Hip Arthroplasty Using the Bencox® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases.

PURPOSE: This is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the Bencox® hip stem-the first Korean-developed hip prosthesis. MATERIALS AND METHODS: A consecutive series of 1,000 hip arthroplasties using the Bencox® hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84). Of these 1,000 cases, patients with a minimum follow-up of at least 1 year (n=616) were retrospectively analyzed for radiographic and clinical outcomes (i.e., Harris hip score). The stability of the prosthesis was evaluated by examining subsidence. RESULTS: During the follow-up period (mean follow-up period of 54.8 months), there were 2 cases requiring revision of the femoral stem-both were caused by periprosthetic fractures and neither involved stem loosening. The mean Harris hip score during follow-up was 95.5. Bone ongrowth occurred in 95% of patients; no cases of subsidence or aseptic loosening of the stem were detected, and no cases of postoperative complications such as ceramic breakage were observed. CONCLUSION: Clinical and radiographic evaluations of hip arthroplasty using the Bencox® hip stem revealed excellent outcomes with an average of 54.8 month follow-up in a consecutive series of 1,000 cases.

Juxta-articular Plate Fixation in Distal Radius Intra-articular Fractures with Accompanying Volar Free Fragments beyond the Watershed Line.

BACKGROUND: Although distal radius fractures (DRF) are common fractures, intra-articular comminuted DRF with volar free fragments are uncommon. There is considerable difficulty in the fixation of free fragments beyond the watershed line using the existing volar locking plate. We aimed to examine the efficacy and potential complications associated with the use of juxta-articular volar plates in intra-articular DRF accompanied by free fragments beyond the watershed line. METHODS: The patients were enrolled in a consecutive manner between 2007 and 2016. In cases of DRF with free fragments beyond the watershed line, we employed a 2.4-mm small fragment juxta-articular volar locking compression plate using a volar Henry approach. A total of 32 patients were included in this study. There were 15 males and 17 females with a mean age of 52.3 years (range, 33 to 69 years). The mean follow-up period was 14.5 months (range, 10 to 24 months). Preoperative radiographs and three-dimensional computed tomography images were used to analyze fracture patterns and assess the free fragments beyond the watershed line. The mean number of free fracture fragments beyond the watershed line was 2.33. Plain radiographs of immediate postoperative and last follow-up were used to confirm fracture union, incongruence, radial height, volar tilt, radial inclination, and arthritic changes. For functional assessment, we measured grip strength, range of motion (ROM), modified Mayo wrist score (MMWS) and determined Disabilities of Arm, Shoulder and Hand (DASH) scores at the last follow-up. Postoperative complications were monitored during the follow-up period. RESULTS: All patients obtained sound union without significant complications. At the last follow-up, 16 cases presented with an articular step-off of more than 1 mm (mean, 1.10 mm). The mean MMWS was 76.3 (range, 55 to 90), mean DASH score was 15.38 (range, 9 to 22), mean visual analogue scale score for pain was 1.2 and mean grip strength was 75.5% of the opposite side. The mean ROM was 74.3° for volar flexion and 71.5° for dorsiflexion. CONCLUSIONS: In cases of intra-articular DRF with free fragments beyond the watershed line, a volar approach with use of a juxtaarticular plate provided favorable outcomes without significant complications.

Correction to: Achilles tenodesis for calcaneal insufficiency avulsion fractures associated with diabetes mellitus.

The original publication of this article [1] contained the wrong versions of tables 1, 2 and 3. In this correction the updated tables are published. The original publication has been updated.

Achilles tenodesis for calcaneal insufficiency avulsion fractures associated with diabetes mellitus.

