Purpose: We evaluated the protective effect of trabecular outflow drugs, Rho kinase (ROCK) inhibitors against oxidative stressin trabecular meshwork cells. Methods: Primary-cultured human trabecular meshwork cells (HTMCs) were exposed to ROCK inhibitors at 10 and 20 μMY-27632, ripasudil or fasudil for 24 hours, after pretreatment with 200 μM hydrogen peroxide for 30 min. The cell viabilities andmetabolic activities were assessed using the Trypan Blue dye exclusion test and MTT assay, respectively. Reactive oxygen species(ROS) production was measured using the H2DCFDA assay, and the degree of apoptosis was measured with flow cytometryusing annexin-propidium iodide double staining. Results: In HTMCs, Y-27632 suppressed ROS production. Ripasudil and fasudil increased the metabolic activities and decreasedthe degrees of apoptosis. Fasudil showed the most cytoprotective effects among the three ROCK inhibitors tested. Conclusions Against oxidative stress, ROCK inhibitors decreased apoptosis accompanied by decreased ROS production, especiallyfasudil. ROCK inhibitors may therefore have cytoprotective properties in addition to increasing trabecular outflow.

PURPOSE: To investigate the effects of hydrogen sulfide (H₂S) on the permeability of a cultured human trabecular meshwork cells (HTMC) monolayer and its interaction with nitric oxide (NO).METHODS: After exposing primary cultured HTMCs to 0, 50, 100, and 500 µM sodium hydrogen sulfide (NaHS) for 6 hours, the permeabilities through the HTMC monolayer were measured using a Transwell assay with carboxyfluorescein. The production of NO and eNOS mRNA expression were assessed using the Griess assay and reverse transcription-polymerase chain reaction, respectively. In addition, 0, 1, and 10 µM NaHS and 10 µM sodium nitroprusside (SN) were co-exposed to evaluate the possible synergistic effect of H₂S and NO.RESULTS: Greater than 100 µM NaHS increased the permeability through the HTMC monolayer in a dose-dependent manner (p < 0.05). These increased permeabilities were not accompanied by NO production or eNOS mRNA expression (p > 0.05). When 0, 1, and 10 µM NaHS and 10 µM SN were exposed together, there was no significant change of permeability, NO production, or eNOS mRNA expression (all, p > 0.05).CONCLUSIONS: NaHS at high concentrations increased the permeability of the HTMC monolayer, which was not affected by NO. NaHS at low concentrations did not show a synergistic effect with NO. Thus, H₂S at high concentrations may increase trabecular outflow, which may not be associated with NO.

PURPOSE: To investigate the effects of valproic acid on the production of nitric oxide (NO) and expression of endothelial nitric oxide synthase (eNOS) in cultured human trabecular meshwork cells (HTMC). METHODS: Primarily cultured HTMC were exposed to 0.25, 0.5, and 1.0 mM valproic acid for 6, 12, and 24 hours. Expression of eNOS mRNA was assessed with Reverse transcription-polymerase chain reaction, and production of NO was assessed with Griess assay. Cellular survival was assessed with the 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide (MTT) assay. RESULTS: Valproic acid at concentrations of 0.25, 0.5, 1.0 mM did not affect the cellular survival of HTMC significantly after exposure for 24 hours. Valproic acid increased NO production in a dose- and time-dependent manner. Also, valproic acid increased the degree of eNOS mRNA expression in a dose-dependent manner in HTMC. CONCLUSIONS: Valproic acid increases production of NO and expression of eNOS mRNA in HTMC. Thus, valproic acid might increase aqueous outflow through the trabecular meshwork.
Humans ; Nitric Oxide Synthase Type III ; Nitric Oxide Synthase ; Nitric Oxide ; RNA, Messenger ; Trabecular Meshwork ; Valproic Acid

