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Do partial glenohumeral degenerative changes in patients undergoing arthroscopic rotator cuff repair influence clinical outcomes?

  • Al-Tawil, Karam;Casey, Joseph;Thayaparan, Prashant;Tavakkolizadeh, Adel;Sinha, Joydeep;Colegate-Stone, Toby
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.112-120
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    • 2022
  • Background: The prognostic factors for patients with full-thickness rotator cuff tears (RCTs) include tear size, muscle atrophy and fatty infiltration. However, the influence of early coexisting degenerative changes on RCT outcomes is unappreciated. The purpose of this study was to calculate the impact that pre-existing partial glenohumeral cartilaginous changes have on patients undergoing arthroscopic RCT repair. Methods: A study of 54 patients undergoing arthroscopic RCT repair was undertaken. The presence of co-existing patches of glenohumeral degenerative cartilaginous changes and RCT size was recorded at surgery. Pre- and postoperative outcomes were assessed using traditional (Oxford Shoulder Score [OSS], 5-level EuroQol-5D [EQ-5D-5L] questionnaire and EuroQol visual analog scale [EQ-VAS]) and patient-centric re-formatted prisms. Outcomes were assessed as an entire dataset, and sub-group analysis was performed according to the grade of co-existing arthritis and tear size. Results: Significant improvements (p<0.05) in clinical outcomes were recognized when assessed using either the traditional or reformatted prisms (average % improvements in OSS, EQ-5D-5L and EQ-VAS were 47%, 33% and 43%, respectively; average improvements in pain, function, and psychological well-being were 48%, 33% and, 29%, respectively). Positive gain was noted in all sub-groups of arthritic grading and tear size. Conclusions: Good clinical outcomes can be achieved following RCT repair even in the presence of local partial degenerative cartilage changes and advancing tear size. These benefits are patient-centered but require RCT repairability.

Effects of prematuration culture with a phosphodiesterase-3 inhibitor on oocyte morphology and embryo quality in in vitro maturation

  • Cheruveetil, Mohammed Ashraf;Shetty, Prasanna Kumar;Rajendran, Arya;Asif, Muhammed;Rao, Kamini A
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.4
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    • pp.352-361
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    • 2021
  • Objective: The study assessed the developmental potential of germinal vesicle (GV) oocytes subjected to in vitro maturation (IVM) after prematuration culture with cilostamide (a phosphodiesterase-3 inhibitor) and the impact of cilostamide exposure on the morphology of meiosis II (MII) oocytes and subsequent embryo quality. Methods: In total, 994 oocytes were collected from 63 patients. Among 307 GV oocytes, 140 oocytes were selected for the experimental group and 130 oocytes for the control group. The denuded GV-stage oocytes were cultured for 6 hours with cilostamide in the experimental group and without cilostamide in the control group. After 6 hours, the oocytes in the experimental group were washed and transferred to fresh IVM medium. The maturational status of the oocytes in both groups was examined at 26, 36, and 48 hours. Fertilization was assessed at 18 hours post-intracytoplasmic sperm injection. Embryo quality was assessed on days 3 and 5. Results: In total, 92.1% of the oocytes remained in the GV stage, while 6.4% converted to the MI stage (p<0.01) after cilostamide exposure. In both groups, more MII oocytes were observed at 36 hours (25.8% vs. 21.5%) than at 26 hours (10.8% vs. 14.6%) and 48 hours (13% vs. 7.9%) (p>0.05). With the advent of cilostamide, blastocyst quality was better in the experimental group than in the control group (p<0.05). Conclusion: Cilostamide effectively blocked nuclear maturation and promoted cytoplasmic growth. Prematuration culture with cilostamide enabled synchronization between cytoplasmic and nuclear maturity, resulting in better blastocyst outcomes.

Clinical Validation of a Deep Learning-Based Hybrid (Greulich-Pyle and Modified Tanner-Whitehouse) Method for Bone Age Assessment

  • Kyu-Chong Lee;Kee-Hyoung Lee;Chang Ho Kang;Kyung-Sik Ahn;Lindsey Yoojin Chung;Jae-Joon Lee;Suk Joo Hong;Baek Hyun Kim;Euddeum Shim
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.2017-2025
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    • 2021
  • Objective: To evaluate the accuracy and clinical efficacy of a hybrid Greulich-Pyle (GP) and modified Tanner-Whitehouse (TW) artificial intelligence (AI) model for bone age assessment. Materials and Methods: A deep learning-based model was trained on an open dataset of multiple ethnicities. A total of 102 hand radiographs (51 male and 51 female; mean age ± standard deviation = 10.95 ± 2.37 years) from a single institution were selected for external validation. Three human experts performed bone age assessments based on the GP atlas to develop a reference standard. Two study radiologists performed bone age assessments with and without AI model assistance in two separate sessions, for which the reading time was recorded. The performance of the AI software was assessed by comparing the mean absolute difference between the AI-calculated bone age and the reference standard. The reading time was compared between reading with and without AI using a paired t test. Furthermore, the reliability between the two study radiologists' bone age assessments was assessed using intraclass correlation coefficients (ICCs), and the results were compared between reading with and without AI. Results: The bone ages assessed by the experts and the AI model were not significantly different (11.39 ± 2.74 years and 11.35 ± 2.76 years, respectively, p = 0.31). The mean absolute difference was 0.39 years (95% confidence interval, 0.33-0.45 years) between the automated AI assessment and the reference standard. The mean reading time of the two study radiologists was reduced from 54.29 to 35.37 seconds with AI model assistance (p < 0.001). The ICC of the two study radiologists slightly increased with AI model assistance (from 0.945 to 0.990). Conclusion: The proposed AI model was accurate for assessing bone age. Furthermore, this model appeared to enhance the clinical efficacy by reducing the reading time and improving the inter-observer reliability.

