The roentgenograms following arthroscopic ACL reconstruction show the enlargement of bone tunnels. Many authors hypothesized the cause of the tunnel enlargement, either mechanical or biological causes. The purpose of this study was to find the factors which affected the enlargement of the tibial tunnel following arthroscopic ACL reconstruction with bone-patellar tendon-bone or hamstring tendon. Sixty patients were reviewed retrospectively for radiographic measurement of tibial tunnel at post-operative one year (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device, 21 patients received Semitendinosus and Gracilis tendons with Endobutton). Roentgenographic anteroposterior and lateral films were checked and the tunnel was measured by two independent observers using a digital caliper. Statistical analysis was performed using a one-way analysis of variance (ANOVA) and t-test. The tibial tunnel enlargement was only related to the position of the fixation of the tibial tunnel. We concluded that tibial tunnel enlargement following arthroscopic ACL reconstruction is attributed to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Retrospective Studies ; Tendons ; Transplants

In anterior cruciate ligament (ACL) deficient knee, several treatment methods were recommended. Recently, arthroscopic reconstruction is widely used as the best treatment method. As the graft materials, bone-patellar tendon-bone (BPB) unit is a gold standard material. Whereas, it has many problems. The purpose of this study was to introduce the new arthroscopic ACL reconstruction technique with quadrupled semitendinosus tendon and Endobutton and to evaluate its results. Twenty one patients were prospectively reviewed after ACL reconstruction with quadrupled semitendinosus tendon and Endobutton at one year post-operation. The surgery was performed in the series of graft tendon harvest, graft preparation, tunnel drilling and Endobutton fixation. The outcomes showed improved knee functions. Endobutton technique with quadrupled semitendinosus tendon is useful method for the arthroscopic ACL reconstruction. Stability and functional outcomes were similar to those with patellar tendon but it showed less donor site morbidity, less pitfall of fixation and simple procedure.
Anterior Cruciate Ligament ; Humans ; Knee ; Patellar Ligament ; Prospective Studies ; Tendons* ; Tissue Donors ; Transplants

Controversies about the posterior cruciate ligament continue with regards to total knee arthroplasty. There has been a long debate regarding PLC and its importance seems to be overrated in total knee arthroplasty. Twenty four patients had twenty six total knee replacements with insertion of the PCL substituting Press Fit Condylar modular total knee system with cement, and they were enrolled in a prospective study to assess the clinicoradiological results and measure the femoral roll-back postoperatively. Follow-up ranged from twenty four months to fifty months with an average of thirty two months. The mean HSS score was 92.1 points and the mean range of motion was 122.7 degrees. Twenty five cases(96.1%) showed excellent and good clinical results. The radiologic evaluation based on Knee Society roentgenographic system revealed proper alignment of all components and one significant radiolucent area. The mean femoral roll-back was 2.3mm posteriorly. In the present series, total knee arthroplasties with the Press Fit Condylar modular knee system resulted in excellent relief of pain, excellent range of motion and restoration of function.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Humans ; Knee ; Posterior Cruciate Ligament ; Prospective Studies ; Range of Motion, Articular

Objectives: The aim of this study was to investigate dietary intakes and nutritional status among Uganda primary school children from two selected schools in urban and rural areas. Methods: Data were collected from 350 pupils (6-14 years) in Mpigi district, Uganda. All participants were offered a school lunch meal (usually maize porridge and boiled beans). Dietary survey was conducted in October 2016. Data for dietary intake levels were collected by the 24-hour recall method with trained school staffs. The data were converted into nutrient intakes using the CAN-Pro 5.0 Program and compared with KDRIs to evaluate the nutritional status of the subjects. Diet quality indexes such as nutrient density, nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) and a diet diversity index such as diet diversity score (DDS) were calculated to evaluate nutritional status among subjects. Data were analyzed using SPSS statistical programs. Results: Results show that the intakes of most nutrients were significantly different by schools. The nutritional status of micro-nutrients was very low in both schools according to analysis of nutritional indexes such as NARs and INQs. Students from both schools should improve intakes of micro-nutrients related to child growth such as calcium, Vitamin B6, zinc and folate. According to the analysis of dietary diversity, there was difference in dietary patterns by schools presumably due to their locations. Conclusions This suggests that current meals could not provide adequate nutrients for the subjects and urgent nutrition interventions for school food services are needed to improve their nutritional well-being. New foods supplements based on local cuisine are also needed to ensure dietary diversity and sustainable development plans.

