No abstract available.
Chromosome Aberrations*

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

No abstract available.
Arteriovenous Fistula* ; Biopsy*

No abstract available.
Pericardial Effusion* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

Purpose: The goal of this study was to evaluate the efficacy of suction drains following total hip arthroplasties, by comparing the post-operative results between the group with suction drains and the group without suction drains. Materials and Methods: Eighty-six patients, who underwent primary total hip arthroplasties from June 2001 to June 2004, were divided into two groups: group 1 (48 patients), with suction drains; and group 2 (38 patients), without suction drains. We assessed the perioperative hemoglobin and platelet levels, the amount of total blood loss, the amount of post-operative blood transfusions, post-operative ranges of motion (ROMs, at 6 weeks), wound problems, and general conditions. Results: Although the postoperative hemoglobin level was greater in group 2 than in group 1, there was no statistically significant difference. The amount of total blood loss and blood transfusions in group 1 were statistically greater than in group 2 (p<0.05). There were no statistically significant differences in the post-operative ROMs and wound complications between groups 1 and 2. Conclusion: There were no limitations of hip motion and no wound complications in the patients without suction drains after total hip arthroplasties. However, they required fewer post-operative blood transfusions than did the patients with suction drains, due to less post-operative blood loss; and the absence of a suction drain might prevent retrograde tube infections. In addition, patients without suction drains after total hip arthroplasties seemed to recover better did than those with suction drains. Therefore, suction drains might provide no benefit in total hip arthroplasties.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Blood Platelets ; Blood Transfusion ; Hip ; Humans ; Suction* ; Wounds and Injuries

Deep vein thrombosis (DVT) is a relatively common complication of total hip arthroplasty. DVT can accompany symptoms of pain and swelling of the lower leg, and can lead to fatal pulmonary thromboembolism. Surgical procedure is a primary risk factor, and obesity, medical status of disease, or patient's factors could be related. Diagnostic modalities include venography, Doppler ultrasound, CT angiography, and magnetic resonance venography. Mechanical prophylaxis, such as compression stocking and use of an intermittent pneumatic compression device or a pharmacological agent, such as Warfarin, low molecular weight heparin, thrombin inhibitors, and factor Xa inhibitor can be useful. Neurovascular injury after total hip arthroplasty is an uncommon complication, but can be disastrous and fatal. To prevent this complication, the surgeon must be well acquainted with the anatomy and proper surgical skill is needed.
Angiography ; Arthroplasty ; Factor Xa ; Heparin, Low-Molecular-Weight ; Hip ; Leg ; Magnetic Resonance Spectroscopy ; Obesity ; Phlebography ; Pulmonary Embolism ; Risk Factors ; Stockings, Compression ; Thrombin ; Venous Thrombosis ; Warfarin

PURPOSE: To report a case of relapsing polychondritis complicated with chorioretinitis without scleritis. CASE SUMMARY: A 35-year-old man who has been previously managed for relapsing polychondritis visited our the clinic because of blurred vision in his both eyes which had developed one month earlier. Although the corrected visual acuity was 1.0 in both eyes, Slit lamp examination of both eyes showed findings of anterior uveitis. Fundus examination showed a whitish-yellow lesion around the posterior pole in both eyes. He had bilateral auricular chondritis, saddle nose deformity, and respiratory difficult. The patient was treated with systemic steroid and prescribed topical 1% prednisolone acetate four times daily in both eyes. Four months later, fundus examination of both eyes showed improvement of chorioretinal lesion, but visual acuity had decreased constantly. Nine months later, chorioretinal lesion resolved and visual acuity improved in both eyes.
Adult ; Chorioretinitis* ; Congenital Abnormalities ; Humans ; Nose ; Polychondritis, Relapsing* ; Prednisolone ; Scleritis* ; Uveitis, Anterior ; Visual Acuity

OBJECTIVE: To assess the axonopathy and demyelination neuropathy according to the electrophysiologic severity in diabetic neuropathy. METHOD: Electrophysiologic data of 246 patients who had been diagnosed with diabetic neuropathy was obtained and classified into suspected, possible, and definite groups by the criteria of our laboratory. Nerve conduction study was performed in the median, ulnar motor and sensory nerves, peroneal and tibial motor nerves, and sural nerve. Statistics were done with the results from the median motor and sensory, tibial motor and sural nerves. According to the severity of diabetic neuropathy, correlation and Chi-square analysis between amplitudes and latencies were performed. RESULTS: Frequencies of diabetic neuropathy according to electrophysiologic severity were as follows: 24 cases of suspected, 141 cases of possible, and 81 cases of definite neuropathy. The correlation ratios between amplitude and latency were 0.41- 0.79 (p<0.05) in the definite group of all the nerves examined, and below 0.3 in the suspected and possible groups. By Chi-square analysis, amplitude reduction was the predominant finding in the suspected and possible groups.si CONCLUSION: In the early stage of diabetic neuropathy, axonopathy might be the preceding pathogenesis, while with progression of diabetic neuropathy, axonopathy and demyelination may coexist.
Demyelinating Diseases* ; Diabetic Neuropathies* ; Humans ; Neural Conduction ; Peroneal Nerve ; Sural Nerve

PURPOSE: The Purpose of the study is to know patients' compliance of drug treatment of osteoporosis after operation of fracture and to compare of accompanying fractures between patients who diagnosed with osteoporosis itself and had the drug treatment of osteoporosis after surgery of periarticular fracture of hip. MATERIALS AND METHODS: In experimental group, consecutive 60 patients who had fracture of femoral neck and trochanter. And in control group, 61 patients diagnosed osteoporosis with drug treatment within the same period in orthopedic department from July 2006 to July 2007. The average age is 73.8 (+/-6.7) year in experimental group, and 66.6 (+/-7.46) year in control group. Both groups had at least a year follow-up with drug treatment and had BMD again at least a year later. RESULTS: BMD test in experimental group showed -3.05 (+/-1.35) preoperatively and -2.74 (+/-1.50) in last follow-up. BMD test in control group showed -3.55 (+/-0.52) in initial administration and -3.10 (+/-0.87) in last follow-up. The results showed a significant improvement in statistical analysis (p=0.0002, p<0.0001). CONCLUSION: The compliance of drug treatment of osteoporosis after operation of periarticular fracture of hip is the same as in patients' diagnosed osteoporosis.
Compliance ; Femur ; Femur Neck ; Follow-Up Studies ; Hip ; Humans ; Orthopedics ; Osteoporosis