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Lee SH, Kim SH, Choi SJ, Lee YK. Cutaneous Calcified Mass of Foot in Pseudohypoparathyoidism: Case Report. Medicina (Kaunas) 2024; 60:595. [PMID: 38674241 PMCID: PMC11052086 DOI: 10.3390/medicina60040595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Soft tissue calcifications frequently appear on imaging studies, representing a prevalent but non-specific discovery, varying from a local reaction without clear cause to suggesting an underlying systemic condition. Because calcifications like these can arise from various causes, an accurate differential diagnosis is crucial. Differential diagnosis entails a methodical assessment of the patient, encompassing clinical presentation, medical history, radiological and pathological findings, and other pertinent factors. Through scrutiny of the patient's medical and trauma history, we can refine potential causes of calcification to vascular, metabolic, autoimmune, neoplastic, or traumatic origins. Furthermore, routine laboratory assessments, including serum levels of calcium, phosphorus, ionized calcium, vitamin D metabolites, and parathyroid hormone (PTH), aid in identifying metabolic etiologies. We describe a rare occurrence of osteoma cutis in a 15-year-old female patient with a history of pseudohypoparathyroidism (PHP) and Albright's hereditary osteodystrophy (AHO). The patient presented with a painful mass on the lateral side of her left foot. The diagnosis was based on medical history, laboratory tests, and imaging, leading to an excisional biopsy and complete pain relief post-surgery. Understanding such rare occurrences and related conditions is crucial for accurate diagnosis and management.
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Affiliation(s)
| | | | | | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea; (S.H.L.); (S.H.K.); (S.J.C.)
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Lee YK, Hariri A, Ghedia R, Tikka T, Kim D. Healing patient, harming planet? A drive towards sustainable surgery: review of waste production and recyclability of surgical instrument packaging. Ann R Coll Surg Engl 2024. [PMID: 38362809 DOI: 10.1308/rcsann.2023.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Healthcare contributes more than 1% of all domestic waste in the United Kingdom (UK), with operating theatre waste alone accounting for approximately 50% of all hospital waste. In November 2022, the UK Surgical Royal Colleges issued an Intercollegiate Climate Emergency Declaration and called for urgent action. We review waste production and the recyclability of surgical instrument packaging used in a common ear, nose and throat procedure (thyroidectomy) and suggest strategies to make this surgery more sustainable,. These strategies can be generalised to other surgeries. METHODS We prospectively audited packaging waste from 20 thyroidectomies performed at the Royal Marsden Hospital in the UK between July and December 2022. All packaging was weighed, categorised and analysed after the operation. RESULTS On average, each thyroidectomy produced packaging waste comprising 183g (34%) of plain paper/cardboard, 167g (31%) of soft plastic film, 142g (26%) of laminated paper, 37g (7%) of hard plastic and 11g (2%) of metal foil. Of all the packaging collected, only one item had a recycling label. When extrapolated to the 7,851 thyroidectomies performed in the National Health Service during the fiscal year 2021/2022, the estimated total weight of packaging waste would be 4.2 tonnes, of which only 31.4kg would be indicated as recyclable. When converted to an estimated carbon footprint, total carbon emissions would be 1,048kg CO2e, equivalent to three round trips from London to Edinburgh in a petrol car. CONCLUSION This audit demonstrates the different categories and vast amount of packaging waste from a common operation. Manufacturers should place clear recyclability labels on packaging, and switch to recyclable materials and a digital information booklet where possible. Local waste audit and analysis can be simple first steps towards making surgery more sustainable.
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Affiliation(s)
- Y K Lee
- The Royal Marsden NHS Foundation Trust, UK
| | - A Hariri
- The Royal Marsden NHS Foundation Trust, UK
| | - R Ghedia
- The Royal Marsden NHS Foundation Trust, UK
| | - T Tikka
- The Royal Marsden NHS Foundation Trust, UK
| | - D Kim
- The Royal Marsden NHS Foundation Trust, UK
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Kim SH, Lee SH, Lee YK. The Clinical Outcomes of Syndesmotic Flexible Fixation for Syndesmotic Injury With Ankle Fracture. Foot Ankle Int 2023; 44:1112-1119. [PMID: 37679997 DOI: 10.1177/10711007231194045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
BACKGROUND We evaluated whether the quality of syndesmotic reduction affects the short-term clinical outcomes of flexible fixation in patients with a rotational ankle fracture. METHODS This study included 59 patients (32 men and 27 women) who underwent syndesmotic flexible fixation. The degree of syndesmotic reduction was evaluated on computed tomography (CT) images acquired within 3 days after surgery. We measured the divergence between anterior and posterior incisura at 1 cm above the distal tibial articular joint, then evaluated the degree of fibular rotation relative to the tibia. At 1 year after surgery, an objective clinical evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, the visual analog scale (VAS), and the Foot and Ankle Outcome Score (FAOS). Additionally, repeat arthroscopy was performed during routine implant removal at nearly 1 year postoperatively. RESULTS Among 59 patients who underwent syndesmotic flexible fixation, 56 patients had syndesmotic stability on repeat arthroscopy. At 1 year postoperation, AOFAS, VAS, and FAOS scores were, respectively, 90, 2.0, and 94 in the accurate reduction group (n = 24) and 90, 1.0, and 94.5 in the malreduction group (n = 35). CONCLUSION Reduction quality after syndesmotic injury with flexible fixation, as determined by early postoperative CT imaging, did not affect patient prognosis. In this cohort, syndesmotic reduction and flexible fixation may produce good clinical outcomes in patients with syndesmotic injury and ankle fracture. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Sang Heon Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
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Choi KH, Mun SM, Seol Y, Lee YK, Lee JH, Lee IK, Lee YS, Jang H. The Role of Postoperative Radiotherapy in T4 Rectal Cancer with Synchronous Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e288. [PMID: 37785066 DOI: 10.1016/j.ijrobp.2023.06.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Studieson the role of surgery and local treatment in M1 rectal cancer have been actively studied recently. However, there is still controversy because no significant results have been reported for local control. The purpose of this study was to analyze the local control rates of postoperative radiotherapy for tumor stage T4 in M1 rectal cancer. MATERIALS/METHODS We investigated local recurrence after surgery for M1 rectal cancer that was operated at Seoul St. Mary's Hospital between 1995 and 2021. Locoregional recurrence rates were compared in patients who received postoperative pelvic radiotherapy and those who did not. In addition, an analytical comparison was performed only for patients with T4 rectal cancer. Statistical analysis was performed using the log rank test, and a p-value of less than 0.05 was considered significant. RESULTS During the investigation period, a total of 206 patients underwent surgery for M1 rectal cancer. There were 55 patients with T4 tumor stage. Of the 55 patients, 11 patients received radiotherapy after surgery, and 44 patients received systemic treatment such as chemotherapy after surgery without radiotherapy. During a median follow-up of 22 months, locoregional recurrence occurred in 1 (RT group) and 25 (no RT group) patients, respectively. Log-rank analysis of locoregional recurrence showed a significant difference between the two groups (p- value = 0.008). Death occurred in 10 (RT group) and 38 (no RT group) patients, respectively. The 2-year locoregional recurrence free-survival rates were 45.5% and 53.0%, respectively, and there was no significant difference between the two groups in the log-rank analysis. CONCLUSION Pelvic radiotherapy could be expected to improve locoregional recurrence in stage T4 of rectal cancer with synchronous distant metastasis. It would be warranted to prove this in a large-scale prospective study.
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Affiliation(s)
- K H Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - S M Mun
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y Seol
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y K Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J H Lee
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea, Republic of (South) Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - H Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
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Park CB, Kang YN, Jang H, Kim YS, Choi BO, Son SH, Song JH, Choi KH, Lee YK, Sung W, Kim JL. Evaluation of Usefulness of Yeast-Based Biological Phantom and Preliminary Study for Verification of Hypoxic Effect of Flash Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e704. [PMID: 37786063 DOI: 10.1016/j.ijrobp.2023.06.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As a basic hypothesis for the effectiveness of flash radiation therapy, the effect of preserving normal tissue during flash radiation is due to the instantaneous chemical depletion of oxygen. A yeast-based biological phantom was created to verify the hypoxic effect of flash radiation therapy. A study to upgrade the previously developed X-Band LINAC to a flash irradiation mode is in progress, and a preceding study is conducted to evaluate the usefulness of a yeast-based biological phantom manufactured by analyzing the change in oxygen by irradiating a high dose in a general radiation therapy device. MATERIALS/METHODS Freeze-dried yeast sample (Saccharomyces cerevisiae, S288C) is activated and sub-cultured. For mass production of yeast samples, yeast culture medium is prepared by adding yeast colonies to the ypd medium. This study was conducted to verify the hypoxic effect among the biological mechanisms that occur during flash radiation therapy at the basic stage, and the oxygen concentration change during general radiation irradiation was measured in real time using a DO (Dissolved oxygen) meter and fiber optic sensor designed to do that. To prevent scatter, which is a concern during flash irradiation, the fiber form was used, and precise experiments are possible as a non-invasive oxygen concentration measurement method. Based on 10MV of general radiation therapy device, high-dose radiation of 500-10,000 cGy is irradiated to measure real-time oxygen concentration change. RESULTS As a result of irradiation with high-dose (500-10,000 cGy) radiation of general LINAC, it was confirmed that the oxygen concentration of the yeast culture medium decreased by 5.7-63.2%, and the usefulness of the biological phantom fabricated based on the yeast culture medium was evaluated. CONCLUSION Prior to the analysis of oxygen concentration change in yeast cells during X-Band LINAC flash irradiation, a preliminary study was conducted at a high dose in a general LINAC to obtain a significant result of oxygen concentration change and confirm the usefulness of the yeast-based biological phantom. Prior research was conducted and verified as a general irradiation experiment using a yeast-based biological phantom manufactured based on a DO meter and a fiber optic oxygen sensor. After irradiation with high-dose radiation, the oxygen concentration of the yeast culture medium was measured 5 times, and it was confirmed that there was a change in oxygen concentration of 5.7-63.2%, verifying the usefulness and stability of the biological phantom. The usefulness of the yeast-based biological phantom for high doses was confirmed, and it is expected that the usefulness of the biological phantom for flash radiation can be verified by additionally measuring the change in oxygen concentration of the biological phantom according to the high dose rate in the future.
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Affiliation(s)
- C B Park
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y N Kang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - H Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y S Kim
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - B O Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - S H Son
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J H Song
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - K H Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y K Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - W Sung
- Department of Biomedical Engineering and Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J L Kim
- Electro-Medical Device Research Center, Korea Electrotechnology Research Institute, Ansan, Korea, Republic of (South) Korea
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Lee JY, Lee HJ, Yang SH, Ryu JH, Kim HT, Lee BH, Kim SH, Kim HS, Lee YK. Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap. Medicina (Kaunas) 2023; 59:1751. [PMID: 37893469 PMCID: PMC10608781 DOI: 10.3390/medicina59101751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Introduction: Distal tibial fractures make up approximately 3% to 10% of all tibial fractures or about 1% of lower extremity fractures. MIPO is an appropriate procedure and method to achieve stable metal plate fixation and osseointegration by minimizing soft tissue damage and vascular integrity at the fracture site. MIPO to the medial tibia during distal tibial fractures induces skin irritation due to the thickness of the metal plate, which causes discomfort and pain on the medial side of the distal leg, and if severe, complications such as infection and skin defect may occur. The reverse sural flap is a well-researched approach for covering defects in the lower third of the leg, ankle, and foot. Materials and Methods: Among 151 patients with distal tibia fractures who underwent minimally invasive metal plate fixation, soft tissue was injured due to postoperative complications. We treated 13 cases with necrosis and exposed metal plates by retrograde nasogastric artery flap surgery. For these patients, we collected obligatory patient records, radiological data, and wound photographs of the treatment results and complications of reconstructive surgery. Results: In all the cases, flap survival was confirmed at the final outpatient follow-up. The exposed area of the metal plate was well coated, and there was no plate failure due to complete necrosis. Three out of four women complained of aesthetic dissatisfaction because the volume of the tunnel through which the skin mirror passed and the skin plate itself were thick. In two cases, defatting was performed to reduce the thickness of the plate while removing the metal plate. Conclusions: Metal plate exposure after distal tibial fractures have been treated with minimally invasive metal plate fusion and can be successfully treated with retrograde nasogastric artery flaps, and several surgical techniques are used during flap surgery.
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Affiliation(s)
- Jun Young Lee
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea; (J.Y.L.); (H.J.L.); (S.H.Y.); (J.H.R.); (H.T.K.)
| | - Hyo Jun Lee
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea; (J.Y.L.); (H.J.L.); (S.H.Y.); (J.H.R.); (H.T.K.)
| | - Sung Hoon Yang
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea; (J.Y.L.); (H.J.L.); (S.H.Y.); (J.H.R.); (H.T.K.)
| | - Je Hong Ryu
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea; (J.Y.L.); (H.J.L.); (S.H.Y.); (J.H.R.); (H.T.K.)
| | - Hyoung Tae Kim
- Department of Orthopaedic Surgery, College of Medicine, Chosun University, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea; (J.Y.L.); (H.J.L.); (S.H.Y.); (J.H.R.); (H.T.K.)
| | - Byung Ho Lee
- Department of Orthopaedic Surgery, Daejung Hospital, 180 Daein-ro, Dong-gu, Gwangju 61473, Republic of Korea;
| | - Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170 Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea; (S.H.K.); (H.S.K.)
| | - Ho Sung Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170 Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea; (S.H.K.); (H.S.K.)
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170 Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea; (S.H.K.); (H.S.K.)
