Purpose: To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods: A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results: For the total patient group, the AUC of the ‘total significant features model’ (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the ‘selected feature model’ (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the ‘selected feature model’ (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.

Purpose: To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods: A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results: For the total patient group, the AUC of the ‘total significant features model’ (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the ‘selected feature model’ (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the ‘selected feature model’ (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.

Purpose: To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods: A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results: For the total patient group, the AUC of the ‘total significant features model’ (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the ‘selected feature model’ (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the ‘selected feature model’ (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.

BACKGROUND: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. METHODS: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg + lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. RESULTS: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of 2.4 +/- 2.1 points, which was lower, with statistical significance, than the VAS score of group 2, which was 4.4 +/- 3.1 points (p<0.001). CONCLUSIONS: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.
Bursitis* ; Follow-Up Studies ; Humans ; Joints ; Lidocaine ; Motion Therapy, Continuous Passive ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder ; Visual Analog Scale

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

The amino acid L-glutamate is a major excitatory neurotransmitter in the central nervous system of vertebrates(1). NMDA (N-methyl-d-aspartate) is one of the L-glutamate receptor subtypes(2). During a critical period of early postnatal development, the visual cortex is susceptible to experience-dependent modification of neuronal responses. Recently, the activation of NMDA receptors has been supposed as a prerequisite for the induction of such modification(3). We therefore investigated developmental changes of NMDA receptors in the rat visual cortex and questioned whether they could be related to the visual development. We assessed the density of [(3)H]-NMDA receptor in the visual cortex of normally reared rate (Group I) and visually deprived rats (Group II) using quantitative autoradiography(4). The density of [(3)H]-NMDA receptor was significantly lower in Group II than in group I during the early postnatal period, and increased rapidly by postnatal 1 week and, decreased after postnatal 5 weeks. These results suggested that NMDA receptors may play a role in neuronal development in the visual cortex during the early postnatal period.
Animals ; Autoradiography ; Dark Adaptation ; Eyelids/surgery ; Glutamates/metabolism ; Glutamic Acid ; Light ; Rats ; Receptors, N-Methyl-D-Aspartate/*metabolism ; Visual Cortex/growth & development/*metabolism

The amino acid L-glutamate is a major excitatory neurotransmitter in central nervous system of vertebrates. NMDA( n-methyl-d-aspartate) is one of the L-glutamate receptor subtypes. During a critical period of early postnatal development, the visual cortex is susceptible to experience-dependent modification of neuronal response. Recently, the activation of NMDA receptors has been supposed as an prerequisite for the induction of such modification We therefore investigated developmental changes of NMDA receptors in rat visual cortex and questioned whether they could be related to the visual development. We assessed the density of [3H] NMDA receptor in visual cortex of normally reared rats (Group I) and visually deprivated rats (Group II) using quantitative autoradiography. The density of [3H] NMDA receptor was increased rapidly by postnatal 1 week and decreased after postnatal 5 weeks, and was significantly lower in Group II than Group I during early postnatal period. These results suggest that NMDA receptors may have a role in neuronal development in visual cortex.
Animals ; Autoradiography ; Central Nervous System ; Critical Period (Psychology) ; Glutamic Acid ; N-Methylaspartate* ; Neurons ; Neurotransmitter Agents ; Rats* ; Receptors, N-Methyl-D-Aspartate* ; Vertebrates ; Visual Cortex*

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*

BACKGROUND: Twenty-four-hour ambulatory blood pressure(ABP) monitoring has become increasingly popular for diagnosing and treating hypertension. Therefore the reference value of normotensive subjects was necessary for interpretation of hypertensive subjects. Several studies were reported on reference values in normotensive subjects. The purpose of this study was to determine 24-hour ABP in normotensive Korean adults stratified for sex and five age groups. This study also assessed ABP in relation to a family history of hypertension, smoking and body mass index(BMI). METHODS: ABP monitoring was performed in 200 healthy normotensive volunteers(ranged in age from 20 to 69 years, five decades, 20 men and 20 women per each decade), over 24 hours, taking measurement at 30-min intervals. The 24-hour interval was divided into day-time(6am-10pm) and night-time(100pm-6am) periods. Mean ABP and pressure loads(percentage of systolic readings>140mmHg, diastolic readings>90mmHg) were obtained. RESULTS: The mean ABP in 200 subjects was 113+/-8.6/72+/-6.9mmHg over 24 hours, 117+/-9.7/75+/-7.0mmHg during day-time, and 106+/-9.8/67+/-8.3mmHg at night-time, and pressure loadd averaged 5.1+/-7.4/7.9+/-8.9% over 24 hours. The +2 standard deviation(SD) as the upper limit of normal was 130/86mmHg over 24 hours in 200 subjects. The mean ABP and pressure load were 116+/-7.6/74+/-7.6mmHg and 6.4+/-8.3/10.1+/-10.2% in 100 subjects of men, and 110+/-8.3+/-70+/-6.6mmHg, 3.7+/-6.0/5.7+/-6.8% in women. Mean ABP and pressure load showed significant difference in relation to age group and sex, however, no significant difference in relation to a family history of hypertension or smoking. In relation to BMI group, diastolic blood pressure and diastolic pressure load were significantly different.
Adult* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Male ; Reference Values ; Smoke ; Smoking

Animals ; Ascorbic Acid ; Asian Continental Ancestry Group ; Calcium ; Cholesterol ; Diet ; Humans ; Iron ; Multivariate Analysis ; Niacin ; Pantothenic Acid ; Plants ; Riboflavin ; Selenium ; Sodium ; Vegetarians ; Vitamin D ; Vitamin K ; Vitamins ; Zinc