Objective To explore the clinical value of IPCL patterns for the diagnosis and treatment of esophageal superficial lesions.Methods Data of 249 esophageal superficial lesions obtained from Digestive Disease Center of Northern Yokohama Hospital were retrospectively analyzed.All specimens were classified based on Haruhiro Inoue IPCL classification,while pathological analysis was performed according to the esophageal cancer classification of Japanese Esophageal Society.The relationship between the IPCL type and pathology was investigated.Results Of all the 249 lesions,22 lesions were identified as IPCL type Ⅲwhich included 16 cases esophagitis and 6 low-grade intraepithelial neoplasm (LGIN).Twenty-nine lesions were IPCL type Ⅳ,including 11 esophagitis,4 LGIN,10 m1 cancer,and 4 m2.Seventy-one lesions were IPCL type Ⅴ1,including 54 m1 cases,8 m2 and 4 m3.Forty-eight lesions were IPCL type Ⅴ2,including 8 m1,34 m2 and 4 m3.Forty-five lesions were IPCLA type Ⅴ3,including 4 m1,19 m2,15 m3 and 4 sm1.Twenty-two lesions were IPCL type Ⅴ3B,including 5 m2,5 m3,3 sm1 and 9 cases that tumor invaded into sm2 or deeper.Twelve lesions were IPCL type Ⅴ N,including 2 sm1 cases and 9 cases that tumor invaded into sm2 or deeper.Conclusion The Haruhiro Inoue IPCL classification is useful for diagnosis and treatment of esophageal superficial lesions.IPCL type Ⅴ1,Ⅴ 2 or Ⅴ 3A indicate early esophageal cancer or esophageal cancer that invades m1-sm1,and EMR or ESD can be performed.IPCL Ⅴ N type often means tumor invades sm2 or deeper.Confronting esophageal superficial lesions of IPCL Ⅲ,Ⅳ of Ⅴ3B type,physicians should also consider the diagnosis with clinical features,biopsy and endoscopic ultrasound.

Although visual examination and palpation are used to assess shoulder motion in clinical practice, there is no consensus on shoulder motion under dynamic and static conditions. This study aimed to compare shoulder joint motion under dynamic and static conditions. Methods: The dominant arm of 14 healthy adult males was investigated. Electromagnetic sensors attached to the scapular, thorax, and humerus were used to measure three-dimensional shoulder joint motion under dynamic and static elevation conditions and compare scapular upward rotation and glenohumeral joint elevation in different elevation planes and angles. Results: At 120° of elevation in the scapular and coronal planes, the scapular upward rotation angle was higher in the static condition and the glenohumeral joint elevation angle was higher in the dynamic condition (P<0.05). In scapular plane and coronal plane elevation 90°– 120°, the angular change in scapular upward rotation was higher in the static condition and the angular change in scapulohumeral joint elevation was higher in the dynamic condition (P<0.05). No differences were found in shoulder joint motion in the sagittal plane elevation between the dynamic and static conditions. No interaction effects were found between elevation condition and elevation angle in all elevation planes. Conclusions: Differences in shoulder joint motion should be noted when assessing shoulder joint motion in different dynamic and static conditions. Level of evidence: Level III, diagnostic cross-sectional study.

Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months) and 24.8 mm (12 months) (P<0.05); active abduction: 153.2º (2 months), 159.0º (6 months), 168.1º (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 “vitality” section: 57.0 points (6 months) and 70.0 points (12 months) (P<0.05). Conclusions Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.