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Anaerobic conditions in waterlogged soil lead to low germination rates, which significantly reduce crop yields. Good seed germination is prerequisite for direct-seeded cultivation of rice to obtain optimal yields not only in irrigated lowland but most importantly in rain-fed and waterlogged areas where water supply could be more than needed. Due to the limited availability of rice genotypes suitable for anaerobic germination, there is an urgent need to select diverse rice germplasm with enhanced anaerobic germinability. In this study, we evaluated 185 rice accessions from six subpopulations for germination rate (AGR) and coleoptile length (ACL) under anaerobic conditions. The highest average AGR (60%) and longest average ACL (2.13 cm) were observed in tropical japonica (TRJ) and temperate japonica (TEJ) germplasm, respectively. Meanwhile, the highest proportion of accessions with “very long” ACL was in the TEJ subpopulation, whereas those with the “highest” AGR were in the aus subpopulation based on our criteria. We selected seven strong accessions for anaerobic germinability (AG) based on AGR and ACL and analyzed the relative expression patterns of four AG-related genes in strong and weak accessions via qRT-PCR. In general, proton pyrophosphatase locus (OVP3) was expressed at the highest levels in strong accessions, whereas the expression level of rice ethylene response element binding protein locus (EREBP1) did not significantly differ among accessions under normal and anaerobic conditions. The relative expression results of rice alpha amylase locus (RAmy3D) and OVP3 showed distinct patterns and divided all strong accessions into two groups, suggesting that major genes involved in AG may vary depending on the germplasm. These findings could be helpful for breeders and lay the foundation for further genetic analysis.

Background: Postoperative anaemia is common after total knee arthroplasty (TKA). Emerging evidence shows the beneficial effects of perioperative iron supplementation in patients at risk of postoperative anaemia. In this study, we aimed to evaluate the efficacy of intraoperative administration of iron isomaltoside for preventing post-TKA anaemia. Methods: This prospective randomised, controlled, double-blinded, parallel-group study was conducted at a tertiary care teaching hospital in Seoul, Korea. Patients undergoing unilateral TKA were randomly assigned to receive intravenous iron isomaltoside or placebo intraoperatively, based on a computer-generated randomisation list. The administered dose of iron isomaltoside was determined based on preoperative haemoglobin level and body weight of each patient according to the manufacturer’s recommendation. The primary outcome measure was the incidence of postoperative anaemia at 30 days after TKA, analysed by intention-to-treat. Findings: Between March 29, 2018, and April 16, 2019, 164 patients were screened for eligibility. In total, 89 patients were included in the final analysis (44 in the treatment group; 45 in the control group). The incidence of postoperative anaemia at 30 days after TKA was significantly lower in the treatment group than that in the control group (15/44 [34·1%]) vs 28/45 [62·2%]; relative risk, 0·55 [95% CI 0·34–0·88], P=0·008). Haemoglobin level, serum ferritin concentrations, and iron saturation were also significantly higher in the treatment group at 30 days after TKA. However, there were no significant differences in both quality of life assessments. Interpretation: Intraoperative administration of iron isomaltoside effectively prevents post-TKA anaemia, and thus it can be included in patient blood management protocols for reducing postoperative anaemia in patients undergoing TKA. Trial Registration: This study is registered with ClinicalTrials.gov (number NCT03470649) and has completed recruitment. Funding Statement: This study was funded by Phambio Korea Inc., Seoul, Korea. Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: This prospective randomised, controlled, double-blinded, parallel-group study was approved by the Institutional Review Board of Soul National University Hospital, Seoul, Korea (No. H-1709-079-885). The study was conducted in accordance with the Declaration of Helsinki, and written informed consent was obtained from all participants.

Co3O4 nanoflowers (NFs) were obtained from cobalt hydroxide coated on silica, Co(OH)2@SiO2, prepared from a homogenous mixture of urea and cobalt nitrate in an aqueous solution. The Co3O4@SiO2 was obtained by calcining Co(OH)2@SiO2 under atmospheric air for 3 h and then immersing in sodium hydroxide to yield Co3O4-NFs. The Ni-deposited Co3O4 NFs (Ni@Co3O4-NFs) were synthesized by chemical deposition of nickel nanoparticles onto Co3O4-NF by a reducing agent, NaBH4. The physical characterization of Co3O4-NFs and Ni@Co3O4-NFs was performed by Brunauer-Emmett-Teller analysis, scanning electron microscopy and X-ray diffraction. The electrochemical properties of Co3O4-NFs and Ni@Co3O4-NFs for the oxygen reduction and evolution reaction were determined in an 8 M KOH solution. Ni@Co3O4-NF showed a better cell performance than that of Co3O4-NF. Moreover, Ni@Co3O4-NF exhibited a higher stability and longer life cycles at 20 mA cm−2 at a 2 h charging and discharging rate as compared to Co3O4-NF. Therefore, Co3O4-NF and Ni@Co3O4-NF could be used as a cathode material for Zn-air rechargeable batteries.

Introduction. Knee osteoarthritis (OA) can affect the hip and ankle joints, as these three joints operate as a kinetic/kinematic chain while walking. Purpose. This study was performed to compare (1) hip and ankle joint gait mechanics between knee OA and control groups and (2) to investigate the effects of knee gait mechanics on the ipsilateral hip and ankle joint. Methods. The study group included 89 patients with end-stage knee OA and 42 age- and sex-matched controls without knee pain or OA. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Range of motion (ROM) during gait, coronal motion arc, and peak joint moment of hip, knee, and ankle joints were investigated. Results. Ankle varus moment was 50% higher in the OA group (p=0.005) and was associated with higher knee adduction moment (p Conclusions. Knee OA has a negative effect on the ROM, coronal motion arc, and joint moment of the ankle joint and hip joint. As knee OA is associated with increased moment of the ankle joint, attention should be paid to the ankle joint when treating patients with knee OA.

