摘要
Background@#Total hip arthroplasty (THA) in patients with hypoplastic femurs presents a significant challenge to orthopedic surgeons due to the limited space available for implant placement. Therefore, the extra-small femoral stems have been proposed as a solution to this problem, but there are limited data on the outcomes. We aimed to evaluate clinical and radiological outcomes of THA in patients with extremely hypoplastic femurs using the Bencox CM stem (Corentec), an extra-small femoral stem. @*Methods@#We included 6 hips from 4 patients. The mean age of the patients was 41.2 years (range, 19.6–60.4 years). The mean height was 135.1 cm (range, 113.6–150.0 cm) with a mean body mass index of 25.7 kg/m 2 (range, 21.3–31.1 kg/m 2 ). The diagnoses for THA were sequelae of septic arthritis in childhood, pseudoachondroplasia, spondyloepiphyseal dysplasia, and juvenile rheumatoid arthritis. Preoperative computed tomography scans were conducted to assess the extent of proximal femoral hypoplasia. The clinical outcomes were assessed using the modified Harris Hip Score, while the radiological outcomes were evaluated using radiographs. The mean follow-up was 2.3 years (range, 1.0–5.9 years). @*Results@#The average modified Harris Hip Score improved to 88.8 at the final follow-up. Intraoperative femoral fractures occurred in 2 cases (33.3%). During the follow-up, 1 stem underwent varus tilting from postoperative 6 weeks to 6 months without subsidence. Otherwise, all stems showed good osteointegration at the latest follow-up. No hip dislocations, periprosthetic joint infection, or loosening of the prosthesis occurred. @*Conclusions@#The use of extra-small femoral stems in THA for extremely hypoplastic femurs can provide reasonable clinical and radiological outcomes with minimal complications. We suggest that this femoral stem could be a viable option for patients with extremely hypoplastic femurs.
摘要
Background@#The purposes of this study were to determine the accuracy of our cup positioning method and to evaluate the dislocation rate after total hip arthroplasty (THA). @*Methods@#After positioning the patient in the lateral decubitus position on the operation table, an anteroposterior view of the hip was taken. The pelvic pitch was measured on the X-ray. A positive pitch was defined as the caudal rotation of the upper hemipelvis. Our target abduction of the cup was 43°. We used the cup holder to guesstimate the cup abduction. In a preliminary study, we found that the weight of the cup holder increased the pelvic pitch by 5°. Thus, the target abduction of the cup holder was calculated by a formula: 43° – pelvic pitch – 5°. During the cup insertion, the cup holder was anteverted to the calculated target according to the concept of combined anteversion. We evaluated 478 THAs (429 patients), which were done with the use of the method. @*Results@#The mean cup abduction was 43.9° (range, 32.0°–53.0°) and the mean error of cup abduction was 2.4° (standard deviation [SD], 2.0°; range, 0.0°–11.0°). The mean cup anteversion was 28.5° (range, 10.0°–42.0°) and the mean error of cup anteversion was 6.7° (SD, 5.2°; range, 0.0°–27.6°). Of all, 82.4% of the cups (394 / 478) were within the safe zone: 30°–50° abduction and 10°–35° anteversion. During 2- to 5-year follow-up, no hip dislocated. @*Conclusions@#Our adjusting method according to the pelvic pitch can be a reliable option for optimizing the cup abduction in THA.
摘要
Objective@#Various patient placement criteria (PPC) have been developed to address alcohol use disorder (AUD), which has a high relapse rate and imposes substantial socioeconomic costs. Although research has shown PPC to be an effective tool, evidence supporting the Korean-PPC (K-PPC) is insufficient. This paper investigated whether treatment matching with the K-PPC was effective, based on variables related to AUD. @*Methods@#In total, 524 participants were evaluated using the 6 dimensions of the K-PPC and levels of care (LoC) were recommended based on the results. Participants whose treatment matched with the recommended LoC were classified into the matched group, and those whose treatment did not match were classified into the mismatched group. Subsequently, treatment was planned according to the determined LoC, and a total of 3 follow-up evaluations were conducted at 1 month, 3 months, and 6 months. @*Results@#There was no significant difference in the follow-up rate between the K-PPC matched group and the mismatched group. Of the variables measured by the 6 dimensions of the K-PPC, alcohol-related variables, depression, insight, and biomedical outcomes showed the most significant results (especially alcohol-related variables) from the baseline evaluation to the 6-month follow-up. In addition, the average adherence to the treatment program in the 6-month period was found to be higher in the matched group than in the mismatched group. @*Conclusion@#The K-PPC could be effective for placing patients and providing treatment by matching patient characteristics. Enhancing treatment program retention can also have a positive effect on clinical outcomes.
