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Acute Postoperative Herpes Zoster With a Sciatic Nerve Distribution After Total Joint Arthroplasty of the Ipsilateral Hip and Contralateral Knee

The differential diagnosis of a patient with acute onset of hip pain during the postoperative recovery period after total hip arthroplasty includes sciatic nerve injury, infection, incisional pain, hardware, or simply muscular issues related to overactivity. Moreover, because the rash of herpes zoster develops after 4 or 5 days of pain, it is difficult to diagnose herpes zoster during the early period. A number of reports have been issued on herpes zoster after surgery or trauma, but no report is available on herpes zoster development with a sciatic nerve distribution after ipsilateral total hip arthroplasty. The authors report the case of 75-year-old woman with herpes zoster with a sciatic nerve distribution after 2 primary total joint arthroplasties of a hip and knee.     

Cementless Acetabular Socket Revisions Using Metasul Metal-on-Metal Bearings

Thirty-four hips were treated with cementless acetabular socket revisions using a metal-on-metal bearing. The causes of revision were aseptic loosening in 33 hips and septic loosening in 1 hip. Revisions were performed for acetabular sockets in 28 hips and for acetabular sockets and femoral stems in 6 hips. Mean follow-up duration was 6.2 years (range, 4.0-9.1 years), and mean Harris Hip Scores improved from 56 to 92 points. No hip required further revision for aseptic loosening. Focal femoral osteolysis newly developed in zone I in 1 hip, which was treated by curettage and bone grafting. The authors suggest that second-generation metal-on-metal bearings in cementless acetabular socket revisions can achieve good medium-term clinical and radiographic results.     

Outcome of the functional treatment of first-time ankle inversion injury

Background  

Avulsion fractures of the lateral malleoli in ankle inversion injuries are often undetected on routine radiographs. Undetected avulsion fractures have been managed as ankle sprain, which may affect the outcome of the treatment of the ankle sprain. The purposes of this study are to compare the outcomes of functional treatment between the first-time severe ligament injury and avulsion fracture of the lateral ankle, and to investigate how the anterior talofibular ligament (ATFL) view or the calcaneofibular ligament (CFL) view affects the diagnosis of the avulsion fracture and outcome of functional treatment of the ankle inversion injury.     

The ameliorative effect of 23-hydroxytormentic acid isolated from Rubus coreanus on cisplatin-induced nephrotoxicity in rats

Previously, the authors demonstrated that the triterpenoid glycoside niga-ichigoside F? (NIF?) and its aglycone 23-hydroxytormentic acid (23-HTA) isolated from the unripe fruits of Rubus coreanus (Rosaceae) ameliorate cisplatin-induced toxicity in renal epithelial LLC-PK? cells. In the present study, the nephroprotective effects of NIF? and 23-HTA were investigated in Sprague-Dawley rats with acute renal injury induced by a single intraperitoneal (i.p.) injection of cisplatin (7 mg/kg). Pretreatment with 23-HTA (10 mg/kg/d, per os (p.o.)) significantly reduced cisplatin-induced elevations in blood urea nitrogen (BUN) and serum creatinine level, whereas NIF? (10 mg/kg, p.o.) slightly reduced these levels. In addition, pretreatment with 23-HTA prevented cisplatin-induced hydroxyl radical generation, malondialdehyde (MDA) production, glutathione (GSH) depletion, and cisplatin-induced changes in the activities of oxidant and antioxidant enzymes in rat renal tissues. In addition, histopathological examinations showed that 23-HTA pretreatment reduced cisplatin-induced acute tubular necrosis and histological changes. In contrast, NIF? was found to have a slight or no influence on cisplatin-induced oxidative enzymes and acute tubular necrosis. Taken together, these results suggest that protective effect of 23-HTA pretreatment on cisplatin-induced renal damage is associated with the attenuation of oxidative stress and the preservation of antioxidant enzymes.     

