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1.
Artigo em Inglês | MEDLINE | ID: mdl-32383583

RESUMO

Bimetallic electrocatalysts provide a promising strategy for improving performance, especially in the enhancement of selectivity of CO2 reduction reactions. However, the first step of CO2 activation on bimetallic materials remains obscure. Considering bimetallic silver-copper (AgCu) as an example, we coupled ambient pressure X-ray photoelectron spectroscopy (APXPS) and quantum mechanics (QM) to examine CO2 adsorption and activation on AgCu exposed to CO2 with and without H2O at 298 K. The interplay between adsorbed species and the surface alloy composition of Cu and Ag is studied in atomic details. The APXPS experiment and density functional theory (DFT) calculations indicate that the clean sample has a Ag-rich surface layer. Upon adsorption of CO2 and surface O, we found that it is thermodynamically more favorable to induce subsurface Cu atoms substitution for some surface Ag atoms, modifying the stability and activation of CO2-related chemisorbed species. We further characterized this substitution effect by correlating the new adsorption species with the observed binding energy (BE) shift and intensity change in APXPS.

2.
Medicina (Kaunas) ; 56(5)2020 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-32429397

RESUMO

Background and objectives: Alterations in mitochondrial DNA (mtDNA) have been observed and studied in various diseases. However, the clinical value of the mtDNA copy number (mtDNA-CN) alterations in osteonecrosis of the femoral head (ONFH) is poorly understood. In the present study, we investigated whether alterations in mtDNA-CNs are associated with clinicopathological parameters in ONFH. Materials and methods: MtDNA-CNs in the synovial tissue of 34 patients with ONFH and 123 control tissues (femoral neck fracture) were measured using quantitative real-time PCR. The present study then analyzed the correlation between the mtDNA-CN and the clinicopathological characteristics of ONFH and fracture patients. Results: The average mtDNA-CN (mean ± standard deviation) was 23.82 ± 22.37 and 25.04 ± 24.27 in ONFH and control tissues, respectively, and was not significantly different between the groups (p = 0.792). The mtDNA-CN was positively associated with age (27.7% vs. 45.9%, p = 0.018) and negatively associated with the erythrocyte sedimentation rate (ESR) (11.8% vs. 39.7%, p = 0.024) in all of the samples. The study also found further associations with age (22.2% vs. 68.8%, p = 0.014), gender (30.0% vs. 64.3%, p = 0.048), and ESR (0% vs. 57.7%, p = 0.043) in ONFH. Conclusions: in this study, we demonstrated that mtDNA-CN might be a significant marker for predicting clinical characteristics in ONFH.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32423200

RESUMO

Because they deliver outstanding energy density, next-generation lithium metal batteries (LMBs) are essential to the advancement of both electric mobility and portable electronic devices. However, the high reactivity of metallic lithium surfaces leads to the low electrochemical performance of many secondary batteries. Besides, Li deposition is not uniform, which has been attributed to the low ionic conductivity of the anode surface. In particular, lithium exposure to CO2 gas is considered detrimental due to the formation of carbonate on the solid electrolyte interphase (SEI). In this work, we explored the interaction of Li metal with CO2 gas as a function of time using ambient pressure X-ray photoelectron spectroscopy to clarify the reaction pathway and main intermediates involved in the process during which oxalate formation has been detected. Furthermore, when O2 gas is part of the surrounding environment with CO2 gas, the reaction pathway is bypassed to directly promote carbonate as a single product.

4.
Orthopedics ; 43(4): e251-e257, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32271933

RESUMO

A considerable number of patients who underwent a 2-stage exchange protocol for periprosthetic hip joint infection could not complete the second-stage reimplantation. The aim of this study was to evaluate the results of unintended retention of temporary articulating spacers for the treatment of periprosthetic hip joint infection. Ninety-four patients with infection after total hip arthroplasty were treated by using a 2-stage exchange protocol with temporary articulating spacers. Of the 94 patients, 35 did not complete the 2-stage exchange protocol and retained spacers for more than 12 months. The authors retrospectively investigated the clinical and radiographic results after a mean follow-up of 36.1 months. Thirty-one patients had well-healed wounds without recurrent infection and did not receive further surgery for any reason (success group). Spacers were revised in 2 patients, and the other 2 patients underwent incision and debridement because of recurrent infection (failure group). There were no statistical differences between the 2 groups in terms of demographics or presence of resistant organisms. After 3 years of follow-up, temporary articulating spacers functioned well in 89% of the patients who retained them. These results support that retention of temporary articulating spacers could be considered an alternative treatment option for select patients. [Orthopedics. 2020;43(4):e251-e257.].

