Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

PHILOS plate fixation with polymethyl methacrylate cement augmentation of an osteoporotic proximal humerus fracture

PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of PMMA augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

Conformational Transitions and Glycation of Serum Albumin in Patients with Minimal-Change Glomerulopathy

BACKGROUND: There has been a lack of study on the structural changes of serum albumin in patients with minimal change disease (MCD). To determine whether glycation and/or conformational transitions of albumin are involved in the pathogenesis of albuminuria, nine patients with MCD were enrolled in a prospective follow-up study for comparison of these parameters in serum albumin during the remission and relapse of nephrotic syndrome. METHODS: Circular dichroism measurements were made with purified albumin. Ellipticities at each wavelength were transformed to mean residue ellipticity. Monosaccharide composition was analyzed by high-pH anion-exchange chromatography with pulsed amperometric detection. RESULTS: There was no difference in the proportions of alpha-helix, beta-conformation, and beta-turn of albumin between the sera of control patients and those with nephrotic syndrome. However, the proportion of the random configuration was slightly higher in the plasma albumin of patients in relapse than in those in remission. The proportion of the random configuration was lower in the albumin of the serum than in the urine of patients with nephrotic syndrome, but there was no difference in the proportions of alpha-helix, beta-conformation, and beta-turn of albumin between their plasma and urine. CONCLUSION: Our results suggest that conformational changes in albumin are involved in albuminuria in patients with MCD.

The Status of Central Nervous System Tumors in Chonnam and Chonbuk Provinces

The authors analized statistically 635 cases of pathologically confirmed central nervous system tumors in the Chonnam and Chonbuk provinces from 1987 to 1989. The results were as follows ; 1) Of the 635 cases, 327 cases(51.5%) were male and 308 cases(48.5%) were female. 2) Intracranial tumors were 518 cases(81.6%), spine and intraspinal tumors 94(14.8%), scalp and skull tumors 23(3.6%). 3) Average incidence rate of tumors was 3.5/year/100,000 population, 3.1 for Chonnam province, 4.4 for Chonbuk province. 4) Among the brain tumors, glial tumors were the most common(28.4%), and followed by meningiomas(18%), pituitary tumors(15.2%), metastatic tumors(8.9%), Among the intraspinal tumors, neurinomas and neurofibromas were found most frequently(41.5%), and rests were metastatic tumors(23.4%), meningiomas(9.5%) in order. 5) Sexual predilection of tumors was as follows : male preponderance was noted for oligodendrogliomas(9:1), metastatic tumors(2.3:1), glioblastomas multiforme(GM)(1.8:1) cysticercosis(1.6:1), and female preponderance for meningiomas(1:3.2), pituitary tumors(1:2), paragonimiases(1:1.5). 6) The incidence rate of brain tumors in children below 15 years was 11.8% and that which occured infratentorially was 47.5%. 7) The brain tumors were found mainly in cerebral hemispheres, in which area most of tumors were meningiomas, astrocytomas in order. In sellar, parasellar most of tumors were meningiomas astrocytomas in order. In sellar, parasellar and suprasellar region, the majority of tumors were pituitary tumors and meningiomas. 8) Cysticercosis showed a predilection for the sixth and seventh decades, meningiomas, metastatic tumors, neurinomas for sixth decade, GM and supratentorial astrocytomas for fourth, fifth and sixth decades, oligodendroliomas for fifth decade, infratentorial astrocytomas, medulloblastomas and craniopharyngiomas for first and second decades. 9) In the spinal tumors, the favorable site was thoracic region and majority of them were located intradural extramedullarily and extradurally in similar incidence.