摘要
Objective@#This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. @*Methods@#Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. @*Results@#Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. @*Conclusion@#Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.
摘要
Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.
摘要
Background@#Early firm fixation of the femoral implant is crucial in total hip arthroplasty (THA) with unstable metaphysis or a large degree of femoral bone loss. This study aimed to evaluate the outcomes of THA using a novel cementless modular, fluted, tapered stem in such cases. @*Methods@#From 2015 to 2020, 105 hips (101 patients) had surgery performed by two surgeons at two tertiary hospitals using a cementless modular, fluted, tapered stem for periprosthetic fractures, massive bone loss, prosthetic joint infection sequelae, or tumorous condition. Clinical outcomes, radiographic results, and survivorship of the implant were evaluated. @*Results@#The average follow-up period was 2.8 years (range, 1–6.2 years). The Koval grade was 2.7 ± 1.7 preoperatively and maintained at 1.2 ± 0.8 at the latest follow-up. The plain radiograph showed bone ingrowth fixation in 89 hips (84.8%). The average stem subsidence at postoperative 1 year was 1.6 ± 3.2 mm (range, 0–11.0 mm). Five reoperations (4.8%) were needed, including 1 for acute periprosthetic fracture, 1 for recurrent dislocation, and 3 for chronic periprosthetic joint infection. Kaplan-Meier survivorship with reoperation for any reason as the endpoint was 94.1%. @*Conclusions@#The early- to mid-term results of THA with the novel cementless modular, fluted, tapered THA stem system were satisfactory clinically and radiologically. The shortcomings inherent to its modularity were not identified. This modular femoral system may provide adequate fixation and be a practical option in the setting of complicated THA.
摘要
Background@#Preoperative concerns of patients undergoing total hip arthroplasty (THA) and their complaints during the initial postoperative period are not well investigated. We evaluated preoperative concerns of patients and patient-perceived problems during the operation and initial 5 days after the operation. @*Methods@#One hundred and thirty-two patients, who underwent primary THA at a tertiary referral hospital, were surveyed using a questionnaire and a face-to-face interview 1 day before the operation, operation day, and postoperative days 1, 2, 3, and 4. The severity of pain was assessed daily using a visual analog scale. @*Results@#The most common preoperative concern was the severity of pain after the surgery (65.2%), followed by the need of transfusion (34.8%) and postoperative rehabilitation (32.6%). Among 29 patients who could recall the experience during the operation, 12 (41.4%) suffered from shoulder pain on the contralateral side, and 6 (20.7%) answered that hammering sound had been annoying. After returning to the ward, 29 patients (22.0%) suffered from nausea, 8 (6.1%) complained of back pain, and 7 (5.3%) had ipsilateral knee pain. On postoperative day 1, 7 patients (5.3%) had persistent back pain, 8 (6.1%) had headache, and 5 (3.8%) suffered from nausea. On postoperative day 2, nine patients (6.8%) complained of radiating pain due to aggravation of preexisting spinal stenosis, 7 (5.3%) complained of weakness of the hip flexor due to periarticular injection of ropivacaine during the operation, and 5 (3.8%) had dressing-related skin problem at the wound. On postoperative days 3 and 4, patients had no problem other than hip pain. The mean pain score was the highest (3.1 ± 1.0) on postoperative day 1. @*Conclusions@#The results of this study might provide information needed to solve problems and improve satisfaction of patients undergoing THA.
