PURPOSE: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. MATERIALS AND METHODS: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. RESULTS: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). CONCLUSION: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femur ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Leg ; Methods ; Muscle Strength ; Operating Tables ; Retrospective Studies

Hemarthrosis occurring after arthroscopic surgery for lesions of the shoulder joint is a very rare complication that can develop due to an injury to the blood vessels when an anterior portal is formed. This is a complication that rarely develops in patients who are taking antithrombotic drugs or who do not have associated diseases, such as thrombocytopenia. We report a case of hemarthrosis that occurred after performing arthroscopic surgery to repair a rotator cuff tear in a patient with a stenosis in an arteriovenous fistula for hemodialysis in the ipsilateral upper arm.
Arm ; Arteriovenous Fistula ; Arthroscopy ; Blood Vessels ; Constriction, Pathologic ; Hemarthrosis ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears ; Thrombocytopenia

PURPOSE: The outcome of hip arthroscopy as a treatment of patients with hip dysplasia is variable. In patients with severe hip dysplasia, arthroscopy has the potential to exacerbate instability and unfavorable outcome. To the best of out knowledge, there has not been a report regarding arthroscopic treatment in patients with borderline hip dysplasia in Korea. We favorable outcome with using arthroscopy to treat symptomatic borderline hip dysplasia. MATERIALS AND METHODS: Between August 2010 and February 2015, 143 patients undergoing hip arthroscopy for intra-articular hip disorder were retrospectively enrolled. From this cohort, a borderline dysplasia group compromising 29 patient with lateral center edge angle (LCEA) >18° and <25° and a minimum of 1 years follow-up, was identified. Patient-reported outcome scores, including modified Harris hip score, the hip outcome score-activity of daily living, the sport-specific subscale, visual analogue scale (VAS) and satisfaction survey were obtained preoperatively and at postoperative 3 months, 6 months, 1 year, 2 years, and 3 years. Revision surgery and complications were recorded for each group. RESULTS: The mean age was 35.7 years (range, 16–63 years) years respectively. There were 16 females (55.2%) and 13 males (44.8%). The mean LCEA was 22.0° (range, 18°–25°) and the mean Tönnis angle was 6.1° (range, 0°–18°). The mean follow-up was 20.2 months (range, 12–39 months), and at the 1 year follow-up, there was significant improvement (p<0.001) in all patient reported outcome scores and VAS. Satisfaction survey showed an average score of 7.7. CONCLUSION: In patients with borderline hip dysplasia, if there is an occurrence of symptomatic labral tear, arthroscopic labral refixation has a good short-term result. Therefore, if patients have no response to conservative treatment or have severe pain, arthroscopic labral refixation is a useful treatment options to relieve symptom.
Arthroscopy* ; Cohort Studies ; Female ; Follow-Up Studies ; Hip Dislocation* ; Hip* ; Humans ; Korea ; Male ; Retrospective Studies ; Tears

No abstract available.
Humans ; Leukemia, Myeloid, Acute* ; Lymphocytes*

Anisakiasis in the gastrointestinal tract is caused by the ingestion of raw marine fish that contain Anisakis lavae. In rare cases, Anisakiasis is found as an eosinophilic granuloma that mimics a submucosal tumor. The diagnosis is usually made after surgical resection. Several cases of gastric anisakiasis imitating a submucosal lesion have been reported. However, colonic anisakiasis forming a submucosal lesion is very rare and only a few cases have been reported. All of the cases were confirmed after surgery. Recently, we encountered a male patient with a submucosal lesion on the ascending colon during a health screening. Several biopsies were performed on the same site as the lesion. The pathological finding was eosinophilic granuloma. We tentatively diagnosed the patient with eosinophilic granuloma due to Anisakis as the patient consumed raw seafood and eosinophilia was detected on a laboratory test. We decided not to perform any procedure. One month later, the eosinophilic granuloma disappeared as seen on a follow-up colonoscopy.
Anisakiasis ; Anisakis ; Biopsy ; Colon ; Colon, Ascending ; Colonoscopy ; Eating ; Eosinophilia ; Eosinophilic Granuloma ; Eosinophils ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Male ; Mass Screening ; Seafood

BACKGROUND AND OBJECTIVES: Hyperhomocyt(e)inemia is known to be one of independent risk factors for the ischemic heart diseases recently, but the role of hyperhomocysteinemia in restenosis after coronary intervention is unclear. The relationship between plasma homocysteine level and restenosis after coronary intervention was evaluated in Korean patients. MATERIALS AND METHOD: Eighty three patients underwent successful percutaneous coronary intervention (PCI) and follow-up coronary angiography were divided into two groups according to restenosis, and the level of plasma homocysteine was compared between groups with restenosis (n=5, M:F=7:8, 60.6+/-13.5 years) and without restenosis (n=8, M:F=0:8, 60.3+/-12.8 years). RESULTS: The clinical manifestation, atherosclerosis risk factors except for hypertension, and coronary angiographic findings were not significantly different in patients with or without restenosis(P=S). The value of homocysteine was 9.3+/-3.1 micromol/L in 35 patients with restenosis and 8.4+/-2.5 micromol/L in 48 patients without restenosis(P=S). All of 8 patients whose values of plasma homocysteine were more than 13 micromol/L, had angiographic restenosis. Plasma homocysteine was not an independent risk factor of restenosis by means of logistic regression analysis. CONCLUSION: Plasma homocysteine is not a potential risk factor of restenosis after percutaneous coronary intervention.
Atherosclerosis ; Coronary Angiography ; Follow-Up Studies ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hypertension ; Logistic Models ; Myocardial Ischemia ; Percutaneous Coronary Intervention* ; Plasma ; Risk Factors

Jejunogastric intussusception is a rare, but potentially lethal complication after gastrectomy or gastrojejunostomy. In the acute condition, early diagnosis and prompt surgical treatment are mandatory to reduce the incidence of mortality. We present here a case of jejunogastric intussusception that was diagnosed by gastroscopy in a patient with a history of subtotal gastrectomy, and she had experienced increasing epigastric pain and vomiting for 1 day.
Early Diagnosis ; Gastrectomy ; Gastric Bypass ; Gastroscopy ; Humans ; Incidence ; Intussusception ; Vomiting

BACKGROUND: Non-small lung cancer(NSCLC) develops as a result of the accumulation of multiple genetic abnormalities. Loss of heterozygosity(LOH) is one of the most frequent genetic alterations that is found in NSCLC, and the chromosomal regions that display a high rate of LOH are though to harbor tumor suppressor genes(TSGs). This study was done to determine the frequency of LOH in 21q with the aim of identifying potential TSG loci. METHOD: Thirty-nine surgically resected NSCLCs were analysed. Patietns peripheral lymphocytes were used as the source of the normal DNA. Five microsatellite markers of 21q were used to study LOH : 21q21.1(D21S1432, and D21S1994) ; 21q21.2-21.3(D21S1442) ; 21q22.1(21S1445) ; and 21q22.2-22.3(D21S266). The fractional allelic loss(FAL) in a tumor was calculated as the ratio of the number of markers showing LOH to the number of informative markers. RESULT: LOH for at least one locus was detected in 21 of 39 tumors(53.8%). Among the 21 tumors with LOH, 5(21.8%) showed LOH at almost all informative loci. Although statistically not significant, LOH was found more frequently in squamous cell carcinomas(15 of 23, 65.2%) than in adenocarcinomas(6 of 16, 37.5%). In the squamous cell carcinomas the frequency of LOH was higher in stage II-III (80.0%) than in stage I (53.8%). The FAL value in squamous cell carcinomas(0.431±0.375) was significantly higher than that found in adenocarcinomas(0.192±0.276). CONCLUSION: These results suggest that LOH on 21q may be involved in the development of NSCLC, and that TSG(s) that contribute to the pathogenesis of NSCLC may exist on 21q.
Arm* ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Chromosomes, Human, Pair 21* ; DNA ; Loss of Heterozygosity* ; Lung ; Lymphocytes ; Microsatellite Repeats

Pulmonary artery stenosis that causes pulmonary hypertension is usually observed in congenital anomalies and is seldom observed in adults. A 47-year-old female patient came to the hospital for aggravated dyspnea and peripheral edema. Severe pulmonary hypertension was found on an echocardiography examination, along with dilation of the main pulmonary artery and alias flow at the bifurcation sites of both pulmonary arteries. Under coronary angio-computed tomography, 70% high grade stenosis was observed on both sides of the proximal pulmonary arteries without showing atherosclerotic plaque or a thrombus. The patient's symptoms improved after performing pulmonary artery angiography and angioplasty. Thus, we report our experience of a patient with Behcet's disease and severe pulmonary hypertension caused by pulmonary artery stenosis, which was treated with percutaneous pulmonary angioplasty.
Adult ; Angiography ; Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic ; Dyspnea ; Echocardiography ; Edema ; Female ; Humans ; Hypertension, Pulmonary ; Plaque, Atherosclerotic ; Porphyrins ; Pulmonary Artery ; Thrombosis

Boerhaave's syndrome is difficult to diagnosis because of the esophageal rupture, which is caused by nausea and vomiting, and Boerhaave's syndrome is known to have a high mortality rate. The mortality increases with a delayed diagnosis; therefore, an early diagnosis and surgical treatment are critical for a good prognosis. Yet some recent cases have shown that non-surgical treatments are successful in some classified patient groups. These groups should be considered according to their symptoms and their laboratory and radiological findings. Sepsis and multi-organ failure should be continuously checked for to see if they occurred and/or progressed. We report here on a 51 year old woman who had Boerhaave's syndrome, and this was caused by heavy drinking, nausea and vomiting, and she improved with just non-surgical treatment such as fasting, antibiotics and endoscopic clipping.
Anti-Bacterial Agents ; Drinking ; Early Diagnosis ; Esophageal Perforation ; Fasting ; Female ; Humans ; Mediastinal Diseases ; Nausea ; Prognosis ; Rupture ; Sepsis ; Vomiting