Dislocation after Hemiarthroplasty due to Insufficiency Fracture of the Superior Acetabulum: A Case Report

Insufficiency fracture of the superior part of the acetabulum after hemiarthroplasty has not been reported before. Here we report a case of dislocation after hemiarthroplaty due to insufficiency fracture of the acetabulum. In our patient, insufficiency fracture of the ilium immediately above the acetabulum produced obvious evidence of compression and collapse that led to dislocation of the outer head of the femoral component. This patient had subsequently been treated with a cementless socket inserted into the fractured acetabulum. We should remember the possibility of insufficiency fracture of the superior acetabulum after hemiarthroplasty, particularly in elderly patients suffering from chronic postoperative pain and disability

HIGH DENSITY LIPOPROTEIN AND DIABETES MELLITUS

The serum HDL2-C, HDL3-C, apo AI and apo AII levels were measured in the non-insulin­dependent diabetic subjects (NIDD) and normal subjects to study the metabolism of HDL in the diabetics. The serum HDL2-C levels in the insulin-treated group were significantly higher than those in the normal group in which the total cholesterol (TC), triglyceride (TG), obesity index and age were matched whereas there was no difference between the serum HDL2-C levels in the oral agent-treated group or group treated by diet only and those in the normal group. These suggest that insulin increases the HDL2-C levels and the increase of the HDL2-C levels is not directly related to changes in the serum TC and TG levels, obesity index and age. No significant differences in the serum apo AI and apo AII levels were found between the insulin group and normal group. From these results it is suggested that in the insulin group the cholesterol/apoprotein ratio in the HDL2 is higher than that in the normal group. The serum apo AI and apo AII levels were significantly lower in the diabetics with an ischemic heart disease (IHD) than those in the diabetics without the IHD. The results show that in the diabetics the apo AI and apo AII play an important role in preventing the development of IHD

STUDY ON CHOLESTERYL ESTER TRANSFER ACTIVITY IN CORONARY HEART DISEASE

The net cholesterol transfer activity from high density lipoprotein (HDL) to low density lipoprotein (LDL) was determined in the patients with coronary heart disease (CHD) to examine its effect on the pathogenesis of arteriosclerosis. Furthermore, in the CHD patients with high HDL cholesterolemia (more than 60 mg/dl), the HDL particle size was measured by high performance liquid chromatography. A significant cholesteryl ester transfer activity (P<0.02) was noted in the CHD patients with low HDL cholesterolemia (less than 60 mg/di). The rate of cholesteryl ester transfer activity (cholesteryl ester transfer activity/hour) inversely correlated with the serum HDL cholesterol value (r=-0.483, P=0.096) in the patients with CHD. These results suggest that an increase of CETA caused a low HDL cholesterol value in the CHD patients with low HDL cholesterolemia and it may have the risk of causing CHD. However, an increase of the CETA was not found in the CHD patients with high HDL cholesterolemia compared to the normal subjects, the HDL particle size beings significantly greater than that in the normal subjects. In the CHD patients with high HDL cholesterolemia, the large size of HDL may have the risk of causing CHD

DEGRADATION AND METABOLISM OF INDOCYANIN E GREEN: HIGH-PRESSURE LIQUID CHROMATOGRAPHIC ANALYSIS

Degradation of indocyanine green solution by exposure to light was studied by high pressure liquid chromatography.Indocyanine green in an aqueous medium exposed to light changed rapidly into an unknown product. The plasma clearance rate and the biliary excretion rate of the unknown product were much slower than those of indocyanine green.Spectrophotometric scan revealed that the unknown product had almost the same absorption spectrum as indocyanine green. Therefore, if degraded indocyanine green solution were to be used in a liver function test, the clearance of indocyanine green assayed by spectrophotometry would apparently be much lower than that of undegraded indocyanine green.According to fast atom bombardment mass spectrometry, the molecular weight of the unknown product was 723, whereas that of indocyanine green was 775.The analysis of rat bile after injection of indocyanine green by high-pressure liquid chromatog1aphy revealed that about 1% of the administered indocyanine green was metabolized in the rat liver

SERUM LEVELS OF LIPIDS AND APOLIPOPROTEINS IN ANGIOGRAPHYCALLY DEFINED ISCHEMIC HEART DISEASE

To determine the predictive risk factors of the severity of the coronary artery disease, the serum levels of lipoprotein cholesterol and apolipoprotein were measured in 103 patients undergoing coronary angiography examination for suspected myocardial ischemia. The extent and severity of the coronary artery disease (CAD) were assessed by assigning scores to each lesion. Twenty-six female patients (59±8 yrs.) showed a stronger relationship of apo B and apo A-1/B to the coronary scores than the 77 male patients (57±8 yrs.). The male patients were divided into four groups based on the coronary scroes: H-CAD (range: over 11points), M-CAD (5-10 points), L-CAD (1-4 points) and N-CAD (0 point). The atherogenic risk factors other than the abnormalities in lipid metabolism (obesity index, fasting plasma glucose, smoking and blood pressure) were well matched in the four groups. T.C., LDL-C., HDL-C., HDL2-C., apo B, apo A-1/B ratio and apo A-II/B ratio significantly differed in the H-CAD and N-CAD groups. These results indicate that T.C., LDL C., HDL-C., HDL2 C., apo B, apo A-1/B ratio and apo A-Il/B ratio are predictive risk factors of the coronary heart disease. Furthermore, apo B and apo A l/B ratio significantly differed in the H-CAD and L-CAD groups. These results suggest that apo B and apo A-1/B ratio may be good discriminators of the severity of the coronary heart disease