This study compared the long-term clinical and radiological outcomes, according to the extent of arthroscopic meniscectomy, of complete and incomplete types of the discoid lateral meniscus. A total of 125 discoid menisci (74 complete and 51 incomplete types) without significant cartilage erosion at the time of surgery were included. The extent of meniscectomy was decided along with tear patterns and the stability of the discoid meniscus. Both clinical and radiological results were evaluated after total or partial meniscectomy. In the complete type of discoid meniscus with less than 5 years of follow-up, the total meniscectomy group showed better clinical results than the partial meniscectomy group. However, with over 5 years of follow-up, there were no differences between the two groups. In the radiological results, there was no significant difference between the two groups during the first 5 years after operation. However, with more than 5 years of follow-up, the partial meniscectomy group showed better results than the total meniscectomy group. In the incomplete-type discoid meniscus, clinical results were better in the partial meniscectomy group regardless of the follow-up periods. In the radiological results, the partial meniscectomy group showed better results for only more than 5 years of follow-up. The long-term prognosis after arthroscopic meniscectomy for the torn discoid lateral meniscus was related to the volume of the meniscus removed.
Buerger's disease (thromboangiitis obliterans) is known as a segmental inflammatory vasculitis that involves the small-sized and medium-sized arteries, veins, and nerves. Most effective treatment for Buerger's disease is smoking cessation. Except for the cessation of tobacco use, surgical revascularization is available in severe ischemia and a distal target vessel. Amputation has been used as the last treatment option of the disease up to the present. Increasing limb survival and decreasing amputation rate is important. This case describes the use of spinal cord stimulation (SCS) in patient with Buerger's disease and its effect is not only the complete healing of ulcers but also amputation is not performed.
BackgroundThe major disadvantage of rocuronium is the withdrawal movement associated with its injection. The analgesic effect of perioperative gabapentin has been evaluated. We investigated the effects of gabapentin on the withdrawal movement induced by rocuronium injection.Methods86 ASA physical status I or II patients, aged 18-69 years who were scheduled to undergo elective surgery with general anesthesia were enrolled. Patients were randomly allocated into two groups to receive either gabapentin 600 mg or placebo 2 hours prior to surgery. The patient's response to rocuronium injection was graded using a 4-point scale.ResultsThe incidence of withdrawal movement after rocuronium administration was significantly lower in the gabapentin group (55.0% in the control group vs 28.6% in the gabapentin group). The number of patients with generalized response indicating severe pain, was 9 (22.5%) in the control group and 3 (7.1%) in the gabapentin group.ConclusionsPretreatment with a single oral dose of gabapentin 600 mg reduced the incidence and severity of withdrawal movement after rocuronium administration.
Tracheal compression by vascular anomalies in adults is uncommon and most related reports are of children. A 79-year-old woman without any respiratory history underwent a lumbar spine surgery under general anesthesia. She suddenly developed airway obstruction after a position change from supine to prone. A fiberoptic bronchoscopy showed the obstruction of endotracheal tube. The obstruction was relieved after we changed the depth of endotracheal tube and supported the patient's neck with a cotton roll. The surgery ended without any other event and the patient recovered safely. A computed tomography revealed the rightward tracheal deviation and tortuous innominate artery contact with trachea. The patient didn't manifest any respiratory related symptoms during postoperative period, and she was discharged without any treatment.
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