Background: Medial meniscus posterior root tear can result in medial meniscus extrusion. However, the severity of medial meniscus extrusion is different in each root tear patient. The purpose of this study was to identify the factors that contribute to the severity of medial meniscus extrusion with medial meniscus posterior root tear, such as duration of disease, the degree of arthritis—chondral wear, subchondral edema, osteophyte size, and Kellgren– Lawrence (K/L) grade—and mechanical alignment for appropriate treatment method. Methods: From January 2009 to August 2014, we retrospectively analyzed magnetic resonance imaging (MRI) and simple x-ray of 99 patients with medial meniscus posterior root tear. The duration of the disease was identified through retrospective chart review. The severity of medial meniscus extrusion, the presence of subchondral edema, the degree of chondral wear, and the size of the osteophyte were measured on MRI. K/L grade was confirmed on simple x-ray, and the mechanical axis was measured on whole extremity radiographs. Statistical analysis was performed by using bivariate correlation analysis and one-way analysis of variance. Results: The mean medial meniscus extrusion was 4.61 mm, and the mean duration of the disease was 15.52 months.The mean degree of chondral wear was 25.8%, and 63 out of 99 cases showed subchondral edema. The average alignment was 4.30 degrees, and the average size of the osteophyte was 1.48 mm. There were 40 cases (40.4%) with K/ L grade I, 48 cases (48.5%) with grade II, 11 cases (11.1%) with grade III, and no cases with grade IV. In the group mean analysis between the K/L grade and the severity of medial meniscus extrusion, the average medial meniscus extrusions were 3.97 mm in grade I, 4.93 mm in grade II, and 5.59 mm in grade III. There was a statistical significance between the size of the osteophyte and the severity of medial meniscus extrusion (P = 0.000), K/L grade, and the severity of medial meniscus extrusion (P = 0.001). Conclusions The severity of medial meniscus extrusion with medial meniscus posterior horn root tear is associated with the size of the osteophyte and K/L grade.

BACKGROUND/AIMS: Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program. METHODS: In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital. RESULTS: Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p < 0.001). CONCLUSIONS: The quality metrics used in the United States and Europe may be directly introduced to other countries, including Korea. However, the optimal quality metrics should be established in each country.
Adenoma ; Colonoscopy ; Colorectal Neoplasms* ; Europe ; Humans ; Korea* ; Male ; Mass Screening* ; United States

The aim of this study was to prepare inclusion nanocomplexes of hyaluronic acid-β-cyclodextrin and simvastatin (HA-β-CD/SIM) and evaluate in vitro anti-inflammation effects on lipopolysaccharide (LPS)-activated synoviocytes and chondrogenic differentiation effects on rat adipose-derived stem cells (rADSCs). The β-CD moieties in HA-β-CD could incorporate SIM to form HA-β-CD/SIM nanocomplexes with diameters of 297–350 nm. HA-β-CD/SIM resulted in long-term release of SIM from the nanocomplexes for up to 63 days in a sustained manner. In vitro studies revealed that HA-β-CD/SIM nanocomplexes were able to effectively and dose-dependently suppress the mRNA expression levels of proinflammatory markers such as matrix metallopeptidase-3 (MMP-3), MMP-13, cyclooxygenase-2 (COX-2), a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5), interleukin-6 (IL-6), and tumor necrosis factor (TNF-α) in LPS-stimulated synoviocytes. HA-β-CD/SIM-treated rADSCs significantly and dose-dependently enhanced mRNA expressions of aggrecan, collagen type II (COL2A1), and collagen type X (COL10A1), implying that HA-β-CD/SIM greatly induced the chondrogenic differentiation of rADSCs. Conclusively, HA-β-CD/SIM nanocomplexes will be a promising therapeutic material to alleviate inflammation as well as promote chondrogenesis.
Aggrecans ; Animals ; Chondrogenesis ; Collagen Type II ; Collagen Type X ; Cyclooxygenase 2 ; In Vitro Techniques* ; Inflammation ; Interleukin-6 ; Rats ; RNA, Messenger ; Simvastatin* ; Stem Cells ; Thrombospondins ; Tumor Necrosis Factor-alpha

