Efficacy of microneedle radiofrequency therapy in the treatment of senile purpura: A prospective study.

BACKGROUND: Radiofrequency (RF) devices have been used for skin rejuvenation and treating skin laxity. It may also be effective for senile purpura (SP) based on its action of promoting neocollagenesis with minimal epidermal damage. This study aimed to evaluate the efficacy and safety of microneedle RF for treating SP of the forearms in elderly. MATERIAL AND METHODS: In this prospective study, 23 patients who underwent a single session of microneedle RF device (GENIUS, Lutronic Co., Korea) therapy for SP were enrolled. Histopathological features were assessed 1 week before and 8 weeks after therapy. The total amount of collagen and elastic fibers were measured using the computer vision method, and epidermal thickness and the number of blood vessels were analyzed using ImageJ. The clinical improvements were evaluated by blinded evaluators and the patients using investigator global assessment (IGA) and patient global assessment (PGA), respectively. Data regarding the number of purpuric lesions and the size of the largest lesion were collected via a telephone survey. RESULTS: The total amount of collagen and elastic fibers, and mean epidermal thickness tended to improve after RF treatments, although they did not reach statistical significance. The locally estimated scatterplot smoothing curve showed decreasing tendency in both size and number of purpuras as weeks progressed. PGA showed very satisfied in 65% of patients and IGA showed 39% near-total improvement and 43% marked improvement. There were no serious adverse events. CONCLUSIONS: Microneedle RF therapy induces remodeling of dermal circumstances with minimal epidermal impairment. It may be a promising therapeutic option for SP.

Automated detection of superficial fungal infections from microscopic images through a regional convolutional neural network.

Direct microscopic examination with potassium hydroxide is generally used as a screening method for diagnosing superficial fungal infections. Although this type of examination is faster than other diagnostic methods, it can still be time-consuming to evaluate a complete sample; additionally, it possesses the disadvantage of inconsistent reliability as the accuracy of the reading may differ depending on the performer's skill. This study aims at detecting hyphae more quickly, conveniently, and consistently through deep learning using images obtained from microscopy used in real-world practice. An object detection convolutional neural network, YOLO v4, was trained on microscopy images with magnifications of 100×, 40×, and (100+40)×. The study was conducted at the Department of Dermatology at Veterans Health Service Medical Center, Seoul, Korea between January 1, 2019 and December 31, 2019, using 3,707 images (1,255 images for training, 1,645 images for testing). The average precision was used to evaluate the accuracy of object detection. Precision recall curve analysis was performed for the hyphal location determination, and receiver operating characteristic curve analysis was performed on the image classification. The F1 score, sensitivity, and specificity values were used as measures of the overall performance. The sensitivity and specificity were, respectively, 95.2% and 100% in the 100× data model, and 99% and 86.6% in the 40× data model; the sensitivity and specificity in the combined (100+40)× data model were 93.2% and 89%, respectively. The performance of our model had high sensitivity and specificity, indicating that hyphae can be detected with reliable accuracy. Thus, our deep learning-based autodetection model can detect hyphae in microscopic images obtained from real-world practice. We aim to develop an automatic hyphae detection system that can be utilized in real-world practice through continuous research.

Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion.

Study Design: Cross-sectional comparison. Introduction: Forearm supination range of motion is often limited by short or stiff pronators. Many studies have examined maximal isometric forearm supination torque (MIFST). However, there is little research comparing MIFST in two elbow positions between subjects with and without limited forearm supination range of motion (LSR). Purpose of the Study: The purpose of this study was to compare MIFST in two elbow positions (90º flexed elbow, extended elbow) between subjects with and without LSR. Methods: Thirteen right-handed subjects (seven men, six women) with LSR and 13 age- and gender-matched healthy controls participated in this study. The forearm supination range of motion and MIFST were measured using a Smart KEMA system. Two-way repeated-measures analysis of variance was used to compare MIFST in two elbow positions between subjects with and without LSR. Results: No significant difference between groups (p > .05) was found. However, there was an interaction effect between elbow position and group on MIFST (p < .05). Independent t-tests were used to confirm the simple effects. In the LSR group, the value of MIFST was significantly lower in the elbow-extended position than in the group without LSR (p < .05). Conclusions: These findings indicate that elbow position should be considered when assessing the strength or increasing the strength of the supinator muscle, especially in patients with LSR.

