The purpose of this study was to evaluate causes and clinical outcomes of revision total knee arthroplasty (TKA) with a minimum 2-year follow-up.
We performed a retrospective review on the records of ...225 revision TKAs performed from 2003 to 2012 at a single institution. Finally, 206 cases were conducted. To evaluate clinical outcomes, we checked the range of motion (ROM), Knee Society (KS) score, Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively, 6 months postoperatively and yearly thereafter and complications after revision TKA.
The causes of revision TKA were septic complications in 120 and aseptic complications in 86. The main aseptic complication was periprosthetic fracture in 36, followed by 25 loosening, 13 polyethylene wear and 9 instability. At the final follow-up, patients showed improvements in ROM and KS, HSS and WOMAC scores. Of the total, 7 patients underwent re-revision due to reinfection in 6 and periprosthetic fracture in 1.
Due to development of implants and surgical techniques, mechanical complications such as aseptic loosening and instability that need a revision decreased whereas septic complications relatively increased. Therefore, we should be cautious for the occurrence of infection. Overall, revision TKA provided clinical improvement in knee function and patient satisfaction.
Despite recent advances in methods for culturing Mycobacterium tuberculosis (MTB), the diagnostic yield of tuberculous pleural effusion (TBPE) remains unsatisfactory. However, unlike repeated sputum ...cultures of pulmonary tuberculosis, little is known about the role of repeated pleural cultures. We examined whether repeated pleural cultures are associated with increased MTB yield from TBPE.
A multicenter, retrospective cohort study was performed from January 2012 to December 2015 in South Korea. Patients were categorized into two groups: single- or repeated-culture groups. The diagnostic yield of MTB and clinical, radiological, and pleural fluid characteristics were evaluated.
Among the 329 patients with TBPE, 77 (23.4%) had repeated cultures and 252 (76.5%) had a single culture. Pleural culture was performed twice in all 77 patients in the repeated-culture group at a 1-day interval (inter-quartile range, 1.0-2.0). In the repeated-culture group, the yield of MTB from the first culture was 31.2%, which was similar to that in the single-culture group (31.2% vs. 29.8%, P = 0.887). However, the yield of MTB from the second culture (10/77, 13.0%) was more than that from the first. These results may be attributable to the insufficient immune clearance for MTB invasion into the pleural space between the first and second cultures. Over time, the yield of the second cultures decreased from 17.4% to 6.7% and then 6.3%. Finally, the overall yield of MTB in the repeated- and single-culture groups was 44.2% and 29.8% respectively (P < 0.001).
The results showed that repeated pleural cultures increased MTB yield from TBPE in human immunodeficiency virus-negative individuals. Furthermore, repeated cultures may increase yield when carried out for two consecutive days.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as ...dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia.
We included 6,027 adults (2,934 men, 3,093 women) aged 30-69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia.
After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00-1.83), 1.29 (0.98-1.70), 1.23 (0.95- 1.60) in men and 1.81 (1.30-2.50), 1.81 (1.32-2.47), 1.39 (1.07-1.81) in women, respectively.
Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.
Three typical folate metabolism enzymes—i.e. methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MS) and MS reductase (MTRR) in the folate cycle—play a critical role in DNA synthesis ...and methylation reactions. We evaluated whether polymorphisms of these three enzymes are associated with non-obstructive male infertility. METHOD: Three hundred and sixty patients with non-obstructive infertility and 325 fertile men without any chromosomal abnormalities were included in this study. The single-nucleotide polymorphism (SNP) analysis was performed by pyrosequencing and PCR-restriction fragment length polymorphism (RFLP) analysis RESULTS: The frequencies of MTHFR 677TT and MTRR 66GG genotypes were higher in non-obstructive infertile men compared with those in fertile men. By classifying 360 infertile patients into 174 azoospermia and 186 oligoasthenoteratozoospermia (OAT) subjects, the MTHFR 677TT and MS 2756GG types were significantly associated with the azoospermia group (P = 0.0227 and 0.0063, respectively). The frequency of MTRR 66GG was significant in the OAT group (P = 0.0014 versus fertile males). CONCLUSIONS: By analysis of a large number of subjects and a more specific patient selection, we showed the first genetic evidence that MTHFR C677T, MS A2756G and MTRR A66G genotypes were independently associated with male infertility. Each SNP of the three enzymes may have a different impact on the folate cycle during spermatogenesis.