Paroxysmal nocturnal hemoglobinuria (PNH) is a acquired clonal disorder of the hematopoietic stem cells characterized by chronic intravascular hemolysis, venous thrombosis, deficient hematopoiesis. Kidney involvement is usually benign and secondary to chronic deposition of hemosiderin. But, acute renal failure may rarely occur in association with a hemolytic crisis or thrombotic complication. Hemolytic crisis is precipitated by nonspecific factors, such as infection, surgery and transfusion. A 69-year- old man was admitted to our hospital who developed acute renal failure after operation of anal fistula. He was diagnosed with PNH accompanied with deep vein thrombosis later. After being treated by hemodialysis and oral low dose steroid, he was discharged with full recovery of renal function. But, he frequently was developed acute renal failure with crisis of PNH despite taking low dose steroid. So, we report a case of PNH with recurrent acute renal failure without precipitating factors.
Acute Kidney Injury* ; Hematopoiesis ; Hematopoietic Stem Cells ; Hemoglobinuria, Paroxysmal* ; Hemolysis ; Hemosiderin ; Kidney ; Precipitating Factors ; Rectal Fistula ; Renal Dialysis ; Venous Thrombosis

PURPOSE: Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. METHODS: Seventy-two patients (23.9+/-2.4 years) with T1 DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. RESULTS: Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects (0.43+/-0.06 mm vs 0.39+/-0.06 mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). CONCLUSION: Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.
Adolescent ; Atherosclerosis ; Body Mass Index ; Diabetes Mellitus, Type 1 ; Dyslipidemias ; Humans ; Hypertension ; Incidence ; Insulin ; Male ; Mass Screening ; Risk Factors ; Vasodilation ; Young Adult

Under normal, non-stressed conditions, intracellular p53 is continually ubiquitinated by MDM2 and targeted for degradation. However, in response to severe genotoxic stress, p53 protein levels are markedly increased and apoptotic cell death is triggered. Inhibiting the ubiquitination of p53 under conditions where DNA damage has occurred is therefore crucial for preventing the development of cancer, because if cells with severely damaged genomes are not removed from the population, uncontrolled growth can result. However, questions remain about the cellular mechanisms underlying the regulation of p53 stability. In this study, we show that p53-inducible gene 3 (PIG3), which is a transcriptional target of p53, regulates p53 stability. Overexpression of PIG3 stabilized both endogenous and transfected wild-type p53, whereas a knockdown of PIG3 lead to a reduction in both endogenous and UV-induced p53 levels in p53-proficient human cancer cells. Using both in vivo and in vitro ubiquitination assays, we found that PIG3 suppressed both ubiquitination- and MDM2-dependent proteasomal degradation of p53. Notably, we demonstrate that PIG3 interacts directly with MDM2 and promoted MDM2 ubiquitination. Moreover, elimination of endogenous PIG3 in p53-proficient HCT116 cells decreased p53 phosphorylation in response to UV irradiation. These results suggest an important role for PIG3 in regulating intracellular p53 levels through the inhibition of p53 ubiquitination.
Apoptosis ; Cell Death ; DNA Damage ; Genome ; HCT116 Cells ; Humans ; In Vitro Techniques ; Phosphorylation ; Ubiquitin* ; Ubiquitination*

The aim of this study is to determine whether the posterior cervical fusion methods with the plate-screw system applied to the lateral mass of cervical spine are radiologically safe to patients. The lateral cervical X-rays and CT scans were done on 40 normal adults without cervical problem. Based on Roy-Camille and Magerl's method, the theological trajectory of screw was shown on films and the parameters were measured. The study based on Roy-Camille's method showed less than one percent chance of injury on the facet joint and the mean depth of the screw to be 10.5+/-1.4mm. On the other hand, Magerl's method showed the mean depth of screw to be 11.9+/-1.5mm which is slightly larger than that of Roy-Camille's method and no chance of facet injury occurred. A reduced lateral angle of screw (19.6+/-3.5 degrees) performed with the concept based on Magerl's method resulted a longer depth of screw (13.5+/-2.1mm). Both Roy-Camille and Magerl's methods seemed to be radiologically safe to normal persons. However, the authors recommend the reduced lateral angle (19.6+/-3.5 degrees) of screw based on the Magerl's method more than an original Magerl's methods.
Adult ; Bone Plates ; Bone Screws ; Cervical Vertebrae/*radiography/*surgery ; Female ; Human ; Male ; *Spinal Fusion ; Support, Non-U.S. Gov't ; Tomography, X-Ray Computed/*methods

Child ; Decompression ; Dentigerous Cyst ; Depression ; Humans ; Jaw ; Paresthesia ; Tooth ; Traction

Fulminant type 1 diabetes is characterized by acute onset, no evidence of islet-related autoantibodies, low glycated hemoglobin(HbA1c) level at onset, and metabolic complications such as diabetic ketoacidosis. Fulminant type 1 diabetes development during pregnancy can result in severe maternal and fetal complications. Most of the patients with fulminant type 1 diabetes during pregnancy have been reported in Japan. In Korea, reports of fulminant type 1 diabetes during pregnancy are uncommon. We report a 36-year-old Korean woman with fulminant type 1 diabetes developed at 32 weeks of gestation who demonstrate a good outcome.
Adult ; Autoantibodies ; Diabetic Ketoacidosis ; Female ; Humans ; Japan ; Korea ; Pregnancy*