Is HOXA5 a Novel Prognostic Biomarker for Uterine Corpus Endometrioid Adenocarcinoma?

Endometrial cancer (EC) is one of the most pervasive malignancies in females worldwide. HOXA5 is a member of the homeobox (HOX) family and encodes the HOXA5 protein. HOXA5 is associated with various cancers; however, its association with EC remains unclear. This study aimed to determine the association between HOXA5 gene expression and the prognosis of endometrioid adenocarcinoma, a subtype of EC (EAEC). Microarray data of HOXA5 were collected from the Gene Expression Omnibus datasets, consisting of 79 samples from GSE17025 and 20 samples from GSE29981. RNA-sequencing, clinical, and survival data on EC were obtained from The Cancer Genome Atlas cohort. Survival analysis revealed that HOXA5 overexpression was associated with poor overall survival in patients with EAEC (p = 0.044, HR = 1.832, 95% CI = 1.006-3.334). Cox regression analysis revealed that HOXA5 was an independent risk factor for poor prognosis in EAEC. The overexpression of HOXA5 was associated with a higher histological grade of EAEC, and it was also associated with TP53 mutation or the high copy number of EC. Our findings suggest the potential of HOXA5 as a novel biomarker for predicting poor survival outcomes in patients with EAEC.

A Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Office Workers with Chronic Neck Pain: A Randomized Controlled Clinical Study.

BACKGROUND Neck pain is associated with computer work, poor posture, imbalanced neck muscles, and fatigue, particularly in office workers. This study from a single center aimed to compare the effects of thoracic spine mobility exercise and thoracic spine manipulation to improve cervical spine range of motion in 26 office workers who had chronic neck pain for more than 12 weeks. MATERIAL AND METHODS The participants were 26 office workers with neck pain lasting >12 weeks. These participants were randomly assigned to undergo TSME (n=13) or TSM (n=13). Both groups underwent cervical joint mobilization and deep cervical flexor muscle exercises for 25 min a day, twice weekly, for 6 weeks. The TSME group additionally performed TSME 15 min a day, twice a week, for 6 weeks, while the TSM group received TSM 2 times a day, twice a week, for 6 weeks. Cervical and thoracic spine ROM, numeric pain rating scale (NPRS), and neck disability index (NDI) were measured before and after interventions. The ROM of cervical and thoracic spine was measured using a dual inclinometer. RESULTS Both groups showed significant changes in cervical spine ROM, thoracic spine ROM, NPRS, and NDI after intervention compared to before intervention (P<0.05). Cervical spine right lateral flexion and right rotation differed significantly between the groups (P<0.05), while thoracic spine ROM, NPRS, and NDI did not. CONCLUSIONS TSME and TSM have similar effects in improving pain and disability in office workers with non-specific chronic neck pain.

Agreement between Azure Kinect and Marker-Based Motion Analysis during Functional Movements: A Feasibility Study.

(1) Background: The present study investigated the agreement between the Azure Kinect and marker-based motion analysis during functional movements. (2) Methods: Twelve healthy adults participated in this study and performed a total of six different tasks including front view squat, side view squat, forward reach, lateral reach, front view lunge, and side view lunge. Movement data were collected using an Azure Kinect and 12 infrared cameras while the participants performed the movements. The comparability between marker-based motion analysis and Azure Kinect was visualized using Bland-Altman plots and scatter plots. (3) Results: During the front view of squat motions, hip and knee joint angles showed moderate and high level of concurrent validity, respectively. The side view of squat motions showed moderate to good in the visible hip joint angles, whereas hidden hip joint angle showed poor concurrent validity. The knee joint angles showed variation between excellent and moderate concurrent validity depending on the visibility. The forward reach motions showed moderate concurrent validity for both shoulder angles, whereas the lateral reach motions showed excellent concurrent validity. During the front view of lunge motions, both the hip and knee joint angles showed moderate concurrent validity. The side view of lunge motions showed variations in concurrent validity, while the right hip joint angle showed good concurrent validity; the left hip joint showed poor concurrent validity. (4) Conclusions: The overall agreement between the Azure Kinect and marker-based motion analysis system was moderate to good when the body segments were visible to the Azure Kinect, yet the accuracy of tracking hidden body parts is still a concern.

