Combination of Superior and Posterior Capsular Release Versus Superior Capsular Release Alone in Arthroscopic Repair of Large-to-Massive Rotator Cuff Tears.

Background: Superior capsular release has been used to reduce tendon tension, especially in arthroscopic repair of large-to-massive rotator cuff tears. Some clinicians have used a more extensive release of capsules in arthroscopic cuff repair for adequate reduction of torn tendons to footprints. Purpose: To explore the effects of additional posterior capsular release for superior capsular release in arthroscopic repair of large-to-massive rotator cuff tears. Study Design: Cohort study; Level of evidence, 3. Methods: We compared 26 shoulders that underwent superior and posterior capsular release (group S&P) with 26 shoulders that underwent superior capsular release alone (group S) in arthroscopic repair of large-to-massive rotator cuff tears between January 23, 2013 and December 2, 2015. The visual analog scale for pain, American Shoulder and Elbow Surgeons score, Constant score, and range of motion (ROM) and muscle power were checked preoperatively and at 2 years postoperatively. Follow-up ultrasound was checked at 2 years postoperatively. Results: In both groups, the overall mean functional outcomes improved from preoperatively to postoperatively. Patients in group S&P showed more pre- to postoperative improvement than patients in group S with regard to internal rotation ROM (mean difference, 30.0° vs 20.6°; P < .001) and internal rotation power (3.4 vs 1.8 kgf; P = .001). Patients in group S had a higher retear rate on the follow-up ultrasound than patients in group S&P, but this difference did not reach statistical significance (23.1% vs 11.5%, respectively; P = .465). Conclusion: In the current study, patients who underwent superior and posterior capsular release in arthroscopic repair of large-to-massive rotator cuff tears had greater postoperative improvement in internal rotation ROM and power compared with patients who underwent superior capsular release alone.

Association between Rapid Ventricular Response and Stroke Outcomes in Atrial Fibrillation-Related Cardiac Embolic Stroke.

INTRODUCTION: Patients with atrial fibrillation-related stroke (AF-stroke) are prone to developing rapid ventricular response (RVR). We investigated whether RVR is associated with initial stroke severity, early neurological deterioration (END) and poor outcome at 3 months. METHODS: We reviewed patients who had AF-stroke between January 2017 and March 2022. RVR was defined as having heart rate >100 beats per minute on initial electrocardiogram. Neurological deficit was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission. END was defined as increase of ≥2 in total NIHSS score or ≥1 in motor NIHSS score within first 72 h. Functional outcome was score on modified Rankin Scale at 3 months. Mediation analysis was performed to examine potential causal chain in which initial stroke severity may mediate relationship between RVR and functional outcome. RESULTS: We studied 568 AF-stroke patients, among whom 86 (15.1%) had RVR. Patients with RVR had higher initial NIHSS score (p < 0.001) and poor outcome at 3 months (p = 0.004) than those without RVR. The presence of RVR [adjusted odds ratio (aOR) = 2.13; p = 0.013] was associated with initial stroke severity, but not with END and functional outcome. Otherwise, initial stroke severity [aOR = 1.27; p = <0.001] was significantly associated with functional outcome. Initial stroke severity as a mediator explained 58% of relationship between RVR and poor outcome at 3 months. CONCLUSION: In patients with AF-stroke, RVR was independently associated with initial stroke severity but not with END and functional outcome. Initial stroke severity mediated considerable proportion of association between RVR and functional outcome.

Direct Oral Anticoagulant Dosing in Patients With Atrial Fibrillation: An Asian Perspective.

Optimal dosing of direct oral anticoagulants (DOACs) for stroke prevention in "gray area" patients with atrial fibrillation (AF) remains a challenge for clinicians. In Asia, this is concerning in patients who are very elderly, have low body weight, and are at a high risk of bleeding. This review aims to summarize the dose reduction criteria for DOACs, discuss the evidence on dosing of DOACs across Asian regions, and collate opinions from authors across Asia. Nonrecommended dosing of DOACs is common in Asia, primarily due to the fear of bleeding, with the total clinical benefit of higher dosing being overlooked. The ELDERCARE-AF (Edoxaban Low-Dose for Elder Care-Atrial Fibrillation Patients) trial and real-world case studies provide some evidence on the use of low-dose DOACs in gray area patients. Opinions on dose adjustment guidance, concomitant medication adjustments, and therapeutic drug monitoring were collated. Research is needed to fill the evidence gaps on optimal DOAC doses for gray area patients.

A concept to detect a subgingival finish line using an intraoral optical coherence tomography system: A clinical report.

This clinical report introduces an approach for detecting the supragingival finish line by penetrating the teeth and gingival tissue using optical coherence tomography (OCT) technology. This approach was used in 3 patients who underwent tooth preparation with a subgingival finish line. Consequently, the subgingival finish line, typically challenging to discern clearly in intraoral scans, was identifiable in the OCT image.

Emerging role of E2F8 in human cancer.

E2F8 is a multifaceted transcription factor that plays a crucial role in mediating the hallmarks of cancer, including sustaining proliferative signaling, resisting cell death, and activating invasion and metastasis. Aberrant E2F8 expression is associated with poor clinical outcomes in most human cancers. However, E2F8 also exhibits tumor-suppressing activity; thus, the role of E2F8 in cell-fate determination is unclear. In this review, we highlight the recent progress in understanding the role of E2F8 in human cancers, which will contribute to building a conceptual framework and broadening our knowledge pertaining to E2F8. This review provides insight into future challenges and perspectives regarding the translation of biological knowledge into therapeutic strategies for the treatment of cancer.

Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial.

BACKGROUND: Early mobilization is an integral part of an enhanced recovery program after colorectal cancer surgery. The safety and efficacy of postoperative inpatient exercise are not well known. The primary objective was to determine the efficacy of a postoperative exercise program on postsurgical recovery of stage I-III colorectal cancer patients. METHODS: We randomly allocated participants to postoperative exercise or usual care (1:1 ratio). The postoperative exercise intervention consisted of 15 min of supervised exercise two times per day for the duration of their hospital stay. The primary outcome was the length of stay (LOS) at the tertiary care center. Secondary outcomes included patient-perceived readiness for hospital discharge, anthropometrics (e.g., muscle mass), and physical function (e.g., balance, strength). RESULTS: A total of 52 (83%) participants (mean [SD] age, 56.6 [8.9] years; 23 [44%] male) completed the trial. The median LOS was 6.0 days (interquartile range; IQR 5-7 days) in the exercise group and 6.5 days (IQR 6-7 days) in the usual-care group (P = 0.021). The exercise group met the targeted LOS 64% of the time, while 36% of the usual care group met the targeted LOS (colon cancer, 5 days; rectal cancer, 7 days). Participants in the exercise group felt greater readiness for discharge from the hospital than those in the usual care group (Adjusted group difference = 14.4; 95% CI, 6.2 to 22.6; P < 0.01). We observed a small but statistically significant increase in muscle mass in the exercise group compared to usual care (Adjusted group difference = 0.63 kg; 95% CI, 0.16 to 1.1; P = 0.03). CONCLUSION: Postsurgical inpatient exercise may promote faster recovery and discharge after curative-intent colorectal cancer surgery. TRIAL REGISTRATION: The study was registered at WHO International Clinical Trials Registry Platform (ICTRP; URL http://apps.who.int/trialsearch ); Trial number: KCT0003920 .

Dental diagnosis for inlay restoration using an intraoral optical coherence tomography system: A case report.

PATIENTS: The patient was a 32-year-old man who underwent amalgam restoration of the mandibular right second molar. An amalgam restoration fracture was diagnosed by intraoral optical coherence tomography (OCT), and pulp exposure was examined during cavity preparation. Subsequently, a definitive ceramic restoration was fabricated, and the marginal fit in the oral cavity was evaluated using the OCT system. DISCUSSION: The existing OCT system cannot acquire images inside the oral cavity because of the large probe size. However, the proposed intraoral OCT system can access the prostheses in the mandibular right second molar. Therefore, dental diagnosis for restoration treatment with dental prosthesis fracture, marginal gap, and pulp exposure after tooth preparation is possible using the proposed intraoral OCT system. CONCLUSIONS: The use of the intraoral OCT system improved dental diagnosis by allowing the dentist to confirm quantitative values through cross-sectional images, rather than that by determining a treatment plan after visual dental diagnosis.

