• Title/Summary/Keyword: visual grading

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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.

Rotator cuff repair with or without proximal end detachment for long head of the biceps tendon tenodesis

  • Mardani-Kivi, Mohsen;Asadi, Kamran;Izadi, Amin;Leili, Ehsan Kazemnejad
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.101-105
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    • 2022
  • Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

Prognostic factors affecting structural integrity after arthroscopic rotator cuff repair: a clinical and histological study

  • Pei Wei Wang;Chris Hyunchul Jo
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.10-19
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    • 2023
  • Background: Tendon degeneration contributes to rotator cuff tears; however, its role in postoperative structural integrity is poorly understood. The purpose of this study was to investigate the factors associated with postoperative structural integrity after rotator cuff repair, particularly focusing on the histology of tendons harvested intraoperatively. Methods: A total of 56 patients who underwent primary arthroscopic rotator cuff repair between 2009 and 2011 were analyzed. A 3-mm-diameter sample of supraspinatus tendons was harvested en bloc from each patient after minimal debridement of the torn ends. Tendon degeneration was assessed using seven histological parameters on a semi-quantitative grading scale, and the total degeneration score was calculated. One-year postoperative magnetic resonance imaging was used to classify the patients based on retear. Results: The total degeneration scores in the healed and retear groups were 13.93±2.03 and 14.08±2.23 (P=0.960), respectively. Arthroscopically measured anteroposterior (AP) tear sizes in the healed and retear groups were 24.30±12.35 mm and 36.42±25.23 mm (P=0.026), respectively. Preoperative visual analog scale pain scores at rest in the healed and retear groups were 3.54±2.37 and 5.16±2.16 (P=0.046), respectively. Retraction sizes in the healed and retear groups were 16.02±7.587 mm and 22.33±13.364 mm (P=0.037), respectively. The odds of retear rose by 4.2% for every 1-mm increase in AP tear size (P=0.032). Conclusions: The postoperative structural integrity of the rotator cuff tendon was not affected by tendon degeneration, whereas the arthroscopically measured AP tear size of the rotator cuff tendon was an independent predictor of retear. Level of evidence: III.

Deep Learning-based Rail Surface Damage Evaluation (딥러닝 기반의 레일표면손상 평가)

  • Jung-Youl Choi;Jae-Min Han;Jung-Ho Kim
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.2
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    • pp.505-510
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    • 2024
  • Since rolling contact fatigue cracks can always occur on the rail surface, which is the contact surface between wheels and rails, railway rails require thorough inspection and diagnosis to thoroughly inspect the condition of the cracks and prevent breakage. Recent detailed guidelines on the performance evaluation of track facilities present the requirements for methods and procedures for track performance evaluation. However, diagnosing and grading rail surface damage mainly relies on external inspection (visual inspection), which inevitably relies on qualitative evaluation based on the subjective judgment of the inspector. Therefore, in this study, we conducted a deep learning model study for rail surface defect detection using Fast R-CNN. After building a dataset of rail surface defect images, the model was tested. The performance evaluation results of the deep learning model showed that mAP was 94.9%. Because Fast R-CNN has a high crack detection effect, it is believed that using this model can efficiently identify rail surface defects.

Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

Relation of the Degree of the Subacromial Bursitis with Acromial Shape and Pain in the Subacromial Impingement Syndrome (견봉하 충돌증후군에서 견봉하 점액낭의 염증 정도와 견봉의 모양 및 통증과의 연관성)

