No abstract available.
Infusions, Intraosseous* ; Resuscitation* ; Shock, Hemorrhagic*

Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

No abstract available.
Emergencies* ; Humans

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy*

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

No abstract available.
Chondromatosis, Synovial* ; Knee Joint* ; Knee* ; Osteoarthritis*

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

BACKGROUND: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. METHODS: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. RESULTS: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. CONCLUSIONS: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Arthroscopy* ; Dislocations ; Elbow ; Humans ; Joint Instability ; Recurrence* ; Reoperation ; Risk Factors* ; Shoulder* ; Surgeons ; Suture Anchors* ; Sutures*

BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

No abstract available.
Resuscitation* ; Shock, Hemorrhagic*