Impact of Social Distancing on Intussusception Incidence in Children

Following nonpharmaceutical intervention (NPI) to mitigate coronavirus disease 2019 has led to drastic reduction in incidence of communicable disease. Intussusception is commonly preceded by infectious pathogens. Indirect effect from NPI implementation on incidence of intussusception has not been understood fully. We conducted a cohort study to estimate the impact of NPI on incidence of intussusception in Korean children. The net risk ratio of intussusception incidence for 2020 compared to 2010–2019 was 0.53 (95% confidence interval [CI], 0.43–0.64) for boys and 0.56 (95% CI, 0.44–0.71) for girls (P for difference = 0.017). Our study showed an association between NPI implementation and reduction of intussusception incidence, with more profound reduction in boys compared to girls.     

Comparative assessment of relapse and failure between CAD/CAM stainless steel and standard stainless steel fixed retainers in orthodontic retention patients:: A randomized controlled trial

ObjectivesTo compare relapse and failure rates of computer-aided design/computer-aided manufacturing (CAD/CAM) and standard fixed retainers.Materials and MethodsThis single-center, single-blinded, prospective randomized clinical trial included 46 patients who completed active orthodontic treatment and complied with retention visits. The patients were randomly assigned to three groups: CAD/CAM group with multistranded stainless steel wires (CAD/CAM, n = 16), Lab group with the same multistranded wires (lab, n = 16), and control group with stainless steel Ortho-FlexTech wires (traditional, n = 14). Intraoral scans were obtained at placement of fixed retainers (T1), 3-month visit (T2), and 6-month visit (T3) and measured for intercanine width and Little''s Irregularity Index. Failures were recorded.ResultsThe CAD/CAM group experienced less intercanine width decrease than the traditional group at 3 months (mean difference, 0.83 ± 0.16 mm; 95% confidence interval [CI], 0.44–1.22; P < .001) and 6 months (mean difference, 1.23 ± 0.40 mm; 95% CI, 0.19–2.27; P < .05). The CAD/CAM group experienced less increase in Little''s Irregularity Index compared with the lab group within 3 months (mean difference, 0.81 ± 0.27 mm; 95% CI, 0.12–1.49; P < .05). Failures from greatest to least were experienced by the lab group (43.8%), the CAD/CAM group (25%), and the traditional group (14.3%).ConclusionsWithin 6 months of bonding fixed retainers, CAD/CAM fixed retainers showed less relapse than lab-based and traditional chairside retainers and less failures than lab-based retainers.     

RETRACTED ARTICLE: MicroRNA-30c-regulated HDAC9 mediates chemoresistance of breast cancer

Cancer Chemotherapy and Pharmacology - Although histone deacetylase (HDAC) inhibitors have been shown to effectively induce the inhibition of proliferation and migration in breast cancer, the...     

Difference between bone age at the hand and elbow at the onset of puberty

In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age.A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich–Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset.There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys (P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods (P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls.The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.     

Effects of Aquatic Backward Locomotion Exercise and Progressive Resistance Exercise on Lumbar Extension Strength in Patients Who Have Undergone Lumbar Diskectomy

Kim Y-S, Park J, Shim JK. Effects of aquatic backward locomotion exercise and progressive resistance exercise on lumbar extension strength in patients who have undergone lumbar diskectomy.

Objective

To compare the effects of aquatic backward locomotion exercise and progressive resistance exercise with a machine on lumbar extension strength in patients who have undergone diskectomy for a lumbar disk herniation.

Design

Prospective comparative study.

Setting

Department of Kinesiology at a state university.

Participants

Male patients (N=30) with disk herniation at spinal levels L3 to S1 completed this study as subjects.

Intervention

After the diskectomy for a lumbar disk herniation, all patients had 6 weeks of rest time. At the end of the rest period, the aquatic backward locomotion exercise and progressive resistance exercise groups, respectively, started first 6 weeks of underwater training and lumbar extension training twice per week. After completion of the first 6-week training, subjects participated in a second 6-week training. After the whole 12-week training, subjects had no training for 6 weeks (detraining) and a follow-up 6-week training (retraining). The control (CON) group did not undergo any training.