Background This study aimed to demonstrate the characteristics of the chondral lesion at the medial femoral condyle (MFC) in patients with medial meniscal posterior root tear (MMPRT), and to compare the progression rate of accompanying chondral disease in MMPRT with that in degenerative non-radial tear. Methods Thirty-one patients who underwent arthroscopic surgery for MMPRT and 31 controls who underwent arthroscopic surgery for degenerative medial meniscus posterior horn horizontal tear (MMPHT) were included. Accompanying chondral lesions in the MFC were evaluated by magnetic resonance imaging (MRI) at initial diagnosis and from video taken at arthroscopic surgery using the International Cartilage Repair Society (ICRS) classification system. The difference in severity and extent of the chondral lesion between initial diagnosis and surgery was measured. Results Twenty-five patients with MMPRT (80.6%) and 29 patients (93.5%) with MMPHT had ICRS grade ≥ 2 chondral injuries at MFC. In the MMPRT and MMPHT groups, the most severely injured areas of the MFC were the far medial compartment (52%) and central compartment (51%), respectively. Comparing MRI and arthroscopy, 12 patients (39%) in the MMPRT group showed progression of chondral disease after a mean of 3.5 months, whereas only three patients (10%) in the MMPHT group showed progression after a mean of 3.1 months. Conclusions MFC lesions accompanying MMPRT were located more medially and progressed faster than those with non-root horizontal tear. Earlier intervention such as repair of MMPRT or high tibial osteotomy, if malalignment is present, may be considered in order to prevent the progression of chondral lesion.

The purpose of this study was to comprehensively analyze the effects of femoral or tibial joint line elevation and patella height change on the clinical results after revision total knee arthroplasty (RTKA) and to determine which one is the significant factor that should be restored. One hundred and sixty-six RTKA cases (144 patients) with a minimum 2-year follow-up were retrospectively analyzed. Demographic, operative, and clinical data were collected. Tibial and femoral joint line elevations were measured based on the distance from the tibial tubercle and from the adductor tubercle to the distal end of the femoral component, respectively. The patellar position was evaluated using the Insall-Salvati ratio and Blackburne-Peel index. The effects of clinical and radiological variables on the changes of range of motion (ROM) and clinical scores after RTKA were analyzed. Fourteen knees (8.4%) showed a femoral joint line elevation of more than 5 mm, and 79 knees (47.6%) showed a tibial joint line elevation of more than 5 mm. Patella baja after RTKA was observed in 33 knees (19.9%), and pseudo-patella baja after RTKA was observed in 90 knees (54.2%). The linear mixed model revealed that the femoral joint line position was the only significant factor that affected the change of ROM after RTKA. No statistically significant correlation was observed between variables and postoperative clinical scores. Restoration of femoral joint line was the significant factor that increased postoperative ROM of the knee after RTKA. In complicated revision situations, surgeons should give priority to the restoration of distal femoral joint line to increase postoperative ROM. IV.

Background Targeting residual varus alignment in total knee arthroplasty may be functionally beneficial to preoperative varus patients. Methods Bilateral TKA patients were enrolled. According to the postoperative hip-knee-ankle axis, patients were allocated into residual varus (3° ± 1°) alignment group or neutral (0° ± 1°) alignment group. Then, 1:2 propensity score matching was used to match preoperative variables. Finally, matched neutral (n = 45) and varus groups (n = 32) were followed-up for two years and compared. The primary outcome was the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were range of motion (ROM), Knee Society knee score and function score, spatiotemporal gait parameters, dynamic alignment, knee flexion angle, knee adduction moment (KAM) and internal knee extension moment. Results At two years after surgery, the mean difference of WOMAC score was 0.3 (95% CI, [− 3.1, 3.7]) between the two groups. All secondary outcomes, except KAM and dynamic alignment, showed no significant difference between the two groups. Residual varus alignment group showed increased KAM and maximum KAM was 19% higher (P = 0.006). Conclusions Residual varus alignment showed no clinical benefits, and both groups of patients had a functionally identical knee gait biomechanics, except for increased KAM and varus alignment. The authors consider that even in patients with varus alignment, the first principle is still achieving neutral alignment, which is helpful for reducing the KAM. Level of evidence III, retrospective cohort study.

Vertical, horizontal, and cross sutures have not been compared simultaneously in double suture fashion for the repair of radial meniscal tears. This study compared suture strength among these 3 techniques using gap configuration analysis. Biomechanical testing was performed on 60 matched and paired porcine menisci that were repaired with 2 stitches of vertical, horizontal, and cross sutures. The specimens were cyclically loaded 500 times at 5 to 30 N, and central, peripheral, and total gap distance were measured. After completing cyclic load testing, the specimens were loaded to failure. Double vertical sutures demonstrated significantly lower total and central gap displacement than cross and double horizontal sutures ( P P =.53). Ultimate failure load and stiffness were significantly greater for double vertical sutures (146.3 N) than for cross (113.8 N) and double horizontal sutures (107.2 N) ( P P Orthopedics . 2019; 42(5):e443–e448.]

Stem cells derived from dental tissues—dental stem cells—are flavored due to their easy acquisition. Among them, dental pulp stem cells (DPSCs) extracted from the dental pulp have many advantages such as high proliferation and highly purified population. Although their ability for neurogenic differentiation has been highlighted and neurogenic differentiation using electrospun nanofibers (NFs) has been performed, graphene-incorporated NFs have never been applied for DPSC neurogenic differentiation. Here reduced graphene oxide (RGO)-polycaprolactone (PCL) hybrid electrospun NFs were developed and applied for enhanced neurogenesis of DPSCs. First, RGO-PCL NFs were fabricated by electrospinning with incorporation of RGO and alignments, and their chemical and morphological characteristics were evaluated. Furthermore, in vitro NF properties such as influence on the cellular alignments and cell viability of DPSCs were also analyzed. The influences of NFs on DPSCs neurogenesis was also analyzed. The results confirmed that an appropriate concentration of RGO promoted better DPSC neurogenesis. Furthermore, the use of random NFs facilitated contiguous junctions of differentiated cells, whereas the use of aligned NFs facilitated aligned junction of differentiated cells along the direction of NF alignments. Our findings showed that RGO-PCL NFs can be a useful tool for DPSC neurogenesis, which will help regeneration in neurodegenerative and neurodefective diseases.

Stem cells derived from dental tissues—dental stem cells—are favored due to their easy acquisition. Among them, dental pulp stem cells (DPSCs) extracted from the dental pulp have many advantages, such as high proliferation and a highly purified population. Although their ability for neurogenic differentiation has been highlighted and neurogenic differentiation using electrospun nanofibers (NFs) has been performed, graphene-incorporated NFs have never been applied for DPSC neurogenic differentiation. Here, reduced graphene oxide (RGO)-polycaprolactone (PCL) hybrid electrospun NFs were developed and applied for enhanced neurogenesis of DPSCs. First, RGO-PCL NFs were fabricated by electrospinning with incorporation of RGO and alignments, and their chemical and morphological characteristics were evaluated. Furthermore, in vitro NF properties, such as influence on the cellular alignments and cell viability of DPSCs, were also analyzed. The influences of NFs on DPSCs neurogenesis were also analyzed. The results confirmed that an appropriate concentration of RGO promoted better DPSC neurogenesis. Furthermore, the use of random NFs facilitated contiguous junctions of differentiated cells, whereas the use of aligned NFs facilitated an aligned junction of differentiated cells along the direction of NF alignments. Our findings showed that RGO-PCL NFs can be a useful tool for DPSC neurogenesis, which will help regeneration in neurodegenerative and neurodefective diseases.

This study was to investigate the satisfaction of construction workers and their physical and physiological responses to work-wear in poor workplaces. A survey was conducted on the physical response to the worker’s satisfaction with the construction worker’s current construction safety clothing and the sense of warmth during work. The results are as follows. First, the workers felt that the body reaction during work, feels more heat above the bottom, and that the construction safety suits worn are easily torn or punctured with arms, elbows, etc. From the above results, we propose that ergonomic study of construction safety apparel considering the work posture and the risk of musculoskeletal disease is required for the construction safety work-wear to prevent the risk of workers in the construction site.

Purpose To (1) determine the length of the osteotomy at the anterior and posterior cortex, (2) compare between uni- and biplanar osteotomy, and (3) evaluate the relationship between the extent of the osteotomy and change of the posterior tibial slope. Methods A prospective comparative study of 24 uniplanar and 30 biplanar osteotomies was performed. To evaluate the length of osteotomy, osteotomy lines of the anterior and posterior cortex were analyzed in the 3-dimensional surface models. For slope measurement, the intramedullary axis of the proximal tibia (slope P), posterior cortical line of the proximal tibia (slope C), and anterior cortical line of the proximal fibula (slope F) were used. An analysis of the changes in the posterior tibial slope was performed independently using a pre- and postoperative lateral plane radiograph. Results In the uniplanar osteotomy, ratios of the osteotomized length to the total cortical length aligned with the osteotomized plane were larger in the anterior cortex (0.91 in uniplanar v 0.46 in biplanar; P = 0) and posterior cortex (0.97 in uniplanar v 0.79 ratio in biplanar; P = 0). Furthermore, the posterior tibial slope was maintained in both groups and the ratios between the anterior and posterior gap in both groups were 0.57 and 0.63, respectively. The maintenance of the slope was not related to any specific variables. Additionally, these phenomena did not differ between those patients who underwent uni- and those who underwent biplanar osteotomy. Conclusions Increase in the posterior tibial slope was prevented with appropriate uni- or biplanar osteotomy with a simple distraction at the most posterior gap. However, in the uniplanar osteotomy, the ratio of the osteotomized length to the total cortical length was larger in both the anterior and posterior cortex. Level of Evidence Level III, case-control study.

Open-wedge high tibial osteotomy for medial unicompartmental arthritis of the knee joint is a successful treatment option but is associated with potential intraoperative complications such as tibial plateau fracture, dislocation of the osteotomy hinge, under- or over-correction of the posterior slope, and neurovascular injury. Therefore we devised a protective cutting system and describe our method for the prevention of these complications. The potential advantages of this system are protection of the posterior neurovascular structures using a curved protector, bone cutting along the natural tibial slope using a superior surface aligning with the natural tibial slope, and complete 1-plane sawing of the posterior wall before the lateral hinge.

Our aim was to develop a novel method for characterizing common skull deformities with high sensitivity and specificity, based on two-dimensional (2D) shape descriptors in computed tomography (CT) images.Between 2003 and 2014, 44 normal subjects and 39 infants with craniosynostosis (sagittal, 29; bicoronal, 10) enrolled for analysis. Mean age overall was 16 months (range, 1-120 months), with a male:female ratio of 56:29. Two reference planes, sagittal (S-plane: through top of lateral ventricle) and coronal (C-plane: at maximum dimension of fourth ventricle), were utilized to formulate three 2D shape descriptors (cranial index [CI], cranial radius index [CR], and cranial extreme spot index [CES]), which were then applied to S- and C-plane target images of both groups.In infants with sagittal craniosynostosis, CI in S-plane (S-CI) usually was1.0 (mean, 0.78; range, 0.67-0.95), with CR consistently at 3 and a characteristic CES pattern of two discrete hot spots oriented diagonally. In the bicoronal craniosynostosis subset, CI was1.0 (mean 1.11; range, 1.04-1.25), with CR at -3 and a CES pattern of four discrete diagonally oriented hot spots. Scatter plots underscored the highly intuitive joint performance of CI and CES in distinguishing normal and deformed states. Altogether, these novel 2D shape descriptors enabled effective discrimination of sagittal and bicoronal skull deformities.Newly developed 2D shape descriptors for cranial CT imaging enabled recognition of common skull deformities with statistical significance, perhaps providing impetus for automated CT-based diagnosis of craniosynostosis.