•A. ovis, T. luwenshuni, T. uilenbergi and B. motasi sp. L/N/T were detected infecting sheep from Qinghai, China.•B. motasi sp. L/N/T, T. luwenshuni and T. uilenbergi were analyzed in sheep in ...Qinghai for the first time.•Mixed infection with the four tick-borne pathogens was firstly identified in sheep in Qinghai, China.
Information regarding the prevalence and genetic characterization of Anaplasma spp., Babesia spp. and Theileria spp. infecting sheep in Qinghai province, northwestern China, is limited. In this study, 277 sheep blood samples were collected from 7 counties in Qinghai and tested by PCR to detect and identify the above mentioned tick-borne pathogens. Among the 277 sheep, 176 (63.5%) were infected with at least one pathogen. A. ovis was the most prevalent pathogen (n = 112, 40.4%), followed by T. luwenshuni (n = 108, 39.0%), T. uilenbergi (n = 65, 23.5%) and B. motasi sp. L/N/T (n = 11, 4.0%). Interestingly and importantly, 83 (30.0%) infections with two or more pathogens were identified. The analysis of the nucleotide sequences of targeted genes showed that A. ovis msp4, B. motasi sp. L/N/T rap-1b, T. luwenshuni 18S rRNA and T. uilenbergi 18S rRNA sequences from Qinghai were not conserved. These sequences shared 97.7–99.7%, 87.0–99.8%, 98.2–100% and 91.3–100% identities with previously published isolates, respectively. The phylogenetic analysis revealed that all A. ovis msp4 sequences belonged to the same clade. On the other hand, B. motasi sp. L/N/T rap-1b isolates showed a closer relationship with B. motasi sp. BQ1/Lintan. One T. luwenshuni and one T. uilenbergi sequence from this study formed branches divergent from the remaining T. luwenshuni and T. uilenbergi isolates. Overall, these results provide a better understanding of the prevalence and molecular characterization of TBPs in sheep in Qinghai and suggest that these pathogens require more attention from veterinarians.
Background. Pharmacopuncture, injection to acupoints with pharmacological medication or herbal medicine, is a new acupuncture therapy widely available in Korea and China for cancer-related symptoms. ...However, the evidence is yet to be clear. Objective. To determine pharmacopuncture’s effectiveness on cancer-related symptoms. Methods. Eleven databases were searched for randomized controlled trials of pharmacopuncture in cancer patients. The Cochrane risk of bias (ROB) assessment tool was used for quality assessment. Results. Twenty-two studies involving 2,459 patients were included. Five trials of chemotherapy-induced nausea and vomiting (CINV) underwent meta-analysis. Pharmacopuncture significantly relieved severity of CINV compared with control group (3 trials, risk ratio (RR) 1.28, 95% confidence interval (CI) = 1.14–1.44). The frequency of CINV was also significantly reduced with pharmacopuncture (2 trials, RR 2.47, 95% CI = 2.12–2.89). Seventeen trials studied various symptoms, and in most studies, pharmacopuncture significantly relieved pain, ileus, hiccup, fever, and gastrointestinal symptoms and improved quality of life in various cancer patients. ROB was generally high. Conclusion. It may be suggested with caution that pharmacopuncture may help various symptom relief in cancer patients, but it is hard to draw a firm conclusion due to clinical heterogeneity and high ROB of the included studies, hence warranting further investigation.