Nivolumab is an immune checkpoint inhibitor approved for the treatment of metastatic cancers. Here, we report the case of a 65-year-old male with recurrent renal cell carcinoma. After six cycles of nivolumab treatment, positron emission tomography/computed tomography (PET/CT) was performed to evaluate the response. PET/CT revealed diffuse ground glass opacities in both lungs. He developed a cough, sputum, chills, and a febrile sense. After bronchoscopic bronchoalveolar lavage, pneumocystis pneumonia was finally diagnosed.
Aged ; Bronchoalveolar Lavage ; Carcinoma, Renal Cell* ; Chills ; Cough ; Electrons ; Glass ; Humans ; Lung ; Male ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Positron-Emission Tomography and Computed Tomography ; Sputum

BACKGROUND/OBJECTIVES: In this study, we investigated whether Gelidium amansii extract (GAE) ameliorates obesity in diet-induced obese (DIO) mice. MATERIALS/METHODS: The mice were maintained on a high-fat diet (HD) for 5 weeks to generate the DIO mouse model. And then mice fed HD plus 0.5% (GAE1), 1% (GAE2) or 2% (GAE3) for 8 weeks. RESULTS: After the experimental period, GAE-supplemented groups were significantly lower than the HD group in body weight gain and liver weight. GAE supplemented groups were significantly lower than the HD group in both epididymal and mesenteric adipose tissue mass. The plasma leptin level was significantly higher in the HD group than in GAE-supplemented groups. The leptin level of HD+GAE3 group was significantly lower than that of the HD+conjugated linoleic acid (CLA) group. In contrast, plasma adiponectin level of the HD group was significantly lower than those of HD+GAE2 and HD+GAE3 groups. The expression levels of adipogenic proteins such as fatty acid synthase, sterol regulatory element-binding protein-1c, peroxisome proliferator-activated receptor γ, and CCAAT/enhancer binding protein α in the GAE supplemented groups were significantly decreased than those in HD group, respectively. In addition, the expression levels of HD+GAE2 and HD+GAE3 groups are significantly decreased compared to those of HD+CLA group. On the contrary, the expression levels of hormone-sensitive lipase and phospho-AMP-activated protein kinase, proteins associated with lipolysis, were significantly increased in the GAE supplemented groups compared to those in the HD group. HD+GAE3 group showed the highest level among the GAE supplemented groups. CONCLUSIONS: These results suggested that GAE supplementation stimulated the expressions of lipid metabolic factors and reduced weight gain in HD-fed C57BL/6J obese mice.
Adipogenesis ; Adiponectin ; Adipose Tissue ; Animals ; Body Weight ; Carrier Proteins ; Diet, High-Fat ; Leptin ; Linoleic Acid ; Lipolysis ; Liver ; Mice ; Mice, Obese* ; Obesity* ; Peroxisomes ; Plasma ; Protein Kinases ; Sterol Esterase ; Transcription Factors* ; Weight Gain

Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.
Humans ; Percutaneous Coronary Intervention* ; Thrombosis

Spontaneous bladder rupture is rare. Such an occurrence may appear similar to renal failure because the resulting urine leakage into the peritoneal cavity and absorption across the peritoneum increases serum creatinine although glomerular filtration rate is normal. A 46-year-old man presented with abdominal distension for 7 days after consuming a large volume of alcohol. Initial laboratory tests showed a blood urea nitrogen level of 174.3 mg/dL, serum creatinine of 11.49 mg/dL, and serum sodium of 105 mmol/L. Abdominal distension resolved after draining 5,200 mL of urine through a bladder catheter. Computed tomography cystography revealed intraperitoneal leakage of contrast dye from the left dome of the bladder, suggesting an intraperitoneal bladder rupture. Azotemia was completely normalized on the third day of hospitalization. This case shows that pseudo-renal failure should be considered when caring for a patient with unexplained azotemia and ascites.
Absorption ; Acute Kidney Injury ; Ascites ; Azotemia ; Blood Urea Nitrogen ; Catheters ; Creatinine ; Glomerular Filtration Rate ; Hospitalization ; Humans ; Hyponatremia* ; Middle Aged ; Peritoneal Cavity ; Peritoneum ; Renal Insufficiency ; Rupture* ; Rupture, Spontaneous ; Sodium ; Urinary Bladder*

