A Missed Diagnosis of Intraprosthetic Dislocation in a Dual-Mobility Bearing Following Closed Reduction.

Dual-mobility bearings have been found to reduce the rate of dislocation following both primary and revision total hip arthroplasty. Their unique design involves two articulating surfaces which increases construct stability but also leaves them susceptible to a unique complication known as intraprosthetic dislocation (IPD). We report the case of a 33-year-old female who sustained an IPD following closed reduction.

Tiger Attack Resulting in a Humeral Defect Treated with Proximal Humeral Replacement and Latissimus Dorsi Flap: A Case Report.

Case: A 69-year-old woman presented with a type IIIB left proximal humerus fracture with a 500-square-centimeter soft tissue defect, 10-cm bone defect, and radial nerve laceration after a tiger attack. The surgical intervention included proximal humeral replacement with muscular integration, radial nerve repair, and latissimus dorsi flap coverage.

Conclusion: This case presents an exceedingly rare injury mechanism resulting in a significant soft tissue and bone defect.

Exercise echocardiographic detection of coronary artery disease in women.

The utility of exercise echocardiography for the diagnosis of coronary artery disease has been demonstrated in populations consisting largely of men with a high prevalence of disease. To determine the diagnostic value of exercise echocardiography in women, 57 women who presented with chest pain were studied with coronary cineangiography and echocardiography combined with either treadmill (n = 38) or bicycle exercise (n = 19). Significant coronary artery disease (greater than or equal to 50% reduction in luminal diameter) was present in 28 (49%) of 57 patients, including 16 (84%) of 19 who had typical angina, and 12 (32%) of 38 who had atypical chest pain.

Upright bicycle exercise echocardiography after coronary artery bypass grafting.

Upright bicycle exercise echocardiography and coronary angiography were performed in 42 patients from 1 month to 15 years (mean 6.3 years) after coronary artery bypass grafting (CABG) to determine if exercise-induced wall motion abnormalities could be correlated with the presence and location of nonrevascularized vessels. Nonrevascularized vessels were defined as obstructed vessels without grafts, obstructed grafts or native vessels obstructed distal to bypass graft insertion.

Palatal insufficiency: a surgical technique for reconstruction.

Nasal regurgitation and hypernasality are the major complications after extirpation of the soft palate, retromolar trigone, and tonsillar areas. The surgical procedure described herein provides satisfactory correction of the defect. The combined approach of advancement-rotation palatoplasty and an advanced lateral pharyngeal wall flap appears to be an alternative solution to the use of an obturator or inferiorly based pharyngeal flap.

Immediate effects of heavy exercise on the circulating thyroid hormones.

Sera from 20 patients with suspected or known coronary artery disease were measured for thyroxine (T4), tri-iodothyronine (T3), tri-iodothyronine uptake ratio (T3UR), thyroid stimulating hormone (TSH), and reverse tri-iodothyronine (rT3), before and after maximal or near-maximal exercise. On the average the patients achieved 92% (rang 68-108) of the predicted maximum heart rate. There were no statistically significant differences between the pre- and the post-exercise serum levels of thyroid hormones.

Associated lung lesions in patients with primary head and neck carcinoma.

From a 9-year Veterans Administration Medical Center experience, 34 patients were identified who had synchronous or metachronous pulmonary lesions in association with primary head-neck carcinoma. Evaluation of the pulmonary lesions included bronchoscopy, mediastinoscopy, and thoracotomy. Lung lesions were felt to be metastatic lesions from head and neck primary in 12 patients, primary lung carcinoma in 20 patients, and metastases from subdiaphragmatic primary neoplasms in two patients.

Ball variance in a Harken mitral prosthesis. Echocardiographic and phonocardiographic features.

A case of ball variance in a caged-ball prosthetic valve is presented, illustrating the echocardiographic and phonocardiographic features. The swollen silicone ball was observed on echocardiographic studies to have diminished motion and to incompletely open within its cage. On phonocardiographic studies, the Q-S1 interval was prolonged, and no opening sound could be recorded.

The effects of minoxidil on pulmonary and systemic hemodynamics in hypertensive man.

Pulmonary hypertension has been described as a possible complication of the antihypertensive vasodilator, minoxidil. A prospective study was undertaken in seven severely hypertensive patients refractory to multiple drug therapy. Treatment was initiated with fixed doses of hydrochlorothiazide (100 mg/day) and propranolol (160 mg/day) for a control period.