ABSTRACT
In the future, we will have more aged patients, more cases of bilateral total hip arthroplasty (THA) and more cases of bilateral revision THA. There are not, however, many reports of long-term follow-up of bilateral revision THA. We report a case of bilateral revision THA followed up for 11 years. A 74-year-old woman presented with bilateral painful hip in 1996. She had undergone left THA in 1984 and right THA in 1986 at another hospital. Her JOA(Japan Orthopaedic Association) scores on her first visit (right/left) were 32 points/31 points. Plain radiographs revealed a clear zone in her bilateral proximal femur. We diagnosed her as having looseness of bilateral THA. She required bilateral revision THA and underwent left revision THA (Charnley) in January 1997 (14 years after the original operation) and right revision THA (Charnley) in July 1997 (12 years after the original operation). After bilateral revision THA, we were able to follow up this patient for 11 years. She had no complaints about her bilateral hip joints, and X-ray examination showed no looseness. The JOA scores and range of motion illustrate the good result achieved for this case.
Subject(s)
Tacrine , Hip , ArthroplastyABSTRACT
The aim of this study was to clarify the worldwide residual levels of organochloride compounds, such as BHC and DDT, which were reportedly concentrated in animal tissues by biological food chains. As a part of the investigation of endocrine disrupting chemicals (EDCs), we had a chance to measure the level of these compounds in Hungarian canned foods.Seven kinds of canned foods were purchased at a market in Budapest, Hungary, and the concentrations of eighteen organochloride compounds (α-BHC; β-BHC; γ-BHC; δ-BHC; p,p'-DDT; p,p'-DDE; p,p'-DDD; o,p'-DDT; heptachlor; heptachlor-epoxide; aldrin; dieldrin; endrin; oxychlordane; trans-chlordane; cischlordane; trans-nonachlor; and cis-nonachlor) were measured.Other than DDT and its metabolites, none of the EDCs were detected (levels <0.4 ppb). DDT and its metabolites, however, were detected in fish, meat and chicken liver pate. One of the DDT metabolites was detected quite frequently: p,p'-DDE was detected at a level of 1.8 ppb in fish soup concentrate, 2.3 ppb in Hungarian luncheon meat, 0.5 ppb in special luncheon meat, and 0.6 ppb in chicken liver pate.Of eighteen organochloride compounds examined, only DDT and its metabolites were detected in fish, animal meat, and animal liver. It is suggested that the DDT contamination in fish and meat is worldwide even after the ban of its use.
ABSTRACT
A 47-year-old man, having undergone mitral valve replacement in another hospital 9 years ago, suffered from sudden dyspnea and was transferred to our hospital immediately. On admission, disturbance of consciousness, severe dyspnea, marked hypotension (60/40) and hypo-oxygenation were noted. Under assisted ventilation with endotracheal intubation, diagnosis was confirmed by chest X-ray. The patient was transferred to the operation room after initiation of percutaneous cardiopulmonary support (PCPS). The emergency re-operation was started 7 hours after the onset of the symptoms. Left atriotomy was performed following total cardiopulmonary bypass and cardioplegic solution infusion. The pyrolite disc and the minor strut were missing and could not be found in the cardiac cavity. The fractured prosthesis was removed and replaced with a 29mm Carbomedics prosthesis. He was weaned from cardiopulmonary bypass with large doses of pressor amines. The disc and the strut were removed from the abdominal aorta and right deep femoral artery respectively 4 weeks after re-MVR surgery. The patient was discharged after 8 weeks' admission, and has been doing well so far. Although it is obvious that prompt diagnosis and early operation to replace the fractured prosthesis are essential for patient survival, percutaneous cardio-pulmonary support is helpful to maintain patient's hemodynamics during rediagnosis and preparation for surgery.
ABSTRACT
Usefulness of balneotherapy in diabetics were discussed. Plasma glucose levels in diabetics treated with insulin decreased significantly after thirty minutes exercise under 38°C hot springs pool. There were positive relationships on plasma glucose levels between before and after exercise in hot springs. Lipids metabolism were improved during three months' balneotherapy. The ratio of VLDL·LDL-cholesterol/HDL-cholesterol decreased. Basal levels of plasma cyclic AMP decreased slightly and plasma cyclic GMP significantly increased. Intrathecal injection of vitamin B<sub>12</sub> (mecobalamin, 2500μg) was apparently effective to reduce the pain on under limb in patients with diabetic peripheral neuropathy whose subjective symptom could not improved by any medications. The effect of mecobalamin was increased by bathing in hot springs. Usually, balneotherapeutic hospitals have facilities of rehabilitation system in Japan.<br>In conclusion, the balneotherapy by adding physical treatment is very benefit to normalize carbohydrate and lipid metabolism. Tranquilizing function of hot springs are effective on psychological disturbance, diabetic autonomic and peripheral neuropathy.