Anti-cancer Activity of Paclitaxel, Lenvatinib and Radiation Combination Therapy on Anaplastic Thyroid Cancer in Vitro and in Vivo / 대한두경부종양학회지

BACKGROUND/OBJECTIVES: Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the deadliest forms of thyroid cancer. The fatality rate for ATC is high, and the survival rate at one year after diagnosis is <20%. The present study aimed to investigate the anti-tumor activities of paclitaxel, radiation, and tyrosine kinase inhibitor (TKI) combined therapy in anaplastic thyroid cancer cells both in vitro and in vivo and explore its effects on apoptotic cell death pathways.MATERIALS #SPCHAR_X0026; METHODS: ATC cell line was exposed to TKI, lenvatinib in the presence or absence of paclitaxel with radiation, and cell viability was determined by MTT assay. Effects of the combined treatment on cell cycle and intracellular signaling pathways were assessed by flow cytometry and western blot analysis. The ATC cell line xenograft model was used to examine the anti-tumor activity in vivo.RESULTS: Our data revealed that the combined administration of paclitaxel, TKI, and radiation decreased cell viability in ATC cells, and also significantly increased apoptotic cell death in these cells, as demonstrated by the cleavage of caspase-3 and DNA fragmentation. This combination therapy reduced anti-apoptotic factor levels in ATC cells, while significantly decreasing tumor volume and increasing survival in ATC xenografts.CONCLUSION: These results indicate that administering the combination of paclitaxel, TKI, and radiation therapy may exert significant anticancer effects in preclinical models, potentially suggesting a new clinical approach for treating patients with ATC.

An Evaluation of the Effectiveness of Hyaluronidase in the Selective Nerve Root Block of Radiculopathy: A Double Blind, Controlled Clinical Trial

STUDY DESIGN: Prospective, double-blind, randomized controlled trial. PURPOSE: To determine the ability of hyaluronidase to provide longer lasting pain relief and functional improvement in patients with lumbar radiculopathy. OVERVIEW OF LITERATURE: Selective nerve root block (SNRB) is a good treatment option in lumbar radiculopathy. We studied the effectiveness of hyaluronidase when added to the traditional SNRB regimen. METHODS: A sample size of 126 patients per group was necessary. A sample of 252 patients who underwent an injection procedure with or without hyaluronidase due to radiculopathy was included in this study. The patients were randomly divided into two groups: the control (C) group and the hyaluronidase (H) group. After SNRB due to radiculopathy, the visual analog scale (VAS) was compared at 2, 4, 6, 8, and 12 weeks between the two groups, and the Oswestry disability index (ODI) was compared at 12 weeks between the two groups. RESULTS: Both groups seemed to have general improvement in VAS, but in C group, the VAS was higher than the H group 2 and 4 weeks after the surgery, and the difference in time-group change between 2 groups was statistically significant (p 0.05). CONCLUSIONS: The rebound pain (the re-occurrence of pain within 2-4 weeks after injection) that occurs within 2-4 weeks after the injection of the routine regimen can be reduced when hyaluronidase is added to the routine SNRB regimen.

The Effect of Surgical Scrub in Orthopaedic Surgery / 대한정형외과학회잡지

PURPOSE: Two antiseptic solutions were investigated for their effect on bacterial growth inhibition. MATERIALS AND METHODS: A total of 38 patients were included in this study, who visited Daegu Catholic Medical Center from August 2, 2011 to September 2, 2011. Bacterial culture was performed at the pre-scrub, post-scrub, and postoperation; patients were divided into two groups according to use of povidone iodine (3.75%) and povidone iodine with Softa-Man(R) as antiseptic agents at the surgical. RESULTS: Comparison between the antiseptic solutions showed a significant difference for the presence of gram positive cocci (p=0.034), however, no difference was observed for the presence of gram positive bacilli (p=0.838). As the scrub time increased, the positive detection ratio of bacteria decreased (p=0.000), and decreased significantly at more than 120 seconds. However, positive detection ratio of bacteria increased significantly at more than 300 seconds in cases with povidone iodine only (p=0.014). Glove wearing time did not have a significant influence on the positive detection ratio of bacteria, and no significant difference was observed between the antiseptic solutions (p=0.143). CONCLUSION: Considering the positive detection ratio of bacteria when using povidone iodine only, the appropriate scrub time should be between 4 and 5 minutes. When using both antiseptics, at least 2 minutes of scrub time is needed.

Valgus Laxity of Elbow Joint in High School Weight Lifters: Ultrasonographic Assessment / 대한스포츠의학회지

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16.18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p>0.05), but the valgus stress view showed 5.6+/-0.8 mm medial joint gap in G1 and 3.8+/-0.8 mm in G2 (p<0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p<0.01). The horizontal distance was an average 4.9+/-1.23 mm for the G1 and 3.1+/-0.78 mm for the G2 (p<0.001). Vertical distance of the proximal portion of the ulna was average 0.58+/-0.94 mm for the G1 and 1.59+/-0.49 mm for the G2 (p<0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p<0.001). Change of horizontal and vertical distance were larger in female (p<0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.

