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《Arthroscopy》2021,37(10):3013-3015
The function and importance of the labrum in hip biomechanics has been established. A labral tear is the most common pathology in patients undergoing hip arthroscopy, and adequate management is critical for favorable outcomes. Although labral debridement was initially performed for arthroscopic labral tear management, there has been a shift toward labral restoration techniques. Currently, restoration with labral repair remains the gold standard for labral tear treatment, particularly in the primary setting. When compared to labral debridement, the literature has shown that labral repair has more favorable outcomes.Irreparable labral tears, although unusual in the primary setting, present a challenge. Labral reconstruction and augmentation are recent advancements in this scenario of hip arthroscopy that can help restore labral function.Two alternatives of labral reconstruction have been described: segmental and circumferential. Clinical data for segmental labral reconstruction has reported good outcomes at short-, mid-, and long-term follow-up. Similarly, arthroscopic circumferential reconstruction has shown good to excellent results at short-term follow-up. As the name suggests, only a segment of the labrum is reconstructed during segmental reconstruction. In a circumferential reconstruction, the entire labrum is taken down from the most anterior to the most posterior aspect of the transverse acetabular ligament and is reconstructed using an auto or allograft. A benefit of circumferential labral reconstruction is the removal of the entire damaged labral tissue, a potential source of pain. However, there is no clear evidence that demonstrates the superiority of one method over the other.Labral graft reinforcement via tissue augmentation or labral augmentation is an interesting option because it preserves the native chondrolabral junction. Labral augmentation can also be used for hypoplastic labrum that intraoperatively demonstrates a deficient suction-seal. 相似文献
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《Arthroscopy》2021,37(10):3001-3002
At the American Orthopaedic Society for Sports Medicine (AOSSM)–Arthroscopy Association of North America (AANA) 2021 Annual Meeting in Nashville, Tennessee, collaboration was the word of the day. AAOSM and AANA are a great pair, and many of us are long-time members of both associations. The attendance was unprecedented. Face-to-face meetings facilitate great spontaneity, profound exchange, nuanced communication, personal sharing, and efficient and passionate occurrence of new ideas. President Mark Getelman will host next year’s AANA Annual Meeting, AANA22, in another fantastic American city with which AANA is very familiar, San Francisco, California. The meeting will be held May 19-21, 2022, and we look forward to seeing many of you in the City by the Bay. It will be AANA’s 40th Annual Meeting, and naturally, your editors are planning to attend. 相似文献
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Bong-Jin Lee Seong-Tae Kim Min Geun Yoon Sung-Soo Kim Myung-Sang Moon 《Clinics in Orthopedic Surgery》2011,3(3):254-257
Pyogenic spondylitis involving only the posterior element of a vertebra is rare. To the best of our knowledge, there have been no reports of osteomyelitis of the transverse process. We report here on a 45-year-old male with a one month history of swelling associated with lower back pain. The magnetic resonance imaging showed a paraspinal soft tissue mass, and computed tomography revealed a fine osteolytic lesion in the right transverse process of the 5th lumbar spine, and this was all consistent with chronic osteomyelitis. A mixed staphylococcal infection was identified. Open drainage, resection of the transverse process and intravenous injection of anti-staphylococcal antibiotics resolved the back pain and reduced the erythrocyte sedimentation rate to normal. Pyogenic osteomyelitis of the transverse process is extremely rare, which can cause a misdiagnosis or a delayed diagnosis. Careful consideration of this disease is needed when evaluating patients who complain of back pain. 相似文献
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Ji Hun Kim Jeong Woon Kim In Ho Jeong Tae Yong Choi Byung Moo Yoo Jin Hong Kim Myung Wook Kim Wook Hwan Kim 《Journal of gastrointestinal surgery》2008,12(5):829-835
The aim of this study was to evaluate the surgical outcomes of laparoscopic cholecystectomy (LC) in patients who were diagnosed
with severe acute cholecystitis (SAC) and to clarify the useful treatment modalities of SAC. Of 112 patients who presented
SAC, we selected 99 patients and divided them into 3 groups: 37 patients who underwent preoperative percutaneous transhepatic