Background Various techniques for lengthening short columellae have been used for bilateral cleft nose repair. However, previous methods have not yielded satisfactory results. We performed a full-thickness skin graft to lengthen short columellae during secondary cleft nose repair in adult patients. Methods Ten bilateral cleft lip and nose patients underwent secondary cheiloplasty with open rhinoplasty between July 2008 and August 2014. The patients underwent a full-thickness skin graft on the medial crura to elongate the columella. The average age of the patients at the time of surgery was 22.2 years. Nasal profiles were evaluated before and after the operation using the photogrammetric method. Results The nasal profiles were improved in all patients, and all skin grafts were well taken, with the exception of one patient. Columellar height, nostril height, and columella-lip angle increased, and nasal width decreased significantly. The ratios of columellar height to nasal height, columellar height to nasal width, and nasal height to nasal width increased to a statistically significant extent. Conclusions Columella lengthening with a full-thickness skin graft is a simple and effective method for the repair of severely short columellae in bilateral cleft nose patients. We had satisfactory outcomes, with good color matching and aesthetically pleasing contours.

Objectives: This study aimed to investigate the dynamic upper airway changes occurring in an obstructive sleep apnea (OSA) rabbit model using dynamic computerized tomography (CT). Methods: In this study, 2.5 U of botulinum toxin type A was injected into the genioglossus to paralyze the tongue in the OSA group (n = 7). The control group was injected with normal saline (n = 7). Apnea-hypopnea index was measured using ApneaLink at baseline and at 1, 2, 3, 4, 6, and 8 weeks post-injection. Anterior to posterior (AP) and transverse diameters at the levels of the palate and tongue base were measured using a dynamic CT at baseline and at 1 and 2 weeks post-injection. Results: The success rate of OSA induction was higher in the OSA group ( P = .02). In the OSA group, transverse and AP diameters at the palate level and AP diameter at the tongue base level significantly decreased 2 weeks post-injection ( P = .01). Conclusions: A single obstruction site may constitute the primary pathogenesis in some OSA patients, even when the involvement of multiple sites is indicated. These findings may contribute to the identification of OSA pathogenesis and improve the planning of treatment based on the primary cause of OSA.

This paper examines the martingale restriction for the KOSPI 200 index options market. And in cases of the rejections, we investigate the relative market efficiency between stock index and stock index options market, using approximate entropy (ApEn) method proposed by Pincus (1994), which quantifies a complexity, irregularity and unpredictability in time series. The empirical results of this study clearly reject the martingale restriction and regression analyses indicate that the historical returns of underlying index can explain about 25% of the price differences between option-implied and market index prices but the total trading volume can explain only a small portion of the price differences. These results have cast doubt on the informational efficiency of this market. Comparing the relative market efficiency based on ApEn have showed that the complexity or irregularity of KOSPI 200 index is larger than the index options during the entire sample period. But, Examining separately ApEn of the magnitude and the sign time series which compose log-returns document that stock index options market reflect more efficiently the information about the direction of price changes than the stock index market in 2014 and the efficiency of the index options market about the directional information may be affected by directional traders who prefer certain strategies designed by exploiting past stock market movements.

Artificial composite tibiae have been widely used for mechanical evaluations of total knee arthoplasty (TKA) because of their low variability and wide availability. However, little information is available about whether artificial defects created during production significantly change the distribution of stress and micromotion within composite tibiae during a mechanical evaluation for TKA. The purpose of this study was to determine the effects of artificial defects on alterations in stress distribution and micromotion in composite tibiae during a mechanical evaluation for TKA using finite element (FE) analysis. The results showed that von Mises stresses near the artificial defect were approximately 1.6-fold higher than those on the same regions of composite tibiae without artificial defects. However, the difference in von Mises stresses decreased gradually beginning 3 mm from the center of the artificial defect. Micromotion in composite tibiae with artificial defects was similar to that of tibiae without artificial defects. These findings suggest that stress/strain on the cortical bone surface should be measured at least 3 mm from artificial defect centers but that micromotion is not affected by the artificial defects during a mechanical evaluation for TKA using composite tibiae.

Background Recently, various endoscopic thyroidectomy techniques have been introduced for cosmetic purposes. However, few reports have compared the quality of life (QOL) between post–endoscopic thyroidectomy and post–conventional open thyroidectomy. In this study, we investigated whether endoscopic thyroidectomy was comparable to conventional open thyroidectomy with respect to QOL. Methods Between January 2010 and September 2011, 75 patients underwent endoscopic thyroid lobectomy and 233 patients underwent conventional open thyroid lobectomy. The QOL was assessed preoperatively and at 1, 3, and 6 months postoperatively by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-question (EORTC-QLQ-C30) instruments. Results Both groups showed similar changes over time in most of the QOL scales. However, patients who underwent endoscopic thyroidectomy showed significantly greater improvement in emotional function at 1 month (p = .039) and physical function at 3 months (p = .032). However, the pain increased more in the patients who underwent endoscopic thyroidectomy at 1 month (p = .042). Conclusion Current findings suggest that endoscopic thyroidectomy may offer more rapid recovery of emotional and physical function than open thyroidectomy. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

