We present the operative technique and clinical results of concomitant reconstruction of the medial collateral ligament (MCL) and the posterior oblique ligament for medial instability of the knee using autogenous semitendinosus tendon with preservation of the tibial attachment. The semitendinosus tendon graft between the screw on the medial epicondyle and the tibial attachment of the graft was overlapped by the MCL, while the graft between the screw and the insertion of the direct head of the semimembranosus tendon was overlapped by the central arm of the posterior oblique ligament. Assessment was by stress radiograph and the Lysholm knee scoring scale. After a mean follow-up of 52.6 months (25 to 92), the medial joint opening of the knee was within 2 mm in 22 of 24 patients. The mean Lysholm score was 91.9 (80 to 100). Concomitant reconstruction of the MCL and posterior oblique ligament using autogenous semitendinosus tendon provides a good solution to medial instability.

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clinicaltrials.gov, NCT01004497.

ObjectiveThe purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012.MethodsWe evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients.ResultsThe patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19−39 years, with a gradual increase in patients aged ≥ 40 years. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth.ConclusionsThe most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.

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Hepatitis C virus (HCV) infection is a serious threat to human health worldwide. In spite of the continued search for specific and effective anti-HCV therapies, the rapid emergence of drug-resistance variants has been hampering the development of anti-HCV drugs designed to target viral enzymes. Targeting host factors has therefore emerged as an alternative strategy offering the potential to circumvent the ever-present complication of drug resistance. We previously identified protein kinase C-related kinase 2 (PRK2) as a cellular kinase that phosphorylates the HCV RNA-dependent RNA polymerase (RdRp). Here, we report the anti-HCV activity of HA1077, also known as fasudil, and Y27632, which blocks HCV RdRp phosphorylation by suppressing PRK2 activation. Treatment of a Huh7 cell line, stably expressing a genotype 1b HCV subgenomic replicon RNA, with 20 microm each of HA1077 and Y27632 reduced the HCV RNA level by 55% and 30%, respectively. A combination of the inhibitors with 100 IU/mL interferon alpha (IFN-alpha) significantly potentiated the anti-HCV drug activities resulting in approximately a 2-log(10) viral RNA reduction. We also found that IFN-alpha does not activate PRK2 as well as its upstream kinase PDK1 in HCV-replicating cells. Furthermore, treatment of HCV-infected cells with 20 microm each of HA1077 and Y27632 reduced the levels of intracellular viral RNA by 70% and 92%, respectively. Taken together, the results identify PRK2 inhibitors as potential antiviral drugs that act by suppressing HCV replication via inhibition of viral RNA polymerase phosphorylation.

We undertook a retrospective review of 24 arthroscopic procedures in patients with symptomatic ossicles around the malleoli of the ankle. Most of the patients had a history of injury and localised tenderness in the area coinciding with the radiological findings. Contrast-enhanced three-dimensional fast-spoiled gradient-echo MRI was performed and the results compared with the arthroscopic findings. An enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 20 patients (83%). The arthroscopic findings correlated well with those of our MRI technique and the sensitivity was estimated to be 91%. At a mean follow-up of 30.5 months (20 to 86) the mean American Orthopaedic Foot and Ankle Society score improved from 74.5 to 93 points (p < 0.001). Overall, the rate of patient satisfaction was 88%. Our results indicate that symptomatic ossicles of the malleoli respond well to arthroscopic treatment.

ObjectiveThe purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews.MethodsA standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales.ResultsA single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch.ConclusionsDisplacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable.