BACKGROUND: This study examined the results of open wedge high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft as a surgical technique for the patients who suffer from osteoarthritis of the knee with a genu varum deformity. METHODS: From March 2007 to August 2007, 33 patients (37 cases) with osteoarthritis of the knee and a genu varum deformity underwent a high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft. The patients were followed up for more than 1 year. Before and after surgery, the correction angle of the genu varum was measured by the lower extremity scannogram and the posterior tibial slope, the joint space distance and the time to bone union were evaluated. The functional factors were evaluated using the Knee Society Score. RESULTS: The average knee score and function score improved from 52.19 +/- 11.82 to 92.49 +/- 5.10 and 52.84 +/- 6.23 to 89.05 +/- 5.53, respectively (p < 0.001). According to the lower extremity scannogram, the mean preoperative varus angle was -1.86 +/- 2.76degrees, and the average correction angle at the last follow-up was 10.93 +/- 2.50degrees (p < 0.001). The tibial posterior slope before surgery and at the last follow-up were 8.20 +/- 1.80degrees and 8.04 +/- 1.30degrees, respectively (p = 0.437). The joint space distance increased from 4.05 +/- 1.30 mm to 4.83 +/- 1.33 mm (p < 0.001). The average time to complete bone union was 12.69 +/- 1.5 weeks. CONCLUSIONS: An open wedge high tibial osteotomy using an Aescula open wedge plate and an allogeneic bone graft to treat osteoarthritis of the knee with a genu varum deformity showed good results for the precision of the correction angle, the time to bone union and the functional improvement.
Adult ; Arthroscopy ; *Bone Plates ; *Bone Transplantation ; Female ; Humans ; Joint Deformities, Acquired/diagnosis/etiology/radiography/*surgery ; Knee Joint ; Male ; Middle Aged ; Orthopedic Procedures/*methods ; Osteoarthritis, Knee/complications/diagnosis/radiography/*surgery ; Osteotomy/*methods ; Tibia/radiography/*surgery ; Transplantation, Homologous

PURPOSE: The objective of this study was to determine the patterns of C-reactive protein (CRP) changes during the postoperative period after total knee replacement (TKR), and to determine the CRP changes associated with infection after TKR. MATERIALS AND METHODS: A retrospective analysis of the pattern of CRP changes during the first 6 postoperative months was conducted on 2,315 patients who underwent unilateral or simultaneous bilateral TKR. This data was also compared with the pattern of CRP changes which occurred in 19 patients with a deep prosthesis infection who were not enrolled in the main study. RESULTS: The CRP levels peaked 3 days postoperatively, and then decreased to baseline levels at 15-28 days postoperatively. Within 14 days postoperatively, the CRP levels were significantly higher in the simultaneous bilateral TKA group than in the unilateral group (p<0.01). Thereafter, no significant difference in CRP levels existed between two groups. After the 8th postoperative day, a significant difference in CRP level existed between patients with and without deep prosthesis infections. CONCLUSION: CRP changes post-TKR provide an effective means of monitoring of infections. In cases of non-inflammatory arthritis in which the CRP levels are significantly difference after the 8th postoperative day or are elevated after the 4th postoperative week, an infection should be suspected.
Arthritis ; Arthroplasty, Replacement, Knee ; C-Reactive Protein ; Humans ; Postoperative Period ; Prostheses and Implants ; Retrospective Studies

Since the introduction of genetic fingerprinting 30 years ago, there has been considerable development in the field of forensic genetics. A cautious approach is emphasized when using human genetic evidence in order to protect individual rights and because of its distinctiveness. Nevertheless, conventional ethical guidelines may no longer be suitable for handling information derived from genetic material. Moreover, projected innovations to maximize such systems' usage have raised previously debated ethical concerns. Recent and on-going research on the use of genetic evidence obtained from crime scenes to estimate physical appearance, ancestry, and/or personal traits is expected to provide additional investigative resources, especially for cases involving unknown identity. Given the special nature of genetic components, ethical issues need to be seriously considered and addressed when conducting research involving human genetic material. However, such ethical parameters may shift with scientific advancements. Moreover, because ethics reflects social consensus, various perspectives must be obtained and discussed. This paper introduces multiple perspectives on using genetic material as additional evidence for police investigations and indicates scope for the discussion of prospective ethical concerns.
Consensus ; Crime ; DNA Fingerprinting ; Ethics* ; Forensic Genetics ; Genetic Testing* ; Human Rights ; Humans ; Investigative Techniques ; Phenotype ; Police ; Prospective Studies

