Acute Pseudoseptic Inflammatory Local Reactions after Intra-articular Hyaluronic Acid Injections in Patients with Knee Osteoarthritis

Knee osteoarthritis is a common, but difficult problem to manage in primary care. Intra-articular hyaluronic acid injection has recently been frequently used for treating knee osteoarthritis. The adverse local reactions, except septic arthritis, following intra-articular hyaluronic acid injections are generally transient and not severe. Pseudoseptic arthritis is an extreme form of inflammatory arthritis that is not due to bacterial infection and it is important to distinguish this from true septic arthritis. In this article, we report 2 cases of acute pseudoseptic local reactions after intra-articular hyaluronic acid injections in patients with knee osteoarthritis.

Ultrasound-Guided Sciatic Nerve Block for the Treatment of Radiation Therapy Induced Sciatic Neuritis: A case report

Sciatic nerve block is frequently used for anesthesia or analgesia during lower leg surgery or chronic lower leg pain syndrome. Recently, a lot of ultrasound-guided peripheral nerve block has been reported because there are several benefits compared to blind technique. We performed ultrasound-guided right sciatic nerve block successfully to the patient who has been suffering from right buttock pain after previous radiation therapy.

Neuralgic Amyotrophy Considered as Cervical Radiculopathy: A case report

Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1-3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4-5 and C5-6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.

Effects of ascorbic acid on coagulation during living donor liver transplantation in adults / 대한마취과학회지

BACKGROUND: Prompt correction of hemostatic and thrombotic derangements during liver transplantation can play a key role in preventing excessive blood transfusion or thrombotic complications. It is well known that reactive oxygen species can affect coagulant and anticoagulant systems. Therefore, we investigated whether ascorbic acid (AA), one of potent antioxidant agents, can improve the coagulation during living donor liver transplantation (LDLT). METHODS: Thirty three adult patients undergoing LDLT were enrolled in this study. The blood samples of these patients were collected at 90 minutes after the beginning of operation and at 150 and 300 minutes after reperfusion. At each time period, blood samples were categorized into hypocoagulation, normal, and hypercoagulation. Within each category, the samples were further divided into three groups: whole blood (WB) (0.36 ml of native WB), AA (0.33 ml of native WB mixed with 0.03 ml of AA solution), and normal saline (NS) groups (0.33 ml of native WB mixed with 0.03 ml of NS), and these samples were analyzed using thromboelastogram (TEG). We compared the parameters of TEG (gamma time, K time, alpha angle, maximum amplitude (MA), and LY60) in each coagulation status. RESULTS: AA did not significantly affect TEG parameters in hypocoagulation or normal coagulation during LDLT. However, AA significantly decreased gamma time, alpha angle and MA at 150 minutes, and, K time and alpha angle at 300 minutes after reperfusion in the blood samples of hypercoagulation category. CONCLUSIONS: We may conclude that ascorbic acid inhibits hypercoagulation after reperfusion period during living donor liver transplantation.

Transient Hypertension, Cardiac Arrhythmia and Prolonged ST-depression due to High Concentration Epinephrine-soaked Gauze Application during Whole Face Resurfacing for Acne Scar with Erbium-Yag Laser : A case report

Subcutaneous and topical epinephrine are widely used for hemostasis during dermatologic procedure. There was substantial variation in the amount of systemic absorption on the basis of patient's general condition, blood supply of wounds. Increased or unpredictable absorption after topical administration may increase anesthetic and cardiovascular risks. There have been no reports about cardiovascular complications developed during laser resurfacing. We experienced a case of transient hypertension, cardiac arrhythmia and ST-depression during whole face resurfacing by Erbium-Yag laser due to application of high concentration epinephrine gauze on the face. The hypertension and arrhythmia were normalized in 2 minutes, and ST-depression was sustained for about 4 hours.