The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and "O"ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994. Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and "O"ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.
Adenoma ; Biopsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Laser Therapy ; Ligation ; Male ; Polyps ; Recurrence ; SNARE Proteins ; Stomach Neoplasms ; Upper Gastrointestinal Tract*

Purpose: This study evaluated the clinical results and implant safety of a newly developed implant, Trochanteric Fixation Nail-Advanced (TFNA; DePuy Synthes), in the treatment of proximal femur fractures. Materials and Methods: This was a retrospective cohort study of 26 patients diagnosed with proximal femur fracture and treated surgically with TFNA. The patients’ demographic data, surgical data, radiologic findings, and functional outcomes, including complications, were evaluated. Results: The mean age of the patients was 71.2 years (95% confidence interval [CI], 68.2-74.2); 65.4% were female. The mean Carlson comorbidity index score was 5.4, and the mean Koval grade before fracture was 2.1. Fracture classification included four cases of AO/OTA 31.A1, nine cases of A2, six cases of A3, and seven cases of 32A including six cases of atypical femoral fractures. The mean operating time was 53.3 minutes (95% CI, 43.6-63.1). There were no early postoperative complications, such as postoperative infection, deep vein thrombosis, pulmonary embolism, or in-hospital death, except one case of pneumonia. The mean Koval score at the postoperative six-month follow-up was 2.9. EuroQol-5 Dimension (EQ-5D) increased from 0.05 to 0.54 after three months and 0.72 at six months postoperatively. Bone union was observed in all cases with a mean union time of 12.9 weeks. No implant failure occurred, and no cases required secondary revision surgery. Conclusion A new intramedullary nail system, TFNA, showed excellent outcomes and safety in the surgical treatment of proximal femur fractures.

We presented several cases of the exophthalmos due to the orbital tumors, with the review of the literatures. We performed modified Kronlein operation and anterior orbitotomy, appropriately for each cases to improve the visual acuity and at least to correct cosmetically the proptosed eye. It will be better to do one's best in order to search a possible way to save the eye ball by which the ophthalmologist can remove the orbital tumor even if the patient lost his vision.
Exophthalmos* ; Humans ; Orbit ; Visual Acuity

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. Objective: To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. Methods: We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. Results: A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). Conclusion Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. Objective: To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. Methods: We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. Results: A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). Conclusion Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

Background: Hereditary multiple exostoses (HME) is an autosomal dominant disorder. The lesion in the proximal femoral metaphysis can bring about hip dysplasia and subsequent degenerative arthritis. Due to its rare prevalence, there have been a few case reports of total hip arthroplasty (THA) for osteoarthritis secondary to HME. The aim of this study was to report mid- to long-term outcomes of THA in HME patients and discuss special considerations that should be taken into account during surgery. Methods: We retrospectively evaluated the clinical and radiological results of THA for osteoarthritis secondary to HME in 11 hips of 9 patients after a minimum follow-up of 5 years (mean, 9.9 years). There were 3 men (3 hips) and 6 women (8 hips), with a mean age of 53.6 years (range, 46.8–58 years) at the index surgery in this study. Harris hip score (HHS) was used for clinical outcome assessment, and radiologically, implant stability, radiolucent lines, liner wear, and any sign of osteolysis or implant loosening were evaluated. Postoperative complications including infection, deep vein thrombosis, and dislocations were also investigated. Results: Cemented stems and cementless cups with the conventional polyethylene liner were used in bilateral hips of a single patient. In the other cases, cementless implants were used with ceramic-on-ceramic bearings. The mean HHS improved from 34.8 preoperatively to 92.5 postoperatively. Polyethylene liner wear and osteolysis were observed in 1 patient with cemented stems. Radiolucent lines were observed in 2 different cases. However, the femoral stems remained stable. There were no surgery-related complications except heterotopic ossification during follow-up. Conclusions Despite the several surgical considerations, the mid- to long-term clinical and radiological outcomes of THA in HME patients were satisfactory. The abnormal, wide mediolateral diameter of the proximal metaphysis should be considered in selecting and inserting the stem with adequate anteversion. Leg length discrepancy was also common, so teleradiographs should be obtained before surgery. Intraoperative leg length evaluation might be difficult due to the morphologic changes in the proximal femur after mass excision and individual bone length differences.