Effect of weight-bearing wrist movement with carpal-stabilizing taping on pain and range of motion in subjects with dorsal wrist pain: A randomized controlled trial.

STUDY DESIGN: Randomized control trial. INTRODUCTION: During weight-bearing wrist movement, potential stabilizing forces caused by carpal stabilizing taping (CST) may restrict movement of the carpal bones, allowing greater wrist joint extension. PURPOSE OF THE STUDY: The purpose of study was to investigate the effect of CST during weight-bearing wrist movement on pain intensity and range of motion (ROM) of wrist extension in subjects with dorsal wrist pain. METHODS: Thirty participants with dorsal wrist pain when weight bearing through the hand were randomly allocated into 2 groups: (1) a CST group using rigid tape and (2) placebo taping (PT) group using elastic tape. Subjects performed weight-bearing wrist movements with CST or PT in 6 sessions for 1 week. Active and passive ROM (AROM and PROM), and the visual analog scale (VAS) were assessed at baseline and after the intervention. RESULTS: The AROM and PROM of wrist extension increased significantly in both groups compared with preintervention values (P < .01). Comparing the PT and CST groups, the differences between preintervention and postintervention AROM (mean difference [MD] = +8.6°) and PROM (MD = +6.8°) were significantly greater in the CST group than in the PT group (P < .01). The CST group also showed greater improvement in VAS compared with the PT group (MD = -18 mm) (P < .01). CONCLUSION: We recommend CST during weight-bearing wrist movement as an effective intervention for both increasing wrist extension ROM and decreasing pain in patients with dorsal wrist pain during weight bearing through the hand.

Comparison of Shoulder Protraction Strength and Electromyography Activity of Serratus Anterior and Pectoralis Major in Subjects With or Without a Winged Scapula.

CONTEXT: A winged scapula (WS) is associated with faulty posture caused by weakness of the serratus anterior (SA), which mainly acts as a scapular stabilizer muscle. It is important to accurately assess and train the SA muscle with a focus on scapula stabilizers during musculoskeletal rehabilitation of individuals with a WS. OBJECTIVE: The authors examined muscle activity in the SA and pectoralis major (PM), upper trapezius (UT), and anterior deltoid (AD) as well as shoulder protraction strength during isometric shoulder protraction in individuals with and without a WS. DESIGN: Cross-sectional study. SETTING: A clinical biomechanics laboratory. PARTICIPANTS: In total, 27 males with no shoulder, neck, or upper-extremity pain participated. MAIN OUTCOME MEASURES: Isometric shoulder protraction strength was collected and surface electromyography used to measure the activity of the SA, PM, UT, and AD muscles and selective SA activity ratio to other shoulder muscles. RESULTS: Electromyography activity of the SA muscle and shoulder protraction strength were significantly lower in individuals with a WS compared with the non-WS group (P < .05). In contrast, PM muscle activity and the PM-to-SA, UT-to-SA, and AD-to-SA ratios were significantly greater in individuals with a WS than in individuals without winging (P < .05). CONCLUSIONS: Isometric shoulder protraction for measuring SA strength in individuals with a WS should focus on isolated muscle activity of the SA, and SA strengthening exercises are important for individuals with a WS.

Effect of applying consistent pressure to the stationary and the moving arm on measurement reliability of glenohumeral internal rotation range of motion.

