BACKGROUND: Osteoporosis is considered a public health problem with high worldwide prevalence. One approach to prevention is through the promotion of physical activity, especially exercise, during adolescence. METHODS: This study compared bone variables in different body segments in adolescents according to participation in track and field. The study included 34 adolescents (22 boys), of whom 17 were track and field athletes and 17 were control subjects. Bone mineral density (BMD, g/cm2) and bone mineral content (BMC, g) were analyzed using dual energy X-ray absorptiometry (total body stratified by body segments). Peak height velocity was used to estimate somatic maturation. RESULTS: Athletes had higher BMD (P=0.003) and BMC (P=0.011) values in the lower limbs and higher whole body BMD (P=0.025) than the control group. However, when adjusted for confounding factors, the difference was not maintained. The groups had similar lean soft tissue values (P=0.094). Training overload was positively correlated with BMD in the upper limbs (r=0.504; 95% confidence interval, 0.031-0.793). Although track and field athletes had higher BMD and BMC values in the lower limbs, these differences were not significant when adjusted for confounding factors. CONCLUSIONS: Track and field participation in adolescence appears to influence BMD and BMC in lower limbs, and fat-free mass seems to mediate this effect. Also, higher training loads were found to be positive for bone health in upper limbs.
Absorptiometry, Photon ; Adolescent ; Athletes ; Bone and Bones ; Bone Density ; Child ; Humans ; Lower Extremity ; Motor Activity ; Osteoporosis ; Pilot Projects ; Prevalence ; Public Health ; Sports ; Track and Field ; Upper Extremity

OBJECTIVE: The potential of a low-cost, novel Kinect?-based markerless motion analysis system as a tool to measure temporospatial parameters, joint and muscle kinematics, and hand trajectory patterns during the propulsion and recovery phase of wheelchair propulsion (WCP) was determined.

METHODS:Twenty (20) adult male track and field paralympians,(mean age = 36 ± 8.47) propelled themselves on a wheelchair ergometer system while their upper extremity motion was recorded by two Kinect? cameras and processed.

RESULTS: The temporospatial parameters, joint kinematics, and hand trajectory patterns during the propulsion and recovery phase of each participant's WCP cycle were determined and averaged. Average cycle time was 1.45s ± 0.19, average cadence was 0.70 cycles/s ± 0.09, and average speed was 0.76m/s ± 0.32. Average shoulder flexion was 30.99° ± 28.38, average elbow flexion was 24.23° ± 12.25, and average wrist flexion was 12.82° ± 26.78. Eighty five percent (85%) of the participants used a semicircular hand trajectory pattern.

CONCLUSION: The low-cost, novel Kinect?-based markerless motion analysis system had the potential to obtain measurable values during independent wheelchair propu
Biomechanical Phenomena ; Ergometry ; Track and Field ; Para-Athletes

OBJECTIVE: This study evaluated the effect of the specific human papillomavirus (HPV) genotypes on severity and prognosis in cervical intraepithelial neoplasia (CIN) patients. METHODS: The medical records of 446 patients treated with loop electrosurgical excision procedure (LEEP) were reviewed. The severity of CIN was categorized as CIN1/CIN2 versus CIN3+ including CIN3 and carcinoma in situ (CIS). HPV genotypes were categorized as 1) low risk, 2) intermediate risk, 3) high risk/HPV 16, 4) high risk/HPV 18, and 5) unclassified. Progression was defined as abnormal cytology, including atypical squamous cells, low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion. The margin status and progression free survival (PFS) by HPV genotypes were analyzed in 355 women with three months or more of post-treatment records. RESULTS: CIN3+ was the most common CIN type (67.7%), and high risk/HPV 16 (26.9%) was the most common genotype. Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2. Patients with high risk/HPV 18 showed the highest rate of positive margins (P < 0.01). The margin status proved to be the only statistically significant factor affecting PFS. CONCLUSION: The proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group. CIN patients with high risk/HPV 18 need to be more carefully tracked than patients with the other HPV genotypes.
Carcinoma in Situ ; Cervical Intraepithelial Neoplasia* ; Disease-Free Survival ; Female ; Genotype* ; Humans* ; Medical Records ; Prognosis* ; Track and Field

BACKGROUND: Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. METHODS: The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. RESULTS: A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12-3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index > or =30) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. CONCLUSIONS: Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.
Dataset ; Hemorrhage ; Humans ; Hypertension ; Inpatients* ; Obesity ; Patient Education as Topic ; Patient Readmission ; Percutaneous Coronary Intervention ; Pulmonary Disease, Chronic Obstructive ; Quality Improvement ; Risk Factors ; Surgery, Plastic* ; Track and Field