The Measurement of the β/α Anomer Composition Within Amorphous Lactose Prepared by Spray and Freeze Drying Using a Simple 1H-NMR Method

Purpose  

Reports of the anomeric composition of amorphous lactose are rare and state a highly variable range of composition (between 0% and 60% w/w β content). We aimed to develop a quantitative measurement by ¹H-NMR of α and β anomer content in amorphous lactose produced by different production methods.     

Hepatitis A virus genotype and its correlation with the clinical outcome of acute hepatitis A in Korea: 2006-2008

Korea has recently experienced a nationwide outbreak of hepatitis A. This study aimed to investigate hepatitis A virus (HAV) genotypes and to compare clinical features between patients infected with HAV genotype IA and those with genotype IIIA. From September 2006 to August 2008, 595 patients with symptomatic hepatitis A were enrolled prospectively in four hospitals in Korea. Among them, 556 patients participated in this study by providing serum or stool samples for genotypic analysis. HAV RNA was detected in 499 patients (89.7%). Major genotypes included IA (n = 244, 48.9%) and IIIA (n = 244, 48.9%), and the remaining genotype was IB (n = 11, 2.2%). From September 2006 to August 2007, the distribution of genotypes IA and IIIA were 64.6% and 35.6%, respectively, which changed to 42.3% and 54.6%, respectively, from September 2007 to August 2008, indicating change of circulating HAV genotypes in the study period from IA to IIIA. Major patterns of amino acid substitution in the VP3/VP1 junction region were observed at position 512 (P → L) in genotype IA and at 520 (R → K) in genotype IIIA. Patients with genotype IIIA infection showed significantly higher aminotransferase levels, prothrombin time, and leukocyte count, with more severe symptoms than those with genotype IA at the time of admission. These results suggest the occurrence of a change of circulating HAV genotypes in recent community‐wide outbreaks of hepatitis A in Korea, and genotype IIIA infection, compared with genotype IA infection, might show more severe clinical manifestations. J. Med. Virol. 83:2073–2081, 2011. © 2011 Wiley Periodicals, Inc.     

Clinical results of multiple fibrous band release for the external snapping hip

Background  External snapping hip is caused by snapping of the thickened iliotibial band or the gluteus maximus over the greater trochanter. We retrospectively reviewed results of the release of multiple fibrous bands of the iliotibial band or gluteus maximus for treatment of external snapping hip in 44 patients. Methods  We wanted to evaluate the functional results of this technique in terms of resolution of symptoms, patient satisfaction, and complications. A snapping hip questionnaire was designed for the evaluation, and the results were evaluated at an average 62 months after surgery. Results  All the patients had resolution of their symptoms after surgery and were satisfied with the treatment. Recurrence of snapping was reported in five patients, but they did not find it severe enough to require a second surgery. Ten patients reported some limp or weakness, and four patients had seroma formation, requiring reinsertion of a drainage tube. Conclusions  We recommend release of multiple fibrous bands of the iliotibial band and gluteus maximus muscle for treatment of external snapping hip, as it has a low rate of recurrence and a high rate of patient satisfaction.     

New two-incision minimally invasive total hip arthroplasty: comparison with the one-incision method

Background  There has been increasing interest in performing total hip arthroplasty (THA) with minimally invasive surgery (MIS). This study was conducted to examine the effectiveness of MIS-THA using the new two-incision technique versus the one-incision technique. Methods  A consecutive series of 113 patients who underwent MIS-THAs (63 one-incision cases, 50 two-incision cases) were studied. One-incision THA was performed with a posterolateral approach. For the two-incision, the first incision for cup insertion was made over the anterolateral side of the hip. Intermuscular dissection was performed between the gluteus medius and the tensor fascia lata. The second incision, for stem insertion, was made on the posterolateral side of the hip along the fiber of the gluteus maximus. Intermuscular dissection was made between the gluteus medius and the piriformis. Results  Postoperative rehabilitation was significantly more rapid in the new two-incision group compared to the group with one incision. Postoperatively, the Harris Hip Score and the Western Ontario and the McMaster Universities Osteoarthritis Index score were significantly different between the two groups, especially the functional sections. Conclusions  The findings of this study show that our new two-incision MIS-THA is an excellent surgical modality that allows early rehabilitation.