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Lee YK, Oh YS, Lee DK, Lee MJ, Song YN, Lee HS, Yeo ED. Evaluation of Contact Area and Pressure After Malreduction in Isolated Medial Malleolar Fractures With 2 mm of Displacement: A Cadaveric Study. J Foot Ankle Surg 2023; 62:774-778. [PMID: 37003511 DOI: 10.1053/j.jfas.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 03/03/2023] [Accepted: 03/18/2023] [Indexed: 04/03/2023]
Abstract
This study was performed to evaluate the changes in contact area and pressure in the tibiotalar joint, with a 2 mm displacement after IMMF (isolated medial malleolar fracture). Ten cadavers with pairs were used to establish a situation in which IMMF occurred during ankle injury. We performed IMMF corresponding to types C and D of the Herscovici classification, and it was displaced by 2 mm. The normal group was defined as a normal tibiotalar joint, the TF (transverse fracture) group as a 2 mm transverse displacement corresponding to the Herscovici classification type C, and the OF (oblique fracture) group as a 2 mm oblique displacement corresponding to the Herscovici classification type D. We measured the contact area and pressure at the tibiotalar joint. The film was scanned and analyzed using the digital imaging software, Scion Image (Scion Crop. Frederick, MD). In normal group, the average contact area of the tibiotalar joint was 317 mm2 (IQR; interquartile range, 256; 347) and 308 mm2 (IQR, 262; 364), average pressure was 2.19 N/mm2 (IQR, 1.94; 2.27) and 2.15 N/mm2 (IQR, 2.06; 2.53). In the TF and OF groups, the average contact area of the tibiotalar joint decreased by 9% and 12%, respectively, and the average pressure increased by 8% and 14%, respectively. There was no statistical difference in peak pressure between the normal, TF, and OF groups. In the case of transverse and oblique fractures, a 2 mm displacement showed significant changes in contact area and contact pressure compared to the normal tibiotalar joint, but there were no significant changes pertaining to type, between the 2 fractures.
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Affiliation(s)
- Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University, Bucheon Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
| | - Yong Seung Oh
- Department of Orthopedic Surgery, Good Samsun Hospital, Sasang-gu, Busan, Republic of Korea
| | - Do Kwan Lee
- School of Mechanical Engineering, Korea University, Seongbuk-gu, Seoul, Republic of Korea
| | - Myoung Jin Lee
- Department of Orthopedic Surgery, Dong-A University Medical Center, Seo-gu, Busan, Republic of Korea
| | - Yong Nam Song
- Department of Orthopedic Surgery, Good Samsun Hospital, Sasang-gu, Busan, Republic of Korea
| | - Hong Seop Lee
- Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Eui Dong Yeo
- Department of Orthopedic Surgery, Veterans Health Service Medical Center, Gangdong-gu, Seoul, Republic of Korea.
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An HM, Choi YS, Bae SK, Lee YK. Effect of the Combination of Probiotics and Korean Red Ginseng on Diabetic Wound Healing Exposed to Diesel Exhaust Particles(DEPs). Medicina (Kaunas) 2023; 59:1155. [PMID: 37374359 DOI: 10.3390/medicina59061155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Diesel exhaust particles (DEPs) are a major component of air pollution and adversely affect respiratory and cardiovascular disease and diabetic foot ulcers if diabetic patients are exposed to them. There are currently no studies on treating diabetic wounds exposed to DEPs. So, the effect of a combination of probiotics and Korean red ginseng on a diabetic wound model exposed to DEPs was confirmed. Materials and Methods: Rats were randomly divided into three groups according to DEP inhalation concentration and whether they underwent applications of probiotics (PB) and Korean red ginseng (KRG). Wound tissue was collected from all rats, and wound healing was evaluated using molecular biology and histology methods. Results: The wound size of all groups decreased over time, but there was no significant difference. As a result of the molecular biology experiment, the expression of NF-κB p65 on day 7 was significantly higher in group 2 than in the normal control group. As a result of histological analysis, unlike the primary control group, it was confirmed that granule tissue was formed on the 14th day in the normal control group and group 2. Conclusions: The findings in this study suggest that combined treatment with PB and KRG can promote the healing of DEP-exposed diabetic wounds.
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Affiliation(s)
- Hye Min An
- Department of Medical Sciences, Soonchunhyang University, Asan-si 31538, Republic of Korea
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si 14584, Republic of Korea
| | - Young Suk Choi
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si 14584, Republic of Korea
- Department of Biology, Soonchunhyang University, Asan-si 31538, Republic of Korea
| | - Sung Kyoung Bae
- Department of Medical Sciences, Soonchunhyang University, Asan-si 31538, Republic of Korea
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si 14584, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si 14584, Republic of Korea
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Kim SH, Choi JH, Lee SH, Lee YK. The Superficial Peroneal Nerve Is at Risk during the "All Inside" Arthroscopic Broström Procedure: A Cadaveric Study. Medicina (Kaunas) 2023; 59:1109. [PMID: 37374313 DOI: 10.3390/medicina59061109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/13/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
Background: The arthroscopic Broström procedure is a promising treatment for chronic ankle instability. However, little is known regarding the location of the intermediate superficial peroneal nerve at the level of the inferior extensor retinaculum; knowledge about this location is important for procedural safety. The purpose of this cadaveric study was to clarify the anatomical relationship between the intermediate superficial peroneal nerve and the sural nerve at the level of the inferior extensor retinaculum. Methods: Eleven dissections of cadaveric lower extremities were performed. The origin of the experimental three-dimensional axis was defined as the location of the anterolateral portal during ankle arthroscopy. The distances from the standard anterolateral portal to the inferior extensor retinaculum, sural nerve, and intermediate superficial peroneal nerve were measured using an electronic digital caliper. The location of inferior extensor retinaculum, the tract of sural nerve, and intermediate superficial peroneal nerve were checked using average and standard deviations. For the statistical analyses, data are presented as average ± standard deviation, and then they are reported as means and standard deviations. Fisher's exact test was used to identify statistically significant differences. Results: At the level of the inferior extensor retinaculum, the mean distances from the anterolateral portal to the proximal and distal intermediate superficial peroneal nerve were 15.9 ± 4.1 (range, 11.3-23.0) mm and 30.1 ± 5.5 (range, 20.8-37.9) mm, respectively. The mean distances from the anterolateral portal to the proximal and distal sural nerve were 47.6 ± 5.7 (range, 37.4-57.2) mm and 47.2 ± 4.1 (range, 41.0-51.8) mm), respectively. Conclusions: During the arthroscopic Broström procedure, the intermediate superficial peroneal nerve may be damaged by the anterolateral portal; the proximal and distal parts of the intermediate superficial peroneal nerve were located within 15.9 and 30.1 mm, respectively, at the level of the inferior extensor retinaculum in cadavers. These areas should be considered danger zones during the arthroscopic Broström procedure.
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Affiliation(s)
- Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
| | - Jae Hyuck Choi
- Department of Orthopedics, Manjok Clinic, 178, Jibeom-ro, Suseong-gu, Daegu 42208, Republic of Korea
| | - Sang Heon Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
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Won SH, Kim SH, Lee YK, Chun DI, Lee BR, Kim WJ. A Neglected Extensor Hallucis Longus Tendon Rupture Caused by Arthritic Adhesion. Medicina (Kaunas) 2023; 59:1069. [PMID: 37374273 DOI: 10.3390/medicina59061069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Extensor hallucis longus tendon injury is relatively rare and is principally caused by a laceration when a sharp object is dropped on the instep. Primary suturing is possible if the injury is acute, but if the tear is chronic, tendon contracture causes the space between the edges of the tear to widen, disrupting the end-to-end connection. In particular, a claw toe or checkrein foot deformity may develop over time due to adhesion of the lower leg tendons near the fracture site or scar. We report on a 44-year-old man who visited our outpatient clinic complaining of pain in the right foot and a hindered ability to extend his great toe. He had enjoyed playing soccer during his schooldays; since that time, the extension of that toe had become somewhat difficult. T2-weighted sagittal magnetic resonance imaging revealed that the continuity of the extensor hallucis longus tendon had been lost at the distal phalangeal base attachment site, and that the region of the proximal tendon was retracted to level of the middle shaft of the proximal phalanx. The findings allowed us to diagnose extensor hallucis longus tendon rupture accompanying osteoarthritic changes in the joint and soft tissues. We performed surgical tenorrhaphy and adhesiolysis. This is a rare case of extensor hallucis longus tendon rupture caused by minor trauma. Arthritis that developed at a young age caused the adhesions. If patients with foot and ankle arthritis show tendon adhesion at the arthritic site, tendon rupture can develop even after minor trauma or intense stretching.
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Affiliation(s)
- Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea
| | - Dong-Il Chun
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Byung-Ryul Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Sooncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea
| | - Woo-Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Sooncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea
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Kim SH, Kim YH, Cha JY, Lee YK. Correlations of Sesamoid Bone Subluxation with the Radiologic Measures of Hallux Valgus and Its Clinical Implications. Medicina (Kaunas) 2023; 59:medicina59050876. [PMID: 37241108 DOI: 10.3390/medicina59050876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Hallux valgus is one of the most common chronic foot complaints, with prevalences of over 23% in adults and up to 35.7% in older adults. However, the prevalence is only 3.5% in adolescents. The pathological causes and pathophysiology of hallux valgus are well-known in various studies and reports. A change in the position of the sesamoid bone under the metatarsal bone of the first toe is known to be the cause of the initial pathophysiology. Purpose: The relationships between the changes in the location of the sesamoid bone and each radiologically measured angle and joint congruency in the hallux valgus remain as yet unknown. Therefore, this study investigated the relationships of sesamoid bone subluxation with the hallux valgus angle, intermetatarsal angle, and metatarsophalangeal joint congruency in hallux valgus patients. The goal is to know the hallux valgus angle, the intermetatarsal angle, and metatarsophalangeal joint congruency's correlation with hallux valgus severity and prognosis by revealing the relationship between each measured value and sesamoid bone subluxation. Materials and Methods: We reviewed 205 hallux valgus patients who underwent radiographic evaluation and subsequent hallux valgus correction surgery in our orthopedic clinic between March 2015 and February 2020. Sesamoid subluxation was assessed using a new five-grade scale on foot radiographs, and other radiologic measurements were assessed, such as hallux valgus angle, the intermetatarsal angle, distal metatarsal articular angle, joint congruency, etc. Conclusions: Measurements of the hallux valgus angle, interphalangeal angle, and joint congruency exhibited high interobserver and intraobserver reliabilities in this study. They also showed correlations with sesamoid subluxation grade.
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Affiliation(s)
- Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
| | - Young Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
| | - Joo Young Cha
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
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Choi YS, Kim YH, An HM, Bae SK, Lee YK. Efficacy of Silver Nanoparticles-Loaded Bone Cement against an MRSA Induced-Osteomyelitis in a Rat Model. Medicina (Kaunas) 2023; 59:medicina59040811. [PMID: 37109771 PMCID: PMC10146363 DOI: 10.3390/medicina59040811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: The purpose of this study was to assess the cytotoxicity and antibacterial effects of AgNP-impregnated Tetracalcium phosphate-dicalcium phosphate dihydrate (TTCP-DCPD). Materials and Methods: Using in vitro experiments, the cytotoxicity of AgNP-impregnated TTCP-DCPD against fibroblasts and osteocytes was assessed in terms of cell viability by water-soluble tetrazolium salt assay. To assess antibacterial effects, a disc diffusion test was used; osteomyelitis was induced first in vivo, by injection of methicillin-resistant Staphylococcus aureus into the tibia of rats. AgNP-impregnated TTCP-DCPD bone cement was then applied at various silver concentrations for 3 or 12 weeks. Antibacterial effects were assessed by culturing and reverse transcription-polymerase chain reaction (RT-PCR). For histological observation, the bone tissues were stained using hematoxylin and eosin. Results: Cell viability was decreased by the impregnated bone cement but did not differ according to AgNP concentration. The diameter of the growth-inhibited zone of MRSA was between 4.1 and 13.3 mm on the disks treated with AgNP, indicating antimicrobial effects. In vivo, the numbers of bacterial colonies were reduced in the 12-week treatment groups compared to the 3-week treatment groups. The groups treated with a higher (10×) dose of AgNP (G2-G5) showed a tendency of lower bacterial colony counts compared to the group without AgNP (G1). The PCR analysis results showed a tendency of decreased bacterial gene expression in the AgNP-impregnated TTCP-DCPD groups (G2-G5) compared to the group without AgNP (G1) at 3 and 12 weeks. In the H&E staining, the degree of inflammation and necrosis of the AgNP-impregnated TTCP-DCPD groups (G2-G5) showed a tendency to be lower at 3 and 12 weeks compared to the control group. Our results suggest that AgNP-impregnated TTCP-DCPD cement has antimicrobial effects. Conclusions: This study indicates that AgNP-impregnated TTCP-DCPD bone cement could be considered to treat osteomyelitis.
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Affiliation(s)
- Young Suk Choi
- Department of Biology, Soonchunhyang University, 22, Soonchunhyang-ro, Asan-si 31538, Chungcheoungnam-do, Republic of Korea
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
| | - Young Hwan Kim
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
| | - Hye Min An
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
- Department of Medical Sciences, Soonchunhyang University, 22, Soonchunhyang-ro, Asan-si 31538, Chungcheoungnam-do, Republic of Korea
| | - Sung Kyoung Bae
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
- Department of Medical Sciences, Soonchunhyang University, 22, Soonchunhyang-ro, Asan-si 31538, Chungcheoungnam-do, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea
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Lee JY, Kim SH, Cha JY, Lee YK. Taekwondo Athlete's Bilateral Achilles Tendon Rupture: A Case Report. Medicina (Kaunas) 2023; 59:medicina59040733. [PMID: 37109691 PMCID: PMC10144442 DOI: 10.3390/medicina59040733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
(1) Background: Achilles tendon rupture is a common sports injury that may result in severe disability. The overall incidence of Achilles tendon rupture is increasing as a result of growing sports participation. However, cases of spontaneous bilateral Achilles tendon rupture with no underlying disease or risk factors, such as systemic inflammatory disease, steroid or (fluoro)quinolone antibiotics use, are rare. (2) Objective: Here, we report a case of a Taekwondo athlete's bilateral Achilles tendon rupture after kicking and landing. By sharing the experience of treatment and the patient's course, we suggest one of the possible treatment options and the need to establish a treatment method. (3) Procedure: A 23-year-old male Taekwondo athlete visited the hospital, presenting foot plantar flexion failure and severe pain in both tarsal joints, which had occurred upon kicking and landing on both feet earlier that day. During surgery, no degenerative changes or denaturation were observed in the ruptured areas of the Achilles tendons. Bilateral surgery was performed using the modified Bunnel method on the right side and minimum-section suturing on the left side was performed using the Achillon system, followed by lower limb casting. (4) Result: Good outcomes were observed on both sides at 19 months postoperatively. (5) Conclusion: The possibility of bilateral Achilles tendon rupture during exercise in young subjects with no risk factors should be acknowledged, especially in association with landing. In addition, in athletes, even if there is a possibility of complications, surgical treatment should be considered for functional recovery.