gallbladder drainage (PTGBD; group 1), 62 patients with SAC but not indicated for PTGBD (group 2), and 59 patients with acute
and chronic cholecystitis (group 3). The conversion rate was 2.7% (1/37) in group 1, 6.5% (4/62) in group 2, and 1.7% (1/59)
in group 3. In groups 1 and 2, the postoperative stay and operative time were longer than those in group 3 with significant
difference, respectively (P < 0.05). In group 2, there was correlation not only between postoperative stay and age but also between postoperative stay
and ASA class (P < 0.05). In group 2, there was no correlation between time to operation and operative time and also between time to operation
and postoperative stay, however, there was surprisingly significant correlation between time to operation and conversion rate
in SAC (P = 0.018). In conclusion, PTGBD should selectively be performed in patients with severe comorbidities rather than improving
surgical outcomes of LC for severe acute cholecystitis. If patients are not indicated for PTGBD, an early laparoscopic cholecystectomy
is recommended because it can decrease conversion rate, although it cannot decrease operative time and postoperative stay. 相似文献
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Jae Hee Lee Hoi Soo Yoon Joon Sup Song Eun Seok Choi Hyung Nam Moon Jong Jin Seo Ho Joon Im 《Journal of Korean medical science》2009,24(5):904-909
We evaluate the outcomes in children with acute leukemia who received allogeneic hematopoietic stem cell transplantation (HCT) using unrelated donor. Fifty-six children in complete remission (CR) received HCT from unrelated donors between 2000 and 2007. Thirty-five had acute myeloid leukemia, and 21 had acute lymphoid leukemia. Stem cell sources included bone marrow in 38, peripheral blood in 4, and cord blood (CB) in 14. Four patients died before engraftment and 52 engrafted. Twenty patients developed grade II-IV acute graft-versus-host disease (GVHD) and 8 developed extensive chronic GVHD. With median follow-up of 39.1 months, event free survival and overall survival were 60.4% and 67.5%, respectively, at 5 yr. Events included relapse in 10 and treatment-related mortality (TRM) in 10. The causes of TRM included sepsis in 4, GVHD in 4 (1 acute GVHD and 3 chronic GVHD), veno-occlusive disease in 1 and fulminant hepatitis in 1. Patients transplanted with CB had event free survival of 57.1%, comparable to 63.2% for those transplanted with other than CB. In conclusion, HCT with unrelated donors is effective treatment modality for children with acute leukemia. In children with acute leukemia candidate for HCT but lack suitable sibling donor, unrelated HCT may be a possible treatment option at the adequate time of their disease. 相似文献
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Ban Seok Lee Jin-Hyeok Hwang Sang Hyub Lee Sang Eon Jang Eun Sun Jang Hyun Jin Jo Cheol Min Shin Young Soo Park Jin-Wook Kim Sook-Hyang Jung Nayoung Kim Dong Ho Lee Jun Kyu Lee Soyeon Ahn 《Digestive diseases and sciences》2013,58(4):1091-1099
Background
Bacteremic cholangitis carries a high mortality rate of up to 10 % in relation to organ failure (OF), including septic shock.Aim
The purpose of this study was to elucidate predictive factors for OF in bacteremic cholangitis.Methods
A retrospective review of all patients diagnosed with acute cholangitis and proven bacteremia from 2003 to 2011 was performed. Comprehensive clinical and laboratory data of 211 patients were analyzed.Results
There were 42 cases (19.9 %) of OF and 5 deaths (2.4 %). In the multivariate logistic regression analysis, significant predictive factors for OF were successful biliary decompression, presence of extended-spectrum beta-lactamase organism (ESBL), higher total bilirubin, and higher blood urea nitrogen (BUN) level at admission with odds ratios (ORs) of 0.129, 6.793, 1.148, and 1.089, respectively. Subgroup analysis of 165 patients who underwent biliary decompression before an event (with OF: 20, without OF: 145) was performed to elucidate the risk factors for organ failure even after successful biliary drainage. Variables significantly associated with OF included ESBL and BUN (OR = 4.123 and 1.177, respectively). We developed a scoring system with regression coefficient of each significant variable. The organ failure score was calculated using the following equation: (1.4 × ESBL) + (0.2 × BUN). This scoring system for predicting OF was highly sensitive (85.0 %) and specific (83.4 %).Conclusions
Biliary decompression, ESBL, total bilirubin, and BUN are prognostic determinants in patients with bacteremic cholangitis. An organ failure scoring system may allow clinicians to identify groups with poor prognosis even after successful biliary decompression. 相似文献8.