摘要
Purpose@#This study examined the clinical and radiological results of cementless hip arthroplasty using a long double-tapered rectangular stem in cases with osteoporotic proximal femoral fractures or in reoperation cases. @*Materials and Methods@#This was a retrospective study on patients treated with a Benfix ® stem (Corentec, Cheonan, Korea) by a single surgeon at a single tertiary institution from September 2011 to August 2020, where 92 hips were treated. Thirty-nine patients were followed up for less than one year. Excluding those patients, the mean follow-up duration was 3.0 years (range 1–8 years). The patients’ deaths were confirmed through data from the Ministry of Interior and Safety. Clinical outcomes were assessed using a modified Harris hip score (mHHS), and radiologic outcomes, such as fixation and subsidence, were assessed by surgeons who did not participate in the surgery. @*Results@#mHHS improved from 45 to 79 points at the latest follow-up, and thigh pain was not observed in 53 patients who were followed up for more than one year. Notching of the stem was not noted. The average subsidence was approximately 1 mm in postoperative one year.Three peri-prosthetic fractures (PPF), one deep prosthetic infection, and one superficial wound infection were observed. Stem loosening occurred in one of these PPF cases, and stem revision surgery was done. All complications occurred within one year postoperatively. The one- and five-year mortality were 21.1% and 50.0%, respectively. @*Conclusion@#The short-term and mid-term results of the cementless hip arthroplasty using long double-tapered rectangular stem appeared encouraging and could be a viable option in osteoporotic proximal femoral fractures or reoperation cases. However, most complications occurred within one postoperative year, and the one-year mortality was relatively high. A long-term follow-up would be necessary with a larger cohort to evaluate its longevity.
摘要
Background@#Studies have reported that osteonecrosis of the femoral head (ONFH) is more prevalent in patients with human immunodeficiency virus (HIV). Total hip arthroplasty (THA) is considered reasonable management of ONFH. However, only scarce data exist on the outcomes of THA for HIV-infected patients in South Korea. The purpose of this study was to evaluate the midterm results of HIV-positive patients who underwent THA for ONFH. @*Methods@#We performed a retrospective review of HIV-infected patients with ONFH who underwent THA in our institution from 2005 to 2021. Twenty-two hips in 15 patients underwent THAs with cementless implants. The clinical and radiographic evaluation was performed at each follow-up, and any complication was recorded. @*Results@#The mean follow-up period was 5.2 years (range, 1.0–16.0 years). The mean age of the HIV infected patients with osteonecrosis at the time of surgery was 44.7 ± 11.6 years. ONFH occurred 9.8 ± 3.7 years after the initial diagnosis of HIV infection.The average modified Harris hip score improved from 58.3 ± 14.8 to 95.2 ± 11.3 at the latest follow-up. Surgical complications such as infection, nerve injury, or dislocation were not present. The radiographic evidence of stable fixation by bone ingrowth without migration was seen in all implants. @*Conclusions@#Our data suggest that THA is a safe and valid option of treatment for ONFH in well-controlled HIV-infected patients in Korea. Further large-scale nationwide studies are warranted.
摘要
Background@#In 2018, Femoral Neck System (FNS), a dedicated fixator for femoral neck fractures, was introduced. This device has been in increasing use because it provides excellent rotational and angular stability. However, the shortest bolt of FNS is 75 mm long. Thus, it is not usable when the axial length of the proximal femur (ALPF), the distance between the innominate tubercle and the surface of the femoral head, is less than 80 mm. In this study, we investigated the incidence and associated factors of small ALPF (< 80 mm) in femoral neck fracture patients. @*Methods@#We measured the ALPF on preoperative computed tomography (CT) scans of 261 patients (166 women and 55 men), who were operated due to nondisplaced or impacted femoral neck fractures. The ALPF was measured on reconstructed oblique coronal images along the femoral neck. We evaluated the distribution of ALPF, calculated the incidence of small ALPF (< 80 mm), and correlated it with patient’s height, weight, body mass index, age, bone mineral density (T-score), and caput-column-diaphysis angle. @*Results@#The ALPF ranged from 67.4 mm to 107.1 mm (mean, 88.4 mm; standard deviation, 7.2 mm). In 19 patients (8.6%, 19 / 221), the length was < 80 mm. The ALPF was strongly correlated with height (correlation coefficient = 0.707, R2 = 0.500, p < 0.001) and moderately correlated with weight (correlation coefficient = 0.551, R2 = 0.304, p < 0.001). The T-score was moderately correlated with the ALPF (correlation coefficient = 0.433, R2 = 0.187, p < 0.001). The age was moderately correlated with the ALPF (correlation coefficient = –0.353, R2 = 0.123, p < 0.001). @*Conclusions@#A considerable percentage of femoral neck fracture patients (8.6%) had small proximal femurs (ALPF < 80 mm), which cannot be operated with FNS. We recommend measuring the ALPF using reconstructed oblique coronal CT images or scaled hip radiographs: en face view of the femoral neck prior to surgery in patients with short stature and/or low body weight. If the ALPF is < 80 mm, the surgeon should prepare other fixation devices.