Bioinformatic Analysis for Influential Core Gene Identification and Prognostic Significance in Advanced Serous Ovarian Carcinoma.

Background and objectives: Ovarian cancer is one of the leading causes of death among women worldwide. Most newly diagnosed ovarian cancer patients are diagnosed in advanced stages of the disease. Despite various treatments, most patients with advanced stage ovarian cancer, including serous ovarian cancer (the most common subtype of ovarian cancer), experience recurrence, which is associated with extremely poor prognoses. In the present study, we aimed to identify core genes involved in ovarian cancer and their associated molecular mechanisms, as well as to investigate related clinicopathological implications in ovarian cancer. Materials and methods: Three gene expression cohorts (GSE14407, GSE36668, and GSE38666) were obtained from the Gene Expression Omnibus databases to explore potential therapeutic biomarkers for ovarian cancer. Nine up-regulated and six down-regulated genes were screened. Three publicly available gene expression datasets (GSE14407, GSE36668, and GSE38666) were analyzed. Results: A total of 14 differently expressed genes (DEGs) were identified, among which nine genes were upregulated (BIRC5, CDCA3, CENPF, KIF4A, NCAPG, RRM2, UBE2C, VEGFA, and NR2F6) and were found to be significantly enriched in cell cycle regulation by gene ontology analysis. Further protein-protein interaction network analysis revealed seven hub genes among these DEGs. Moreover, Kaplan-Meier survival analysis showed that a higher expression of CDCA3 and UBE2C was associated with poor overall patient survival regardless of tumor stage and a higher tumor histologic grade. Conclusion: Altogether, our study suggests that CDCA3 and UBE2C may be valuable biomarkers for predicting the outcome of patients with advanced serous ovarian cancer.

Immediate Effects of Thoracic Spinal Manipulation on Pulmonary Function in Stroke Patients: A Preliminary Study.

OBJECTIVES: The purpose of this study was to investigate the immediate effects of thoracic spinal manipulation (TSM) on pulmonary function in stroke patients. METHODS: Thirty-six volunteers with stroke (20 men, 16 women) were recruited and randomized to a TSM group (n = 18) and a sham group (n = 18). All participants underwent initial pulmonary function test and then rested supine for 10 minutes before the intervention. Pulmonary function test was repeated immediately after the intervention. Forced vital capacity, forced expiratory volume at 1 second, maximum voluntary ventilation, and residual volume were measured by a spirometer in preintervention and post-intervention. RESULTS: Significant between-group differences were observed in forced vital capacity and forced expiratory volume at 1 second in the TSM group (P < .05). No significant changes in dependent variables were seen in the sham group. CONCLUSION: The pulmonary function values for patients in the TSM group were significantly enhanced with no significant improvement in maximum voluntary ventilation and residual volume. Mechanical factors may be responsible for the improved pulmonary function in the TSM group.

Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults.

Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.

Kinematic analysis of head, trunk, and pelvic motion during mirror therapy for stroke patients.

[Purpose] The purpose of this study was to investigate mirror therapy (MT) condition by analyzing kinematic parameters according to mirror size and angle. [Subjects and Methods] Three hemiparesis stroke patients and five healthy adults participated in this cross-sectional study. Kinematic parameters during the MT were collected over a total of 5 trials for each subject (3 mirror angles × 3 mirror sizes). Center of pressure (COP) excursion data was collected by force plate, and other kinematic parameters by infra-red cameras. [Results] The larger the size and smaller the angle, the overall dependent variables decreased in all participants. Particularly, when virtual reality reflection equipment (VRRE) was used, the value of the flexion and the lateral tilt was the closest to the midline compared to all other independent variables. Moreover, it showed tendency of moving towards the affected side. Based on the results, MT for stroke patients has a disadvantage of shifting weight and leaning towards the unaffected side during therapy. [Conclusion] Therefore, it seems to be more effective in terms of clinics to apply VRRE to make up for the weak parts and provide more elaborate visual feedback.

Glutamine Prevents Late-Phase Anaphylaxis via MAPK Phosphatase 1-Dependent Cytosolic Phospholipase A2 Deactivation.

