Biomechanical comparison of single-bundle versus double-bundle anterior cruciate ligament reconstruction: a meta-analysis

Methods@#The electronic databases MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for relevant articles comparing the outcomes of SB-ACLR versus DB-ACLR that were published until November 2019. @*Results@#Seventeen biomechanical studies were included. The anterior laxity measured using the anterior drawer test showed significantly better results in DB-ACLR when compared with SB-ACLR. In addition, outcomes of the anterior tibial translation test under a simulated pivot shift presented with better results at low flexion and 30° in DB-ACLR, compared with SB-ACLR. However, there were no significant biomechanical differences between the groups in internal rotation. @*Conclusions@#The present study demonstrated that both techniques for ACLR are associated with restoration of normal knee kinematics. DB-ACLR is superior to SB-ACLR in terms of restoration of anteroposterior stability.However, which technique yields better improvement in internal rotation laxity, and internal rotation laxity under a simulated pivot shift at a specific angle, remains unclear.Level of evidence: This is a level II meta-analysis.

Therapeutic Effects of Mesenchymal Stem Cells on a Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Model

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are the most severe cutaneous drug hypersensitivity reactions, which are unpredictable adverse drug reactions. SJS/TEN is associated with significant mortality and morbidity; however, effective treatment is difficult. Mesenchymal stem cells (MSCs) are well-known for their anti-inflammatory and tissue regeneration properties. The purpose of the present study was to verify whether MSCs could be applied for the treatment of SJS/TEN. We developed an SJS/TEN mouse model using peripheral blood mononuclear cells from a lamotrigine-induced SJS patient. MSCs were injected into the model to verify the treatment effect. In SJS model mice treated with MSCs, ocular damage rarely occurred, and apoptosis rate was significantly lower. We demonstrated a therapeutic effect of MSCs on SJS/TEN, with these cells presenting a potential novel therapy for the management of this disorder.

A Tender Fingertip Papule in an Elderly Woman / 대한피부과학회지

No abstract available.

Methods for Locating the Pores of Epidermal Cysts

No abstract available.

A Rapid Effect in Childhood Granulomatous Periorificial Dermatitis with Oral Metronidazole and Topical Tacrolimus / 대한피부과학회지

No abstract available.

Depressed Facial Scars Successfully Treated with Autologous Platelet-Rich Plasma and Light-Emitting Diode Phototherapy at 830 nm

No abstract available.

Autoerythrocyte sensitization syndrome presenting with general neurodermatitis

Autoerythrocyte sensitization syndrome (AES) was first described by Gardner and Diamond in 1955, when four women with painful bruising were depicted. Patients with AES typically present with the development of recurrent, spontaneous, painful ecchymosis, frequently preceded by a prodrome of pain or itching of the skin. The patients are sensitive to their own red blood cells injected intradermally, and underlying coagulopathies are thought to be absent. We introduce a 70-year-old woman presenting with recurrent episodes of painful bruising on the trunk and extremities.

A Case of Zosteriform Lichen Planus on the Right Scapular Area / 대한피부과학회지

No abstract available.

Multiple Digital Mucinous Cysts / 대한피부과학회지

No abstract available.

A Case of Syphilid with Nail Dystrophy / 대한피부과학회지

Syphilis, the "great imitator" of skin diseases, is a chronic systemic infectious disease with a waxing and waning course. Clinical manifestations of syphilis are variable in appearance and have been described for centuries. Especially, secondary syphilis is characterized by large diversity of presentation. They include macular, papular, papulosquamous, syphilis cornee, psoriasiform, annular en cockade, nodular, condylomata lata, malignant syphilis, mucosal lesions, loss of the hairs, and alteration of the nails. Nail involvement of syphilis includes changes on nail plate (syphilitic onychia) or periungual tissue (syphilitic paronychia). A 20-year-old man was presented with multiple erythematous broad eroded surfaced papules and macules on the scrotum and scaly exfoliated patch with erythematous swelling on the right thumb with onychodystrophy and mild tenderness on the nail. Serological screening for syphilis showed increased titer for VDRL (1:16) and TPHA (+). After intramuscular treatments with benzathine penicillin G, the skin lesions on the scrotum cleared within 1 month and the nail dystrophy showed slight improvement.

Folluculitis Decalvans of the Scalp: Improvement with Intralesional Injection of Triamcinolone Acetonide and Oral Isotretinoin / 대한피부과학회지

No abstract available.