Background: This study aimed to investigate the impact of microfractures generated within the footprint of the greater tuberosity (GT) on postoperative cuff healing following arthroscopic rotator cuff repair (ARCR). Methods: A retrospective analysis was conducted on patients who underwent ARCR for full-thickness rotator cuff tear (FTRCT) between April 2020 and October 2023 at our institution. A total of 73 patients was categorized into two groups based on the presence of microfractures: a microfracture group (group M, n=33) and a non-microfracture group (group N, n=40). Six months post-surgery, magnetic resonance imaging was performed to assess cuff healing and retear rates between the two groups. Furthermore, patients were stratified into retear and healing groups based on cuff integrity to analyze the factors influencing retear. Results: There was no significant difference in retear rates between groups M and N (18.2% vs. 10.0%, P=0.332). Among demographic factors, age showed a significant difference between the retear and healing groups (67.4±8.5 vs. 61.6±6.1, P=0.044). ML tear size (3.1±1.7 vs. 2.0±1.1, P=0.015), AP tear size (2.4±1.2 vs. 1.6±1.0, P=0.332), FI of the supraspinatus (2.3±1.3 vs. 1.4±1.0, P=0.029), and FI of the infraspinatus (1.6±1.3 vs. 0.9±0.8, P=0.015) exhibited significant differences between the retear and healing groups. Conclusions ARCR with concurrent microfracture of the GT footprint did not significantly impact cuff healing in patients with FTRCT. However, older age and larger ML tear size were associated with an increased risk of retear.Level of evidence: III.

Background: This study aimed to investigate the impact of microfractures generated within the footprint of the greater tuberosity (GT) on postoperative cuff healing following arthroscopic rotator cuff repair (ARCR). Methods: A retrospective analysis was conducted on patients who underwent ARCR for full-thickness rotator cuff tear (FTRCT) between April 2020 and October 2023 at our institution. A total of 73 patients was categorized into two groups based on the presence of microfractures: a microfracture group (group M, n=33) and a non-microfracture group (group N, n=40). Six months post-surgery, magnetic resonance imaging was performed to assess cuff healing and retear rates between the two groups. Furthermore, patients were stratified into retear and healing groups based on cuff integrity to analyze the factors influencing retear. Results: There was no significant difference in retear rates between groups M and N (18.2% vs. 10.0%, P=0.332). Among demographic factors, age showed a significant difference between the retear and healing groups (67.4±8.5 vs. 61.6±6.1, P=0.044). ML tear size (3.1±1.7 vs. 2.0±1.1, P=0.015), AP tear size (2.4±1.2 vs. 1.6±1.0, P=0.332), FI of the supraspinatus (2.3±1.3 vs. 1.4±1.0, P=0.029), and FI of the infraspinatus (1.6±1.3 vs. 0.9±0.8, P=0.015) exhibited significant differences between the retear and healing groups. Conclusions ARCR with concurrent microfracture of the GT footprint did not significantly impact cuff healing in patients with FTRCT. However, older age and larger ML tear size were associated with an increased risk of retear.Level of evidence: III.

Background: This study aimed to investigate the impact of microfractures generated within the footprint of the greater tuberosity (GT) on postoperative cuff healing following arthroscopic rotator cuff repair (ARCR). Methods: A retrospective analysis was conducted on patients who underwent ARCR for full-thickness rotator cuff tear (FTRCT) between April 2020 and October 2023 at our institution. A total of 73 patients was categorized into two groups based on the presence of microfractures: a microfracture group (group M, n=33) and a non-microfracture group (group N, n=40). Six months post-surgery, magnetic resonance imaging was performed to assess cuff healing and retear rates between the two groups. Furthermore, patients were stratified into retear and healing groups based on cuff integrity to analyze the factors influencing retear. Results: There was no significant difference in retear rates between groups M and N (18.2% vs. 10.0%, P=0.332). Among demographic factors, age showed a significant difference between the retear and healing groups (67.4±8.5 vs. 61.6±6.1, P=0.044). ML tear size (3.1±1.7 vs. 2.0±1.1, P=0.015), AP tear size (2.4±1.2 vs. 1.6±1.0, P=0.332), FI of the supraspinatus (2.3±1.3 vs. 1.4±1.0, P=0.029), and FI of the infraspinatus (1.6±1.3 vs. 0.9±0.8, P=0.015) exhibited significant differences between the retear and healing groups. Conclusions ARCR with concurrent microfracture of the GT footprint did not significantly impact cuff healing in patients with FTRCT. However, older age and larger ML tear size were associated with an increased risk of retear.Level of evidence: III.