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Affiliation(s)
- Jun Young Lee
- Department of Orthopaedic Surgery, Chosun University Hospital, 365, Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea
| | - Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea
| | - Joo Young Cha
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Gyeonggi-do, Bucheon-si 14584, Republic of Korea
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Yau SY, Lee YK, Li SY, Lai SK, Huang S, Lee LC, Wong SL. 1245 HEALTH CARE WORKERS’ EXPERIENCES ON WORKING AT RESIDENTIAL CARE HOME FOR THE ELDERLY: AN INTEGRATIVE REVIEW. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract
Introduction
The ageing population poses challenges to the health care industry worldwide. The huge demand for residential care home for the elderly (RCHE) services induces pressure on health care workers (HCWs) recruitment and retention. HCWs are personnel who have prominent roles in direct basic care to the older adults, and all kinds of hands-on care. Due to the “unpleasant” work nature, shift work, and physical demands for HCWs, it is essential to unfold how HCWs comprehend their working experiences.
Methods
An integrative review was conducted to synthesize various streams of literature in order to generate new knowledge. Multiple databases such as CINAHL, ERIC, LWW nursing were adopted to search for relevant literature published between 2012 and 2022.
Results
A total of 24 articles were retrieved at the initial stage, and 7 articles were sorted after in-depth review. In general, results supported that HCWs experienced positively on the works at RCHEs though there were job stresses. The HCWs perceived the roles at RCHEs as routinized and task-oriented by providing direct care to older adults. They perceived their roles at RCHEs as care providers who provided direct care to older adults. Also, their responsibilities to maintain the safety and dignity of older adults was expressed as utmost importance. The meaning of works lay on three levels: interpersonal (e.g. self-achievement), interpersonal (e.g. communication with team members), and job performance (e.g. task compliance).
Conclusions
This study reveals the experiences of working at RCHE from the HCWs’ perspective. The HCWs’ experiences reflected in this study as well as the meaning of works discovered can generate insights for policy-makers on HCWs recruitment and retention.
Acknowledgement
The work described in this abstract was fully supported by a grant from the Research Grants Council of HKSAR, China [RGC: UGC/FDS16/M12/20].
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Affiliation(s)
- S Y Yau
- Hong Kong Metropolitan University
| | - Y K Lee
- Hong Kong Metropolitan University
| | - S Y Li
- Hong Kong Metropolitan University
| | - S K Lai
- Hong Kong Metropolitan University
| | - S Huang
- Hong Kong Metropolitan University
| | - L C Lee
- Hong Kong Metropolitan University
| | - S L Wong
- Hong Kong Metropolitan University
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15
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Kim SH, Kim WJ, Park ES, Kim JY, Lee YK. Iatrogenic Ankle Charcot Neuropathic Arthropathy after Spinal Surgery: A Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58121776. [PMID: 36556978 PMCID: PMC9785748 DOI: 10.3390/medicina58121776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Charcot neuropathic arthropathy is a relatively rare, chronic disease that leads to joint destruction and reduced quality of life of patients. Early diagnosis of Charcot arthropathy is essential for a good outcome. However, the diagnosis is often based on the clinical course and longitudinal follow-up of patients is required. Charcot arthropathy is suspected in patients with suggestive symptoms and an underlying etiology. Failed spinal surgery is not a known cause of Charcot arthropathy. Herein we report a patient with ankle Charcot neuropathic arthropathy that developed after failed spinal surgery. A 58-year-old man presented to the emergency room due to painful swelling of the left ankle for 2 weeks that developed spontaneously. He underwent spinal surgery 8 years ago that was associated with nerve damage, which led to weakness of great toe extension and ankle dorsiflexion, and sensory loss below the knee. CT and T2-weighted sagittal MRI showed a fine erosive lesion, subluxation, sclerosis, fragmentation, and large bone defects. Based on the patient's history and radiological findings, Charcot arthropathy was diagnosed. However, the abnormal blood parameters, positive blood cultures, and severe pain despite the decreased sensation suggested a diagnosis of septic arthritis. Therefore, diagnostic arthroscopy was performed. The ankle joint exhibited continued destruction after the initial surgery. Consequently, several repeat surgeries were performed over the next 2 years. Despite the early diagnosis and treatment of Charcot arthropathy, the destruction of the ankle joint continued. Given the chronic disease course and poor prognosis of Charcot arthropathy, it is essential to consider this diagnosis in patients with neuropathy.
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Affiliation(s)
- Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
| | - Woo-Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Sooncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea
| | - Eun Seok Park
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
| | - Jun Yong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea
- Correspondence:
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16
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Yoon YS, Cha JG, Lee YK. Prediction of anterior tibiotalar ligament injury: measurement of the angle between the deep posterior tibiotalar ligament and talus on MRI. Acta Radiol 2022; 64:1579-1588. [PMID: 36345217 DOI: 10.1177/02841851221135614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Identification of anterior tibiotalar ligament (aTTL) injury is essential because it influences the surgeon's treatment option and patient prognosis. Purpose To assess the diagnostic accuracy of the angle measurement between the talus and posterior tibiotalar ligament (talus-pTTL) on magnetic resonance imaging (MRI) in patients with arthroscopically proven aTTL injuries. Material and Methods Ankle MRI scans of 67 patients who underwent arthroscopic examination were retrospectively reviewed. The talus-pTTL angle on axial T2-weighted MRI and the medial clear space (MCS) on mortise ankle radiograph were measured. Inter-observer agreement of the measurements was calculated. Also, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC) were the metrics of diagnostic accuracy. Results AUC was 0.90 for observer 1 with 78.6% sensitivity, 97.4% specificity, 88% accuracy, and 54.7° cutoff value for the talus-pTTL angle. AUC was 0.87 for observer 2 with 85.7% sensitivity, 84.6% specificity, 85.2% accuracy, and 53.7° cutoff value for the talus-pTTL angle. AUC was 0.86 with 82.1% sensitivity, 79.5% specificity, and 80.8% accuracy for observer 1 and 0.79 with 57.1% sensitivity, 92.3% specificity, and 74.7% accuracy for observer 2 for the MCS. Different MCS values and additional capabilities when complemented with the angle measurement showed an increase in diagnostic performances. Intra-observer reliability of MCS and talus-pTTL angle of the two radiologists was excellent. Inter-observer reliability of the two radiologists was excellent for both the talus-pTTL angle (0.95) and the MCS (0.85). Conclusion Measurement of the talus-pTTL angle showed good sensitivity, specificity, and accuracy for the evaluation of aTTL injury with excellent inter-observer reliability.
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Affiliation(s)
- Yu Sung Yoon
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
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Lee YK, Tomey D, Secchi R, Martinino A, Oviedo R. V-009 ROBOTIC UMBILICAL HERNIA REPAIR WITH RETRORECTUS SUBLAY MESH AND PLICATION OF RECTUS DIASTASIS VIA THE TRANSABDOMINAL PREPERITONEAL (TAPP) APPROACH. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Umbilical hernias and rectus diastasis can greatly reduce patients’ quality of life, especially in this patient who is a professional athlete and coach. We present a robotic umbilical hernia repair with retrorectus sublay mesh and plication of rectus diastasis through the transabdominal preperitoneal (TAPP) approach.
Material & Methods
Video recording from the operating room was included. In the recording, we demonstrate the steps of this robotic approach with clear visualization of anatomic structures.
Results
A 37-year-old male with an enlarging umbilical hernia with intermittent incarceration and associated rectus diastasis presented for repair due to a significant impact on his work and quality of life. The patient underwent a TAPP robotic repair of his umbilical hernia and plication of rectus diastasis with a retrorectus sublay mesh placement. This was a same-day discharge procedure that the patient tolerated without complications.
Conclusions
Umbilical hernias and associated rectus diastasis can effectively be repaired robotically with retrorectus sublay mesh through the TAPP approach.
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Affiliation(s)
- Y K Lee
- Surgery, Houston Methodist Hospital , Houston , United States
| | - D Tomey
- School of Medicine, University of Zulia , Maracaibo , Venezuela
| | - R Secchi
- School of Medicine, Universidad Anahuac Queretaro , Santiago de Queretaro , Mexico
| | - A Martinino
- Surgery, Sapienza University of Rome , Rome , Italy
| | - R Oviedo
- Surgery, Houston Methodist Hospital , Houston , United States
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Jalil NB, Lee PY, Nor Afiah MZ, Abdullah KL, Azizi FNSM, Rassip NNSA, Ong TA, Ng CJ, Lee YK, Cheong AT, Razack AH, Saad M, Alip A, Malek R, Sundram M, Omar S, Sathiyananthan JR, Kumar P. Effectiveness of Decision Aid in Men with Localized Prostate Cancer: a Multicenter Randomized Controlled Trial at Tertiary Referral Hospitals in an Asia Pacific Country. J Cancer Educ 2022; 37:169-178. [PMID: 32564251 DOI: 10.1007/s13187-020-01801-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There are several treatment options for localized prostate cancer with very similar outcome but vary in terms of technique and side effect profiles and risks. Considering the potential difficulty in choosing the best treatment, a patient decision aid (PDA) is used to help patients in their decision-making process. However, the use and applicability of PDA in a country in Asia Pacific region like Malaysia is still unknown. This study aims to evaluate the effectiveness of a PDA modified to the local context in improving patients' knowledge, decisional conflict, and preparation for decision making among men with localized prostate cancer. Sixty patients with localized prostate cancer were randomly assigned to control and intervention groups. A self-administered questionnaire, which evaluate the knowledge on prostate cancer (23 items), decisional conflict (10 items) and preparation for decision-making (10 items), was given to all participants at pre- and post-intervention. Data were analyzed using independent T test and paired T test. The intervention group showed significant improvement in knowledge (p = 0.02) and decisional conflict (p = 0.01) from baseline. However, when compared between the control and intervention groups, there were no significant differences at baseline and post-intervention on knowledge, decisional conflict and preparation for decision-making. A PDA on treatment options of localized prostate cancer modified to the local context in an Asia Pacific country improved patients' knowledge and decisional conflict but did not have significant impact on the preparation for decision-making. The study was also registered under the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12614000668606 registered on 25/06/2014.
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Affiliation(s)
- N B Jalil
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - P Y Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
| | - M Z Nor Afiah
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - K L Abdullah
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - F N S Mohd Azizi
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - N N S Abdul Rassip
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - T A Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - C J Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Y K Lee
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A T Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - A H Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - M Saad
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Alip
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - R Malek
- Unit of Urology, Selayang Hospital, Selangor, Malaysia
| | - M Sundram
- Unit of Urology, General Hospital of Kuala Lumpur, Kuala Lumpur, Malaysia
| | - S Omar
- Unit of Urology, Johor Bahru Hospital, Johor Bahru, Johor, Malaysia
| | | | - P Kumar
- Department of Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Yeo ED, Park SB, Lee SW, Cho WJ, Kim HK, Cheon SH, Lee YK. Knotless All-Inside Arthroscopic Modified Broström Procedure for Lateral Ankle Instability. J Foot Ankle Surg 2021; 60:541-547. [PMID: 33549425 DOI: 10.1053/j.jfas.2020.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/07/2020] [Accepted: 11/30/2020] [Indexed: 02/03/2023]
Abstract
One reported complication of the arthroscopic modified Broström operation is pain caused by the suture anchoring knot. We hypothesized that a knotless technique could reduce such pain. Therefore, in this study we evaluated the clinical and radiological outcomes after knotless all-inside arthroscopic modified Broström operation for lateral ankle instability. From July 2017 to November 2017, 28 patients were treated. Clinical and radiological features were evaluated preoperatively and 3, 6, and 12 months postoperatively using the American Orthopaedic Foot & Ankle Society ankle-hindfoot scale score, visual analogue scale score for pain, anterior talar drawer test, and talar tilt angle. The mean age of the 28 patients (14 men, 14 women) was 41.71 ± 17.19 years. Three (10.7%) complications, but no knot-associated pain, occurred. The clinical and radiological outcomes were significantly improved 12 months postoperatively compared with preoperative outcomes (all p < .05). Knotless all-inside arthroscopic modified Broström operation for lateral ankle instability avoided knot-associated pain and improved not only patient satisfaction but also clinical and radiological outcomes.
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Affiliation(s)
- Eui Dong Yeo
- Department of Orthopedic Surgery, VHS medical center, South Korea
| | - Sung Bum Park
- Department of Orthopaedic Surgery, Lee Chun Tek Hospital, South Korea
| | - Sang Woo Lee
- Department of Orthopaedic Surgery, Yonsei The Bareun Hospital, South Korea
| | - Whi Je Cho
- Departments of Orthopedic Surgery, Soonchunhyang University, Bucheon Hospital, South Korea
| | - Hyun Kwon Kim
- Departments of Orthopedic Surgery, Soonchunhyang University, Bucheon Hospital, South Korea
| | - Seung Hee Cheon
- Department of Orthopedic Surgery, VHS medical center, South Korea
| | - Young Koo Lee
- Departments of Orthopedic Surgery, Soonchunhyang University, Bucheon Hospital, South Korea.