摘要
When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient’s occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient’s chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.
摘要
Purpose@#The optimal short-course chemotherapeutic regimen for rectal cancer has not been clearly defined until now. KROG 10-01 and KROG 11-02 prospective trials investigated the efficacy and safety of 1- and 2-week chemoradiotherapy (CRT), respectively. @*Materials and Methods@#Patients eligible for KROG 10-01 and KROG 11-02 involved those with clinical T3-4N0-2M0 rectal cancers. They received preoperative CRT and total mesorectal excision. Patients in KROG 10-01 received radiation of 25 Gy in 5 fractions during 1 week with 5-fluorouracil/leucovorin. Patients in KROG 11-02 received radiation of 33 Gy in 10 fractions for 2 weeks with oral capecitabine. @*Results@#A total of 150 patients consisting of 70 patients from KROG 10-01 and 80 patients from KROG 11-02 were collectively analyzed. With a median follow-up time of 89.2 months, the 5-year overall survival rate was 86.5% in 1-week CRT and 85.3% in 2-week CRT (p=0.841). The 5-year recurrence-free survival rate was 83.5% in 1-week CRT and 77.1% in 2-week CRT (p=0.448). One patient (1.4%) in 1-week CRT and 11 patients (13.8%) in 2-week CRT exhibited pathologic complete regression (ypT0N0M0) after radiotherapy (p=0.006). One-week CRT had significantly higher acute hematologic (12.8% vs. 3.8%, p=0.040) and nonhematologic (38.6% vs. 16.3%, p=0.002) toxicity than 2-week CRT. @*Conclusion@#Both 1- and 2-week schedules of CRT showed favorable survival outcomes after 7 years of follow-up. But, 2-week course achieved more increased tumor response and decreased acute toxicity than 1-week course.
摘要
Purpose@#Studies about the effect of radiation therapy (RT) on immune cells are usually limited to a high-grade glioma mostly exposed to chemotherapy and a high dose of steroid which also could affect immune cells. The purpose of this retrospective analysis of low-grade brain tumor patients treated by RT alone is to determine significant factors influencing neutrophil-to-lymphocyte ratio (NLR), absolute neutrophil counts (ANC), and absolute lymphocyte counts (ALC). @*Materials and Methods@#A total of 41 patients who received RT between 2007 and 2020 were analyzed. Patients who received chemotherapy and high-dose of steroid were excluded. ANC and ALC were collected before starting RT (baseline) and within one-week before ending RT (post-treatment). Changes of ANC, ALC, and NLR between baseline and post-treatment were calculated. @*Results@#ALC decreased in 32 patients (78.1%). NLR increased in 31 patients (75.6%). No patients developed grade 2 or higher hematologic toxicities. The decrease of ALC was significantly correlated with the dose to brain V15 in a simple and multiple linear regression (p = 0.043). Brain V10 and V20 adjacent to V15 were also marginally significant factors determining the reduction of lymphocytes (p = 0.050 and p = 0.059, respectively). However, it was difficult to find predictive factors affecting changes of ANC and NLR. @*Conclusion@#In low-grade brain tumor patients who are treated by RT alone, ALC decreased and NLR increased in three-fourth of patients, although the magnitude was minimal. The decrease of ALC was mainly affected by low dose to the brain. However, RT dose was not correlated with changes of ANC or NLR.