Stroke is a major health burden in Thailand. It is the leading cause of death and long term disability in both men and women. Despite the improvement of healthcare system, the mortality rate of stroke is still increasing during the past 5 years. The incidence of stroke in Thailand is now being studied in a large population based cohort. The prevalence of stroke is estimated to be 1.88% among adults 45 years and older. Stroke is more prevalent in men than in women and the mean age of stroke onset is 65 years. Hypertension, diabetes, dyslipidemia, metabolic syndrome, and atrial fibrillation are major risk factors of stroke in the Thai population. Evolution from predominantly rural to urbanized industrial communities result in the increasing prevalence of these risk factors. Similar to other parts of the world, ischemic stroke is the most common stroke type but the proportion of hemorrhagic stroke is higher when compared to Caucasian populations. Among patients with ischemic stroke, lacunar stroke is most common, accounting for almost half followed by atherosclerotic disease. Intracranial atherosclerosis is also prevalent in Thai population. For acute treatment, intravenous thrombolysis has been used in Thailand for over 20 years. Its cost is reimbursed by the national health care system but its use is still limited. With the introduction of the stroke fast track system, prompt stroke treatment across the country is warranted. Stroke unit is now the standard of care in large regional and provincial hospitals.
Adult ; Asian Continental Ancestry Group ; Atrial Fibrillation ; Cause of Death ; Cohort Studies ; Delivery of Health Care ; Dyslipidemias ; Epidemiology* ; Female ; Humans ; Hypertension ; Incidence ; Intracranial Arteriosclerosis ; Male ; Mortality ; Prevalence ; Risk Factors ; Standard of Care ; Stroke* ; Stroke, Lacunar ; Thailand* ; Track and Field

PURPOSE: A number of longitudinal studies have tracked blood pressure over time in children and adults. Although there are a few blood pressure tracking studies for Asian populations, they are all relatively short-term studies with around only 10 years of follow-up. Accordingly, we assessed the stability of blood pressure tracking from childhood to adulthood over a 24-year follow-up period among participants in the Kangwha Study. MATERIALS AND METHODS: The Kangwha Study was a community-based prospective cohort study that started in 1986 in Kangwha County, South Korea. The study dataset included 14 blood pressure measurements over a 24-year period from 266 (123 male and 143 female) participants who completed the 2010 examination. All participants were 7 years old when the study began and were followed for the next 24 years. RESULTS: The tracking coefficient (95% confidence interval) for systolic blood pressure was 0.81 (0.52-1.11) in men and 0.72 (0.51-0.92) in women; diastolic blood pressure was 0.53 (0.26-0.80) in men and 0.33 (0.15-0.52) in women. After adjusting for body mass index, the tracking coefficient for systolic blood pressure was 0.68 (0.39-0.97) in men and 0.67 (0.44-0.89) in women; diastolic blood pressure was 0.51 (0.24-0.78) in men and 0.33 (0.15-0.51) in women. All tracking coefficients were statistically significant (p<0.001). CONCLUSION: In this 24-year longitudinal study, we confirmed the stability of blood pressure tracking from childhood to adulthood for participants in the Kangwha Study.
Adult ; Asian Continental Ancestry Group ; Blood Pressure* ; Body Mass Index ; Child ; Cohort Studies ; Dataset ; Female ; Follow-Up Studies* ; Humans ; Korea* ; Longitudinal Studies ; Male ; Methods ; Prospective Studies ; Republic of Korea ; Track and Field*

