ABSTRACT
Background@#Arthroscopic partial meniscectomy (APM) continues to be the popular treatment for meniscal tears, but recent randomized controlled trials have questioned its efficacy. To provide more evidence-based criteria for patient selection, we undertook this study to identify prognostic factors associated with clinical failure after APM for medial meniscus tears. @*Methods@#Medical records of 160 patients followed up for at least 5 years after APM for medial meniscal tears were retrospectively reviewed. Demographic data (age, sex, and body mass index), radiographic variables (Kellgren-Lawrence [K-L] grade and hip-knee-ankle [HKA] angle), and clinical scores (International Knee Documentation Committee score, Tegner activity scale score, Lysholm score, and Knee injury and Osteoarthritis Outcome Score) were recorded. Clinical failure was defined as the need for an additional surgical procedure (arthroscopy, osteotomy, or arthroplasty) or the presence of intolerable pain. Survivorship analysis with clinical failure as an end point was performed using Kaplan-Meier survival curves. Factors related to clinical failure were analyzed using a Cox proportional hazard model. Cutoff values were determined using areas under receiver operating characteristic (ROC) curves. Radiographic progression of osteoarthritis was analyzed using the chi-square test, and serial changes of clinical scores were analyzed using a linear mixed model. @*Results@#Clinical success rates were 95.7% at 5 years, 75.6% at 10 years, and 46.3% at 15 years. Age, HKA angle, and K-L grade (p = 0.01, p = 0.02, and p = 0.04, respectively) were found to be significant risk factors of clinical failure. Cutoff values at 10 years postoperatively as determined by ROC analysis were 50 years for age (sensitivity = 0.778, 1-specificity = 0.589), grade 2 for K-L grade (sensitivity = 0.778, 1-specificity = 0.109), and 5.5° for HKA angle (sensitivity = 0.667, 1-specificity = 0.258). In patients who had clinical success until 10 years after APM, radiological osteoarthritis progressed gradually. However, the clinical scores of patients who achieved clinical success did not decrease significantly over the 10-year follow-up. @*Conclusions@#The poor prognostic factors found to be related to clinical failure after APM for a medial meniscal tear were patient age (≥ 50 years), preoperative K-L grade (≥ grade 2), and preoperative HKA angle (≥ varus 5.5°).
ABSTRACT
Purpose@#This study examined the level of self-esteem and awareness of sexual harassment among college students majoring in physical therapy to discover the status of sexual harassment and the types of and responses to sexual harassment at clinical training sites. @*Methods@#The study participants included 195 college students majoring in physical therapy in Gyeonggi and Chungcheong provinces, who responded fully to the survey questionnaire. The data were prepared through self-reporting on a structured questionnaire and collected from September to November 2018. @*Results@#The difference in the mean value of self-esteem was evident between the two groups investigated. The most common types of sexual harassment were verbal, visual, and physical. The types of damage reported by the participants were emotional, physical, and social. The group of participants who experienced sexual harassment had a high rate of avoidance, while the group of participants who did not experience sexual harassment exhibited a high rate of coping. @*Conclusion@#The incidence of verbal sexual harassment was reported to be significantly higher, and the emotional damage was the most serious. Students should be provided with more specific and realistic preventive education or countermeasures so they can respond more proactively to real situations.
ABSTRACT
Myringotomy and ventilation tube insertion are widely performed in pediatric patients with chronic otitis media. This procedure is performed under general anesthesia or sedation with local anesthesia infiltration in pediatric patients. In this case report, we report a case of transient facial paralysis in a pediatric patient who underwent myringotomy and ventilation tube insertion using sevoflurane inhalation and four-quadrant blocks with lidocaine.
ABSTRACT
Purpose@#This study examined the level of self-esteem and awareness of sexual harassment among college students majoring in physical therapy to discover the status of sexual harassment and the types of and responses to sexual harassment at clinical training sites. @*Methods@#The study participants included 195 college students majoring in physical therapy in Gyeonggi and Chungcheong provinces, who responded fully to the survey questionnaire. The data were prepared through self-reporting on a structured questionnaire and collected from September to November 2018. @*Results@#The difference in the mean value of self-esteem was evident between the two groups investigated. The most common types of sexual harassment were verbal, visual, and physical. The types of damage reported by the participants were emotional, physical, and social. The group of participants who experienced sexual harassment had a high rate of avoidance, while the group of participants who did not experience sexual harassment exhibited a high rate of coping. @*Conclusion@#The incidence of verbal sexual harassment was reported to be significantly higher, and the emotional damage was the most serious. Students should be provided with more specific and realistic preventive education or countermeasures so they can respond more proactively to real situations.
ABSTRACT
BACKGROUND: The molecular basis of follicular dendritic cells (FDC)-germinal center (GC) B cell interaction is largely unknown, although this cellular interaction is thought to be important for the whole process of GC B cell differentiation. METHODS: Using FDC-like cells, HK, and highly purified GC B cells, we attempted to identify the molecules that play critical roles in the interactions between FDC and B cells. GC B cells were co-cultured with HK cells and soluble CD154 in the presence or absence of various function-blocking monoclonal antibodies to examine their effect on GC B cell binding to HK cells and B cell proliferation. RESULTS: Anti-CD11a and anti-CD54 antibodies inhibited GC B cell binding to HK cells while anti-CD49d and anti-CD106 antibodies did not. GC B cell proliferation was not impaired by the disruption of GC B cell-HK cell adherence. CONCLUSION: Our results suggest that CD11a/CD18-CD54 interactions play an important roles in the initial binding of GC B cells to FDC and diffusible growth factors from FDC may be responsible the massive proliferation of GC B cells.