Mid-Term Results after Anterior Cruciate Ligament Reconstruction Using Four-Strand Single Semitendinosus Tendon / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the mid-term results after anterior cruciate ligament (ACL) reconstruction using a single four-strand semitendinosus tendon. MATERIALS AND METHODS: We evaluated 81 patients (84 cases) who had undergone ACL reconstruction using an autologous single four-strand semitendinosus tendon. The patients consisted of 77 men and 4 women with a mean age of 28.8 years (15-59 years) years. Most injuries were sports related, and the largest number of cases occurred during a soccer game (38 cases). Combined injuries were meniscus injuries in 43 cases, cartilage injuries in 6 cases and medial collateral ligament injuries in 8 cases. Femoral fixation device was PINN-ACL CrossPin in 44 cases and extracortical suspension device in 40 cases. Suture tie around a screw post and an additional bioabsorbable screw were used for tibial fixation. The mean time from injury to surgery was 9+/-16 months (7 days-10 years) and the mean follow-up period was 72.0+/-8.3 months (53-95 months). Clinical evaluation was performed using Lachman test, pivot-shift test, KT-2000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and return to pre-injury sports activity. Radiologic evaluation was performed using plain radiographs to evaluate joint space narrowing. RESULTS: All patients showed normal range of motion at the final follow-up. The Lachman test was positive in 4 cases, and pivot-shift test was positive in 3 cases. Lysholm score improved from 76.7 to 92.2, Tegner activity score improved from 5.1 to 6, IKDC score improved from 72.0 to 86.5, and mean anterior translation by KT-2000 improved from 7.4 mm to 2.3 mm, and 80.2micro of patients returned to pre-injury sports activity. No significant differences in joint space narrowing were observed in plain radiographs. CONCLUSION: In this study, good results were obtained after ACL reconstructions using the autologous four-strand single semitendinosus tendon with maintaining the joint stability at mid-term follow-up.

The photodynamic therapy on Streptococcus mutans biofilms using erythrosine and dental halogen curing unit / 国际口腔科学杂志·英文版

The purpose of our study was to evaluate the effect of photodynamic therapy (PDT), using erythrosine as a photosensitizing agent and a dental halogen curing unit as a light source, on Streptococcus mutans in a biofilm phase. The S. mutans biofilms were formed in a 24-well cell culture cluster. Test groups consisted of biofilms divided into four groups: group 1: no photosensitizer or light irradiation treatment (control group); group 2: photosensitizer treatment alone; group 3: light irradiation alone; group 4: photosensitizer treatment and light irradiation. After treatments, the numbers of colony-forming unit (CFU) were counted and samples were examined by confocal laser scanning fluorescence microscopy (CLSM). Only group 4 (combined treatment) resulted in significant increases in cell death, with rates of 75% and 55% after 8 h of incubation, and 74% and 42% at 12 h, for biofilms formed in brain-heart infusion (BHI) broth supplemented with 0% or 0.1% sucrose, respectively. Therefore, PDT of S. mutans biofilms using a combination of erythrosine and a dental halogen curing unit, both widely used in dental clinics, resulted in a significant increase in cell death. The PDT effects are decreased in biofilms that form in the presence of sucrose.

Quantitative localization of impacted mesiodens using panoramic and periapical radiographs

PURPOSE: The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. MATERIALS AND METHODS: Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. RESULTS: The smallest difference between the calculated and the actual distance was 0.1+/-0.7 mm in Group 1/Method 3. The largest difference was -4.2+/-1.6 mm in Group 3/Method 2. In all groups, method 3 was the most accurate. CONCLUSION: Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.

The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate

PURPOSE: The purpose of this study was to evaluate the surgical outcomes of isolated greater tuberosity fractures of the proximal humerus fixed with the spring plates. MATERIALS AND METHODS: Fourteen patients who could be followed up at least 1 year after the surgical treatment of isolated greater tuberosity fracture were evaluated. Their mean age was 51 years (range, 25~73 years). The deltopectoral approach and fixation with the spring plate were performed in all cases. The spring plate was used in all cases. In some circumstances, sutures incorporating the rotator cuff, interfragmentary screw or tension band wire were added. We evaluated the clinical outcomes using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS: The mean UCLA score was 29.8 and the mean KSS was 89.4. The average time of bony union was 10.2 weeks (range, 7~14 weeks) after the surgery, including 1 case that was performed the secondary operation due to metal failure. The shoulder stiffness were observed in 4 cases and one case of infection was treated well without operation. CONCLUSION: In the treatment of isolated greater tuberosity fractures of the proximal humerus, the spring plates fixation can be a good surgical option providing reliable functional results.

Plate Fixation for Fractures of the Coronoid Process of the Ulna

PURPOSE: The purpose of this study was to evaluate the results of eight cases of coronoid process fractures that were fixed with a plate. MATERIALS AND METHODS: Eight coronoid process fractures were treated by plating and these cases were reviewed retrospectively. Six patients were men and two were women. The average age was 41 years (range: 22-79) at the time of injury. According to Regan's classification, there were five type 2 and three type 3. According to O'Driscoll's classification, there were five anteromedial type and three base type. Open reduction and internal fixation with a plate were performed through a medial approach by splitting of the two heads of the flexor carpi ulnaris. The patients were follow-up for a mean of 15.8 months (range: 6-25). We evaluated the clinical outcomes with using the Mayo Elbow Performance Score. RESULTS: The average active motion of the elbow joint was 120 degrees. The average Mayo Elbow Performance Score was 86.9. There were 5 excellent results, 1 good result and 2 fair results. SUMMARY: Plating through a medial approach of the elbow provided stable fixation and satisfactory union for treating displaced coronoid process fractures with the unstable elbow.