PURPOSE: We compared the results of total ankle arthroplasty in patients with preoperative varus deformity of more than 20degrees with those of patients with varus deformity less than 20degrees. MATERIALS AND METHODS: From January 2005 to January 2013, 9 ankles with preoperative varus deformity of more than 20degrees (varus group) and 31 ankles with varus deformity less than 20degrees (control group) underwent total ankle arthroplasty. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score, and radiographic results were assessed using tibiotalar varus angle in standing anteroposterior radiographs taken preoperatively and at the last follow-up. RESULTS: The mean duration of clinical follow-up was 42.8 months (14~60 months). The AOFAS score was improved by a mean 47.0 points in the varus group and 37.6 points in the control group. Statistically significant difference was observed between the two groups (p=0.041). Tibiotalar varus angle measured at the last follow-up radiograph was 2.5degrees in the varus group and 1.0degrees in the control group and the difference was not statistically significant (p=0.820). CONCLUSION: Satisfactory clinical and radiographic results can be achieved in patients with varus deformity more than 20degrees by precise bone resection and soft tissue release.
Ankle* ; Arthroplasty* ; Congenital Abnormalities* ; Follow-Up Studies ; Foot ; Humans

Clinically, the fit of fixed prosthesis is an essential element for successful restoration. The fit of prosthesis is largely classified into marginal fit and internal fit, and various methods to assess these have been introduced including microscopic margin measurement, cross-sectional measurement, silicone replica technique, 3-dimensional scanning data superposition, weight technique and micro CT scanning. Thus, this study is aimed at proposing a more convenient and accurate measurement method of fits in a digital environment by comparatively analyzing the advantages and disadvantages of each known method based on existing literature.
Crowns ; Dental Prosthesis* ; In Vitro Techniques* ; Methods* ; Prostheses and Implants ; Replica Techniques ; Silicon ; Silicones ; Tomography, X-Ray Computed

Background: Ibuprofen, a well-known analgesic, is commonly used as a component of a multimodal analgesic approach for postoperative pain. This systematic review and meta-analysis aimed to investigate whether a single-dose preoperative intravenous ibuprofen can reduce postoperative pain and opioid consumption. Methods: PubMed/MEDLINE, Embase, Cochrane Library (CENTRAL), and Web of Science databases were searched to identify relevant studies published up to May 2020. Randomized controlled trials comparing preoperative single-dose intravenous ibuprofen effect with the control group on postoperative pain and opioid consumption after surgery under general anesthesia were included. Results: Six studies involving 366 participants were included. Single-dose administration of intravenous ibuprofen preoperatively significantly reduced postoperative pain score on a scale of 0-10 at 1 h (MD: -1.64, 95% CI [-2.56, -0.72], P < 0.001, I2 = 95%), at 4-6 h (MD: -1.17, 95% CI [-2.09, -0.26], P < 0.001, I2 = 94%), and 24 h (MD: -0.58, 95% CI [-0.99, -0.18], P < 0.001, I2 = 90%). Cumulative opioid consumption, presented as fentanyl equivalents, was also reduced significantly in the ibuprofen group compared to placebo group until postoperative 4-6 h (MD: -56.35 μg, 95% CI [-101.10, -11.60], P < 0.001, I2 = 91%) and 24 h (MD: -131.39 μg, 95% CI [-224.56, -38.21], P < 0.001, I2 = 95%). Conclusions Preoperative single-dose intravenous ibuprofen can reduce postoperative pain and opioid consumption until 24 h postoperatively. Considering the high heterogeneity and small number of studies included, care should be taken when generalizing these findings.

