Total hip arthroplasty for ankylosed hip has a higher risk of failure due to the poor condition of the hip abductors and the altered configuration of the bone, which lead to poor positioning or fixation of the prosthesis. Fifty-one hips (42 patients) converted to total hip arthroplasty between March 1983 and March 1994 have been reviewed three to thirteen years six months after operation. The average period of follow-up was four years nine months. Twenty six of the patients were men and sixteen were women. The average age at the time of operation was 40 years old (range,19 to 70 years). Among the 51 hips, bony ankylosis were 27 hips and fibrous ankylosis were 24 hips, spontaneous ankylosis were 40 hips and surgical ankylosis were 11 hips. The duration of hip fusion was 13 years six months in the bony ankylosis and 16 years one month in the fibrous ankylosis. Preoperatively 33 cases had low back pain, ipsilateral or contralateral knee or hip pain. In asymptomatic 18 cases, conversion total hip arthroplasty was also performed for the management of functional disabilities due to severe malpositioned ankylosis. At the time of the last follow-up, 25 cases were free from pain and six patients had a mild degree pain on the hip, knee or thigh. In bony ankylosis, the postoperative average hip motion ranged from 1.1 degrees to 93.2 degrees (average arc of motion of 92.1 degrees). In fibrous ankylosis, the postoperative average hip motion ranged from 1.7 degrees to 96.6 degrees (average arc of motion of 94.9 degrees). The average Harris hip score was improved from 66 to 86.9 in bony ankylosis and from 49 to 89.5 in fibrous anklyosis. The postoperative leg length discrepancy was 1.1 cm in average. The postoperative complications included heterotropic ossification in 25 cases (49%), cup loosening in two cases (3.9%) and stem loosening in three cases (5.6%). As for the clinical results, 24 cases (89%) of bony ankylosis and 23 cases (96%) of fibrous ankylosis had satisfactory functional results at the last follow-up. In conclusion, the conversion total hip arthroplasty could provide functional improvement, pain relief and especially correction of leg length discrepancy in most cases of ankylosed hip.
Adult ; Ankylosis ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Knee ; Leg ; Low Back Pain ; Male ; Postoperative Complications ; Prostheses and Implants ; Thigh

From August 1976 to February 1997, we have experienced 29 cases of rapidly destructive coxarthrosis in 23 patients who represented severe hip pain and destruction of the femoral head more than 50% within one year. The retrospective analyses of clinical, radiographic and operative findings of 2090 hips in 1534 patients, who have been diagnosed as ischemic necrosis of femoral head were performed to investigate the correlation between ischemic necrosis of the femoral head and rapidly destructive coxarthrosis. The incidence of rapidly destructive coxarthrosis was 1 % of the overall ischemic necrosis of the femoral head. The average duration of hip pain was 9 months. The average age of the patients was 56 years old and most of them were male. The cultures of synovial fluid for bacteria were negative in all cases except one case of non-pathogenic organism. But, the erythrocyte sedimentation rate and C-reactive protein were elevated. The pathologic findings were not different from the ischemic necrosis except the destruction of articular cartilage. Therefore, we concluded that rapidly destructive coxarthrosis is a subtype of ischemic necrosis of the femoral head.
Bacteria ; Blood Sedimentation ; C-Reactive Protein ; Cartilage, Articular ; Femur Head Necrosis ; Head ; Hip ; Humans ; Incidence ; Male ; Middle Aged ; Necrosis ; Osteoarthritis, Hip* ; Retrospective Studies ; Synovial Fluid

Background: Unilateral peripheral facial nerve palsy may have a detectable cause (secondary facial nerve palsy) or may be idiopathic (Bell’s palsy). Facial palsy is attributable to various causes ranging from mild infection to severe neurological disorders. We investigated the prevalence and types of serious neurological disorders in patients with unilateral facial palsy. Methods: We reviewed the medical records of patients with unilateral facial nerve palsy and identified patients diagnosed with facial palsy secondary to serious or life-threatening causes. We investigated the clinical characteristics, as well as electrodiagnostic and imaging findings in these patients. Results: Of 924 patients with facial palsy, 11 patients (1.2%) were diagnosed with the following serious neurological disorders: acoustic schwannoma in two patients, facial nerve schwannoma, glossopharyngeal schwannoma, meningioma, epidermoid cyst, parotid gland tumor, pontine infarct, skull base osteomyelitis, brain metastasis, and pachymeningitis. Conclusions Although unilateral facial palsy is rarely associated with serious neurological disorders, early detection of the etiopathogenetic contributors is important for prompt initiation of optimal management. Therefore, clinicians should be mindful of disorders that can mimic Bell’s palsy.

Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Mucinous borderline ovarian tumors (BOTs) occur most often in women between the ages of 20 and 30. Early-stage detection of the condition has a more favorable prognosis. In this case report, the authors present an elderly 93-year old woman who visited our hospital due to severe abdominal pain after being diagnosed with a pelvic mass 2 years ago and not undergoing any treatment since the diagnosis was made. She underwent emergency left salpingo-oophorectomy and was diagnosed with mucinous BOT according to biopsy results.
Abdominal Pain ; Aged ; Biopsy ; Diagnosis ; Emergencies ; Female ; Humans ; Mucins* ; Ovarian Neoplasms ; Prognosis

Ovarian leiomyoma is a rare type of tumor that only takes about 1% of benign ovarian tumor. It mostly does not induce any symptoms and is often found by chance during a surgical operation in abdominal cavity. It is microscopically observed that smooth muscle cells with an identical shape and a small nucleus grow in a bundle or in a storiform configuration, and they need to be distinguished from other tumors of the smooth-muscle origin that can occur in ovary such as fibroma/thecoma and extragastrointestinal stromal tumor. Using immunohistochemistry staining on desmin, smooth muscle actin (SMA), alpha-inhibin, c-kit, etc can help with distinguishing these tumors. Recently, the authors experienced in this hospital a primary ovarian leiomyoma of a 43-year-old female patient and hereby report the case with a review of literatures.
Abdominal Cavity ; Actins ; Adult ; Desmin ; Female ; Humans ; Immunohistochemistry ; Leiomyoma* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Ovary

Salmonella usually invades the Peyer's patch of the terminal ileum or ascending colon. A 55-year old female was referred to our hospital for general weakness and sustained fever. On the abdominal contrast computed tomography (CT) scan, we found symmetric circular hypertrophy of the intestinal wall and multiple hypertrophied lymph nodes in the terminal ileum. The positron emission tomography computed tomography (PET-CT) scan showed skipped areas of wall thickening and intense fluorodeoxyglucose (FDG) uptake in the terminal ileum and the ileocecal valve with adjacent lymphadenopathies. On the colonoscopy, multiple mass forming variable-sized ulcers on the terminal ileum were found, so a biopsy specimen and the colonic luminal fluid were obtained, and we made a diagnosis of lymphoma. However, the blood and colonic luminal fluid culture for Salmonella paratyphi-A was reported as positive, and therefore we corrected the diagnosis to Salmonella infection. We report here on a case of Salmonella infection in the terminal ileum, which looked like malignant lymphoma on the baseline radiologic image studies, including the CT and PET-CT.
Biopsy ; Colon ; Colon, Ascending ; Colonoscopy ; Female ; Fever ; Humans ; Hypertrophy ; Ileocecal Valve ; Ileum ; Lymph Nodes ; Lymphoma ; Phenobarbital ; Positron-Emission Tomography ; Salmonella ; Salmonella Infections ; Ulcer