Background: This study aimed to investigate the impact of microfractures generated within the footprint of the greater tuberosity (GT) on postoperative cuff healing following arthroscopic rotator cuff repair (ARCR). Methods: A retrospective analysis was conducted on patients who underwent ARCR for full-thickness rotator cuff tear (FTRCT) between April 2020 and October 2023 at our institution. A total of 73 patients was categorized into two groups based on the presence of microfractures: a microfracture group (group M, n=33) and a non-microfracture group (group N, n=40). Six months post-surgery, magnetic resonance imaging was performed to assess cuff healing and retear rates between the two groups. Furthermore, patients were stratified into retear and healing groups based on cuff integrity to analyze the factors influencing retear. Results: There was no significant difference in retear rates between groups M and N (18.2% vs. 10.0%, P=0.332). Among demographic factors, age showed a significant difference between the retear and healing groups (67.4±8.5 vs. 61.6±6.1, P=0.044). ML tear size (3.1±1.7 vs. 2.0±1.1, P=0.015), AP tear size (2.4±1.2 vs. 1.6±1.0, P=0.332), FI of the supraspinatus (2.3±1.3 vs. 1.4±1.0, P=0.029), and FI of the infraspinatus (1.6±1.3 vs. 0.9±0.8, P=0.015) exhibited significant differences between the retear and healing groups. Conclusions ARCR with concurrent microfracture of the GT footprint did not significantly impact cuff healing in patients with FTRCT. However, older age and larger ML tear size were associated with an increased risk of retear.Level of evidence: III.

Purpose: This study examined the factors affecting valgus deformities after arthroscopic reduction and internal fixation (ARIF) in lateral joint-depression tibial plateau fractures. Materials and Methods: Patients with lateral joint-depression tibial plateau fractures treated with ARIF were assessed retrospectively. The radiological evaluations included the articular depression distance (ADD) and the lateral plateau widening distance (LPWD) on preoperative and postoperative computed tomography. A postoperative valgus deformity was defined as valgus malalignment (mechanical axis ≥3°) and valgus deviation (Δmechanical axis of the operated knee from the healthy knee of ≥5°). Subgroup analyses based on a postoperative valgus deformity were performed to compare the clinical outcomes, including the range of motion, patient-reported outcomes measures, and failure and osteoarthritis progression. Furthermore, factors affecting the postoperative mechanical and Δmechanical axes were assessed. Results: Thirty-nine patients were included with a mean follow-up of 44.6 months (range, 24-106 months). Valgus malalignment and valgus deviation were observed after ARIF in 10 patients (25.6%) and five patients (12.8%), respectively. The clinical outcomes were similar in patients with and without a postoperative valgus deformity. On the other hand, lateral compartment osteoarthritis progression was significantly higher in the valgus deformity group than in the non-valgus deformity group (valgus malalignment group: 50.0% vs 6.9%, p=0.007; valgus deviation group: 60.0% vs 11.8%, p=0.032).One patient with valgus deformity underwent realignment surgery at postoperative five years. The preoperative ADD and postoperative LPWD were significantly associated with the postoperative mechanical (both, p<0.001) and Δmechanical (ADD, p=0.001; LPWD, p=0.025) axes. Moreover, the lateral meniscectomized status during ARIF was significantly associated with the Δmechanical axis (p=0.019). Conclusion Osteoarthritis progression was highly prevalent in patients with postoperative valgus deformity. Thus, the restoration of lateral plateau widening and articular depression and preservation of the meniscus are necessary to prevent a valgus deformity after ARIF in lateral joint-depression tibial plateau fractures.

The therapeutic indication for endoscopic submucosal dissection (ESD) can be expanded to treat small-sized (<2 cm) early gastric cancer (EGC) with undifferentiated histology. Here, we report the case of a 62-year-old woman in whom EGC was initially diagnosed by endoscopy and CT. She subsequently underwent ESD. Histological examination revealed a mixed type adenocarcinoma with poorly differentiated histology confined to the mucosa without ulcer and lymphovascular involvement. Subsequent regular examinations showed no recurrence for 7 years. She complained of fatigue and weight loss on the 7th year of follow-up. Radiologic examination showed multiple bone metastases and the bone biopsy specimen revealed adenocarcinoma resembling the previous EGC.
Adenocarcinoma ; Biopsy ; Endoscopy ; Fatigue ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis* ; Recurrence ; Stomach Neoplasms* ; Ulcer ; Weight Loss

BACKGROUND: Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. METHOD: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. RESULTS: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. 2) Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82% of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1% and large opacity is 17.9%. Small opacity has t/t type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest X-ray density, the more decreasing FEV1 (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. 6) Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. CONCLUSION: These findings indicate that tuberculosis infection has a decisive influence on the progress and prognosis of pneumoconiosis.
Chest Pain ; Coal ; Cough ; Disease Progression ; Dust ; Dyspnea ; Electrocardiography ; Hemoptysis ; Humans ; Inhalation ; Korea ; Lung Diseases ; Medical Records ; Pneumoconiosis* ; Prevalence ; Prognosis ; Pulmonary Heart Disease ; Respiratory Function Tests ; Respiratory Insufficiency ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary