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Purpose: The purpose of this study was to assess the use of resected condyle thickness measurement, obtained with caliper, when verifying the accuracy of distal femoral bone resection in total knee arthroplasty.Methods: Fifty-two total knee arthroplasties were performed to treat osteoarthritis with varus knee. The difference of caliper-measured thickness of resected medial and lateral femoral condyles after removal of cartilage from the lateral condyle was compared with radiographically measured values. The preoperative planned valgus cut angles and the postoperative femoral component valgus angles were compared.Results: The difference of radiograph-measured thickness averaged 2.4 ± 2.2 mm and the difference of caliper-measured thickness averaged 2.0 ± 2.1 mm (r = 0.735, P < 0.001). The postoperative femoral component valgus angle averaged 4.8° ± 1.6° (range, 2.0°-7.6°). The difference between the valgus cut angle and femoral component valgus angle averaged -0.3° ± 1.5°.Conclusions: The confirmation of correspondence between the caliper-measured and radiographically measured thickness of resected condyles could verify the accuracy of distal femoral bone resection in total knee arthroplasty.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the results of total knee arthroplasty (TKA) following a closed wedge high tibial osteotomy (HTO). A total of 16 TKAs were performed in 13 patients who had previously undergone a closed wedge HTO. The clinical results were reviewed using the Hospital for Special Surgery (HSS) score. The radiographic results were evaluated with respect to the femorotibial angle (FTA), joint line height (JLH) and tibial bone resection. The average HSS score before TKA was 63.6, which improved to 92.8 at the last follow-up. The FTA averaged varus 0.9 preoperatively and valgus 5.7 at the last follow-up. The JLH averaged 13.9 mm preoperatively and 15.6 mm at the last follow-up. The amount of tibial bone resection averaged 4.8 mm. A meticulous surgical technique can produce satisfactory results in TKA after HTO, considering the correction of the deformity, JLH and the amount of the tibial bone resection. [ABSTRACT FROM AUTHOR]

AIM OF THE STUDY: Gyeongshingangjeehwan (GGEx), which is a polyherbal drug composed of four medicinal plants, has traditionally been used as anti-obesity drug in Korean local clinics. Thus, we investigated the effects of GGEx on visceral adiposity and examined whether adipose peroxisome proliferator-activated receptor [alpha] (PPAR[alpha]) activation is involved in this process. MATERIALS AND METHODS: After Obese Otsuka Long-Evans Tokushima Fatty (OLETF) rats and differentiated 3T3-L1 adipocytes were treated with GGEx, we studied the effects of GGEx on not only visceral white adipose tissue (WAT) mass and adipocyte size, but also the expression of adipocyte marker and PPAR[alpha] target genes. RESULTS: Administration of GGEx to obese rats for 8 weeks decreased visceral WAT weight by 30% and the size of adipocytes in mesenteric WAT by 31% without weight changes of other organs. Concomitantly, GGEx increased mRNA levels of PPAR[alpha] target genes responsible for fatty acid ß-oxidation in mesenteric WAT whereas decreased mRNA expression of adipocyte markers, such as PPAR[gamma], aP2 and leptin. Serological studies demonstrated that plasma levels of free fatty acids and triglycerides as well as insulin and glucose were decreased following GGEx treatment. Consistent with the in vivo data, GGEx increased PPAR[alpha] reporter gene activity and induced the mRNA expression of PPAR[alpha] target genes involved in mitochondrial fatty acid ß-oxidation in 3T3-L1 cells. GGEx also inhibited triglyceride accumulation in these cells. CONCLUSION: These results suggest that GGEx promotes the reductions in visceral fat mass and adipocyte size in obese animals, and that this event may be mediated by adipose PPAR[alpha] activation. [ABSTRACT FROM AUTHOR]

AIMS: We investigated the long-term changes in the prevalence and the control rate of hypertension among Korean adults diagnosed with diabetes. METHODS: Using data from the Korean National Health and Nutrition Examination Survey (1998-2008), including 1384 adults diagnosed with diabetes, we analyzed changes in the prevalence of hypertension (mean SBP>=140mmHg, DBP>=90mmHg, or use of antihypertensive medication) and the control rate of hypertension (BP<130/80mmHg). RESULTS: The prevalence of hypertension in diabetic adults was 50.9% in 1998 and 51.7% in 2008 (P=0.563). The mean blood pressure decreased from 138.1±1.1/80.0±0.6mmHg to 124.7±0.8/76.0±0.5mmHg (P<0.001); awareness (37.4 to 85.2%, P<0.001), treatment (37.4 to 81.8%, P<0.001), and the control rate (20.1 to 34.7%, P=0.001) steadily increased. The prevalence of hypertension increased significantly more in the obese group compared with the non-obese group (53.3% vs. 49.0% in 1998, P=0.784; 64.3% vs. 42.0% in 2008, P<0.0001, respectively, P for trend=0.0001). CONCLUSIONS: Although the rates of hypertension treatment have significantly improved, the control rate remains inadequate, and intensive intervention is urgently needed. [ABSTRACT FROM AUTHOR]

