Objective: This study aimed to compare aneuploidy rates and clinical outcomes between trophectoderm biopsy at fresh blastocyst (biopsy-fresh) followed by vitrification and biopsy at vitrified-warmed blastocyst (biopsy-vitri) followed by next day transfer (without re-vitrification). Methods: This retrospective study included 844 patients undergoing 844 cycles conducted from August 2019 to December 2023. Preimplantation genetic testing for aneuploidy (PGT-A) was performed via trophectoderm biopsy using array comparative genomic hybridization or next-generation sequencing for comprehensive 24-chromosome screening. Patients were divided into two groups based on the blastocyst status at the time of biopsy: the biopsy-fresh group (531 patients) and the biopsy-vitri group (313 patients). Results: The clinical pregnancy rate was significantly higher in the biopsy-fresh group compared to the biopsy-vitri group (58.7% vs. 45.6%; odds ratio [OR], 1.695; 95% confidence interval [CI], 1.215 to 2.364; p=0.002). Furthermore, the biopsy-fresh group showed higher implantation rates (45.6% vs. 32.1%; OR, 1.767; 95% CI, 1.274 to 2.451; p=0.002), ongoing pregnancy or live birth rates per cycle (48.0% vs. 35.8%; OR, 1.652; 95% CI, 1.177 to 2.319; p=0.004), and rates of good-quality blastocysts (57.1% vs. 32.1%, p<0.001) compared with the biopsy-vitri group. Miscarriage rates did not differ significantly between the groups (18.2% vs. 21.4%; OR, 0.818; 95% CI, 0.457 to 1.465; p=0.501). Conclusion Biopsy at fresh blastocyst demonstrated superior clinical outcomes compared with biopsy at vitrified-warmed blastocyst, likely due to better embryo quality. Both biopsy at fresh blastocyst and vitrified-warmed blastocyst remain viable options for PGT-A, with biopsy at vitrified-warmed blastocyst serving as a practical alternative. Embryo quality and euploid status continue to be critical considerations for embryo transfer selection.

Purpose: The goniometer, the gold standard for range of motion (ROM) assessment, has significant limitations including physical contact requirements and high interrater variability. While markerless motion capture using deep learning (e.g., Sports2D) offers a noncontact alternative, its clinical reliability remains unestablished. This study evaluated Sports2D's reliability for ROM measurement using smartphone cameras compared to conventional goniometry. Methods: Fifty healthy adults (25 males, 25 females; mean age, 22.42±2.58 years) participated. Ten joint ROM types (17 total measurements including left/right) were measured using both traditional goniometry (by an experienced clinician) and Sports2D (smartphone camera at 3 m distance). Reliability and agreement were analyzed using concordance correlation coefficient (CCC), Pearson correlation, and Bland-Altman plots. Results: Sports2D demonstrated very high reliability for elbow flexion (CCC, 0.906−0.955), neck extension (CCC, 0.928), and right hip flexion (CCC, 0.920). Good reliability (CCC, ≥ 0.8) was observed for neck flexion, left knee flexion, and trunk flexion. However, all ankle measurements showed clinically unacceptable reliability (CCC, ＜ 0.3), including dorsiflexion (CCC, 0.072−0.099) and plantarflexion (CCC, 0.174–0.211). Bland-Altman plots confirmed proportional bias for ankle measurements, particularly at smaller angles. Conclusion Sports2D is a reliable noncontact tool for measuring ROM in specific joints including elbow, neck, knee, hip, and trunk. However, it is unreliable for ankle joint assessment due to significant measurement discrepancies. These findings highlight the need for selective clinical application of markerless motion capture based on joint-specific validation.

Purpose: The current drain tubes for preventing surgically biliary anastomotic stricture are not naturally and easily removed. If a drain tube using biodegradable material is easily available and the degradation time of the tube is well controlled, surgical anastomotic stricture and fibrosis could be prevented. The aim of this animal study was to evaluate the preventive effect of novel biodegradable stents (BS) on biliary stricture and fibrosis after duct-to-duct (DD) biliary anastomosis. Methods: Ten mini-pigs were allocated to the control group (n = 5) and or the stent group (n = 5). The common bile duct was exposed through surgical laparotomy and then resected transversely. In the stent group, a 4-mm or 6-mm polydioxanone/ magnesium sheath-core BS was inserted according to the width of the bile duct, followed by DD biliary anastomosis. In the control group, DD biliary anastomosis was performed without BS insertion. Results: In the stent group, stents were observed without deformity for up to 4 weeks in all animals. Eight weeks later, histopathologic examination revealed that the common bile duct of the anastomosis site was relatively narrower in circumference in the control group compared to the stent group. The degree of fibrosis in the control group was more marked than in the stent group (3.84 mm vs. 0.68 mm, respectively; P < 0.05). Conclusion Our study showed that novel BS maintained their original shape and radial force for an adequate time and then disappeared without adverse events. The BS could prevent postoperative complications and strictures after DD biliary anastomosis.