BACKGROUND: Calcaneal insufficiency avulsion (CIA) fractures often present with neuropathic etiology, such as Charcot neuroarthropathy (CN). Under the same surgical procedures, the outcomes of CIA fractures are less desirable, compared to the outcomes of the traumatic calcaneal avulsion fractures. Here, the study suggests Achilles tenodesis technique using suture anchor after resection of the CIA fracture fragments could provide satisfactory clinical results in the cases of surgically indicated CIA fractures. MATERIALS AND METHODS: This retrospective study included seven patients of calcaneal avulsion fracture who had underlying diabetes mellitus (DM) and no specific traumatic event. The patients were treated with Achilles tenodesis techniques for their CIA fractures. Achilles tenodesis was performed using suture anchor with removal of the fracture fragments. The patients were evaluated with the Foot and Ankle Outcome Score (FAOS), visual analogue scale (VAS), single-heel rise test, and X-ray images on their final follow-ups. RESULTS: Initially, three of the CIA fracture cases treated with traditional open reduction and internal fixation reported pullout failure. Consequently, all patients received Achilles tenodesis using suture anchor after bone fragment resection and had good clinical outcomes. Only one subject with low compliance reported poor outcome. The FAOS of each patient were obtained at a mean of 16.3 months after surgery. The results are as follows: pain 80.6 (SD = 6.2), symptom 83.8 (SD = 4.9), activities of daily living 80.5 (SD = 8.0), sport and recreation function 75.6 (SD = 11.93), and foot- and ankle-related quality of life 77.9 (SD = 6.7). On their final follow-ups, the average VAS was 2.6 (range, 1 to 4). CONCLUSION: Achilles tenodesis using suture anchor after bone fragment resection achieved competent clinical results in the patients with CIA fractures. The study proposes that this surgical procedure could be an appropriate treatment option for patients with CIA fractures. TRIAL REGISTRATION: The study was approved by the institutional review board (IRB) of our medical center (IRB File No. 2016-07-043), retrospectively registered.

Direct repair of the sagittal band for extensor tendon subluxation caused by finger flicking.

PURPOSE: For patients with metacarpophalangeal (MCP) extensor tendon subluxation caused by finger flicking injury, we performed an extensor tendon realignment and direct repair technique. The purpose of this study was to evaluate the clinical outcome after direct repair of the sagittal band in patients with MCP extensor tendon subluxation caused by finger flicking injury and to introduce the repair technique. METHODS: A total of 26 patients with a mean age of 39.9 years were included in the study. The mean time from injury to surgery was 51.3 days. The ruptured sagittal band was reattached to the lateral side of the extensor tendon using a continuous interlocking suture. Patients were evaluated for pain using a visual analog scale (VAS), range of motion, long fingertip pinch strength, disabilities of the arm, shoulder, and hand (DASH) score, and the recurrence of extensor tendon subluxation or dislocation. RESULTS: All patients had full range of motion compared to the uninjured contralateral digit. Long fingertip pinch strength was also comparable to that of the contralateral digit in all patients. The DASH score was also improved from a preoperative average of 28.8 to a postoperative average of 1.0. CONCLUSIONS: Realignment of the extensor tendon and direct repair of the superficial layer of the sagittal band to the extensor digitorum communis (EDC) tendon is recommended as a treatment option in patients with chronic MCP extensor tendon subluxation, as well as for acute MCP extensor tendon subluxation in patients that have failed or could not maintain conservative treatment approaches.

Dual plate fixation on distal third diaphyseal fracture of the humerus.

INTRODUCTION: Displaced unstable distal third fractures of the humeral diaphysis are treated surgically through open reduction and internal fixation. Conventionally, surgeons prefer using long plates for secure fixation; however, we performed short plate dual plating for robust fixation that required a smaller incision and less dissection through an anterior approach. In this study, we report the results of dual plating of fractures of the humeral shaft, with radiographic evidence and clinical analysis. METHODS: This retrospective study included 29 patients with distal third diaphyseal fractures of the humerus. There were 18 men and 11 women, with an average age of 43 years, and a mean follow-up period of 21.2 months. We investigated the type of fracture, plate length, number of fixed screws, and fracture union. Range of motion, Disabilities of Arm, Shoulder, and Hand (DASH) score, and complications during follow-up were analyzed for clinical results. RESULTS: All fractures were classified according to AO classification. We used 4.5-mm narrow locking compression plates (LCP) and 3.5-mm LCP reconstruction plates. Fracture union was achieved in all cases during the follow-up. All patients recovered favourable elbow range of motion at final follow-up. At the final follow-up, average DASH score was 10.0, and no patient showed postoperative complications. CONCLUSIONS: Satisfactory radiographic evidence and clinical results suggest that dual plating for distal diaphyseal humeral fractures may be considered a surgical option, with the advantages of strong fixation, less invasion of soft tissue, and early rehabilitation.

Bacteroides fragilis enterotoxin induces human beta-defensin-2 expression in intestinal epithelial cells via a mitogen-activated protein kinase/I kappaB kinase/NF-kappaB-dependent pathway.