Context: With increasing globalization and East-West exchanges, the increasing epidemic of type 2 diabetes in Asia has far-reaching public health and socioeconomic implications.Objective: To review recent data in epidemiologic trends, risk factors, and complications of type 2 diabetes in Asia.Evidence Acquisition: Search of MEDLINE using the term diabetes and other relevant keywords to identify meta-analyses, systematic reviews, large surveys, and cohort studies. Separate searches were performed for specific Asian countries. The review was limited to English-language articles published between January 1980 and March 2009; publications on type 1 diabetes were excluded.Evidence Synthesis: The prevalence of diabetes in Asian populations has increased rapidly in recent decades. In 2007, more than 110 million individuals in Asia were living with diabetes, with a disproportionate burden among the young and middle aged. Similarly, rates of overweight and obesity are increasing sharply, driven by economic development, nutrition transition, and increasingly sedentary lifestyles. The "metabolically obese" phenotype (ie, normal body weight with increased abdominal adiposity) is common in Asian populations. The increased risk of gestational diabetes, combined with exposure to poor nutrition in utero and overnutrition in later life in some populations, may contribute to the increasing diabetes epidemic through "diabetes begetting diabetes" in Asia. While young age of onset and long disease duration place Asian patients with diabetes at high risk for cardiorenal complications, cancer is emerging as an important cause of morbidity and mortality.Conclusions: Type 2 diabetes is an increasing epidemic in Asia, characterized by rapid rates of increase over short periods and onset at a relatively young age and low body mass index. Prevention and control of diabetes should be a top public health priority in Asian populations. [ABSTRACT FROM AUTHOR]

Gyeongshingangjeehwan (GGEx), which comprises Liriope platyphylla F.T. Wang & T. Tang (Liliaceae), Platycodongrandiflorum A. DC. (Campanulaceae), Schisandrachinensis K. Koch (Magnoliaceae), and Ephedra sinica Stapf (Ephedraceae), has traditionally been used as an anti-obesity drug in Korean local clinics, although there is no evidence concerning the scientific analyses of its effects and mechanism(s) of action. Thus, we investigated the effects of GGEx on obesity, as well as the mechanism by which GGEx functions, in Otsuka Long-Evans Tokushima Fatty (OLETF) male rats. Compared with obese OLETF control rats, administration of GGEx for 8 weeks significantly decreased food intake and plasma leptin levels as well as body weight gain and abdominal fat in OLETF rats. GGEx treatment not only decreased circulating triglycerides, but also inhibited lipid accumulation in the liver. GGEx increased the hepatic mRNA levels of PPARalpha target genes responsible for fatty acid beta-oxidation. Consistent with the in vivo data, GGEx elevated PPARalpha reporter gene expression in NMu2Li liver cells. These results suggest that GGEx may effectively prevent obesity and hypertriglyceridemia in part through the inhibition of feeding and the activation of hepatic PPARalpha. [ABSTRACT FROM AUTHOR]

The authors describe a surgical procedure to 'fine-tune' the tibial slope during high-tibial osteotomy. Fifteen consecutive patients were treated for medial compartment osteoarthritis of the knee using a temporary unilateral external fixator and accompanying internal fixator composed of two plates (with different sized space). All 15 patients were evaluated by measuring femoro-tibial angles (FTAs) in the frontal plane, and using the proximal tibial anatomical axis (PTAA) and the posterior tibial cortex (PTC) methods to assess tibial slope in the sagittal plane. FTA, PTAA, and PTC angles were measured using: (1) radiographs taken before surgery, (2) fluoroscopic images taken after inserting the first plate during surgery, (3) fluoroscopic images taken after tibial slope restoration using an external fixator system during surgery, and finally using, (4) radiographs taken after surgery. In all patients, preoperative PTAA and PTC angles increased significantly after inserting the first plate posteromedially at osteotomy site. After tibial slope had been accurately restored using the external fixator system, PTAA and PTC angles decreased to the preoperative tibial slope level without changing femorotibial angles in the coronal plane. The authors were able to acquire a consistent and reproducible natural tibial slope using tibial slope "fine tuning" using an external fixator and a stable internal fixator. [ABSTRACT FROM AUTHOR]

AIMS: We examined whether the common polymorphisms of the peroxisome proliferator-activated receptor-gamma (PPARgamma) gene are associated with Type 2 diabetes or obesity in the Korean population. METHODS: We genotyped two common PPARgamma polymorphisms (Pro12Ala and 161C > T) and examined their association with the clinical phenotypes found in 684 patients with Type 2 diabetes mellitus and 291 non-diabetic control subjects. RESULTS: The 12Ala allele was less frequent in the Type 2 diabetic patients than in the non-diabetic control subjects (0.036 vs. 0.053, P = 0.024). The allele frequencies of the 161C > T polymorphism did not differ between the control and Type 2 diabetic group (0.158 vs. 0.173). In the non-diabetic controls, those with the T allele had lower BMI and fasting serum triglyceride (TG) concentrations than those with the C/C homozygote (22.7 +/- 2.9 vs. 23.8 +/- 3.2 kg/m2, P = 0.002; 1.45 +/- 0.81 vs. 1.65 +/- 0.83 mmol/l, P = 0.03, respectively). The 12Ala-161T haplotype was associated with a decreased risk for Type 2 diabetes (OR = 0.47, P = 0.009), whereas the 12Pro-161T haplotype was associated with lower BMI and lower fasting serum TG (22.5 +/- 2.8 vs. 23.7 +/- 3.2 kg/m2, P = 0.004; 1.41 +/- 0.87 vs. 1.64 +/- 0.79 mmol/l, P = 0.02, respectively). CONCLUSIONS: The PPARgamma 12Ala allele was associated with a reduced risk of Type 2 diabetes, whereas the PPARgamma 161T allele was associated with lower BMI and fasting serum TG concentrations in the Korean subjects. The subjects with 12Ala-161T haplotypes had a reduced risk of Type 2 diabetes. [ABSTRACT FROM AUTHOR]