To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and theKorean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measlesmumps- rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.

To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and the Korean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measles-mumps-rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.

PURPOSE: We aimed to analyze the clinical results and investigate the factors that affect the range of motion (ROM) after revision total knee arthroplasty. MATERIALS AND METHODS: We measured the range of motion from 61 knees of 55 patients who underwent revision total knee arthroplasty using the Nexgen(R) LCCK and we investigated the factors affecting the postoperative ROM, including age, the body mass index (BMI), the preoperative ROM, deformity, causes of revision (septic vs. aseptic) and the type of polyethylene inserts (constrained vs. posterior-stabilized). The clinical results and radiographic findings were assessed using the American Knee Society Score and the roentgenographic method of the American Knee Society. RESULTS: The mean range of motion was improved from 113.7degrees to 127.2degrees. The preoperative ROM (p=0.000) and diagnosis (p=0.006) significantly influenced the postoperative ROM, yet age (p=0.386), BMI (p=0.054), deformity (p=0.218) and the type of polyethylene insert (p=0.195) were not related to the postoperative knee ROM. The American Knee Society Knee Score and Function Score on average was improved from 31.7 and 27.9 points to 86.7 and 64.7 points, respectively. CONCLUSION: The range of motion and clinical results were satisfactory after revision total knee arthroplasty using the Nexgen(R) LCCK, and the important factors affecting the range of motion after operation were the preoperative ROM and the causes of revision. The range of motion after arthroplasty using the constrained type polyethylene insert was not inferior to that using the posterior-stabilized insert.
Arthroplasty ; Body Mass Index ; Congenital Abnormalities ; Humans ; Knee ; Knee Joint ; Polyethylene ; Range of Motion, Articular

PURPOSE: This study was conducted to measure the length of the patellar tendon in normal adults and to analyze the effect of several anthropological variables on the patellar tendon length. MATERIALS AND METHODS: The study included 316 knees (278 males, 38 females) that were undergoing anterior cruciate ligament reconstruction with a bone-patellar-bone autograft. The patellar tendon length was measured on the middle 1/3 of the ipsilateral patellar tendon taken during the operation and we analyzed the relationships between the tendon length and age, weight, height and gender using simple correlation tests and linear regression analysis. RESULTS: The mean tendon length was 42.6 mm (range: 30~60 mm) and the mean age, mean weight and mean height was 32.7 years, 72.8 kg and 170.2 cm, respectively. There was weak negative correlation between the tendon length and age (Pearson correlation r=-0.187) and weak positive correlation between the tendon length and weight (r=0.288) but there was no significant correlation between tendon length and the body mass index (p=0.282) There was a positive correlation between tendon length and height (r=0.434). There was a significant difference between the males and females for the length of tendon (p<0.001), yet after removing the variance of height, the difference was statistically insignificant (beta=-0.041, p=0.491). The linear regression equation for the patellar tendon length (y, in centimeters) as a function of height (x, in centimeter) can be expressed as y=0.032x1.183. CONCLUSION: The length of the patellar tendon is correlated with height, and a patient's height can predict the length of the patellar tendon.
Adult ; Anterior Cruciate Ligament Reconstruction ; Body Mass Index ; Female ; Humans ; Knee ; Linear Models ; Male ; Patellar Ligament ; Tendons

PURPOSE: We wanted to evaluate the results of treating acromioclavicular joint dislocation using an AO hook plate. MATERIALS AND METHODS: Between February 2008 and September 2009, 10 patients underwent implant removal after surgical treatment of acromioclavicular joint dislocation using a AO hook plate. The Constant-Murley scoring system was administered postoperatively for evaluating the clinical results, and simple X-ray was taken for evaluating the state of reduction. RESULTS: All cases showed satisfactory results on the clinical and radiological study. The mean Constant-Murley score at follow-up was 90.5 (range: 84~95). Three patients had some degree of discomfort with the hook plate, but these symptoms were relieved on removal of the plate. The radiological evaluation showed restoration of the vertical displacement of the clavicle in all the patients. No complications occurred such as infection, plate failure or redislocation after removal of the plate. CONCLUSION: The short term follow-up results of treating acromioclvicular joint dislocation using an AO hook plate were satisfactory both clinically and radiologically.
Acromioclavicular Joint ; Clavicle ; Dislocations ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Joints

Bony ankylosis secondary to heterotopic ossification following total knee arthroplasty is extremely rare, and to the best of our knowledge, there has been no reported case of this in Korea. We present such a case in a 48 year-old female who underwent primary total knee replacement due to traumatic osteoarthritis.
Ankylosis ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Female ; Humans ; Knee ; Korea ; Ossification, Heterotopic ; Osteoarthritis

