To determine the usefulness of MR axial images for diagnosis ACL tears, we reviewed MRIs of 67 patients with ACL tear confirmed by arthroscopic examination, retrospectively. There were 53 acute and 14 chronic tears. The axial MR images had a 97% sensitivity(acute: 96%, chronic: 100%). Findings of acute ACL tears on sequential axial imaging could be categorized as 1) diffuse swelling with abnormal substance signal in 14 cases(27.5%), 2) focal bulging or irregularity of medial border in 11 cases(21.6%) or 3) combination of the two in 26 cases(50.9%). Findings of chronic ACL tears also could be categorized as abnormally irregular thin fibers in 6 cases(42.9%) or nonvisualization(empty lateral wall) in 8 cases(57.1%). We concluded that MR axial images could provide additional useful information in the diagnosis of ACL tear.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Frictional force between the orthodontic bracket and arch wire during sliding tooth movement is related to many factors, such as the size, shape and material of both the bracket and wire, ligation method and the angle formed between the bracket and wire. There have been clear conclusions drawn in regard to most of these factors, but as to the effect of bracket width on frictional force there are only conflicting studies. This study was designed to investigate the effect of bracket width on the amount of frictional forces generated during clinically simulated tooth movement. Three different widths of brackets (0.018x0.025"standard), narrow (2.40mm), medium (3.00mm) and wide (4.25mm) were used in tandem with 0.016x0.022" stainless steel wire. Three bracket-arch wire combinations were drawn on for 4 minutes on a testing apparatus with a head speed of 0.5mm/min and tested 7 times each. To reproduce biological conditions, dentoalveolar models were designed with indirect technique using a material with similar elastic properties as periodontal ligament (PDL). In addition, to minimize the effect of ligation force, elastomer was used with added resin, which was attached to the bracket to make up for the discrepancies of bracket width. The results were as follows: 1. Maximum frictional force for each bracket-arch wire combination was: Narrow (2.40mm) : 68.09+/-4.69 gmf Medium (3.00mm) : 72.75+/-4.98 gmf Wide (4.25mm) : 72.59+/-4.54 gmf 2. Frictional force was increased with more displacement of wire through the bracket slot. 3. The ANOVA post-hoc test showed that the bracket width had no significant effect on frictional force when tested under clinically simulated conditions (P>0.05)
Elastomers ; Friction* ; Glia Maturation Factor ; Head ; Ligation ; Orthodontic Brackets ; Periodontal Ligament ; Stainless Steel ; Tooth Movement* ; Tooth*

Ultrasonography-guided core needle biopsy has been standard of care for diagnosing suspicious breast lesion. The procedure is safe and has a low rate of complications. Most common complication might be bleeding or hematoma, which could be avoided by careful process or changing it to excisional biopsy or managed by proper management. Rarely, Post-procedural arteriovenous fistula is reported in almost all body fields, which is life quality threatening, not life-threatening. Most of them occur with obvious vessel injury, and their primary end-point of management is the obliteration of fistula by thrombosis. However, we experienced a case of iatrogenic arteriovenous fistula after core needle biopsy for breast lesion with small vessel injury which was not but small ones, and its thrill did not disappear even after thrombosis. We would like to share our clinical learnings from surgical management process of this rare complication.
Arteriovenous Fistula* ; Biopsy ; Biopsy, Large-Core Needle* ; Breast* ; Fistula ; Hematoma ; Hemorrhage ; Iatrogenic Disease ; Quality of Life ; Standard of Care ; Thrombosis

The funding acknowledgment in this article was omitted as published.

Objective: Various and accurate psychiatric assessments in patients with breast cancer who frequently suffer from psychological problems due to long-term survivors are warranted. This systematic review aimed to investigate the current evidence on psychometric properties of psychiatric assessment for evaluating psychological problems in breast cancer patients. Methods: This systematic review progressed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Four electronic databases such as Web of Science, PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched. This study protocol was registered on Open Science Framework. Results: Of the 2,040 articles, 21 papers were finally included. Among them, only five studies showed the performance of psychiatric assessment tools. Among 13 assessment tools used in the selected articles, the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), or Mini-Mental Adjustment to Cancer Scale was frequently used for the evaluation of psychological problems. The DT and Psychosocial Distress Questionnaire-Breast Cancer showed acceptable performances for the prediction of depression and anxiety assessed by the HADS. Conclusion This systematic review found psychiatric assessment tools with acceptable reliability and validity for breast cancer patients. However, comparative studies on reliability and validity of various scales are required to provide useful information for the selection of appropriate assessment tools based on the clinical settings and treatment stages of breast cancer. Joint research among the fields of psychiatry and breast surgery is needed for research to establish the convergent, concurrent, and predictive validity of psychiatric assessment tools in breast cancer patients.