5.
Sci Rep ; 10(1): 276, 2020 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937851

RESUMO

A subsurface thermohaline front semi-permanently formed in association with near-bottom cyclonic circulation in the northern East China Sea was newly found from detailed hydrographic data collected during two cruises in February 2017 (winter) and April 2018 (spring) along with supplementary satellite remote sensing and historical hydrographic data. An alternate intruding frontal structure in water properties was observed across the cyclonic circulation in both seasons as formed by two contrasting water masses-low-temperature and low-salinity (i.e., low spiciness) water transported by the East China Sea Current and high-temperature and high-salinity (i.e., high spiciness) water transported by the Tsushima Warm Current. Consistent structures were confirmed from current observations during the two cruises, historical hydrographic observations, and satellite altimetry-derived sea surface height and surface frontal structure, indicative of retroflection of the Cheju Warm Current as deemed by the seasonal development of thermal stratification in spring. Our results reveal significant heat and material exchanges between the open Pacific and the broad shelf, particularly via diapycnal mixing and cross-front transports associated with across-front flow and cyclonic circulation, in the northern East China Sea.

6.
J Arthroplasty ; 35(3): 805-810, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31690522

RESUMO

BACKGROUND: Polyethylene wear and subsequent periprosthetic osteolysis remain a major concern of total hip arthroplasty (THA) failure in young, active patients with osteonecrosis of the femoral head (ONFH). The literature is lacking regarding the long-term performance of highly cross-linked polyethylene (HXLPE) in these patients. The purpose of this study is to evaluate long-term results for cementless THA using metal-on-HXLPE bearing couplings in patients younger than 50 years with ONFH. METHODS: We retrospectively evaluated the clinical and radiographic results of a consecutive series of 85 THAs (in 67 patients) performed with HXLPE liners (Durasul) in patients younger than 50 years who had ONFH. All procedures were performed at a single institution by a single surgeon using the same type of implants. The minimum duration of follow-up was 10 years (mean, 13.5 years; range, 10-17.3 years). Wear was measured using computer software. Osteolysis was evaluated with the use of radiography and computed tomography. RESULTS: The mean Harris hip score was 49.3 points (range, 26-68 points) before surgery, which improved to 93.6 points (range, 87-98 points) after surgery. Neither femoral nor acetabular components displayed mechanical loosening, and no components had been revised by the final follow-up evaluation. Radiographs and computed tomography scans did not demonstrate osteolysis. The mean liner wear was 0.037 mm/y (range, 0-0.099 mm/y). With the data available, univariate regression analysis did not demonstrate that age, sex, weight, activity level, underlying cause of osteonecrosis, liner thickness, or cup inclination had any influence on liner penetration. CONCLUSION: Although the long-term effects of HXLPE particles remain unknown, the implant survivorship rate and wear rate in our study are promising and support the continued use of metal-on-HXLPE bearing couplings in these high-risk patients because they do not produce any of the issues associated with hard-on-hard couplings. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

