Intravenous Patient Controlled Analgesia (IV PCA) after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, Spinal ; Catheterization ; Catheters ; Humans ; Knee Joint ; Nausea ; Nerve Block ; Pain, Postoperative ; Sciatic Nerve ; Vomiting

PURPOSE: To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures. MATERIALS AND METHODS: 17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked. RESULTS: The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points. CONCLUSION: By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.
Animals ; Ankle ; Follow-Up Studies ; Tibia ; Tibial Fractures

A 20 year old woman with noninsulin-dependent diabetes mellitus (NIDDM) developed an extensive warty and focally cauliflower like mass located at anogenital area. Its histopathologic study and in situ DNA hybridization revealed this lesion an ordinary condyloma acuminatum without large bulbous downward proliferation of which HPV type was 6 and/or 11. The mass lesion was successfully treated by excision and electrodesiccation under spinal anesthesia. Intermittent recurrence of several papular condylomata acuminata was observed during a follow up period of 6 months, which were easily cured by podophylline application on each occasion.
Anesthesia, Spinal ; Brassica ; Condylomata Acuminata ; Diabetes Mellitus, Type 2* ; DNA ; Female ; Follow-Up Studies ; Humans ; Podophyllin ; Recurrence ; Young Adult

Treatment strategies for femoroacetabular impingement (FAI) syndrome have evolved in tandem with increased comprehension of FAI’s impact on hip joint health. Early intervention, including arthroscopic surgery, has gained popularity due to its potential to delay the progression of osteoarthritis. Arthroscopic surgery has demonstrated significant efficacy in treating FAI syndrome, with robust evidence from randomized controlled trials and systematic reviews supporting its use. Despite arthroscopic surgery’s success, complications and reoperations are not uncommon. The incidence ranges from 1% to 31% and 4% to 13%, respectively.Adjunctive biologic treatments, such as bone marrow aspirate concentrates and platelet-rich plasma, have shown promise in chondral lesion management. However, robust evidence supporting their routine use in FAI syndrome is currently lacking. Among conservative treatment methods, intra-articular injections offer diagnostic and therapeutic benefits for FAI patients. While they may provide pain relief and aid in prognosis, their long-term efficacy remains a subject of debate. Comparative studies between conservative and arthroscopic treatments highlight the importance of personalized approaches in managing FAI syndrome. In conclusion, recent advancements in FAI syndrome management have illuminated various treatment modalities. Arthroscopic surgery stands as a pivotal intervention, offering substantial benefits in pain relief, function, and quality of life. However, careful patient selection and postoperative monitoring are crucial for optimizing outcomes. Adjunctive biologics and intra-articular injections show promise but require further investigation. Tailoring treatment to individual patient characteristics remains paramount in optimizing FAI syndrome management.

Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.
Anesthesia, Local ; Femoral Nerve ; Foot* ; Humans ; Leg* ; Nerve Block* ; Sciatic Nerve ; Skin Transplantation* ; Tissue Donors ; Ulcer*

No abstract available.
Hemorrhage* ; Humans ; Infant* ; Infant, Very Low Birth Weight*

Cell kinetic information is an important adjunct to histologically-based tumor classification. Studies on growth regulation and cellular transformation will be assisted by the identification of proteins that are synthesized in dividing cells. Proliferating cell nuclear antigen(PCNA) also known as cyclin, is a cell cycle-related nuclear protein that is maximally elevated in late G1 and S phases of proliferating cells. PCNA reacts with proliferating cells including tumor cells but gives undetectable immunofluorescence with resting cells of normal tissue. NORs are loop of DNA which occur in nucleoli and possess ribosomal DNA genes. Ribosomal DNA genes are of vital significance in the ultimate synthesis of protein, and that protein associated with NORs are stained with silver nitrate(Ag-NORs). AgNORs were studied in various tumors and may reflect the activity of cells and may be an indicator of the degree of malignancy. To evaluate the correlation between cellular proliferating activity and variable prognostic parameters, an immunohistochemical staining for PCNA and silver nitrate staining of NORs were performed in 23 cases of prostatic adenocarcinoma and 10 cases of benign prostatic hyperplasia, as control. The results were summarized as follows; 1. The mean expression of PCNA in BPH, well, moderately and poorly differentiated adenocarcinoma was 8.17+/-2.77(mean+/-SD ;n = 10), 21.75+/-6.11(n = 6), 19.40+/-6.98 (n=10) 27.93+/-8.23%(n=7), respectively in each group. Statistically significant differences were found in each group (p <0.05) except between well and moderately differentiated adenocarcinoma. 2. The mean number of Ag-NORs in BPH, well, moderately and poorly differentiated adenocarcinoma was 1.24+/-0.10(mean+/-SD;n=10), 1.87+/-0.23(n=6), 2.08+/-0.28(n=10) 4.02+/-0.22 (n = 7), respectively in each group. As the grade of tissues increased, the mean number of Ag-NORs increased too. The results showed statistically significant differences in each group (p < 0.05) except between well and moderately differentiated adenocarcinoma. 3. The mean area of Ag-NORs calculated by morphometry in BPH, well, moderately and poorly differentiated adenocarcinoma was 5.40+/-1.8um2, 7.84+/-3.68um2, 14.02+/-4.95um2, 23.9+/-6.94um2, respectively and significant differences was found statistically in each group (p < 0.05 ). 4. There was significant correlation between the expression of PCNA and the number of AgNORs(r= 0.800, p= 0.0001), the expression of PCNA and the area of AgNORs (r=0.788, p=0.0001). We concluded that the expression of PCNA and the number and area of NORs were increased with the degree of malignancy and may reflect the proliferative activity of cells in prostatic adenocarcinoma. PCNA and Ag-NORs may be a valuable prognostic indicator of patient's survival, but further studies will be needed to confirm its exact prognostic role.
Adenocarcinoma* ; Classification ; Cyclins ; DNA ; DNA, Ribosomal ; Fluorescent Antibody Technique ; Nuclear Proteins ; Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen ; Prostatic Hyperplasia ; S Phase ; Silver ; Silver Staining

Endosteum and bone marrow thermal necrosis caused by reaming during tibial intramedullary nail insertion, and unskilled operation of soft tissue penestration by reamer resulted in chronic osteomyelitis and soft tissue defect. So, several times of free flaps were done but the result was unsuccessful. At last, the authors performed radical necrotic bone resection and internal bone transport using Ilizarov external fixator. The authors report case with literature review.
Bone Marrow ; External Fixators ; Fracture Fixation, Intramedullary ; Free Tissue Flaps ; Nails ; Necrosis ; Osteomyelitis ; Tibia

Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation.
Acetabulum* ; Arthroscopy* ; Head ; Hip Dislocation* ; Hip Joint ; Hip* ; Osteoarthritis ; Pathology

The current conventional portals for hip arthroscopic surgery are the anterior, anterolateral, and posterolateral portals. For lesions in the medial anteroinferior or posteroinferior portion of the hip, these portals provide insufficient access to the lesion and consequently lead to incomplete treatment. Thus, in such a situation, a medial portal approach might be helpful. However, operators have avoided this procedure because of the risk of injury to the obturator, femoral neurovascular structures, and the medial femoral circumflex artery. Thus, to overcome the disadvantages of the conventional method for medial lesions of the hip, we performed a cadaveric study to evaluate the technique, usefulness, and risk of the medial portal technique.
Aged ; Arthroscopy/*instrumentation/*methods ; Female ; Hip Joint/*surgery ; Humans ; Male ; Middle Aged ; Patient Positioning