Effects of Capsule Type on the Characteristics of Cement Mortars Containing Powder Compacted Capsules.

Several studies have been reported on self-healing concrete using bacteria, admixtures, and microcapsules. Among these self-healing techniques, encapsulating cement-based materials is advantageous in that large amounts of self-healing material can be contained in a capsule and released at the cracked site for a targeted reaction. This study produced a powder compacted capsule (PCC) using the droplet and blended manufacturing methods to encapsulate cementitious materials. This study refers to the PCCs as droplet-PCC (D-PCC) and blended-PCC (B-PCC) according to the manufacturing method used. The fluidity, compressive strength, carbonation, drying shrinkage, and water permeability of cement mortar with PCCs were evaluated. The test results show that the flow of the mortar sample using D-PCC was slightly higher than that of the mortar using B-PCC. The compressive strength of the mortar sample with B-PCC was generally higher than that of the mortar sample with D-PCC. The compressive strength of the B-PCC2 sample (with 0.2% of B-PCC) was the highest at all curing ages. This may be because the B-PCC fracture load was higher than that of the D-PCC. In addition, more hydrates were observed in the B-PCC sample than in the D-PCC sample. A crack healing effect was observed in the samples with PCC, regardless of the PCC type. The effect was the greatest in the B-PCC6 sample (with 0.6% of B-PCC). The results of this study provide a reference for the PCC type and mix ratio that would yield the best mechanical properties and crack healing effect.

Effect of Bio-Inspired Polymer Types on Engineering Characteristics of Cement Composites.

Cement concrete is the most commonly used building and construction material worldwide because of its many advantages. Over time, however, it develops cracks due to shrinkage and tension, which may lead to premature failure of the entire structure. Recently, the incorporation of polymers has been explored to improve the overall strength and durability of cement concrete. In this study, two types of chitosan-based bio-inspired polymers (a-BIP and b-BIP) were synthesized and mixed with cement mortar in different proportions (5-20%). The fluidity of the resulting mixtures and the properties of the hardened samples, such as the compressive and tensile strengths, drying shrinkage, and carbonation resistance, were evaluated. The characteristics of the polymers were tuned by varying the pH during their syntheses, and their structures were characterized using nuclear magnetic resonance spectroscopy, Fourier-transform infrared spectroscopy, and ultraviolet-visible spectroscopy. After 28 days of aging, all samples containing BIPs (35.9-41.4 MPa) had noticeably higher compressive strength than the control sample (33.2 MPa). The tensile strength showed a similar improvement (up to 19.1%). Overall, the mechanical properties and durability of the samples were separately dependent on the type and amount of BIP.

Effect of Cementitious Materials on the Engineering Properties of Lightweight Aggregate Mortars Containing Recycled Water.

With the trend toward taller and larger structures, the demand for high-strength and lightweight cement concrete has increased in the construction industry. Equipment for transporting ready-mixed concrete is frequently used to bring concrete to construction sites, and washing this equipment generates a large amount of recycled water, which is an industrial by-product. In this study, we recycled this water as the pre-wetting water for lightweight aggregate and as mixing water, and we substituted blast furnace slag powder (BS) and fly ash (FA) as cementitious materials (Cm). In addition, we evaluated the fluidity, compressive strength, tensile strength, drying shrinkage, and accelerated carbonation depth of lightweight ternary cementitious mortars (TCMs) containing artificial lightweight aggregate and recycled water. The 28-day compressive strengths of the lightweight TCM specimens with BS and FA were ~47.2-51.7 MPa, except for the specimen with 20% each of BS and FA (40.2 MPa), which was higher than that of the control specimen with 100% OPC (45.9 MPa). Meanwhile, the 28-day tensile strengths of the lightweight TCM specimens containing BS and FA were ~2.81-3.20 MPa, which are ~13.7-29.5% higher than those of the control specimen. In this study, the TCM specimen with 5% each of BS and FA performed the best in terms of the combination of compressive strength, tensile strength, and carbonation resistance.

