A magnetic resonance imaging test was performed on a 56-year-old male patient, who visited with a one-month history of painless swelling at the popliteal area of the left knee. A popliteal cyst and non-calcified loose body in the cyst were identified. Synovial chondromatosis was diagnosed from a histology examination by excision and biopsy. This paper reports this case of extra-articular synovial chondromatosis of the knee with a review of the relevant literature.

Background: We aimed to evaluate the effect of vitamin D levels on the functional outcome of elderly women who underwent total knee arthroplasty (TKA). Methods: Seven hundred and four patients (1013 knees) who underwent primary TKA were included in our retrospective study. Preoperative vitamin D levels were measured and the relationship analyzed between these and age, weight, height, body mass index, and bone mineral density. Two hundred and twenty patients (220 knees) who received unilateral TKA and were followed up for more than 1 year after operation were divided into two groups: Group 1, serum 25-hydroxyvitamin D3 (25(OH)D3) level < 20 ng/ml; and Group 2, 25(OH)D3 level ≥ 20 ng/ ml. Both groups were evaluated for the relationship between vitamin D levels and postoperative Visual Analogue Scale (VAS) score, Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. Results: The number of vitamin D-deficient patients (< 20 ng/ml of serum 25(OH)D3 level) was 556 (79.0%). In the correlation analysis, the vitamin D level was negatively correlated with weight only (pConclusions Vitamin D deficiency was highly prevalent in patients who underwent TKA. Vitamin D levels negatively correlated with weight. Low vitamin D level was not a risk factor for unsatisfactory TKA outcome in elderly women.

Background: We applied bibliometric tools to original articles published in the official journal of the Korean Knee Society between 1999 and 2018 to identify their characteristics related to knee surgery and to examine the changes in research trends in the last 20 years. Methods: Over a 20-year period, 579 original articles were published in the journal Knee Surgery and Related Research (KSRR). We analyzed the title, keywords, and abstract of the article to analyze the research topics and assigned original articles to seven surgical categories as follows: total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), high tibial osteotomy (HTO), arthroscopy, surgery for cruciate ligament, revision surgery, and other surgery. To analyze the trends in research, we divided the study period into two equal parts of 10 years each, examined the percentage of articles in each decade, and analyzed topic trends using the growth rate. Results: Among the original articles, 86 on the topic of non-surgery were excluded, and 493 original articles related surgical research were included. Articles related to surgery accounted for 85.2% of the total original articles published annually. By period, this was 85.6% in the first half and 84.8% in the late half (p = 0.76). A total of 493 original articles related to surgery, with the largest number of TKA-related research at 52.1%. In the study period, the largest increase in the percentage of articles was on the topic of HTO surgery, by 149%. The topics of UKA and revision surgery increased by 95.3% and 33.9%. The topic of TKA increased by 5.9% and the topic of surgery for cruciate ligament decreased by 18.7%. The topic of arthroscopy showed the largest decrease, by 47.6%. Conclusions The bibliometric findings of this study suggest that the majority of surgery-related original articles published in KSRR during the last 20 years involved research about TKA surgery, and the greatest relative increase over the study period involved research about HTO surgery. The authors expect that the analysis of characteristics and research trends of original articles published in KSRR will provide useful information about KSRR for future researchers.

Purpose: This study evaluated the usefulness of a silicone ring tourniquet by analyzing the changes in the perioperative hemoglobin (Hb) levels or amount of perioperative bleeding compared to those of a pneumatic tourniquet or no usage during minimally invasive plate fixation for distal femoral fractures. Materials and Methods: From January 2017 to December 2019, 30 patients who underwent minimally invasive plate fixation using a locking compression plate for distal femoral fractures were evaluated and classified as a silicone ring tourniquet (Group 1), a pneumatic tourniquet (Group 2), and no usage (Group 3). The variables for analysis were age, sex, preoperative Hb (preHb), postoperative 72-hour Hb (postHb), differences between preHb and postHb (preHb-postHb), amount of intraoperative and overall transfusion, estimated unit of transfusion corrected by preHb-postHb and total transfusion (Hb-lost), amount of intraoperative and postoperative and total bleeding. One-way ANOVA was used to identify the differences between the groups. Results: The age, sex, operation time, preHb, preHb-postHb, amount of intraoperative and overall transfusion and Hb-lost were similar in the two groups. The amount of intraoperative bleeding was significantly lower in Group 1 than Group 3 (p=0.004), but there was no difference in the amount of postoperative and total bleeding between the two groups. Conclusion The use of a silicone ring tourniquet in the minimally invasive plate fixation for distal femoral fractures decreased the amount of intraoperative bleeding compared to no use of a tourniquet.