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

  • Jeppe Holm Rasmussen;Maise Hoeigaard Fredgart;Jes Sanddal Lindholt;Jens Brock Johansen;Niels Sandgaard;Abdulrahman Haj Yousef;Selma Hasific;Pernille Sonderskov;Flemming Hald Steffensen;Lars Frost;Jess Lambrechtsen;Marek Karon;Martin Busk;Grazina Urbonaviciene;Kenneth Egstrup;Axel Cosmus Pyndt Diederichsen
    • Journal of Cardiovascular Imaging
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    • v.30 no.1
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    • pp.62-75
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    • 2022
  • BACKGROUND: Due to its location very close to the bundle of His, mitral annulus calcification (MAC) might be associated with the development of atrioventricular (AV) conduction disturbances. This study assessed the association between MAC and AV conduction disturbances identified by cardiac implantable electronic device (CIED) use and electrocardiographic parameters. The association between MAC and traditional cardiovascular risk factors was also assessed. METHODS: This cross-sectional study analyzed 14,771 participants, predominantly men aged 60-75 years, from the population-based Danish Cardiovascular Screening trial. Traditional cardiovascular risk factors were obtained. Using cardiac non-contrast computed tomography imaging, MAC scores were measured using the Agatston method and divided into absent versus present and score categories. CIED implantation data were obtained from the Danish Pacemaker and Implantable Cardioverter Defibrillator Register. A 12-lead electrocardiogram was available for 2,107 participants. Associations between MAC scores and AV conduction disturbances were assessed using multivariate regression analyses. RESULTS: MAC was present in 22.4% of the study subjects. Participants with pacemakers for an AV conduction disturbance had significantly higher MAC scores (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.01-1.23) than participants without a CIED, whereas participants with a CIED for other reasons did not. Prolonged QRS-interval was significantly associated with the presence of MAC (OR, 1.45; 95% CI, 1.04-2.04), whereas prolonged PQ-interval was not. Female sex and most traditional cardiovascular risk factors were significantly associated with high MAC scores. CONCLUSIONS: MAC was associated with AV conduction disturbances, which could improve our understanding of the development of AV conduction disturbances.

The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea

  • Cho, Bong-Hae;Jung, Yun-Hoa;Nah, Kyung-Soo
    • Imaging Science in Dentistry
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    • v.37 no.4
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    • pp.185-189
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    • 2007
  • Purpose: This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Materials and Methods: Panoramic radiographs from 10,646 patients (4,982 males and 5,664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Results: Of 10,646 panoramic radiographs, 33 radiographs (0.31 %) exhibited evidence of COD. The prevalence of COD increased to over 1 % in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due to the multiplicity of FCOD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesions examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. Conclusion : COD has a predilection for the mandibular molar area of middle-aged and older women.

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Evaluation of a Career Ladder Program for Nurses in a Hospital (임상간호사 경력개발 프로그램 평가)

  • Park, Kwang-Ok;Park, Sung Hee;Kim, Yeon-Hee;Choi, Jeong-Hee
    • Perspectives in Nursing Science
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    • v.11 no.2
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    • pp.123-131
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    • 2014
  • Purpose: The purposes of this study were to assess the efficacy and usefulness of the career ladder program in a hospital and to evaluate nurses' satisfaction with the program. Methods: The study was conducted using a survey consisting of 14 questions on the appropriateness, necessity and usefulness of the career ladder program. The data were gathered from 403 nurses in a hospital. We assessed differences in responses according to the participants' workplace, age, educational background, marital status, experience (total years and years at current working place). We analyzed the data using SPSS/WIN 12.0. Results: Nurses acknowledged that the career ladder program is necessary and profitable within the nursing field, but they worried about the appropriateness of the nurse's role at each career level and rationality of the portfolio. The study also identified nurses' characteristics that were significant factors in explaining nurses' satisfaction with the career ladder program. Finally, we identified complaints and improvements for the program. Conclusion: We assessed differences in attitude towards the career ladder program according to nurses' characteristics.