7.
Injury ; 51(2): 367-371, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31822345

RESUMO

INTRODUCTION: The purpose of this study is to evaluate the clinical and radiographic result in patients who got salvage treatment for the failed fixation of intertrochanteric fracture and to evaluate the factors that may affect healing of these treatment. PATIENTS AND METHODS: Between 1997 and 2016, 39 patients who could be followed up for more than 1 year after treatment were enrolled. For determining of factor that may affect healing of treatment, the primary outcome was based on union. There were success group which achieved a restored union and failure group which had an additional revisional surgery because of another complication for analysis. And neck-shaft angle (NSA) was measured with a goniometer. RESULTS: Fracture healing as a primary outcome (after revision surgery) was achieved 31 out of 39 patients (80%). There were no statistically significant differences between two groups in terms of age, sex, BMI and laterality. In the clinical outcomes, four categories of outcomes were compared between the success and failure groups and significant improvements were observed. In measurements at final follow-up, it the angle was 133.4° in the success group and 123.4° in the failure group. CONCLUSION: The clinical and radiographic results of the salvage treatment for the failed fixation of intertrochanteric fracture were satisfactory in our study. Restoration of femoral neck-shaft angle of failed intertrochanteric fracture is key factors for obtaining successful results.

8.
Clin Orthop Surg ; 11(4): 427-435, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31788166

RESUMO

Background: The purpose of this study was to investigate the incidence of acromial fracture after reverse total shoulder arthroplasty (RTSA) and clinical and radiological outcomes of treatment of the fracture. Methods: A systematic review was performed to identify studies that reported the results of treatment of acromial fractures after RTSA. A literature search was conducted by two investigators using four databases (PubMed, Embase, Cochrane, and Ovid Medline). Results: Fifteen studies (2,857 shoulders) satisfied our inclusion criteria. The incidence of acromial fracture after RTSA was 4.0% (114 / 2,857). The mean age of the patients at the time of fracture was 72.9 years (range, 51 to 91 years). The mean time from RTSA to diagnosis of acromial fracture was 9.4 months (range, 1 to 94 months). One hundred shoulders (87.7%) were treated conservatively and 14 shoulders (12.3%) were treated surgically. The mean follow-up period after acromial fracture was 33.8 months. The overall union rate was 50.0% (43.8% for conservative treatment and 87.5% for operative treatment). The fracture incidence was significantly different among the medial glenoid and medial humerus prosthesis design (8.4%), the lateral glenoid and medial humerus design (4.0%), and the medial glenoid and lateral humerus design (2.8%). The mean values at final follow-up were as follows: visual analog scale score, 2.2; American Shoulder and Elbow Surgeons score, 59.1; Constant score, 59.7; and Simple Shoulder Test, 5.8. The mean forward flexion, abduction, and external rotation were 102.3°, 92.3°, and 25.8°, respectively. Conclusions: Acromial fractures after RTSA are a complication neither uncommon nor negligible. In the absence of studies with high-level evidence, there is a controversy on the outcomes after treatment. Further well-designed prospective randomized controlled studies with a long-term follow-up should be performed to ascertain the diagnosis, treatment, and prognosis of acromial fractures after RTSA.


Assuntos
Acrômio/lesões , Artroplastia do Ombro/efeitos adversos , Fraturas Ósseas/etiologia , Complicações Pós-Operatórias/etiologia , Humanos
9.
BMC Public Health ; 19(1): 1679, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842839

RESUMO

It was highlighted that the original article [1] contained a mismatch between the result section of the abstract and Table 2. This Correction article shows the incorrect and correct result section of this article's Abstract.

10.
Ann Occup Environ Med ; 31: e30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31737285

RESUMO

Background: We aimed to find the exposure level of environmental harmful substances related to the secondhand smoke (SHS) using a nationally representative data of the general population in Korea. Methods: Total 3,533 people were included in this study. We compared the proportion exceeding 95 percentile of the concentrations of harmful substances by sex according to SHS exposure. 16 kinds of substances related to tobacco smoke were analyzed including heavy metals, polycyclic aromatic hydrocarbons, volatile organic compounds, and environmental phenol. For 16 kinds of substances, the odds ratios (ORs) for exceeding 95 percentile of each harmful substance were calculated by multiple logistic regression according to SHS exposure. Age, education level, marital status, body mass index, drinking, and exercise were adjusted as covariates. Cotinine level was additionally adjusted to increase reliability of our results. Results: SHS was associated with high exposure of mercury, methylhippuric acid, fluorene, and cotinine. In women, SHS was associated with mercury, methylhippuric acid, fluorene, and cotinine, while in men, it was associated with cotinine. After adjusting covariates, ORs of blood mercury, methylhippuric acid and hydroxyfluorene in the exposed gruop were greater than that in the non-exposed group. Especially in female, methylhippuric acid and hydroxyfluorene showed consistent result. Conclusions: Our finding demonstrates that SHS is related to several harmful substances. Therefore, to reduce the health effects of SHS, it is necessary to educate and publicize the risk of SHS. Future studies are necessary to more accurately analyze factors such as exposure frequency, time, and pathway of SHS.

