Purpose: The purpose of this study was to determine whether the direct anterior approach (DAA) can be applied to hemiarthroplasty for treatment of unstable femoral intertrochanteric fractures in elderly patients. Materials and Methods: We conducted a retrospective review of 34 cases (34 patients) who underwent bipolar hemiarthroplasty using a DAA from February 2019 to April 2020. The mean age of the patients was 82.68 years (range, 67-95 years). A cementless distal fixation hip system was used in all cases. Operation time, total amount of blood loss, intraoperative and postoperative fractures, infections, and reoperations were measured. The patients performed weight-bearing walking as tolerated immediately after surgery. Measurement of migration of the greater trochanter (GT) and progressive subsidence of the femoral stem was performed using follow-up radiographs. Results: The mean operative time was 83.50 minutes (range, 60-120 minutes). The mean amount of bleeding was 263.53 mL (range, 112-464 mL). Walking started a mean of 3.03 days (range, 3-4 days) after surgery. There was no case of progressive migration of the GT more than 5 mm even though it was not fixed. There were no cases of infection, dislocation, or reoperation. Conclusion Bipolar hemiarthroplasty using the DAA for treatment of unstable femoral intertrochanteric fractures could be considered a useful option that provides many advantages in elderly patients.

Background: The aim of this study was to determine if it was feasible and safe to perform total hip arthroplasty (THA) using the direct anterior approach (DAA) when compared with the conventional posterolateral approach (PA) in patients with femoral neck fractures. The time required to start walking was investigated to identify advantages of the muscle-sparing approach. Safety of the approach was judged based on the incidence and nature of all complications. Methods: We retrospectively reviewed 67 THA cases due to femoral neck fractures from October 2015 to January 2019. The PA was used in 31 cases, and the DAA was used in 36 cases. The average operative time and amount of bleeding were evaluated. Cup inclination, anteversion, and leg length discrepancy (LLD) were also measured on radiographs. The time to start walking and complications (e.g., intraoperative fracture, infection, and dislocation) were recorded. Results: The mean operative time was 84.35 ± 13.95 minutes in PA group and 99.22 ± 20.33 minutes in DAA group (p = 0.010). But after experiencing 20 cases using the DAA, there was no statistically significant difference in the operative time between the groups. The mean volume of bleeding was 428.73 ± 207.26 mL in the PA group and 482.47 ± 150.14 mL in the DAA group. There was no difference in the acetabular cup position between two groups. Ambulation was started at 3.94 days after surgery on average in the PA group and 3.14 days in the DAA group, showing a statistically significant difference. Intraoperative fracture and infection were not observed in either group. The incidence of LLD was 1 in each group. The dislocation rate was 3.2% (1 case) in the PA group and 5.5% (2 cases) in the DAA group. Conclusions Although the DAA for THA was similar to the PA in terms of operative time, volume of bleeding, and complications, the DAA showed a great advantage in early rehabilitation as a muscle-sparing procedure in the elderly with femoral neck fractures.

Myeloid sarcoma is characterized by the presence of myeloid blasts at an extramedullar site that disrupts the normal architecture of the organ. Many of these cases are associated with acute myeloid leukemia, chronic myeloid leukemia, myelodysplastic syndrome, or occur in de novo. It occurs most commonly in skin, lymph node, gastrointestinal tract, bone, soft tissue but, rarely in head and neck; especially in nasal cavity. Therefore, it is often misdiagnosed as a different disease: most commonly as lymphoma. Here we report a rare case of myeloid sarcoma in the nasal cavity that occurred in a patient with leukemic transformation with myelodysplastic syndrome, provided with literature review.

Recurrent abortion has been defined as the occurrence of three or more clinically recognized pregnancy loss before 20 weeks and it occurs in 1% of women. The chromosomal abnormalities of abortuses have been suggested as the most common causes of recurrent abortion. We have studied the incidence of chromosomal abnormalities in 57 patients with recurrent abortion using the chorionic villi samples. Of the 57 abortuses analysed, 32 (56.1%) had chromosomal abnormalities. Trisomy was predominant (23 cases, 40.4%), followed by mosaicism 3 (5.2%), tetraploidy 2 (3.5%), monosomy 2 (3.5%), and structural anomaly 1 (1.8%). Trisomy for the chromosome 16 was most prevalent among trisomies. The incidence of trisomy was positively related to matemal age above 35 year-old. But there is not statistically significant. And there are no correlation between gestational age and chromosomal abnormalities. In conclusion, the incidence of chromosomal abnormalities of recurrent abortuses was 56.1% which was similar to that of the other reports. This means that the analysis of karyotype of chorionic villi, as the first test to investigate the cause of recurrent abortion, may be not useful, however, it will require further.
Abortion, Habitual ; Adult ; Chorion* ; Chorionic Villi Sampling ; Chorionic Villi* ; Chromosome Aberrations ; Chromosomes, Human, Pair 16 ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Monosomy ; Mosaicism ; Pregnancy ; Tetraploidy ; Trisomy

Membranous croup is a rare disease that is characterized by diffuse inflammation of the larynx, trachea, and bronchi with adherent or semiadherent mucopurulent membranes in the subglottic trachea and larynx. All cases have occurred in children and there has been no case of adults. The clinical signs, symptoms, progress and prognosis of membranous croup are more severe than those of ordinary croup. The detached membrane in membranous croup may cause a high degree of air way obstruction and give similar characteristics of laryngeal diphtheria, thus it is important to differentiate it from diphtheria by identifying the pathogen. Herein we report with a review of literature a rare case of adult membranous croup caused by methicillin-resistant staphylococcus aureus mimicking laryngeal diphtheria.

