BACKGROUND: The authors report the results of preserving the infrapatellar branch of the saphenous nerve during unicompartmental knee arthroplasty to prevent lateral skin numbness. METHODS: All 100 cases had medial compartmental osteoarthritis and a minimally invasive technique had been used. The mean follow-up duration was two years and eight months (range, 24 to 42 months). RESULTS: The classification according to the location of this nerve was observed as either Mochida Type I with 76 cases (76%), Type II with 16 cases (16%), and unclassified type with 8 cases (8%). In Type I, the nerve was saved in 62 cases (82%), but could not be preserved in Type II because of the surgical procedure. These results showed that the mean distance from the joint line to the nerve of Type I was 9.13 mm (range, 4 to 15 mm) and the nerve passed inferiorly. CONCLUSIONS: This study showed the location of this nerve can be predicted ahead of the procedure, which will help preserve it during the surgery.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects/*methods ; Female ; Humans ; Hypesthesia/etiology/*prevention & control ; *Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Skin/*innervation

Intraneural ganglion of the tibial nerve is very rare. We have experienced a case of the intraneural ganglion cyst in the tibial nerve and medial plantar nerve, which was located at the level of the ankle and foot. A 29-year-old male suffered from lumps causing numbness around the medial aspect of the sole and great toe. But there was no weakness and change of the motor function. We excised the cystic mass successfully and the neurologic symptoms disappeared.
Adult ; Animals ; Ankle ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Male ; Neurologic Manifestations ; Tibial Nerve ; Toes

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

No abstract available.
Heart* ; Thoracic Surgery*

It is common to administrate neostigmiae methylsulfate and atropiae aulfate to counteract the effect of nondepolarising neuromuscular blocker. In case of cardiovascular disease, the effect of bradycardia or tachycardia resultiag from the administration of these drugs may be harmful to the patient. The purpose of this study is to investigate the effects of combinatioa and method of administration of neostigmine methylsulfate and atropine sulfate on heart rate. One hundred and two patients in both sexes were devided into three groups(A, B, C), and each group was devided into three subgroups (AI, AII, AIII, BI, BII, BIII, CI, CII, CIII). In group A, neostigmine methylsulfate and atropine aulfate were mixed and administered intravenously within fifteen seconds. In group B, atropine eulfate was administered thirty seconds after the administration of neostigmine methylsulfate. In group C, the two drugs were mixed and administered over a period of five minutes. In subgroup I the ratio of neostigmine methyliulfate to atropine sulfate was 2: 1(0. 04 mg/kg: 0.02 mg/kg) in subgroup 3 the ratio was 3: 2(0.03 mg/kg: 0. 02 mg/kg), and in subgroup lll the ratio was 1: 1(0. 02 mg/kg: 0. 02 mg/kg). The heart rate was counted just before, 0. 5 minute, 1 miaute, l. 5 minutes, 2 minutes, 3 minutes, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes, 30 minutes after the administration of the drugs. The results were as follows: 1) Initial increase in heart rate was significant in lager atropine ratio. 2) The later decrease in heart rate waa less in larger atropine ratio. 3) The maximal increases in heart rate in groap A and B appeared thirty seconds apart, but there was little difference betweea them. 4) The change ia heart rate was the least in group C.
Atropine* ; Bradycardia ; Cardiovascular Diseases ; Heart Rate* ; Heart* ; Humans ; Neostigmine ; Neuromuscular Blockade ; Tachycardia

Penile amputation is quite rare and requires emergency reimplantation by using microvascular surgery. Herein we report a case of an 8-year-old boy who accidentally has his penis amputated during circumcision. Emergency reimplantation was performed by using microvascular surgery. Thereafter partial necrosis of glans penis and distal penile skin was noted So penoplasty by using scrotal skin was done to restore normal shape penis. After 6 months later, normal erection and sensation were restored.
Amputation ; Child* ; Circumcision, Male ; Emergencies ; Female ; Humans ; Male ; Necrosis ; Penis* ; Replantation* ; Sensation ; Skin

No abstract available.
Abscess*

No abstract available.
Adult* ; Fistula* ; Humans

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs