Objectives: Bony impingement of the proximal femur on the pelvis is an important factor for dislocation after total hip arthroplasty (THA). We evaluated bony impingement after THA using the rotation matrix derived from postoperative computed tomography (CT) images.
Patients and Methods: One hundred and seven hip joints were subjected to primary THA via a posterolateral approach. We used the rotation matrix derived from CT images to calculate internal rotation (IR) limit prior to bony impingement, and compared this limit with the intraoperative limit.
Results: The average calculated IR limit was 63 degrees (range: 30 to 85 degrees). The average intraoperative IR limit was 49 degrees (range: 20 to 70 degrees). The correlation between the intraoperative IR limit (Y) and the calculated IR limit (X) was expressed as Y=8.9+0.66X (R=0.73; p < 0.0001).
Conclusions: We could show a patient´s safe range of motion prior to bony impingement, and this will be a good indicator for dislocation not occurring during postoperative rehabilitation.

Guardians' perceptions of the oral food challenge (OFC) test with 1-day hospitalization have not yet been investigated. In this study, a questionnaire survey on the OFC test was distributed to guardians of children who underwent the test for food allergies with 1-day or overnight hospitalization between April 2015 and May 2016. Patients who underwent the test at other hospitals and those with incomplete responses were excluded. A total of 164 patientguardian pairs were included in this study, and the valid response rate was 68% (112/164). Among negative aspects of OFC with overnight hospitalization, the response “visiting the next day” was the most frequent at 74%(83 guardians) and was significantly more frequent than the responses “anxiety at night,” “consultation and questions the next day are possible,” and “observation time is long” (all p<0.01). Among the positive aspects of OFC with 1-day hospitalization, the response “no next-day visit” was the most frequent at 87%(97 guardians) and was significantly more frequent than the responses “relief at night,” “cannot go to work the next day,” and “observation time is short” (all p<0.01). Among the negative aspects of OFC with 1-day hospitalization, the response “anxiety at night” was the most frequent at 45% (50 guardians) and was significantly more frequent than the responses “no next-day visit,” “cannot go to work the next day,” and “observation time is short”（p<0.01, each). The number of patients whose child underwent the OFC test with 1-day hospitalization was significantly higher than that with overnight hospitalization (87 guardians [78%] vs.8 guardians [7%] , p<0.01). These results suggested that majority of the guardians preferred that OFC be performed with 1-day hospitalization because there was no need to visit the hospital again the next day. However, many guardians had anxiety at night in OFC with 1-day hospitalization.

Behçet’s disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.