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1.
Background
Despite significant pain relief following total hip arthroplasty (THA) in patients with ankylosing spondylitis, a small subset of patients presenting with extra-articular extension contracture of hips remains unsatisfied.Methods
We retrospectively evaluated the patients with ankylosing spondylitis who underwent simultaneous bilateral THA and had extensor tightness of both hips preoperatively. They were managed with modified Z-plasty of iliotibial band. Patients with windswept deformity, commonly seen in bilateral hip arthritis caused by ankylosing spondylitis, were excluded.Results
Between July 2011 and June 2015, out of 148 patients with bilateral hip involvement, 10 patients (20 hips) had extension contracture of both hips that was addressed during surgery. All patients were followed up for a minimum of 2 years. They could sit comfortably on a chair of height 18 inches with hips and knees flexed to at least 90°. The mean postoperative sum range of motion was 144.6° with an average hip flexion of 95° (range, 90°-105°). None of them had recurrence of extension contracture. There was significant improvement in range of motion and hence ambulation and function. No radiolucent lines exceeding 2 mm were seen in any of the zones around either of the components as evaluated in latest X-rays.Conclusion
Extension contracture of hip although rare is a noticeable problem and needs to be addressed during THA. Modified Z-plasty technique of iliotibial band is a reliable method in managing these patients. 相似文献2.
Rajesh Verma Puneet Kumar Dixit Rakesh Lalla Babita Singh 《Annals of Indian Academy of Neurology》2015,18(2):246-248
Mirror movements are simultaneous, involuntary, identical movements occurring during contralateral voluntary movements. These movements are considered as soft neurologic signs seen uncommonly in clinical practice. The mirror movements are described in various neurological disorders which include parkinsonism, cranio veretebral junction anamolies, and hemiplegic cerebral palsy. These movements are intriguing and can pose significant disability. However, no such observation regarding mirror movements in progressive hemifacial atrophy have been reported previously. We are reporting a teenage girl suffering from progressive hemifacial atrophy and epilepsy with demonstrable mirror movements in hand. 相似文献
3.
Rajesh Bhat Alison Severn Sam Chakraverty 《Nephrology, dialysis, transplantation》2006,21(9):2642-2643
Placement of tunnelled dialysis lines is effective using ultrasoundand fluoroscopic guidance [1] and has a higher success ratethan blind insertion [2]. After the ultrasound guided access into a neck vein, wires andcatheters are guided in to a suitable position in the 相似文献
4.
Ajay Punpale C S Pramesh Nirmala Jambhekar Rajesh C Mistry 《Annals of thoracic and cardiovascular surgery》2006,12(6):425-427
Liposarcomas are extremely rare in the mediastinum. They may achieve considerable size before causing any symptoms. Mediastinal liposarcomas may invade surrounding structures like the pericardium or the superior vena cava. Complete surgical excision is the optimal treatment in resectable cases. Excision of adjacent structures like the pericardium may be needed if the tumor infiltrates them. We report on a case of a giant liposarcoma of the mediastinum involving both hemithoraces and extending into the neck, which was successfully managed by complete surgical excision. 相似文献
5.
Joe Jacob Shibhu George B. R. Suchit Roy P. U. Rajesh 《Indian journal of otolaryngology and head and neck surgery》2006,58(1):76-77
Malignancy larynx usually presents early, the common symptoms being hoarseness, pain thorat, cough and irritation of throat. An advanced malignancy is likely to be complicated by a pharyngo-cutaneous fistula. However it is an occurrence towards the end stage of the disease. Here we present a case of malignancy larynx primarily presenting as pharyngo-cutaneous fistula without any other symptoms. 相似文献
6.
7.
Uday Eknathrao Jadhav M.Ch. Raghavendra Chikkatur M.Ch. Rajesh Parida M.Ch. Susheel Kumar M.Ch. Vinod Ahuja M.Ch. Ashish Agrawal MS Anil Tendolkai M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):116-120
Introduction Coronary artery bypass grafting (CABG) associated with Endarterectomy is a high risk procedure. After the first report of
coronary endarterectomy by Bailey et al in 1951, the preference for this surgical procedure was decreased due to increased
morbidity and mortality In patients with total or subtotal large coronary artery obstructions in which there is no possibility
to receive a conduit as graft for myocardial revascularisation, endarterectomy remains the procedure of choice. This study
was designed to study early and midterm results of off pump coronary artery endarterectomy.
Methods Of 172 Consecutive Off Pump CABG done at our institution from Jan 2003 to July 2005, 22 patients underwent supplementary coronary
endarterectomy. 16 patients had chronic stable angina 4 had unstable angina two required emergency CABG with endarterectomy
following perioperative infarction. The mean ejection fraction was 29.2±4.3 and all of the patients were in New York Heart
Association (NYHA) III or IV. All patients were planned for complete total arterial revascularisation using Left Internal
Mammary Artery (LIMA). Right Internal Mammary Artery (RIMA), Radial composite “Y” graft, Two patients operated for periop
infarct received vein graft. In 16 patients closed endarterectomy was done in five patients double endarterectomy in single
vessel was done to chase the plaque distally, in one patient open left anterior descending (LAD) endarterectomy with vein
patch reconstruction was performed.
Results There were no deaths. None of the procedures were converted to on pump operation. All endarterectomies and bypasses were performed
on Beating Heart, all patients were completely revascularised. Peri operative cardiac enzymes studied showed no significant
rise in the Creatinine Phoshpokinase (CPK)-Creatinine Phosphokinase myocardial Band (CPK-MB). The mean postoperative Ejection
Fraction (EF) was 36.7%±7.2% which was significantly higher than the Preoperative one (p<.05). At the end of four months to
one and half year 22 patients were in NYHA class I to II and all were angina free in canadian cardiovascular society class.f
Conclusions Coronary End Arterectomy without cardiopulmonary bypass can be performed in patients who are expected to benefit from complete
revascularisation. It can be performed with closed as well as open method. However to achieve complete endarterectomy by closed
technique in some patients it is essential to chase the plaque. Early and mid term results are encouraging. 相似文献
8.
Rajesh Venkataraman Karthik R. Vaidyanathan Madhu N. Sankar Kotturathu M. Cherian 《Journal of cardiac surgery》2009,24(4):443-445
Abstract Dissection of the pulmonary autograft is an extremely rare complication requiring emergent treatment as there is a chance of rupture and proximal aortic involvement. The autograft dissection can involve the aortic annulus, causing separation of leaflets from the annulus in addition to causing annular dilatation, thereby precluding resuspension of leaflets. The usual treatment in such cases is to perform the Bentall procedure, which involves placing a valved conduit (usually mechanical valve) and thereby necessitating anticoagulation. This report describes a case of successful valve-sparing aortic root replacement following the Ross procedure with dissection of autograft. 相似文献
9.
10.
Alan J Thomas Sue Davis I Nicol Ferrier Rajesh N Kalaria John T O'Brien 《Neuropsychopharmacology》2004,55(6):652-655
BACKGROUND: Neuroimaging reports of increases in signal hyperintensities in white and deep gray matter and other work indicate that there might be an inflammatory response in affective disorders. METHODS: The microvascular immunoreactivity of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 was measured with image analysis in postmortem tissue from the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) from 15 unipolar and 15 bipolar subjects and compared with each other and with 15 subjects with schizophrenia and 15 control subjects. RESULTS: Intercellular adhesion molecule-1 immunoreactivity in gray and white matter of the ACC in bipolar subjects was increased compared with control subjects (gray: p =.001; white: p <.001) and schizophrenic subjects (gray: p =.016; white: p =.025) and modestly increased in white matter compared with unipolar subjects (p =.049). No such differences were found in the DLPFC. CONCLUSIONS: These findings are consistent with the presence of an inflammatory response in the ACC in bipolar disorder. 相似文献