11.
J Prev Med Public Health ; 52(5): 292-298, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31588698

RESUMO

OBJECTIVES: Presenteeism is currently recognized as a significant global health issue that can potentially cause productivity losses. Hence, many studies have analyzed the relationships between workplace factors and presenteeism. However, few studies have considered non-occupational factors. This study examined the associations between presenteeism and activities outside work, including volunteering, self-development, leisure/sports, and gardening and house repair activities, in Korean wage workers. METHODS: This study analyzed the fourth Korean Working Conditions Survey, in which a total of 19 294 wage workers participated. To identify relationships between presenteeism and activities outside work, multivariate logistic regression analysis was used after adjusting for general and occupational characteristics. RESULTS: Self-development and leisure/sports activities significantly increased the odds ratio (OR) of presenteeism (OR, 1.166; 95% confidence interval [CI], 1.061 to 1.282 and OR, 1.276; 95% CI, 1.181 to 1.379, respectively). CONCLUSIONS: Certain activities outside work, such as self-development or leisure/sports, were related to presenteeism among Korean wage workers. Although many previous studies have emphasized the positive effects of those activities on health, this study documented negative effects of these activities outside work on health.


Assuntos
Atividades de Lazer , Presenteísmo/estatística & dados numéricos , Esportes , Local de Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Inquéritos e Questionários
12.
BMC Public Health ; 19(1): 1339, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640649

RESUMO

BACKGROUND: The association between spontaneous abortion (SA) and occupational characteristics among working women is not well-studied. This study aimed to assess the risk of SA and occupational factors such as occupational classification, working hours, and work schedules among working Korean women aged > 19 years. METHODS: In this cross-sectional study, 4078 working women were identified from among 25,534 workers in the Korea National Health and Nutrition Examination Surveys V (2010-2012) database, to obtain data on SA history and the number of SAs. Odds ratios (ORs) and 95% confidence intervals (CIs) for SA were calculated using multiple logistic regression models after adjusting for age, education, household income, cigarette smoking, alcohol consumption, and obesity status. The weighted prevalence for the number of SAs was calculated according to occupational characteristics to demonstrate the SA status among working Korean women. RESULTS: SA occurrence was reported in 5.7% of the study participants. The ORs (95% CIs) for SA were significantly higher in pink-, green-, and blue-collared workers than in white-collared workers. Regarding weekly working hours, compared with ≤50 h spent working, the ORs (95% CIs) for 51-60, 61-70, and > 70 h per week were 1.26 (0.87-1.84), 1.63 (1.04-2.56), and 1.73 (1.10-2.70), respectively. A significantly higher weighted prevalence of repeat SAs was observed in pink- and green-collared workers and in those who worked long hours. CONCLUSION: We found a significant association between SA, repeat SA, and occupational characteristics among working Korean women.


Assuntos
Aborto Espontâneo/epidemiologia , Doenças Profissionais/epidemiologia , Mulheres Trabalhadoras/estatística & dados numéricos , Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Gravidez , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Adulto Jovem
13.
J Occup Environ Med ; 61(9): e367-e373, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31490324

RESUMO

OBJECTIVE: We sought to determine whether weekend catch-up sleep (CUS) influenced serum high-sensitivity C-reactive protein (hs-CRP) levels in workers. METHODS: We analyzed the Korean National Health and Nutrition Examination Survey (2016) data from 3304 workers. Univariate and multivariate logistic regression analyses were used to calculate odds ratios and 95% confidence intervals based on serum hs-CRP cut-off values of 1.0 and 3.0 mg/L, respectively. RESULTS: We found that at least 1-hour and less than 2 hours of weekend CUS reduced the risk of elevated hs-CRP levels (odds ratio 0.80, 95% confidence interval 0.64 to 0.99) in multivariate logistic regression analysis. CONCLUSION: CUS may reduce serum hs-CRP levels in workers, thereby reducing the risk of cardiovascular disease.