Parkinson’s disease (PD) is one of the late-onset neurodegenerative movement disorder. Major pathological markers of PD include progressive loss of dopaminergic neurons, Lewy body formation, genetic mutations, and environmental factors. Epigenetic regulation of specific gene expression via impaired histone acetylation is associated with neuronal dysfunction in various neurodegenerative diseases. In this study, we hypothesized that histone deacetylase (HDAC) inhibitor, valproic acid (VPA), can improve motor function by enhancing cell survival in PD genetic model mice with LRRK2 R1441G mutation. To address this question, we administered VPA in LRRK2 R1441G transgenic mice to determine whether VPA affects 1) histone acetylation and HDAC expression, 2) dopaminergic neuron survival, 3) inflammatory responses, 4) motor or non-motor symptoms. As results, VPA administration increased histone acetylation level and the number of tyrosine hydroxylase (TH) positive neurons in substantia nigra of LRRK2 R1441G mice. VPA reduced iba-1 positive activated microglia and the mRNA levels of pro-inflammatory marker genes in LRRK2 R1441G mice. In addition, VPA induced the improvement of PD-like motor and non-motor behavior in LRRK2 R1441G mice. These data suggest that the inhibition of HDAC can be further studied as potential future therapeutics for PD.
Acetylation ; Animals ; Cell Survival ; Dopaminergic Neurons ; Epigenomics ; Gene Expression ; Histone Deacetylases ; Histones ; Lewy Bodies ; Mice ; Mice, Transgenic ; Microglia ; Models, Genetic ; Movement Disorders ; Neurodegenerative Diseases ; Neurons ; Neuroprotection ; RNA, Messenger ; Substantia Nigra ; Tyrosine 3-Monooxygenase ; Valproic Acid

The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for breast reconstruction. However, it has the disadvantage of frequent seroma formation at the donor site, and late seroma has also been reported. The authors report histological findings after the surgical treatment of a late, repeatedly recurrent seroma at 10 years after breast reconstruction with LDMCF. In 2008, a 66-year-old female patient underwent immediate breast reconstruction with LDMCF. In 2015, a late seroma was found at the donor site. After aspiration and drainage, the seroma recurred again in 2018. Total surgical excision of the seroma was performed and bloody-appearing fluid was identified in the capsule. The excised tissue was biopsied. Histological examination revealed no evidence of blood in the fluid, and multinucleated giant cells with amorphous eosinophilic proteinaceous material were identified. The cyst was suggestive of chronic granulomatous inflammation. There was no recurrence at 8 months postoperatively. The patient described herein underwent surgical treatment of late seroma that recurred after immediate breast reconstruction with LDMCF, and histological findings were identified. These results may be helpful for other future studies regarding late seroma after breast reconstruction with LDMCF.

Objective: Due to the high frequency of depressive symptoms associated with breast cancer, it is crucial to screen for depression in breast cancer patients. While numerous screening tools are available for depression in this population, there is a need for a brief and convenient tool to enhance clinical use. This study aims to investigate the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) in patients with breast cancer. Methods: Patients with breast cancer (n=327) who visited the Breast Cancer Clinic were included in this study. The reliability of the PHQ-9 was analyzed by Cronbach’s α, and the construct validity of the PHQ-9 was explored by factor analysis. The concurrent validity of the PHQ-9 was evaluated by Pearson correlation analysis with the Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Results: The values of Cronbach’s α ranged from 0.800 to 0.879 was acceptable. The exploratory factor analysis revealed that the one-factor model and two-factor model of the PHQ-9 explained 46% and 57% of the variance, respectively. The PHQ-9 were significantly correlated with those of HADS (r=0.702, p<0.001) and PSS (r=0.466, p<0.001). Consequently, the PHQ-9 demonstrated acceptable reliability and validity in breast cancer patients. Conclusion The findings of this study indicate that the PHQ-9 exhibits acceptable reliability and validity in patients with breast cancer. The convenience of this brief self-report questionnaire suggests its potential as a reliable and valid tool for assessing depression in breast cancer clinics.

A 7-year-old spayed female English Cocker Spaniel dog presented with polyuria (PU), polydipsia (PD), intermittent vomiting, and weight loss. Physical examination revealed pale, tacky mucous membranes and severe emaciation. Hematological and biochemical examinations revealed moderate normocytic normochromic non-regenerative anemia and moderate azotemia. Abdominal ultrasonography demonstrated bilaterally small lumpy-bumpy kidneys with hyperechoic parenchyma as well as loss of renal corticomedullary junction. Based on clinical history and examinations, the dog was diagnosed with chronic kidney disease (CKD). The dog was treated with supportive care including fluid therapy, phosphate-binding agent, and histamine H2-receptor antagonist. Darbepoetin Alfa was administered to control renal secondary non-regenerative anemia. Prescribed diet with low-protein and low-phosphorus was fed to alleviate CKD signs. Further, dietary probiotics were supplemented. This case demonstrates that oral probiotic supplementation helped reduce blood urea-nitrogen (BUN) levels. This case indicates that dietary probiotics can be a potential alternative therapeutic agent for management of renal failure.
Anemia ; Animals ; Azotemia ; Child ; Darbepoetin alfa ; Diet ; Dietary Supplements* ; Dogs* ; Emaciation ; Female ; Fluid Therapy ; Histamine ; Humans ; Kidney ; Mucous Membrane ; Physical Examination ; Polydipsia ; Polyuria ; Probiotics* ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Ultrasonography ; Vomiting ; Weight Loss