Ipsilateral Mydriasis after Open Reduction of a Left Blow Out Fracture: A case report / 대한마취과학회지

Perioperative unilateral mydriasis is a disturbing finding, which is suggestive of acute intracranial pathology during general anesthesia. In addition, the assessment of an abnormal neurological injury is limited during general anesthesia, with anisocoria requiring special consideration. The case of a 27 year old healthy male patient, with ipsilateral mydriasis found near the end of surgery of open reduction for left blow out fracture, was experienced. The patient's pupils were bilaterally equal four hours after uneventfully surgery. The possible causes of unilateral mydriasis include the effects of anesthetic agents, stellate ganglion block, impaired venous return from head and neck, an acute intracranial mass lesion or hemorrhagic event, direct eye trauma, pre-existing medical or surgical conditions (Adie's tonic pupil, artificial eye etc.) and inadvertent direct deposition of alpha-adrenergic or anticholinergic agents in the eye. The understanding and diagnosis of unusual mydriasis during general anesthesia requires knowledge of the autonomic nerve pathways and pharmacology of the eye. In this case, the myadriasis of the left eye was considered to have resulted from the absorption of 1:100.000 topical epinephrine infiltrated into the lower eyelid via episcleral vessels.

Developed Extrapotine Myelinolysis after Hysteroscopic Myomectomy: A case report / 대한마취과학회지

Transcervical resection of endometrium is under-utilized in the treatment of dysfunctional uterine bleeding, uterine myoma and menorrhagia. The procedure is similar to transurethral resection of prostate in men with a possibility of substantial absorption of irrigation fluid. Absorption of a large volume of fluid can cause excessive intravascular volume, hyponatremia, cerebral edema and death. Severe hyponatremia leading to extrapontine myelinolysis is an extremely rare complication of this procedure. So, We report a case of developed extrapontine myelinolysis after hysteroscopic myomectomy which, however, showed complete recovery.

Anesthetic Management of Emergent Cesarean Section in a Patient with Allergic Reaction to an Antibiotic: A case report / 대한마취과학회지

Allergic reactions developed in parturients can cause fetal asphyxia and some difficulties in anesthetic management. We performed general anesthesia for an emergent cesarean section on 30 yrs old woman who showed an allergic reaction to an antibiotic. Dyspnea, urticaria, sweating, generalized edema and fetal bradycardia suddenly occurred after an intravenous injection of the antibiotic. Dexamethasone 10 mg was administered intravenously. General anesthesia was induced with pentothal and succinylcholine. Despite of severe airway edema, endotracheal intubation was successful. During the operation, the allergic signs became decreased. After the operation, no additional problems were evident. Potential epitopes should be removed in susceptible parturients and medical staff should be familiar with anesthetic management in allergic patients during pregnancy.

Hydrohemothorax and Subclavian Artery Laceration during Internal Jugular Vein Cannulation: A case report / 대한마취과학회지

Central venous cannulation via an internal jugular vein has become a common procedure in the management and monitoring of severely ill patients. Although complications such as carotid artery puncture or pneumothorax have been reported, hemothorax is relatively uncommon. We describe a case of hydrohemothorax and subclavian artery laceration which occurred during right internal jugular vein cannulation. A 44-year-old female patient was admitted for laparoscopic adrenalectomy under general anesthesia. For central venous pressure monitoring, central venous cannulation performed. However, dilator overinsertion injured the right subclavian artery. This led to a massive ipsilateral hydrohemothorax requiring thoracotomy for subclavian artery repair. This case suggests that central venous cannulation should be done carefully and improves awareness of the potential for dilator induced injury.

Effect of Elimination of CO2 Absorption Canisters on the Rate of Recovery from General Anesthesia / 대한마취과학회지

BACKGROUND: The most important route for elimination of inhalation anesthetics is exhalation. The lower anesthetic circuit volume and absorption by the anesthetic circuit maKes recovery more fast. The purpose of this study is to evaluate the effect of the elimination of CO2 absorption canisters on the rate of recovery from anesthesia. METHODS: Forty patients were randomly assigned into two groups. Group 1 patients recovered from enflurane anesthesia with CO2 absorption canisters (baralyme), but group 2 patients emerged from anesthesia without CO2 absorption canisters. The changes of expiratory enflurane and inspiratory nitrous oxide concentration at 30, 60, 90, 120, 150, 180 sec after the end of anesthetic administration, and time from the end of anesthetic administration to extubation were measured and compared between the groups. RESULTS: Enflurane and nitrous oxide concentrations after the end of anesthetic administration in group 2 were significantly lower than in group 1 at each time interval (P < 0.05). Time from the end of anesthetic administration to extubation in group 2, 7.7 +/- 1.4 min, was significantly shorter than in group 1, 10.5 +/- 2.6 min (P < 0.05). CONCLUSIONS: The results show that the patients emerging from anesthesia without CO2 absorption canisters can recover from anesthesia more rapidly than those with CO2 absorption canisters.

