PURPOSE: To identify the structural integrity of the healing site after medial open wedge high tibial osteotomy (MOWHTO) in patients with a posterior root tear of the medial meniscus (PRTMM) and chondral lesion by second-look arthroscopy and to determine the clinical and radiological findings. MATERIALS AND METHODS: From August 2010 to June 2016, 52 consecutive patients underwent MOWHTO and arthroscopic examination without a chondral resurfacing procedure and meniscal treatment for PRTMM. Twenty-four patients were available for second-look arthroscopic evaluation. The mean follow-up period was 19.5 months (range, 5 to 46 months). Clinical evaluation was based on the Lysholm knee scores and Hospital for Special Surgery (HSS) scores. RESULTS: There were 5 lax healing, 6 scar tissue, 13 failed healing of PRTMM. Definite change of chondral lesion was not observed. The Kellgren-Lawrence grade did not improve according to the follow-up plain radiograph. The mean Lysholm score improved from 34.7 preoperatively to 77.1 at the last follow-up, and the mean HSS score significantly increased from 36.5 to 82.4. CONCLUSIONS: This study revealed a low rate of healing potency of PRTMM and chondral lesion after MOWHTO without any attempt for meniscal treatment or chondral resurfacing. The cartilage and healing status of PRTMM was not associated with improved clinical outcomes and radiological findings.
Arthroscopy ; Cartilage ; Cicatrix ; Follow-Up Studies ; Humans ; Knee ; Menisci, Tibial ; Osteoarthritis ; Osteotomy ; Tears

BACKGROUND: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. MATERIALS AND METHODS: One hundred and thirteen patients (male:female=35:78, mean age=66.7+/-9.9 years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. RESULTS: Sixty-five patients (47.5%) received the RBC transfusion (mean 2.2+/-3.2 units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (>75 minutes) and total operation time (>5.5 hours, p<0.05). CONCLUSION: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.
Aspirin ; Blood Transfusion ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Erythrocyte Transfusion ; Erythrocytes ; Hematocrit ; Hospitalization ; Humans ; Intensive Care Units ; Mammary Arteries ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Ticlopidine ; Transplants ; Ventilators, Mechanical

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma which responds well to conventional chemotherapy. However, quite a few patients have a recurrence with more aggressive forms after completion of therapy. Multidrug resistance proteins (MRP) are related to this process in several ways such as cell cycle alteration and modulation of apoptosis. METHODS: We investigated the expression of P-glycoprotein (Gp), one of the well-known MRP, as well as apoptosis associated proteins in DLBCL. Immunohistochemical staining for Gp, p53, Bcl-2, Ki-67, active caspase 3 and FADD was done in forty DLBCL cases. The association between MRP and apoptosis associated proteins to clinical findings was also tested. RESULTS: Twenty-nine patients out of 40 (73%) with DLBCL were positive for Gp, and 26 cases (65%) had a strong positive for Gp. Gp expression was stronger in high-grade lesions than in low-grade lesions and was associated to Bcl-2 expression. However, we could not find an adverse impact of Gp expression on patients' overall survival or relapse free survival rate. CONCLUSIONS: Our study revealed a high frequency of expression for Gp in DLBCL with a possible relationship between the expressions of Gp to apoptosis associated proteins.
Apoptosis ; B-Lymphocytes ; Caspase 3 ; Cell Cycle ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; P-Glycoprotein ; P-Glycoproteins ; Proteins ; Recurrence ; Survival Rate

BACKGROUND: The association of simian virus 40 (SV40) with certain types of human cancers, including malignant lymphomas, has been a topic of interest for some time. Although the virus is distributed worldwide, its incidences vary according to the specific types of tumors, and the epidemiological areas. The aim of this study was to investigate the frequency of SV40 in malignant lymphomas among Korean patients. METHODS: One hundred seventy three cases of malignant lymphomas were evaluated by immunohistochemical staining for SV40 large T antigen (TAg), using an extremely sensitive, tyramide based, catalyzed signal amplification method. RESULTS: From 158 non-Hodgkin's lymphomas, including 115 diffuse large B-cell lymphomas, and 15 Hodgkin's lymphomas, none of the cases were positive for SV40 TAg. CONCLUSIONS: SV40 does not appear to be related to the pathogenesis of malignant lymphomas among Koreans.
Antigens, Polyomavirus Transforming ; Antigens, Viral, Tumor ; Hodgkin Disease ; Humans ; Incidence ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Simian virus 40 ; Viruses