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20
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Lee HS, Kim WJ, Young KW, Jeong GM, Yeo ED, Lee YK. Comparison of Open Anterior Syndesmotic Repair Augmented With Suture-Tape and Trans-syndesmotic Screw Fixation: A Biomechanical Study. J Foot Ankle Surg 2021; 60:339-344. [PMID: 33431315 DOI: 10.1053/j.jfas.2020.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/22/2020] [Accepted: 04/01/2020] [Indexed: 02/03/2023]
Abstract
The treatment of syndesmotic injuries with ankle fractures is controversial. The purpose of this study was to compare the biomechanical properties of open anterior syndesmotic repair with those of screw fixation. Ten matched pairs of human cadaver specimens were subjected to open syndesmotic repair or screw fixation. Each specimen underwent initial intact physiologic loading, consisting of 10 cycles of external torsional loading with a peak torque of 7.5 Nm at 0.05 Hz. Injuries of the anterior inferior tibiofibular ligament, tibiofibular interosseous membrane, and deltoid ligament were applied to each specimen. Postfixation cyclic loading consisted of 50 cycles of combined axial and external rotation loading with peak torques of 750 N and 7.5 Nm at a rate of 0.05 Hz. After postfixation loading, each specimen underwent failure loading by external rotation at 0.25 degrees/second. Failure torque and failure angle were measured. The paired t test and Wilcoxon signed-rank test were used to analyze the data. Mean failure torques were 95.63 Nm in the open anterior syndesmotic repair augmented with suture-tape group and 108.61 Nm in the screw group. Mean failure angles were 34.93 degrees in the open anterior syndesmotic repair augmented with suture-tape group and 43.55 degrees in the screw group. These data were not statistically significantly different between the groups (p= .7682 and .4133, respectively). Open anterior syndesmotic repair augmented with suture tape for ankle syndesmotic injury provides similar torsional strength to that of screw fixation. Therefore, this technique can be considered as an alternative treatment option for syndesmosis injury.
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Affiliation(s)
- Hong Seop Lee
- Professor, Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Woo Jong Kim
- Professor, Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea
| | - Ki Won Young
- Professor, Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Gu Min Jeong
- Resident, Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Eui Dong Yeo
- Surgeon, Department of Orthopedic Surgery, Veteran Health Service Medical Center, Seoul, Korea
| | - Young Koo Lee
- Professor, Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Gyunggi-do, Korea.
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21
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Choi YS, Ham DS, Lim JY, Lee YK. Validation of the Osteomyelitis Induced by Methicillin-Resistant Staphylococcus aureus (MRSA) on Rat Model with Calvaria Defect. Tissue Eng Regen Med 2021; 18:671-683. [PMID: 34165776 DOI: 10.1007/s13770-021-00340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. METHODS The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. RESULTS In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. CONCLUSION This study suggests that the minimum dose (6 × 103 CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.
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Affiliation(s)
- Young Suk Choi
- Department of Biology, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea.,Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea
| | - Dae Sung Ham
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.,Department of Medical Sciences, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea
| | - Ji Yun Lim
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.,Department of Medical Sciences, Soonchunhyang University, Soonchunhyang-ro, Sinchang-myeon, Asan-si, Chungcheongnam-do, 31538, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, 4 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, 14584, Republic of Korea.
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22
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Jung KJ, Lee HS, Chang HJ, Lee YK, Yeo ED, Won SH, Cho HK, Ryu A, Lee DW, Kim WJ. Pure isolated medial talonavicular joint dislocation following low-energy trauma: a case report. J Int Med Res 2021; 49:3000605211004697. [PMID: 33823634 PMCID: PMC8033483 DOI: 10.1177/03000605211004697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Midtarsal dislocations are relatively rare injuries secondary to high-energy
trauma and are typically accompanied by disruption of ligamentous structures and
fractures of the midfoot. We herein present a case of a pure isolated medial
swivel dislocation of the talonavicular joint (TNJ) that was sustained following
low-energy trauma without an associated fracture. A 78-year-old woman visited
our emergency department with severe pain in the midfoot area of the right foot
without neurovascular deficits. She had sustained this injury after severe ankle
inversion while going downstairs. Plain radiographs of the right foot showed
that the navicular was dislocated medially on the talus; no other malalignments
were present. Three-dimensional computed tomography revealed dislocation of the
TNJ, but no other tarsal or midtarsal bone fractures or dislocations. A medial
dorsal incision was made to expose the TNJ. The dorsal talonavicular ligament
was ruptured and interposed between the navicular and talus. The ligament was
removed and the TNJ was reduced. The clinical outcome at the 1-year follow-up
was satisfactory with no limitations in daily activities. In summary, we have
reported an extremely rare case of a pure isolated medial TNJ dislocation in
which the interposed dorsal talonavicular ligament served as an obstacle to
reduction.
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Affiliation(s)
- Ki Jin Jung
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
| | - Hong Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Nowon-gu, Seoul, Korea
| | - Hee Jun Chang
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Wonmi-gu, Bucheon, Korea
| | - Eui Dong Yeo
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu, Seoul, Korea
| | - Hyung Ki Cho
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu, Seoul, Korea
| | - Aeli Ryu
- Department of Obstetrics and Gynecology, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
| | - Dhong Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Gwangjin-gu, Seoul, Korea
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
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23
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Lee YK, Young KW, Kim JS, Lee HS, Cho WJ, Kim HN. Arthroscopic microfracture with atelocollagen augmentation for osteochondral lesion of the talus: a multicenter randomized controlled trial. BMC Musculoskelet Disord 2020; 21:716. [PMID: 33143647 PMCID: PMC7640454 DOI: 10.1186/s12891-020-03730-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to evaluate whether arthroscopic microfracture with atelocollagen augmentation could improve the clinical outcomes and quality of regenerated cartilage in patients with osteochondral lesion of the talus (OLT). We hypothesized that the clinical outcomes and quality of the regenerated cartilage would be superior in patients undergoing arthroscopic microfracture with atelocollagen augmentation compared to those undergoing arthroscopic microfracture alone. METHODS In this multicenter, randomized controlled trial, 60 patients were randomly allocated to two groups: arthroscopic microfracture with atelocollagen augmentation (group 1, n = 31) and arthroscopic microfracture alone (group 2, n = 29). Mean 100-mm visual analog scale (VAS), Hannover scoring system (HSS), and American Orthopedic Foot and Ankle Society (AOFAS) scores were assessed 2 years postoperatively and compared between the groups. The quality of the regenerated cartilage was assessed according to the Magnetic Resonance Observation of CArtilage Repair Tissue (MOCART) score based on magnetic resonance imaging. RESULTS Forty-six patients (22 in group 1, 23 in group 2) completed the 2-year follow-up. The quality of the regenerated cartilage assessed based on the MOCART score was significantly superior in group 1 compared to group 2 (64.49 ± 18.27 vs 53.01 ± 12.14, p = 0.018). Clinical outcomes in terms of 100-mm VAS (17.25 ± 20.31 vs 19.37 ± 18.58, p = 0.72), HSS (93.09 ± 13.64 vs 86.09 ± 13.36, p = 0.14), and AOFAS (91.23 ± 8.62 vs 86.91 ± 10.68, p = 0.09) scores were superior in group 1 compared to group 2, but the differences were not statistically significant. Both groups showed significant improvements in clinical outcomes compared with the preoperative values. CONCLUSION The quality of the regenerated cartilage was superior after arthroscopic microfracture with atelocollagen augmentation compared to that after microfracture alone in patients with OLT. Clinical outcomes assessed 2 years postoperatively were superior in patients who underwent arthroscopic microfracture with atelocollagen augmentation compared to those who underwent arthroscopic microfracture alone, although the differences were not statistically significant. A long-term study of the cohort is required to confirm these findings. TRIAL REGISTRATION ClinicalTrials.gov ( NCT02519881 ), August 11, 2015.
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Affiliation(s)
- Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyunggi-do, Republic of Korea
| | - Ki Won Young
- Department of Foot and Ankle Surgery, Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Jin Su Kim
- Department of Orthopedic Surgery, Sejong Sports Medicine and Performance Center, Seoul, Republic of Korea
| | - Hong Seop Lee
- Department of Foot and Ankle Surgery, Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Whi-Je Cho
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyunggi-do, Republic of Korea
| | - Hyong Nyun Kim
- Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea.
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24
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Chan CK, Yeung AM, Lee YK, Chau LH, Man CW, Chu PS. Urethroscrotal fistula complicating large spermatocele in a male ketamine abuser: A case report. Urol Case Rep 2020; 33:101284. [PMID: 32514403 PMCID: PMC7267707 DOI: 10.1016/j.eucr.2020.101284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/26/2022] Open
Abstract
Ketamine related urinary tract complications were first reported in Hong Kong since 2007. The current case report describes a 37 years old male with long history of ketamine abuse, renal impairment, hypertension and HCV hepatitis, presented to us with insidious onset of painful scrotal swelling post bilateral nephrectomy, prostate and seminal vesicle preserving cystectomy. Radiological imaging and intraoperative finding revealed that it was a large spermatocele with urethroscrotal fistula, which was likely due to urethra stricture. The review of literature showed no guidelines for treatment, a symptoms based and multidisciplinary team approach is recommended.
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Affiliation(s)
- Calvin Ky Chan
- Department of Surgery, Tuen Mun Hospital, Hong Kong, China
| | | | - Y K Lee
- Department of Surgery, Tuen Mun Hospital, Hong Kong, China
| | | | - C W Man
- Department of Surgery, Tuen Mun Hospital, Hong Kong, China
| | - Peggy Sk Chu
- Department of Surgery, Tuen Mun Hospital, Hong Kong, China
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25
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Kim HM, Lee YK, Kim ES, Koo JS. Energy transfer from adipocytes to cancer cells in breast cancer. Neoplasma 2020; 67:992-1001. [PMID: 32412774 DOI: 10.4149/neo_2020_191017n1050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/13/2019] [Indexed: 11/08/2022]
Abstract
Limitations of the current therapeutic approach have raised the need for a novel therapeutic agent in breast cancer. Recently, interest in drugs targeting the tumor microenvironment (TME) had drawn attention in the treatment of breast cancer. Furthermore, recent studies have suggested the role of adipocytes, which are part of the TME, in tumor initiation, growth, and metastasis. In this study, we investigated the metabolic interaction between adipocytes and breast cancer cells and its potential as a new therapeutic target in breast cancer. Breast cancer cell lines and human breast cancer tissue samples were evaluated. Compared to cancer cells cultured alone, or the control group, those co-cultured with adipocytes showed lipid transfer from adipocytes to cancer cells and it was different according to the molecular subtype of breast cancer. Breast cancer cells affected the lipolysis of adipocytes and adipocytes affected the β-oxidation of breast cancer cells. The key molecule of the process was fatty acid binding protein 4 (FABP4), which is combined with free fatty acid (FFA) and supports its migration to cancer cells. When FABP4 was suppressed, lipid transfer between adipocytes and cancer cells, lipolysis of adipocytes, and β-oxidation of breast cancer cells were reduced. Furthermore, the expression of lipid metabolism-related proteins and lipolysis-related proteins in breast cancer with adipose stroma showed significantly different expression according to the region of breast cancer tissue. Taken together, we demonstrated the metabolic interaction between adipocytes and breast cancer cells. Breast cancer cells increase the lipolysis in adipocytes and produce a fatty acid, and fatty acid enters into cancer cells. Also, adipocytes contribute to the survival and growth of cancer cells through increased mitochondrial β-oxidation by using fatty acid from adipocytes. The key molecule of the process is FABP4 and when FABP4 is suppressed, the metabolic interaction is reduced, suggesting its role as a potential therapeutic target.
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Affiliation(s)
- H M Kim
- Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea
| | - Y K Lee
- Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea
| | - E S Kim
- Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea
| | - J S Koo
- Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea
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26
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Ducournau F, Arianni M, Awwad S, Baur EM, Beaulieu JY, Bouloudhnine M, Caloia M, Chagar K, Chen Z, Chin AY, Chow EC, Cobb T, David Y, Delgado PJ, Woon Man Fok M, French R, Golubev I, Haugstvedt JR, Ichihara S, Jorquera RA, Koo SCJJ, Lee JY, Lee YK, Lee YJ, Liu B, Kaleli T, Mantovani GR, Mathoulin C, Messina JC, Muccioli C, Nazerani S, Ng CY, Obdeijn MC, Van Overstraeten L, Prasetyono TOH, Ross M, Shih JT, Smith N, Suarez R FA, Chan PT, Tiemdjo H, Wahegaonkar A, Wells MC, Wong WY, Wu F, Yang XF, Yanni D, Yao J, Liverneaux PA. COVID-19: Initial experience of an international group of hand surgeons. Hand Surg Rehabil 2020; 39:159-166. [PMID: 32278932 PMCID: PMC7194873 DOI: 10.1016/j.hansur.2020.04.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 12/29/2022]
Abstract
The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.
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Affiliation(s)
- F Ducournau
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - M Arianni
- Department of Surgery, RSUD Pasar Minggu Hospital, Jl. TB Simatupang No.1, RT.1/RW.5, Ragunan, Kec. Ps. Minggu, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12550, Indonesia
| | - S Awwad
- National Guard Hospital Medina, Ad Dar, Medina, Saudi Arabia
| | - E-M Baur
- Practice of Plastic and Hand Surgery, James-Loeb-Straße 13, 82418 Murnau am Staffelsee, Germany
| | - J-Y Beaulieu
- Hôpitaux universitaire de Genève, département de chirurgie, rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland
| | - M Bouloudhnine
- Les Cliniques El Manar, 2092 rue Habib Echatti, Tunis, Tunisia
| | - M Caloia
- Department of Orthopaedic Surgery, Facultad de Ciencias Biomedicas, Universidad Austral, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
| | - K Chagar
- Pôle de chirurgie orthopédique, hôpital Militaire d'Instruction Mohamed V, Hay Riad, Rabat, Morocco
| | - Z Chen
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 328 Qi'an Ave, Xinzhou, Wuhan, Hubei, China
| | - A Y Chin
- Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Academia Building, Outram Rd, Singapour 169608, Singapore
| | - E C Chow
- Department of Orthopaedics and Traumatology, United Christian Hospital, 130 Hip Wo St, Kwun Tong, Hong Kong
| | - T Cobb
- Orthopedic Specialists, P.C., 4622 Progress Drive Suite C, Davenport, IA 52807, USA
| | - Y David
- Hand surgery unit and microsurgery, Hospital Kaplan medical center, Derech Pasternak, Rehovot, Israel
| | - P J Delgado
- Hand Surgery and Microsurgery Department, University Hospital HM Monteprincipe, CEU San Pablo University, Calle de Julián Romea 23, 28003 Madrid, Spain
| | - M Woon Man Fok
- Department of Orthopaedics and Traumatology 5/F, Professorial Block, Queen Mary Hospital, The University of Hong Kong, Queen Mary Hospital Main Block, Pok Fu Lam Rd, Pok Fu Lam, Hong Kong
| | - R French
- The Specialist Referral Clinic, 555W 12th Ave #121, Vancouver, BC V5Z 3X7, Canada
| | - I Golubev
- N. Priorov Research Institute of Trauma Surgery and Orthopaedics, 10 Moscow Ulitsa Priorova, Russia
| | - J R Haugstvedt
- Division of Handsurgery, Department of Orthopedics, Østfold Hospital, Per Gynts vei 78, 1535 Moss, Norway
| | - S Ichihara
- Department of Hand Surgery, Juntendo University Urayasu Hospital, 2 Chome-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan
| | - R A Jorquera
- Department of Hand Surgery and Microsurgery, Clínica Indisa, Andrés Bello University, Av. Sta. María 1810, Santiago, Providencia, Región Metropolitana, Chile
| | - S C J J Koo
- Department of Orthoapedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, NT, Hong Kong
| | - J Y Lee
- Department of Orthopedic Surgery, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, 1021 Tongil-ro, Eunpyeong-gu, 03312 Seoul, Korea
| | - Y K Lee
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 567 Baekje-daero, Geumam 1(il)-dong, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Y J Lee
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - B Liu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, the 4th Clinical College of Peking University, 31 Xinjiekou E Rd, Beijing Xicheng District, China
| | - T Kaleli
- Uludag University, Faculty of Medicine, Department of Orthopaedics, Hand Surgery Clinic, Özlüce, Görükle Kampüsü, 16059 Nilüfer/Bursa, Turkey
| | - G R Mantovani
- Department of Hand Surgery, Sao Paolo Hand center, Ben Portuguesa Hospital, R. Maestro Cardim 769, Bela Vista, São Paulo, SP, 01323-001, Brazil
| | - C Mathoulin
- International Wrist Center, clinique Bizet, Institut de la main, 23, rue Georges-Bizet, 75116 Paris, France
| | - J C Messina
- Gaetano Pini- CTO Orthopaedic Institute, First Orthopaedic Clinic University of Milan, Piazza Cardinale Andrea Ferrari 1, 20122 Milano MI, Italy
| | - C Muccioli
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France
| | - S Nazerani
- Department of Hand and Reconstructive Microsurgery, Mehr General Hospital, W Zartosht St, District 6, Tehran, Tehran Province, IR, Iran
| | - C Y Ng
- Upper Limb Unit, Wrightington Hospital, Appley Bridge, Wigan, UK
| | - M C Obdeijn
- Department of Plastic, Reconstructive and Hand surgery, Amsterdam University Medical Centers, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - L Van Overstraeten
- Hôpital Erasme, ULB, route de Lennik 808, 1070 Bruxelles, Belgium; Hand and foot surgery unit, Rue Pierre Caille 9, 7500 Tournai, Belgium
| | - T O H Prasetyono
- Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No.71, RW.5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta 10430, Indonesia
| | - M Ross
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane City QLD 4000, Australia
| | - J T Shih
- Department of Orthopaedic Surgery, Armed Forces Taoyuan General Hospital, No. 168, Zhongxing Road, Longtan District, Taoyuan City, Taiwan
| | - N Smith
- Southern Highlands Private Hospital, St Jude Specialist Centre, 21 St Jude St, Bowral NSW 2576, Australia
| | - F A Suarez R
- Universidad Militar Nueva Granada, Bogota, Colombia/Private clinic Centro de Cirugia Minimamente Invasiva CECIMIN, 76, Autopista Nte. #104, Bogotá, Colombia
| | - P-T Chan
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Block H, Tsing Chung Koon Rd, Tuen Mun, Hong Kong
| | - H Tiemdjo
- Centre de chirurgie de la main et des paralysies de Douala, Bonamoussadi, Douala, Cameroon
| | - A Wahegaonkar
- Dept of Upper Limb, Hand and Microvascular Reconstructive Surgery, Brachial Plexus and Peripheral Nerve Surgery, Sancheti Institute for Orthopaedics and Rehabilitation, Jehangir Hospital, 32, Sasoon Road Opposite Railway Station, Central Excise Colony, Sangamvadi, Pune, Maharashtra 411001, India; The Hand Surgery Clinics, 81/A/11 Giridarshan Society, Behind NEXA Showroom, Baner Road, Pune, Maharashtra 411007, India
| | - M C Wells
- Orthopaedic hand surgeon, Mediclinic Panorama, Panorama, Rothschild Blvd, Panorama, Cape Town, 7500, South Africa
| | - W-Y Wong
- Department of Orthopaedics and Traumatology, the Chinese University of Hong Kong, Central Ave, Hong Kong
| | - F Wu
- Dept of Orthopaedics, University Hospitals Birmingham, Bordesley Green East, Bordesley Green E, Birmingham B9 5SS, UK
| | - X F Yang
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiang'an District, Wuhan, Hubei, China
| | - D Yanni
- KIMS Hospital, Newnham Ct Way, Weavering, Maidstone ME14 5FT, Kent, UK
| | - J Yao
- Robert A. Chase Hand and Upper Limb Center, Stanford University Medical Center, 450 Broadway, Redwood City, CA 94063, USA
| | - P A Liverneaux
- Icube CNRS 7357, department of hand surgery, hôpital de Hautepierre, university hospital of Strasbourg, FMTS, university of Strasbourg, 1, avenue Molière, 67200 Strasbourg cedex, France.
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Khil EK, Cha JG, Lee YK, Kim HJ. Evaluation of the anterior inferior tibiofibular and anterior talofibular ligaments using 2D oblique coronal imaging and 3D isotropic resolution T2-weighted fast spin-echo sequences at 3.0 T: Is there additional diagnostic value? J Med Imaging Radiat Oncol 2020; 64:338-346. [PMID: 32239668 DOI: 10.1111/1754-9485.13028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 02/23/2020] [Accepted: 03/04/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To compare diagnostic performance of additional two-dimensional (2D) oblique coronal view and three-dimensional (3D) T2-weighted fast spin-echo(FSE) images for diagnosing injury of the anterior inferior tibiofibular (AiTFL) and anterior talofibular ligaments (ATFL). METHODS This study included 48 patients with ankle sprain who had undergone MRI using standard protocol and two additional sequences with 2D oblique coronal and 3D isotropic images, followed by arthroscopic surgery. Ligament injuries was subdivided by intact tendon, partial or complete tear. Retrospectively, two musculoskeletal radiologists respectively reviewed three image sets of MR including 2D axial image only (set 1), 2D axial and oblique coronal images (set 2), and 2D axial with 3D-isotropic images (set 3). Using arthroscopic findings as reference standard, diagnostic performances of both methods were analysed by the area under the curve (AUC). RESULTS Arthroscopy confirmed 13 AiTFL and 41 ATFL injuries. For AiTFL, when set 1 and set 3 were compared, AUC value was significantly higher for set 3 (P < 0.05). However, there was no significant difference between AUC values for set 2 and set 3 sequences by either reader for either type of tear (P > 0.05). For ATFL, both readers found there was no significant difference in AUC values between set 1 and set 3 and between set 2 and set 3. CONCLUSION Additional oblique coronal sequence demonstrated better diagnostic performance for AiTFL injury than conventional and isotropic imaging did. This sequence showed as much diagnostic accuracy as isotropic sequence for evaluation of ATFL injury.
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Affiliation(s)
- Eun Kyung Khil
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospitial, Bucheon-si, Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospitial, Bucheon-si, Korea
| | - Hyun-Joo Kim
- Department of Radiology, Soonchunhyang University Seoul Hospitial, Bucheon-si, Korea
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Lee YK, Lee HS, Cho WJ, Won SH, Kim CH, Kim HK, Ryu A, Kim WJ. Peroneal tendon irritation after arthroscopic modified Broström procedure: A case report. Medicine (Baltimore) 2019; 98:e18424. [PMID: 31861008 PMCID: PMC6940051 DOI: 10.1097/md.0000000000018424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/30/2019] [Accepted: 11/14/2019] [Indexed: 11/26/2022] Open
Abstract
RATIONALE With the development of ankle arthroscope techniques and procedures, the number of arthroscopic modified Broström procedures (MBPs) is increasing. All-inside arthroscopic MBP was developed recently, with good to excellent results. However, several complications have been reported in patients after arthroscopic MBP. This case report describes a rare complication of arthroscopic MBP. PATIENT CONCERNS A 34-year-old woman presented with severe pain in her right ankle and underwent arthroscopic MBP for lateral ankle instability. About 6 months postoperatively, she presented with severe pain on the lateral aspect of the right ankle, especially while walking. DIAGNOSIS In physical examinations, there was marked swelling around the ankle and focal tenderness in the posterolateral malleolar area. Ankle ultrasonography showed a diffuse low-echoic mass-like lesion at the distal fibula between the fibular tip and peroneus tendon. T1-weighted sagittal magnetic resonance imaging images showed an irregularly shaped mass-like lesion with a heterogeneous signal near the distal fibula posteriorly where the anchor protruded. INTERVENTIONS The suture anchor in the posterior distal fibula area, which had irritated the peroneus tendon, was removed with debridement of the granulomatous lesion. OUTCOMES At the 3-month follow-up, the patient was almost asymptomatic and had a nearly full range of motion. No complications or recurrent symptoms were noted at the 1-year follow-up. LESSONS Three-dimensional computed tomography studies of the appropriate fibular depth and position of suture anchors are needed to standardize the procedure and reduce complications.
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Affiliation(s)
- Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Wonmi-gu, Bucheon
| | - Hong Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Nowon-gu
| | - Whi Je Cho
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Wonmi-gu, Bucheon
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu, Seoul
| | - Chang Hyun Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
| | - Hyun Kwon Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Wonmi-gu, Bucheon
| | - Aeli Ryu
- Department of Obstetrics and Gynecology
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan, Korea
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Sima O, De Vismes Ott A, Dias MS, Dryak P, Ferreux L, Gurau D, Hurtado S, Jodlowski P, Karfopoulos K, Koskinas MF, Laubenstein M, Lee YK, Lépy MC, Luca A, Menezes MO, Moreira DS, Nikolič J, Peyres V, Saganowski P, Savva MI, Semmler R, Solc J, Thanh TT, Tyminska K, Tyminski Z, Vidmar T, Vukanac I, Yucel H. Consistency test of coincidence-summing calculation methods for extended sources. Appl Radiat Isot 2019; 155:108921. [PMID: 31629294 DOI: 10.1016/j.apradiso.2019.108921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/08/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
An internal consistency test of the calculation of coincidence-summing correction factors FC for volume sources is presented. The test is based on exact equations relating the values of FC calculated for three ideal measurement configurations. The test is applied to a number of 33 sets of FC values sent by 21 teams. Most sets passed the test, but not the results obtained using the quasi-point source approximation; in the latter case the test qualitatively indicated the magnitude of the bias of FC.
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Affiliation(s)
- O Sima
- Physics Department, University of Bucharest, Bucharest-Magurele, Romania; Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania.
| | | | - M S Dias
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - P Dryak
- Czech Metrology Institute, Brno, Czech Republic
| | - L Ferreux
- IRSN / PSE-ENV / SAME / LMN, Vésinet, France
| | - D Gurau
- Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania
| | - S Hurtado
- University of Sevilla, Sevilla, Spain
| | - P Jodlowski
- Faculty of Physics and Applied Computer Science, AGH University of Science and Technology, Cracow, Poland
| | - K Karfopoulos
- Greek Atomic Energy Commission, Environmental Radioactivity Monitoring Department, Athens, Greece
| | - M F Koskinas
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - M Laubenstein
- Laboratori Nazionali del Gran Sasso, Istituto Nazionale di Fisica Nucleare, Assergi, Italy
| | - Y K Lee
- DEN/DANS/DM2S/SERMA, CEA-Saclay, France
| | - M C Lépy
- Laboratoire National Henri Becquerel, CEA Saclay, France
| | - A Luca
- Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania
| | - M O Menezes
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - D S Moreira
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - J Nikolič
- Laboratory for Radiation Measurements, Department of Radiation and Environmental Protection, Vinča Institute of Nuclear Sciences, Belgrade, Serbia
| | - V Peyres
- Laboratorio de Metrología de Radiaciones Ionizantes, CIEMAT, Madrid, Spain
| | | | - M I Savva
- INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - R Semmler
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - J Solc
- Czech Metrology Institute, Brno, Czech Republic
| | - T T Thanh
- University of Science, VNU-HCM, Faculty of Physics & Engineering Physics, Department of Nuclear Physics, Ho Chi Minh City, Viet Nam
| | - K Tyminska
- Radioisotope Centre, POLATOM, NCBJ, Poland
| | - Z Tyminski
- Radioisotope Centre, POLATOM, NCBJ, Poland
| | - T Vidmar
- SCK•CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400, Mol, Belgium
| | - I Vukanac
- Laboratory for Radiation Measurements, Department of Radiation and Environmental Protection, Vinča Institute of Nuclear Sciences, Belgrade, Serbia
| | - H Yucel
- Ankara University, Institute of Nuclear Sciences, Ankara, Turkey
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Kim WJ, Lee HS, Moon SI, Kim HS, Yeo ED, Kim YH, Seok Park E, Lee YK. Presence of Subfibular Ossicle Does Not Affect the Outcome of Arthroscopic Modified Broström Procedure for Chronic Lateral Ankle Instability. Arthroscopy 2019; 35:953-960. [PMID: 30611585 DOI: 10.1016/j.arthro.2018.10.148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/10/2018] [Accepted: 10/21/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the clinical and radiological outcomes of the all-inside, arthroscopic, modified Broström procedure (MBP) used to treat chronic lateral ankle instability (CLAI) according to subfibular ossicle (SFO) status. METHODS Between January 2013 and September 2016, we retrospectively analyzed CLAI patients who underwent the arthroscopic MBP. When performing the arthroscopic MBP, SFO was removed with all inside technique regardless of size. Patients who were not followed for more than a minimum of 12 months after surgery were excluded. The patients were divided into 2 groups: ankles with SFOs were assigned to the SFO group and the others to the non-SFO (NSFO) group. The evaluation tools used included the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score, a pain visual analog scale, and the talar tilt angle. RESULTS Following the inclusion criteria, we included 125 patients (125 ankles) in this study. The SFO group consisted of 26 patients and the NSFO group consisted of 99 patients. The preoperative scores in the 2 groups shows no significant difference except for AOFAS scores. The final AOFAS scores in both groups improved compared with the preoperative scores (18.4 ± 16.3 and 22.1 ± 21.6 for the SFO and NSFO groups, respectively). The final follow-up visual analog scale scores also improved in both groups (5.0 ± 1.7 and 5.2 ± 1.4, respectively). The mean ± standard deviation talar tilt improved from 8.7 ± 5.0° preoperatively to 4.6 ± 3.6° at the final follow-up in the SFO group, and from 7.3 ± 4.4° preoperatively to 3.2 ± 3.0° at the final follow-up in the NSFO group. Neither the preoperative nor final talar tilt angle differed between the 2 groups (P = .300 and P = .072, respectively). CONCLUSIONS All-inside arthroscopic MBP after SFO resection was as successful as the same surgery without SFO resection. The clinical outcomes of the SFO and NSFO groups did not differ. Both groups achieved successful radiological outcomes at the last follow-up. All-inside arthroscopic MBP is a reliable treatment for CLAI patients regardless of SFO status. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Hong Seop Lee
- Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Sang Il Moon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Hak Soo Kim
- Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Eui Dong Yeo
- Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Young Hwan Kim
- Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Eun Seok Park
- Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Young Koo Lee
- Soonchunhyang University Hospital, Bucheon, Republic of Korea.