BACKGROUND: The porion (Po) is used to construct the Frankfort horizontal (FH) plane for cephalometrics, and the external auditory meatus (EAM) is to transfer and mount the dental model with facebow. The classical assumption is that EAM represents Po by the parallel positioning. However, we are sometimes questioning about the possible positional disparity between Po and EAM, when the occlusal cant or facial midline is different from our clinical understandings. The purpose of this study was to evaluate the positional parallelism of Po and EAM in facial asymmetries, and also to investigate their relationship with the maxillary occlusal cant. METHODS: The 67 subjects were classified into three groups. Group I had normal subjects with facial symmetry (1.05 +/- 0.52 mm of average chin deviation) with minimal occlusal cant (<1.5 mm). Asymmetry group II-A had no maxillary occlusal cant (average 0.60 +/- 0.36), while asymmetry group II-B had occlusal cant (average 3.72 +/- 1.47). The distances of bilateral Po, EAM, and mesiobuccal cusp tips of the maxillary first molars (Mx) from the horizontal orbital plane (Orb) and the coronal plane were measured on the three-dimensional computed tomographic images. Their right and left side distance discrepancies were calculated and statistically compared. RESULTS: EAM was located 10.3 mm below and 2.3 mm anterior to Po in group I. The vertical distances from Po to EAM of both sides were significantly different in group II-B (p = 0.001), while other groups were not. Interside discrepancy of the vertical distances from EAM to Mx in group II-B also showed the significant differences, as compared with those from Po to Mx and from Orb to Mx. CONCLUSIONS: The subjects with facial asymmetry and prominent maxillary occlusal cant tend to have the symmetric position of Po but asymmetric EAM. Some caution or other measures will be helpful for them to be used during the clinical procedures.
Chin ; Dental Models ; Facial Asymmetry* ; Maxilla ; Molar ; Orbit

Simultaneous thrombosis of multiple coronary arteries in acute myocardial infarction is very rare in clinical settings. Its mechanism is not yet clear, but patients displaying multivessel simultaneous thrombosis tend to have poor clinical outcomes. Hence, it is important to recognize this condition and provide timely and proper management. We report a case of simultaneous thrombosis involving multiple coronary arteries in a patient with ST-segment elevation myocardial infarction.
Coronary Occlusion ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Thrombosis*

Although various animals have been used as models of cardiac valvular diseases in humans, the structural characteristics of cardiac valves in animals remain unclear. In this study, we investigated cardiac valves in representative animal models for the purpose of comparative anatomy. Adult hearts from three dogs, four goats, six rabbits, and six fowls were fixed with 10% neutral-buffered formalin and analyzed gross-anatomically. Cardiac appearance was spherical or oval in dogs, goats, and rabbits, whereas it had a long conical shape in fowls. Left atrioventricular (AV) valve was composed of membranous septal and parietal cusps connected to two papillary muscles in all animals. The right AV valve was composed of membranous septal, parietal, and angular cusps with three papillary muscles in dogs and goats, membranous septal and parietal cusps attached to four papillary muscles in rabbits, and a single muscular plate without any papillary muscles and chorda tendinae in fowls. Aortic valves with thin membranous right, left, and septal semilunar cusps in dogs, goats, and rabbits had a thick membrane with a bended free border in fowls. Pulmonary valve (PV) with membranous right, left, and intermediate semilunar cusps made a large central hole by being closely attached to the surrounding wall in dogs, goats, and rabbits, whereas it protruded into half of the lumen as a thick membrane in fowls. The membranous cusp of the PV was composed of several layers in dogs and goats but was a single layer in rabbits and fowls. These findings indicate that even if animals have two completely separated atria and ventricles each, cardiac valves have species-specific morphological characteristics, especially between mammals and fowls.
Adult ; Anatomy, Comparative ; Animals ; Aortic Valve ; Dogs ; Formaldehyde ; Goats ; Heart ; Heart Valves* ; Humans ; Mammals ; Membranes ; Models, Animal ; Papillary Muscles ; Pulmonary Valve ; Rabbits ; Rabeprazole