Since the risk of developing allergic disease increases in individuals exposed to allergens previously, even during the neonatal period, the immunologic status of a fetus may be important in the subsequent development of allergy. We evaluated the fetal factors to predict atopic dermatitis (AD) at 12 months in 412 infants of a COhort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in the general Korean population. Cord blood mononuclear cells (CBMCs) were stimulated with ovalbumin and phytohemagglutinin and cellular proliferative response and concentrations of interleukin-13 and interferon-gamma, were measured. The risk of developing AD was greater in boys than girls (OR 1.97, 95% CI 1.26-3.09), infants delivered by cesarean section than vaginally (OR 1.93, 95% CI 1.14-3.26) and infants with than without parental history of AD (OR 2.34, 95% CI 1.29-4.24). The CBMC proliferative response to phytohemagglutinin stimulation was higher in infants with than without AD (P = 0.048), but no difference was observed in ovalbumin-stimulated cells (P = 0.771). Risk factors for the development of AD at 12 months include male gender, delivery by cesarean section and parental history of AD. Increased CBMC proliferative response to phytohemagglutinin stimulation may predict the development of AD at 12 months.
Adult ; Cell Proliferation ; Cesarean Section ; Dermatitis, Atopic/*diagnosis/metabolism ; Female ; Fetal Blood/*cytology/metabolism ; Humans ; Infant ; Interferon-gamma/metabolism ; Interleukin-13/metabolism ; Leukocytes, Mononuclear/drug effects/*metabolism ; Male ; Odds Ratio ; Ovalbumin/toxicity ; Phytohemagglutinins/toxicity ; Predictive Value of Tests ; Pregnancy ; Risk Factors ; Sex Factors

Since the risk of developing allergic disease increases in individuals exposed to allergens previously, even during the neonatal period, the immunologic status of a fetus may be important in the subsequent development of allergy. We evaluated the fetal factors to predict atopic dermatitis (AD) at 12 months in 412 infants of a COhort for Childhood Origin of Asthma and Allergic Diseases (COCOA) in the general Korean population. Cord blood mononuclear cells (CBMCs) were stimulated with ovalbumin and phytohemagglutinin and cellular proliferative response and concentrations of interleukin-13 and interferon-gamma, were measured. The risk of developing AD was greater in boys than girls (OR 1.97, 95% CI 1.26-3.09), infants delivered by cesarean section than vaginally (OR 1.93, 95% CI 1.14-3.26) and infants with than without parental history of AD (OR 2.34, 95% CI 1.29-4.24). The CBMC proliferative response to phytohemagglutinin stimulation was higher in infants with than without AD (P = 0.048), but no difference was observed in ovalbumin-stimulated cells (P = 0.771). Risk factors for the development of AD at 12 months include male gender, delivery by cesarean section and parental history of AD. Increased CBMC proliferative response to phytohemagglutinin stimulation may predict the development of AD at 12 months.
Adult ; Cell Proliferation ; Cesarean Section ; Dermatitis, Atopic/*diagnosis/metabolism ; Female ; Fetal Blood/*cytology/metabolism ; Humans ; Infant ; Interferon-gamma/metabolism ; Interleukin-13/metabolism ; Leukocytes, Mononuclear/drug effects/*metabolism ; Male ; Odds Ratio ; Ovalbumin/toxicity ; Phytohemagglutinins/toxicity ; Predictive Value of Tests ; Pregnancy ; Risk Factors ; Sex Factors

Purpose: Mycoplasma pneumoniae pneumonia (MP) is a major cause of community-acquired pneumonia (CAP) in children and is associated with extrapulmonary manifestations (EPM). The incidence and risk factors for EPM in children are unknown. Methods: This was a retrospective study involving 65,243 pediatric patients with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Medical records were reviewed to collect information regarding the clinical characteristics, radiological results, and laboratory findings. Logistic regression with multivariate analysis was performed to evaluate the risk factors associated with EPM in MP. Results: The incidence of EPM was 23.9%, including elevation of liver enzymes (18.1%), mucocutaneous manifestations (4.4%), proteinuria (4.1%), cardiovascular and neurological manifestations (0.4%), hematologic manifestations (0.2%), and arthritis (0.2%). Statistical analysis showed that mucocutaneous manifestations significantly increased with elevated alanine aminotransferase (adjusted odds ratio [aOR], 3.623; 95% confidence interval [CI], 1.933-6.790) and atopic sensitization (aOR, 2.973; 95% CI, 1.615–5.475) and decreased with respiratory virus coinfection (aOR, 0.273; 95% CI, 0.084–0.887). Elevated liver enzymes were significantly associated with elevated lactate dehydrogenase (aOR, 3.055; 95% CI, 2.257–4.137), presence of pleural effusion (aOR, 2.635; 95% CI, 1.767–3.930), and proteinuria with respiratory virus coinfection (aOR, 2.245; 95% CI, 1.113–4.527). Conclusion Approximately 24% of pediatric patients with MP had various EPM. As the risk factors associated with each EPM were different, it is necessary to evaluate the various clinical aspects and findings of MP to predict and prepare for the occurrence of EPM.