14.
Sci Rep ; 9(1): 10297, 2019 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311944

RESUMO

An essential requirement for bio/chemical sensors and electronic nose systems is the ability to detect the intended target at room temperature with high selectivity. We report a reduced graphene oxide (rGO)-based gas sensor functionalized with a peptide receptor to detect dinitrotoluene (DNT), which is a byproduct of trinitrotoluene (TNT). We fabricated the multi-arrayed rGO sensor using spin coating and a standard microfabrication technique. Subsequently, the rGO was subjected to photolithography and an etching process, after which we prepared the DNT-specific binding peptide (DNT-bp, sequence: His-Pro-Asn-Phe-Se r-Lys-Tyr-IleLeu-HisGln-Arg-Cys) and DNT non-specific binding peptide (DNT-nbp, sequence: Thr-Ser-Met-Leu-Leu-Met-Ser-Pro-Lys-His-Gln-Ala-Cys). These two peptides were prepared to function as highly specific and highly non-specific (for the control experiment) peptide receptors, respectively. By detecting the differential signals between the DNT-bp and DNT-nbp functionalized rGO sensor, we demonstrated the ability of 2,4-dinitrotoluene (DNT) targets to bind to DNT-specific binding peptide surfaces, showing good sensitivity and selectivity. The advantage of using the differential signal is that it eliminates unwanted electrical noise and/or environmental effects. We achieved sensitivity of 27 ± 2 × 10-6 per part per billion (ppb) for the slope of resistance change versus DNT gas concentration of 80, 160, 240, 320, and 480 ppm, respectively. By sequentially flowing DNT vapor (320 ppb), acetone (100 ppm), toluene (1 ppm), and ethanol (100 ppm) onto the rGO sensors, the change in the signal of rGO in the presence of DNT gas is 6400 × 10-6 per ppb whereas the signals from the other gases show no changes, representing highly selective performance. Using this platform, we were also able to regenerate the surface by simply purging with N2.

15.
Injury ; 50(7): 1339-1346, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31151758

RESUMO

INTRODUCTION: Despite the generally successful outcome of intertrochanteric fracture fixation, the treatment is challenging when fixation failure occurs. Some studies have reported a systemic treatment strategy for salvaging failed intertrochanteric fracture fixation. This prospective study with a retrospective review of data aimed to evaluate and validate the efficacy of an evidence-based protocol developed for the treatment of failed intertrochanteric fractures. PATIENTS AND METHODS: Between 1997 and 2016, 83 patients who could be followed up for more than 1 year after treatment were enrolled at an academic medical centre. An evidence-based protocol was established in July 2008 and was implemented prospectively. The treatment protocol was determined keeping in mind the condition of the femoral head, the deformation of the fracture site and the bone defect. Clinical results were evaluated, and fracture union and femoral neck-shaft angle were evaluated radiographically for patients in valgus osteotomy and re-fixation subgroups. RESULTS: The Pain score, leg length discrepancy, Koval score for ambulatory levels and modified Harris Hip Score showed statistically significant improvement after the implementation of the new protocol. The radiographic success rate was 73% (27 of 37 patients) in the pre-protocol group and 91% (42 of 46 patients) in the post-protocol group, which shows statistically significantly improvement. CONCLUSION: The new treatment strategy for failed intertrochanteric fracture fixation based on the condition of the femoral head, deformation of the fracture site and bone defect is successful based on clinical and radiographic results. Restoration of NSA of failed intertrochanteric fractures is a key factor for obtaining successful results.