Sang Eon Jang Dong-Won Ahn Sang Hyub Lee Ban Seok Lee Ji Bong Jeong Jin-Hyeok Hwang Ji Kon Ryu Yong-Tae Kim Kyoung Ho Lee Young Hoon Kim 《Digestive diseases and sciences》2013,58(8):2353-2360
Background
Small stone fragments after an endoscopic stone extraction for choledocholithiasis may act as the nidus for recurrent choledocholithiasis. Therefore, efforts to eliminate the nidus might reduce the recurrence of choledocholithiasis and cholangitis related to choledocholithiasis.Aims
The purpose of this study was to determine whether an additional preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones would decrease residual stones and the recurrence of cholangitis.Methods
A retrospective analysis was performed for the consecutively collected data about the patients who underwent the complete endoscopic treatment for common bile duct stone.Results
Among 99 patients, 45 patients underwent saline irrigation. Residual stones were detected in 18 patients (18.2 %). The incidences of residual stones were 8.9 % (4 of 45 patients) in the irrigation group and 25.9 % (14 of 54 patients) in the non-irrigation group (P = 0.037). In multivariate analysis, preventive saline irrigation was found to be the only significant factor for the decrease of residual stones (HR = 0.258, P = 0.039). When analyzing the occurrence of recurrent cholangitis and the procedure related to complications, there were no significant differences according to the performance of preventive saline irrigation of the bile duct.Conclusions
Preventive saline irrigation could reduce the residual common bile duct stones without complications. 相似文献9.
《Vaccine》2022,40(15):2258-2265
BackgroundInvasive pneumococcal disease (IPD) is associated with substantial morbidity and mortality in children and elderly populations. Serotype distribution and antibiotic susceptibility of IPD isolates are changing with the implementation of pneumococcal vaccination and increasing antibiotic use worldwide. We aimed to determine serotype distribution, antibiogram, and molecular epidemiology of pneumococci in the late stage of PCV13 era.MethodsProspective multicenter IPD surveillance study was conducted for adults aged ≥ 19 years from July 2019 to June 2021. Clinical and epidemiologic data were collected. In addition, antibiotic susceptibility test, serotype identification and multi-locus sequence typing (MLST) was taken for pneumococcal isolates.ResultsA total of 160 IPD cases were collected with mean age of 65.1 years (male, 72.5%). Serotyping was taken for 116 available pneumococcal isolates. PCV13 and PPSV23 serotypes were 32.8% (n = 38) and 56.0% (n = 65), respectively. Serotype 3 (13.8%) and 19A (9.5%) were the most common causative agents of IPD, followed by serogroup 11 (6.9%), 23A (6.9%), 10A (4.3%), and 15B (4.3%). Notably, 32.5% of invasive pneumococcal isolates were non-susceptible to ceftriaxone. Serotypes 11A, 11E and 19A pneumococci showed high ceftriaxone non-susceptible rate (80%, 100% and 81.8% respectively), and they were related to sequence type (ST) 166 and ST320. In comparison, most serotype 3 isolates were ceftriaxone susceptible and related to ST180.ConclusionsPCV serotypes, especially 3 and 19A, are still prevalent in adult IPDs, suggesting that individual PCV13 immunization would be necessary for the elderly people and chronically ill patients. Ceftriaxone non-susceptible rate was remarkably high in invasive pneumococcal isolates. 相似文献
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