PURPOSE: To investigate the in vitro response of MC3T3-E1 osteoblastic cells to X-ray in the presence and absence of 2 deoxy-D-glucose (2-DG) and quercetin (QCT). MATERIALS AND METHODS: The MC3T3-E1 cells were cultured in an alpha-MEM supplemented with 5 mM 2-DG or 10 micrometer QCT and then the cells were incubated for 12 h prior to irradiation with 2, 4, 6, and 8 Gy using a linear accelerator (Mevaprimus, Germany) delivered at a rate of 1.5 Gy/min. At various times after the irradiation, the cells were processed for the analyses of proliferation, viability, cytotoxicity, and mineralization. RESULTS: Exposure of the cells to X-ray inhibited the tritium incorporation, 3-(4, 5-dimethylthiazol-2yl-)-2, 5- diphenyl tetrazolium bromide (MTT)-reducing activity, and alkaline phosphatase (ALP) activity, and caused cytotoxicity and apoptosis in a dose-dependent manner of the X-ray. This effect was further apparent on day 3 and 7 after the irradiation. RA+2-DG showed the decrease of DNA content, cell viability, and increase of cytotoxicity rather than RA. ALP activity increased on day 7 and subsequently its activity dropped to a lower level. 2-DG suppressed the calcium concentration, but visual difference of number of calcified nodules between RA and RA+2-DG was not noticed. RA+QCT showed the increase of DNA content, cell viability, but decrease of cytotoxicity and subG1 stage cells in the cell cycle, and increased calcified nodules in von Kossa staining rather than the RA. ALP activity showed significant increases on day 7 and subsequently its activity dropped to a lower level. CONCLUSION: The results showed that the 2-DG acted as a radiosensitizing agent and QCT acted as a radioprotective agent respectively in the irradiated MC3T3-E1 osteoblast-like cells.
Alkaline Phosphatase ; Apoptosis ; Calcium ; Cell Cycle ; Cell Survival ; Deoxyglucose* ; DNA ; Osteoblasts* ; Particle Accelerators ; Quercetin* ; Tritium

Hemolytic uremic syndrome (HUS) is characterized clinically by classic triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The illness is uncommon and various agents have been associated with HUS, such as infectious, genetic, environmental and phamacological factor. We experienced a case of hemolytic uremic syndrome in a eighty-year old man with a evidence for recent Epstein-barr virus infection. He developed hemolytic anemia, thrombocytopenia, hypertension and azotemia. His renal dysfunction was recovered by hemodialysis, plasmapheresis, warfarin and dypiridamole. We present this case with a review of the literature.
Acute Kidney Injury ; Anemia, Hemolytic ; Azotemia ; Disseminated Intravascular Coagulation ; Hemolytic-Uremic Syndrome* ; Herpesvirus 4, Human ; Hypertension ; Plasmapheresis ; Renal Dialysis ; Thrombocytopenia ; Warfarin

Metastatic tumors to the jaw bones are uncommon. The most common metastatic tumors to the jaw bones are the breast, lung and kidney. In the jaw bones, the common location of the lesions is the mandible, and the posterior area of the mandible is more commonly affected. The radiographic appearance is quite variable. In this report, a very rare case of metastatic gastric adenocarcinoma to the mandible is presented. The patient had undergone a gastrectomy 3 years ago.
Adenocarcinoma* ; Breast ; Gastrectomy ; Gingival Neoplasms ; Humans ; Jaw ; Kidney ; Lung ; Mandible* ; Neoplasm Metastasis ; Stomach Neoplasms

PURPOSE: To characterize the effects of 2-deoxy-D-glucose (2DG) and quercetin (QCT) on cytokine secretion of IL-6, TGF-beta and gene expression of Col I in irradiated MC3T3-E1 cells. MATERIALS AND METHODS: The MC3T3-E1 cells were cultured in an alpha-MEM supplemented with 5 mM 2DG or 10 mM QCT and then the cells were incubated 12h before irradiation with 2, 4, 6, and 8 Gy X-ray using a linear accelerator delivered at a dose rate of 1.5 Gy/min. Level of IL-6 and TGF-beta was determined by ELISA. Also expression of Col I was examined by RT-PCR. RESULTS: In accordance with the radiation dose, the amount of TGF-beta was not different in RA+QCT, but it showed a peak value in control and RA+2DG at 4Gy on the 3rd day. However, all groups showed a decreasing tendency dose-dependently in RA+QCT on the 7th day (p< 0.01). In accordance with the radiation dose, the amount of IL-6 increased dose-dependently in all groups on the 3rd day. On the 7th and 21st day, all groups showed peak values at 4Gy. RA+QCT showed a slightly increased amount of IL-6 at 2 Gy, but it showed a slightly decreased amount at 4, 6, and 8 Gy. In accordance with the period of culture after irradiation, the expression of Col I increased dosedependently in RA+QCT. CONCLUSIONS: The result showed that QCT acted as radiosensitizer in the secretion of TGF-beta and gene expression of Col I during differentiation in irradiated MC3T3-E1 cells at the cellular level.
Collagen Type I* ; Deoxyglucose* ; Enzyme-Linked Immunosorbent Assay ; Gene Expression* ; Interleukin-6 ; Osteoblasts* ; Particle Accelerators ; Quercetin* ; Transforming Growth Factor beta