The Experts below are selected from a list of 270 Experts worldwide ranked by ideXlab platform
Hiroshi Otake - One of the best experts on this subject based on the ideXlab platform.
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Retraction Note: Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach.
JA clinical reports, 2020Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site. We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular Nerve and the fifth and sixth cervical Nerves for the clavicle fracture surgery. We can perform selective supraclavicular Nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax.
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Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach.
JA clinical reports, 2016Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Objectives Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site.
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Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach
SpringerOpen, 2016Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Abstract Objectives Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site. Case report We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular Nerve and the fifth and sixth cervical Nerves for the clavicle fracture surgery. Conclusions We can perform selective supraclavicular Nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax
P. Vermersch - One of the best experts on this subject based on the ideXlab platform.
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Phrenic Nerve Paralysis, Vegetative Symptoms and Restrictive Cardiomyopathy in a Case of Poems Syndrome
Journal of the Peripheral Nervous System, 2003Co-Authors: S. Delalande, Tanya Stojkovic, C Rose, Alain Millaire, J.-f. Hurtevent, P. VermerschAbstract:We report a case of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M protein and Skin changes) with unusual clinical features. A 62-year-old woman presented a severe polyneuropathy with dysphonia and vegetative symptoms, including bradycardia and sphincterial disorders. The clinical examination showed facial hyperpigmentation, cachexia, anasarca and splenomegaly. She also presented restrictive cardiomyopathy and endocrine disturbances. Nerve conduction studies revealed a severe demyelinating sensorimotor neuropathy. Cerebrospinal fluid analysis showed an elevated protein level. We detected a biclonal gammapathy (Ig G and Ig A with lambda light chain) and lytic pelvic bone lesions. Later, she developed a severe ventilatory failure due to a bilateral Phrenic Nerve Paralysis leading to a mechanical ventilation. Steroids followed by localized radiotherapy partially improved the respiratory status and stabilized the neuropathy. Phrenic Nerve Paralysis, restrictive cardiomyopathy, vegetative symptoms and cranial Nerve palsy are exceptional in POEMS syndrome. Moreover, this case emphasizes the importance of radiological investigations since the discover of plasmocytoma may improve the prognosis of POEMS syndrome.
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Bilateral Phrenic Nerve Paralysis, dysautonomia and restrictive cardiomyopathy in a case of POEMS syndrome
Revue neurologique, 2002Co-Authors: S. Delalande, Tanya Stojkovic, C Rose, Alain Millaire, J.-f. Hurtevent, P. VermerschAbstract:We report a case of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M protein and Skin changes) with unusual clinical features. A 62-year-old woman presented a severe polyneuropathy with dysphonia and vegetative symptoms, including bradycardia and sphincterial disorders. The clinical examination showed facial hyperpigmentation, cachexia, anasarca and splenomegaly. She also presented restrictive cardiomyopathy and endocrine disturbances. Nerve conduction studies revealed a severe demyelinating sensorimotor neuropathy. Cerebrospinal fluid analysis showed an elevated protein level. We detected a biclonal gammapathy (Ig G and Ig A with lambda light chain) and lytic pelvic bone lesions. Later, she developed a severe ventilatory failure due to a bilateral Phrenic Nerve Paralysis leading to a mechanical ventilation. Steroids followed by localized radiotherapy partially improved the respiratory status and stabilized the neuropathy. Phrenic Nerve Paralysis, restrictive cardiomyopathy, vegetative symptoms and cranial Nerve palsy are exceptional in POEMS syndrome. Moreover, this case emphasizes the importance of radiological investigations since the discover of plasmocytoma may improve the prognosis of POEMS syndrome.
Hironobu Ueshima - One of the best experts on this subject based on the ideXlab platform.
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Retraction Note: Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach.
JA clinical reports, 2020Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site. We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular Nerve and the fifth and sixth cervical Nerves for the clavicle fracture surgery. We can perform selective supraclavicular Nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax.
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Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach.
JA clinical reports, 2016Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Objectives Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site.
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Successful clavicle fracture surgery performed under selective supraclavicular Nerve block using the new subclavian approach
SpringerOpen, 2016Co-Authors: Hironobu Ueshima, Hiroshi OtakeAbstract:Abstract Objectives Cervical Nerves block cannot be performed on some patients because of the risk of Phrenic Nerve Paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular Nerve block at the subclavian site. Case report We present the case of a 62-year-old woman with clavicular fracture. We performed a selective block of the supraclavicular Nerve and the fifth and sixth cervical Nerves for the clavicle fracture surgery. Conclusions We can perform selective supraclavicular Nerve blocks for clavicular fracture surgery of patients who have bilateral pneumothorax
Alan D. Kaye - One of the best experts on this subject based on the ideXlab platform.