BACKGROUND: Cytosolic phospholipase A2 (cPLA2) plays a key role in the development of late-phase anaphylaxis. L-Glutamine (Gln), a nonessential amino acid, has anti-inflammatory activity via inhibiting cPLA2. METHODS: We used a penicillin-induced murine model of anaphylaxis, and late-phase anaphylaxis was quantified by measuring the increase in the hematocrit (Ht) value. Various inhibitors, small interfering RNA, and knockout mice were used in inhibition experiments. Phosphorylation and protein expression of cPLA2, ERK, and MAPK phosphatase 1 (MKP-1) were detected by Western blotting. RESULTS: Leukotriene (LT) B4 was found to be another potent inducer of late-phase anaphylaxis besides the known mediator platelet-activating-factor (PAF). Gln efficiently prevented late-phase anaphylaxis when it was administered up to 3 h after challenge injection via inhibiting cPLA2. Inhibition studies indicated that p38 MAPK was the major upstream regulator of cPLA2. Gln dephosphorylated p38 and cPLA2 via up-regulating the negative regulator of p38 MAPK, i.e., MKP-1 protein. MKP-1 blockade abrogated all the effects of Gln. CONCLUSION: Of the cPLA2 metabolites, PAF and LTB4 play a key role in the development of late-phase anaphylaxis, and Gln prevents the reaction via MKP-1-dependent deactivation of cPLA2.

Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials.

BACKGROUND Virtual reality reflection therapy (VRRT) is a technically enhanced version of the mirror therapy concept. The aim of this study was to investigate whether VRRT could improve the postural balance and gait ability of patients with chronic stroke. MATERIAL AND METHODS Twenty-five patients with chronic stroke were randomly allocated into the VRRT group (n=13) and the control group (n=12). The participants in both groups performed a conventional rehabilitation program for 30 minutes. The VRRT group also performed a VRRT program for 30 minutes, five times a week for 4 weeks. The control group performed conventional rehabilitation program and a placebo VRRT program. Outcome measures included Berg Balance Scale (BBS), the Functional Reaching Test (FRT), and the Timed Up and Go (TUG) test (for dynamic balance ability), postural sway (for static balance ability), and 10 meter walking velocity (10 mWV) for gait ability. RESULTS There were statistically significant improvements in the VRRT group compared with the control group for BBS, FRT, TUG, postural sway (mediolateral sway distance with eyes open and eyes closed, anteroposterior and total sway distance with eyes open but not with eyes closed), and 10 mWV (p<0.05). CONCLUSIONS Applying VRRT (even as a home treatment) along with a conventional rehabilitation program for patients with chronic stroke might be even more beneficial than conventional rehabilitation program alone in improving affected lower limb function. Future studies should investigate the effectiveness of VRRT with optimal patient selection, and duration and intensity of training.

Determining the Posture and Vibration Frequency that Maximize Pelvic Floor Muscle Activity During Whole-Body Vibration.

BACKGROUND The aim of this study was to investigate the electromyogram (EMG) response of pelvic floor muscle (PFM) to whole-body vibration (WBV) while using different body posture and vibration frequencies. MATERIAL AND METHODS Thirteen healthy adults (7 men, 6 women) voluntarily participated in this cross-sectional study in which EMG data from PFM were collected in a total of 12 trials for each subject (4 body postures, 3 vibration frequencies). Pelvic floor EMG activity was recorded using an anal probe. The rating of perceived exertion (RPE) was assessed with a modified Borg scale. RESULTS We found that vibration frequency, body posture, and muscle stimulated had a significant effect on the EMG response. The PFM had high activation at 12 Hz and 26 Hz (p<0.05). PFM activation significantly increased with knee flexion (p<0.05). The RPE significantly increased with increased frequency (p<0.05). CONCLUSIONS The knee flexion angle of 40° at 12 Hz frequency can be readily promoted in improving muscle activation during WBV, and exercise would be performed effectively. Based on the results of the present investigation, sports trainers and physiotherapists may be able to optimize PFM training programs involving WBV.

Biomechanical alterations of gait termination in middle-aged and elderly women.

