Surgical exploration and repair of spinal accessory nerve injuries is difficult. With perseverance, however, these patients with complete or severe deficits achieved favorable functional outcomes through operative exploration and repair.

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Sealants are useful as agents that can prevent the leakage of gas or nonclotting fluids from damaged tissues and of blood from the vascular system following injury or repair. Various formulations for sealants have been developed and applied clinically, but problems still remain in terms of biocompatibility issues, long crosslinking times and low adhesive properties. Herein, to address these issues, we report a methacrylated silk fibroin sealant (Sil-MAS) with rapidly crosslinkable, highly adhesive and biocompatible properties and demonstrate its versatility as a medical glue. The excellent physical properties of Sil-MAS are revealed via in vitro mechanical tests and ex vivo aorta pressure tests. In addition, in in vivo biological tests on the skin, liver, and blood vessels of rats, Sil-MAS showed a superb hemostatic and adhesive ability, with high biocompatibility. Specifically, Sil-MAS strongly contributed to faster wound healing than commercially available materials. Furthermore, we showed a successful proof of concept that Sil-MAS could serve as an ideal photocuring laparoscopic medical glue in a laceration rabbit model of liver and stomach serosa using a homemade endoscopic device. These findings on the applicability of rapidly photocurable silk fibroin indicate that Sil-MAS is a suitable material to supplant existing sealants, adhesives, or hemostatic agents.

ObjectivePosture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy.MethodsFrom June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time.ResultsThe inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients.ConclusionWe suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.