OBJECTIVES: The aim of this study was to determine the inter-rater reliability of glenohumeral internal rotation (GIR) range of motion (ROM) and pressure measurements among four measurement methods: (1) Manual stabilization of the humeral head and coracoid process (MSHC) without applying consistent pressure (ACP) to both the stationary and the moving arms (BSaMA); (2) MSHC with ACP to the moving arm; (3) MSHC with ACP to the stationary arm; and (4) MSHC with ACP to BSaMA. DESIGN: Test-retest analyses. PARTICIPANTS: 39 subjects with GIR deficit. MAIN OUTCOME MEASURES: GIR ROM and pressure were measured on the stationary or moving arm by four examiners using the Clinometer application and a pressure biofeedback unit. RESULTS: GIR ROM measurement with MSHC and ACP to the moving arm resulted in the lowest intra-class correlation coefficient (ICC = .43); the ICC for MSHC without ACP to BSaMA was .54; that for MSHC with ACP to the stationary arm was .77; and that for MSHC with ACP to BSaMA was highest, at .81. CONCLUSION: MSHC with ACP to both arms leads to reliable GIR ROM measurement in a clinical setting.

Effects of deep breathing on internal oblique and multifidus muscle activity in three sitting postures.

[Purpose] This study was to investigate differences in the level of activity of the external oblique (EO), internal oblique (IO), and multifidus (MF) muscles with deep breathing in three sitting postures. [Subjects and Methods] Sixteen healthy women were recruited. The muscle activity (EO, IO, MF) of all subjects was measured in three sitting postures (slumped, thoracic upright, and lumbo-pelvic upright sitting postures) using surface electromyography. The activity of the same muscles was then remeasured in the three sitting postures during deep breathing. [Results] Deep breathing significantly increased activity in the EO, IO, and MF compared with normal breathing. Comparing postures, the activity of the MF and IO muscles was highest in the lumbo-pelvic upright sitting posture. [Conclusion] An lumbo-pelvic upright sitting posture with deep breathing could increase IO and MF muscle activity, thus improving lumbo-pelvic region stability.

Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

Chromo/Fluorogenic Detection of Co(2+), Hg(2+) and Cu(2+) by the Simple Schiff Base Sensor.

Herein, we reported the ditriazole Schiff base derivative 1 and evaluated its photophysical properties on induction of varieties of metal ions including Na(+), Ag(+), Ni(2+), Mn(2+), Pd(2+), Co(2+), Hg(2+), Cu(2+), Pb(2+), Cd(2+), Zn(2+), Sn(2+), Fe(2+), Fe(3+), Cr(3+) and Al(3+), in order to figure out its potential as ion sensor. The ligand 1 exhibited the strong colorimetric change in the reaction solution as well as absorption spectral shifting with the concomitant appearance of well-defined isosbestic points only upon Co(2+), Hg(2+) and Cu(2+) addition corroborates its applicability as multichannel ion detector. The different extent of spectral shifting as well as unique chromogenic change in the probe solution upon Co(2+), Hg(2+) and Cu(2+) introduction can be used as the discrimination tool for these metal ions. The ligand-metal binding stoichiometry was assessed by their optical response which was further supported by the FT-IR, NMR and mass spectrometric analysis. The association constant and the detection limits of the ligand toward Co(2+), Hg(2+) and Cu(2+) ions were calculated to be 1.52 × 10(-8), 3.26 × 10(-9), 1.16 × 10(-8) and 3.87 × 10(-10), 5.47 × 10(-11), 8.91 × 10(-11) M, respectively, employing the Benesi-Hilderbrand equation and 3 σ slope(-1) methods. Furthermore, the successive addition of Co(2+), Hg(2+) and Cu(2+) induce the constant decline in the fluorescence emission signal intensity of the probe. The quenching efficiency of the probe upon metallic induction was fitted to the Stern-Volmer equation which yielded the upward curvature in case of all the three metals ions (Co(2+), Hg(2+) and Cu(2+)) when (Io/I-1) was plotted against the quencher concentration indicating the occurrence of both the dynamic and static quenching process in the system with the average Stern-Volmer quenching constant values of 9.25 × 10(-7), 1.14 × 10(-7), 1.829 × 10(-7), respectively.

Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus.

[Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exercise. The hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction were measured initially and after 8 weeks by radiography and ultrasonography. [Results] While there were no significant changes in the three parameters in the orthosis group, there were significant differences in the orthosis plus toe-spread-out exercise group after 8 weeks. In addition there were significant differences in the three measures between the two groups. [Conclusion] The toe-spread-out exercise reduces the hallux valgus angle and hallux valgus angle during active abduction, and increases the cross-sectional area of the abductor hallucis muscle. The toe-spread-out exercise is recommended for patients with mild to moderate hallux valgus.

Effects of performing an abdominal hollowing exercise on trunk muscle activity during curl-up exercise on an unstable surface.

[Purpose] The purpose of this study was to investigate the effects of the abdominal hollowing exercise on trunk muscle activity during the curl-up exercise on an unstable surface by measuring electromyography (EMG) activity. [Subjects] Fourteen young healthy adults (nine male, five female) voluntarily participated in this study. [Methods] Each subject was asked to perform a curl-up exercise on two supporting surfaces (stable and unstable surfaces) combined with the abdominal hollowing exercise on an unstable surface. The muscle activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were measured using surface EMG during performance of the curl-up exercise. [Results] The EMG activity of the RA and EO was significantly higher on an unstable surface than on a stable surface during the curl-up exercise. The EMG activities of the TrA and IO were greater in combination with the abdominal hollowing exercise on an unstable surface than during the curl-up exercise on both a stable and unstable surface. [Conclusion] These findings suggest that the local trunk muscle activity during the curl-up exercise is more strongly affected by combination with the abdominal hollowing exercise than by performance on an unstable supporting surface.

Effects of humeral head compression taping on the isokinetic strength of the shoulder external rotator muscle in patients with rotator cuff tendinitis.

[Purpose] The purpose of this study was to examine the effects of humeral head compression taping (HHCT) on the strength of the shoulder external rotator muscle in patients with rotator cuff tendinitis. [Subjects and Methods] Twenty patients with rotator cuff tendinitis were recruited. The shoulder external rotator strength was measured using a Biodex isokinetic dynamometer system. A paired t-test was performed to evaluate within-group differences in the strength of the shoulder external rotator muscle. [Results] Significantly higher shoulder external rotator peak torque and peak torque per body weight were found in the HHCT condition than in the no-taping condition. [Conclusion] HHCT may effectively increase the shoulder external rotator muscle strength in patients with rotator cuff tendinitis.

The photophysical behavior of the photochromic naphthopyran derivative having photo-switching ability.

The photophysical behavior of the photochromic naphthopyran derivative 9 with photo-switching ability has been investigated in solution phase as well as in crystalline form. The proposed switching motifs might be a versatile framework in the development of photonic devices whose properties can be toggled between two states on exposure to electromagnetic radiations. The closed form of 9 undergoes reversible transformation upon irradiation with light by changing the molecular structure from ring closed conformation 9 to the ring opened form 10. The compound 9 exhibited first absorption signal at 238nm with shoulder peak at 261nm and second absorption signal at 353nm while on photo-irradiation, the colorless solution of 9 turn to colored and there was ratiometric downfall in the signal intensity for shoulder signal at 261nm as well as second absorption signal at 353nm and ultimately results in the disappearance of these both signal after 20min of irradiations. Meanwhile, the colorimetric change in the reaction solution and considerable shift in the absorption and emission signal intensity as well as position suggest the conformational changes in the molecules from less conjugate conformation 9 to the extended conjugated conformation 10.

One Year Experience of Iliac Bifurcated Device for Aortoiliac Aneurysm in a Korean Single Center.

