The detrimental effects of hyperlipidemia on the healing of rotator cuff tears are well documented. The proposed underlying mechanisms for these effects include alterations in the extracellular matrix, inflammation, and oxidative stress, which hamper the reparative processes in the affected tendon tissues. Recent therapeutic strategies target these pathways, reflecting a growing body of research dedicated to mitigating these effects and promoting healing. This literature review aims to provide a comprehensive understanding of the pathophysiology underlying rotator cuff tears, examine the interplay between hyperlipidemia and rotator cuff tear healing, synthesize current knowledge on contributing biological mechanisms, and outline potential therapeutic interventions to optimize clinical management and treatment outcomes for patients.

Background: This study aimed to investigate changes after repeated subacromial drug injections in a rat model of normal rotator cuff. Methods: Thirty-nine male Sprague-Dawley rats were divided into groups 1 (no injection, n = 3), 2 (parecoxib, n = 18; 6 subgroups, n = 3 each; 0.5 mg/kg), and 3 (triamcinolone, n = 18; 6 subgroups, n = 3 each; 0.3 mg/kg). Groups 2 and 3 received subacromial injections 1–6 times once weekly for 6 weeks. The supraspinatus and infraspinatus tendons and muscles were used for biomechanical and histological evaluation. The subacromial bursa was used to analyze the prostaglandin E2 (PEG2) level. Results: In the biomechanical test, load-to-failure and ultimate stress decreased in groups 2 and 3 with repeated injections and the values were significantly lower in group 3 than in group 1 only at the sixth injection (p = 0.007 and p = 0.008, respectively). On the Bonar score, the cellularity, ground substance, and total score were significantly different among the 3 groups at the fifth and sixth injections (cellularity: p = 0.028 and p = 0.033, ground substance: p = 0.018 and p = 0.006, and total score: p = 0.029 and p = 0.027, respectively). The myocyte cross-sectional area of the infraspinatus muscle showed a significant difference among the 3 groups at the third and fourth injections (p = 0.031 and p = 0.020, respectively). The PEG2 level in the subacromial bursa was significantly different among the 3 groups at the third, fifth, and sixth injections (p = 0.019, p = 0.004, and p = 0.004, respectively). Conclusions In the rat model of normal rotator cuff, repeated local injections of the cyclooxygenase-2 inhibitor showed fewer negative effects on the biomechanical and histological properties of the normal tendon than triamcinolone.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

The detrimental effects of hyperlipidemia on the healing of rotator cuff tears are well documented. The proposed underlying mechanisms for these effects include alterations in the extracellular matrix, inflammation, and oxidative stress, which hamper the reparative processes in the affected tendon tissues. Recent therapeutic strategies target these pathways, reflecting a growing body of research dedicated to mitigating these effects and promoting healing. This literature review aims to provide a comprehensive understanding of the pathophysiology underlying rotator cuff tears, examine the interplay between hyperlipidemia and rotator cuff tear healing, synthesize current knowledge on contributing biological mechanisms, and outline potential therapeutic interventions to optimize clinical management and treatment outcomes for patients.

Background: This study aimed to investigate changes after repeated subacromial drug injections in a rat model of normal rotator cuff. Methods: Thirty-nine male Sprague-Dawley rats were divided into groups 1 (no injection, n = 3), 2 (parecoxib, n = 18; 6 subgroups, n = 3 each; 0.5 mg/kg), and 3 (triamcinolone, n = 18; 6 subgroups, n = 3 each; 0.3 mg/kg). Groups 2 and 3 received subacromial injections 1–6 times once weekly for 6 weeks. The supraspinatus and infraspinatus tendons and muscles were used for biomechanical and histological evaluation. The subacromial bursa was used to analyze the prostaglandin E2 (PEG2) level. Results: In the biomechanical test, load-to-failure and ultimate stress decreased in groups 2 and 3 with repeated injections and the values were significantly lower in group 3 than in group 1 only at the sixth injection (p = 0.007 and p = 0.008, respectively). On the Bonar score, the cellularity, ground substance, and total score were significantly different among the 3 groups at the fifth and sixth injections (cellularity: p = 0.028 and p = 0.033, ground substance: p = 0.018 and p = 0.006, and total score: p = 0.029 and p = 0.027, respectively). The myocyte cross-sectional area of the infraspinatus muscle showed a significant difference among the 3 groups at the third and fourth injections (p = 0.031 and p = 0.020, respectively). The PEG2 level in the subacromial bursa was significantly different among the 3 groups at the third, fifth, and sixth injections (p = 0.019, p = 0.004, and p = 0.004, respectively). Conclusions In the rat model of normal rotator cuff, repeated local injections of the cyclooxygenase-2 inhibitor showed fewer negative effects on the biomechanical and histological properties of the normal tendon than triamcinolone.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