Background: Ibuprofen, a well-known analgesic, is commonly used as a component of a multimodal analgesic approach for postoperative pain. This systematic review and meta-analysis aimed to investigate whether a single-dose preoperative intravenous ibuprofen can reduce postoperative pain and opioid consumption. Methods: PubMed/MEDLINE, Embase, Cochrane Library (CENTRAL), and Web of Science databases were searched to identify relevant studies published up to May 2020. Randomized controlled trials comparing preoperative single-dose intravenous ibuprofen effect with the control group on postoperative pain and opioid consumption after surgery under general anesthesia were included. Results: Six studies involving 366 participants were included. Single-dose administration of intravenous ibuprofen preoperatively significantly reduced postoperative pain score on a scale of 0-10 at 1 h (MD: -1.64, 95% CI [-2.56, -0.72], P < 0.001, I2 = 95%), at 4-6 h (MD: -1.17, 95% CI [-2.09, -0.26], P < 0.001, I2 = 94%), and 24 h (MD: -0.58, 95% CI [-0.99, -0.18], P < 0.001, I2 = 90%). Cumulative opioid consumption, presented as fentanyl equivalents, was also reduced significantly in the ibuprofen group compared to placebo group until postoperative 4-6 h (MD: -56.35 μg, 95% CI [-101.10, -11.60], P < 0.001, I2 = 91%) and 24 h (MD: -131.39 μg, 95% CI [-224.56, -38.21], P < 0.001, I2 = 95%). Conclusions Preoperative single-dose intravenous ibuprofen can reduce postoperative pain and opioid consumption until 24 h postoperatively. Considering the high heterogeneity and small number of studies included, care should be taken when generalizing these findings.

No abstract available.
Child* ; Heel* ; Humans

The mutation of the PKD1 gene causes autosomal dominant polycystic kidney disease (ADPKD), and the PKD1 gene encodes polycystin-1 (PC-1). PC-1 is thought to be a cell-cell/matrix adhesion receptor molecule at the cell surface that is widely expressed in the kidney. However, there are controversies about the role of PC-1 protein and its expression when using different antibodies to detect it. We used two PC-1 antibodies; C-20 (Santa Cruz, sc-10372) as the C-terminal antibody, and P-15 (Santa Cruz, sc-10307) as the N-terminal antibody. We evaluated the PC-1 expression by performing immunoblotting on the human embryonic kidney (HEK) 293 cells and the renal proximal tubular epithelial cell (RPTEC) lysates. We characterized the expression of PC-1 in the fetal, adult and polycystic kidneys tissues by performing immunohistochemistry. We confirmed the PC-1 expression in the HEK 293 cells and the RPTEC lysates, but the expression was very low. The PC-1 proteins were diffusely expressed in the tubular epithelial cells cytoplasm in the fetal and adult kidneys, and the PC-1 expression was more prominent in the proximal tubules of the fetal kidney. In the ADPKD kidney, the PC-1 proteins were heterogenously and weakly expressed in the tubular or cyst lining epithelial cells. Our data suggests that the development of the kidney may regulate the expression of PC-1, and an altered PC-1 expression may contribute to cyst formation in ADPKD.
TRPP Cation Channels/chemistry/*metabolism ; Protein Structure, Tertiary ; Polycystic Kidney, Autosomal Dominant/*metabolism ; Middle Aged ; Male ; Kidney/*embryology/metabolism/*pathology ; Immunohistochemistry ; Humans ; *Gene Expression Regulation, Developmental ; *Gene Expression Regulation ; Cytoplasm/metabolism ; Cell Line

OBJECTIVE: The aim of this study was to compare titanium and cobalt alloy clip induced artifacts in 16- and 64-row multislice computed tomography angiograms. METHODS: A total of 40 intracranial aneurysms in 37 patients treated using titanium or cobalt-alloy clips were enrolled in this study. Computed tomography angiography (CTA) was performed using a 16-row (12 aneurysms; cobalt-alloy clips in 8 and titanium clips in 4) or 64-row (28 aneurysms; cobalt-alloy clips in 14 and titanium clips in 14) multislice CT machine after surgical clipping. Clip-induced artifacts were divided into white and black components, and artifact sizes were quantified by measuring the areas of these components. RESULTS: The titanium clips (634.9 +/- 308.44 mm2) produced smaller artifacts than cobalt alloy clips (2,797.4 +/- 3,121.98 mm2) by CTA (p=0.006), but the mean size of titanium clip induced artifacts was smaller for 64-row (544.0 +/- 68.77 mm2) than for 16-row (953.3 +/- 279.95 mm2) multislice CTA (p=0.026). On the other hand, cobalt alloy clip related artifacts were similarly sized (64-row, 2,191.5 +/- 2,072.86 mm2 versus 16-row, 3,857.6 +/- 4,386.56 mm2, p=0.246). CONCLUSION: Titanium clips produce smaller artifacts than cobalt-alloy clips and 64-row multislice CTA reduced titanium clip-induced artifacts as compared with 16-row multislice CTA. However, cobalt-alloy clip artifacts were huge and were not reduced by the higher row CTA unit.
Alloys ; Aneurysm ; Angiography ; Artifacts ; Cobalt ; Hand ; Humans ; Intracranial Aneurysm ; Multidetector Computed Tomography ; Surgical Instruments ; Titanium

