Arthroscopic meniscus repair for recurrent subluxation of the lateral meniscus.

PURPOSE: This study was undertaken to diagnose and to document the clinical results and technical aspects of arthroscopic meniscus repair for recurrent subluxation with peripheral tears around the popliteal hiatus of the lateral meniscus. METHODS: Twenty-three patients (24 knees) with symptomatic recurrent subluxation of the lateral meniscus treated by arthroscopic meniscus repair were included. The inclusion criteria were: (1) patients with knee pain, locking or snapping symptoms despite 3 months of conservative treatment; (2) non-discoid lateral meniscus; (3) stable knee, and (4) tears involving the red-white or red-red zone. All tears were repaired by either the modified all-inside suture technique only or a combination of the modified all-inside and modified outside-in suture techniques. Clinical results were evaluated preoperatively and at final follow-up according to Tegner activity level, Lysholm knee, and Hospital for Special Surgery (HSS) scores. RESULTS: No reoperations were required after a median follow-up of 41 months (range 24-124). Although recurrence of a locking episode was documented in one knee and catching sensations were experienced in three knees, those patients did not require reoperation. At the last follow-up, the median Tegner activity level had improved significantly from 4 (range 2-6) to 7 (range 3-10, p < 0.0001), the median Lysholm knee score improved from 76 (range 25-90) preoperatively to 94 (range 76-100) at final follow-up (p < 0.0001), and the median preoperative HSS score improved from 86 to 95 at final follow-up (p < 0.0001). CONCLUSION: The described arthroscopic meniscus suture technique is effective for treating symptomatic recurrent subluxation of the lateral meniscus without any complications or recurrence. Clinical suspicion and understanding of recurrent subluxation with lateral meniscus are important to diagnose the disease especially when definite meniscal tear signs are absent on magnetic resonance imaging. LEVEL OF EVIDENCE: IV.

Factors increasing the risk for psychosocial stress among Korean adults living in rural areas: using generalized estimating equations and mixed models.

BACKGROUND: This study was conducted to analyze the distribution of the psychosocial well-being index among adults living in two rural communities in Korea and to examine its correlation with lifestyle variables such as sleep duration, regular exercise, and sedentary time. METHODS: Using the cohort data of the Atherosclerosis Risk of a Rural Area Korean General Population, this study examined 3631 participants living in Wonju and Pyeongchang in Gangwon Province; their preliminary data were established from 2005 to 2007 while their follow-up data were collected 3 years later. This study investigated demographic characteristics, lifestyle habits, disease history, Psychosocial Well-being Index-Short Form (PWI-SF) scores, sleep duration, regular exercise, and sedentary time during work. Using repeated measures ANOVA, this study examined how the variables and PWI-SF scores changed over the course of 3 years and identified the correlation between them based on mixed model analysis. Afterwards, using the generalized estimation equation, this study identified each variable's risk towards the PWI-SF high-risk group and performed a stratified analysis by occupation after dividing the participants into farmers and non-farmers. RESULTS: The PWI-SF high-risk group was found to be 18.9% of the participants from preliminary data and 15.5% from follow-up data. The odds ratio towards the PWI-SF high-risk group was 1.503 (95% CI 1.241-1.821) in the short sleep duration group and 1.327 (95% CI 1.136-1.550) in the non-regular exercise group. A stratified analysis by occupation showed that middle and long sedentary time in the white-collar group increased the risk toward the PWI-SF high-risk group. CONCLUSIONS: Short sleep duration, no regular exercise, and long sedentary time in the white-collar group were identified as risk factors toward the PWI-SF high-risk group in the rural communities, and policy interventions are needed to address this issue.

Dissociation of Polyethylene Liner of the Dual Mobility Acetabular Component after Closed Reduction of Dislocation: A Case Report.

A dual mobility acetabular component has a structure that combines a polyethylene liner and a femoral head, unlike the general design of acetabular cups, making the dissociation of a polyethylene liner highly unlikely. In addition, it increases the range of motion and reduces the possibility of dislocations by increasing a jump distance. A fifty-one-year-old male who had received total hip arthroplasty with the dual mobility acetabular component visited a hospital for a posterior hip dislocation 10 weeks after the operation. At the emergency room, closed reduction was performed and the dislocation was reduced. However, plain imaging test revealed polyethylene liner dissociation after the closed reduction. Revision surgery was performed. We will report a rare case of early dislocation of the dual mobility acetabular component and dissociation of polyethylene liner accompanied with a literature review.