One of the predominant methods for preserving the internal iliac artery (IIA) in aortoiliac aneurysms is to use an iliac bifurcated device (IBD). However, there are a few limitations to the use of IBD in Korea. Our study aims to present the technical aspects of these devices, and to provide a mid-term analysis of IBD. Since 2013, 4 IBDs were used in 4 patients, with a mean follow-up of 14 months (range, 6-22 months). A 100% technical success rate was achieved without mortality and morbidity in our cases. The mean procedural time was 176 min (range, 145-240 min), and the mean contrast dose used was 184 mL (range, 135-220 mL). Type I or III endoleaks and postoperative expansion of the aneurysms weren't observed. Our cases demonstrates that IBD is a relatively safe repair method of aortoiliac aneurysms with preservation of the IIAs. However, a longer follow-up is needed to review the midterm results.

Influence of walking with talus taping on the ankle dorsiflexion passive range of motion.

[Purpose] This study investigated the effects of walking with talus taping on the ankle dorsiflexion passive range of motion (DF PROM) in individuals with limited ankle DF PROM. [Subjects] Fifteen ankles with limited DF PROM were examined. [Methods] After rigid strapping tape was applied to the ankles from the talus to the calcaneus, progressing posteriorly and inferiorly, the subjects walked on a walkway for 10 min. Using a goniometer, the ankle DF PROM was measured with the knee extended before and after walking with talus taping. The difference in ankle DF PROM between before and after walking with talus taping was analyzed using the paired t-test. [Results] The ankle DF PROM was significantly increased after walking with talus taping. [Conclusion] Our findings indicate that walking with talus taping is effective for increasing the ankle DF PROM in individuals with limited ankle DF PROM.

Comparison of erector spinae and hamstring muscle activities and lumbar motion during standing knee flexion in subjects with and without lumbar extension rotation syndrome.

The aim of this study was to compare the activity of the erector spinae (ES) and hamstring muscles and the amount and onset of lumbar motion during standing knee flexion between individuals with and without lumbar extension rotation syndrome. Sixteen subjects with lumbar extension rotation syndrome (10 males, 6 females) and 14 healthy subjects (8 males, 6 females) participated in this study. During the standing knee flexion, surface electromyography (EMG) was used to measure muscle activity, and surface EMG electrodes were attached to both the ES and hamstring (medial and lateral) muscles. A three-dimensional motion analysis system was used to measure kinematic data of the lumbar spine. An independent-t test was conducted for the statistical analysis. The group suffering from lumbar extension rotation syndrome exhibited asymmetric muscle activation of the ES and decreased hamstring activity. Additionally, the group with lumbar extension rotation syndrome showed greater and earlier lumbar extension and rotation during standing knee flexion compared to the control group. These data suggest that asymmetric ES muscle activation and a greater amount of and earlier lumbar motion in the sagittal and transverse plane during standing knee flexion may be an important factor contributing to low back pain.

Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus.

BACKGROUND AND OBJECTIVE: Muscle imbalance between the abductor hallucis (AbdH) and adductor hallucis (AddH) has been demonstrated in hallux valgus (HV). Clinically, the short-foot (SF) is performed for strengthening foot intrinsic muscle. The toes-spread-out (TSO), the newly introduced, was devised to correct HV deformity. However, there was no study to determine which exercise is effective in balancing the ratio of activation between AbdH and AddH muscles. The purpose of this study was to compare the muscle activities of the AbdH and AddH between SF and TSO exercises in subjects with mild HV. METHODS: Eighteen subjects with mild HV participated. The muscle activity of AbdH and AddH and the angle of first metatarsophalangeal (MTP) joint in the horizontal plane were measured during the SF and TSO exercises. Values of dependent variables were compared using a paired t-test between the SF and TSO exercises. RESULTS: The TSO exercise showed significantly greater activation of the AbdH than did the SF exercise (mean difference=44.96% of maximum voluntary isometric contraction; p< 0.001). There was no significant difference between the SF and TSO exercises in activating the AddH (mean difference=8.28% of maximum voluntary isometric contraction; p=0.271). The ratio of AbdH to AddH muscle activity was significantly higher in the TSO exercise than in the SF exercise (mean difference=0.54; p=0.001). The angle of the first MTP joint in the horizontal plane during the TSO was significantly greater than that in the SF exercise (mean difference=9.60°; p<0.001). CONCLUSIONS: These results suggest that the TSO exercise can be recommended for preventing or correcting HV deformity at an early stage.

