Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

PURPOSE: To compare extended care facility (ECF) and home as discharge destination after total knee arthroplasty (TKA) at a single high-volume tertiary center in South Korea. MATERIALS AND METHODS: We retrospectively analyzed 1,120 primary TKAs (614 patients) performed between January 2012 and December 2013. A telephonic survey was conducted to determine discharge destination. The data reviewed included demographic and surgical data, functional outcome at 2 years and complications within 3 months. RESULTS: ECF and home received 316 patients (51%) and 298 patients (49%), respectively. The ECF group had more bilateral TKA patients than the home group (272 vs. 234; p=0.014) and more patients with additional hospital stay (44 vs. 22; p=0.009). A higher tendency of complications was seen at home (n=8, 2.7%) than the ECF (n=2, 0.6%) (p=0.057). No significant differences were found in any functional outcome measure. Home patients had better patient satisfaction than ECF patients (81.9% vs. 54.3%; p < 0.001). CONCLUSIONS: Patients who returned home after discharge had similar functional outcome at 2 years after surgery and higher patient satisfaction than those in the ECF in spite of the higher tendency of complications. Patients need adequate counseling and education regarding advantages and limitations of the two discharge destinations.

Bioprospecting Potential of the Soil Metagenome: Novel Enzymes and Bioactivities

The microbial diversity in soil ecosystems is higher than in any other microbial ecosystem. The majority of soil microorganisms has not been characterized, because the dominant members have not been readily culturable on standard cultivation media; therefore, the soil ecosystem is a great reservoir for the discovery of novel microbial enzymes and bioactivities. The soil metagenome, the collective microbial genome, could be cloned and sequenced directly from soils to search for novel microbial resources. This review summarizes the microbial diversity in soils and the efforts to search for microbial resources from the soil metagenome, with more emphasis on the potential of bioprospecting metagenomics and recent discoveries.

Recent Trend and Transition of Last 10 Years of Ski and Snowboard Injuries / 대한스포츠의학회지

To analysis the trend of ski and snow board injury, and use this study result in designing injuries prevention strategy. We studied 25,292 patients who had the ski and snow board injuries in a ski resort in Pyeongchang Gun, Gangwon Do, Korea during 1999-2001 season, 2005-2007 season, and 2008-2010 season. They were studied with a questionnaires, physical examination and radiograph. And the analysis was based on age, sex, injury type and site and slope level of difficulty. Snow board related injury have increased, injury to teens and thirties increased, injury to female snowboarder increased (p<0.001), contusion type of ski and snow board injury increased (p<0.001) and upper extremity injury increased but beginner grade slope injury (p<0.001) decreased since last 10 years. The overall type and site of ski and snowboard injuries have changed due to increased snowboard injury, gender and age of them have shown the diversity since last 10 years.

Screening for Antifungal Endophytic Fungi Against Six Plant Pathogenic Fungi

A total of 187 endophytic fungi were isolated from 11 plant species, which were collected from 11 locations in Korea. Their antifungal activities were screened in vivo by antifungal bioassays after they were cultured in potato dextrose broth and rice solid media. Antifungal activity against plant pathogenic fungi such as Magnaporthe grisea (rice blast), Corticium sasaki (rice sheath blight), Botrytis cinerea (tomato gray mold), Phytophthora infestans (tomato late blight), Puccinia recondita (wheat leaf rust), and Blumeria graminis f. sp. hordei (barley powdery mildew) was determined in vivo by observing the inhibition of plant disease development. Twenty (11.7%) endophytic fungi fermentation broths were able to control, by more than 90%, at least one of the six plant diseases tested. Among 187 liquid broths, the F0010 strain isolated from Abies holophylla had the most potent disease control activity; it showed control values of more than 90% against five plant diseases, except for tomato late blight. On the other hand, fourteen (7.5%) solid culture extracts exhibited potent disease control values of more than 90% against one of six plant diseases. The screening results of this study strongly suggested that metabolites of plant endophytic fungi could be good potential sources for screening programs of bioactive natural products.

A Survey on the Use of Alternative Medicine in Allergy Patients / 소아알레르기및호흡기학회지

PURPOSE: Alternative medicine(AM) is defined as the approaches and techniques that are not included in the curricula of medical schools or residency training at present. This study aimed to evaluate the present status of the use of AM in allergic diseases and to propose an appropriate guide. METHODS: Mailed questionnaires on the patterns of the use of AM were collected during the month of May in 2001. The data was analyzed using SPSS WINDOW 8.0. RESULTS: 1) One hundred and five patients responded. Their mean age was 46.5 years old and the mean duration of the diseases was 67 months. 2) Ninety six(91.4%) out of 105 responders who have allergic diseases experienced AM. Herb medicine(57.3%) was most popular and hot spring(22.9%), immune stimulants(22.9%), nutritional supplements(13.5%), acupuncture(12.5%), breathing exercise, aroma-therapy and foods such as aloe, honey and ginkgo nuts were also tried. 3) The annual mean expenditure for the AM was about 690,000 Won. Severely diseased patients spent more money out of their pocket for AM. 4) Doctors(43.5%), oriental doctors(19.8%), neighbours(27.1%) and mass media played some roles for the distribution of the information about AM. 5) The patients purchased the products for AM from drug store, hospital, market, health care shop and by mail or internet orders. 6) Thirty two patients(33.3%) were satisfied with the AM and 35(36.5%) patients answered that they would recommend the AM to the others. CONCLUSION: Many allergy patients used various kinds of AM without any guidelines. Therefore, doctors' active participation in AM is necessary to confirm the scientific basis, to strengthen patient's education and to filter the informations about AM spreaded by the mass media.

A Case of Encephalopathy Presented with Motor Aphasia and Quadriplegia Following Intrathecal Methotrexate

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.

A Case of Childhood Multiple Focal Nodular Hyperplasia of the Liver / 대한소아혈액종양학회지

Focal nodular hyperplvasia (FNH) is a rare benign hepatic tumor that likely represents a local hyperplastic response of hepatocytes to a congenital vascular anomaly. FNH is typically asymtomatic and has a benign course. Hepatic resection is performed when the lesions are large, symptomatic and complicated or when the diagnosis remains uncertain. Although many cases of FNH in children have been described to date in other countries, only one Korean case of multiple FNH has been reported on English literature. We recently experienced a rare case of multiple FNH in a 10-year-old boy, that was confirmed by right inferior subsegmentectomy, left lateral segmentectomy and left medial tumorectomy. We report this case with brief review of literature.