Enterotoxigenic Bacteroides fragilis (ETBF) produces an approximately 20-kDa heat-labile enterotoxin (BFT) that plays an essential role in mucosal inflammation. Although spontaneous disappearance of ETBF infection is common, little information is available on regulated expression of antibacterial factors in response to BFT stimulation. This study investigates the role of BFT in human beta-defensin 2 (hBD-2) induction from intestinal epithelial cells. Stimulation of HT-29 and Caco-2 intestinal epithelial cell lines with BFT resulted in the induction of hBD-2. Activation of a reporter gene for hBD-2 was dependent on the presence of NF-kappaB binding sites. In contrast, suppression of AP-1 did not affect hBD-2 expression in BFT-stimulated cells. Inhibition of p38 mitogen-activated protein kinase (MAPK) using SB203580 and small interfering RNA (siRNA) transfection resulted in a significant reduction in BFT-induced I kappaB kinase (IKK)/NF-kappaB activation and hBD-2 expression. Our results suggest that a pathway including p38 MAPK, IKK, and NF-kappaB activation is required for hBD-2 induction in intestinal epithelial cells exposed to BFT, and may be involved in the host defense following infection with ETBF.

Dual effects of Helicobacter pylori vacuolating cytotoxin on human eosinophil apoptosis in early and late periods of stimulation.

Although Helicobacter pylori infections of the gastric mucosa are characterized by the infiltration of inflammatory cells such as eosinophils, the responses of eosinophils to H. pylori vacuolating cytotoxin (VacA) have not been fully elucidated. This study investigates the role of VacA in the apoptosis of human eosinophils. We treated human eosinophils with purified H. pylori VacA and observed that induction of apoptosis is a relatively late event. Expression of cellular inhibitor of apoptosis protein (c-IAP)-2 was upregulated during the early period of VacA stimulation, and transfection with c-IAP2 siRNA augmented apoptotic cell death. VacA caused the translocation of cytoplasmic Bax to the mitochondria and increased cytochrome c release from mitochondria in eosinophils. Transfection of an EoL-1 eosinophil cell line with Bax siRNA decreased the release of cytochrome c and DNA fragmentation. Furthermore, apoptosis facilitated by Bax and cytochrome c was primarily regulated by p38 MAPK in VacA-treated eosinophils. These results suggest that the exposure of human eosinophils to H. pylori VacA induces the early upregulation of c-IAP2 and a relatively late apoptotic response, with the apoptosis progressing through a sequential pathway that includes p38 MAPK activation, Bax translocation, and cytochrome c release.

Fabrication of nano- and micro-scale UV imprint stamp using diamond-like carbon coating technology.

Two-dimensional (2-D) and three-dimensional (3-D) diamond-like carbon (DLC) stamps for ultraviolet nanoimprint lithography were fabricated with two methods: namely, a DLC coating process, followed by focused ion beam lithography; and two-photon polymerization patterning, followed by nanoscale-thick DLC coating. We used focused ion beam lithography to fabricate 70 nm deep lines with a width of 100 nm, as well as 70 nm deep lines with a width of 150 nm, on 100 nm thick DLC layers coated on quartz substrates. We also used two-photon polymerization patterning and a DLC coating process to successfully fabricate 200 nm wide lines, as well as 3-D rings with a diameter of 1.35 microm and a height of 1.97 microm, and a 3-D cone with a bottom diameter of 2.88 microm and a height of 1.97 microm. The wafers were successfully printed on an UV-NIL using the DLC stamps without an anti-adhesive layer. The correlation between the dimensions of the stamp's features and the corresponding imprinted features was excellent.

Fluorinated organic-inorganic hybrid mold as a new stamp for nanoimprint and soft lithography.

In this paper, we fabricated a fluorinated organic-inorganic hybrid mold using a nonhydrolytic sol-gel process which can produce a crack-free mold without leaving any trace of solvent. No special chemical treatment of a release layer is needed because the fluorinated hybrid mold has fluorine molecules in the backbone. The other advantages of the hybrid mold are thermal stability over 300 degrees C. The hybrid mold produced from UV nanoimprint lithography (UV-NIL) was used as a mold for the next UV-NIL and soft lithography without requiring use of an antisticking layer. Various nanometer scale patterns including sub-100 nm patterns could be obtained from the hybrid mold. Nanopatterning processes using this low-cost mold are useful because they preserve the expensive original master.