The purpose of this study was to evaluate the clinical effect of electrocautery on the reduction of pain in patellar non-resurfacing bilateral total knee arthroplasty.A total of 50 patients were enrolled into this study; all patients had undergone bilateral patellar non-resurfacing total knee arthoplasty at our hospital, between January 2007 to December 2008. The minimum follow-up period was 1 year. The electrocautery of the patellar rim was performed randomly on one side only. The clinical results were evaluated between the electrocautery group and the non-electrocautery group based on measures of anterior knee pain, range of motion, American Knee Society clinical rating score, Feller knee score, Western Ontario and McMaster Universities score, and radiographic analysis.There were statistically significant differences between preoperative and postoperative status for all parameters. There were no statistically significant differences noted between the electrocautery group and the non electrocautery group for all parameters.Electrocautery of patellar rim is thought to be less effective in reducing anterior knee pain.
Calcific tendinitis on gluteus medius tendon of the amateur athletes were reviewed, and a study on the therapeutic effect of conservative treatment methods. From January 2003 to December 2010, among the patients who had been treated with calcific tendinitis on gluteus medius tendon, there were nine patients available to monitor more than a year as outpatients. ten cases were observed from them and were retrospectively analyzed and magnetic resonance examinations were performed in every case. All of the ten cases were initially treated with non-steroid anti-inflammatory oral doses. If a non-steroid anti-inflammatory treatment could not relieve pain or caused an aggravation of a condition, a local steroid injection was enforced. There were responses to non-steroid anti- inflammatory oral doses of therapeutic methods in four cases and the time required for the symptoms to be improved was approximately 3 weeks (range: 1–3 weeks). In the remainder of six cases, conditions got worsened or did not improve even after 3 weeks. In these cases, the condition was altered for better in 3 days (range: 1–3 days) by using local steroid injections. There was no recurrence in all cases. The amateur athlete with a severe pain around his or her hip joint should be questioned with calcific tendinitis on gluteus medius tendon and differential diagnosis of hip around diseases. After calcific tendinitis was diagnosed, initial treatment was considered conserevative treatment. Although it is invasive, the initial treatment with a local steroid injection is considered to be helpful in treating amateur athletes with calcific tendinitis.
Purpose:We believe that cemented femoral stems will relieve the stiffness of ceramic-based bearings, resulting in reduced complication of ceramic-on-ceramic bearing total hip arthroplasty (THA).The purpose of this study was to evaluate the midterm effect of ceramic-on-ceramic bearing THA using cemented femoral stems. Materials and Methods:We studied 32cases (30 patients) of THA using ceramic-on-ceramic bearing cemented femoral stems and 33 cases (31 patients) of THA using ceramic-on-ceramic bearing cementless femoral stems.All total hip arthroplasties were performed between January 2004 and December 2005 and were followed up for more than 5 years.The clinical results and radiographic results were evaluated. Results:The mean HHS improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05).The mean WOMAC score also improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05).But no statistically significant difference was noted between the cemented and cementless stem groups in HHS and WOMAC scores (P=0.304,P=0.769).There were 3 patients with a sense of discomfort on ambulation and 5 patients with thigh pain in the cementless stem group and no cases in the cemented stem group.There was no instance of acetabular loosening in either group.Subsidenc of the cemented femoral stem was less than 1mm in 30 cases and less than 2 mm in 2 cases.All cementless femoral stems acquired firm bony union. Conclusion:Midterm results showed no statistical links between ceramicon-ceramic-bearing THA using cemented femoral stems or cementless femoral stems.
Ethanol treatment during the brain growth spurt period has been known to induce the death of Purkinje cells. The underlying molecular mechanisms and the role of reactive oxygen species (ROS) in triggering ethanol-induced Purkinje cell death are, however, largely unresolved. We undertook TUNEL staining, westem blotting assay and immunohistochemistry for the cleaved forms of caspase-3 and -9, with calbindin D28K double immunostaining to identify apoptotic Purkinje cells. The possibility of ROS-induced Purkinje cell death was immunohistochemically determined by using anti-8-hydroxy-2'-deoxyguanosine (8-OHdG), a specific cellular marker for oxidative damage. The results show that Purkinje cell death of PD 5 rat cerebellum following ethanol administration is mediated by the activation of caspase-3 and -9. However, unexpectedly, TUNEL staining did not reveal any positive Purkinje cells while there were some TUNEL-positive cells in the internal and external granular layer. 8-OHdG was detected in the Purkinje cell layers at 8 h, peaked at 12-24 h, but not at 30 h post-ethanol treatment. No 8-OHdG immunoreactive cells were detected in the internal and external granular layer. The lobule specific 8-OHdG staining patterns following ethanol exposure are consistent with that of ethanol-induced Purkinje cell loss. Thus, we suggest that ethanol-induced Purkinje cell death may not occur by the classical apoptotic pathway and oxidative damage is involved in ethanol-induced Purkinje cell death in the developing cerebellum.
