vertebral in origin are rare. We encountered a patient with a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that...

BACKGROUND This clinical study aimed at investigating the impact of postoperative thoracic epidural analgesia on extracellular glycerol concentration and glucose metabolism in subcutaneous adipose tissue, using the microdialysis technique. The sympathetic nervous activity, which can be attenuated by epidural anesthesia, influences lipolysis and the release of glycerol. METHODS Fourteen patien...

INTRODUCTION Thyroid carcinoma initially presents with clinical symptoms due to metastatic lesions in less than 5% of cases. Spinal cord compression from an epidural metastatic lesion as a first symptom is extremely rare. One would expect such a presentation to occur much later in the course of the disease. METHODS We are presenting a case report of a follicular thyroid carcinoma that present...

BACKGROUND Risk scoring system for thoracic surgery patients have not been widely used, as of recently. We tried to forge a risk scoring system that predicts the risk of postoperative complications in patients undergoing major thoracic surgery. We used a prolonged ICU stay as a representative of postoperative complications and tested various possible risk factors for its relation. METHODS Dat...