BACKGROUND: The purpose of this study was to report findings of exploratory arthroscopic assessment performed in conjunction with removal of internal fixation device placed in the initial surgery for rotational ankle fracture. METHODS: A total of 53 patients (33 male, 20 female) who underwent surgery for rotational ankle fracture between November 2002 and February 2008 were retrospectively reviewed. All patients gave consent to the exploratory arthroscopic surgery for the removal of internal fixation devices placed in the initial surgery. Lauge-Hansen classification system of ankle fractures was assessed for all patients. Intra-articular lesions (osteochondral lesion, loose body, and fibrosis) were evaluated via ankle arthroscopy. Comparative analysis was then performed between radiological classification of ankle fracture/patient's symptoms and arthroscopic findings. RESULTS: Lauge-Hansen classification system of ankle fractures included supination-external rotation type (n = 35), pronation-external rotation type (n = 9), and pronation-abduction type (n = 9). A total of 33 patients exhibited symptoms of pain or discomfort while walking whereas 20 exhibited no symptoms. Arthroscopic findings included abnormal findings around the syndesmosis area (n = 35), intra-articular fibrosis (n = 51), osteochondral lesions of the talus (n = 33), loose bodies (n = 6), synovitis (n = 13), and anterior bony impingement syndrome (n = 3). Intra-articular fibrosis was seen in 31 of symptomatic patients (93.9%). Pain or discomfort with activity caused by soft tissue impingement with meniscus-like intra-articular fibrosis were found in 19 patients. There was statistical significance (p = 0.02) between symptoms (pain and discomfort) and the findings of meniscus-like fibrosis compared to the group without any symptom. CONCLUSIONS: Arthroscopic examination combined with treatment of intra-articular fibrosis arising from ankle fracture surgery may help improve surgical outcomes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ankle/*pathology/radiography/*surgery ; Ankle Fractures/*pathology/radiography/*surgery ; Arthralgia ; Arthroscopy/*methods ; Female ; Fibrosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Immunoinhibitory protein extracted from sonicated Treponema denticola have been shown to suppress cell cycle progression of human lymphocytes. To study in detail about the effect of this microorganism on the function of lymphocytes, we investigated the levels of Interleukin-2 (IL-2) and Interleukin-4 (IL-4) production by T lymphocytes before and after the addition of 12.5 microg/ml T. denticola sonicated extracts. In this study, levels of IL-2 and IL-4 produced from T cells pretreated with sonicated extracts were evaluated by using the quantitative sandwich enzyme immunoassay technique. In response to phytohemagglutinin (PHA) stimulation, T cell produced increased levels of IL-2 and IL-4. However, the expressions of both cytokines were significantly inhibited when PHA activated-T cells were pre-exposed to sonicated T. denticola extracts (p < 0.05). These findings suggest that the T. denticola sonicated extracts induced-immunosuppression in Th1 and Th2 cell functions could be a part of the pathogenic mechanism of the endodontic failure associated with this microorganism.
Cell Cycle ; Cytokines ; Humans ; Immunoenzyme Techniques ; Interleukin-2 ; Interleukin-4 ; Lymphocytes ; T-Lymphocytes* ; Th2 Cells ; Treponema denticola* ; Treponema*

OBJECTIVE: To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. METHODS: We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. RESULTS: The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. CONCLUSION: Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.
Endometriosis ; Female ; Fertilization ; Humans ; Infertility ; Laparoscopy ; Pregnancy Rate ; Retrospective Studies

PURPOSE: We report a case of rapid progression to proliferative diabetic after generalized edema occurrence in a non proliferative diabetic retinopathy patient. CASE SUMMARY: A 48-year-old man visited our hospital with both eyes visual disturbance which occurred 1 week ago. He was diagnosed with moderate non proliferative diabetic retinopathy 5 months ago and there was no significant interval change 3 weeks ago. Date of visit, diffuse macular edema and neovascularization were observed in both eyes. Accompanying visual disturbance, he had generalized edema and 10 kg of weight gain. We thought it was not common diabetic macular edema, we held ophthalmic treatment such as an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection and requested medical treatment to the department of nephrology. Diagnosed with aggravation of left ventricle heart failure and diabetic nephropathy, he took diuretics and low salt diet for 10 days. After 10 days, his visual acuity improved and macular edema disappeared. Since then, he received intravitreal anti-VEGF injection and panretinal photocoagulation for proliferative diabetic retinopathy treatment. Nevertheless, he underwent pars plana vitrectomy due to vitreous hemorrhage in right eye. CONCLUSIONS: We experienced a case of sudden diffuse macular edema and progression to proliferative diabetic retinopathy associated with generalized edema. We suggest that it is necessary to consider systemic changes in diabetic retinopathy.
Diabetic Nephropathies ; Diabetic Retinopathy* ; Diet ; Diuretics ; Edema* ; Endothelial Growth Factors ; Heart Failure ; Heart Ventricles ; Humans ; Light Coagulation ; Macular Edema ; Middle Aged ; Nephrology ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Weight Gain

