Is the popliteus tendon always inserted antero-inferiorly 18.5 mm from the lateral collateral ligament of the femur? Magnetic resonance imaging and cadaveric evaluations

BackgroundThe aim of this study was to analyze the locations of the femoral attachments of the popliteus tendon (PT) and lateral collateral ligament (LCL) via magnetic resonance imaging (MRI) and cadaveric dissection in a Korean population and compare with literature standards to determine whether variability exists.MethodsWe retrospectively analyzed knee MRIs from 87 cases selected from January 2017 to December 2018. The relationship between the femoral attachment of PT and LCL was analyzed by MRI using PACS and Image J. In addition, the femoral attachments of each structure were identified and marked in 14 unpaired human cadaveric knees. Three-dimensional models were reconstructed, and the surface area, location and distances were analyzed.ResultsOn MRI, the femoral attachment of PT was located at mean distances of 0.89 mm posterior and 9.35 mm inferior to the LCL femoral attachment. We identified three groups of PT locations relative to the LCL on MRI evaluation: parallel (63%), posterior (29%), and anterior (8%). On cadaveric evaluation, the femoral attachment of the PT was located at mean distances of 0.77 mm posterior and 8.90 mm inferior to the LCL femoral attachment. We also identified three groups of PT locations relative to the LCL on cadaveric evaluation: parallel (43%), posterior (36%), and anterior (21%).ConclusionsBased on both MRI and cadaveric evaluations in a Korean population, the femoral attachment of the PT is located just distal to and posterior to the LCL. The differences between the centroids of the femoral attachments of the two structures was approximately 9.7 mm, suggesting that racially based anatomical differences of the posterolateral corner may exist.     

Long-term efficacy and safety of anti-hyperglycaemic agents in new-onset diabetes after transplant: Results from outpatient-based 1-year follow-up and a brief review of treatment options

Background and aimsEvaluation of long-term efficacy and safety of various anti-hyperglycaemic agents (AHA) for glycaemic control in NODAT, in stable kidney transplant recipients (KTRs) during 1-year outpatient follow-up.MethodsWe collected FPG, PPG, HbA1c, serum creatinine, eGFR, blood tacrolimus level, hypoglycaemia and body weight values from an existing database of KTRs diagnosed to have NODAT. Those newly initiated on AHA over 3 months post-transplant; received standard triple immunosuppressive therapy; and followed up for 1-year after referral, were included.ResultsIn ninety-five patients’ (Male = 65), mean decrease at 1-year from baseline in FPG (185.01 ± 62.11 mg/dL), PPG (293.21 ± 85.23 mg/dL) and HbA1c (8.48 ± 1.08%) was 67.09, 126.11 and 1.4 respectively (p < 0.0001). At 1-year, mean HbA1c was 7.08 ± 0.38%, ninety-one patients achieving HbA1c ≤ 7.5%. Fifty-two patients received oral combination therapy based on linagliptin/metformin/repaglinide/gliclazide, 19 received insulin-based regimen, and 24 received linagliptin monotharapey. Thirty patients reported hypoglycaemia (10 with gliclazide and 15 with insulin) and fifty patients gained body-weight at 1-year. Mean serum creatinine and eGFR significantly improved by 0.29 and 15.77 from baseline of 1.56 ± 0.62 mg/dL and 53.95 ± 16.10 mL/min/1.73 m² respectively.ConclusionsSignificant proportion of NODAT patients achieved long-term glycemic control with improved renal function. Combination therapy was needed in most within 1-year. Linagliptin monotherapy was effective, without producing hypoglycaemia or weight gain.     

Rotura del tendón de Aquiles asociada al uso de fluoroquinolonas en pacientes mayores de 60 años: experiencia de un centro de tercer nivel

BackgroundFluoroquinolones have been associated with increased risk of tendinopathy and Achilles tendon rupture (ATR), especially in patients over 60 years of age.MethodsA retrospective study was carried out including patients over 60 years of age with ATR attended in our centre over the period 2000-2017.ResultsWe identified 44 patients with RTA, of whom 18% (8/44) had been previously treated with fluoroquinolones, with a mean age at diagnosis of ATR of 77.37 years and concomitant corticotherapy in 4 of them. In 7 patients, the rupture was spontaneous and all required surgical management. A significantly higher frequency of smoking, concomitant corticotherapy and spontaneous ruptures were found in the group treated with fluoroquinolones.ConclusionsATR is an adverse event that can occur in patients over 60 years of age treated with fluoroquinolones, so an adequate risk-benefit assessment should be carried out in this population, especially in the presence of associated risk factors.     