Acute Dystonia by Droperidol during Intravenous Patient-Controlled Analgesia in Children / 대한마취과학회지

Patient-controlled analgesia (PCA) is an important means for postoperative analgesia with parenteral opioids. However, postoperative nausea and vomiting (PONV) remains a major complication with a PCA system. Droperidol is used in PCA to prevent PONV. Extrapyramidal reactions by droperidol are, however, occasionally induced. We describe two cases of severe extrapyramidal hypertonic syndrome with an IV administration of droperidol in PCA in two children, following orthopedic surgery. One patient showed a hypertonic syndrome 20 minutes after receiving droperidol 1.0 mg IV and the symptoms persisted for nearly 12 h without prescription. Another patient revealed an acute rigidity 19 h after the beginning of PCA and was treated with an IM administration of midazolam 2 mg successfully.

Acute Dystonia by Droperidol during Intravenous Patient-Controlled Analgesia in Young Patients

Patient-controlled analgesia (PCA) is an important means for postoperative analgesia with parenteral opioid. However, postoperative nausea and vomiting (PONV) remains a major problem with a PCA system. Droperidol is used in PCA to prevent PONV. Extrapyramidal reactions by droperidol are, however, occasionally induced. We describe two cases of severe extrapyramidal hypertonic syndrome with an intravenous administration of droperidol in PCA in young patients, following orthopedic surgery.

The Effect of Pretreated Pyridostigmine on the Change of Blood Pressure and Heart Rate Following Intrathecally Injected Clonidine in Cats / 대한마취과학회지

Intrathecal clonidine injection induces analgesia without significant respiratory depression, but decreases blood pressure and causes sedation. Injection of spinal cholinesterase inhibitor alone increases blood pressure in animals, and enhances clonidine induced analgesia. To evaluate the effect of pretreated pyridostigmine on the change of blood pressure and heart rate, clonidine was injected intrathecally in cats. We divided fifteen cats into three groups and administered saline(0.5 cc) to group 1, pyridostigmine(0.5 cc, 2.5 mg) to group 2, pyridostigmine(0.5 cc, 2.5 mg) and glycopyrrolate(0.5 cc, 0.1 mg) to group 3 before 20 minute of clonidine injection and measured mean arterial pressure, heart rate, P CO2 and central venous pressure. The results were as follows: 1)After clonidine injection, all mean arterial pressure values were significantly reduced in group 1, but in group 3, 20, 30 and 40 minutes values were significantly reduced, and 10, 40 minutes values after clonidine injection were not reduced significantly in group 2 compared to group 1. 2)After clonidine injection, heart rates were significantly reduced in all groups, but there was no significant difference between group 1, group 2 and group 3. 3)There was no significant difference of central venous pressure in any groups. 4)There was no significant difference for reversal of pyridostigmines effect by glycopyrrolate. Based on these results, these data suggest that pyridostigmine pretreatment counteracts clonidine induced hypotension, but further study of spinal az adrenergic-cholinergic combination for pain therapy is needed before clinical application.

Hemodynamic Changes Measured by a Thoracic Electrical Bioimpedance Technique during a Laparoscopic Cholecystectomy / 대한마취과학회지

BACKGROUND: We performed this study to determine the changes of hemodynamic parameters following major surgical events such like incision for trochar insertion, institution and deflation of pneumoperitoneum during a laparoscopic cholecystectomy. METHODS: Ten-female patients ASA physical status 1 during a laparoscopic cholecystectomy were enrolled into this study. Anesthesia was performed with propofol, alfentanil and vecuronium. Pneumoperitoneum was instituted by CO2 gas with intraperitonial pressure under 12 mmHg. Hemodynamic parameters before skin incision (BI), after skin incision (AI), 2, 5, 10, 15 and 20 min after the institution of pneumoperitoneum (P + 2, P + 5, P + 10, P + 15 and P + 20), 2 and 5 min after deflation (D + 2 and D + 5) were measured by the use of a thoracic electrical bioimpedance technique (TEB). RESULTS: Trochar insertion did not significantly change the hemodynamic parameters. Heart rate, total fluid content and left cardiac work index were not significantly changed through this study. Mean BP (MBP), pre-ejection period (PEP) and systemic vascular resistance index (SVRI) were significantly increased, and acceleration time index (ACI), cardiac index (CI), stroke index (SI) and velocity index (VI) were significantly more decreased after institution of pneumoperitonium than those of BI and AI. However, all parameters in P + 20, D + 2 and D + 5 were not significantly different from those of BI and AI. CONCLUSIONS: MBP, PEP, SVRI, ACI, CI, SI and VI measured by TEB were significantly changed by the institution of pneumoperitonium during a laparscopic cholecystectomy, but they all recovered to the values before the institution of pneumoperitonium within 20 min.