Remifentanil in combination with propofol provides good analgesic and sedative effects, which were shorter lasting compared with fentanyl-based sedation, and caused fewer delayed adverse effects. The use of remifentanil was associated with respiratory depression, emphasizing the need for experienced anesthesiologists.

The areas of the most frequent cartilage loss in mild–moderate medial osteoarthritis (OA) were reviewed from previous studies. Implant components were designed to resurface these areas. The surface geometries of the components were based on an average femur and tibia produced from 20 magnetic resonance imaging (MRI) models of normal knees. Accuracy of fit of the components was determined on these 20 individual knees. The femoral surface was toroidal, covering a band on the distal end of the femur, angled inward anteriorly. For a five-size system, the average deviations between the implant surfaces and the intact cartilage surfaces of 20 femurs were only 0.3 mm. For the tibia, the deviations were 0.5–0.7 mm, but the errors were mainly around the tibial spine, with smaller deviations in the central bearing region. Hence, these small implant components would accurately restore the original bearing surfaces and allow for preservation of all the knee structures. Using a thin metal component for the tibia would preserve the strong cancellous bone near the surface, an advantage for fixation. In this case, the femoral component would have a plastic bearing surface, but still be less than 10 mm thickness. Such a design could have a useful place in the early treatment of medial OA of the knee.

No abstract

In the past, leading points causing intussusception were identified either during barium enema performed for reduction of the invaginated bowel or during surgery. A persistent filling defect in the ileocecal region or in the colon was the hallmark of a possible causative factor for the intussusception. In recent years, the ultrasonographic features of intussusception have been defined, and occasionally a leading point has been shown. We present a 4-month-old child in whom an intussusception was diagnosed by ultrasound examination. A duplication cyst was identified in close proximity to the intussusception and was suspected to be the causative factor. This was shown by computed tomography and confirmed at surgery.