BACKGROUND: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. METHODS: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. RESULTS: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. CONCLUSIONS: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.
Baseball* ; Education ; Elbow* ; Humans ; Shoulder Pain ; Shoulder* ; Weather

BACKGROUND: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. METHODS: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. RESULTS: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. CONCLUSIONS: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.
Baseball ; Education ; Elbow ; Humans ; Shoulder Pain ; Shoulder ; Weather

Purpose: The purpose of this study is to analyze the clinical results of patients with basicervical fractureundergoing cephalomedullary nailing (CMN) with an additional cannulated screw fixation compared to only performing CMN. We hypothesized that a difference may exist in the clinical outcomes if an ad-ditional screw is fixed with CMN compared to only performing CMN in basicervical fracture. Materials and Methods: A total of 28 consecutive patients who underwent CMN for basicervical fracture were included. In 9 cases, only CMN was conducted, and in 19 cases, an additional cannulated screw fixation was performed with CMN. Bone union, sliding distance, reduction status, and fixation failure were evaluated by postoperative radiography, and ambulatory ability was evaluated by functional results. These findings were compared between a group of CMN and a group of CMN with an additional cannulated screw. Results: There were 4 males and 24 females with a mean age of 84 years (range, 69–100 years). No significant difference was found in postoperative reduction, tip-apex distance, bone union, and walking function recovery after surgery between the two groups, but in the sliding distance of the lag screw, the CMN group demonstrated more sliding (6.2 mm [range, 2.5–13.4 mm] vs 3.5 mm [range, 0.1– 9.2 mm]; p=0.045). Among the two groups, only one case of fixation failure at the postoperative four months was observed in the CMN group (p=0.321), and hemiarthroplasty with nail construct removal was performed. Conclusion CMN with additional cannulated screw fixation is a safe and reliable surgical option in basicervical fracture. It provided favorable clinical outcomes and may be a good alternative for treating basicervical fracture.

Here, we examined the effect of melting point of drug carriers on drug release of dexamethasone (Dex)-loaded microspheres. We prepared poly(L-lactide-ran-ε-caprolactone) (PLC) copolymers with varying compositions of poly(εcaprolactone) (PCL) and poly(L-lactide) (PLLA). As the PLLA content increased, the melting points of PLC copolymers decreased from 61 to 43 ℃. PLC copolymers in vials solubilized at 40–50 ℃ according to the incorporation of PLLA into the PCL segment. Dexamethasone (Dex)-loaded PLC (MCxLy) microspheres were prepared by the oil-in-water (O/W) solvent evaporation/extraction method. The preparation yields were above 70%, and the mean particle size ranged from 30 to 90 µm. The MC(x)L(y) microspheres also showed controllable melting points in the range of 40–60 ℃. Dex-loaded MC(x)L(y) microspheres showed similar in vitro and in vivo sustained release patterns after the initial burst of Dex. The in vitro and in vivo order of the Dex release was MC₈₀L₂₀>MC₉₀L₁₀>MC₉₅L₅, which agreed well with the melting point order of the drug carrier. Using in vivo fluorescence imaging of fluorescein (FI)-loaded microspheres implanted in animals, we confirmed the sustained release of FI over an extended period. In vivo inflammation associated with the PLC microsphere implants was less pronounced than that associated with Poly(lactide-co-glycolide) (PLGA). In conclusion, we successfully demonstrated that it is possible to control Dex release using Dex-loaded MC(x)L(y) microspheres with different melting points.
Animals ; Dexamethasone ; Drug Carriers* ; Drug Liberation* ; Fluorescein ; Freezing* ; In Vitro Techniques ; Inflammation ; Methods ; Microspheres* ; Optical Imaging ; Particle Size ; Polyglactin 910

