BACKGROUND:The regeneration ability of articular cartilage is limited.However,the emerging of tissue regeneration based on the use of autologous cells appears to offer great promise in repairing articular cartilage defects.OBJECTIVE:To evaluate the short-term effectiveness and safety of autologous chondrocyte implantation (ACI).DESIGN,TIME AND SETTING:A prospective study was performed at the eighty university hospitals and general hospitals in Korea from March 2001 to April 2006.PARTICIPANTS:Two hundred and sixty-one patients with articular cartilage injury of the knee were selected,including 169 males,92 females,with the mean age of 36.47 years (ranged:15-70 yeats old),and the mean size of chondral defect was 4.91 cm2 (ranged:2.0-20.0 cm2).Totally 215 cases were femoral condyle injury,30 cases with trochlear,25 cases with patellar,and 2 cases with tibia defects.METHODS:A total of 200-300 mg of cartilage tissue was obtained from a non-weight-bearing portion of the knee,followed by in society score after ACI was evaluated by Knee Society Score-A (KSS-A)and Knee Society Score-B (KSS-B)system.MAIN OUTCOME MEASURES:KSS-A and KSS-B score of defected areas after ACI.RESULTS:All patients Received: followed-up without any loss.The KSS-A was 63.55±18.47 and 88.74±11.47 prior to and at 6 months after implantation,the difference had significance (P＜0.05).The KSS-B was 59.56±24.92 and 85.13±14.67 respectively prior to and at 6 months after implantation,which had obviously difference (P＜0.05).The joint pain,activity,stability,flexion contracture,locomotor activity and stair climbing were obviously improved.The effective rate was 97.3% and excellent and good rate was 89.3%.CONCLUSION:ACI can achieve a good result in treating knee articular cartilage defects,which can encourage the recover of knee function.

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter* ; Bacteremia ; Comamonas testosteroni* ; Comamonas* ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic* ; Testosterone ; Ventilators, Mechanical ; Virulence

Azoles are currently the most widely used class of antifungal drugs clinically, and are effective for treating fungal infections. Target site of azoles is ergosterol biosynthesis in fungal cell membrane, which is absent in the mammalian host. However, the development of resistance to azole treatments in the fungal pathogen has become a significant challenge. Here, we report the identification and functional characterization of a UPC2 homolog in the human pathogen Cryptococcus neoformans. UPC2 plays roles in ergosterol biosynthesis, which is also affected by the availability of iron in Saccharomyces cerevisiae and Candida albicans. C. neoformans mutants lacking UPC2 were constructed, and a number of phenotypic characteristics, including antifungal susceptibility and iron utilization, were analyzed. No differences were found between the mutant phenotypes and wild type, suggesting that the role of C. neoformans UPC2 homolog may be different from those in S. cerevisiae and C. albicans, and that the gene may have a yet unknown function.
Azoles ; Candida albicans ; Cell Membrane ; Cryptococcus ; Cryptococcus neoformans ; Danazol ; Ergosterol ; Humans ; Iron ; Phenotype ; Saccharomyces cerevisiae

Adult ; Airway Obstruction ; Emphysema ; Female ; Heart Failure ; Humans ; Mediastinal Emphysema ; Mediastinitis ; Mediastinum ; Molar, Third ; Pneumothorax ; Subcutaneous Emphysema ; Thorax ; Tracheostomy

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

PURPOSE: In IgA nephropathy (IgAN), crescent formation appears to represent a nonspecific response to severe injury to the glomerular capillary wall. This study was performed to evaluate the clinicopathological manifestations of the crescents and their effects on the clinical courses of IgAN. METHODS: The patients diagnosed IgAN were included and the information about their renal biopsies, chemistries and immunohistochemistry findings were collected retrospectively. Some patients that have similar renal function and protenuria were followed up for 12 months to examine the effects of crescents on the renal prognosis. RESULTS: 38 patients with crescents and 177 patients without crescents were enrolled. The patients with IgAN with crescents showed significantly lower renal function (MDRD eGFR 58.5 vs 88.4 ml/min/1.73m2), higher blood pressure, larger amount of proteinuria and more severe hematuria than those patients without crescents. In pathologic findings, HS Lee grades were higher (2.9 vs 1.9). When we selected patients with mildly decreased renal function (serum creatinine <2.5 mg/dL, PCR 0.5-8 g/gCr), the patients with crescents presented lower renal function and higher proteinuria but no statistical significance. After 12 months of treatment, the patients with crescents showed significantly lower renal function (MDRD eGFR 78.6 vs 96.5 ml/min/1.73m2) and higher proteinuria (0.9 vs 0.6 g/gCr). CONCLUSION: The patients with IgAN with crescents showed more deteriorated clinicopathological findings than those without crescents. Despite aggressive treatments, they presented a significantly decreased renal function and larger amount of proteinuria after 1 year. So crescents are supposed to have poor effects on the clinical course.
Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A ; Immunohistochemistry ; Polymerase Chain Reaction ; Proteinuria ; Retrospective Studies