Assuntos
Mau Alinhamento Ósseo/cirurgia , Cabeça do Fêmur/patologia , Fixação Interna de Fraturas/métodos , Fraturas não Consolidadas/cirurgia , Fidelidade a Diretrizes , Fraturas do Quadril/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Mau Alinhamento Ósseo/diagnóstico por imagem , Parafusos Ósseos , Medicina Baseada em Evidências , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Consolidação da Fratura , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
16.
Nat Commun ; 10(1): 1875, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31015453

RESUMO

Converting carbon dioxide (CO2) into liquid fuels and synthesis gas is a world-wide priority. But there is no experimental information on the initial atomic level events for CO2 electroreduction on the metal catalysts to provide the basis for developing improved catalysts. Here we combine ambient pressure X-ray photoelectron spectroscopy with quantum mechanics to examine the processes as Ag is exposed to CO2 both alone and in the presence of H2O at 298 K. We find that CO2 reacts with surface O on Ag to form a chemisorbed species (O = CO2δ-). Adding H2O and CO2 then leads to up to four water attaching on O = CO2δ- and two water attaching on chemisorbed (b-)CO2. On Ag we find a much more favorable mechanism involving the O = CO2δ- compared to that involving b-CO2 on Cu. Each metal surface modifies the gas-catalyst interactions, providing a basis for tuning CO2 adsorption behavior to facilitate selective product formations.

17.
Ann Occup Environ Med ; 30: 67, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30524733

RESUMO

Background: It has been reported that long working hours are hazardous to the workers' health. Especially, work-related musculoskeletal disorders (WMSDs) have been considered as one of the significant health issues in workplace. The objective of this study was to identify the association between long working hours and work-related musculoskeletal symptoms. Methods: The analysis was conducted using data from the Fourth Korean Working Conditions Survey (KWCS). Subjects of this study were 24,783 wage workers and divided into three groups according to the weekly working hours, which were ≤ 40, 41-52 and > 52 h. The relationship between long working hours and work-related musculoskeletal symptoms was analyzed by multivariate logistic regression method after adjusting for general, occupational characteristics including specific working motions or postures and psychosocial factors. Results: Approximately 18.4% of subjects worked more than 52 h per week and 26.4 and 16.4% of male subjects and 33.0 and 23.4% of female subjects experienced work-related upper and lower limb pains, respectively, over the last 12 months. Moreover, the prevalence of upper and lower limb pain was increased in both genders as the weekly working hours increased. The odds ratios (ORs) of upper limb pain for those working 41-52 h and more than 52 h per week when adjusted for general, occupational characteristics including specific motions or postures and psychosocial factors were 1.36 and 1.40 for male workers and 1.26 and 1.66 for female workers compared to the reference group, respectively. Furthermore, ORs of lower limb pain for the same weekly working hour groups were 1.26 and 1.47 for male workers and 1.20 and 1.47 for female workers, respectively. Conclusions: Long working hours were significantly related to work-related musculoskeletal symptoms in Korean wage workers and appropriate interventions should be implemented to reduce long working hours that can negatively affect workers' health.

18.
Hip Pelvis ; 30(4): 202-209, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30534538

RESUMO

Atypical femoral fractures differ from ordinary femoral diaphyseal or subtrochanteric fractures in several aspects. Although several authors have reported the results of surgical treatment for atypical femoral fractures, the rate of complications (e.g., delayed union, nonunion, fixation failure, and reoperation) is still high. Therefore, we reviewed principles of surgical treatment and describe useful methods for overcoming femoral bowing in these high-risk patients.