As the incidence of thyroid cancer has increased, hypocalcemia, a common complication of thyroid surgery, has become a serious problem. However, no definite predictor of postoperative hypocalcemia is known. In this study, our purpose was to investigate the potential role of vitamin D as a predictor of postoperative hypocalcemia. A prospective observational study was performed on patients who underwent total thyroidectomy for thyroid cancer performed by a single experienced surgeon between October 2013 and September 2014. Their serum 25-OH vitamin D levels were measured preoperatively. On the day after surgery, serum calcium and intact parathyroid hormone levels were measured, and symptoms of hypocalcemia were recorded. Of the 134 patients, laboratory and symptomatic hypocalcemia developed in 52 patients (39 %) and 25 patients (19 %), on the day after surgery. The preoperative vitamin D level was 16.5 ± 9.2 ng/mL, and this value did not differ according to laboratory or symptomatic hypocalcemia (p = 0.94). The incidence of laboratory or symptomatic hypocalcemia did not differ according to vitamin D deficiency. Only incidental parathyroidectomy was associated with symptomatic hypocalcemia (p = 0.03). Vitamin D level is not a predictor of hypocalcemia after total thyroidectomy for thyroid cancer. Thus, routine preoperative screening for vitamin D is not recommended.

The Rubus genus consists of more than 600 species that are distributed globally. Only a few Rubus species, including raspberries and blueberries, have been domesticated. Genetic diversity within and between Rubus species is an important resource for breeding programs. We developed genomic microsatellite markers using an SSR-enriched R. coreanus library to study the diversity of the Rubus species. Microsatellite motifs were discovered in 546 of 646 unique clones, and a dinucleotide repeat was the most frequent (75.3%) type of repeat. From 97 microsatellite loci with reproducible amplicons, we acquired 29 polymorphic microsatellite markers in the Rubus coreanus collection. The transferability values ranged from 59.8% to 84% across six Rubus species, and Rubus parvifolius had the highest transferability value (84%). The average number of alleles and the polymorphism information content were 5.7 and 0.541, respectively, in the R. coreanus collection. The diversity index of R. coreanus was similar to the values reported for other Rubus species. A phylogenetic dendrogram based on SSR profiles revealed that seven Rubus species could be allocated to three groups, and that R. coreanus was genetically close to Rubus crataegifolius (mountain berry). These new microsatellite markers might prove useful in studies of the genetic diversity, population structure, and evolutionary relationships among Rubus species.

수생식물 샘플은 낙동강과 금호강이 만나는 달성습지에서 자라풀을 채집하였다. 자라풀의 뿌리에서 내생균류를 분리하고 형태가 다른 균주를 관찰하여 최종적으로 16개 균주를 선발하였다. 내생균류의 배양여과액은 식물생장촉진활성 검정을 위하여 난장이벼에 처리하여 스크리닝하였으며, HD1008 균주가 식물생장촉진활성이 가장 높은 것으로 확인되었다. HD1008 균주의 배양여과액을 HPLC와 GC/MS-SIM을 이용하여 분석하였고, HD1008 균주가 식물호르몬인 지베렐린 $GA_1$ (1.2 ng/100 mL)과 $GA_4$ (5 ng/100 mL) 를 생산하는 것을 정량분석을 통하여 확인하였다. 또한, HD1008균주의 beta-tubulin 유전자 염기서열을 이용하여 동정에 이용하였으며, 분자적인 방법과 형태적인 방법으로 관찰하였을 때, 지베렐린을 생산하는 새로운 P. trzebinskii로 동정되었다. 【Aquatic plant Hydrocharis dubia (Blume) Backer was collected from the Dalsung wetland in Daegu. Sixteen endophytic fungi with different colony morphologies were isolated from the roots of aquatic plants. Waito-c rice (WR) seedlings were treated with fungal culture filtrates (FCF) for screening plant growth-promoting activity. In the results, HD1008 strain isolated from aquatic plant showed highest plant growth-promoting activity. The FCF of HD1008 strain was analyzed using gas chromatography mass spectrometry (GC/MS) with selected ion monitoring (SIM). Analysis of the FCF of HD1008 strain found that it contained gibberellins (GA) ( $GA_1$ , 1.2 ng/100 mL; $GA_4$ , 5 ng/100 mL). Phylogenetic tree of HD1008 strain was constructed by partial internal transcribed spacer (ITS) region and partial beta-tubulin gene sequences. Therefore, we describe HD1008 strain as a new gibberellin-producing Penicillium trzebinskii based on morphological and molecular characteristics.】

Endophytic fungal strains were isolated from 5 aquatic plant species (Trapa japonica, Miscanthus sacchariflorus, Oenanthe javanica, Typha orientalis and Zizania latifolia) native to river wetland of tributary in Nakdong river. Total 34 strains were purely isolated, and then its internal transcribed spacer (ITS) regions were amplified. After that, phylogenetic analysis based on ITS sequences and deduction of diversity indices were done. Fungal isolates were belonged to 17 genera, concretely in Acremonium, Alternaria, Aspergillus, Cladosporium, Emericellopsis, Fusarium, Galactomyces, Leptosphaeria, Microsphaeropsis, Penicillium, Peyronellaea, Phoma, Pseudeurotium, Rhizomucor, Talaromyces, Trematosphaeria and Zalerion. Especially, fungal isolates were distributed intensively in genera Alternaria and Talaromyces. This study deals with the diversity of endophytic fungal species that showing symbiotic relationship with their host aquatic plants.

Eighteen endophytic fungi with different colony morphologies were isolated from the roots of Nymphoides peltata growing in the Dalsung wetland. The fungal culture filtrates of the endophytic fungi were treated to Waito-c rice seedling to evaluate their plant growth-promoting activities. Culture filtrate of Y2H0002 fungal strain promoted the growth of the Waito-c rice seedlings. This strain was identified on the basis of sequences of the partial internal transcribed spacer region and the partial beta-tubulin gene. Upon chromatographic analysis of the culture filtrate of Y2H0002 strain, the gibberellins (GAs: GA1, GA3, and GA4) were detected and quantified. Molecular and morphological studies identified the Y2H0002 strain as belonging to Aspergillus clavatus. These results indicated that A. clavatus improves the growth of plants and produces various GAs, and may participate in the growth of plants under diverse environmental conditions.