[Purpose] The purpose of this study was to analyze the biomechanical changes and patterns of the lower extremities after gait termination in middle-aged and elderly women. [Subjects] The study population comprised an elderly group and middle-aged group. [Methods] To collect kinematic and kinetic data related to gait termination, six infrared cameras and one force platform were used, and variables were calculated by using Visual 3D. [Results] During the termination phase, the elderly group generated less braking force than the middle-aged group. During initiation of the termination phase and after the center of gravity completely stopped moving, there was a difference between the two groups in the hip joint angle. During the termination phase, the maximum angular velocity and extension moment of the ankle joint and those of the knee joint were higher in the elderly group than in the middle-aged group. [Conclusion] In contrast to the middle-aged group that showed a rapid increase and then decrease of the initial extension moment during gait termination, the maximum extension moment that was created during the early stage of the termination phase in the elderly group continued until the center of gravity completely stopped.

Relationship of body composition, knee extensor strength, and standing balance to lumbar bone mineral density in postmenopausal females.

[Purpose] This study aimed to investigate correlations between lumbar bone mineral density (BMD) and general characteristics of postmenopausal females, including body composition, knee extensor strength, standing balance, and femur BMD. [Subjects and Methods] A total of 40 postmenopausal females (55.6 ± 4.6 years) who were caregivers or guardians of patients in the K hospital were included in the study. The weight, height, body composition, left and right knee extensor strength, standing balance, femur BMD, and lumbar BMD measurements of the subjects were obtained. [Results] The effect of measurement variables on lumbar BMD was examined. Increases in age and menopausal duration were observed to significantly increase lumbar BMD, whereas an increase in height was found to significantly decrease lumbar BMD. An increase in soft lean mass, skeletal muscle mass, fat-free mass, and femur BMD was also associated with significantly decreased lumbar BMD. [Conclusion] Age, menopausal duration, soft lean mass, skeletal muscle mass, and fat-free mass were factors that decreased lumbar BMD in menopausal females. This study is expected to provide basic knowledge for osteoporosis prevention and treatment programs for postmenopausal females.

Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction.

[Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility was evaluated as the distance from the bladder base using ultrasound. [Results] According to exercise method, bridge exercise and abdominal curl-ups led to significantly different pelvic floor mobility. The pelvic floor muscle was elevated during the abdominal drawing-in maneuver and descended during maximal expiration. Finally, pelvic floor muscle mobility was greater during abdominal curl-up than during the bridge exercise. [Conclusion] According to these results, the abdominal drawing-in maneuver induced pelvic floor muscle contraction, and pelvic floor muscle contraction was greater during the abdominal curl-up than during the bridge exercise.

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study.

BACKGROUND: Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients. MATERIAL AND METHODS: Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing. RESULTS: The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study. CONCLUSIONS: These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population.

Acute effects of unilateral whole body vibration training on single leg vertical jump height and symmetry in healthy men.

[Purpose] The aim of the present study was to investigate the acute effects of unilateral whole body vibration training on height and symmetry of the single leg vertical jump in healthy men. [Subjects] Thirty males with no history of lower limb dysfunction participated in this study. [Methods] The participants were randomly allocated to one of three groups: the unilateral vibratory stimulation group (n=10), bilateral vibratory stimulation group (n=10), and, no vibratory stimulation group (n=10). The subjects in the unilateral and bilateral stimulation groups participated in one session of whole body vibration training at 26 Hz for 3 min. The no vibratory stimulation group subjects underwent the same training for 3 min without whole body vibration. All participants performed the single leg vertical jump for each lower limb, to account for the strong and weak sides. The single leg vertical jump height and symmetry were measured before and after the intervention. [Results] The single leg vertical jump height of the weak lower limb significantly improved in the unilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump height of the strong lower limb significantly improved in the bilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump symmetry significantly improved in the unilateral vibratory stimulation group, but not in the other groups. [Conclusion] Therefore, the present study found that the effects of whole body vibration training were different depending on the type of application. To improve the single leg vertical jump height in the weak lower limbs as well as limb symmetry, unilateral vibratory stimulation might be more desirable.

Electromyographic analysis of trunk and lower extremity muscle activities during pulley-based shoulder exercises performed on stable and unstable surfaces.