19.
Clin Orthop Surg ; 10(3): 299-306, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30174805

RESUMO

Background: Although satisfactory mid- to long-term results of rotational acetabular osteotomy for early osteoarthritis secondary to acetabular dysplasia have been reported, there is still controversy about the long-term effects of this surgery in more advanced osteoarthritis. The purpose of this study was to investigate the radiographic progression of osteoarthritic changes after rotational acetabular osteotomy in acetabular dysplasia according to the preoperative Tönnis grade and evaluate its effects after minimum 10-year follow-up. Methods: We performed 71 consecutive rotational acetabular osteotomies in 64 patients with symptomatic acetabular dysplasia between November 1984 and April 2005. Of these, 46 hips (four hips with Tönnis grade 0, 30 with grade 1, and 12 with grade 2) whose clinical and radiographic findings were available after minimum 10-year follow-up were evaluated in this study. The mean age at the time of surgery was 39.0 years (range, 18 to 62 years) and the average follow-up duration was 17.3 years (range, 10.0 to 27.7 years). Clinical and radiographic evaluations were performed according to the preoperative Tönnis grade. Results: The average Harris hip score improved from 71.8 (range, 58 to 89) to 85.1 (range, 62 to 98). The radiographic parameters also improved in all Tönnis grades after the index surgery. Although the improvement of radiographic parameters was not different between preoperative Tönnis grades, the incidence of osteoarthritic progression was significantly different between grades (zero in Tönnis grade 0, four in Tönnis grade 1, and 10 in Tönnis grade 2; p < 0.001). The mean age at the time of surgery was also significantly older in osteoarthritic progression patients (p < 0.002). Kaplan-Meier survivorship analysis, with radiographic progression of osteoarthritis as the endpoint, predicted a 10-year survival rate of 100% in Tönnis grade 0, 85.7% in Tönnis grade 1, and 14.3% in Tönnis grade 2 (p < 0.001). Conclusions: The outcome of rotational acetabular osteotomy in most hips with Tönnis grade 0 and 1 was satisfactory after an average of 17 years of follow-up. The incidence of osteoarthritic progression was higher in Tönnis grade 2 and older age. Our results support that early joint preserving procedure is essential in the case of symptomatic dysplastic hips.


Assuntos
Acetábulo/cirurgia , Luxação do Quadril/cirurgia , Osteoartrite do Quadril/epidemiologia , Osteotomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Acetábulo/diagnóstico por imagem , Adolescente , Adulto , Feminino , Seguimentos , Luxação do Quadril/diagnóstico por imagem , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/mortalidade , Osteotomia/métodos , Osteotomia/mortalidade , Complicações Pós-Operatórias/mortalidade , Resultado do Tratamento , Adulto Jovem
20.
Clin Orthop Surg ; 10(3): 352-357, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30174812

RESUMO

Background: The aim of this study was to assess the consistency between preoperative ultrasonographic and intraoperative measurements of the ulnar nerve in patients with cubital tunnel syndrome. Methods: Twenty-six cases who underwent anterior transposition of the ulnar nerve for cubital tunnel syndrome were enrolled prospectively. On preoperative ultrasonography, largest cross-sectional diameters of the ulnar nerve were measured at the level of medial epicondyle (ME) and 3 cm proximal (PME) and distal (DME) to the ME on the transverse scan by a single experienced radiologist. Intraoperative direct measurements of the largest diameter at the same locations were performed by a single surgeon without knowledge of the preoperative values. The consistency between ultrasonographic and intraoperative values including the largest diameter and swelling ratio were assessed. Results: Significant differences between ultrasonographic and intraoperative values of the largest diameter were found at all levels. The mean difference was 1.29 mm for PME, 1.38 mm for ME, and 1.12 mm for DME. The mean ME-PME swelling ratio for ultrasonographic and intraoperative measurements was 1.50 and 1.39, respectively, showing significant difference. The mean ME-DME swelling ratio for ultrasonographic and intraoperative measurements was 1.53 and 1.43, respectively, showing no significant difference. Conclusions: Ultrasonographically measured largest diameters of the ulnar nerve at any levels were smaller than the real values determined intraoperatively. The ME-DME swelling ratio of the ulnar nerve measured by ultrasonography was consistent with the intraoperative measurement.


Assuntos
Síndrome do Túnel Ulnar , Cuidados Pré-Operatórios/estatística & dados numéricos , Cirurgia Assistida por Computador/estatística & dados numéricos , Nervo Ulnar/diagnóstico por imagem , Ultrassonografia/estatística & dados numéricos , Adulto , Idoso , Síndrome do Túnel Ulnar/diagnóstico por imagem , Síndrome do Túnel Ulnar/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Cirurgia Assistida por Computador/métodos , Nervo Ulnar/cirurgia
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