Main Outcome Measures

For each test, maximum voluntary isometric lumbar extension strength was measured in 7 trunk positions (72°, 60°, 48°, 36°, 24°, 12°, and 0° of the trunk angle).

Results

The progressive resistance exercise and aquatic backward locomotion exercise groups showed increases in lumbar extension strength after the first 6-week training, although they were not statistically different from the CON group. After a second 6-week training, the progressive resistance exercise and aquatic backward locomotion exercise groups showed statistically significant increases in their strength levels as compared with the CON group. After the detraining period, the strength levels of the progressive resistance exercise and aquatic backward locomotion exercise groups did not statistically differ from the CON group. After the retraining period, the progressive resistance exercise and aquatic backward locomotion exercise groups showed increases in their strength levels, which were different from that of the CON group.

Conclusions

The results obtained suggested that the aquatic backward locomotion exercise is as beneficial as progressive resistance exercise for improving lumbar extension strength in patients after lumbar diskectomy surgery.     

Effect of Training with Whole Body Vibration on the Sitting Balance of Stroke Patients

[Purpose] The purpose of this study was to determine the effects of task-oriented training with whole body vibration (WBV) on the sitting balance of stroke patients. [Subjects] The subjects were 30 stroke patients who were randomly divided into experimental (n₁=15) and control (n₂=15) groups. [Methods] Subjects in both groups received general training five times per week. Subjects in the experimental group practiced an additional task-oriented training program with WBV, which was performed for 15 minutes, five times per week, for four weeks. The center of pressure (COP) path length and average velocity were used to assess subjects static sitting balance, and the Modified Functional Reach Test (MFRT) was used to assess their dynamic sitting balance. The paired t-test was performed to test the significance of differences between before and after the intervention. The independent t-test was conducted to test the significance of differences between the groups. [Results] Following the intervention, the experimental group showed a significant change in MFRT. [Conclusion] The results of this study suggest that task-oriented training with WBV is feasible and efficacious for stroke patients.Key words: Balance, Stroke, Whole body vibration     

Laparotomic radical hysterectomy versus minimally invasive radical hysterectomy using vaginal colpotomy for the management of stage IB1 to IIA2 cervical cancer: Survival outcomes

This study compared survival outcomes for patients with stage IB1 to IIA2 (International Federation of Gynecology and Obstetrics stage 2009) cervical cancer who underwent open radical hysterectomy (ORH) versus those who underwent minimally invasive radical hysterectomy (MIRH) using vaginal colpotomy (VC).Data for 550 patients who were diagnosed with cervical cancer at our institution during the period August 2005 to September 2018 was retrospectively reviewed. Of these, 116 patients who underwent radical hysterectomy (RH) were selected after applying the exclusion criteria. All MIRH patients underwent VC. Clinicopathological characteristics and survival outcomes between the ORH and MIRH groups were compared using appropriate statistical testing.Ninety one patients were treated with ORH and 25 with MIRH during the study period. Among the MIRH patients, 18 underwent laparoscopy-assisted radical vaginal hysterectomy and 7 underwent laparoscopic RH. Preoperative conization was performed more frequently in MIRH patients than in ORH patients (44% vs 22%, respectively, P = .028). The incidence of lymph node invasion was higher in the ORH group than in MIRH group (37.4% vs 12.0% respectively; P = .016). Following RH, ORH patients underwent adjuvant treatment more frequently than MIRH patients (71.4% vs 56.0%, respectively, P = .002). There were no significant differences between ORH and MIRH patients for either progression-free survival (PFS) (91.3% vs 78.7%, respectively; P = .220) or 5-year overall survival (OS) (96.6% vs 94.7%, respectively, P = .929). In univariate analysis, lympho-vascular space invasion was the only clinicopathological feature associated with decreased PFS. No other clinicopathological factors was significantly associated with PFS or OS in univariate and multivariate analyses.Despite a higher incidence of unfavorable prognostic factors in ORH patients, their survival outcomes were not different to those of MIRH patients with VC.     