关节镜利用腘肌腱缝合固定外侧半月板腘肌腱区损伤

目的：探讨关节镜下利用腘肌腱缝合固定外侧半月板腘肌腱区损伤的中期疗效及相关并发症。方法：回顾性分析 2016 年 1 月至 2020 年 12 月收治的经关节镜下腘肌腱缝合固定术治疗的 57 例外侧半月板腘肌腱区损伤患者资料,其中男 35 例,女 22 例,年龄 18~47(32.9±7.9)岁。比较术前、末次随访时国际膝关节评分委员会(InternationalKnee Documentation Committee,IKDC)评分、Lysholm 评分评价膝关节功能,根据术后 Barrett 标准评估半月板愈合情况,并记录术后切口愈合情况,腘肌腱、血管、神经损伤及下肢静脉血栓等并发症情况。结果：57 例患者术后均获得随访,时间 12~58(38.1±14.9)个月。术后患者切口均为甲级愈合,无感染,无腘肌腱、血管、神经损伤及下肢静脉血栓情况。IKDC 评分由术前的(49.7±3.6)分增至末次随访的(88.5±4.4)分(P<0.05);Lysholm 评分由术前的(48.8±4.9)分增至末次随访的(91.9±3.9)分(P<0.05)。术后 3、6 个月及 1 年随访,根据 Barrett 评价标准,术后临床愈合 54 例,愈合率94.7%(54/57)。结论：本研究初步证实通过关节镜缝合技术将损伤的外侧腘肌腱区半月板缝合固定于腘肌腱可取得较好的临床稳定效果,且术后中期随访未见对膝关节功能造成不利影响。     

腱鞘巨细胞瘤的超声诊断分析

正腱鞘巨细胞瘤是手足较常见的软组织肿瘤,尤其是手指腱鞘瘤。高频超声不但可以清晰显示浅表肿块,尚可显示肿块与周边肌肉、肌腱、神经及血管等组织结构的关系。本组回顾性分析我院62例经手术病理证实的腱鞘巨细胞瘤患者的临床及术前超声影像资料,旨在探讨超声检查在该病诊断及鉴别诊断中的价值。资料与方法一、临床资料收集2014年1月至2016年12月我院经手术病理证实的腱鞘巨细胞瘤患者62例,其中女40例,男22例,年龄5~71岁,     

慢性肾衰竭大鼠肾移植后骨髓红细胞生成素受体的变化

目的通过观察慢性肾衰竭大鼠肾移植前后骨髓红系祖细胞的红细胞生成素受体(EPOR)的变化及与肾功能和贫血的关系,探讨红细胞生成素受体(EPOR)抑制在肾性贫血中的作用。方法以慢性肾衰竭(CRF)大鼠作为受者行同种异体肾移植术模拟人类肾移植。模型建立后RT-PCR法测定假手术组、CRF组和肾移植后不同时间大鼠骨髓红系祖细胞EPORmRNA表达的变化,WesternBlot分析EPOR蛋白质含量变化趋势,同时作EPORmRNA、EPOR蛋白质含量、Scr、Hb之间的相关性分析。结果CRF模型在5／6肾切除后90d时成功,接受肾移植后其血清肌酐和尿素氮迅速下降。CRF时EPORmRNA的表达和EPOR蛋白质含量较正常对照组明显降低,肾移植术后第7d开始二者明显升高,14d时恢复正常。相关性分析显示,EPORmRNA、EPOR蛋白含量、血红蛋白(Hb)均与血清肌酐呈显著性负相关,而EPORmRNA、EPOR蛋白含量与Hb呈显著性正相关。结论大鼠接受肾移植,尿毒症毒素完全清除后EPORmRNA及EPOR蛋白质含量显著增加至正常水平,提示EPOR抑制是引起肾性贫血的重要机理之一。     

解肌舒筋口服液生产工艺及薄层鉴别

对解肌舒筋口服液中所合成分葛根素、麻黄碱进行鉴别，认为该方中挥发油制成芳香水与其他提取物混合溶解，不易产生分层，稳定性较佳，有效成分均匀分散，药品质量稳定。