Background: Few studies have been conducted in Korea on concordance regarding chronic diseases and lifestyle factors among couples. We, therefore, evaluated spousal concordance regarding lifestyle factors and chronic diseases among Korean couples. Methods: A total 1,040 participants (520 couples) who visited family physicians were recruited from 22 hospitals. All participants were aged ≥40 years. Participants completed questionnaires on smoking, drinking, physical activity, and irregular eating habits, including skipping breakfast. We estimated the spousal concordance regarding lifestyle factors and chronic diseases using McNemar tests and logistic regression analysis. Results: The concordance rate was high among couples who shared unhealthy behaviors, such as low physical activity, irregular diet, and skipping breakfast (P<0.05). When cardiovascular risk factors such as overweight (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.14–2.63), hypertension (OR, 1.88; 95% CI, 1.23–2.86), or hyperlipidemia (OR, 2.41; 95% CI, 1.60–3.64) were prevalent among husbands, the odds that their wives also had the same risk factors at the same time was significantly high. The odds of being depressed when the spouse was depressed were also significantly high in both men (OR, 5.54; 95% CI, 2.19–13.96) and women (OR, 4.52; 95% CI, 1.77–11.53). Conclusion There was a high level of concordance regarding lifestyle factors among couples, which could lead to an increase in the prevalence of chronic diseases among couples. In addition, if a spouse has depression, the odds of their partner also having depression was high.

OBJECTIVES: To investigate the relationship between polymorphisms of sclerostin (SOST) gene and bone mineral density (BMD) in postmenopausal Korean women. MATERIALS AND METHODS: The SOST rs865429 (g.5942C>T), rs17882143 (c.28G>A), rs10534024 (-1396TCC/Del) polymorphisms were analyzed by Taqman assay and direct DNA sequencing in 399 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin, osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) were measured by enzyme linked immunosorbent assay. The BMD at the lumbar spine (LS) and femoral neck (FN) were determined by dual energy X-ray absorptiometry, and in 311 postmenopausal women receiving hormone therapy (HT) BMD was also measured after HT of 1 year.
Absorptiometry, Photon ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Collagen ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Humans ; NF-kappa B ; Osteocalcin ; Osteoporosis ; Osteoprotegerin ; Peptide Fragments ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prevalence ; Receptor Activator of Nuclear Factor-kappa B ; Sequence Analysis, DNA ; Spine

BACKGROUND/AIMS: Healthcare-associated pneumonia (HCAP) occurs outside hospitals, but its characteristics are similar to those of hospital-acquired pneumonia (HAP). We evaluated the clinical and microbial characteristics of HCAP in Korea. METHODS: Of 130 subjects with suspected pneumonia, 49 were classified as HCAP and 81 as HAP. We retrospectively examined the clinical presentations, outcomes, pathogens, and drug resistance rates of Pseudomonas aeruginosae in both groups. RESULTS: The clinical presentations, including the symptoms and laboratory findings, at the time of hospitalization were comparable in both groups. The hospital mortalities of HCAP (28.6%) and HAP (34.6%) did not differ significantly; the length of the hospital stay was similar for all of the survivors (14 vs. 17 days, respectively). Of the identified pathogens, methicillin-resistant Staphylococcus aureus was significantly less common in HCAP than in HAP (two vs. 18 cases, respectively, p<0.01), whereas Klebsiella pneumoniae was more common in HCAP (five vs. zero cases, respectively, p<0.01). The frequency of other Gram-negative rods was similar in both groups. The rate of resistance to antibiotics in P. aeruginosae in both groups was substantial, with the highest resistant rate to ciprofloxacin (50% and 61.5% in HCAP and HAP, respectively). CONCLUSIONS: Although the clinical features and outcomes of HCAP were comparable to those of HAP in the study population, the frequency of methicillin-resistant S. aureus was significantly lower in HCAP compared to HAP.
Anti-Bacterial Agents ; Ciprofloxacin ; Drug Resistance ; Hospital Mortality ; Hospitalization ; Humans ; Klebsiella pneumoniae ; Korea ; Length of Stay ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Retrospective Studies ; Survivors

BACKGROUND: Despite recent advance in conventional cancer therapies including surgery, radiotherapy, chemotherapy, and immunotherapy to reduce tumor size, unfortunately cancer mortality and metastatic cancer incidence remain high. Along with a deeper understanding of stem cell biology, cancer stem cell (CSC) is important in targeted cancer therapy. Herein, we review representative patents using not only normal stem cells as therapeutics themselves or delivery vehicles, but also CSCs as targets for anti-cancer strategy. METHODS: Relevant patent literatures published between 2005 and 2017 are discussed to present developmental status and experimental results on using normal stem cells and CSCs for cancer therapy and explore potential future directions in this field. RESULTS: Stem cells have been considered as important element of regenerative therapy by promoting tissue regeneration. Particularly, there is a growing trend to use stem cells as a target drug-delivery system to reduce undesirable side effects in non-target tissues. Noteworthy, studies on CSC-specific markers for distinguishing CSCs from normal stem cells and mature cancer cells have been conducted as a selective anti-cancer therapy with few side effects. Many researchers have also reported the development of various substances with anticancer effects by targeting CSCs from cancer tissues. CONCLUSION: There has been a continuing increase in the number of studies on therapeutic stem cells and CSC-specific markers for selective diagnosis and therapy of cancer. This review focuses on the current status in the use of normal stem cells and CSCs for targeted cancer therapy. Future direction is also proposed.
Biology ; Diagnosis ; Drug Therapy ; Immunotherapy ; Incidence ; Mortality ; Neoplastic Stem Cells* ; Radiotherapy ; Regeneration ; Stem Cells*

Educational evironment and condition strongly influence the quality of graduate medical education. However, in Korea educational environment of in-hospital graduate medical education and training has not been explored in details. To evaluate current situation, we investigated 1,859 graduate trainees(residents) by self-administered questionnaire from May to July in 1996. Major findings of the survey were as follows; 1. Major providers of education were senior trainees(46.7%), compared with other sources of training such as self-study(22.9%) and staff trainers(14.5%). 2. At hospitals with less than or equal to 500 beds, formal educational programs for training were more poorly developed than hospitals with more than 500 beds. Among them, weakness in programs of case conference, staff lecture and training in affiliated hospitals was more remarkable. 3. At small hospitals with less than or equal to 500 beds, satisfaction level of trainees on their training were lower than that of trained at hospitals with more than 500beds. Research, conference, discussion with senior residents, and outpatient care were more dissatisfactory in particular. 4. Significant barriers to ideal training were work overload(57.2%) and shortage of educational programs(19.0%). Most of trainees are not satisfied with environment and condition of their training programs. To improve the quality of graduate medical education which is closely related with health care quality in the near future, general environment of education such as work load and educational programs has to be reoriented.
Ambulatory Care ; Education ; Education, Medical, Graduate* ; Korea ; Quality of Health Care ; Surveys and Questionnaires

We have undertaken this study to identify the usefulness of two variable dinucleotide tandem repeats within the factor VIII gene for carrier detection and prenatal diagnosis of hemophilia A in the Korean population. We have analyzed these polymorphisms in 50 unrelated Korean mothers of patients with severe hemophilia A, using polymerase chain reaction. The expected heterozygosity rates of the intron 13 and intron 22 dinucleotide repeats were 56% and 40%, respectively. Analysis of the intron 13 and intron 22 dinucleotide repeats revealed heterozygous patterns in 29(58%) and 17(34%) of 50 mothers studied, respectively. The combined overall informativity of the intron 13 and intron 22 dinucleotide repeats was 68%. Using linkage analysis with the intron 13 dinucleotide repeats, we have attempted three cases of carrier detection and two cases of prenatal diagnosis in two families of patients with severe hemophilia A. Two pregnant women were diagnosed as carriers, and the other patients as non-carrier Prenatal diagnosis revealed an unaffected male in one fetus, and an unaffected female in another fetus. This data demonstrated that the analysis of the intron 13 and intron 22 dinucleotide repeats very useful in the carrier detection and prenatal diagnosis of hemophilia A in the Korean population.
Dinucleotide Repeats ; Factor VIII* ; Female ; Fetus ; Hemophilia A* ; Humans ; Introns ; Male ; Microsatellite Repeats ; Mothers ; Polymerase Chain Reaction ; Pregnant Women ; Prenatal Diagnosis* ; Tandem Repeat Sequences*