RESUMEN
BACKGROUND: This study investigated the effects of total knee arthroplasty (TKA) on bone mineral density (BMD) of the proximal femur in patients who underwent the procedure. METHODS: Forty-eight patients scheduled to undergo unilateral TKA because of primary knee osteoarthritis were included in this study, which was conducted at a medical center between October 2006 and October 2009. In these 48 patients, 96 hips were evaluated. Measurement of BMD was performed preoperatively and one month, three months, six months, and one year after unilateral TKA. Repeated measured analysis of variance and paired t-tests for comparison of two repeated samples were used to compare differences between time points (preoperation, one, three, six, and 12 months) and between the operative and nonoperative sides. RESULTS: Preoperatively, BMD of the femoral neck, trochanter, and total hip on the operative side were lower than on the nonoperative side; however, there was no statistical difference. BMD of both femoral neck areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both trochanter areas was significantly lower than preoperative BMD at one month and three months after TKA. BMD of both total hips was significantly lower than preoperative BMD at three months after TKA. However, no statistical differences of changes in BMD were observed between the operative and nonoperative sides at each measurement time. CONCLUSIONS: According to our results, TKA was found to affect both proximal femurs during the acute period. However, TKA did not affect a change in BMD of the proximal femur during one year postoperative.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Artroplastia de Reemplazo de Rodilla/efectos adversos , Densidad Ósea/fisiología , Cuello Femoral/fisiopatología , Estudios de SeguimientoRESUMEN
The fingernail is damaged and deformed by various causes such as crushing, laceration, avulsion injury, infection, tumor and personal habit. The growth disturbance of nail plate may be caused by systemic diseases or trauma without a direct injury of the fingernail and is usually found in accident. We experienced abnormal growth of nail plate in four patients with previous fractures of metacarpal bone. At about 8 weeks after trauma, a swelling and tenderness on the eponychium and a growth disturbance of affected nail plates occurred. All affected fingernails were treated with the nail extraction. The authors report four cases of growth disturbance of nail plates which obtained the satisfactory results by using the nail extraction.
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Humanos , Laceraciones , UñasRESUMEN
PURPOSE: The records of 12 patients diagnosed with a fracture of the penis were reviewed to assess the usefulness, not only of penile ultrasonography, but also the outcome of an emergent surgical operation for a fracture of the penis. MATERIALS AND METHODS: Twelve patients with a fracture of the penis, as a result of blunt trauma (mean age 41 years old), were reviewed. Of the 12 patients, 9 fractured their penis during sexual intercourse, and 3 during penile manipulation. Patients were managed with an emergent surgical operation, which was performed on the basis of a preoperative cavernosography, penile ultrasonography and retrograde urethrography. All 12 patients were treated with a surgical operation, with follow-up examinations performed 2 weeks later. However, only 5 patients were followed-up over a long period (average 3.5 year). RESULTS: To identify the rupture site of the corpus cavernosum, both penile ultrasonography and cavernosography were performed, and the precise rupture site also confirmed. All patients presented successful outcomes, with the exception of 3 that complained of intermittent painful erections. Five patients were able to preserve potency during the long evaluation period following the operation. However, two patients complained about a mild curvature of the penis and three had intermittent painful erections. CONCLUSIONS: Using penile ultrasonography for the purpose of diagnosing patients with a fractured penis is useful as an investigative methods, and the use of an additional diagnostic tool is almost unnecessary. Despite minimal complications (2 penile curvatures and 3 intermittent painful erections), the result of an emergent surgical operation was excellent for the preservation of sexual potency in patient with a fracture of the penis.
Asunto(s)
Humanos , Masculino , Coito , Estudios de Seguimiento , Pene , Rotura , Ultrasonografía , Heridas y LesionesRESUMEN
PURPOSE: We prospectively evaluated the usefulness of unenhanced helical computerized tomography (UCT) in patients with acute flank pain in the emergency room. MATERIALS AND METHODS: Between March and July 2001, 57 patients, visiting the emergency room with acute flank pain suggestive of urinary stone by physical examination, urine analysis, plain abdominal radiology (KUB) and clinical history, underwent UCT. This UCT study was evaluated for the presence or absence of urinary stones and secondary signs of ureteral obstruction on UCT (tissue-rim sign, hydronephrosis, hydroureter, strands of perinephric fat). The findings of UCT and intravenous pyelography (IVP) were compared for the presence or absence of ureteral obstruction and delineation of urinary stones according to their sizes and locations. The reading accuracy of urinary stones on UCT of one urologic resident was compared with that of one member of the radiologic staff. RESULTS: Fifty-two of the 57 patients had one or more urinary stones. UCT depicted 66 of 68 stones in the 52 patients. The sensitivity and specificity of UCT were 97% and 100%, respectively. Two cases of urinary stones, which were identified by ureteroscopy and spontaneous passing, couldn't be found on UCT, but hydronephrosis was identified. IVP disclosed 55 of 68 stones, with a sensitivity and specificity of 80% and 83%, respectively. In secondary signs of ureteral obstruction on UCT, stones above 4mm in size showed more frequent secondary signs of ureteral obstruction on UCT than those below 4mm in size. The reading accuracy of the urologic resident improved during the period, being 57% in the first half and 83% in the second half. CONCLUSIONS: UCT was an accurate, safe, and rapid technique to assess acute flank pain in the emergency room. The reading ability to diagnose ureter stones in UCT films required an adequate learning curve. Because not all stones could be identified with UCT, it would not completely replace IVP.
Asunto(s)
Humanos , Cálculos , Urgencias Médicas , Servicio de Urgencia en Hospital , Dolor en el Flanco , Hidronefrosis , Curva de Aprendizaje , Examen Físico , Estudios Prospectivos , Lectura , Sensibilidad y Especificidad , Tomografía Computarizada Espiral , Uréter , Obstrucción Ureteral , Ureteroscopía , Cálculos Urinarios , Sistema Urinario , UrografíaRESUMEN
PURPOSE: Chronic pelvic pain syndrome(CPPS) is a debilitating condition characterized by pelvic pain and voiding symptoms. Pelvic floor tension myalgia is hypothesized to be a contributing factor in CPPS. The therapeutic effect of biofeedback and electrical stimulation for CPPS was evaluated prospectively. MATERIALS AND METHODS: Thirteen patients with CPPS intractable to conventional medication were enrolled. The patients were treated by domestic KontinenceTM equipment 2 times a week for 6 weeks. Patients completed the National Institute of Health Chronic Prostatitis Symptom Index(NIH-CPSI) before and after treatment. RESULTS: The average score for all 3 domains in NIH-CPSI significantly decreased. Pain domain decreased from 12.9+/-3.4 to 9.8+/-1.7(p=0.002), voiding symptoms from 4.5+/-1.6 to 3.2+/-0.9(p=0.006), and impact plus quality of life from 7.3+/-2.2 to 4.7+/-1.5(p=0.003). CONCLUSIONS: Biofeedback with electrical stimulation therapy can provide significant improvement in CPPS intractable to medication. Large, randomized trials are needed to confirm its efficacy.