Ceruminous glands are specialized sudoriferous glands located in the external auditory canal (EAC). Tumors originating from these ceruminous glands are rare lesions of EAC; in particular, syringocystadenoma papilliferum (SCAP) is an extremely rare ceruminous glands neoplasm to occur in the EAC. Although it is rare, the association of SCAP with tubular apocrine adenoma in the background of nevus sebaceous on the body, extremities, and scalp is well documented. In this article, we report on a 60-year-old male who presented a mass in EAC, which was surgically removed. The final diagnosis of SCAP was determined by histological analysis and the patient has been well without recurrence.

Background and Objectives: Various materials are used to perform post-mastoidectomy mastoid obliteration (MO) to reduce the risk of recurrent infections, stasis of secretions, or caloric dizziness. Autologous materials used as fillers for MO tend to be insufficient owing to shrinkage over time or inadequate volume of these substances. Synthetic materials are unsatisfactory for MO because of the risk of rejection and extrusion. We investigated the safety and effectiveness of bone allografts for post-mastoidectomy MO. Subjects and Methods: We reviewed the medical records of patients who underwent mastoidectomy with MO between January 2013 and January 2021. In the MO group, bone allografts were additionally used to fill the residual mastoid cavity. In the canal wall down (CWD) group, all patients underwent CWD mastoidectomy with use of additional inferiorly based mucoperiosteal flaps. Results: The study included the MO group (23 ears) and the CWD group (53 ears). In the MO group, compared with the preoperative status, we observed a decrease in the tendency of the air-bone gap postoperatively. Compared with the CWD group, the total complication rate showed a decreasing tendency in the MO group. Conclusions No patient showed post-MO shrinkage of the grafted bone allograft or otorrhea. Further large-scale studies are warranted to confirm the advantages of bone allografts for MO, including maintenance with time and sufficient amount.

Background and Objectives: Various materials are used to perform post-mastoidectomy mastoid obliteration (MO) to reduce the risk of recurrent infections, stasis of secretions, or caloric dizziness. Autologous materials used as fillers for MO tend to be insufficient owing to shrinkage over time or inadequate volume of these substances. Synthetic materials are unsatisfactory for MO because of the risk of rejection and extrusion. We investigated the safety and effectiveness of bone allografts for post-mastoidectomy MO. Subjects and Methods: We reviewed the medical records of patients who underwent mastoidectomy with MO between January 2013 and January 2021. In the MO group, bone allografts were additionally used to fill the residual mastoid cavity. In the canal wall down (CWD) group, all patients underwent CWD mastoidectomy with use of additional inferiorly based mucoperiosteal flaps. Results: The study included the MO group (23 ears) and the CWD group (53 ears). In the MO group, compared with the preoperative status, we observed a decrease in the tendency of the air-bone gap postoperatively. Compared with the CWD group, the total complication rate showed a decreasing tendency in the MO group. Conclusions No patient showed post-MO shrinkage of the grafted bone allograft or otorrhea. Further large-scale studies are warranted to confirm the advantages of bone allografts for MO, including maintenance with time and sufficient amount.

Background and Objectives: Various materials are used to perform post-mastoidectomy mastoid obliteration (MO) to reduce the risk of recurrent infections, stasis of secretions, or caloric dizziness. Autologous materials used as fillers for MO tend to be insufficient owing to shrinkage over time or inadequate volume of these substances. Synthetic materials are unsatisfactory for MO because of the risk of rejection and extrusion. We investigated the safety and effectiveness of bone allografts for post-mastoidectomy MO. Subjects and Methods: We reviewed the medical records of patients who underwent mastoidectomy with MO between January 2013 and January 2021. In the MO group, bone allografts were additionally used to fill the residual mastoid cavity. In the canal wall down (CWD) group, all patients underwent CWD mastoidectomy with use of additional inferiorly based mucoperiosteal flaps. Results: The study included the MO group (23 ears) and the CWD group (53 ears). In the MO group, compared with the preoperative status, we observed a decrease in the tendency of the air-bone gap postoperatively. Compared with the CWD group, the total complication rate showed a decreasing tendency in the MO group. Conclusions No patient showed post-MO shrinkage of the grafted bone allograft or otorrhea. Further large-scale studies are warranted to confirm the advantages of bone allografts for MO, including maintenance with time and sufficient amount.

PURPOSE: To evaluate the clinical and radiological results of total hip arthroplasty using a ceramic on ceramic bearing surfaces. MATERIALS AND METHODS: From April 1999 to April 2005, 53 hips had total hip arthroplasty with a ceramic on ceramic bearing surfaces in our hospital. Causes of total hip arthroplasty were avascular necrosis of femoral head in 47 hips, osteoarthritis in 3 hips and ankylosing spondylitis in 3hips. We used three kinds of acetabular cup and two kinds of femoral stem in this study. Follow-up period was an average of 55months (24-92). Clinical results were evaluated with Harris hip score and squeak sound. Radiological results included liner wear rate, breakage of ceramic, component loosening and osteolysis. RESULTS: Mean Harris hip scores improved from 58 to 88.3. No breakage of ceramic liner or head occurred. No acetabular or femoral osteolysis was seen. Audible squeak sound or sensation was detected in 10 hips (18%). Revision was done in three cases (5.7%), the cause of one of them was acetabular cup loosening. CONCLUSION: Total hip arthroplasty with a ceramic on ceramic bearing surfaces showed satisfactory clinical and radiological results in an average of 4.6 years follow-up. However, we have to study causes and adverse effect of squeaking on the total hip arthroplasty.
Arthroplasty ; Ceramics ; Follow-Up Studies ; Head ; Hip ; Necrosis ; Osteoarthritis ; Osteolysis ; Sensation ; Spondylitis, Ankylosing ; Ursidae