PURPOSE: Postcholecystectomy syndrome (PCS) is characterized by abdominal symptoms following gallbladder removal. However, there is no consensus for the definition or treatment for PCS. The purpose of this study was to define PCS among various symptoms after laparoscopic cholecystectomy, and to identify risk factors affecting PCS. METHODS: This study was conducted at Dongguk University Ilsan Hospital and Chung-Ang University Hospital (2012–2013). Outcomes were assessed using European Organization for Research and Treatment of Cancer QLQ–C30 questionnaire. Symptom cluster for determining PCS was made by factor analysis. Cluster analysis evaluating risk factors of PCS was made by Ward methods and Dentogram. RESULTS: Factor analysis revealed three distinct symptom clusters, those are ‘insomnia and financial difficulties (eigenvalue, 1.707; Cronbach α, 0.190),’‘appetite loss and constipation (eigenvalue, 1.413; Cronbach α, 0.480),’ and ‘right upper quadrant (RUQ) pain and diarrhea (eigenvalue, 1.245; Cronbach α, 0.315).’ Among these symptom clusters, the cluster of ‘RUQ pain and diarrhea’ was determined as PCS. However, we could not find any risk factors between high symptomatic group and low symptomatic group. CONCLUSION: PCS could consist of RUQ pain and diarrhea. Well-designed prospective trials are needed to determine risk factors of PCS.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Consensus ; Constipation ; Diarrhea ; Gallbladder ; Postcholecystectomy Syndrome* ; Prospective Studies ; Quality of Life ; Risk Factors

Background: As the coronavirus disease 2019 (COVID-19) pandemic continues, there are concerns regarding waning immunity and the emergence of viral variants. The immunogenicity of Ad26.COV2.S against wild-type (WT) and variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) needs to be evaluated.Method: This prospective cohort study was conducted between June 2021 and January 2022 at two university hospitals in South Korea. Healthy adults who were scheduled to be vaccinated with Ad26.COV2.S were enrolled in this study. The main outcomes included anti-spike (S) IgG antibody and neutralizing antibody responses, S-specific T-cell responses (interferon-γ enzyme-linked immunospot assay), solicited adverse events (AEs), and serious AEs. Results: Fifty participants aged ≥ 19 years were included in the study. Geometric mean titers (GMTs) of anti-S IgG were 0.4 U/mL at baseline, 5.2 ± 3.0 U/mL at 3–4 weeks, 55.7 ± 2.4 U/mL at 5–8 weeks, and 81.3 ± 2.5 U/mL at 10–12 weeks after vaccination. GMTs of 50% neutralizing dilution (ND50) against WT SARS-CoV-2 were 164.6 ± 4.6 at 3-4 weeks, 313.9 ± 3.6 at 5–8 weeks, and 124.4 ± 2.6 at 10–12 weeks after vaccination. As for the S-specific T-cell responses, the median number of spot-forming units/10 6 peripheral blood mononuclear cell was 25.0 (5.0–29.2) at baseline, 60.0 (23.3–178.3) at 5-8 weeks, and 35.0 (13.3–71.7) at 10–12 weeks after vaccination. Compared to WT SARS-CoV-2, ND50 against Delta and Omicron variants was attenuated by 3.6-fold and 8.2-fold, respectively. The most frequent AE was injection site pain (82%), followed by myalgia (80%), fatigue (70%), and fever (50%). Most AEs were grade 1–2, and resolved within two days. Conclusion Single-dose Ad26.COV2.S was safe and immunogenic. NAb titer and S-specific T-cell immunity peak at 5–8 weeks and rather decrease at 10–12 weeks after vaccination.Cross-reactive neutralizing activity against the Omicron variant was negligible.

Various cell types in higher multicellular organisms are genetically homogenous, but are functionally and morphologically heterogeneous due to the differential expression of genes during development, which appears to be controlled by epigenetic mechanisms. However, the exact molecular mechanisms that govern the tissue-specific gene expression are poorly understood. Here, we show that dynamic changes in histone modifications and DNA methylation in the upstream coding region of a gene containing the transcription initiation site determine the tissue-specific gene expression pattern. The tissue-specific expression of the transgene correlated with DNA demethylation at specific CpG sites as well as significant changes in histone modifications from a low ratio of methylated H3- lysine 4 or acetylated H3-lysine 9, 14 to acetylated H4 to higher ratios. Based on the programmed status of transgene silenced in cloned mammalian ear-derived fibroblasts, the transgene could be reprogrammed by change of histone modification and DNA methylation by inhibiting both histone deacetylase and DNA methylation, resulting in high expression of the transgene. These findings indicate that dynamic change of histone modification and DNA methylation is potentially important in the establishment and maintenance of tissue-specific gene expression.
Transgenes/*genetics ; Swine ; Organ Specificity/genetics ; Methylation ; Lysine/*metabolism ; Histones/*metabolism ; Histone Deacetylases/metabolism ; Gene Silencing ; *Gene Expression ; Fibroblasts ; Ear ; *DNA Methylation ; Cells, Cultured ; Animals, Genetically Modified ; Animals ; Acetylation