Role of Preoperative Colonoscopy in Patients with Gastric Cancer: A Case Control Study of the Prevalence of Coexisting Colorectal Neoplasms

Background

We evaluated the prevalence of coexisting asymptomatic colorectal neoplasm (CRN) in patients with gastric cancer (GC).

Methods

Preoperative colonoscopic examinations were performed in 495 patients with GC who underwent gastrectomy between January 2009 and December 2010. To compare the prevalence of CRN in these patients with that in a normal population, we selected 495 sex- and age-matched persons who underwent colonoscopies for health screening. Risk factors for CRN were evaluated by univariate and multivariate analyses.

Results

The overall incidence of CRN was 41.8 % (414/990). The prevalence of overall CRN, high-risk CRN, and colorectal carcinoma (CRC) were significantly higher in the GC group than in the control group (overall CRN: 48.9 % vs. 34.7 %; high-risk CRN: 28.3 % vs. 13.5 %; CRC: 2.6 % vs. 0.2 %; all P < 0.001). The presence of GC [odds ratio (OR), 1.82; 95 % confidence interval (CI), 1.4–2.38; P < 0.001], age ≥50 years (OR, 2.58; 95 % CI, 1.75–3.81; P < 0.001), and male sex (OR, 2.28; 95 % CI, 1.72–3.02; P < 0.001) were risk factors for overall CRN. In patients with GC, age ≥40 years (OR, 3.22; 95 % CI, 1.24–8.37; P = 0.016) and male sex (OR, 3.21; 95 % CI, 2.17–4.76; P < 0.001) were risk factors for overall CRN.

Conclusions

The prevalence of coexisting CRN, including CRC, was higher in patients with GC than in the normal population. Preoperative colonoscopy is strongly indicated in patients with GC who are male and/or ≥40 years of age.     

Cell membrane and nuclear expression of programmed death ligand-1 in prostate needle biopsy tissue in prostate cancer patients undergoing primary radiation therapy

BackgroundProgrammed death ligand-1 (PD-L1) expression in cancer is often associated with cancer aggressiveness and responsiveness to treatment with PD-1 pathway inhibitors. We conducted a systematic study on the expression of membranous PD-L1 (mPD-L1) and nuclear PD-1-L1 (nPD-L1) in prostate needle biopsy specimens of prostate cancer patients who underwent primary radiotherapy and analyzed the association between PD-L1 expression and clinicopathological characteristics and prognosis of patients.MethodA total of 971 cancer-containing prostate needle biopsy cores from 172 patients were immunohistochemically stained with anti-PD-L1 antibody. The association of PD-L1 expression with Gleason score and tumor volume percentage was evaluated for each biopsy core. Total of 171 patients were divided according to mPD-L1 or nPD-L1 expression, and clinicopathological characteristics were compared between the positive and negative groups. The prognostic significance of mPD-L1, nPD-L1 and common prognostic factors were analyzed in terms of biochemical recurrence.ResultTotal of 15% and 46% of biopsy cores were stained positive for mPD-L1 and nPD-L1, respectively. There was a positive correlation between Gleason score and mPD-L1 and a negative correlation between Gleason score and nPD-L1. Between mPD-L1 and nPD-L1, there was no significant correlation. There was intraindividual heterogeneity in PD-L1 expression among different Gleason scores. For mPD-L1, only pretreatment PSA was significantly higher in the positive group than in the negative, but not Gleason score and T stage. For nPD-L1, Gleason score and T stage were significantly higher in the positive group than in the negative. Both mPD-L1 and nPD-L1 expression were not predictive of BCR-free survival in univariate and multivariate analyses.ConclusionsOur results suggest that PD-1 pathway inhibitor may be a potential therapeutic option in high risk prostate cancer patients as early as neoadjuvant setting. The novel discovery of PD-L1 expression in the nucleus of PC should be subjected to further research.