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Lee HS, Lee YK, Kim HS, Lee DW, Won SH, Jung KJ, Kim CH, Kim WJ. Medial malleolar stress fracture resulting from repetitive stress caused by lateral ankle instability: A case report. Medicine (Baltimore) 2019; 98:e14311. [PMID: 30702607 PMCID: PMC6380793 DOI: 10.1097/md.0000000000014311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
RATIONALE Stress fractures are most commonly sustained in the lower extremities owing to the repetitive weight-bearing forces. They are overuse injuries that are seen often in athletes, but rare in the general population, so early diagnosis and proper treatment are important to enable athletes to return to activity. This is a rare example of successful treatment of a medial malleolar stress fracture with lateral ankle instability. PATIENT CONCERNS A 16-year-old athlete presented with acute-onset left ankle pain. He was a baseball pitcher who had previously sprained left ankle while training. Subsequently, the ankle pain worsened, and he had tenderness on the medial aspect of his left ankle. The symptoms were mild at rest, but increased upon walking and training. Three years previously, he had sprained his ankle several times during baseball training. DIAGNOSIS Plain standing radiographs of the left ankle showed a vertical fracture line in the medial malleolus. Computed tomography also showed the vertical fracture in the medial malleolus. Magnetic resonance imaging revealed mild bone marrow edema in the medial malleolar area and total rupture of the anterior talofibular ligament. INTERVENTIONS Surgery was performed under general anesthesia, and we checked the instability of his ankle using a C-arm image intensifier, and the varus talar tilt angle was increased (10.3°). The medial malleolus stress fracture was fixed using tension bend wiring, and an arthroscopic modified Broström procedure was done. OUTCOMES Two months postoperatively, the patient started walking, and raised-heel squatting. The medial malleolar fracture was completely united at the 3 months postoperatively on plain radiography, and return to full activity was achieved by 3 months postoperatively. Then the hardware was removed 1-year after operation and both the anterior drawer and external rotation stress tests were negative. LESSONS Medial malleolar stress fractures are rare, so they can be overlooked. With these fractures, plain radiographs are frequently normal initially because the medial malleolus consists mainly of cancellous bone. Physicians require a high level of suspicion when taking the patient's history and doing the physical examination. Because most occur in athletes, early diagnosis and proper treatment are important for patients' subsequent athletic performance.
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Affiliation(s)
- Hong Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, 68, Hangeulbiseok-ro, Nowon-gu, Seoul
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Jomaru-ro, Wonmi-gu, Bucheon
| | - Hak Soo Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Jomaru-ro, Wonmi-gu, Bucheon
| | - Dhong Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Neungdong-ro, Gwangjin-gu
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul
| | - Ki Jin Jung
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea
| | - Chang Hyun Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea
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Lee HS, Kim WJ, Park ES, Kim JY, Kim YH, Lee YK. Mid-term follow-up results of calcaneal reconstruction for calcaneal malunion. BMC Musculoskelet Disord 2019; 20:43. [PMID: 30696419 PMCID: PMC6352372 DOI: 10.1186/s12891-019-2419-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/14/2019] [Indexed: 11/28/2022] Open
Abstract
Background We hypothesized that calcaneal reconstruction can relieve chronic pain due to calcaneal malunion. We report the mid-term follow-up results of calcaneal reconstruction for calcaneal malunion. Methods We reviewed the records of 10 male patients (10 ft) who underwent calcaneal reconstruction for calcaneal malunion between January 2009 and July 2014 at the mid-term follow-up. Talocalcaneal height and angle, calcaneal pitch, calcaneal width, Böhler angle, Stephens classification, and Zwipp classification were evaluated by three orthopedic doctors at each visit (pre-reconstruction, post-reconstruction, and at the last follow-up). Results The mean follow-up period was 67.1 months (range, 48–101 months). The sites of pain before reconstruction were lateral aspect (4 patients), plantar aspect (3 patients), diffuse pain (2 patients), and anterior aspect (1 patient). There was a significant difference in talocalcaneal height, talocalcaneal angle, calcaneal pitch, calcaneal width, and Böhler angle before and after reconstruction (p < 0.05). There was no significant difference between reconstruction and the last follow-up. Radiological measurement agreement was calculated to be moderate to strong (intraclass correlation coefficient: 0.659–0.988). Mean American Orthopedic Foot & Ankle Society Ankle and Hindfoot score improved from 66.50 ± 9.37 pre-reconstruction to 80.30 ± 8.52 at the last follow-up (p < 0.05). The mean visual analog scale score improved from 8.60 ± 1.43 before reconstruction to 3.40 ± 0.84 at the last follow-up (p < 0.05). Most patients were satisfied with the outcome postoperatively. Conclusions Our results showed substantial improvement in the clinical and radiological outcomes after calcaneal reconstruction of calcaneal malunion. This outcome was maintained until the mid-term follow-up. Therefore, calcaneal reconstruction may be a good option for the treatment of chronic pain caused by the malunion of a calcaneal fracture without severe subtalar arthritis. Further prospective studies are needed to test this theory. Level of Evidence: Level IV, Retrospective Case Series.
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Affiliation(s)
- Hong Seop Lee
- Department of Foot and Ankle Surgery, Eulji Medical Center, Eulji University, 68, Hangeulbiseok-ro, Nowoungu, Seoul, 01830, Korea
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea
| | - Eun Seok Park
- Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea
| | - Jun Young Kim
- Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea
| | - Young Hwan Kim
- Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea
| | - Young Koo Lee
- Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea.
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Yeo ED, Yoon SA, Oh SR, Choi YS, Lee YK. Retracted: Degree of the Hazards of Silver-Containing Dressings on MRSA-Infected Wounds in Sprague-Dawley and Streptozotocin-Induced Diabetic Rats. Wounds 2018; 30:A4. [PMID: 30212360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Editor and Publisher regretfully have to retract the following two publications due to faulty study design.
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Affiliation(s)
- Eui Dong Yeo
- Department of Orthopedics, Soon Chun Hyang University Hospital Bucheon, Bucheon City, Gyeonggi-do, South Korea
| | - Su Ah Yoon
- Department of Orthopedics, Soon Chun Hyang University Hospital Bucheon, Bucheon City, Gyeonggi-do, South Korea
| | - Seong Rok Oh
- Department of Orthopedics, Soon Chun Hyang University Hospital Bucheon, Bucheon City, Gyeonggi-do, South Korea
| | - Young Suk Choi
- Department of Orthopedics, Soon Chun Hyang University Hospital Bucheon, Bucheon City, Gyeonggi-do, South Korea
| | - Young Koo Lee
- Department of Orthopedics, Soon Chun Hyang University Hospital Bucheon, Bucheon City, Gyeonggi-do, South Korea
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Choi YS, Gwak HC, Park JK, Lim JY, Yeo ED, Park E, Kim J, Lee YK. Retracted: Comparison of DNA Damage and Apoptosis Induced By Silver Nanoparticle-containing Dressing Materials During Wound Healing. Wounds 2018; 30:A4. [PMID: 30212359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Editor and Publisher regretfully have to retract the following two publications due to faulty study design.
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Affiliation(s)
- Young Suk Choi
- Clinical Research Center, Soonchunhyang University, Gyeonggi-Do, South Korea
| | - Heui-Chul Gwak
- Department of Orthopedic Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jae Keun Park
- Department of Orthopedic Surgery, Dong-Rae Bong Seng Hospital, Dongnae-gu, Busan, South Korea
| | - Ji Yun Lim
- Clinical Research Center, Soonchunhyang University, Gyeonggi-Do, South Korea
| | - Eui Dong Yeo
- Department of Orthopedic Surgery, Veterans Health Service Medical Center, Gangdong-gu, Seoul, South Korea
| | - Eunseok Park
- Department of Orthopedics, Soonshunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-do, South Korea
| | - Junyong Kim
- Department of Orthopedics, Soonshunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-do, South Korea
| | - Young Koo Lee
- Department of Orthopedics, Soonshunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-do, South Korea
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Kim JH, Seol YJ, Ko IK, Kang HW, Lee YK, Yoo JJ, Atala A, Lee SJ. 3D Bioprinted Human Skeletal Muscle Constructs for Muscle Function Restoration. Sci Rep 2018; 8:12307. [PMID: 30120282 PMCID: PMC6098064 DOI: 10.1038/s41598-018-29968-5] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/20/2018] [Indexed: 12/31/2022] Open
Abstract
A bioengineered skeletal muscle tissue as an alternative for autologous tissue flaps, which mimics the structural and functional characteristics of the native tissue, is needed for reconstructive surgery. Rapid progress in the cell-based tissue engineering principle has enabled in vitro creation of cellularized muscle-like constructs; however, the current fabrication methods are still limited to build a three-dimensional (3D) muscle construct with a highly viable, organized cellular structure with the potential for a future human trial. Here, we applied 3D bioprinting strategy to fabricate an implantable, bioengineered skeletal muscle tissue composed of human primary muscle progenitor cells (hMPCs). The bioprinted skeletal muscle tissue showed a highly organized multi-layered muscle bundle made by viable, densely packed, and aligned myofiber-like structures. Our in vivo study presented that the bioprinted muscle constructs reached 82% of functional recovery in a rodent model of tibialis anterior (TA) muscle defect at 8 weeks of post-implantation. In addition, histological and immunohistological examinations indicated that the bioprinted muscle constructs were well integrated with host vascular and neural networks. We demonstrated the potential of the use of the 3D bioprinted skeletal muscle with a spatially organized structure that can reconstruct the extensive muscle defects.
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Affiliation(s)
- Ji Hyun Kim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
| | - Young-Joon Seol
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
| | - In Kap Ko
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
| | - Hyun-Wook Kang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
| | - Young Koo Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-Do, 420-726, Republic of Korea
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
- School of Biomedical Engineering and Sciences, Wake Forest University-Virginia Tech, Winston-Salem, NC, 27157, United States
| | - Anthony Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States
- School of Biomedical Engineering and Sciences, Wake Forest University-Virginia Tech, Winston-Salem, NC, 27157, United States
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, United States.
- School of Biomedical Engineering and Sciences, Wake Forest University-Virginia Tech, Winston-Salem, NC, 27157, United States.
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Ran X, Lee YK, Pan G, Pei D, Tse HF. 1430CRISPR/Cas9-mediated correction of Troponin I R186Q mutation rescues myofibrillar disarray and excitation-contraction coupling abnormalities in IPSC model from hypertrophic cardiomyopathy patient. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- X Ran
- The University of Hong Kong, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y K Lee
- The University of Hong Kong, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - G Pan
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China People's Republic of
| | - D Pei
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China People's Republic of
| | - H F Tse
- The University of Hong Kong, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
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Lee YK, Lau YM, Ran X, Cai ZJ, Lai WH, Siu CW, Tse HF. P5714Disease modeling of laminopathy-related dilated cardiomyopathy (DCM) - Proarrhythmic effects and electrical-contraction (EC) coupling defeats due to altered mechanosensitivity of lamin A. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y K Lee
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y M Lau
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - X Ran
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - Z J Cai
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - W H Lai
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - C W Siu
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
| | - H F Tse
- The University of Hong Kong, Department of Medicine, Division of Cardiology, Hong Kong, Hong Kong SAR People's Republic of China
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Abstract
Deltoid ligament repair can be challenging, and implementation of an arthroscopic method can be useful in terms of minimizing morbidity associated with open dissection, as long as the repair is effective and durable. In this brief report, we describe a method of arthroscopic deltoid ligament repair that we have found to be useful.
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Affiliation(s)
- Jeon Gyo Kim
- Doctor, Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea
| | - Heui Chul Gwak
- Professor, Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea
| | - Myoung Jin Lee
- Professor, Department of Orthopedic Surgery, Dong-A University Hospital, Busan, Republic of Korea
| | - Jung Woo Yoo
- Doctor, Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Ji Yong Park
- Doctor, Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Keon Hee Yun
- Doctor, Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea
| | - Young Koo Lee
- Professor, Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea.
