This study was conducted to evaluate the results of high-dose-rate superficial brachytherapy （SBT） after keloidectomy in comparison with the results of electron beam radiotherapy （ERT）.
  Forty-six patients who underwent postoperative SBT for 60 histologically confirmed keloids were evaluated. For SBT, the tube catheter and a spacer 5 mm thick were placed on the skin to match the area of the surgical wound. Dose evaluation points were established 2 mm below the skin surface. Twenty Gray （Gy） was delivered in 4 daily fractions to scars on the anterior chest wall, scapular region, and suprapubic region, while a dose of 15 Gy was delivered in 3 daily fractions to lesions in other areas. Therapeutic outcome was judged in terms of recurrence, control, and side effects. For comparison of the therapeutic effect, 50 patients who underwent ERT for 90 keloids in 2006 were also evaluated.
  The two-year recurrence-free rates after SBT and ERT were 84.5%. Two patients suffered grade 1 skin erythema, but no toxicity of grade 2 or higher occurred. Compared with the ERT, there were no statistically significant differences in recurrence-free rate and incidence of adverse reactions between the two treatment groups.
  Our results indicate that SBT is effective and safe for preventing recurrence of keloids, and might be a feasible alternative to ERT.

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  Wide resection and prosthetic replacement arthroplasty are generally performed in limb-sparing surgical resection of bone sarcomas around the knee; therefore, covering the defect with a viable flap is necessary. Extensor mechanism reconstruction is needed if the patella tendon and extensor mechanism are resected together with bone sarcomas. In recent years, we have covered arthroplasty and bridged extensor mechanism with gastrocnemius muscle flap. This study described eleven patients treated with gastrocnemius muscle flap including complications, functional results, and additional operations.
  Ten prosthetic replacements, one heat-treated bone graft, and five extensor mechanism reconstructions were performed. Infection was observed in four patients. All infections healed after debridement and reutilization of gastrocnemius muscle flap. Overall functional results including range of motion and extension lag were good; however, poor results were observed in two patients, which were attributed to infection.
  Gastrocnemius muscle flap is useful following limb-sparing surgical resection of bone sarcomas around the knee.

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  Major amputations in cases with peripheral vascular disease are often complicated by old age, cardiovascular disease, and cerebrovascular disease. For these problems, anesthetic management is constrained.
  We reviewed the efficacy and complications of major lower limb amputations under local anesthesia. In the past 4 years, 13 major lower limb amputations were carried out: 6 cases were above the knee amputations, one knee amputation, and 6 below the knee amputations. 0.5-1% lidocaine hydrochloride was given, and the mean dose was 233 mg. Seven cases had midazolam or propofol for sedation. No patients had any complications, for example, cardiorespiratory problems.
  Local anesthesia alone or with sedation is an option for major amputation in patients at high risk.

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