OBJECTIVE: The aim of this study was to compare titanium and cobalt alloy clip induced artifacts in 16- and 64-row multislice computed tomography angiograms. METHODS: A total of 40 intracranial aneurysms in 37 patients treated using titanium or cobalt-alloy clips were enrolled in this study. Computed tomography angiography (CTA) was performed using a 16-row (12 aneurysms; cobalt-alloy clips in 8 and titanium clips in 4) or 64-row (28 aneurysms; cobalt-alloy clips in 14 and titanium clips in 14) multislice CT machine after surgical clipping. Clip-induced artifacts were divided into white and black components, and artifact sizes were quantified by measuring the areas of these components. RESULTS: The titanium clips (634.9 +/- 308.44 mm2) produced smaller artifacts than cobalt alloy clips (2,797.4 +/- 3,121.98 mm2) by CTA (p=0.006), but the mean size of titanium clip induced artifacts was smaller for 64-row (544.0 +/- 68.77 mm2) than for 16-row (953.3 +/- 279.95 mm2) multislice CTA (p=0.026). On the other hand, cobalt alloy clip related artifacts were similarly sized (64-row, 2,191.5 +/- 2,072.86 mm2 versus 16-row, 3,857.6 +/- 4,386.56 mm2, p=0.246). CONCLUSION: Titanium clips produce smaller artifacts than cobalt-alloy clips and 64-row multislice CTA reduced titanium clip-induced artifacts as compared with 16-row multislice CTA. However, cobalt-alloy clip artifacts were huge and were not reduced by the higher row CTA unit.
Alloys ; Aneurysm ; Angiography ; Artifacts ; Cobalt ; Hand ; Humans ; Intracranial Aneurysm ; Multidetector Computed Tomography ; Surgical Instruments ; Titanium

Background: Residual neuromuscular blockade (RNMB) is a frequent event after general anesthesia, which can lead to serious complications, such as upper airway obstruction. Sugammadex is useful in reversing RNMB. However, its use in infants has not yet been approved by the Food and Drug Administration. Therefore, anesthesiologists can be hesitant use it, even in situations where no other choice is available.Case: A two-month-old baby presented to the hospital for umbilical polypectomy. At the end of the surgery, neostigmine was administered. Even after waiting for 30 min and injecting an additional dose of neostigmine, neuromuscular blockade was not adequately reversed. Eventually, sugammadex was administered, and spontaneous breathing returned. Conclusions If there were no particular causes of delayed return to spontaneous breathing in infants, RNMB should be considered and reversal with sugammadex would be useful.

Purpose: Using a new robotic endoscopic platform system developed for retrograde intrarenal surgery (RIRS) called easyUretero (ROEN Surgical Inc.), we evaluated the feasibility and safety of renal stone retrieval in a porcine model. Materials and Methods: Six female pigs were used for our in vivo study. First, 0.3-cm-sized phantom stones were inserted into the kidneys of each pig via the ureteral access sheath. Next, renal stone retrieval was attempted using manual RIRS in three pigs and robotic RIRS in three pigs. Three surgeons performed extraction of 10 stones in each session. Results: The mean stone retrieval time by manual RIRS was significantly shorter than that by robotic RIRS (399.9±185.4 sec vs. 1127.6±374.5 sec, p=0.001). In contrast, the questionnaire regarding usability showed high satisfaction in the surgeons’ fatigue category for surgeons using robotic RIRS. The radiation exposure dose was also lower in robotic RIRS than in manual RIRS (0.14 μSv vs. 45.5 μSv). Postoperative ureteral injury assessment revealed Grade 0 in manual RIRS cases and Grades 0, 1, and 2 in robotic RIRS cases. Conclusion The easyUretero system is a new robotic RIRS system that was developed in Korea. The results of the present study suggest that using easyUretero for stone retrieval during RIRS is safe and ergonomic.