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We performed a single-center, randomized, double-blind study to compare muscle strength in patients who had undergone primary total knee arthroplasty (TKA), performed using either a minimally invasive or a conventional surgical technique. We evaluated 30 knees in healthy age-matched subjects, 22 knees after conventional TKA (conventional group), and 23 knees after minimally invasive surgery TKA (MIS group). The Hospital for Special Surgery (HSS) score, Oxford knee score (OKS), and isokinetic (60º/s) muscle strength were evaluated the day before surgery and 3, 6, and 12 months after surgery. HSS and OKS improved significantly over time during follow-up (p0.001), but there was no significant difference between the groups (p0.05). The extensor peak torque (EPT) and flexor peak torque (FPT) improved significantly over time (p0.001) and EPT was greater in the MIS group than in the conventional group during the follow-up period (p0.05). There was no difference in FPT and the hamstring-to-quadriceps ratio between the groups. Although MIS patients had a significant deficit in extensor strength following TKA, compared with healthy controls, this approach offers a significant improvement in extensor muscle strength over conventional surgery. These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

This article describes a novel medial meniscal allograft transplantation method that permits easy passage of posterior bone plugs and facilitates bone-to-bone healing. With this method, an anterior bone plug with a long cylindrical shape is prepared, and the posterior bone plug is prepared using only a 2-mm deep, flat bone shell containing cancellous material with 6 baseball Ethibond stitches placed around it. The graft is divided into 3 portions, and boundaries of each are marked. Using a posteromedial portal, the posterior bony bed is prepared directly, and the exact anatomic location is visualized. This modified method facilitates graft passage as well as bone-to-bone healing.

The purpose of this study was to investigate the improvement of allergic dermatitis in chemical allergen-induced mice by Lactobacillus sakei probio 65. L. sakei probio-65 was isolated from kimchi, a traditional Korean fermented food. This strain was resistant to gastric acidity, bile, and several antibiotics and possessed antimicrobial activity against several pathogenic microorganisms. To investigate whether the probiotic activity of L. sakei probio 65 was effective for treating allergic dermatitis, the organism was supplied to mice triggered by allergen (1-chloro-2,4-dinitrobenzene). Mice that received L. sakei probio 65 showed a more rapid recovery compared to control mice, as assessed by visual evaluation of the severity of allergic dermatitis and levels of immunoglobulin (Ig) E and interleukin (IL)-4. L. sakei probio 65 exhibited good probiotic properties in vitro and in mice and was effective in reducing allergen-induced skin inflammation through the regulation of both elevated IgE and IL-4 in sensitized mice.

Insulin-like growth factor-I (IGF-I) rich fraction, collected components between 1 kDa and 30 kDa, was fractionated from bovine colostral whey using an ultrafiltration membrane. IGF-I was confirmed in the collected IGF-I rich fraction by both SDS- PAGE and Western blotting. The concentration of IGF-I in the IGF-I rich fraction was 10 ng/mg protein. One hundred microliters of the reconstituted IGF-I rich fraction was intraperitoneally injected into ICR male mice for 2 weeks at 24 h intervals. The functions of peritoneal macrophages, including phagocytosis, interleukin (IL)-6 and tumor necrosis factor (TNF)-α production, and nitric oxide and hydrogen peroxide production, were enhanced significantly by the administration of the IGF-I rich fraction in a dose-dependent manner (p

One of the biological functions of lactoferrin is the modulation of the host defense systems, including cytokine production and immune responses. We have tested the effect of lactoferrin on the productions of tumor necrosis factor-α and nitric oxide in some cells. Lactoferrin itself did not induce either tumor necrosis factor-α production or nitric oxide production, but lipopolysaccharide-stimulated tumor necrosis factor-α production of macrophages and monocytes were inhibited by lactoferrin treatment combined with stimulant. The induction of nitric oxide synthesis in stimulated macrophages and vascular smooth muscle cells was not affected by the lactoferrin. J. Cell. Biochem. 76:30–36, 1999. © 1999 Wiley-Liss, Inc.

Desflurane is the most pungent of the currently used volatile anesthetics. We assessed whether the incidence of perioperative upper respiratory events in children undergoing general anesthesia via a supraglottic airway is higher with desflurane than with sevoflurane as maintenance anesthetic.We retrospectively reviewed and analyzed the electronic medical records of consecutive children 1 to 15 years of age who underwent general anesthesia via a supraglottic airway at Seoul National University Bundang Hospital between June 2013 and June 2015. The patients were assigned to the sevoflurane or desflurane group according to the anesthetic used. The characteristics of the patients were compared. The primary outcome variable was the incidence of upper respiratory events.The incidence of upper respiratory events in the 3439 evaluated patients was 0.43% (12/2777) in the sevoflurane group and 0.30% (2/662) in the desflurane group (P = 0.75; odds ratio = 0.69 [95% confidence interval = 0.16-3.13]). The difference between the 2 groups was not significant.Compared with sevoflurane, desflurane does not increase the risk of perioperative upper respiratory events in children receiving general anesthesia via a supraglottic airway.