  • Lee, Kwan-Hee;Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Woo-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.34-38
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    • 2009
  • Purpose: To evaluate the association of subacromial bursa inflammation with acromial shape and shoulder pain in subacromial impingement syndrome. Materials and Methods: 24 cases with subacromial impingement syndrome were reviewed. Eighteen patines were males and six females(mean age: 58.3 yrs). During arthroscopic operation, the specimens were taken from subacromial bursa with arthroscopic knife($1{\times}1$ cm size). The shape of acromion were classified according to Bigliani grading system. The shoulder pain of patients was graded with visual analog scale (VAS). The grade of inflammation was classified to the pathological three grade system (mild, moderate, severe) by pathohistological 8 factors. Results: Of total 24 cases, 9 cases were the pathological grade I and 15 cases were grade II. None was grade III. In the 9 cases of pathological grade I, 6 cases were the radiologic grade II of acromial shape and 3 cases were grade III. In the 15 cases of pathological grade II, 5 cases were the radiologic grade II and 10 cases were grade III. The VAS was 7 point at pathological grade I and 8 point at grade II. As the statistical analysis, the pathological grade of subacromial bursa was associated with acromial shape (p<0.05), but not associated with pain of patient (p>0.05). Conclusion: Our study suggests that pathological grade of subacromial bursa inflammation was associated with acromial shape. But pathological grade of subacromial bursa inflammation was not associated with shoulder pain of patients.

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Indicators for the Quantitative Assessment of Tree Vigor Condition and Its Theoretical Implications : A Case Study of Japanese Flowering-cherry Trees in Urban Park (도시공원에 식재된 왕벚나무 수종을 중심으로 한 수목활력도의 정량평가지표 개발 및 이론적 고찰에 관한 연구)

  • Song, Youngkeun
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.17 no.4
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    • pp.57-67
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    • 2014
  • The vigor condition of trees is an important indicator for the management of urban forested area. But difficulties in how to assess the tree vigor condition still remain. Previous efforts were limited in the 1) measurement of single indicator rather than using multiple indices, 2) purpose-oriented measurement such as for air-pollution effect or specific pathological symptom, and 3) ordinal-scale evaluations by field crews 4) despite human errors based on his/her experiences or prior knowledge. Therefore, this study attempted to develop a quantitative and objective methodology for assessing tree vigor condition, by measuring multiple modules and building the profile inventory. Furthermore, the possibility and limitations were discussed in terms of schematic frames describing tree vigor condition. The vigor condition of 56 flowering cherry plants in urban park were assessed by in-situ measurements of following eight items; growth of crown(Gc), growth of shoots, individual tree volume(Vol), plant area index, woody area index, leaf area index, leaf chlorophyll content(Lc) and leaf water content(Lw). For validation, these measurements were compared with the ranks of holistic tree vigor condition, which were visually assessed using a 4-point grading scale based on the expert's knowledge. As a result, the measures of each evaluation item successfully highlighted a variety of aspects in tree vigor condition, including the states of both photosynthetic and non-photosynthetic parts. The variation in the results depending on evaluated parts was shown within an individual tree, even though the broad agreement among the results was found. The result of correlation analysis between the tested measurements and 4-point visual assessment, demonstrated that the state of water-stressed foliage of the season (Lw) or the development of plant materials since sapling phase (Vol) could be better viewed from the outer appearance of trees than other symptoms. But only based on the visual assessment, it may be difficult to detect the quality of photosynthesis (Lc) or the recent trend in growth of trees (Gc). To make this methodology simplified for the broad-scale application, the tested eight measurements could be integrated into two components by principal component analysis, which was labelled with 'the amount of plant materials' and 'vigor trend', respectively. In addition, the use of these quantitative and multi-scale indicators underlies the importance of assessing various aspects of tree vigor condition, taking into account the response(s) on different time and spatial scale of pressure(s) shown in each evaluated module. Future study should be advanced for various species at diverse developing stages and environment, and the application to wide areas at a periodic manner.

Preoperative Shoulder MRI Findings to Predict Subscapularis Tendon Tear Requiring Surgical Repair (수술이 필요한 견갑하건 파열을 예측하기 위한 수술 전 어깨 MRI 소견)