Single-stranded oligonucleotides (ssDNA) containing guanine bases in their sequences were adsorbed onto gold nanoparticles (AuNPs) by electrostatic interaction. Cyclic voltammetry of Ru(bpy)32+ in the presence of the ssDNA-AuNP complex resulted in an enhanced anodic current due to the oxidation of the guanine bases of DNA. The current obtained with ssDNA-AuNP appeared much smaller than the corresponding ssDNA alone. This current reduction was due to the decrease in solvent accessibility of the guanines in ssDNA immobilized to AuNPs. A progressive decrease in the current was observed in the titration of AuNPs to ssDNA, and a minimum current was eventually obtained, indicating complete binding of ssDNA. The size dependences of AuNPs on the interaction between ssDNA and AuNP were also studied, and the ssDNA adsorbed to 5 nm AuNPs was more solvent-accessible for the Ru mediator than 13 and 30 nm AuNPs.
Patellar clunk syndrome after total knee arthroplasty is a complication that causes pain and poping or catching of patella.We experienced a case after mobile bearing total knee arthroplasty that medial synovial tissue was impinged between patella and femoral component and intra-articular fibrotic nodule of superior pole of patella was observed.Also, wear of Polyethylene were observed at anterio side.We resolved the patient symptom after excision of fibrotic nodule, synovectomy of medial synovial hypertrophy, and change of polyethylene.We report this case with literature review.
The immune response to standard doses of COVID-19 vaccines in kidney transplant recipients (KTRs) is suboptimal and additional doses are being recommended. The type of COVID-19 vaccine one had access to during the initial standard doses of vaccination was largely dependent on its availability. Thus some had homologous vaccines (i.e. 2 doses of viral vector vaccine or 2 doses of mRNA vaccine) and others had heterologous vaccines during the initial standard vaccination. The effect of such different vaccine combinations on the effectiveness of booster shots using mRNA vaccines in KTRs is largely unknown.The current study is a noninterventional prospective study examining the efficacy of the additional dosage of the COVID-19 vaccine in KTRs. Patients with standard doses of COVID-19 vaccines were enrolled. Reactogenicity to COVID-19 was assessed two weeks before and one month after the additional dose (booster shot) by examining anti-SARS-CoV-2 IgG antibodies against the receptor-binding domain of the S1 subunit of the spike protein using SARS-CoV-2 IgG II Quant assay (Abbott). A total of 235 KTRs with standard doses of COVID-19 vaccine were enrolled. During the initial vaccination, 106 (45.1%) had two doses of mRNA vaccine (BNT162b2 or mRNA-1273), 73 had ChAdOX1-S/ BNT162b2 52 (22.1%) had ChAdOX1-S/ ChAdOX1-S, and one (0.4%) had Janssen COVID-19 vaccine. All patients had mRNA vaccines (BNT162b2 or mRNA-1273) for booster.After the booster dose, seropositivity improved from 55.3% (130/235) to 81.3% (191/235) with seroconversion in 58.1% (61/105) of the initially seronegative patients. Antibody titer also was significantly increased (median, 62.3 to 1382.8 AU/mL, p<0.01 by Wilcoxon rank sum test). Risk factors for negative antibody response to booster mRNA were low eGFR (OR 0.95, 95% CI 0.93-0.98) and having two doses of viral vector vaccines during the standard vaccination (OR 5.43, 95%CI 1.59-18.49; reference-mRNA/mRNA vaccine). This was likely due to the relatively low immunity before the third vaccine dose within this patient group (negative response in 69.2%).The use of an additional dose of COVID-19 mRNA vaccine is effective in eliciting antibody response in KTRs, especially for those in whom the primary vaccination failed. Overall response after an additional dose of mRNA vaccine was affected by the type of vaccines used during the standard vaccination.
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