Comparison of the conventional Henry approach and trans-flexor carpi radialis approach for the treatment of distal radius fracture: A retrospective cohort study.

Few studies have compared the clinical outcomes of the conventional Henry approach and trans-flexor carpi radialis (FCR) approach. The purpose of this study was to compare the clinical and radiologic outcomes of the conventional Henry approach and trans-FCR approach for the treatment of distal radius fractures. We compared 20 wrists that underwent the conventional Henry approach with 20 wrists that underwent the trans-FCR approach for open reduction and internal fixation of distal radius fracture. The clinical and radiological parameters were checked at 3 months, 6 months, and 1 year after surgery. A visual analogue scale score, the modified Mayo wrist score, range of motion, and grip strength were collected. In addition, tenderness in the area of the FCR tendon were assessed. Regarding radiologic evaluations, the radial inclination, radial height, volar tilt, and ulna variance were measured. In the trans-FCR approach group, 15 patients complained of tenderness in the area of the FCR tendon at 3 months after surgery, which was significantly higher than those of conventional Henry approach group (P < .05). In the conventional Henry approach group, the tenderness had resolved spontaneously by 1 year after surgery in 19 patients. The trans-FCR approach can cause discomfort such as tenderness to the area of the FCR tendon compared to the conventional Henry approach, but there is no significant difference in the final clinical and radiologic outcomes.

Three-Dimensional Anatomically Pre-Contoured Locking Plate for Isolated Weber B Type Fracture.

We aimed to evaluate the functional and radiographic outcomes of a three-dimensionally (3D) pre-contoured lateral locking plate fixation for isolated Weber B type fractures and to evaluate the necessity of an interfragmentary lag screw in the use of the plate. Patients who underwent surgery for isolated Weber B type fracture were divided into two groups: 41 patients treated with the 3D plate and lag screw (Group A) and 31 patients treated with the 3D plate only (Group B). The included patients were evaluated regarding the functional and radiographic outcomes. According to the McLennan and Ungersma criteria, the majority of patients showed good or fair outcomes in both groups. Comparing the two groups, Group B showed better functional outcomes (p < 0.0046), while no difference between the two groups was found in terms of the radiographic outcomes (p = 0.143). The operation time was significantly shorter in Group B (p < 0.001) and the time to bony union was within 14 months in all patients with no significant difference between the two groups (p = 0.0821). No postoperative complication was observed in both groups. In conclusion, the use of a 3D pre-contoured lateral locking plate fixation for isolated Weber B type fractures demonstrated satisfactory functional and radiographic outcomes, regardless of lag screw insertion.

Efficacy and radiographic analysis of oblique lumbar interbody fusion in treating lumbar degenerative spondylolisthesis with sagittal imbalance.

The aim of this study was to evaluate the effectiveness of OLIF (oblique lumbar interbody fusion) in the treatment of lumbar degenerative spondylolisthesis with sagittal imbalance. Fifty-nine patients were included in our analysis. Included patients were divided into 2 groups according to the surgical techniques: PLIF (posterior lumbar interbody fusion) (n = 31) and OLIF + PSF (OLIF combined with posterior spinal fixation) (n = 28). Perioperative radiographic parameters, complications, and clinical outcome from each group were assessed and compared. The operation time for both groups was 165.1 min in the OLIF group and 182.1 min in the PLIF group (P < 0.05). The intraoperative blood loss was 190.6 ml in the OLIF group and 356.3 ml in the PLIF group (P < 0.05). The number of intraoperative and postoperative complications for both groups was 7 in the OLIF group and 11 in the PLIF group. Significant clinical improvement was observed in VAS scores and ODI when comparing preoperative evaluation and final follow-up. The preoperative SVA (the distance from the posterosuperior corner of S1body to the C7 plumb line), PI (pelvic incidence), LL (lumbar lordosis), PI-LL mismatch, DH (disc height), and lumbar Cobb angles of both groups were similar. The postoperative and final follow-up SVA, LL, PI-LL mismatch, and disc height were improved in both groups, and a statistical difference was found between both groups (P < 0.05). An improvement of SVA, LL, PI-LL mismatch, and disc height at the OLIF group was better than that found at the PLIF group. An improvement in radiographic and clinical outcomes for the OLIF group was better than that seen for the PLIF group. Then, OLIF had a more curative effect in lumbar degenerative spondylolisthesis with sagittal imbalance.