Engineering Characteristics of Cement Composites Containing a Chitosan-Based Polymer and Steel Slag Aggregates.

Recently, sustainable development has attracted significant global attention. Toward this, several studies have been performed on the development of alternative aggregates for mortar or concrete to prevent environmental damage and rapid depletion of natural aggregates. In this study, we investigated the applicability of a chitosan-based polymer (CBP), a biomimetic polymer, to cement mortar using steel slag as a fine aggregate. The CBP was synthesized via an amide coupling reaction among chitosan, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride, and 3-(3,4-dihydroxyphenyl)propionic acid. Upon addition to cement mortar using natural sand or a blast furnace slag aggregate, the CBP contributed toward increasing the compressive strength and tensile strength. However, in mortar mixes using a ferronickel slag aggregate, the tensile strength decreased by ~5.7-25.4% upon CBP addition. Moreover, the CBP reduced the total charge passed through the mixes. In particular, in the mortar mix using the steel slag aggregate, the CBP showed improved chloride-ion penetration resistance. The results showed that the as-prepared CBP was a suitable improving agent and exhibited promising compatibility with cement composites containing steel slag aggregates.

Strength, Carbonation Resistance, and Chloride-Ion Penetrability of Cement Mortars Containing Catechol-Functionalized Chitosan Polymer.

There have been numerous recent studies on improving the mechanical properties and durability of cement composites by mixing them with functional polymers. However, research into applying modified biopolymer such as catechol-functionalized chitosan to cement mortar or concrete is rare to the best of our knowledge. In this study, catechol-functionalized chitosan (Cat-Chit), a well-known bioinspired polymer that imitates the basic structures and functions of living organisms and biological materials in nature, was synthesized and combined with cement mortar in various proportions. The compressive strength, tensile strength, drying shrinkage, accelerated carbonation depth, and chloride-ion penetrability of these mixes were then evaluated. In the ultraviolet-visible spectra, a maximum absorption peak appeared at 280 nm, corresponding to catechol conjugation. The sample containing 7.5% Cat-Chit polymer in water (CPW) exhibited the highest compressive strength, and its 28-day compressive strength was ~20.2% higher than that of a control sample with no added polymer. The tensile strength of the samples containing 5% or more CPW was ~2.3-11.5% higher than that of the control sample. Additionally, all the Cat-Chit polymer mixtures exhibited lower carbonation depths than compared to the control sample. The total charge passing through the samples decreased as the amount of CPW increased. Thus, incorporating this polymer effectively improved the mechanical properties, carbonation resistance, and chloride-ion penetration resistance of cement mortar.

Characteristics of Mortars with Blast Furnace Slag Powder and Mixed Fine Aggregates Containing Ferronickel-Slag Aggregate.

Recently, interest in environmentally friendly development has increased worldwide, especially in the construction industry. In this study, blast furnace slag powder (BFSP) and mixed steel fine aggregates were applied to cement mortars to reduce the environmental damage caused by the extraction of natural aggregate and to increase the recycling rate of steel by-products in the construction industry. We investigated the fluidity, compressive strength, tensile strength, accelerated carbonation depth, and chloride ion penetration resistance of mortars with steel slag aggregate and their dependence on the presence or absence of BFSP. Because the recycling rate of ferronickel slag is low and causes environmental problems, we considered mortar samples with mixed fine aggregates containing blast furnace slag fine aggregate (BSA) and ferronickel slag fine aggregate (FSA). The results showed that the 7-day compressive strength of a sample containing both 25% BSA and 25% FSA was nearly 14.8% higher than that of the control sample. This trend is likely due to the high density and angular shape of steel slag particles. The 56-day compressive strength of the sample with BFSP and 50% FSA was approximately 64.9 MPa, which was higher than that of other samples with BFSP. In addition, the chloride ion penetrability test result indicates that the use of BFSP has a greater effect than the use of steel slag aggregate on the chloride ion penetration resistance of mortar. Thus, the substitute rate of steel slag as aggregate can be substantially enhanced if BFSP and steel slag aggregate are used in an appropriate combination.