摘要
BACKGROUND@#In guided bone regeneration (GBR), there are various problems that occur in the bone defect after the wound healing period. This study aimed to investigate the enhancement of the osteogenic ability of the dual scaffold complex and identify the appropriate concentration of growth factors (GF) for new bone formation based on the novel GBR concept that is applying rapid bone forming GFs to the membrane outside of the bone defect. @*METHODS@#Four bone defects with a diameter of 8 mm were formed in the calvaria of New Zealand white rabbits each to perform GBR. Collagen membrane and biphasic calcium phosphate (BCP) were applied to the bone defects with the four different concetration of BMP-2 or FGF-2. After 2, 4, and 8 weeks of healing, histological, histomorphometric, and immunohistochemical analyses were conducted. @*RESULTS@#In the histological analysis, continuous forms of new bones were observed in the upper part of bone defect in the experimental groups, whereas no continuous forms were observed in the control group. In the histomorphometry, The group to which BMP-2 0.5 mg/ml and FGF-2 1.0 mg/ml was applied showed statistically significantly higher new bone formation. Also, the new bone formation according to the healing period was statistically significantly higher at 8 weeks than at 2, 4 weeks. @*CONCLUSION@#The novel GBR method in which BMP-2, newly proposed in this study, is applied to the membrane is effective for bone regeneration. In addition, the dual scaffold complex is quantitatively and qualitatively advantageous for bone regeneration and bone maintenance over time.
摘要
objectives@#：The purpose of this study is to determine whether there is a significant difference in the neutro-phil-to-lymphocyte ratio and platelet-to-lymphocyte ratio according to the history of suicide attempt in patients with psychiatric diseases. @*Methods@#：A medical record review was conducted on patients who had been hospitalized in Konyang University Hospital since 2021-03-01 to 2023-02-28 to collect demographic and clinical characteristics. T-test for continuous variables and Chi-square test for categorical variables were performed to determine demographic differences according to the history of suicide attempt, and the ANCOVA test was performed to compare the average value of peripheral inflammatory marker according to the history of suicide attempt with gender and age as co-variates. One-way variance analysis was performed to determine whether the number of suicide attempt causes significant difference of the peripheral inflammatory marker. @*Results@#：The final analysis target of this study was 266 patients, 101 had history of suicide attempt, and 165 had no history of suicide attempt. The neutrophil-to-lymphocyte ratio (p<0.001) and platelet-to-lymphocyte ratio (p<0.001) were higher in patients with the history of suicide attempt than patients without the history of suicide attempt, but the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were not significantly in-creased depending on the serial increase of number of suicide attempts. @*Conclusions@#：This study suggests that peripheral inflammatory markers are meaningful and easily accessible indicators for predicting the risk of suicide attempt in psychiatric patients. We expect that prospective follow-up study will be conducted with more subjects and controlled potential confounding variables.
摘要
Purpose@#The standard of care for early rectal cancer is radical surgery; however, it carries high postoperative morbidity. This study aimed to assess the short-term and oncological outcomes of local excision and adjuvant radiotherapy in patients with high-risk pathological stage (p) T1 rectal cancer. @*Methods@#Fifty-five patients underwent local excision with adjuvant radiotherapy or radical resection for high-risk T1 rectal cancer. Patients with adenocarcinoma within 10 cm from the anal verge; pT1 with high-risk features (grade 3–4); a tumor size of ≥3 cm; a positive margin; a lymphovascular or perineural invasion; or a submucosal invasion depth of ≥SM2 were included. @*Results@#The rates of postoperative complications and stoma formation were higher in the radical surgery group (P = 0.021 and P = 0.003, respectively). No significant differences were observed in the overall survival and disease-free survival (DFS) between the 2 groups (P = 0.301 and P = 0.076, respectively). Vascular invasion was a significantly poor prognostic factor for DFS (P = 0.033). The presence of 3 or more high-risk features was associated with a poor DFS (P = 0.002). @*Conclusion@#Local excision with adjuvant radiotherapy significantly reduces the risk of complications and stoma formation. It is also an alternative option for patients with fewer than 3 high-risk features.