Prevalence of rotator cuff diseases in adults older than 40 years in or near Chuncheon city, Korea.

BACKGROUND: To determine the prevalence of rotator cuff diseases in a population older than 40 years in or nearby Chuncheon city, Republic of Korea. METHODS: Sixty shoulders of 30 people older than 40 years who participated in a health lecture were examined for free by an orthopedic surgeon. Visual analog scale of pain and American Shoulder and Elbow Surgeons scores were assigned, and routine physical examination was performed. Ultrasonography was performed on the shoulder. RESULTS: On ultrasonographic examination, there were one shoulder with full thickness rotator cuff tear, 20 of 60 (33%) with partial thickness rotator cuff tear, five of 60 (8%) with calcific tendinitis, one of 60 (2%) with tear of the long head of the biceps, and five of 60 (8%) with tendinitis of the long head of the biceps. Participants older than 60 years showed significantly high proportions of lesion of the long head of the biceps and rotator cuff diseases (P=0.019 and P=0.015, respectively). Participants who performed physical labor had high proportions of rotator cuff tear and rotator cuff disease (P=0.001 and P<0.001, respectively). CONCLUSIONS: Rotator cuff diseases showed a high prevalence in aged persons and resulted in a decrease in shoulder function.

Comparison of femoral tunnel length and obliquity of anatomic versus nonanatomic anterior cruciate ligament reconstruction: A meta-analysis.

PURPOSE: Theoretical considerations suggest that femoral tunnel length might cause graft mismatch, and femoral tunnel obliquity could be related to the longevity of graft in anterior cruciate ligament (ACL) reconstruction. However, controversy still exists regarding these issues in the context of the comparison of anatomic and nonanatomic ACL reconstructions. The purpose of this meta-analysis was to compare the length and obliquity of the femoral tunnel created by drilling through either anatomic or nonanatomic ACL reconstructions. MATERIALS AND METHOD: In this meta-analysis, we reviewed studies that compared femoral tunnel length and femoral tunnel obliquity in the coronal plane with the use of anatomic or nonanatomic ACL reconstruction. The major databases were reviewed for appropriate studies from the earliest available date of indexing through December 31, 2018. No restrictions were placed on the language of publication. RESULTS: Twenty-seven studies met the criteria for inclusion in this meta-analysis. The femur tunnel length of anatomic ACL reconstruction was significantly shorter compared with that of nonanatomic ACL reconstruction by 8.66 mm (95% CI: 7.10-10.22 mm; P<0.001), while the femur tunnel obliquity in the coronal plane of anatomic ACL reconstruction was significantly more oblique versus that of nonanatomic ACL reconstruction by 15.29° (95% CI: 8.07°-22.52°; P<0.001). Similar results in terms of femoral tunnel length were found for the subgroup with cadaveric (7.15 mm; 95% CI: 2.69-11.61 mm; P = 0.002) and noncadaveric (8.96 mm; 95% CI: 7.24-10.69 mm; P<0.001) studies, whereas different results in terms of femoral tunnel obliquity were noted for the subgroup with cadaveric (10.62°; 95% CI: -6.12° to 27.37°; P = 0.21) and noncadaveric (15.86°; 95% CI: 8.11°-23.60°; P<0.001) studies. CONCLUSION: Anatomic ACL reconstruction resulted in the femoral tunnel length and femoral tunnel obliquity in the coronal plane being shorter and more oblique, respectively, as compared with nonanatomic ACL reconstruction. LEVEL OF EVIDENCE: Therapeutic study, Level III.