Positional and morphologic changes of the temporomandibular joint disc using magnetic resonance imaging

  • Ahn Hyoun-Suk;Cho Su-Beom;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.31 no.4
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    • pp.235-240
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    • 2001
  • Purpose: To evaluate displacement and morphologic changes of the temporomandibular joint (TMJ) disc in patient with internal derangement using magnetic resonance imaging (MRI). Materials and Methods: One hundred and forty five MR images of TMJs in 73 patients were evaluated. Positional and morphologic changes of the TMJ discs were assessed. Lateral or medial disc displacement was also evaluated on coronal images. Results: Among 63 discs with anterior disc displacement, 37 discs were assessed as a biconcave disc and 21 as a deformed disc. Rotational disc displacement was observed in 35 discs. Anteromedial disc displacement was observed in 29 discs, and anterolateral direction in 6 discs. Among 35 rotational displacement, 5 biconcave discs and 21 deformed discs were observed. Conclusion : Rotational and sideways displacement of TMJ discs were found to be common and an important aspect of internal derangement. This study also suggests that sagittal and coronal images of the TMJ have complementary abilities for an assessment of joint abnormality.

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Effects of Trunk Position Sense through Visual Cue Deprivation Balance Training in Subacute Stroke (앉은 자세에서의 시각을 차단한 균형훈련이 아급성기 뇌졸중 환자의 체간 위치감각에 미치는 영향)

  • Han, Kyu-Bum;Shin, Won-Seob
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.327-335
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    • 2013
  • PURPOSE: The purpose of this study is to investigate effects of trunk position sense through visual cue deprivation balance training in subacute stroke patients. METHODS: The subjects were randomly allocated to two groups: experimental(n=10) and control(n=10). Both groups performed balance training on sitting for 30minute after measurements. Trunk position sense test was assessed using the David back concept to determine trunk repositioning error for four movement(flexion, extension, affected side lateral flexion, non-affected side lateral flexion). Measurements on each test were assessed prior to the balance training and then immediately following the balance training. RESULTS: In comparison of the difference of the trunk position sense between groups, the experimental group decreased significantly in trunk repositioning error of flexion, extension and affected side lateral flexion than control group(p<.05). CONCLUSION: The trunk position sense of the experimental group showed more improvement after the balance training program compared to the control group, Therefore, these results suggest that visual cue deprivation training is considered an effective exercise method for individuals with subacute stroke.

Reproducibility of the Isokinetic Joint Torque as a Rotator Cuff Weakness Test Protocol in Patients With Rotator Cuff Tendinitis

  • Kim, Soo-yong;Oh, Jae-seop
    • Physical Therapy Korea
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    • v.24 no.3
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    • pp.21-29
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    • 2017
  • Background: The measurement of the strength of the shoulder muscles is an important element of the overall assessment of patients with various shoulder disorders. However, the clinical utilization of this measurement is dependent on its reproducibility. Objects: To explore the reproducibility of the measurements derived from testing of the isokinetic strength of shoulder muscles in patients with tendinitis of the rotator cuff. Methods: A total of 20 patients with tendinitis of the rotator cuff participated in this study and were assessed twice in 1 week. Isokinetic testing was performed concentrically for shoulder flexors, abductors, and external rotators and eccentrically for the shoulder extensors, adductors, and internal rotators. The relative and absolute reproducibility of the peak torque (PT) and ratios were assessed using intra-class correlation coefficients (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID), respectively. Results: Overall, high to excellent ICC, clinically acceptable SEM and MCID values were obtained for the PT (ICC: .83-.95, SEM: 1.2%-9%, MCID: 3.4%-25%) and ratios (ICC: .85-.93, SEM: 5.1%-10%, MCID: 14.2%-27.6%). Conclusion: These findings suggest that isokinetic tests may be effectively utilized for the determination of shoulder strength profiles and appropriate position are recommended to perform test without pain in patients with tendinitis of the rotator cuff.

Uncertainty assessment for a towed underwater stereo PIV system by uniform flow measurement

  • Han, Bum Woo;Seo, Jeonghwa;Lee, Seung Jae;Seol, Dong Myung;Rhee, Shin Hyung
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.10 no.5
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    • pp.596-608
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    • 2018
  • The present study aims to assess test uncertainty assessment method of nominal wake field measurement by a Stereoscopic Particle Image Velocimetry (SPIV) system in a towing tank. The systematic uncertainty of the SPIV system was estimated from repeated uniform flow measurements. In the uniform flow measurement case, time interval between image frames and uniform flow speed were varied to examine the effects of particle displacement and flow around the SPIV system on the systematic standard uncertainty. The random standard uncertainty was assessed by repeating nominal wake field measurements and the estimated random standard uncertainty was compared with that of laser Doppler velocimetry. The test uncertainty assessment method was applied to nominal wake measurement tests of a very large crude oil carrier model ship. The nominal wake measurement results were compared with existing experimental database by other measurement methods, with its assessed uncertainty.