摘要
Background@#The Bencox M stem is a mid-short type 1 stem with additional unique design features. It has a reduced stem length and a lateral shoulder to facilitate minimally invasive surgery, as well as an angular lateral shoulder and a trapezoidal neck to minimize stem-liner impingement. There have been many mid-term reports on type 1 stems, but no results have been reported so far on this novel design type 1 femoral stem. This study presents the clinical and radiological outcomes of total hip arthroplasty performed with the M stem after a minimum 5-year follow-up. @*Methods@#From July 2014 to February 2015, 125 primary total hip arthroplasties using the M cementless femoral stem were performed on 112 patients in our hospital. Among them, 94 patients (106 hips) were eligible for the study and were followed up for more than 5 years. Our primary outcome was clinical results, which were evaluated by the Harris Hip Score (HHS), thigh pain, noise, and other complications. Secondary outcome was radiological outcomes. Seventy-seven hips were evaluated radiologically with attention to implant fixation, migration, loosening of component, degree of stress shielding, radiolucent lines, focal osteolysis, heterotopic ossification, and the evidence of impingement between the stem and liner. @*Results@#The average HHS improved from 54.6 points (range, 24–67 points) to 96.8 points (range, 91–100 points) at the latest follow-up. Three hips (2.8%) had intermittent thigh pain, which was tolerable without medication. Five hips (4.7%) had ceramicrelated noise. There were no other complications such as infection, nerve injury, dislocation, or revision. All implants showed radiographic evidence of stable fixation by bone ingrowth without migration. Fifty-seven hips (74%) showed mild femoral stress shielding. Distal cortical hypertrophy was detected in 7 hips (9%), and heterotopic ossification was observed in 17 hips (22%). No implant demonstrated focal osteolysis and notching of the femoral neck or shoulder on radiographs. @*Conclusions@#The minimum 5-year results of total hip arthroplasty performed with the M cementless femoral stem were encouraging clinically and radiologically. A long-term follow-up will be necessary to evaluate its longevity.
摘要
Background@#At the end of 2014, we implemented an online video to inform patients of the entire process from admission to rehabilitation after total hip arthroplasty (THA). In this study, we investigated the effectiveness of online video instruction in THA patients. @*Methods@#Electronic medical records of 184 patients undergoing THA in 2014 (pre-video group) and 182 patients in 2015 (post-video group) were reviewed. We compared 1) the time to start wheelchair ambulation, 2) walker or crutch ambulation, 3) the length of hospital stay, 4) postoperative satisfaction using visual analogue scale (0–10 points), and 5) modified Harris Hip Score (mHHS) at postoperative 6 weeks. @*Results@#In the post-video group, the time to start wheelchair ambulation (1.8 ± 0.6 vs. 2.4 ± 3.2 days, P = 0.021) and walker/crutch ambulation were faster (2.9 ± 1.2 vs. 3.8 ± 1.0 days, P = 0.016), and the hospital stay was shorter (8.2 ± 4.7 vs. 9.9 ± 7.8 days, P = 0.001) compared to the pre-video group. The visual analogue scale for satisfaction (7.84 ± 1.62 vs. 7.68 ± 1.85 points) and mHHS (89.59 ± 9.47 vs. 89.58 ± 8.59) were similar. @*Conclusion@#Online video instruction is an effective tool to expedite ambulation and reduce the hospital stay without compromising the clinical outcome and postoperative complications after THA.
摘要
Objectives@#：This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. @*Methods@#：The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. @*Results@#：The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. @*Conclusions@#：This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.
摘要
Objectives@#: In this study, we evaluate psychological stress, symptoms of anxiety and depressed mood and resilience which medical residents and interns perceived during COVID-19 event, then investigate the associations between stress and the symptoms and mediating effect of resilience on the associations. @*Methods@#: In this study, we made a self-reporting form to evaluate psychological stress with perceived stress scale (PSS), symptoms of anxiety and depressed mood with Hospital anxiety and depression scale (HAD), and resilience with Conner-Davidson Resilience Scale (CD-RISC). Medical residents and interns, who worked in a hospital during COVID-19 event, filled the self-reporting forms from july, 2020 to august, 2020. We conducted a Pearson correlation coefficient and a multiple regression to confirm association between psychological stress and symptoms of anxiety and depressed mood, then mediating effect of resilience. @*Results@#: The higher stress perceived, the more symptoms of anxiety and depressed mood were reported by medical residents and interns. The higher resilience is associated with lower stress and less symptoms of anxiety and depressed mood, which resilience is proven to mediate partially the association between stress and symptoms of depressed mood. @*Conclusions@#: This study shows that resilience has a partial mediating effects on the association between stress and psychological pathology especially depressed mood, given that medical residents and interns were under psychological distress during COVID-19 event. This suggests that resilience is the key for medical trainees to overcome the future crisis like COVID-19 event.