The effects of catecholamine excess due to pheochromocytoma on body composition, including skeletal muscle mass, are unknown. Here, we investigated the effects of catecholamine metabolites on body ...composition in subjects with pheochromocytoma. After body compositions using bioelectrical impedance analysis, urinary metanephrine (UM), and urinary normetanephrine (UNM) were measured in 16 patients with pheochromocytoma and 224 patients with nonfunctioning adrenal incidentaloma (NFAI), we compared skeletal muscle mass and fat mass (FM) between the two groups. After adjustments for confounders, UM (
β
= − 0.171,
P
= 0.006) and UNM (
β
= − 0.249,
P
< 0.001) levels were correlated inversely with skeletal muscle mass index (SMI), but not FM or percentage FM (pFM), in all subjects. Patients with pheochromocytoma had lower ASM by 7.7% (
P
= 0.022) and SMI by 6.6% (
P
= 0.001) than patients with NFAI. Conversely, FM and pFM were not statistically different between the two groups. The odds ratio for low skeletal muscle mass in the presence of pheochromocytoma was 10.33 (95% confidence interval, 2.65–40.22). Our results indicate that patients with pheochromocytoma have a reduced skeletal muscle mass and suggest that catecholamine excess has adverse effects on skeletal muscle metabolism.
Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. ...Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition.
Background and aims:
Frequent failure of adrenal vein (AV) cannulation is a major obstacle to the universal use of adrenal vein sampling (AVS) for subtyping primary aldosteronism (PA). This study ...aimed to confirm and modify the value of a previously reported AVS parameter for PA subtyping in the case of cannulation failure on one side.
Methods:
Successfully catheterized AVS studies in 157 patients (121 patients as a derivation cohort and 36 patients as a validation cohort) from two tertiary hospitals were retrospectively reviewed. The AV/inferior vena cava (IVC) index was defined by dividing the aldosterone/cortisol ratio (ACR) of AV by the ACR of the IVC. Cutoff values for lateralized PA were obtained from two methods: scatterplots and the values corresponding to Youden’s index in receiver operating characteristic (ROC) curves, on the assumption of catheterization failure on one side.
Results:
Due to multiple samplings in a single AVS procedure, 252 left AV/IVC ratios (LIRs) and 272 right AV/IVC ratios (RIRs) were calculated. Scatterplot cutoffs of LIR >5.4 or <0.5 predicted unilateral PA with a sensitivity of 42.1% and a specificity of 98.6%. Scatterplot cutoffs of RIR <0.5 or >7.0 showed a sensitivity of 55.1% and a specificity of 98.6%. ROC curve cutoffs of LIR ⩽0.8 or >3.1 predicted unilateral PA with a sensitivity of 82.5% and a specificity of 69.6%. ROC curve cutoffs of RIR ⩽0.8 or >3.9 resulted in 87.4% sensitivity and 80.7% specificity.
Conclusion:
In the case of unilateral AVS failure, the AV/IVC index may help in diagnosing PA subtype.
A tangential X-ray pinhole camera based on a gas electron multiplier (GEM) detector was installed on KSTAR to study high temperature plasmas emitting X-ray photons in the energy band of 4–15 keV. The ...camera system consists of a triple-GEM gas chamber with a readout printed circuit board and a pinhole to image the plasma in two dimensions (2-D). The advantages of this tangential camera system include its compactness, high efficiency, energy discrimination in bands, and selectivity of the photon energy range etc. This camera system allows a selection of the viewing area through a remote control of the entire setup. The Philips-Tikhonov algorithm for tangential reconstruction was used to visualize the poloidal cross-sectional images. Phantom tests were performed with synthetic D-shaped plasma images and a comparison with the magnetic equilibrium flux surfaces from the real-time EFIT code obtaining a good agreement between each other. The 2-D X-ray images of the KSTAR plasma were successfully acquired during sawtooth crash, electron cyclotron heating, vertical displacement event, and emissivity from the injected trace Ar impurity.
•Compact movable imaging diagnostic system based on gas electron multiplier X-ray detector.•Tangential reconstruction of X-ray emission from toroidal fusion plasma.•Various 2-D X-ray images of the KSTAR plasma.
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