Intraneural Ganglion Cyst in Foot and Ankle / 대한족부족관절학회지

PURPOSE: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. MATERIALS AND METHODS: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. RESULTS: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. CONCLUSION: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

The Relationship between the Evaluation of the Graft-bone Interface and the Clinical Results after Double Bundle Anterior Cruciate Ligament Reconstruction

PURPOSE: This study examined the relationship between an evaluation of the graft-bone interface using magnetic resonance (MR) arthrography and the clinical results after double bundle anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: From December 2005 to October 2007, 15 cases that underwent double bundle ACL reconstruction and that were evaluated by MR arthrography were reviewed. The mean follow-up period was 20 months. The graft-bone interface was assessed by the leakage of contrast medium seen on MR arthrography. Four groups were classified according to the degree of contrast media leakage: no contrast media leakage, the focal type, the crescent type and the circumferential type. A functional evaluation was made using the Lysholm score, the international knee documentation committee (IKDC) score, the difference in the midthigh circumference and the Hop test. The stability was evaluated using a Lachmann test, a pivot shift test, a KT-2000 arthrometer and an anterior drawer stress radiograph using Telos(R) with the knee in 30degrees flexion. RESULTS: Ten cases showed no leakage of contrast media, five cases showed focal leakage and there was no case of crescent and circumferential leakage. The clinical results of the no leakage and focal leakage groups were compared. The functional evaluation such as the Lysholm score, the IKDC score, the difference in the midthigh circumference and the Hop test showed no significant difference between the two groups. The stability evaluation, such as the Lachmann test, the pivot shift test, the KT-2000 arthrometer and anterior drawer stress radiograph, also showed no significant difference. CONCLUSION: On MR arthrography after double bundle ACL reconstruction, adequate osteointegration and satisfactory clinical results could be obtained in the no leakage and focal leakage groups.

A Case Report of Delayed Hemolytic Transfusion Reaction after Administration of Apparently Compatible Blood / 대한마취과학회지

Hemolytic transfusion reactions may occur after the administration of donor bloods even when they have been shown compatible apparently by crossmatch tests. Such episodes present a diagnostic challenge and raise serious doubts about our understanding of blood group incompatibility. Fever, hemoglobinuria, oliguria and marked fall in hematocrit values developed in a patient 30 hours after she had received one unit of apparently compatible blood during operation under general anesthesia. Results of routine serologic studies at the time of the transfusion reaction were normal. She died on 40 hours after operation.

Laryngeal Edema after Tracheal Intubation for General Anesthesia: Report of 3 Cases / 대한마취과학회지

The authors have experience of three cases of laryngeal edema after tracheal intubation for general anesthesia. Two cases have been treated by oxygen therapy, epinephrine spray on the larynx and dexamethasone injection. A case has been treated after tracheostomy. We find the etiology of laryrigeal edema as follows; trauma, infection and allergic response to the lubricant, rubber, plastic and to topical anesthetics. We should like to prevent and remedy complications of tracheal intubation.