Association of fibrosis in the infrapatellar fat pad and degenerative cartilage change of patellofemoral joint after anterior cruciate ligament reconstruction.

BACKGROUND: The purpose of this study was to evaluate the prevalence and risk factor of cartilage degeneration of the patellofemoral joint (PFJ) that was diagnosed by second-look arthroscopy. METHODS: One-hundred and seven patients who underwent ACL reconstruction were evaluated by preoperative MRI, postoperative MRI and second-look arthroscopy. Severity of infrapatellar fat pad (IPFP) fibrosis was evaluated by MRI at an average of 26months after ACL reconstruction. Cartilage degeneration was assessed by second-look arthroscopy at 29months. RESULTS: Twenty-five patients (24.0%) showed cartilage degeneration of the PFJ in second-look arthroscopy. Patients were divided into three groups according to severity of IPFP fibrosis of postoperative MRI (i.e. Group A, focal and incomplete band fibrosis, n=69; Group B, complete band fibrosis, n=31; and Group C, diffuse and infiltrated fibrosis, n=7). Cartilage degeneration of the PFJ was significantly worsened with more fibrosis formation of the IPFP (P<0.001). Other factors for instabilities (BMI, age, concomitant meniscal procedure, time from injury to reconstruction, severity of IPFP fibrosis at preoperative MRI and clinical scores) were not correlated with cartilage degeneration of the PFJ. The multivariate logistic regression analysis of degeneration of the PFJ after ACL reconstruction identified more severe fibrosis tissue formation of the IPFP and initial cartilage defect as significant predictors. CONCLUSIONS: More extensive fibrosis of the IPFP and initial cartilage defect may be related to further degenerative changes of the PFJ. Other factors did not affect cartilage degeneration of the PFJ, although the muscle strength, the individual activity level or the rehabilitation protocol was not evaluated in the short-term follow-up period.

Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers.

BACKGROUND: This study was conducted to check whether self-resilience, one of the characteristics known to affect the occurrence of post-traumatic stress disorder (PTSD) symptoms after experiencing traumatic events, could serve as a protective factor for police officers whose occupational factors are corrected. METHODS: We conducted a cross-sectional study in which 112 male police officers in Gangwon Province participated. They visited the Wonju Severance Christian Hospital Occupational Environment Center for medical check-ups from June to December 2015. Their general characteristics were identified using structured questionnaires, and they were asked to fill in the Korean Occupational Stress Scale-Short Form (KOSS-SF). Further, the Center for Epidemiologic Studies-Depression Scale (CES-D), Connor-Davidson Resilience Scale-Korean (CD-RI-K), and Impact of Event Scale-Revised-Korean version (IES-R-K) were used to evaluate their job stress, depression, self-resilience, and PTSD symptoms. Logistic regression analysis was conducted to correct their personal, occupational, and psychological factors to analyze the relationship between self-resilience and PTSD symptoms. RESULTS: Among 112 respondents who experienced a traumatic event, those with low self-resilience had significantly higher rate of PTSD symptoms than those with high self-resilience even after correcting for the covariate of general, occupational, and psychological characteristics (odds ratio [OR] 3.51; 95 % CI: 1.06-19.23). CONCLUSIONS: Despite several limitations, these results suggest that a high degree of self-resilience may protect police officers from critical incident-related PTSD symptoms.

Association between night work and cardiovascular diseases: analysis of the 3rd Korean working conditions survey.

OBJECTIVES: This study was conducted to investigate the relationship between night work and cardiovascular diseases among wage workers in Korea. METHODS: The study was based on the 3rd Korean Working Conditions Survey (KWCS; 2011). This study included 29,711 wage workers. We used the chi-squared test and logistic regression to examine the association between cardiovascular diseases and night work and cumulative night work. RESULTS: Among all of the paid workers, 12.5% reported doing night work ≥ 1 day per month. Night work was significantly associated with an increased risk of cardiovascular diseases (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.11-2.25). Also, compared to the group that did not do night works, the group with higher cumulative night work demonstrated an increased risk for cardiovascular diseases (OR 1.81, 95% CI 1.19-2.74). CONCLUSIONS: This study suggests that night work is significantly associated with cardiovascular diseases.