  • Ji-hoon Jung;Young-Hoon Jo;Yeo Ju Kim;Seunghun Lee;JeongAh Ryu
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.171-183
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    • 2024
  • Purpose This study aimed to investigate which indirect parameters on preoperative MRI were the principal predictors of subscapularis tendon tears (STTs) requiring surgical repair. Materials and Methods Preoperative MRI scans of 86 patients were retrospectively reviewed for visual assessment of the STT, pathology of the long head of the biceps tendon (LHBT), posterior decentering (PD) of the humeral head, humeral rotation, fatty degeneration, and subscapularis muscle atrophy. To evaluate atrophy, visual grading using the anatomical line connecting the coracoid tip to the glenoid base, designated as the base-to-tip line (BTL), and thickness measurements were performed in the en-face view. Results Arthroscopically, 31 patients (36%) exhibited Lafosse type III or IV STT and underwent surgical repair. LHBT pathology (p = 0.002), PD of the humeral head (p = 0.012), fatty degeneration (p < 0.001), and BTL grade (p = 0.003) significantly correlated with STT. In the multivariate analysis, PD of the humeral head (p = 0.011, odds ratio [OR] = 5.14) and fatty degeneration (p = 0.046, OR = 2.81) were independent predictors of STT. Conclusion PD of the humeral head and fatty degeneration of the subscapularis can help to diagnose clinically significant STT. Interpretation of these findings may contribute to the planning of an optimal surgical strategy.

T1-weighted MR Imaging of the Neonatal Brain at 3.0 Tesla: Comparison of Spin Echo, Fast Inversion Recovery, and Magnetization-prepared Three Dimensional Gradient Echo Techniques (3T 자기공명영상 장비에서 신생아 뇌의 T1 강조 영상: 스핀에코, 고속 역전회복, 자기화 삼차원 경사에코기법의 비교)

  • Jeong, Jee-Young;Yoo, So-Young;Jang, Kyung-Mi;Eo, Hong;Lee, Jung-Hee;Kim, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.2
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    • pp.87-94
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    • 2007
  • Purpose: The purpose of this study was to evaluate the usefulness of fast inversion recovery (FIR) and magnetization-prepared three dimensional gradient echo sequence (3D GRE) T1-weighted sequences for neonatal brain imaging compared with spin echo (SE) sequence in a 3T MR unit. Materials and Methods: T1-weighted axial SE, FIR and 3D GRE sequences were evaluated from 3T brain MR imaging in 20 neonates. The signal-to-noise ratio (SNR) of different tissues was measured and contrast-to-noise ratios (CNR) were determined and compared in each of the sequences. Visual analysis was carried out by grading gray-white matter differentiation, myelination, and artifacts. The Wilcoxon signed ranked test was used for evaluation of the statistical significance of CNR differences between the sequences. Results: Among the three sequences, the 3D GRE had the best SNRs. CNRs obtained with FIR and 3D GRE were statistically superior to those obtained with SE; these CNRs were better on the 3D GRE compared to the FIR. Gray to white matter differentiation and myelination were better delineated on the FIR and 3D GRE than the SE. However, motion artifacts were more commonly observed on the 3D GRE and flow-related artifacts of vessels were frequently seen on the FIR. Conclusion: FIR and 3D GRE are valuable alternative T1-weighted sequences to conventional SE imaging of the neonatal brain at 3T providing superior image quality.

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A Visual Study of the Quality of English Pronunciation Using the Praat Program (Praat을 활용한 영어발음특성의 시각적 연구)

  • Park, Heesuk
    • Journal of Digital Contents Society
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    • v.14 no.3
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    • pp.323-331
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    • 2013
  • This study aims at investigating and comparing the diphthongs, words, and sentences between two Korean highschool students groups using the Praat program. To do this English words and sentences were uttered and recorded by twenty Korean subjects; each group has ten subjects. All the subjects are female and their grades range from freshman to sophomore. Acoustic features were measured from a sound spectrogram with the help of the Praat software program and analyzed through statistical analysis. Results showed that the lengths of diphthongs and words were different between two groups, but the difference was not significant. However, in the lengths of sentence utterance, the group of 5 to 6 grade students in the current grading system pronounced longer than that of 1 to 2 grade students. Especially in the pronunciation of the first two sentences with more than five words, the difference was significant. From the data of the overall sum of words between the two subject groups, we were able to find out that the differences of the lengths of the words with the diphthongs were not significant, but those of the sentences with more than five words were significant. In the pronunciation of the words between coat and code, the length of the diphthong in coat was smaller than that of in code.