[Purpose] The aim of the present study was to identify the effects of an unstable support surface (USS) on the activities of trunk and lower extremity muscles during pulley-based shoulder exercise (PBSE). [Subjects] Twenty healthy college students were included in this study. [Methods] Surface EMG was carried out in twenty healthy adult men. The activities of trunk and lower extremity muscles performed during PBSE using a resistance of 14 kg on a stable or unstable support surface were compared. The PBSE included shoulder abduction, adduction, flexion, extension, internal rotation, and external rotation. [Results] On the unstable surface, the rectus abdominis and erector spinae showed significantly less activation during shoulder external rotation, but the extent of activation was not significantly different during other shoulder exercises. The external oblique and rectus femoris showed no significant difference during any shoulder exercises. The tibialis anterior showed significantly greater activation during all shoulder exercises, except flexion and extension. The gastrocnemius showed significantly greater activation during shoulder abduction, extension, and internal rotation. However, during shoulder adduction, flexion, and external rotation, the gastrocnemius showed no significant difference. [Conclusion] The use of USS to increase core stability during PBSE is probably not effective owing to compensatory strategies of the ankle.

Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women.

[Purpose] The aim of this study was to investigate the changes in pain intensity, spinal curvature, and balance and gait ability according to the pregnancy period. [Subjects] Nineteen pregnant women and fifteen nonpregnant women were recruited in this study. [Methods] The pain intensity, spinal curvature, gait, and balance of pregnant women were measured according to the pregnant period (2nd and 3rd trimester). The changes in the pregnant women were also compared with those in the nonpregnant women. [Results] The pain intensity and spinal curvature in the third trimester of pregnancy were significantly increased compared with the second trimester. Only the lumbar spine curvature in the third trimester pregnancy was significantly greater in the pregnant women than in non-pregnant women. The gait velocity and cadence in the third trimester of pregnancy showed a significant decrease compared with the second trimester. The gait speed in the second and third trimester of pregnancy showed a significant decrease in the pregnant women compared with nonpregnant women. Balance in the third trimester of pregnancy showed significant improvement compared with the second trimester. The balance of the pregnant women showed a significant decrease compare with that nonpregnant women only on unstable surfaces. [Conclusion] These research findings can be used as basic data for health promotion programs for sound daily activities in pregnant women.

Virtual dual-task treadmill training using video recording for gait of chronic stroke survivors: a randomized controlled trial.

[Purpose] The aim of this study was to examine the effects of virtual dual-task treadmill training using a real-world video recording of the gait of individuals with chronic stroke. [Subjects] Forty chronic stroke survivors were randomly divided into two groups of 20 subjects each. [Methods] The experimental group performed virtual dual-task treadmill training using a video recording for 30 minutes per session, three times a week for 4 weeks, whereas the control group performed only treadmill training for 30 minutes per session, three times a week for 4 weeks. A video recording was performed in a large supermarket, and the subjects could walk at their favorable speed on a treadmill. The temporospatial gait variables were measured to examine the training effect. [Results] The experimental and control groups showed statistically significant improvements in the gait variables after training. The enhancement of gait ability was statistically better in the experimental group than in the control group. [Conclusion] Our findings suggest that virtual dual-task treadmill training using a video recording can improve the gait parameters of chronic stroke survivors.

The effects of core muscle release technique on lumbar spine deformation and low back pain.

[Purpose] The purpose of this study was to examine the effects of the core muscle release technique on correction of lumbar deformation and alleviation of low back pain. [Subjects] Ninety patients diagnosed with lumbar deformation and low back pain participated in this study. [Methods] The participants were divided into three groups according to method of treatment. The first group was treated with the core muscle release technique (CRT), the second group was treated with general exercise, and the third group was treated with electrotherapy. The core muscle release technique group received 50-minute of the core muscle release technique 5 times a week for 2 weeks, and the participants in this group were instructed not to receive any other treatments. After the 2 weeks of treatment, the patients were reexamined. The general exercise group performed Williams flexion exercises and McKenzie extension exercises 5 times a week for 2 weeks. The electrotherapy group was treated by application of electrotherapy with an interferential current therapy machine (TM-301. TOPMED. Seongnam, Republic of Korea) to the abdominal muscles and back muscles of the lumbar region. [Results] The data suggest that the core muscle release technique, general exercise, and electrotherapy all helped to decrease the alignment angle and VAS score. Of these treatment methods, however, the core muscle release technique was the most effective for treatment of lumbar spine deformation and low back pain. [Conclusion] The core muscle release technique was most effective for correction of lumbar spine deformation and pain alleviation.