Effect of Amorphous Metallic Fibers on Strength and Drying Shrinkage of Mortars with Steel Slag Aggregate.

Recently, with increasingly stringent environmental regulations and the depletion of natural aggregate resources, high-quality aggregates have become scarce. Therefore, significant efforts have been devoted by the construction industry to improve the quality of concrete and achieve sustainable development by utilizing industrial by-products and developing alternative aggregates. In this study, we use amorphous metallic fibers (AMFs) to enhance the performance of mortar with steel slag aggregate. Testing revealed that the 28-day compressive strength of the sample with steel slag aggregate and AMFs was in the range of 48.7-50.8 MPa, which was equivalent to or higher than that of the control sample (48.7 MPa). The AMFs had a remarkable effect on improving the tensile strength of the mortar regardless of the use of natural aggregates. With AMFs, the drying shrinkage reduction rate of the sample with 100% steel slag aggregate was relatively higher than that of the sample with 50% natural fine aggregate. Furthermore, the difference in the drying shrinkage with respect to the amount of AMFs was insignificant. The findings can contribute to sustainable development in the construction industry.

Strength and Durability Characteristics of Cement Composites with Recycled Water and Blast Furnace Slag Aggregate.

Recently, interest in sustainable development has been increased. In this regard, efforts have been made to prevent environmental pollution, and research on the recycling of construction industry byproducts has been actively conducted in the construction industry. In South Korea, about 20 million tons of waste wash water from the ready-mixed concrete production process are generated, and some of them are recycled using recycling facilities in a ready-mixed concrete plant, but a significant portion of them is discharged or landfilled without permission, causing environmental problems. To increase the recycling rate of steel slag and reduce environmental pollution in the construction industry, we simultaneously applied blast furnace slag fine aggregate (BSFA) and recycled water (RW) to cement mortar. In this study, to examine the feasibility of RW and BSFA, we evaluated the fluidity, compressive strength, tensile strength, drying shrinkage, carbonation depth, and chloride penetration resistance of cement mortar using RW and BSFA. From the test results, the 28-day compressive strengths of all samples using RW and BSFA were higher than that of the control sample. In the case of samples using RW, as the BSFA replacement ratio was increased, the carbonation depth of the samples decreased. Therefore, when RW and BSFA are used properly, the mechanical properties of cement mortar, carbonation resistance, and chloride ion penetration resistance are expected to be effectively improved.

Effects of the loss of mismatch repair genes on single-strand annealing between divergent sequences in Saccharomyces cerevisiae.

Eukaryotic genomes contain many duplicated genes closely located with each other, such as the hexose transporter (HXT) genes in Saccharomyces cerevisiae. They can potentially recombine via single-strand annealing (SSA) pathway. SSA between highly divergent sequences generates heteroduplex DNA intermediates with many mismatches, which can be corrected by mismatch repair (MMR), resulting in recombinant sequences with a single junction point. In this report, we demonstrate that SSA between HXT1 and HXT4 genes in MMR-deficient yeast cells produces recombinant genes with multiple-junctions resulting from alternating HXT1 and HXT4 tracts. The mutations in MMR genes had differential effects on SSA frequencies; msh6Δ mutation significantly stimulated SSA events, whereas msh2Δ and msh3Δ slightly suppressed it. We set up an assay that can identify a pair of recombinant genes derived from a single heteroduplex DNA. As a result, the recombinant genes with multiple-junctions were found to accompany genes with single-junctions. Based on the results presented here, a model was proposed to generate multiple-junctions in SSA pathway involving an alternative short-patch repair system.

Convolutional Network With Twofold Feature Augmentation for Diabetic Retinopathy Recognition From Multi-Modal Images.