To investigate the clinical, radiologic, and arthroscopic findings of pullout repair in medial meniscus root tear (MRT) and to compare the results of pullout repair and partial meniscectomy.This study enrolled 58 consecutive patients with medial MRT who underwent partial meniscectomy (M group, n = 28) or pullout repair (R group, n = 30) between September 2003 and August 2007. The patients were evaluated by the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, joint space narrowing, and Kellgren-Lawrence grade on simple radiographs. Medial meniscal extrusion and the state of the meniscus and articular cartilage on magnetic resonance imaging (MRI) were documented. We performed second-look arthroscopy in 14 patients with pullout repair and evaluated fixation strength and hoop tension of the meniscus and the state of the articular cartilage.There were no differences in demographic data (age, sex, and body mass index) between the 2 groups. The mean follow-up was 48.5 months in the R group and 46.1 in the M group. Lysholm and IKDC scores improved significantly in both groups (P.05). However, the R group had better Lysholm and IKDC scores and less joint space narrowing and progression of the Kellgren-Lawrence grade than the M group did (P.05). In a subgroup analysis of the R group, medial meniscal extrusion on MRI decreased from 3.13 to 2.94 mm. Of the patients, 28 (93.3%) showed complete or partial healing of the meniscus. On MRI, 6 (20%) showed arthrosis progression. On second-look arthroscopic examinations in 14 patients in the R group, 9 (64.3%) showed normal fixation strength, 10 (71.4%) had normal restoration of hoop tension, 5 (35.7%) showed arthrosis progression, and 2 (6.7%) had repeat tears of the meniscus.Arthroscopic pullout repair of a medial MRT gave significantly better clinical and radiologic results than partial meniscectomy, and sound healing with restoration of hoop tension of the meniscus was observed on MRI and second-look arthroscopy. We propose that this method is an effective treatment for medial MRT.Level III, retrospective comparative study.

Female athletes are more prone to anterior cruciate ligament (ACL) injury than their male counterparts, presumably because of anatomical, hormonal, and neuromuscular differences. Of these three, only the neuromuscular component can be modified by preventive exercise. We aimed to evaluate the effect of a neuromuscular protocol on the prevention of ACL injury by performing meta-analysis, and to identify essential factors by subgroup analysis. An extensive literature review was conducted to identify relevant studies, and eventually, only seven randomized controlled trials or prospective cohort studies were included in the analysis. The odds ratios (OR) and the confidence interval (CI) for the overall effects of training and of potentially contributory factors were estimated. The OR and the 95% CI for the overall effect of the preventive training were 0.40 and [0.27, 0.60], respectively. Subgroup analysis revealed that an age under 18, soccer rather than handball, pre- and in-season training rather than either pre- or in-season training, and the plyometrics and strengthening components rather than balancing were significant. Meta-analysis showed that pre- and in-season neuromuscular training with an emphasis on plyometrics and strengthening exercises was effective at preventing ACL injury in female athletes, especially in those under 18 years of age. Further study is required to develop a relevant training program protocol of appropriate intensity.

A 68-year-old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain, swelling, and a warm sensation in her left thigh. She had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation. Her erythrocyte sedimentation rate and C-reactive protein (CRP) levels were elevated. In addition, a postoperative infection was suspected in the 3-phase bone scan; therefore, she received intravenous antibiotic therapy. This approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color Doppler ultrasonography. It is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection. Furthermore, an elevated CRP level is frequently observed in patients suffering from polycythemia vera. Therefore, the two conditions, which require completely different treatments, can be confused. We report on this case with a review of the relevant literature.

Purpose: This study was conducted for comparison of clinical and second look arthroscopic results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. Materials and Methods: Thirty-six patients who underwent ACL reconstruction between March 2008 and October 2011 were enrolled in this study. We divided the patients into two groups, those in the early reconstruction group underwent surgery before one week, and those in the delayed reconstruction group underwent surgery after three weeks, before six weeks. We checked clinical results and second look arthroscopic results and analyzed correlation of clinical and second look arthroscopic results. Results: At the final follow up, the Lysholm, International Knee Documentation Committee, and Tegner score were not statistically different between the two groups (p=0.173, p=0.154, p=0.109). No difference for the range of motion (p=0.808, p=0.680), Lachman test (p=0.377), and pivot shift test (p=0.894) was observed between the groups. In the results of second look arthroscopy, there was no difference in graft continuity (p=0.936), tension (p=0.944) and synovial coverage (p=0.789). No statistical clinical correlation was observed between clinical and second look arthroscopic results (p>0.05). Conclusion: We obtained satisfactory clinical and second look arthroscopic results in both the early and delayed ACL reconstruction groups. Therefore, early reconstruction of ACL performed before one week could be a treatment options for acute ACL injury.

Results: The volume of blood loss during the operation was statistically lesser in the PFNA group (P

The gene (bglT) encoding Tca beta-glycosidase (Thermus caldophilus GK24 beta-glycosidase) was overexpressed under the control of the trp promoter on a high-copy-number plasmid, pTRPES, in Escherichia coli W3110. The purified Tca beta-glycosidase enzyme was used in a galactosyl-transfer reaction to synthesize galacto-oligosaccharides from lactose. The optimum temperature and pH for the enzyme to synthesize galacto-oligosaccharides from 30% (w/v) lactose were 80 degrees C and 6.0, respectively. The major product of the reaction was a trisaccharide. The thermostable Tca beta-glycosidase produced galacto-oligosaccharides efficiently during the hydrolysis of lactose.