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Supraclavicular and paravertebral blocks: Are we underutilizing these regional techniques in perioperative analgesia?
Best practice & research. Clinical anaesthesiology, 2014Co-Authors: Veerandra Koyyalamudi, Sailesh Arulkumar, Benjamin R. Yost, Charles J. Fox, Richard D. Urman, Alan D. KayeAbstract:There has been a renewed interest in supraclavicular and paravertebral blocks for regional anesthesia. Studies have shown a high block success rate with the supraclavicular approach to the brachial plexus. Despite the use of ultrasound, pleural puncture and pneumothorax may still occur. The supraclavicular block is associated with a higher incidence of Phrenic Nerve Paralysis and caution should be exercised in patients with respiratory difficulties. Paravertebral blocks have been used successfully to provide analgesia and anesthesia for a variety of surgical procedures. When compared to thoracic epidural blockade for thoracic surgery, paravertebral blockade provides comparable analgesia with a better preservation of pulmonary function and a lower incidence of hypotension. This brings forth the question as to whether paravertebral blocks have replaced epidural blockade as the gold standard in perioperative pain management for thoracoabdominal procedures.
Tamas Szili-torok - One of the best experts on this subject based on the ideXlab platform.
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Right diaphragmatic Paralysis following endocardial cryothermal ablation of inappropriate sinus tachycardia.
Europace : European pacing arrhythmias and cardiac electrophysiology : journal of the working groups on cardiac pacing arrhythmias and cardiac cellula, 2006Co-Authors: Radu Vatasescu, Tchavdar N. Shalganov, Attila Kardos, Khatuna Jalabadze, Dóra Paprika, Margit Gyorgy, Tamas Szili-torokAbstract:Inappropriate sinus tachycardia (IST) is a rare disorder amenable to catheter ablation when refractory to medical therapy. Radiofrequency (RF) catheter modification/ablation of the sinus node (SN) is the usual approach, although it can be complicated by right Phrenic Nerve Paralysis. We describe a patient with IST, who had symptomatic recurrences despite previous acutely successful RF SN modifications, including the use of electroanatomical mapping/navigation system. We decided to try transvenous cryothermal modification of the SN. We used 2 min applications at −85°C at sites of the earliest atrial activation guided by activation mapping during isoprenaline infusion. Every application was preceded by high output stimulation to reveal Phrenic Nerve proximity. During the last application, heart rate slowly and persistently fell below 85 bpm despite isoprenaline infusion, but right diaphragmatic Paralysis developed. At 6 months follow-up, the patient was asymptomatic and the diaphragmatic Paralysis had partially resolved. This is the first report, we believe, of successful SN modification for IST by endocardial cryoablation, although this case also demonstrates the considerable risk of right Phrenic Nerve Paralysis even with this ablation energy.
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P4-109: Right diaphragmatic Paralysis following endocardial cryothermal ablation of inappropriate sinus tachycardia
Heart Rhythm, 2006Co-Authors: Radu Vatasescu, Tchavdar N. Shalganov, Khatuna Jalabadze, Dóra Paprika, Margit Gyorgy, Tamas Szili-torokAbstract:Inappropriate sinus tachycardia (IST) is a rare disorder amenable to catheter ablation when refractory to medical therapy. Radiofrequency (RF) catheter modification/ablation of the sinus node (SN) is the usual approach, although it can be complicated by right Phrenic Nerve Paralysis. We describe a patient with IST, who had symptomatic recurrences despite previous acutely successful RF SN modifications, including the use of electroanatomical mapping/navigation system. We decided to try transvenous cryothermal modification of the SN. We used 2 min applications at 2858C at sites of the earliest atrial activation guided by activation mapping during isoprenaline infusion. Every application was preceded by high output stimulation to reveal Phrenic Nerve proximity. During the last application, heart rate slowly and persistently fell below 85 bpm despite isoprenaline infusion, but right diaphragmatic Paralysis developed. At 6 months follow-up, the patient was asymptomatic and the diaphragmatic Paralysis had partially resolved. This is the first report, we believe, of successful SN modification for IST by endocardial cryoablation, although this case also demonstrates the considerable risk of right Phrenic Nerve Paralysis even with this ablation energy.