BACKGROUND: An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research.METHODS: Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified.RESULTS: An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep·set⁻¹ 1-2 set·region⁻¹ and 3 days·week⁻¹ using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps·min⁻¹, 10 min·day⁻¹ and 2 days·week⁻¹.CONCLUSIONS: Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.
Adolescent ; Aging ; Bone Density ; Exercise ; Humans ; Incidence ; Methods ; Miners ; Motor Activity ; Muscles ; Osteoporosis ; Physiology ; Public Health

BACKGROUND AND OBJECTIVES: We compared improvements in hearing thresholds in acute low-tone sensorineural hearing loss (ALHL) patients after two different treatments: steroid alone and steroid and diuretic combined. We analyzed how the duration between the onset of symptoms and the initiation of treatment affected hearing loss improvement and investigated the relation between presence of vertigo in ALHL patients and ALHL progression to Ménière's disease (MD). SUBJECTS AND METHODS: We retrospectively analyzed the medical records of 47 ALHL patients aged 21 to 76 years. Patients received either orally administered steroid alone (n=12) or steroid and diuretic combined (n=35). We compared improvements in the two groups' hearing thresholds at three lower frequencies (125, 250, and 500 Hz) after participants had received one month of each respective treatment. RESULTS: Our two treatments did not show any statistical difference in hearing loss improvement after one month. Forty percent of ALHL patients with vertigo developed MD, which was a significantly higher rate than the 12.5% of ALHL patients without vertigo who developed MD. The shorter duration between the onset of symptoms and the initiation of treatment significantly increased improvement in the sum of lower frequency hearing threshold after one month. CONCLUSIONS: The current study suggests that steroid and diuretic administered together and steroid alone similarly improve the hearing threshold in ALHL patients after one month. We concluded that patients should initiate ALHL treatment as soon as they experience symptoms. ALHL patients should also be notified of their higher risk of developing MD.
Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Medical Records ; Meniere Disease ; Retrospective Studies ; Vertigo

OBJECTIVES: This study was aimed to investigate the neurocognitive functioning of patients with remitted bipolar disorder and compare with schizophrenic patients' neurocognitive functioning. METHODS: This issue was addressed by comparing remitted DSM-IV diagnosed bipolar, schizophrenics patients and controls on several clinical and neurocognitive measures. Clinical state was assessed using the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and Montgomery-Asberg Depression Rating Scale (MADRS). Neurocognitive measures included the KWIS, WMS-III, Korean California Verbal Learning Test (K-CVLT), Wisconsin Card Sorting Test (WCST), Rey-Osterrieth Complex Test (RCFT), and Color Trails Test (CTT). Thirty-two subjects with remitted bipolar disorder, twenty-four remitted schizophrenia and twelve normal controls were studied. RESULTS: Analysis of variance (ANOVA) revealed no differences across groups on age, education and IQ. With respect to neurocognitive test performance, bipolar disorder patients and schizophrenic patients were similar and both groups were impaired compared to normal controls. Two diagnosed groups have persistent impairments in neurocognitive function, particularly in the domains of declarative memory. CONCLUSION: The results provide support for the view that remitted patients with bipolar disorder suffer cognitive impairment.
Bipolar Disorder ; California ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Schizophrenia ; Sensitivity and Specificity ; Verbal Learning ; Wisconsin

OBJECTIVES: The long-term outcome of schizophrenia is still considered variable and inconclusive. We performed a one-year prospective observational study to investigate the longitudinal outcomes in patients with recent-onset schizophrenia. The primary purpose was to determine the descriptive outcomes in terms of symptom remission and psychosocial function. The secondary purpose was to identify predictor variables associated with the outcomes. METHODS: Patients experiencing their first episode of psychosis or hospitalization within the past 2 years with a diagnosis of DSM-IV schizophrenia were included. Clinical symptoms were assessed monthly using Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) scale. Psychosocial function was measured using PSYCH-UP (Psychosocial symptoms you currently have, follow-up version) and Heinrichs' Quality of Life Scale (QLS) at baseline, 6, and 12 months and Global Assessment of Functioning (GAF) monthly. Remission was defined on the basis of overall, and psychotic core symptoms as having 1) BPRS total score < or =36, and 2) Each individual item score of core psychotic items (conceptual disorganization, suspiciousness, hallucinatory behavior, unusual thought content) < or =3, and 3) CGI severity score < or =3, and 4) Duration of remission at least for 2 consecutive months. To identify the predictive variables for the outcome, relationships between time to remission and various clinical variables were examined using Cox proportional hazards model. RESULTS: A total of 49 patients with schizophrenia were enrolled in this study. The proportions of patients with symptom remission were 54.5% (24/44, drop outs=5) at 3 months, 55.3% (21/38, drop outs=11) at 6 months, and 64.3% (18/28, drop outs=21) at 12 months. Mean time to remission was 3.76+/-2.43 (s.d.) months, and the mean duration of remission was 7.54+/-2.99 months. Significantly longer time to remission was predicted by higher SANS total score at baseline in various predictor variables (p=0.01). Impairments of psychosocial function measured using PSYCH-UP and QOL were significantly improved at the end of this study, but still remained at mild to moderate level. SANS total score and GAF score significantly correlated with most of the items related to psychosocial function at 12 months. The proportion of the patients with GAF score > or =60 increased from 6.1% at baseline to 85.8% at 12 months. Of the patients who were in remission at 12 months, 95.5% obtained GAF score > or =60. CONCLUSION: This study showed 64.3% of symptom remission rate in patients with recent-onset schizophrenia. Symptom remission was accompanied by significant improvement of global function. The severity of negative symptom at baseline appeared to be a significant predictor for time to remission. Psychosocial function was improved at the end of this study, but impairments still remained at mild to moderate level. GAF score and negative symptoms significantly correlated with psychosocial function.
Brief Psychiatric Rating Scale ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Follow-Up Studies ; Hospitalization ; Humans ; Observational Study* ; Proportional Hazards Models ; Prospective Studies* ; Psychotic Disorders ; Quality of Life ; Schizophrenia*