Low power light (LPL) treatment has been widely used in various clinical trials, which has been known to reduce pain and inflammation and to promote wound healing. LPL was also shown to enhance differentiation of stem cells into specific lineages. However, most studies have used high power light in mW order, and there was lack of studies about the effects of very low power light in μW. In this study, we applied 810 nm LPL of 128 μW/cm2 energy density in vitro. Upon this value, continuous wave (CW) irradiation did not induce any significant changes for differentiation of human dental pulp stem cells (hDPSCs). However, the membrane hyperpolarization, alkaline phosphatase activity, and intracellular oxidative stress were largely enhanced in the pulsed wave (PW) with 30% of duty cycle and 300–3000 Hz frequencies-LPL in which LED driver work in the form of square wave. After 21 days of daily LPL treatment, Western blot revealed the dentinogenesis in this condition in vitro. This study demonstrates that the very low power light at 810 nm enhanced significant differentiation of hDPSCs in the PW mode and there were duty cycle dependency as well as pulsing frequency dependency in the efficiency.

Introduction. Several ongoing studies aim to improve the survival rate following total knee arthroplasty (TKA), which is an effective orthopedic surgical approach for patients with severely painful knee joint diseases. Among the studied strategies, baseplate rotational arrangement techniques for TKA components have been suggested but have been the subject of only simple reliability evaluations. Therefore, this study sought to evaluate comparatively three different baseplate rotational arrangement techniques that are commonly used in a clinical context. Materials and Methods. Three-dimensional (3D) finite element (FE) models of the proximal tibia with TKA were developed and analyzed considering three baseplate rotational arrangement techniques (anterior cortex line, tibial tuberosity one-third line, and tibial tuberosity end line) for six activities of daily life (ADLs) among patients undergoing TKA. Mechanical tests based on the ASTM F1800 standard to validate the FE models were then performed using a universal testing machine. To evaluate differences in biomechanical characteristics according to baseplate rotational arrangement technique, the strain and peak von Mises stresses (PVMSs) were assessed. Results. The accuracy of the FE models used in this study was high (94.7 ± 5.6%). For the tibial tuberosity one-third line rotational arrangement technique, strains ≤ 50 µstrain (the critical bone damage strain, which may affect bone remodeling) accounted for approximately 2.2%–11.3% and PVMSs within the bone cement ranged from 19.4 to 29.2 MPa, in ADLs with high loading conditions. For the tibial tuberosity end line rotational arrangement, strains ≤ 50 µstrain accounted for approximately 2.3%–13.3% and PVMSs within the bone cement ranged from 13.5 to 26.7 MPa. For anterior cortex line rotational arrangement techniques, strains ≤50 µstrain accounted for approximately 10.6%–16.6% and PVMSs within the bone cement ranged from 11.6 to 21.7 MPa. Conclusion. The results show that the most recently developed frontal cortex line rotational alignment technique is the same or better than the other two rotational alignment techniques in terms of biomechanics. This finding can be, however, dependent on the contact characteristics between the baseplate and the proximal tibia. That is, it is indicated that the optimum baseplate rotational arrangement technique in terms of reducing the incidence of TKA mechanical failure can be achieved by adjusting the characteristics of contact between the baseplate and the proximal tibia.

Damage to the eardrum causes acute pain and can lead to chronic otitis media if it develops into chronic tympanic membrane (TM) perforations. Chronic TM perforations are usually treated with surgical methods such as tympanoplasty and myringoplasty. However, these surgeries are not only complicated and difficult but also cost a lot of money. Our research team developed chitosan patches (E-CPs) that release epidermal growth factor (EGF) as a patch therapy to replace surgical methods. However, there was a limitation in the healing ratio of the treatment compared to the surgical methods. In this study, we developed EGF and epidermal growth factor receptor (EGFR) gene-releasing polyethyleneimine (PEI)/chitosan patches (EErP-CPs) to increase the regeneration of TM perforations. The addition of PEI increased the adhesion and migration ability of TM cells on the patches. The simultaneous release of the EGF and the EGFR gene further enhanced TM cell proliferation, adhesion and migratory ability. It was confirmed that the EGF protein and EGFR gene were released for 30 days; however, EGF was released and increased TM cell viability almost immediately after treatment and EGFR took a minimum of 3 days before showing its effect on improved cell viability. It was also shown that EErP-CPs are more hydrophilic and have more positive charge than E-CP because of added amine groups from PEI. In conclusion, the developed EErP-CPs resulted in the improved healing of TM perforations and can potentially be applied to the regeneration of both chronic and acute tympanic membrane perforations.

Background and Purpose. Debate exists on whether septic revision total knee arthroplasty (TKA) results in inferior clinical outcomes, and limited information is available regarding the factors associated with such outcomes. This study aimed to (1) compare clinical outcomes and characteristics of aseptic versus septic revision TKA and (2) identify the risk factors associated with inferior clinical outcomes. Methods. We retrospectively reviewed 144 revision TKAs (90 aseptic and 54 septic revisions) that were followed for a minimum of 3 years (mean = 7 years). Clinical outcome data, namely, Knee Society knee and function scores and the Hospital for Special Surgery knee score, were collected. We reviewed 13 pre- and intraoperative variables. Results. Postoperative clinical outcomes were inferior in septic revision surgeries (p p Interpretation. Clinical outcomes of septic revision were inferior to those of aseptic revision. However, poor outcomes were mainly associated with large bone defects and an increased number of surgeries. The outcomes of aseptic and septic revision surgery were similar when patients with larger bone defects and more than three surgeries were excluded.