PURPOSE: We retrospectively reviewed the long term results of arthroscopic resection of the discoid meniscus in children and evaluated postoperative clinical symptoms and radiological changes. MATERIALS AND METHOD: The results of arthroscopic surgery in 27 symptomatic discoid menisci of 22 patients who were under 15 years old at the time of operation (average; 11 year 9 month old) were evaluated. Average follow-up period was 9 years 4 months (5 years-18 years 1 months). Clinical results were analyzed according to Ikeuchi's clinical grading system and radiological degenerative changes were classified according to Fairbank at the last follow-up. RESULTS: According to Ikeuchi's grading system, excellent results were obtained in 10 cases (37.0%), good in 12 cases (44.4%), fair in 5 cases (18.5%). No radiological change was observed in 1 case (3.7%), 1 radiological sign in 5 cases (18.5%), 2 radiological signs in 13 cases (48.1%) and more than 3 radiological signs in 8 cases (29.6%) in the last follow-up radiograph. No correlation between clinical results and radiological changes. CONCLUSION: Arthroscopic resection of discoid meniscus in children was effective at relieving symptoms over a follow up of more than 5 years, though radiological degenerative changes occurred. We recommend that follow up is resuired to determine whether the clinical results of knees in middle or older age groups will worsen.
Adolescent ; Arthroscopy ; Child* ; Follow-Up Studies ; Humans ; Knee ; Retrospective Studies

Herpes simplex virus esophagitis and candidal esophagitis can be found in immunocompromised patients. But it rarely occurs in immunocompetent patients. Diagnosis is usually established with an upper gastrointestinal endoscopy. The lesions of herpes simplex virus esophagitis involves the squamous mucosa, where the earlist manifestation is a vesicle, rarely. We report a case of herpes simplex virus esophagitis who, being immunologically healthy, presented with substernal pain and dysphagia and showed vesicle formation on endoscopy. The patient also showed whitish patch and spot on esophageal mucosae. The patient showed loss of symptom and improvement of endoscopic finding after conservative management and antifungal therapy.
Deglutition Disorders ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagitis* ; Herpes Simplex* ; Humans ; Immunocompromised Host ; Mucous Membrane ; Simplexvirus*

Epidural administration of opioid and/or local anesthetics during general anesthesia is widespread method for postoperative pain control. Despite of its availability, inadvertent administration of non-epidural medications into epidural space can be associated with serious neurologic sequelae. We report a case of accidental epidural atracurium injection.
Anesthesia, General ; Anesthetics, Local ; Atracurium* ; Epidural Space ; Lidocaine* ; Pain, Postoperative

BACKGROUND: Hepatocellular carcinoma(HCC) has characteristic differences in both viral profiles and the most frequently occurring age in each country. It also has clinically distinct features between adult patients of the age under 65 and senile patients over 65 years. Herein we investigate differences in clinical features of the patients with HCC of the three different age groups : young patients (group 1) below 45 years of age; most frequently occurring age (45 - 65 year) (group 2); and elderly patients (group 3) above 65 years of age. METHODS: The 371 HCC patients hospitalized and followed-up from 1986 to February 1997 have been analyzed. At the time of diagnosis there was no significant difference among the three groups in alcohol intake, cigarette smoking, sex, family history of liver disease, mean values of aminotransferases, Child-Pugh class, tumor location, TNM stage, tumor size, varix grade, metastasis, abdominal pain, ascites, encephalopathy, fever, or jaundice. RESULTS: In the younger group HCC showed (1) a high incidence of HBsAg positivity (group 1, 95.3%; group 2, 78.6%; group 3, 25%; p<0.001) ; (2) a low positive rate of anti-HCV (group 1, 0%; group 2, 7.7%; group 3, 44.4; p<0.001); (3) a low incidence of NBNC(group 1, 4.9%; group 2, 14.1%; group 3, 30.4%; p<0.01); (4) a high incidence of diffuse type (group 1, 40.5%; group 2, 29.5%; group 3, 11.9%; p<0.05); (5) a higher levels of serum AFP (group 1, 4,180 ng/mL; group 2, 3,224 ng/mL; group 3, 2,025 ng/mL; between group 1 and group 3, p<0.05). But three different levels of AFP (<20 ng/mL, 20-400 ng/mL, >400 ng/mL) showed no differences among the three age groups (p=0.23766). (6) The overall survival rates did not differ statistically among the three groups (mean survival: group 1, 12 months; group 2, 18 months; group 3, 15 months; p=0.4635, log rank test). CONCLUSION: These data support the younger patients with HCC are the most frequently associated with HBV contrarily to the elderly patients the more frequently associated with HCV or NBNC rather than HBV. This suggests, in turn, that the onset of HCC occurs one or two decades later in those with adult-acquired HCV than it does in lifelong HBV patients after neonatal vertical infection.
Abdominal Pain ; Adult ; Aged ; Ascites ; Carcinoma, Hepatocellular* ; Clonorchis sinensis ; Diagnosis ; Eosinophilia ; Fever ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Jaundice ; Liver Diseases ; Neoplasm Metastasis ; Smoking ; Survival Rate ; Transaminases ; Varicose Veins