Proteomic analysis of reproduction proteins involved in litter size from porcine placenta.

A gel-free and label-free quantitative proteomic approach based on a spectral counting strategy was performed to discover prolificacy-related proteins. Soluble proteins of porcine placenta from small litter size group (SLSG) and large litter size group (LLSG) were extracted and subsequently applied to in-solution tryptic digestion followed by liquid chromatography-tandem mass spectrometry analysis. Six and thirteen proteins were highly expressed in SLSG and LLSG, respectively. Of the dominantly expressed proteins, we chose prolificacy-related proteins such as puromycin-sensitive aminopeptidase (PSA) and retinol-binding protein 4 (RBP4). Western blot analysis confirmed that the processed form (70 kDa) of PSA was more expressed and RBP4 (23 kDa) was dominantly expressed in LLSG. These results indicate that PSA and RBP4 are representative proteins involved in porcine fertility traits, and this finding may help to increase litter size of pigs.

Pharmacokinetic comparison of amlodipine adipate/valsartan fixed-dose combination with amlodipine besylate/valsartan fixed-dose combination in healthy volunteers.

The aim of this study was to compare pharmacokinetic characteristics of fixed-dose combination (FDC) of two different salt form of amlodipine, amlodipine adipate/valsartan and amlodipine besylate/ valsartan, in healthy Korean volunteers under fasting conditions. A randomized, open-label, single-dose, two-treatment, two-way crossover study with a 14-day wash-out period was conducted. Plasma samples were collected for up to 144 hours for amlodipine and 24 hours for valsartan. Plasma concentrations of amlodipine and valsartan were analyzed using a validated ultra-performance liquid chromatography tandem mass-spectrometry. A non-compartmental method was used to calculate pharmacokinetic parameters. Vital signs and adverse events were monitored and physical examinations, laboratory tests, and electrocardiograms were conducted to evaluate safety. 44 subjects completed the study. The 90% CIs for the geometric mean ratio of Cmax and the AUC0-t were 93.5 - 100.4% and 93.2 - 98.3% for amlodipine, and 92.1 - 121.3% and 94.1 - 115.2% for valsartan, respectively. 17 adverse events occurred in 15 subjects during the study; 5 and 7 adverse drug reactions from the 5 and 6 subjects were considered to probably be related to the test and reference treatments respectively. All adverse drug reactions were in line with those known for the reference drug. All subjects recovered fully with no sequelae. A FDC of amlodipine adipate/valsartan and amlodipine besylate/valsartan combination tablets met the regulatory criteria for bioequivalence. In addition, no significant difference was observed in the safety assessments between two treatments. Thus, the newly developed FDC of amlodipine adipate/valsartan seems to be interchangeable with amlodipine besylate valsartan combination.

Dynamic proteomic profile of potato tuber during its in vitro development.

Potato tuberization is a complicated biochemical process, which is dependent on external environmental factors. Tuber development in potato consists of a series of biochemical and morphological processes at the stolon tip. Signal transduction proteins are involved in the source-sink transition during potato tuberization. In the present study, we examined protein profiles under in vitro tuber-inducing conditions using a shotgun proteomic approach involving denaturing gel electrophoresis and liquid chromatography-mass spectrometry. A total of 251 proteins were identified and classified into 9 groups according to distinctive expression patterns during the tuberization stage. Stolon stage-specific proteins were primarily involved in the photosynthetic machinery. Proteins specific to the initial tuber stage included patatin. Proteins specific to the developing tuber stage included 6-fructokinase, phytoalexin-deficient 4-1, metallothionein II-like protein, and malate dehydrogenase. Novel stage-specific proteins identified during in vitro tuberization were ferredoxin-NADP reductase, 34 kDa porin, aquaporin, calmodulin, ripening-regulated protein, and starch synthase. Superoxide dismutase, dehydroascorbate reductase, and catalase I were most abundantly expressed in the stolon; however, the enzyme activities of these proteins were most activated at the initial tuber. The present shotgun proteomic study provides insights into the proteins that show altered expression during in vitro potato tuberization.

Non-synonymous SNP in the ApoR gene associated with pork meat quality.

Two novel non-synonymous SNPs in the 2nd and 3rd exons of the porcine ApoR gene are reported. One was identified as a novel SNP significantly associated with multiple traits of pork meat quality. The data can provide a useful resource for developing a marker in the genetic improvement of pigs.