ABSTRACT
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.
ABSTRACT
Prolymphocytic leukemia (PL) is usually derived from B cells and shares some features with chronic lymphocytic leukemia (CLL), but it is clearly a distinct entity and defined to have more than 55% prolymphocytes. Chronic lymphocytic leukemia/prolymphocytic leukemia (CLL/PL) is a mixed type of CLL and is defined to have 11~55% prolymphocytes with intermediate features between CLL and PL. We experienced two different cases of leukemia PL and CLL/PL. On physical examination, PL (stage II, B) patient showed multiple cervical lymph node enlargement and 5cm sized splenomegaly and hepatomegaly. But CLL/PL (stage III, C) patient showed 10cm sized splenomegaly and no lymph node enlargement. On immunological phenotyping, surface markers showed 72% CD5 (+), 85% CD19 (+), and 40% SmIg (+) in PL patient and 3% CD5 (+), 90% CD19 (+) and SmIg (-) in CLL/PL patient. PL patient was refractory to chlorambucil and prednisolone chemotherapy and showed poor prognosis. CLL/PL patient did not show remarkable response to chlorambucil and prednisolone therapy.
Subject(s)
Humans , B-Lymphocytes , Chlorambucil , Drug Therapy , Hepatomegaly , Leukemia , Leukemia, Lymphocytic, Chronic, B-Cell , Leukemia, Prolymphocytic , Lymph Nodes , Physical Examination , Prednisolone , Prognosis , SplenomegalyABSTRACT
Anisakis is an accidental parasitic infection caused by the larvae of marine mammals. An individual becomes infected with a larval form of the nematode Anisakis by consuming raw or undercooked fish containing the parasite. Generally, the clincal symptoms are characterized by severe cramping abdomianl pain, nausea, vomiting, and an epigastric full sensation. A case was recently experienced by a patient who suffered acute esophageal anisakiasis, and had a history of eating raw sea fish. His symptoms included substernal chest pain and odynophagia. Early endoscopic examination revealed a whitish linear worm in the mid-esophagus, which was removed by biopsy forceps.
Subject(s)
Humans , Anisakiasis , Anisakis , Biopsy , Chest Pain , Eating , Esophagus , Larva , Mammals , Muscle Cramp , Nausea , Parasites , Sensation , Surgical Instruments , VomitingABSTRACT
OBJECTIVES: The serum total cholesterol is supposed to be increased as dietary pattern is westernized recently in our country. We studied the longitudinal change of serum total cholesterol levels in normal adult Korean male workers and analyzed the influence of lifestyle on change of serum total cholesterol levels. METHODS: The 7677 healthy adult male workers were studied during recent 5years(1992 and 1997). Those who suffered from hypertension, diabetes mellitus, ischemic heart disease, nephritis were excluded. Those who ingested antilipidemic drugs were also excluded. Serum total cholesterol were measured by the same enzymatic method and their levels were analyzed during fasting state. Data on lifestyle were obtained using self administered questionnaires. RESULTS: 1) The serum total cholesterol levels increased by 9.45+/-23.99mg/dl(1.89mg/dl per year) between 1992 and 1997 surveys. 2) The increment of serum total cholesterol levels was most prominent in the twenties (3.45mg/dl per year) and less prominent in 5th, 6th decades. 3) A change of 1kg/m2 in body mass index contributed a change of 3.449mg/dl in serum total cholesterol. 4) The change of body mass index(BMI) was most significantly correlated with that of serum total cholesterol levels among the influencing variables.( =3.449 p=0.0001 r2=0.035) 5) The changed value of serum total cholesterol levels was significantly correlated with smoking and exercise, however, was not significantly correlated with the amount of alcohol ingestion. CONCLUSION: The serum total cholesterol levels increased by 9.45mg/dl(1.89mg/dl per year) during recent 5 years. The increment of serum total cholesterol levels was more prominent in younger age group. The changed value of BMI was most strongly correlated with that of serum total cholesterol levels of all influencing variables.
Subject(s)
Adult , Humans , Male , Body Mass Index , Cholesterol , Diabetes Mellitus , Eating , Fasting , Follow-Up Studies , Hypertension , Life Style , Longitudinal Studies , Myocardial Ischemia , Nephritis , Smoke , Smoking , Surveys and QuestionnairesABSTRACT
No abstract available.