BACKGROUND: Various methods based on gold nanoparticles (AuNPs) have been applied to enhance the photothermal effect. Among these methods, combining gold nanoparticles and stem cells has been suggested as a new technique for elevating the efficiency of photothermal therapy (PT) in terms of enhancing tumor targeting effect. However, to elicit the efficiency of PT using gold nanoparticles and stem cells, delivering large amounts of AuNPs into stem cells without loss should be considered. METHODS: AuNPs, AuNPs-decorated silica nanoparticles, and silica-capped and AuNPs-decorated silica nanoparticles (SGSs) were synthesized and used to treat human mesenchymal stem cells (hMSCs). After evaluating physical properties of each nanoparticle, the concentration of each nanoparticle was estimated based on its cytotoxicity to hMSCs. The amount of AuNPs loss from each nanoparticle by exogenous physical stress was evaluated after exposing particles to a gentle shaking. After these experiments, in vitro and in vivo photothermal effects were then evaluated. RESULTS: SGS showed no cytotoxicity when it was used to treat hMSCs at concentration up to 20 lg/mL. After intravenous injection to tumor-bearing mice, SGS-laden hMSCs group showed significantly higher heat generation than other groups following laser irradiation. Furthermore, in vivo photothermal effect in the hMSC-SGS group was significantly enhanced than those in other groups in terms of tumor volume decrement and histological outcome. CONCLUSION Our results suggest that additional silica layer in SGSs could protect AuNPs from physical stress induced AuNPs loss. The strategy applied in SGS may offer a prospective method to improve PT.

Cell transformation induced by epidermal growth factor (EGF) and 12-O-tetradecanoylphorbol-13-acetate (TPA) is a critical event in cancer initiation and progression, and understanding the underlying mechanisms is essential for the development of new therapeutic strategies. Licorice extract contains various bioactive compounds, which have been reported to have anticancer and anti-inflammatory effects. This study investigated the cancer preventive efficacy of licochalcone D (LicoD), a chalcone derivative in licorice extract, in EGF and TPA-induced transformed skin keratinocyte cells. LicoD effectively suppressed EGF-induced cell proliferation and anchorage-independent colony growth. EGF and TPA promoted the S phase of cell cycle, while LicoD treatment caused G1 phase arrest and down-regulated cyclin D1 and up-regulated p21 expression associated with the G1 phase. LicoD also induced apoptosis and increased apoptosis-related proteins such as cleaved-caspase-3, cleaved-caspase-7, and Bax (Bcl-2-associated X protein). We further investigated the effect of LicoD on the AKT signaling pathway involved in various cellular processes and found decreased p-AKT, p-GSK3β, and p-NFκB expression. Treatment with MK-2206, an AKT pharmacological inhibitor, suppressed EGF-induced cell proliferation and transformed colony growth. In conclusion, this study demonstrated the potential of LicoD as a preventive agent for skin carcinogenesis.

OBJECTIVE: To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors. METHODS: The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR). RESULTS: Majority of polio survivors were middle-aged and mean age was 51.2+/-8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5+/-11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS. CONCLUSION: We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.
Age of Onset ; Cohort Studies ; Surveys and Questionnaires* ; Delivery of Health Care ; Female ; Gait ; Humans ; Interviews as Topic* ; Medical Records ; Middle Aged ; Odds Ratio ; Orthotic Devices ; Paralysis ; Poliomyelitis* ; Postpoliomyelitis Syndrome* ; Prevalence ; Risk Factors* ; Social Problems ; Survivors* ; Walking ; Surveys and Questionnaires