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter ; Bacteremia ; Comamonas testosteroni ; Comamonas ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic ; Testosterone ; Ventilators, Mechanical ; Virulence

Background: To compare knee laxity between the conventional round tunnel and oval tunnel techniques in primary anterior cruciate ligament (ACL) reconstruction in a porcine knee model. Methods: Twenty porcine knees were used for evaluating laxity in terms of anterior translation and anterolateral rotation. The study determined porcine knee kinematics on the Instron instruments under simulated Lachman (89 N anterior tibial load) at 15°, 30°, and 60° of flexion and a simulated pivot shift test (89 N anterior tibial load, 10 Nm valgus, and 4 Nm internal tibial torque) at 30° of flexion. Kinematics were recorded for intact (n = 10), ACL-deficient (n = 10), and conventional round (n = 10) or oval tunnel (n = 10) techniques. All measurements were repeated twice, and the average was used for comparison. Results: Under the Lachman test, the conventional round tunnel and oval tunnel both showed significantly larger anterior tibial translation (ATT) at 30° and 60° compared to the intact knee (p < 0.05), but smaller ATT compared to the ACL-deficient knees (p < 0.05). However, there were no differences in ATT between the conventional round tunnel and oval tunnel techniques (p > 0.05). Under simulated pivot shift at 30° flexion, there was a significant difference between the conventional round tunnel and oval tunnel techniques (round vs. oval: 4.27 ± 0.87 mm vs. 3.52 ± 0.49 mm, p = 0.028). Conclusions Both conventional round tunnel and oval tunnel techniques reduced ATT compared to ACL-deficient knees but failed to restore normal knee stability. However, the oval tunnel technique showed better rotational stability at 30° than the round tunnel technique. These findings suggest that the oval tunnel technique would be a reasonable option in anatomical single-bundle ACL reconstruction.

Background: To compare knee laxity between the conventional round tunnel and oval tunnel techniques in primary anterior cruciate ligament (ACL) reconstruction in a porcine knee model. Methods: Twenty porcine knees were used for evaluating laxity in terms of anterior translation and anterolateral rotation. The study determined porcine knee kinematics on the Instron instruments under simulated Lachman (89 N anterior tibial load) at 15°, 30°, and 60° of flexion and a simulated pivot shift test (89 N anterior tibial load, 10 Nm valgus, and 4 Nm internal tibial torque) at 30° of flexion. Kinematics were recorded for intact (n = 10), ACL-deficient (n = 10), and conventional round (n = 10) or oval tunnel (n = 10) techniques. All measurements were repeated twice, and the average was used for comparison. Results: Under the Lachman test, the conventional round tunnel and oval tunnel both showed significantly larger anterior tibial translation (ATT) at 30° and 60° compared to the intact knee (p < 0.05), but smaller ATT compared to the ACL-deficient knees (p < 0.05). However, there were no differences in ATT between the conventional round tunnel and oval tunnel techniques (p > 0.05). Under simulated pivot shift at 30° flexion, there was a significant difference between the conventional round tunnel and oval tunnel techniques (round vs. oval: 4.27 ± 0.87 mm vs. 3.52 ± 0.49 mm, p = 0.028). Conclusions Both conventional round tunnel and oval tunnel techniques reduced ATT compared to ACL-deficient knees but failed to restore normal knee stability. However, the oval tunnel technique showed better rotational stability at 30° than the round tunnel technique. These findings suggest that the oval tunnel technique would be a reasonable option in anatomical single-bundle ACL reconstruction.