Thromboembolic events are reported to occur with a high frequency in the setting of malignancy. However, reports on an association between cholangiocarcinoma and pulmonary thromboembolism, thus far, are almost lacking. We present here an unusual case of a 56-yr-old patient presenting cholangiocarcinoma and unexplained pulmonary thromboembolism. The patient had been quite healthy before the diagnosis. Coagulation tests showed elevated levels of fibrinogen, fibrinogen degradation product (FDP), D-dimer, and IgM anticardiolipin antibody (aCL Ab). The thromboemboli were resolved 3 weeks after anticoagulant therapy using lowmolecular-weight-heparin. Then, follow-up coagulation tests showed a marked decrease to normal in aCL Ab titer as well as the normalization of FDP and D-dimer levels. In this case, we describe pulmonary thromboembolism caused by hypercoagulable state associated with cholangiocarcinoma and speculate that such a thrombotic phenomenon could be regressed by anticoagulant therapy.
Antibodies, Anticardiolipin/blood ; Anticoagulants/therapeutic use ; Bile Duct Neoplasms/*complications ; *Bile Ducts, Intrahepatic ; Blood Coagulation Factors/analysis ; Cholangiocarcinoma/*complications ; Fibrin Fibrinogen Degradation Products/analysis ; Fibrinogen/analysis ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/*blood/drug therapy/etiology ; Syndrome ; Treatment Outcome

Liver cirrhosis is one of the major complications of hepatitis C virus (HCV) infection, but the mechanisms underlying HCV-related fibrogenesis are still not clear. Although the roles of HCV core protein remain poorly understood, it is supposed to play an important role in the regulation of cellular growth and hepatocarcinogenesis. The aim of this study was to examine the role of HCV core protein on the hepatic fibrogenesis. We established an in vitro co-culture system with primary hepatic stellate cell (HSC) isolated from rats, and a stable HepG2-HCV core cell line which had been transfected with HCV core gene. The expressions of fibrosis-related molecules transforming growth factor beta1 (TGF-beta1), transforming growth factor b receptor II (TGF beta RII), alpha-smooth muscle actin (alpha-SMA) and connective tissue growth factor (CTGF) were analyzed via histological or molecular methods. In addition, the expression levels of matrix metaloprotinase-2 (MMP-2) and collagen type I (Col I) from the co-cultured media were measured by zymogram and ELISA, respectively. The expressions of alpha-SMA, TGF-beta1, Col I, TGF beta RII and MMP-2 were significantly increased in the co-culture of stable HepG2-HCV core with HSC. Moreover, the significant increases of CTGF and TGF-beta1 in the HCV core-expressing cells were observed by either Northern or Western blot analysis. These results suggest that HCV core protein may contribute to the hepatic fibrogenesis via up-regulation of CTGF and TGF-beta1.
Actins/metabolism ; Animals ; Cell Line, Tumor ; Cells, Cultured ; Coculture Techniques ; Collagen Type I/metabolism ; Gelatinase A/metabolism ; Immediate-Early Proteins/*biosynthesis ; Intercellular Signaling Peptides and Proteins/*biosynthesis ; Liver/metabolism/*pathology ; Liver Cirrhosis/*metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Transforming Growth Factor beta/metabolism ; Research Support, Non-U.S. Gov't ; Transforming Growth Factor beta/*metabolism ; Up-Regulation ; Viral Core Proteins/genetics/*metabolism

BACKGROUND/AIMS: Lamivudine is an antiviral nucleoside analogue effective for the treatment of hepatitis B virus (HBV) infection via the inhibition of DNA polymerase activity. The mutations, however, in YMDD motif, such as YVDD and YIDD, have been found to interfere with the therapeutic efficacy of lamivudine. This study was performed to identify the role of such mutant-type HBV among Korean hepatitis B patients with chronic hepatitis or cirrhosis receiving lamivudine treatment. METHODS: Serum samples were collected from four groups of patients; patients with breakthrough (group I, n = 8); patients who showed no response after the treatment (group II, n = 6); patients who showed good response (group III, n = 6); patients with chronic hepatitis B without any treatment (group IV, n = 4). Mutations were detected by PCR-cloning and automated sequencing. RESULTS: Mutations in YMDD were found in only 4 (50%) in group I and were negative in group II. No mutations could be identified in the serum samples collected before treatment and from groups III and IV. YVDD mutation was found to be associated with two additional mutations, 'L-to-M' in 528th amino acid and 'L-to-V' in 577th amino acid. CONCLUSIONS: Lamivudine resistance appeared in three different patterns: (1) breakthrough related to the mutations in YMDD motif; (2) breakthrough not related to the YMDD mutations; and (3) primary non-responder not related to the YMDD mutations.
DNA ; Fibrosis* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Lamivudine

PURPOSE: In the present study, the effects of bFGF on the early responses of proliferation of UMR 106-01 osteoblast cells during cell cycle reentry from the latent(G0/G1) to the proliferative periods(S/M) were investigated. MATERIALS AND METHODS: The synchronized cell culture method using the serum starvation was utilized. After the addition of bFGF, the time courses of protein synthesis, DNA synthesis, thymidylate synthase(TS) activity, TS mRNA level and expression of c-fos were determined. RESULTS: 87% UMR 106-01 cells were synchronized to G0/G1 by serum starvation for seven days in the medium containing 0.1% serum. The protein level began to increase 3 hours after bFGF treatment and reached the maximum at 18 hours. TS activity began to increase 3 hours after the bFGF treatment and reached its peak at 6 hours while its mRNA level, determined by quantitative PCR, reached the maximum at 12 hours. The expression of c-fos protein, determined by western blot analysis and immunocytochemistry, increased 3 hours after bFGF treatment. On the contrary, these prominent changes and responses to bFGF were not observed in the case of using non-synchronized cells cultured in the medium containing 10% serum. CONCLUSION: Based on these data it can be concluded that bFGF-induced DNA synthesis in the early proliferative phase is due to increases in both TS activity and mRNA amount and that the increase in c-fos expression and TS activity occur before the increase in TS mRNA level.
Blotting, Western ; Cell Culture Techniques ; Cell Cycle ; DNA ; Fibroblasts* ; Immunohistochemistry ; Osteoblasts* ; Polymerase Chain Reaction ; RNA, Messenger ; Starvation ; Thymidylate Synthase*

PURPOSE: In the present study, the effects of bFGF on the early responses of proliferation of UMR 106-01 osteoblast cells during cell cycle reentry from the latent(G0/G1) to the proliferative periods(S/M) were investigated. MATERIALS AND METHODS: The synchronized cell culture method using the serum starvation was utilized. After the addition of bFGF, the time courses of protein synthesis, DNA synthesis, thymidylate synthase(TS) activity, TS mRNA level and expression of c-fos were determined. RESULTS: 87% UMR 106-01 cells were synchronized to G0/G1 by serum starvation for seven days in the medium containing 0.1% serum. The protein level began to increase 3 hours after bFGF treatment and reached the maximum at 18 hours. TS activity began to increase 3 hours after the bFGF treatment and reached its peak at 6 hours while its mRNA level, determined by quantitative PCR, reached the maximum at 12 hours. The expression of c-fos protein, determined by western blot analysis and immunocytochemistry, increased 3 hours after bFGF treatment. On the contrary, these prominent changes and responses to bFGF were not observed in the case of using non-synchronized cells cultured in the medium containing 10% serum. CONCLUSION: Based on these data it can be concluded that bFGF-induced DNA synthesis in the early proliferative phase is due to increases in both TS activity and mRNA amount and that the increase in c-fos expression and TS activity occur before the increase in TS mRNA level.
Blotting, Western ; Cell Culture Techniques ; Cell Cycle ; DNA ; Fibroblasts* ; Immunohistochemistry ; Osteoblasts* ; Polymerase Chain Reaction ; RNA, Messenger ; Starvation ; Thymidylate Synthase*

PURPOSE: When cells are subjected to stressful stimuli such as, heat shock, toxic metal, nutrient deprivation, and metabolic disruption, they increase production of specific stress proteins that buffer them from harm. We reported that the expression of a navel 90 kDa cellular protein was increased by the infection of a fish rhabdovirus and heat shock in a fish cell. This new 90 kDa protein is not expressed in normal animal tissues but is highly induced in progressively transforming tissues or cells. That gives us some ideas tl at it is possible for this stress protein to be expressed in specific human cancer tissues. MATERIALS AND METHODS: Commercialized checkerboard multi-tumor block (DAKO Co. Carpinteria, CA) was used for immunohistochemical analysis. The samples of human gastric cancer, colon cancer and breast cancer tissues were evaluated by Western blot and Northern blot for overexpression of the novel 90 kDa stress protein. Sera of those patients were analyzed by ELISA for the presence of antibody against the novel 90 kDa stress protein. RESULTS: Immunohistochemical staining of human tumor tissue blocks showed significant immunostaining of novel 90 kDa stress protein in carcinomas such as colon cancer, breast cancer and stomach cancer but no apparent immunostaining in sarcomas. Coinciding with the immunohistochemical result, Western blotting and Northern blotting analyses indicate that the expression of the novel 90 kDa stress protein was increased in carcinomas. In addition, the antibody titer against the novel 90 kDa stress protein was found to be elevated in the sera of cancer patients. CONCLUSIONS: The novel 90 kDa stress protein gene expression was elevated in carcinomas such as gastric cancer, breast cancer and colon cancer. These findings suggest that this new stress protein can be used as a tumor marker and may function as a chaperone in tumor growth.
Animals ; Blotting, Northern ; Blotting, Western ; Breast Neoplasms ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Heat-Shock Proteins ; Hot Temperature ; Humans* ; Rhabdoviridae ; Sarcoma ; Shock ; Shock, Septic ; Stomach Neoplasms