BACKGROUND: Intravenous lidocaine has been reported previously to inhibit neuropathic pain. But it`s analgesic effect in postoperative pain has provided controversial results. The object of this study was to define the analgesic effect of intravenous lidocaine in addition to morphine on postoperative pain control. METHOD: Female patients scheduled for total abdominal hysterectomy were randomly assigned to one of two groups to be studied in a double-blind manner. Group M (n=20) and Group M+L (n=18) received intravenous morphine (0.1 mg/kg) or intravenous morphine (0.1 mg/kg) + lidocaine (30 mg), respectively, after closure of the peritoneum. Continuous infusion of morphine (1.5 mg/hr) or morphine (1.5 mg/hr) + lidocaine (60 mg/hr) was started immediately after i.v. bolus injection, respectively, until the end of the operation. Postoperative pain was managed with a PCA pump (Walkmed, Medex, USA), setting the basal rate of morphine (0.5 mg/hr) + bolus dose (1.5 mg) and lock out time of 10 min in group M, adding the lidocaine (basal rate: 20 mg/hr and bolus dose: 60 mg) to the same dose of morphine as group M in group M+L. Postoperative visual analogue pain scores (VAS), analgesic requirements and side effects were examined for 2 days postoperatively and compared between groups. RESULTS: VAS at movement were significantly less (p< 0.05) in group M+L than in group M of 2, 12, 24, 36 and 48 hrs after surgery. Patient-controlled morphine cumulative consumption in group M+L was significantly less (p< 0.05) than in group M for 24 hours (26.3 mg vs 35.3 mg) after the operation (p<0.01). CONCLUSIONS: Intravenous lidocaine reduces postoperative pain at movement and analgesic requirements. These results suggest that low-dose adminstration of i.v. lidocaine attenuates the postoperative hyperalgesic state.
Analgesia ; Analgesics ; Anesthetics ; Female ; Humans ; Hysterectomy ; Lidocaine* ; Morphine* ; Neuralgia ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Peritoneum

MicroRNA polymorphisms may be associated with carcinogenesis or immunopathogenesis of infection. We evaluated whether the mircoRNA-604 (miR-604) polymorphism can affect the persistence of hepatitis B virus (HBV) infection, and the development to hepatocellular carcinoma (HCC) in patients with chronic HBV infection. A total of 1,439 subjects, who have either past or present HBV infection, were enrolled and divided into four groups (spontaneous recovery, chronic HBV carrier without cirrhosis, liver cirrhosis and HCC). We genotyped the precursor miR-604 genome region polymorphism. The CC genotype of miR-604 rs2368392 was most frequently observed and T allele frequency was 0.326 in all study subjects. The HBV persistence after infection was higher in those subjects with miR-604 T allele (P=0.05 in a co-dominant and dominant model), which implied that the patients with miR-604 T allele may have a higher risk for HBV chronicity. In contrast, there was a higher rate of the miR-604 T allele in the chronic carrier without HCC patients, compared to those of the HCC patients (P=0.03 in a co-dominant model, P=0.02 in a recessive model). The T allele at miR-604 rs2368392 may be a risk allele for the chronicity of HBV infection, but may be a protective allele for the progression to HCC in chronic HBV carriers.
Adult ; Aged ; Aged, 80 and over ; Base Sequence ; Carcinoma, Hepatocellular/etiology/*genetics/pathology ; Case-Control Studies ; Demography ; Female ; Gene Frequency ; *Genetic Predisposition to Disease ; Genotype ; Hepatitis B Antibodies/blood ; Hepatitis B Surface Antigens/blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/metabolism ; Hepatitis B, Chronic/complications/*genetics/virology ; Humans ; Liver Neoplasms/etiology/*genetics/pathology ; Male ; MicroRNAs/*genetics/metabolism ; Middle Aged ; Polymorphism, Single Nucleotide ; Risk Factors

The ovarian dermoid cyst is the most common ovarian neoplasm in young women and comprises approximately 10-20% of all ovarian tumors. But malignant transformation is an uncommon complication in an ovarian dermoid cyst, usually being reported in about 1.0-1.8% of cases. Most common malignant transformation of ovarian dermoid cyst is squamous cell carcinoma, which represents about 75-80% followed by adenocarcinoma in 6-7%. We report a case of adenocarcinoma arising from ovarian dermoid cyst with a brief review of literatures.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Dermoid Cyst* ; Female ; Humans ; Ovarian Neoplasms ; Ovary*