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Kim WJ, Lee YK. All-inside Arthroscopic Modified Broström Operation for Lateral Ankle Instability with Os Subfibulare. Foot & Ankle Orthopaedics 2018. [DOI: 10.1177/2473011418s00292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Category: Sports Introduction/Purpose: Os Subfibulare(OSF) is an accessory ossicle that lies at the tip of the lateral malleolus of the ankle. Patients with chronic lateral ankle instability (CLAI) have a high incidence of OSF, and there relationship implies that there is a correlation between OSF and CLAI. The all-inside arthroscopic Modified Broström Operation (MBO) has been developed for the treatment of chronic lateral ankle instability (CLAI) and the outcome was reported as good or excellent. But there were no report about comparison of the outcome between OSF and non-OSF patients with chronic lateral ankle instability treated by all-inside arthroscopic MBO. The purpose of this study was to evaluate the clinical and radiologic outcomes of the arthroscopic MBO procedure for CLAI with or without OSF. Methods: From January 2013 to september 2016, arthroscopic MBO was performed on 133 patients with CLAI. Of these, 126 ankles were evaluated for this study. Patients were divided into two groups: the OSF group (26 patients), without OSF group (100 patients). Evaluation tools included the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot ankle score and pain Visual Analogue Scale (VAS) at preoperatively, 6 and 12 months postoperatively for clinical outcomes. And we also evaluated the talar tilt angle in the varus stress radiograph at preoperatively, 6 and 12 months postoperatively for radiologic outcomes. Results: There were no difference in age, sex, preoperative AOFAS hindfoot ankle scores and VAS scores and talar tilt angle between the two groups preoperatively(P >.05). And there also were no difference at the final follow-up (P >.05).The final follow-up AOFAS hindfoot ankle score and Vas in both group showed improvement compared with preoperaive values. Conclusion: There were no difference in both clinical and radiologic outcomes between OSF group and non-OSF group at a minimum 12 months follow-up. We achieved similar successful outcomes in both groups using All-inside arthroscopic MBO. Arthroscopic MBO should be considered as a reasonable alternative method in patients who have chronic lateral ankle instability regardless of the presence of OSF.
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Lee YK, Park S, Lee S. Comparison of Mid-term Outcomes Between an Arthroscopic and an Open Modified Broström Procedure for Ankle Instability. Foot & Ankle Orthopaedics 2018. [DOI: 10.1177/2473011418s00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Category: Arthroscopy Introduction/Purpose: Although the short-term results of an all-inside arthroscopic Modified Broström operation (MBO) have been as satisfactory as open MBO, there is always a concern about the long-term stability of an arthroscopic MBO. The purpose of this study was to compare clinical and radiologic outcomes of all-inside arthroscopic and open MBOs at mid-term follow up. Methods: From August 2012 to July 2014, totally 87 patients underwent an arthroscopic MBO and an open MBO. Of these, we retrospectively reviewed 48 patients who had a more than 3 years follow-up period. They were divided into two groups: all-inside arthroscopic MBO goup (26 patients), open MBO group (22 patients). The American Orthopaedic Foot & Ankle Society (AOFAS) ankle–hindfoot score, visual analog scale (VAS) score, and Karlsson score were used to evaluate clinical outcomes. Anterior talar translation and talar tilt were used to evaluate radiologic outcomes. Clinical and radiologic outcome evaluations were performed preoperatively, at 12 months postoperatively, and at a final follow-up at a minimum of 36 months postoperatively. Results: Evaluations were performed for 26 ankles in the all-inside arthroscopic MBO group and 22 in the open MBO group. There was no difference in age, gender, symptom duration, preoperative AOFAS, VAS, Karlsson scores, anterior talar translation, or talar tilt between the 2 groups (all P > .05). At the final follow-up, the AOFAS, VAS, and the Karlsson scores had improved significantly in both groups (P < .001). There was no difference in the Karlsson, AOFAS, or VAS scores, anterior talar translation, or talar tilt between the 2 groups at final follow-up (all P > .05). Conclusion: There was no difference in the clinical and radiologic outcome between the all-inside arthroscopic MBO and open MBO for the treatment of lateral ankle instability at up to 3 years after surgery. An all-inside arthroscopic MBO should be a good treatment option in patients who have lateral ankle instability.
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Lee YK, Yoo J. Open syndesmotic repair for open-book type syndesmotic injury. Foot & Ankle Orthopaedics 2018. [DOI: 10.1177/2473011418s00316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Category: Trauma Introduction/Purpose: Although there are several approaches to the treatment of syndesmosis injury, there is no gold standard technique. Syndesmotic screw fixation is one of commonly used treatment options but there remains debate topics such as implant breakage and the need for device removal. The purpose of this study was to evaluate the clinical, radiologic and arthroscopic outcomes of open syndesmotic repair for open-book type syndesmotic injury as a new treatment option. Methods: We reviewed the clinical, radiographic and arthroscopic results of 20 patients with traumatic injuries to the distal tibiofibular syndesmosis who were treated with open syndesmotic repair. Arthroscopic evaluations including cotton test were performed at the primary and second-look operation. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle–hindfoot score and visual analog scale (VAS) score were used to evaluate clinical outcomes. The measurement of the tibiofibular clear space and tibiofibular overlap were used to evaluate radiologic outcomes. Both Clinical and radiologic outcome evaluations were performed preoperatively, at 6 weeks and 6 months postoperatively, and at a final follow-up at a minimum 12 months postoperatively. The average follow-up period was 15.3 months. Results: The average AOFAS score improved from 45.4 (range 30-68) preoperatively to 94.12 (range 83-100) at the last follow-up (P < .001). The radiologic parameters of the syndesmosis returned to normal range since the first postoperative follow-up. At second-look arthroscopy, all the patients showed negative cotton test results and the gap of distal tibiofibular joint was remained less than 2 mm in all patients. Conclusion: We had excellent clinical, radiologic and arthroscopic results and there is no major complication. Open syndesmotic repair for open-book type syndesmotic injury is effective in healing and maintaining the injured joint. Therefore this procedure could be a reasonable alternative treatment for traumatic syndesmosis injury of the ankle.
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Lee YK, Ahn JH. Mid-term follow up results of Calcaneal Reconstruction for the Late Complication of Calcaneus Fracture. Foot & Ankle Orthopaedics 2018. [DOI: 10.1177/2473011418s00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Category: Trauma Introduction/Purpose: Calcaneal fracture is the most common fracture in hindfoot. The treatment is challenging, because of various patterns of fractures and high complication rates which leads to high level of dysfunction and low satisfaction of the patients. There are many previous studies reporting various methods about treatment of calcaneal malunion, such as subtalar arthrodesis, corrective osteotomy and corrective osteotomy with subtalar arthrodesis. However, there are no mid-term clinical results reporting about lateral ostectomy and sliding osteotomy, which is called calcaneal reconstruction. The purpose of this study is to evaluate the mid-term clinical and radiologic results of calcaneal reconstruction in the patients who have chronic complications after calcaneal fracture. Methods: Between January 2009 to May 2014, 196 patients (257 feet) were treated by calcaneal fracture. 34 patients (37 feet) underwent calcaneal reconstruction because of the dysfunction and the pain caused by malunion. Inclusion criteria were those whom underwent calcaneal reconstruction and able to be followed up at least 4 years postoperatively. The patients who had severe subtalar arthritis or whom underwent subtalar arthrodesis or simple bone resection were excluded. We reviewed 10 patients (10 feet) postoperatively and at mid-term follow up. Radiologic results including Böhler angle, calcaneal pitch, talocalcaneal height, talar inclination, talocalcaneal angle, talo-1st metatarsal angle, calcaneal width were measured and clinical results including AOFAS Ankle-Hindfoot scale and VAS score were checked preoperative, postoperatively and at the last follow up. The satisfaction of the patient was checked by survey. Results: The mean interval between the first operation and reconstructive operation was 16.6 months. The mean follow-up period after calcaneal reconstruction was 67.1 months. The most common symptom of the patient were pain on the inferior aspect of the lateral malleolus (4 patients) and heel area (3 patients). After calcaneal reconstruction, all the mean values of talocalcaneal height, calcaneal pitch, and Böhler angle were improved, which was statistically significant, respectively. In the postoperative period, 3 patients were very satisfied, 5 were satisfied, and 2 were not satisfied. The results maintained till mid-term follow up. Also, AOFAS and VAS score were improved comparing pre-reconstruction and mid-term follow up. Although the pain did not completely resolved, most of the patients were satisfied postoperatively. Conclusion: In patients without severe subtalar arthritis, the known main causes of the pain in calcaneal malunion are the loss of calcaneal height and hindfoot widening rather than subtalar arthritis. Our results showed signigficant clinical and radiological results by calcaneal reconstruction. And the outcome maintained till mid-term follow up. Calcaneal reconstruction can be a good choice for chronic pain which is caused by malunion of calcaneal fracture without severe subtalar arthritis.
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Abstract
RATIONALE Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel that is often caused by a variety of space-occupying lesions, such as ganglia, lipomas, varicosities, neural tumors, trauma, or systemic disease. The os sustentaculi is a small accessory bone, bridged to the posterior aspect of the sustentaculum tali by fibrocartilage. To the best of our knowledge, this is a rare case of successful treatment of TTS caused by the os sustantaculi. PATIENT CONCERNS A 37-year-old male presented with insidious onset of right ankle and foot pain for 1 year. He also complained of a tingling sensation and paresthesia from the plantar and medial aspect of the forefoot to the middle foot area along the main distribution of the medial plantar nerve. The symptoms were mild at rest, but increased upon prolonged walking. He had an ankle sprain history during a football game 2 years previously and recurrent ankle sprains had occurred more frequently in this ankle since that trauma. DIAGNOSES Plain standing anteroposterior and lateral view radiographic findings of the right ankle reveled an accessory ossicle located posterosuperomedial to the sustentaculum tali. A computed tomography scan showed that the ossicle articulated between the talus and calcaneus. A magnetic resonance image revealed mild bone marrow edema in the ossicle and medial displacement of the tarsal structures. INTERVENTIONS Surgery was performed under general anesthesia. The ossicle was delineated from its surrounding structures and was removed. Tension on the nerve was released. OUTCOMES The patient's pain and hypoesthesia were immediately relieved, and the tingling sensation disappeared 6 months after surgery. The patient had no complications or recurrence of symptoms at the 1-year follow-up.
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Affiliation(s)
- Chang Hwa Hong
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Suncheonhyang 6-gil, Dongam-gu, Cheonan
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Jomaru-ro, Wonmi-gu, Bucheon
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Daesagwan-ro, Yongsan-gu
| | - Dhong Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Neungdong-ro, Gwangjin-gu, Seoul, Korea
| | - Sang Il Moon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Suncheonhyang 6-gil, Dongam-gu, Cheonan
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Suncheonhyang 6-gil, Dongam-gu, Cheonan
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Lee YK, Kim JW, Kim TY, Ha YC, Koo KH. Validity of the intra-operative measurement of stem anteversion and factors for the erroneous estimation in cementless total hip arthroplasty using postero-lateral approach. Orthop Traumatol Surg Res 2018; 104:341-346. [PMID: 29458202 DOI: 10.1016/j.otsr.2017.11.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/07/2017] [Accepted: 11/23/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Intra-operative estimation of stem anteversion in total hip arthroplasty (THA) using postero-lateral approach is made by the surgeon's visual assessment, using the tibia as a guide, with the assumption that tibial axis is vertical to the trans-epicondylar axis. However, the accuracy of the intra-operative estimation has rarely been verified with postoperative CT-scans, with controversies regarding these measurements particularly in case of knee osteoarthritis. Therefore we performed a prospective study to: (1) determine the accuracy of the intra-operative measurement and (2) investigate factors affecting the discrepancy between the surgeon's estimation and the real stem anteversion. HYPOTHESIS Intra-operative estimation of stem anteversion correlated with the real stem anteversion on CT-scan. PATIENTS AND METHODS Sixty-seven THAs using cementless straight stems (65 patients) without ipsilateral total knee arthroplasty were prospectively evaluated to compare the intra-operative measurement of stem anteversion with the real stem anteversion on computed tomography (CT) scans. There were 33 men and 34 women with a mean age of 59.7years (range, 27-84years) at the time of surgery. Age, tibia plateau angle, native femoral anteversion, femoro-tibial angle, body mass index, operative site, gender, coronal and sagittal tilt of the stem, stem type, ipsilateral knee osteoarthritis, and preoperative diagnosis were analyzed to evaluate the factors affecting the discrepancy between the intra-operative and CT measurements. RESULTS The intra-operative estimation (mean, 21.5°±8.5°; range, 5.0°-39.0°) was greater than the CT measurement (mean, 19.5°±8.7°; range, 4.5°-38.5°) by 2.0°. The mean absolute value of discrepancy was 4.5°. The correlation coefficient between intra-operative and CT measurements was 0.837. The femoro-tibial angle was associated with the discrepancy between the two measurements. In the presence of genu varum deformity, the intra-operative measurement underestimated the stem anteversion. DISCUSSION Although intra-operative estimation of stem anteversion was slightly greater than the real stem anteversion, there was an excellent correlation between the two. The femoro-tibial angle should be considered to optimize the stem anteversion during cementless THA using postero-lateral approach. LEVEL OF EVIDENCE Level III, prospective case control study.