Combinatorial feature embedding based on CNN and LSTM for biomedical named entity recognition.

With the rapid advancement of technology and the necessity of processing large amounts of data, biomedical Named Entity Recognition (NER) has become an essential technique for information extraction in the biomedical field. NER, which is a sequence-labeling task, has been performed using various traditional techniques including dictionary-, rule-, machine learning-, and deep learning-based methods. However, as existing biomedical NER models are insufficient to handle new and unseen entity types from the growing biomedical data, the development of more effective and accurate biomedical NER models is being widely researched. Among biomedical NER models utilizing deep learning approaches, there have been only a few studies involving the design of high-level features in the embedding layer. In this regard, herein, we propose a deep learning NER model that effectively represents biomedical word tokens through the design of a combinatorial feature embedding. The proposed model is based on Bidirectional Long Short-Term Memory (bi-LSTM) with Conditional Random Field (CRF) and enhanced by integrating two different character-level representations extracted from a Convolutional Neural Network (CNN) and bi-LSTM. Additionally, an attention mechanism is applied to the model to focus on the relevant tokens in the sentence, which alleviates the long-term dependency problem of the LSTM model and allows effective recognition of entities. The proposed model was evaluated on two benchmark datasets, the JNLPBA and NCBI-Disease, and a comparative analysis with the existing models is performed. The proposed model achieved a relatively higher performance with an F1-score of 86.93% in case of NCBI-Disease, and a competitive performance for the JNLPBA with an F1-score of 75.31%.

The conflicting role of E2F1 in prostate cancer: A matter of cell context or interpretational flexibility?

The transcription factor E2F1 plays a crucial role in mediating multiple cancer hallmark capabilities that regulate cell cycle, survival, apoptosis, metabolism, and metastasis. Aberrant activation of E2F1 is closely associated with a poor clinical outcome in various human cancers. However, E2F1 has conflictingly been reported to exert tumor suppressive activity, raising a question as to the nature of its substantive role in the control of cell fate. In this review, we summarize deregulated E2F1 activity and its role in prostate cancer. We highlight the recent advances in understanding the molecular mechanism by which E2F1 regulates the development and progression of prostate cancer, providing insight into how cell context or data interpretation shapes the role of E2F1 in prostate cancer. This review will aid in translating biomedical knowledge into therapeutic strategies for prostate cancer.

A study of factors affecting the physical activity of youth: analysis of data from the 13th youth health behavior online survey in 2017.

This study was intended to provide basic data to promote youth participation in physical activity by determining the factors that affect the physical activities of Korean youth. To achieve the purpose of this study, data obtained from the 13th Youth Health Behavior Online Survey in 2017 was used as raw data and data on 62,276 youths were analyzed by frequency analysis, chi-square test, and logistic regression analysis using IBM SPSS Statistics ver. 22.0. The results suggested gender (P<0.001), school grade (P<0.001), and residential type (P<0.001) in general characteristics; subjective health status (P<0.001), stress perception (P<0.001), and sleep satisfaction (P<0.001); and finally drinking experience (P<0.004), smoking experience (P<0.009), and skipping breakfast in the morning (P<0.009) as factors affecting Korean youth's participation in physical activity. These results indicate that: male students participated in physical activities more than female students, and middle school students participated in physical activities more than high school students; students with a higher economic status and academic performance participated more in physical activities; and students with higher subjective health status, higher happiness, and higher sleep satisfaction, students who did not drink or smoke, and students who had breakfast participated more in physical activities.

Effects of exercise and nutrition education programs on motor function and eating habit in mild dementia patients.

