Background: Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. Objective: The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. Methods: Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at −80°C prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. Results: The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. Conclusions Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines

This study was conducted to evaluate three different mixed formulations of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) using a low-humidity air flow-induced rat dry eye model and determine the most suitable mixture. The total thickness of the cornea, corneal epithelial thickness, corneal stroma thickness, damaged corneal epithelium percentage region, thickness of the bulbar conjunctiva epithelium, number of goblet cells, goblet cell occupation percentage region, and damaged bulbar conjunctiva epithelium percentage region were measured by histomorphological evaluation. After 5 h exposure to drying airflow, the thickness of the cornea and conjunctiva was decreased with desquamation of the corneal and conjunctiva epithelium. However, these dry eye symptoms were markedly inhibited by treatment with the reference and test formulations. More favorable effects on decreased thickness were detected in response to the CMC than the SH. However, SH had a greater protective effect against corneal and conjunctiva epithelial damage. The application of a mixture of 0.1% SH and 0.2% CMC showed more favorable effects on the corneal and conjunctival damage and the stabilization of the ocular surface than SH or CMC alone.
Animals ; Carboxymethylcellulose Sodium* ; Conjunctiva ; Cornea ; Corneal Stroma ; Epithelium ; Epithelium, Corneal ; Goblet Cells ; Hyaluronic Acid* ; Occupations ; Rats* ; Sodium*

The objective of the present study was to examine the effects of beta-glucan originating from Aureobasidium on full-thickness skin wound healing in diabetic C57BL/KsJ-db/ db mouse models. In the diabetic C57BL/KsJ-db/db model, test articles were topically applied twice a day for 20 days starting from 1 day after wounding. The results were compared to that of MadecassolTM ointment (madecassol; 1% Centella asiatica extracts) topically applied at a concentration of 100 mg/kg. Treatment with beta-glucan resulted in significant (p<0.01 or p<0.05) and dose-dependent decreases in wound size compared with that of vehicle control showing increased wound size (WS, %). In addition, 50% contraction time (CT50) was dramatically and dose-dependently reduced, and inflammatory cells in granulation tissues of the wound area were significantly (p<0.01 or p<0.05) and dosedependently reduced compared with that of vehicle control showing increased numbers of micro-vessels and fibroblasts as well as re-epithelialization. In the madecassol group, similar changes in inflammatory cells and fibroblasts with re-epithelialization were also observed, but madecassol did not influence angiogenesis. No meaningful changes in body weight were detected in all tested groups compared with the vehicle control. Therefore, these data suggest that beta-glucan has a beneficial effect on diabetic delayed skin wound healing and may be useful to manage incurable skin wounds in diabetic animals.
Animals ; Body Weight ; Centella ; Fibroblasts ; Granulation Tissue ; Mice* ; Re-Epithelialization ; Skin ; Wound Healing* ; Wounds and Injuries*

PURPOSE: To determine what proportion of patients visiting a tertiary knee clinic had pre-obtained knee magnetic resonance imaging (MRI) and to assess the impact of pre-obtained knee MRI on the selection of treatment plans. MATERIALS AND METHODS: Six hundred and eighty patients were enrolled from patients who visited our knee clinic during a 6-month period. The proportion of patients with pre-obtained knee MRI was calculated, and associations of sociodemographic factors, disease category, and finally selected treatment options with knee MRI pre-obtainment were investigated. A utility assessment panel of five orthopaedic surgeons was formed and established utility assessment criteria. Two rounds of utility assessment (before and after MRI review) were performed. RESULTS: Of the 680 patients, 185 (27%) had pre-obtained knee MRI. In the first round of utility assessment, 39%, 18%, and 43% of the 185 knee MRIs were evaluated as useful, equivocal, and arguably useless, respectively, and almost identical results were obtained in the second round. The proportion of assessed 'useful MRI' was higher in sports related injury (84%) and other conditions (91%) than in degenerative joint disease (18%) and nonspecific knee pain (31%). Utility assessment results among panels varied little for practice patterns and education duration. CONCLUSIONS: This study suggests clinicians should reconsider and counsel patients the expected utility of knee MRI acquisition.
Education ; Humans ; Joint Diseases ; Knee ; Magnetic Resonance Imaging ; Sports

PURPOSE: Although the analgesic effects of corticosteroids have been well documented, little information is available on periarticular injection (PI) containing corticosteroids for early postoperative pain management after total knee arthroplasty (TKA). We performed a prospective double-blind randomized trial to evaluate the efficacy and safety of an intraoperative corticosteroid PI in patients undergoing TKA. MATERIALS AND METHODS: Seventy-six consecutive female patients undergoing bilateral staged TKA were randomized to receive steroid or non-steroid PI, with 3 months separating the procedures. The steroid group received PI with a mixture containing triamcinolone acetonide (40 mg). The non-steroid group received the same injection mixture without corticosteroid. During the postoperative period, nighttime pain, functional recovery [straight leg raising (SLR) ability and maximal flexion], patient satisfaction, and complications were recorded. Short-term postoperative clinical scores and patient satisfaction were evaluated at 6 months. RESULTS: The pain level was significantly lower in the PI steroid than the non-steroid group on the night of the operation (VAS, 1.2 vs. 2.3; p=0.021). Rebound pain was observed in both groups at POD1 (VAS, 3.2 vs. 3.8; p=0.248), but pain remained at a low level thereafter. No significant differences were seen in maximal flexion, frequency of acute rescuer, clinical scores, and patient satisfaction. The steroid group was able to perform SLR earlier than the non-steroid group (p=0.013). The incidence of complications was similar between the groups. CONCLUSION: PI containing a corticosteroid provided an additional pain-relieving effect on the night of the operation. In addition, corticosteroid PI did not increase the perioperative complications of TKA.
Adrenal Cortex Hormones ; Arthroplasty* ; Female ; Humans ; Incidence ; Knee* ; Leg ; Methods ; Pain Management* ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Triamcinolone Acetonide