History of the Artificial Hip Joint / 대한고관절학회지

For several centuries, orthopaedic surgeons have been given the task of managing the pain, limp, and gait disturbance that develop in association with various trauma and diseases of the hip joint. Progress has been made in development of surgical methods for the hip joint, and a recent concept was determined by introduction of the 'Clean Air Operating Enclosure' system and 'low frictional arthroplasty' in total hip arthroplasty (THA) by John Charnley, in 1960. THA has been performed as an exclusive method for hip joint reconstruction. We report on understanding of the current status from the past, present, and future trends with an introduction of the prior method of THA and a discussion of the history.

Traumatic Hip Dislocation in a Three-year-old Child: A Case Report / 대한고관절학회지

Traumatic hip dislocation is relatively rare in children and it should be reduced rapidly as that in adults. Evaluation of injuries of the cartilage, labrum, and soft tissue around the hip joint, and continuous follow-up for detection of development of complications is necessary. We report on an unusual case of a three-year-old child with traumatic hip dislocation treated with closed reduction and bed rest without immobilization.

Choice of Initial Operation and Functional Outcome in Rotator Cuff Repair on Both Shoulder / 대한정형외과학회잡지

PURPOSE: We evaluated the influencing factors in selection of initial operation and outcomes after operative treatment of symptomatic rotator cuff tear including both sides. MATERIALS AND METHODS: From December 2000 to March 2011, 60 shoulders of 30 patients underwent arthroscopic rotator cuff repair by a single experienced shoulder surgeon in our clinic. We retrospectively compared outcome by operation order according to hand dominance, tear size and by operation timing, operation method, and tear size. Symptom period was 10 months until the first operation and 19 months until the second operation. Interval between first and second operation was nine months. RESULTS: In comparison by operation order according to hand dominance and tear size, the functional scores did not differ significantly between the initial repair and delayed repair group (p>0.05). In comparison in a total of 60 cases, the functional outcome according to the operation timing and method of operation was not significantly different (p>0.05). The smaller sized tear group showed significantly better functional outcome, compared to the larger sized tear group (p<0.05). CONCLUSION: In cases of both-side symptomatic rotator cuff tear, most operations were performed on the more symptomatic side and the dominant arm first. The functional outcome showed improvement, regardless of operation order according to hand dominance and tear size, and regardless of operation timing and operation method as well. Tear size was the only significant factor influencing functional outcome.

Intravascular Papillary Endothelial Hyperplasia in Foot (A Case Report) / 대한족부족관절학회지

Intravascular papillary endothelial hyperplasia (IPEH) known as Masson's hemangioma is a rare benign reactive vascular lesion caused by the abnormal proliferation of endothelial cells. The lesion occurs most commonly in the fingers, head and neck, but very rare in the foot. We report a case of IPEH in the foot treated with operative excision.

Clinical Characteristics of Ischemic Colitis According to Location

PURPOSE: The aim of this study was to analyze various clinical characteristics of ischemic colitis according to its location. METHODS: The medical records of 92 cases of gastrointestinal ischemic colitis (IC) diagnosed at Bundang CHA Hospital from 1995 to 2008 were reviewed and analyzed retrospectively. The patients were diagnosed by using colonoscopic biopsies or laparotomy findings. The patients were divided into two groups, right and left, according to the main involvement area of the IC at the embryologic boundary line of the distal transverse colon, and the two groups were compared as to clinical characteristics and co-morbid diseases. RESULTS: Left IC was present in 59 patients (64.1%) and right IC in 33 patients (35.9%). No differences between the two groups in terms of clinical characteristics, cardiovascular disease and diabetes mellitus were observed. However, in 16 cases with renal failure, 10 patient had right IC and 6 patients had left IC, and this difference had statistical significance (P = 0.014). Among the 16, the 11 patients requiring hemodialysis included 8 with right IC (24.2%) and 3 with left IC (5.1%; P = 0.009). Among the 19 cases of severe IC requiring surgical treatment or involving mortality, irrespective of surgery, 11 patients showed right IC and 8 patients showed left IC (P = 0.024). CONCLUSION: Right-side ischemic colitis was significantly associated with renal failure and disease severity, so patients with right-side colon ischemia should be more carefully observed and managed.

Superior Lumbar Hernia

Lumbar hernia is an uncommon pathological defect of the abdominal wall. It presents difficulties in diagnosis and treatment because of the depth of the sac and the surrounding layers of muscle, fascia, and bone. It is an extrusion of intraperitoneal or extraperitoneal organs of the abdomen through a defect of the transversalis fascia. Inferior lumbar hernias are bordered by the iliac crest representing its base, limited by the external oblique muscle laterally, the latissimus dorsi medially, and the internal oblique muscle as its floor. Superior lumbar hernias are bordered by the 12th rib superiorly, quadratus lumborum muscle medially, and the internal oblique muscle laterally underneath the latissimus dorsi muscle. Diagnosis depends largely on the capacity for clinical suspicion, and confirmation is based on imaging tests. We report a case of an acquired primary lumbar hernia diagnosed by computed tomography, which was treated successfully at our institution.