BACKGROUND AND OBJECTIVES: We evaluated the utility of two-dimensional (2D) and three-dimensional (3D) left ventricular (LV) global myocardial deformity parameters for assessing LV diastolic function by comparing invasive measures of LV performance. SUBJECTS AND METHODS: Echocardiography and LV pressure were assessed in 39 patients. Myocardial LV longitudinal, circumferential, and radial deformations, as well as area strain, were evaluated utilizing 2D and 3D speckle tracking software. The 2D early diastolic strain rate (2D-SRe) was measured from the 3 apical and 3 short axis views. The 3D diastolic index (3D-DI) was calculated by the % change of global strain during the first one-third of the diastolic period. LV end diastolic pressure (LVEDP) and the rate of LV pressure change (dP/dt) were collected using a pressure-conducted catheter and tau was calculated. RESULTS: dP/dt(min) were related to early mitral annular velocity (e'), 2D-SRe(long), 2D-SRe(radial), as well as 3D-DI(long), and 3D-DI(as). Additionally, LVEDP was associated with the ratio of mitral early diastolic velocity (E) to 2D-SRe(long), 2D-SRe(circ), 2D-SRe(radial), 3D-DI(long), 3D-DI(circ), and 3D-DI(as). E/2D-SRe(long), E/2D-SRe(radial), E/3D-DI(long), and E/3D-DI(as) were comparable with E/e' in predicting patients with elevated LVEDP. Among those patients with E/e' of 8 to 15, E/3D-DI(long) provided incremental value in identifying those with LVEDP > or =15 mm Hg. CONCLUSION: 2D-SRe(long), 2D-SRe(radial), 3D-DI(long), and 3D-DI(as) were related to LV relaxation, and the ratios of E to those parameters were associated with LVEDP. In addition, among patients with indeterminate E/e', E/3D-DI(long) offered incremental value in predicting elevated LVEDP, suggesting it may provide supplementary information in the evaluation of LV diastolic function.
Axis, Cervical Vertebra ; Blood Pressure ; Catheters ; Congenital Abnormalities ; Diastole ; Echocardiography ; Humans ; Relaxation ; Sprains and Strains ; Track and Field ; Ventricular Pressure

PURPOSE: To evaluate the usefulness of in vivo magnetic resonance (MR) imaging for tracking intravenously injected superparamagnetic iron oxide (SPIO)-labeled human umbilical vein endothelial cells (HUVECs) in an acute renal failure (ARF) rat model. MATERIALS AND METHODS: HUVECs were labeled with SPIO and poly-L-lysine (PLL) complex. Relaxation rates at 1.5-T MR, cell viability, and labeling stability were assessed. HUVECs were injected into the tail vein of ARF rats (labeled cells in 10 rats, unlabeled cells in 2 rats). Follow-up serial T2*-weighted gradient-echo MR imaging was performed at 1, 3, 5 and 7 days after injection, and the MR findings were compared with histologic findings. RESULTS: There was an average of 98.4+/-2.4% Prussian blue stain-positive cells after labeling with SPIO-PLL complex. Relaxation rates (R2*) of all cultured HUVECs at day 3 and 5 were not markedly decreased compared with that at day 1. The stability of SPIO in HUVECs was maintained during the proliferation of HUVECs in culture media. In the presence of left unilateral renal artery ischemia, T2*-weighted MR imaging performed 1 day after the intravenous injection of labeled HUVECs revealed a significant signal intensity (SI) loss exclusively in the left renal outer medulla regions, but not in the right kidney. The MR imaging findings at days 3, 5 and 7 after intravenous injection of HUVECs showed a SI loss in the outer medulla regions of the ischemically injured kidney, but the SI progressively recovered with time and the right kidney did not have a significant change in SI in the same period. Upon histologic analysis, the SI loss on MR images was correspondent to the presence of Prussian blue stained cells, primarily in the renal outer medulla. CONCLUSION: MR imaging appears to be useful for in vivo monitoring of intravenously injected SPIO-labeled HUVECs in an ischemically injured rat kidney.
Acute Kidney Injury ; Animals ; Cell Survival ; Cell Tracking ; Culture Media ; Endothelial Cells ; Ferric Compounds ; Ferrocyanides ; Follow-Up Studies ; Human Umbilical Vein Endothelial Cells ; Injections, Intravenous ; Iron ; Ischemia ; Kidney ; Magnetic Resonance Spectroscopy ; Magnets ; Rats ; Relaxation ; Renal Artery ; Track and Field ; Umbilical Veins ; Veins

BACKGROUND: Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. METHODS: Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. RESULTS: A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). CONCLUSIONS: The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.
Acellular Dermis ; Body Mass Index ; Breast ; Breast Implantation ; Cohort Studies ; Collagen ; Female ; Humans ; Logistic Models ; Mammaplasty ; Multivariate Analysis ; Prostheses and Implants ; Quality Improvement ; Risk Factors ; Smoke ; Smoking ; Tissue Expansion Devices ; Track and Field ; Transplantation, Homologous

OBJECTIVES: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. METHODS: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patients and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, WHO Quality of Life scale, and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated ; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. RESULTS: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. CONCLUSION: Through the study, it was confirmed that when hospitalized schizophrenic patients receive continuous day hospital care after being discharged, they receive further out patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients' treatment adherence issues and improvement of treatment outcomes.
Hospitalization ; Humans ; Outpatients ; Patient Care ; Prospective Studies* ; Quality of Life ; Schizophrenia ; Survival Rate ; Track and Field ; Treatment Outcome