OBJECTIVE: With the scenario of limited labeled dataset, this paper introduces a deep learning-based approach that leverages Diabetic Retinopathy (DR) severity recognition performance using fundus images combined with wide-field swept-source optical coherence tomography angiography (SS-OCTA). METHODS: The proposed architecture comprises a backbone convolutional network associated with a Twofold Feature Augmentation mechanism, namely TFA-Net. The former includes multiple convolution blocks extracting representational features at various scales. The latter is constructed in a two-stage manner, i.e., the utilization of weight-sharing convolution kernels and the deployment of a Reverse Cross-Attention (RCA) stream. RESULTS: The proposed model achieves a Quadratic Weighted Kappa rate of 90.2% on the small-sized internal KHUMC dataset. The robustness of the RCA stream is also evaluated by the single-modal Messidor dataset, of which the obtained mean Accuracy (94.8%) and Area Under Receiver Operating Characteristic (99.4%) outperform those of the state-of-the-arts significantly. CONCLUSION: Utilizing a network strongly regularized at feature space to learn the amalgamation of different modalities is of proven effectiveness. Thanks to the widespread availability of multi-modal retinal imaging for each diabetes patient nowadays, such approach can reduce the heavy reliance on large quantity of labeled visual data. SIGNIFICANCE: Our TFA-Net is able to coordinate hybrid information of fundus photos and wide-field SS-OCTA for exhaustively exploiting DR-oriented biomarkers. Moreover, the embedded feature-wise augmentation scheme can enrich generalization ability efficiently despite learning from small-scale labeled data.

Revisiting Internal Covariate Shift for Batch Normalization.

Despite the success of batch normalization (BatchNorm) and a plethora of its variants, the exact reasons for its success are still shady. The original BatchNorm article explained it as a mechanism that reduces the internal covariate shift (ICS), i.e., the distribution shifts in the input of the layers during training. Recently, some articles manifested skepticism on this hypothesis and provided alternative explanations for the success of BatchNorm, such as the applicability of very high learning rates and the ability to smooth the landscape in optimization. In this work, we counter these alternative arguments by demonstrating the importance of reduction in ICS following an empirical approach. We demonstrated various ways to achieve the abovementioned alternative properties without any performance boost. In this light, we explored the importance of different BatchNorm parameters (i.e., batch statistics and affine transformation parameters) by visualizing their effectiveness in the performance and analyzed their connections with ICS. Afterward, we showed a different normalization scheme that fulfills all the alternative explanations except reduction in ICS. Despite having all the alternative properties, we observed its poor performance, which nullifies the alternative claims, rather signifies the importance of the ICS reduction. We performed comprehensive experiments on many variants of BatchNorm, finding that all of them similarly reduce ICS.

Analyses of DNA double-strand break repair pathways in tandem arrays of HXT genes of Saccharomyces cerevisiae.

Eukaryotic genomes contain numerous homologous repeat sequences including redundant genes with divergent homology that can be potential recombination targets. Recombination between divergent sequences is rare but poses a substantial threat to genome stability. The hexose transporter (HXT) gene family shares high sequence similarities at both protein and DNA levels, and some members are placed close together in tandem arrays. In this study, we show that spontaneous interstitial deletions occur at significantly high rates in HXT gene clusters, resulting in chimeric HXT sequences that contain a single junction point. We also observed that DNA double-strand breaks created between HXT genes produce primarily interstitial deletions, whereas internal cleavage of the HXT gene resulted in gene conversions as well as deletion products. Interestingly, interstitial deletions were less constrained by sequence divergence than gene conversion. Moreover, recombination-defective mutations differentially affected the survival frequency. Mutations that impair single-strand annealing (SSA) pathway greatly reduced the survival frequency by 10-1,000-fold, whereas disruption of Rad51-dependent homologous recombination exhibited only modest reduction. Our results indicate that recombination in the tandemly repeated HXT genes occurs primarily via SSA pathway.

Strength, Drying Shrinkage, and Carbonation Characteristic of Amorphous Metallic Fiber-Reinforced Mortar with Artificial Lightweight Aggregate.

This paper investigates the strength, drying shrinkage, and carbonation characteristic of amorphous metallic fiber-reinforced mortar with natural and artificial lightweight aggregates. The use of artificial lightweight aggregates has the advantage of reducing the unit weight of the mortar or concrete, but there is a concern that mechanical properties of concrete such as compressive strength and tensile strength may deteriorate due to the porous properties of lightweight aggregates. In order to improve the mechanical properties of lightweight aggregate mortar, we added 0, 10, 20, and 30 kg/m3 of amorphous metallic fibers to the samples with lightweight aggregate; the same amount of fiber was applied to the samples with natural aggregate for comparison. According to this investigation, the flow of mortar decreased as the amount of amorphous metallic fiber increased, regardless of the aggregate type. The compressive strength of lightweight aggregate mortar with 10 kg/m3 amorphous metallic fiber was similar to that of the LAF0 sample without amorphous metallic fiber after 14 days. In addition, the flexural strength of the samples increased as the amount of amorphous metallic fiber increased. The highest 28-d flexural strength was obtained as approximately 9.28 MPa in the LAF3 sample, which contained 30 kg/m3 amorphous metallic fiber. The drying shrinkage of the samples with amorphous metallic fiber was smaller than that of the sample without amorphous metallic fiber.

Bimodal learning via trilogy of skip-connection deep networks for diabetic retinopathy risk progression identification.

BACKGROUND: Diabetic Retinopathy (DR) is considered a pathology of retinal vascular complications, which stays in the top causes of vision impairment and blindness. Therefore, precisely inspecting its progression enables the ophthalmologists to set up appropriate next-visit schedule and cost-effective treatment plans. In the literature, existing work only makes use of numerical attributes in Electronic Medical Records (EMR) for acquiring such kind of DR-oriented knowledge through conventional machine learning techniques, which require an exhaustive job of engineering most impactful risk factors. OBJECTIVE: In this paper, an approach of deep bimodal learning is introduced to leverage the performance of DR risk progression identification. METHODS: In particular, we further involve valuable clinical information of fundus photography in addition to the aforementioned systemic attributes. Accordingly, a Trilogy of Skip-connection Deep Networks, namely Tri-SDN, is proposed to exhaustively exploit underlying relationships between the baseline and follow-up information of the fundus images and EMR-based attributes. Besides that, we adopt Skip-Connection Blocks as basis components of the Tri-SDN for making the end-to-end flow of signals more efficient during feedforward and backpropagation processes. RESULTS: Through a 10-fold cross validation strategy on a private dataset of 96 diabetic mellitus patients, the proposed method attains superior performance over the conventional EMR-modality learning approach in terms of Accuracy (90.6%), Sensitivity (96.5%), Precision (88.7%), Specificity (82.1%), and Area Under Receiver Operating Characteristics (88.8%). CONCLUSIONS: The experimental results show that the proposed Tri-SDN can combine features of different modalities (i.e., fundus images and EMR-based numerical risk factors) smoothly and effectively during training and testing processes, respectively. As a consequence, with impressive performance of DR risk progression recognition, the proposed approach is able to help the ophthalmologists properly decide follow-up schedule and subsequent treatment plans.

Display in the Wild (DIW): An Adaptive Projection-Imaging System to Screen Geometry in Real Time.

TVs and monitors are among the most widely used displays in various environments. However, they have limitations in their physical display conditions, such as a fixed size/position and a rigid/flat space. In this paper, we suggest a new "Display in the Wild" (DIW) concept to overcome the aforementioned problems. Our proposed DIW system allows us to display a flexibly large screen on dynamic non-planar surfaces at an arbitrary display position. To implement our DIW concept practically, we choose a projector as the hardware configuration in order to generate a screen anywhere with different sizes. However, distortion occurs when the projector displays content on a surface that is dynamic and/or non-planar. Therefore, we propose a distortion correction method for DIW to overcome the aforementioned surface constraints. Since projectors are not capture devices, we propose using a depth camera to determine the distortions on the surfaces quickly. We also propose DIW-specific calibration and fast/precise correction methods. Our calibration method is constructed to detect the projection surface easily and quickly, and also allows our proposed system to accommodate the intrinsic parameters such as a display resolution and field of view. We accomplish a fast undistortion process of the projector by considering only surface boundary pixels, which enables our method to run in real time. In our comprehensive experiments, the proposed DIW system generates undistorted screens such as TVs and monitors on dynamic non-planar surfaces at an arbitrary display position with Unmanned Aerial Vehicles (UAVs) in a fast and accurate manner, demonstrating its usefulness in practical DIW scenarios.

Learning-Based Just-Noticeable-Quantization- Distortion Modeling for Perceptual Video Coding.

Conventional predictive video coding-based approaches are reaching the limit of their potential coding efficiency improvements, because of severely increasing computation complexity. As an alternative approach, perceptual video coding (PVC) has attempted to achieve high coding efficiency by eliminating perceptual redundancy, using just-noticeable-distortion (JND) directed PVC. The previous JNDs were modeled by adding white Gaussian noise or specific signal patterns into the original images, which were not appropriate in finding JND thresholds due to distortion with energy reduction. In this paper, we present a novel discrete cosine transform-based energy-reduced JND model, called ERJND, that is more suitable for JND-based PVC schemes. Then, the proposed ERJND model is extended to two learning-based just-noticeable-quantization-distortion (JNQD) models as preprocessing that can be applied for perceptual video coding. The two JNQD models can automatically adjust JND levels based on given quantization step sizes. One of the two JNQD models, called LR-JNQD, is based on linear regression and determines the model parameter for JNQD based on extracted handcraft features. The other JNQD model is based on a convolution neural network (CNN), called CNN-JNQD. To our best knowledge, our paper is the first approach to automatically adjust JND levels according to quantization step sizes for preprocessing the input to video encoders. In experiments, both the LR-JNQD and CNN-JNQD models were applied to high efficiency video coding (HEVC) and yielded maximum (average) bitrate reductions of 38.51% (10.38%) and 67.88% (24.91%), respectively, with little subjective video quality degradation, compared with the input without preprocessing applied.

Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI.

PURPOSE: The purpose of this study was to analyse the natural course of symptomatic full-thickness and partial-thickness rotator cuff tears treated non-operatively and to identify risk factors affecting tear enlargement. METHODS: One hundred and twenty-two patients who received non-surgical treatment for a partial- or full-thickness supraspinatus tear were included in this study. All rotator cuff tears were diagnosed with magnetic resonance imaging (MRI), and the same modality was used for follow-up studies. Follow-up MRI was performed after at least a 6-month interval. We evaluated the correlation between tear enlargement and follow-up duration. Eleven risk factors were analysed by both univariate and multivariate analyses to identify factors that affect enlargement of rotator cuff tears. The mean follow-up period was 24.4 ± 19.5 months. RESULTS: Out of 122 patients, 34 (27.9%) patients had an initial full-thickness tear and 88 (72.1%) patients had a partial-thickness tear. Considering all patients together, tear size increased in 51/122 (41.8%) patients, was unchanged in 65/122 (53.3%) patients, and decreased in 6/122 (4.9%) patients. Tear size increased for 28/34 (82.4%) patients with full-thickness tears and 23/88 (26.1%) patients with partial-thickness tears. From the two groups which were followed over 12 months, a higher rate of enlargement was observed in full-thickness tears than in partial-thickness tears (6-12 months, n.s.; 12-24 months, P = 0.002; over 24 months, P < 0.001). Logistic regression revealed that having a full-thickness tear was the most reliable risk factor for tear progression (P < 0.001). CONCLUSIONS: This study found that 28/34 (82.4%) of symptomatic full-thickness rotator cuff tears and 23/88 (26.1%) of symptomatic partial-thickness tears increased in size over a follow-up period of 6-100 months. Full-thickness tears showed a higher rate of enlargement than partial-thickness tears regardless of the follow-up duration. Univariate and multivariate analyses suggested that full-thickness tear was the most reliable risk factor for tear enlargement. The clinical relevance of these observations is that full-thickness rotator cuff tears treated conservatively should be monitored more carefully for progression than partial-thickness tears. LEVEL OF EVIDENCE: IV.