The purpose of this study was to investigate the effects of physical ac-tivity and nutrition education programs on mild dementia patients with changes in exercise function and eating habits. We examined the effects of pre and post program on 23 old patients with dementia who were diagnosed with menarche or mild dementia with the permission of the dementia center in Incheon city and visited from April to July 2017. The Mini-Mental State Examination score of the subjects in this study was 19.68±3.25, consisting of mild dementia patients. After performing the program for 16 weeks, the senior fitness test showed a significant change in the arm curl test, chair sit-and-reach test, and 2-min step test, and a total score of mini nutrition assessment increased from 19.16 to 21.0. In particular, in a level 2 evaluation, which contains more details such as the condition of taking drugs, number of daily meals, protein food intake condition, intake of vegetables, fruit, and water, whether one can eat alone, and evaluation of nutritive condition, a significant increase from 9.78 to 11.28 was verified. There is a significant increase in nutrition condition recovery as a result of nutrition education. In comparing pre and post program, a significant result was confirmed, and there was significance to provide the basic empirical data for the exercise and dietary life nutritional education of mild dementia patients.

Hyaluronate - parathyroid hormone peptide conjugate for transdermal treatment of osteoporosis.

Human parathyroid hormone 1-34 fragment (PTH1-34) has been used as a FDA-approved therapeutics to treat osteoporosis by daily subcutaneous injection. In this work, we successfully developed PTH1-34 conjugated hyaluronic acid (HA) for the transdermal treatment of osteoporosis with improved patient compliance. HA-PTH1-34 conjugate was synthesized by the coupling reaction between aldehyde group introduced to HA and amine group of PTH1-34. After characterization by gel permeation chromatography (GPC) and ELISA, the biological effect of HA-PTH1-34 conjugate on the proliferation of human osteoblast cells was confirmed by in vitro calcium colorimetric assay and cAMP assay. Two-photon microscopy clearly visualized the effective skin penetration of FITC modified HA-PTH1-34 conjugate. The transdermally delivered HA-PTH1-34 conjugates elevated the blood calcium concentration for more than 2 days, reflecting the feasibility for the treatment of osteoporosis.

Changes in physical fitness and body composition according to the physical activities of Korean adolescents.

This study comparatively analyzed obesity, lean balance, and physical fitness related to growth and development in female middle school students to investigate the importance of regular physical activity on body composition and physical fitness in adolescence. The subjects were 31 elementary school students in grades 5-6 in Seoul, consisting of 16 students in the regularly active group and 15 students in the inactive group. Body composition and physical fitness factors were measured. Height, weight, body mass index (BMI), fat mass, and fat-free mass were measured using Inbody 3.0. Physical fitness factors such as muscle strength (grip strength), muscle endurance (situps), flexibility (body flexion), agility (side stepping), and lean balance (balancing with eyes closed), were measured as described herein. The results of comparing the two groups' obesity-related body composition, the weight (P<0.001), body fat mass (P<0.001), BMI (P<0.002), and % body fat (P<0.033) were significantly higher in the inactive group compared to the physically active group. Comparison of lean balance was there was a significant difference in muscle mass between the left and right Arm (P<0.001), left and right leg (P<0.002) in the inactive group. comparing physical fitness between groups was trunk flexion (P<0.001) and side stepping (P<0.001) were higher in the physically active than the inactive group. This study found significant differences in weight, body fat, BMI, flexibility, and side stepping between the physically active and inactive groups, which may negatively affect health indicators related to adolescents' growth, development, and obesity. Therefore, attempts to promote physical activity in growing adolescents are crucial.

Hyaluronate-Peanut Agglutinin Conjugates for Target-Specific Bioimaging of Colon Cancer.

Colon cancer is one of the most common death-related cancers in the world. For treating colon cancer, it is crucial to detect and remove malignant lesions early. Here, we developed hyaluronate (HA)-peanut agglutinin (PNA) conjugates for the bioimaging of colon cancer. The HA-PNA conjugates were successfully synthesized by the coupling reaction between aldehyde-modified HA and the N-terminal amine group of PNA. For diagnostic imaging, rhodamine B (RhoB) was chemically conjugated onto PNA in HA-PNA conjugates. After intraluminal injection of HA-PNA-RhoB conjugates into tumor-bearing mice, small-sized colon cancers could be effectively visualized by ex vivo imaging with an in vivo imaging system (IVIS) and a two-photon microscope. With these results taken together, we could confirm the feasibility of HA-PNA-RhoB conjugates as a bioimaging agent for detecting colon cancers.