Basal cell carcinoma (BCC) is the most common of all skin cancers, and ultraviolet radiation is the major etiologic agent in the pathogenesis of BCC. BCC occurring on areas that are not exposed to the sun seems to have different pathogenesis that is not fully understood. Many histologic variants of BCC exist, reflecting its pluripotential origin from epithelial germ cells. Herein we report a case of BCC on the right axilla, which is an unusual place for its occurrence.
Axilla ; Carcinoma, Basal Cell ; Germ Cells ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Skin Neoplasms ; Solar System

Amelanotic maliganat melanoma is a comparatively rare disease. It accounts for 1.8~8.1% of all malignant melanoma. It is sometime difficult to diagnose amelanotic malignant melanoma because there is no pigmentation, clinically. Polypoid melanoma is a variant of nodular melanoma, which in depth seldom reaches the reticular dermis. The main part of the tumor is located above the nearby epidermis, raised in the form resembling cauliflower. We report a rare case of amelanotic malignant melanoma with polypoid feature in a 78-year-old woman who presented a single bright red nodule on the left thigh.
Aged ; Brassica ; Dermis ; Epidermis ; Female ; Humans ; Melanoma ; Melanoma, Amelanotic ; Pigmentation ; Rare Diseases ; Thigh

BACKGROUND AND OBJECTIVES: There is no general consensus as to the normal limit or recommended procedure for visual fixation index (VFI) during caloric test because fixation suppression (FS) could be influenced by different variables. In this study, we present our mathematical modeling according to different variables to establish a clinical implication of VFI in patients with vertigo. MATERIALS AND METHODS: Data were analyzed from a retrospective record of patients who underwent caloric testing. Three subgroups were classified (normal caloric response, unilateral vestibular hypofunction and central vertigo). VFI distribution and mathematical modeling to estimate an associated probability were performed from each group. A receiver operation characteristics (ROC) curve was plotted to determine its diagnostic value. RESULTS: Four hundred eighteen, 67 and 14 patients met our inclusion criteria for normal caloric response, unilateral vestibular hypofunction and cerebellar infarction respectively. VFIs on warm irrigation showed more consistent distribution than cold irrigation in normal caloric response group. In contrast, there was significant inconsistency of VFIs between each side in unilateral vestibular hypofunction group (p>0.05). FS ability was inversely propositional with increase in age on all caloric (p<0.05). The area under the ROC curve of VFIs on warm caloric irrigation was 0.821 and that on cold irrigation was 0.785 for detecting central vertigo. CONCLUSION: Calibrated normal limit for VFI according to age is needed to ensure its clinical implication. Diagnostic value of VFI and its reliability on warm stimulation was superior to that of cold, which indicates VFI on warm stimulation seems to be a more reliable parameter.
Caloric Tests ; Cold Temperature ; Consensus ; Dietary Sucrose ; Humans ; Infarction ; Models, Theoretical ; Retrospective Studies ; ROC Curve

In this study, immunohistochemistry was used to examine the changes in the density of colonic endocrine cells - argyrophil and argentaffin cells, chromogranin A (CGA), serotonin, somatostatin and glucagon-containing cells in trinitrobenzene sulfonic acid (TNBS)-induced rat colitis. Ulcerative colitis was induced by the instillation of 10 mg of TNBS into the colonic lumen through the anus. To confirm the inducement of ulcerative colitis, the macroscopic and microscopic scores as well as the colonic myeloperoxidase (MPO) activities were monitored for 8 days after TNBS instillation in the colonic lumens. In addition, the number of argyrophil and argentaffin cells, CGA, serotonin, somatostatin and glucagon-immunoreactive cells were counted in the colonic mucosa, respectively. After TNBS instillation into the lumen of the colon from the anus in rats, increases in macroscopic and microscopic scores in the colon tissues were observed along with increases in the colonic MPO activities. Therefore, ulcerative colitis was relatively well induced by the TNBS instillations. Marked decreases in the number of colonic endocrine cells were detected in the TNBS-treated animal compared to the sham control. These results suggest that colonic endocrine cells were also disrupted by TNBS-induced ulcerative colitis.
Anal Canal ; Animals ; Chromogranin A ; Colitis ; Colitis, Ulcerative ; Colon ; Endocrine Cells ; Enterochromaffin Cells ; Immunohistochemistry ; Mucous Membrane ; Peroxidase ; Rats ; Salicylamides ; Serotonin ; Somatostatin