A Novel Image Quality Assessment With Globally and Locally Consilient Visual Quality Perception.

Computational models for image quality assessment (IQA) have been developed by exploring effective features that are consistent with the characteristics of a human visual system (HVS) for visual quality perception. In this paper, we first reveal that many existing features used in computational IQA methods can hardly characterize visual quality perception for local image characteristics and various distortion types. To solve this problem, we propose a new IQA method, called the structural contrast-quality index (SC-QI), by adopting a structural contrast index (SCI), which can well characterize local and global visual quality perceptions for various image characteristics with structural-distortion types. In addition to SCI, we devise some other perceptually important features for our SC-QI that can effectively reflect the characteristics of HVS for contrast sensitivity and chrominance component variation. Furthermore, we develop a modified SC-QI, called structural contrast distortion metric (SC-DM), which inherits desirable mathematical properties of valid distance metricability and quasi-convexity. So, it can effectively be used as a distance metric for image quality optimization problems. Extensive experimental results show that both SC-QI and SC-DM can very well characterize the HVS's properties of visual quality perception for local image characteristics and various distortion types, which is a distinctive merit of our methods compared with other IQA methods. As a result, both SC-QI and SC-DM have better performances with a strong consilience of global and local visual quality perception as well as with much lower computation complexity, compared with the state-of-the-art IQA methods. The MATLAB source codes of the proposed SC-QI and SC-DM are publicly available online at https://sites.google.com/site/sunghobaecv/iqa.

Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography.

BACKGROUND: Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. METHODS: A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. RESULTS: The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 ± 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. CONCLUSIONS: The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function.

Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears.

PURPOSE: To compare the clinical outcomes of arthroscopic in situ repair with the tear completion repair technique for partial-thickness rotator cuff tears (PT-RCTs). METHODS: We prospectively enrolled 100 cases with articular-sided and bursal-sided PT-RCTs exceeding 50% of tendon thickness and allocated them randomly. An in situ repair was performed in group 1 (n = 50). Completion of the remaining cuff tissue and repair were performed in group 2 (n = 50). The medial row was knotted as transosseous repair (suture-bridge technique) in all cases. American Shoulder Elbow Society (ASES) score, Constant shoulder (CS) score, Simple shoulder (SS) score, and Korean shoulder (KS) score, and visual analog scale (VAS) for pain and range of motion were assessed at 3, 6, and 12 months and at the last visit. Repaired tendon integrity was determined at 6 to 12 months by magnetic resonance imaging. RESULTS: Eight cases were lost to follow-up. Ultimately, 92 cases were analyzed. The average follow-up was 19.1 months (range, 12 to 42 months). Significant improvements in the VAS for pain and functional outcomes were observed in both groups postoperatively (P = .001 for VAS; P < .001 for ASES score; P < .001 for CS score; P = .001 for SS score; P<.001 for KS score). No significant difference in the clinical results was observed at any time between the groups. No difference of retear rate on articular-sided PT-RCT was observed between the groups (P = .34). Retears on the bursal-sided PT-RCT were more frequent in group 2 (P = .02). CONCLUSIONS: Arthroscopic repair of PT-RCT exceeding 50% of the thickness provided functional improvements and pain relief regardless of the repair technique. The retear rate for bursal-sided PT-RCT was higher in group 2, although the retear rate for the articular-sided PT-RCT was not different. LEVEL OF EVIDENCE: Level II, prospective comparative study.