The detrimental effects of hyperlipidemia on the healing of rotator cuff tears are well documented. The proposed underlying mechanisms for these effects include alterations in the extracellular matrix, inflammation, and oxidative stress, which hamper the reparative processes in the affected tendon tissues. Recent therapeutic strategies target these pathways, reflecting a growing body of research dedicated to mitigating these effects and promoting healing. This literature review aims to provide a comprehensive understanding of the pathophysiology underlying rotator cuff tears, examine the interplay between hyperlipidemia and rotator cuff tear healing, synthesize current knowledge on contributing biological mechanisms, and outline potential therapeutic interventions to optimize clinical management and treatment outcomes for patients.

Background: This study aimed to investigate changes after repeated subacromial drug injections in a rat model of normal rotator cuff. Methods: Thirty-nine male Sprague-Dawley rats were divided into groups 1 (no injection, n = 3), 2 (parecoxib, n = 18; 6 subgroups, n = 3 each; 0.5 mg/kg), and 3 (triamcinolone, n = 18; 6 subgroups, n = 3 each; 0.3 mg/kg). Groups 2 and 3 received subacromial injections 1–6 times once weekly for 6 weeks. The supraspinatus and infraspinatus tendons and muscles were used for biomechanical and histological evaluation. The subacromial bursa was used to analyze the prostaglandin E2 (PEG2) level. Results: In the biomechanical test, load-to-failure and ultimate stress decreased in groups 2 and 3 with repeated injections and the values were significantly lower in group 3 than in group 1 only at the sixth injection (p = 0.007 and p = 0.008, respectively). On the Bonar score, the cellularity, ground substance, and total score were significantly different among the 3 groups at the fifth and sixth injections (cellularity: p = 0.028 and p = 0.033, ground substance: p = 0.018 and p = 0.006, and total score: p = 0.029 and p = 0.027, respectively). The myocyte cross-sectional area of the infraspinatus muscle showed a significant difference among the 3 groups at the third and fourth injections (p = 0.031 and p = 0.020, respectively). The PEG2 level in the subacromial bursa was significantly different among the 3 groups at the third, fifth, and sixth injections (p = 0.019, p = 0.004, and p = 0.004, respectively). Conclusions In the rat model of normal rotator cuff, repeated local injections of the cyclooxygenase-2 inhibitor showed fewer negative effects on the biomechanical and histological properties of the normal tendon than triamcinolone.

Background/Aims: Although numerous noninvasive steatosis indices have been developed to assess hepatic steatosis, whether they can be applied to young adults in the evaluation of metabolic dysfunction-associated steatotic liver disease (MASLD) remains uncertain. Methods: Data from patients under 35 years of age who visited the Liver Health Clinic at the Armed Forces Goyang Hospital between July 2022 and January 2024 were retrospectively collected. Steatosis was diagnosed on the basis of a controlled attenuation parameter score ≥250dB/m. MASLD was defined as the presence of steatosis in patients with at least one cardiometabolic risk factor. Results: Among the 1,382 study participants, 901 were diagnosed with MASLD. All eight indices for diagnosing steatosis differed significantly between the MASLD and non-MASLD groups (p<0.001). Regarding the predictive performance, the hepatic steatosis index (HSI), fatty liver index (FLI), Framingham steatosis index, Dallas steatosis index, Zhejiang University index, lipid accumulation product, visceral adiposity index, and triglyceride glucose-body mass index exhibited an area under the curve of 0.898, 0.907, 0.899, 0.893, 0.915, 0.869, 0.791, and 0.898, respectively. The cutoff values for the FLI and HSI were re-examined, indicating a need for alternative cutoff values for the HSI, with a rule-in value of 42 and a rule-out value of 36 in this population. Conclusions This study presents novel findings regarding the predictive performance of established steatosis markers in young adults. Alternative cutoff values for the HSI in this population have been proposed and warrant further validation.

The detrimental effects of hyperlipidemia on the healing of rotator cuff tears are well documented. The proposed underlying mechanisms for these effects include alterations in the extracellular matrix, inflammation, and oxidative stress, which hamper the reparative processes in the affected tendon tissues. Recent therapeutic strategies target these pathways, reflecting a growing body of research dedicated to mitigating these effects and promoting healing. This literature review aims to provide a comprehensive understanding of the pathophysiology underlying rotator cuff tears, examine the interplay between hyperlipidemia and rotator cuff tear healing, synthesize current knowledge on contributing biological mechanisms, and outline potential therapeutic interventions to optimize clinical management and treatment outcomes for patients.