There remains no consensus as to whether mobile total knee arthroplasty (TKA) should use a posterior cruciate ligament-sacrificing ultracongruent (UC) or a posterior cruciate ligament-substituting posterior stabilized (PS) prosthesis. The purpose of this study was to assess intraoperative kinematics and clinical outcomes of UC and PS rotating platform mobile-bearing TKA.In this randomized controlled study, mobile UC TKA prostheses (n = 45) were compared with mobile PS TKA prostheses (n = 45) with regard to intraoperative kinematics and clinical outcomes. The passive kinematic study using intraoperative navigation system included anterior/posterior translation, varus/valgus alignment and rotation of femur during flexion. The patients were clinically and radiographically evaluated over a 3-year follow-up.Paradoxical anterior translation of the femur was 10.8 ± 5.2 mm in the UC knee from 0° to 82° of knee flexion and 8.7 ± 3.0 mm in the PS knee from 0° to 70° of knee flexion (p = 0.027). Paradoxical internal rotation of the femur was 5.8° in the UC knees and 9.9° in the PS knees (p = 0.003). But, there was no significant difference between the groups in regard to the coronal alignment. There was no significant difference in the range of motion, KS knee scores, KS function scores, and WOMAC index scores.Despite different intraoperative kinematics between mobile UC and mobile PS TKA, neither design reproduced physiologic knee kinematics and there was no difference in clinical outcomes between the two groups. The clinical relevance of the study is that despite different intraoperative kinematics, UC design can be a considerable alternative to PS design in mobile-bearing TKA in respect of clinical outcomes.II.

Background The goals of this study were (1) to document the gait pattern of patients with unilateral knee osteoarthritis (OA), (2) to determine the knee adduction moment (KAM) changes in the non-operated knee, and (3) to identify the predictors of change in KAM in the non-operated knee. Methods The study recruited 23 patients with advanced unilateral knee OA. The preoperative Kellgren–Lawrence (KL) grade of the non-operated knee was one or two; non-operated knee pain, rated using a numeric rating scale (NRS), was less than three out of 10 points. We used a commercial gait analysis system to evaluate kinetics and kinematics. Radiological and gait measurements at the two-year follow-up were compared with baseline data. Results The preoperative asymmetrical gait cycle characterized by elongation of the stance phase of the non-operated knee became symmetrical after TKA. The average KAM of the non-operated knee increased (P = 0.010) and it was best predicted by the baseline mechanical axis of the non-operated knee. If the baseline mechanical axis was varus four degrees or above (varus group), the average KAM increased by 0.64 (% body weight × height, P = 0.015), while for varus less than four degrees (non-varus group), KAM was unchanged. The KL grade was increased in the varus group (P = 0.020) but it was unchanged in the non-varus group. Average pain NRS score was also higher (P = 0.044) in the varus group. Conclusions Close follow-up is necessary for patients with a baseline varus deformity of the non-operated knee because of the higher possibility of developing pain, subsequent arthritis and increased joint loading of the non-operated knee. Level of evidence III, retrospective cohort study.

Background Although two-stage exchange arthroplasty is considered a treatment of choice for chronic features of fungal PJI (periprosthetic joint infection), there is no consensus for local use of antifungal agent. The purpose of this study was to evaluate the efficacy of antifungal-impregnated cement spacer (AICS). Methods Nine patients who were diagnosed and treated for chronic fungal PJI after TKA in a single center from January 2001 to December 2016 were enrolled. Two-stage exchange arthroplasty was performed. During the 1st stage resection arthroplasty, AICS was inserted for all patients. Systemic antifungal medication was used during the interval between the two stage operations. Results The average duration from the initial symptom to fungal PJI diagnosis was 20 months (range, five to 72 months). Average erythrocyte sedimentation rate and C-reactive protein level at diagnosis were 56 mm/h (range, 30 to 89 mm/h) and 2.25 mg/dl (range, 0.11 to 3.97 mg/dl), respectively. Fungal PJI was confirmed by open debridement tissue culture in three cases (33%). The average number of operations before final exchange arthroplasty was 2.7 times (range, one to five times). Average duration of antifungal agent use confirmed by sensitivity test was seven months (range, four to 15 months). Mean interval between the two stage operations was six months (range, 1.5 to 15 months). After two-stage exchange arthroplasty, no patient had recurrent fungal infection during a mean follow-up of 66 months (range, 24 to 144 months). Conclusion Two-stage exchange arthroplasty with AICS is a very effective strategy with excellent outcomes. Level of evidence Case series, IV.

Summary Background Esthetic reduction malarplasty is popular in East Asia, where a small and balanced facial profile is considered a desirable characteristic. Various surgical techniques have been applied; however, several complications can impact the bony structure and final esthetic appearance. We examined the outcomes of revision malarplasty with regard to strategic assessments to achieve facial balance and skeletal stability. Methods This retrospective study reviewed 97 patients who underwent revision malarplasty between December 2014 and November 2016. We analyzed the indications of revision and categorized the patients into three surgical groups. Dual bone flap procedures utilizing new osteotomies were performed to achieve a natural malar contour in certain cases. In addition, zygomatic arches were fixed in a lifted position to revise both bony dehiscence and soft tissue drooping. Postoperative results were assessed using medical records, photographs, and facial bone computerized tomography images. Results The major reason for revision malarplasty was undercorrection that required additional repositioning. The zygomatic body and arch with a bony gap (5–7 mm) necessitated additional osteotomy and repositioning to achieve zygomatic continuity and natural curvature. Significant bony defects and segmental resorption were addressed with reconstructive bone grafts. Conclusion The causes of complications after malarplasty should be cautiously evaluated before revision procedures. We categorized patients on the basis of strategic analysis considering reposition vector and the necessity of additional osteotomy. Unstable zygomatic segments were revised to obtain structural stability, and the zygomatic arch lifting technique using an intraoral approach can be used to achieve promising and predictable outcomes in revision malarplasty.

Background The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). Methods This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. Results After 6 weeks, the polmacoxib-placebo treatment difference was -2.5 (95% confidence interval [CI], -4.4 to -0.6; p = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, -0.9 to 2.2; p = 0.425). According to Physician's Global Assessments, more subjects were "much improved" at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. Conclusions Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.

Background Rotational alignment of the tibial component is important for long-term success of total knee arthroplasty (TKA). This study aimed to compare five axes in normal and osteoarthritic (OA) knees to determine a reliable landmark for tibial rotational alignment in TKA. Methods One hundred twenty patients with OA knees and 40 with normal knees were included. The angle between a line perpendicular to the surgical transepicondylar axis and each of five axes were measured on preoperative computed tomography. The five axes were as follows: a line from the center of the posterior cruciate ligament (PCL) to the medial border of the patellar tendon (PCL-PT), medial border of the tibial tuberosity (PCL-TT1), medial one-third of the tibial tuberosity (PCL-TT2), and apex of the tibial tuberosity (PCL-TT3), as well as the anteroposterior axis of the tibial prosthesis along the anterior tibial curved cortex (ATCC). Results For all five axes tested, the mean angles were smaller in OA knees than in normal knees. In normal knees, the angle of the ATCC axis had the smallest mean value and narrowest range (1.6° ± 2.8°; range, −1.7°–7.7°). In OA knees, the mean angle of the ATCC axis (0.8° ± 2.7°; range, −7.9°–9.2°) was larger than that of the PCL-TT1 axis (0.3° ± 5.5°; range, −19.7°–10.6°) (P = 0.461), while the angle of the ATCC axis had the smallest SD and narrowest range. Conclusion The ATCC was found to be the most reliable and useful anatomical landmark for tibial rotational alignment in TKA.

Background Femoral component rotation (FCR) is one of the most important factors in total knee arthroplasty. In this prospective study, we used three different techniques for FCR and analyzed their accuracy with postoperative axial computed tomography (CT) images. We also evaluated effect of FCR to clinical outcome. Methods One hundred sixty-five patients were randomly allocated into three groups. In the measured resection group, FCR was set by externally rotating the axis 3° off the posterior femoral condylar axis. In the tensor group, a gap-tensioning device set at 20 lbf was used. In the block group, spacer blocks of various thicknesses were used. The FCR angle (FCRa) was measured on postoperative axial CT as an angle between the clinical transepicondylar and posterior condylar axes of the femoral component. Outliers were defined as FCRas deviated more than 3° either internally or externally. Postoperative 2 year clinical scores and knee range of motion were checked. Results The tensor group had significantly better positioning of the femoral component to the neutral position compared with the measured resection group and the block group (mean FCRa: internal rotation 1.79, 0.43 and 2.63°, respectively, p

The purpose of the study was to evaluate the influence of synovial coverage of the remnant on clinical outcomes and graft healing in anterior cruciate ligament (ACL) reconstruction. Seventy-five patients who underwent second-look arthroscopy after a single-bundle ACL reconstruction using autologous quadriceps tendon graft were included. The patients were divided into two groups according to whether the remnant was preserved (group P, n = 42) or sacrificed (group S, n = 33). Group P was further classified according to the degree of synovial coverage of the remnant on initial arthroscopic findings: group A (remnant fully covered with synovium, n = 15), group B (synovial coverage >50%, n = 15), and group C (coverage

Background The purpose of this study was to determine the effects of different cementing techniques on the rate of early femoral loosening of high-flexion total knee arthroplasties (TKAs). Methods A total of 734 knees from 486 patients treated with high-flexion design TKA between July 2001 and July 2010 were divided into two groups based on the cementing technique used. For 403 knees (group N), cement was applied onto the distal and anterior cut surfaces of the femur and the posterior flanges of the femoral component without pressurization. For 331 knees (group P), cement was applied onto distal and anterior femoral cut surfaces with digital pressurization and whole cement surfaces of the femoral component. Two groups were subjected to clinical and radiological evaluation with a minimum five year follow-up period. Cox proportional hazards model with revision surgery of the prosthesis or radiological loosening as an endpoint was used to evaluate the effect of the cementing technique and other covariates. Results The pressurizing and bi-surface cementing technique resulted in significant reduction in femoral radiological loosening incidence compared to that without pressurization (0.3% vs. 2.5%, P = 0.015) and revision rate for aseptic causes (0.9% vs. 3.2%, P = 0.032). Cox proportional hazard regression analysis revealed a significant difference in component survival rate between the two groups if femoral radiological loosening was considered as failure (hazard ratio, 4.229, 95% confidence interval (CI): 1.256–14.243, P = 0.020). Conclusion Pressurizing and bi-surface cementation can reduce the occurrence rate of early loosening around the femoral component in high-flexion TKAs.

The aim of this study was to investigate gait speed changes 2 years after bilateral total knee arthroplasty (TKA) and identify kinetic and kinematic factors associated with such changes by comparing patients with age- and sex-matched controls. The study group included 34 female patients with end-stage knee osteoarthritis (OA) who underwent bilateral TKA and 42 age- and sex-matched controls without knee pain or OA. Standard TKA was performed on all arthritic patients with placement of posterior stabilized fixed-bearing implants. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Gait speed, kinetic and kinematic changes and determinants of speed were assessed via principal component analysis and multiple regression analysis. The average gait speed of an arthritic patient was 90.2 ± 18.4 cm/s and improved to 96.0 ± 12.3 cm/s after TKA (p = 0.032). However, the speed remained slower than that of controls (111.2 ± 8.2 cm/s, p