Reliability and validity of goniometric and photographic measurements of clavicular tilt angle.

The aims of the present study were to assess the reliability of clavicular tilt angle measurement using goniometric and photographic measurements and to test the validity of the measurement by comparing the results with radiographic findings (gold standard). Clavicular tilt angles were measured in 18 healthy subjects (36 clavicles) using goniometric, photographic, and radiographic measurement. Repeated measurements using goniometric and photographic measurements were made in two test sessions conducted on different days by two examiners to assess inter-rater and intra-rater reliability of the two methods. Radiographic measurement was taken once, and the correlation between the radiographic findings and those of the indirect methods was calculated to test the validity of the goniometric and photographic measurement of clavicular tilt angle. No significant difference in clavicular tilt angle measurement was found between test sessions. The reliability of goniometric measurement (inter-rater intraclass correlation coefficients (ICC) = 0.85 (95% CI = 0.72-0.92) - 0.87 (95% CI = 0.77-0.87); intra-rater ICC = 0.80 (95% CI = 0.64-0.89)) and photographic measurement (inter-rater ICC = 0.89 (95% CI = 0.80-0.94) - 0.95 (95% CI = 0.91-0.98); intra-rater ICC = 0.84 (95% CI = 0.71-0.92) - 0.84 (95% CI = 0.69-0.91)) were excellent. The goniometric and photographic measurements of clavicular tilt angle were highly correlated with the radiographic findings (r = 0.83, 0.78, respectively). Goniometric and photographic measurements of clavicular tilt angle obtained by raters in this study may be considered reliable, and data obtained using the goniometric and photographic measurements are representative of radiographic findings of clavicular tilt angle.

Dry anaerobic digestion of food waste under mesophilic conditions: performance and methanogenic community analysis.

The performance of dry anaerobic digestion (AD) of food waste was investigated under mesophilic conditions and the methanogenic community was investigated using 454 pyrosequencing. Stable dry AD was achieved by hydraulic retention time (HRT) control without the addition of alkali agents. The average CH4 production rate, CH4 content, and volatile solid reduction rate were 2.51±0.17m(3)/m(3)/d, 66±2.1%, and 65.8±1.22%, respectively, at an HRT of 40d. The methanogenic community of the seed sludge experienced a significant reduction in genus diversity from 18 to 4 and a dominant methanogenic shift from hydrogenotrophic to acetoclastic groups after the acclimation under dry condition. Almost all sequences of the dry anaerobic digester were closely related with those of Methanosarcina thermophila with similarity of 96.4-99.1%. The experimental results would serve as useful information to understand the dry AD system.

Enhanced activity of methanogenic granules by low-strength ultrasonication.

In this study, low-strength ultrasonication was applied at various ultrasonication densities (UDs) (0-0.1 W/mL) and ultrasonication time (UT) (0-30 min) to methanogenic granules on the purpose of increasing their activity, and eventually, enhancing the performance of upflow anaerobic sludge blanket reactor (UASBr). Batch test results showed that 5 min of ultrasonication at 0.05 W/mL was found to be the optimal conditions, resulting in the increase of dehydrogenase activity and adenosine triphosphate content by 257%, and 374%, respectively, compared to the control. These increments were confirmed by specific methanogenic activity test. When ultrasonication (UD 0.05 W/mL, UT 5 min) was irradiated every 8h during the continuous operation of UASBr, it caused a gradual drop of methanogenic activity, complete loss after 20 days. At further operation, UT was decreased to 1s but irradiated every 1 min, which resulted in a 43% higher specific CH(4) production rate.