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Affiliation(s)
- Y K Lee
- Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, 166 Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea
| | - J W Kim
- Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, 166 Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea
| | - T Y Kim
- Hallym University Sacred Heart Hospital, Department of Orthopaedic Surgery, 896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, South Korea; Konkuk University Medical Center, Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul 05030, South Korea.
| | - Y C Ha
- Chung-Ang University, College of Medicine, Department of Orthopaedic Surgery, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, South Korea
| | - K H Koo
- Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, 166 Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea
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Choi YS, Gwak HC, Park JK, Lim JY, Yeo ED, Park E, Kim J, Lee YK. Comparison of DNA Damage and Apoptosis Induced By Silver Nanoparticle-containing Dressing Materials During Wound Healing. Wounds 2018:WNDS20180413-1. [PMID: 29718810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Silver nanoparticle (AgNP)-containing dressings are used worldwide for the treatment of wounds; however, many studies have indicated that AgNPs are toxic to humans and cause cell death, primarily via apoptosis. OBJECTIVE In this study, the investigators compare the apoptotic effects of various AgNP dressing materials, with the hypothesis that nanosilver would be less toxic than ionic silver. MATERIALS AND METHODS For the in vivo experiments, Sprague-Dawley (SD) and streptozotocin (STZ)-induced diabetic rats were treated with 5 dressing materials: Aquacel Ag (product A, silver ion; ConvaTec, Berkshire, UK), Acticoat (product B, AgNP; Smith & Nephew, Fort Worth, TX), Medifoam Silver (product C, silver ion; Genewel Science Co Ltd, Seongnam, South Korea), PolyMem Silver (product D, AgNP; Ferris Mfg Corp, Fort Worth, TX), and Vaseline-impregnated dressing gauze (control; Unilever, London, UK). All treatments were applied 3 times per week. After 14 days of treatment, the SD and STZ rats were euthanized, and wound samples were examined for apoptosis. The analysis included immunohistochemistry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, Western blotting, and reverse transcription polymerase chain reaction for a semiquantitative evaluation of apoptosis. RESULTS The AgNP-containing dressing materials were more cytotoxic than the silver dressings. Compared with the AgNP dressing materials, no significant levels of apoptotic factors were observed in the silver dressing-treated wounds. The TUNEL staining showed that product C-dressed wounds contained the most apoptotic cells, while some apoptotic cells were observed in product B-dressed wounds. Moreover, apoptotic gene expression was altered, including a decline in B-cell lymphoma-2 and activation of caspase-3. This was most evident in wounds treated with product C. Interestingly, apoptotic gene expression was not induced in product A-treated wounds. Finally, product D had a relatively lower silver concentration and was less toxic than products A-C. CONCLUSIONS Dressing materials containing AgNP have an antimicrobial effect. However, the authors observed that some AgNP dressings induced DNA damage and apoptosis. Although AgNP dressings did not cause significant acute apoptotic effects, they should be examined for cytotoxic effects in chronic wounds and should be used with caution when treating chronic wounds and those with low bacteria counts.
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Yeo ED, Park JY, Kim JH, Lee YK. Comparison of Outcomes in Patients With Generalized Ligamentous Laxity and Without Generalized Laxity in the Arthroscopic Modified Broström Operation for Chronic Lateral Ankle Instability. Foot Ankle Int 2017; 38:1318-1323. [PMID: 29034742 DOI: 10.1177/1071100717730336] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The arthroscopic modified Broström operation (MBO) has been frequently used to treat chronic lateral ankle instability (CLAI). However, no reports comparing the clinical outcomes between patients with or without generalized ligamentous laxity (laxity or no laxity, respectively) currently exist. The purpose of this study was to compare the clinical outcomes of the 2 groups with CLAI. METHODS Between January 2013 and November 2015, arthroscopic MBO was performed on 99 patients with CLAI. Patients were divided into 2 groups: the laxity group (24 ankles) and no laxity group (75 ankles). Generalized ligamentous laxity was defined as a Beighton score of 4 or more points. Evaluation tools included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot ankle score, a pain visual analog scale (VAS), and talar tilt angle. RESULTS The change in talar tilt angle from preoperative to 12 months postoperative was significantly greater in the laxity group (-6.9 ± 5.2) compared with the no-laxity group (-4.2 ± 4.2) ( P = .03). The final follow-up AOFAS hindfoot ankle score and pain VAS in both groups showed improvement compared with the preoperative values. CONCLUSION All groups achieved successful clinical and radiological final follow-up outcomes. Arthroscopic MBO should be considered a reasonable method in patients who have chronic lateral ankle instability, regardless of generalized ligamentous laxity. LEVEL OF EVIDENCE III, comparative study.
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Affiliation(s)
- Eui Dong Yeo
- 1 Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Ji Young Park
- 2 Departments of Orthopedic Surgery, Soonchunhyang University Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
| | - Jin Hyeung Kim
- 3 Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Young Koo Lee
- 2 Departments of Orthopedic Surgery, Soonchunhyang University Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
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Low JSY, Soh SE, Lee YK, Kwek KYC, Holbrook JD, Van der Beek EM, Shek LP, Goh AEN, Teoh OH, Godfrey KM, Chong YS, Knol J, Lay C. Ratio of Klebsiella/Bifidobacterium in early life correlates with later development of paediatric allergy. Benef Microbes 2017; 8:681-695. [PMID: 29022383 DOI: 10.3920/bm2017.0020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Several studies have reported that intestinal microbial colonisation patterns differ between non-allergic and allergic infants. However, the microbial signature underlying the pathogenesis of allergies remains unclear. We aim to gain insight into the development of the intestinal microbiota of healthy infants and infants who develop allergy in early life, and identify potential microbiota biomarkers of later allergic disease. Using a case-control design in a Chinese sub-cohort of a Singaporean birth cohort (GUSTO), we utilised 16S rRNA gene sequencing to assess intestinal microbial composition and diversity of 21 allergic and 18 healthy infants at 3 weeks, 3 months and 6 months of age, and correlated the microbiota with allergy at ages 18 and 36 months. Pronounced differences in intestinal microbiota composition between allergic and healthy infants were observed at 3 months of age. The intestine of healthy infants was colonised with higher abundance of commensal Bifidobacterium. Conversely, Klebsiella, an opportunistic pathogen, was significantly enriched in the allergic infants. Interestingly, infants with a high Klebsiella/Bifidobacterium (K/B) ratio (above the population median K/B ratio) at age 3 months had an odds ratio of developing allergy by 3 years of age of 9.00 (95% confidence interval 1.46-55.50) compared to those with low K/B ratio. This study demonstrated a relationship between the ratio of genera Klebsiella and Bifidobacterium during early infancy and development of paediatric allergy in childhood. Our study postulates that an elevated K/B ratio in early infancy could be a potential indicator of an increased risk of allergy development. This line of research might enable future intervention strategies in early life to prevent or treat allergy. Our study provides new insights into microbial signatures associated with childhood allergy, in particular, suggests that an elevated K/B ratio could be a potential early-life microbiota biomarker of allergic disease.
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Affiliation(s)
- J S Y Low
- 1 Nutricia Research, Danone Nutricia Early Life Nutrition, Matrix Building #05-01B, 30 Biopolis Street, 138671 Singapore, Singapore
| | - S-E Soh
- 2 Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609, Singapore, Singapore.,3 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Science drive 2, 117597, Singapore, Singapore
| | - Y K Lee
- 4 Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Science drive 2, 117597, Singapore, Singapore
| | - K Y C Kwek
- 5 KK Women's and Children's Hospital, Singapore, Singapore
| | - J D Holbrook
- 2 Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609, Singapore, Singapore.,6 Human Development & Health Academic Unit, University of Southampton & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - E M Van der Beek
- 7 Nutricia Research, Uppsalalaan 12, 3584 CT, Utrecht, the Netherlands.,8 Department of Pediatrics, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands
| | - L P Shek
- 2 Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609, Singapore, Singapore.,3 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Science drive 2, 117597, Singapore, Singapore
| | - A E N Goh
- 5 KK Women's and Children's Hospital, Singapore, Singapore
| | - O H Teoh
- 5 KK Women's and Children's Hospital, Singapore, Singapore
| | - K M Godfrey
- 9 MRC Lifecourse Epidemiology Unit, and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Tremona Road, SO16 6YD Southampton, United Kingdom
| | - Y-S Chong
- 2 Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609, Singapore, Singapore.,10 Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Science drive 2, 117597 Singapore, Singapore
| | - J Knol
- 7 Nutricia Research, Uppsalalaan 12, 3584 CT, Utrecht, the Netherlands.,11 Laboratory of Microbiology, Wageningen University, P.O. Box 7005, 6700 CA, Wageningen, the Netherlands
| | - C Lay
- 1 Nutricia Research, Danone Nutricia Early Life Nutrition, Matrix Building #05-01B, 30 Biopolis Street, 138671 Singapore, Singapore.,3 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Science drive 2, 117597, Singapore, Singapore
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Kim HJ, Yeo ED, Rhyu IJ, Lee SH, Lee YS, Lee YK. Changes in ankle joint motion after Supramalleolar osteotomy: a cadaveric model. BMC Musculoskelet Disord 2017; 18:389. [PMID: 28888229 PMCID: PMC5591493 DOI: 10.1186/s12891-017-1749-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 08/31/2017] [Indexed: 11/17/2022] Open
Abstract
Background Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. Methods Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers. They were harvested from five males (10 ankles)whose average age was 70 years. We assessed the motion of ankle joint as well as plantar pressure for SS(supra-syndesmotic) SMO and IS(intra-syndesmotic) SMO. After the osteotomy, each specimen was subjected to axial compression from 20 N preload to 350 N representing half-body weight. For the measurement of the motion of ankle joint, the changes in gap and point, angles in ankle joint were measured. The plantar pressure were also recorded using TekScan sensors. Results The changes in the various gap, point, and angles movements on SS-SMO and IS-SMO showed no statistically significant differences between the two groups. Regarding the shift of plantar center of force (COF) were noted in the anterolateral direction, but not statistically significant. Conclusions SS-SMO and IS-SMO with intact fibula showed similar biomechanical effect on the ankle joint. We propose that IS-SMO should be considered carefully for the treatment of osteoarthrosis when fibular osteotomy is not performed because lateral cortex fracture was less likely using the intrasyndesmosis plane because of soft tissue support.
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Affiliation(s)
- Hak Jun Kim
- Department of Orthopedic Surgery, Guro Hospital, Korea University College of Medicine, 80 Gurodong, Gurogu, Seoul, 152-703, South Korea
| | - Eui Dong Yeo
- Department of Orthopedic Surgery, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 134-791, South Korea
| | - Im Joo Rhyu
- Department of Anatomy, Korea University College of Medicine University, 73 Inchon-ro, Seongbuk-gu, Seoul, South Korea
| | - Soon-Hyuck Lee
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, South Korea
| | - Yeon Soo Lee
- Department of Biomedical Engineering, College of Medical Science, Catholic University of Daegu, 330, Geumrak, Hayang-eup, Gyeongsan-si, Gyeongbuk, 712-702, South Korea
| | - Young Koo Lee
- Department of Orthopaedic Surgery,Bucheon Hospital, College of Medicine, Soonchunhyang University, 1174 Jung-1-dong, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea.
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49
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Gan CS, Lee YK, Heh CH, Rahman NA, Yusof R, Othman S. The synthetic molecules YK51 and YK73 attenuate replication of dengue virus serotype 2. Trop Biomed 2017; 34:270-283. [PMID: 33593007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dengue virus infection has been posing alarming economic and social burden on affected nations. It is estimated that 50-100 million dengue infections occur annually with over 2.5 billion people at risk for endemic transmission. In the effort to develop effective antiviral agents, we previously reported potential antiviral activities from selected array of natural products and compounds against dengue virus serotype 2 (DV2). In this study, we report the synthesis of two efficacious novel compounds, YK51 and YK73, and their activities against DV2 replication. Both compounds were chemically synthesised from nicotinic acid using a modified method for the synthesis of dihydropyridine. The products were tested with cell-based assays against DV2 followed by a serine protease assay. As a result, both YK51 and YK73 exhibited intriguing antiviral properties with EC50 of 3.2 and 2.4 µM, respectively. In addition, YK51 and YK73 were found to attenuate the synthesis of intracellular viral RNA and protect the switching of non-classic mechanism of protein translation. These compounds demonstrated inhibitory properties toward the activity of DV2 serine protease in a dose dependent manner. These findings demonstrate that both YK51 and YK73 serve as DV2 serine protease inhibitors that abrogate viral RNA synthesis and translation. Further investigation on these compounds to corroborate its therapeutic properties towards dengue is warranted.
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Affiliation(s)
- C S Gan
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y K Lee
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - C H Heh
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N A Rahman
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - R Yusof
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S Othman
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Drug Design and Development Research Group, University of Malaya, 50603 Kuala Lumpur, Malaysia
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50
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Kratz A, Plebani M, Peng M, Lee YK, McCafferty R, Machin SJ. ICSH recommendations for modified and alternate methods measuring the erythrocyte sedimentation rate. Int J Lab Hematol 2017; 39:448-457. [PMID: 28497537 DOI: 10.1111/ijlh.12693] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The gold standard for the determination of the erythrocyte sedimentation rate (ESR) is the Westergren method. Other methods to measure the ESR have become available. They range from modest modifications of the Westergren method to very different methodologies. The ICSH therefore established a Working Group to investigate these new approaches and compile recommendations for their validation and verification. METHODS A panel of six experts in laboratory hematology examined the peer-reviewed literature and EQA surveys from over 6000 laboratories on four continents performing ESR testing. This information was used to create lists of ESR instrument manufacturers and their methods. RESULTS Only 28% of laboratories surveyed used the unmodified Westergren method, while 72% of sites used modified or alternate methods. Results obtained with the new instruments could differ from results obtained with the Westergren method by up to 142%. Different non-Westergren methods showed differences from each other of up to 42%. The new methods were often significantly faster, safer, and less labor-intensive. They reduced costs and often used standard EDTA tubes, eliminating the need for a dedicated ESR tube. CONCLUSION Based on the consensus of the Working Group, recommendations for manufacturers for the validation of new ESR methods were developed. In addition, a list of recommendations for laboratories that are moving to modified or alternate methods was compiled, addressing instrument performance verification and communications of results to clinical users.
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Affiliation(s)
- A Kratz
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - M Plebani
- Department of Laboratory Medicine, University Hospital of Padua, Padua, Italy
| | - M Peng
- National Center for Clinical Laboratories (NCCL), Beijing, China
| | - Y K Lee
- Department of Laboratory Medicine, Hallym University College of Medicine & Hallym University Sacred Heart Hospital, Anyang, Korea
| | | | - S J Machin
- University College London Hospitals, London, UK
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