Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using a 19-gauge needle is an efficient sampling method for the diagnosis of lymphadenopathy. This study compared 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma (ML). Methods: Patient characteristics, number of needle passes, puncture route, sensitivity, specificity, and accuracy of cytology/histology for lymphadenopathy were analyzed in patients diagnosed with lymphadenopathy by EUS-FNA using conventional or Franseen needles. Results: Between 2012 and 2022, 146 patients met the inclusion criteria (conventional [n=70] and Franseen [n=76]). The median number of needle passes was significantly lower in the conventional group than in the Franseen group (3 [1–6] vs. 4 [1–6], p=0.023). There were no significant differences in cytological/histological diagnoses between the two groups. For ML, the immunohistochemical evaluation rate, sensitivity of flow cytometry, and cytogenetic assessment were not significantly different in either group. Bleeding as adverse events (AEs) were observed in three patients in the Franseen group. Conclusions Both the 19-gauge conventional and Franseen needles showed high accuracy in lymphadenopathy and ML classification. Considering sufficient tissue collection and the avoidance of AEs, the use of 19-gauge conventional needles seems to be a good option for the diagnosis of lymphadenopathy.

Purpose: Despite widespread adoption of open abdominal management (OAM), there is currently no threshold criterion for OAM duration for non-trauma patients. Moreover, there is a positive relationship between morbidity and the duration of OAM, but an uncertain relationship with patients’ age. Therefore, a novel clinical index for the duration of open abdominal management (IDOM) was developed based on the patient’s age and risk of severe complications following OAM to indicate the maximum tolerable number of days of OAM based on the individual’s age. The utility of this new index was evaluated. Methods: This retrospective study included 65 non-trauma patients managed with an open abdomen (OA) from August 2015 to August 2018. The IDOM was developed based on the patient’s age. The result indicated the maximum number of OA days. Patients’ demographic and operative variables were examined and patient data was assigned to one of two groups according to whether the actual number of OA days was above or below the calculated IDOM. Prevalence of complications between these groups was compared. Measures of validity were employed to assess the utility of the IDOM for patient complications. Results: Sixty-five patients were included. The above-the calculated IDOM group exhibited a significantly longer OA and higher rates of wound complications and postoperative respiratory complications compared with the below the calculated IDOM group. The IDOM predicted the incidence of OA-related complications with a sensitivity of 72.4%, and a specificity of 80.6%. Conclusion The IDOM is a potentially useful tool for appropriate duration at the outset of OA.

The purpose of this study was to evaluate the change of the hardness of the gastrocnemius muscle (GM) and the Achilles tendon (AT) using Real-time Tissue Elastography (RTE) before and after acute exercise. Nine healthy young male without any exercising custom performed a total of 100 reps. of one-leg heel-rise exercise and the hardness of the gastrocnemius muscle and the Achilles tendon before and after the exercise was examined in comparison. The strain ratio (SR) was even measured in comparison to a reference material. The result indicated that the SR of the GM significantly increased immediately, 15min, 30min and 24h after the exercise, whereas the SR of the AT significantly increased just immediately and 15min after the exercise. In summary, the hardness of GM and AT increased after exercise. These findings suggest that RTE is a useful technique for assessing specific hardness of muscles and tendon, More RTE measurements of various parts of the body and the examination of the relationship between injury and RTE are required for the conditioning of muscles and tendons.

The purpose of this study is to identify the risk factors which affect the consecutive onset of throwing shoulder injury of a collegiate baseball team, and to calculate regression formula which could predict the future onset.Prospective study. The subjects are 69 asymptomatic collegiate baseball players. We executed medical checkups and investigated who got throwing shoulder injury during this year. We did logistic regression analysis with the medical checkup findings and the data of the onset and found out the factors which significantly affected the onset. We also calculated Odds ratio of these factors and regression formula which predict the probability of the onset of throwing shoulder injury and evaluated the validity of regression model.52%(36/69 cases) of the players suffered throwing shoulder injury during this year. Among the medical checkup findings of asymptomatic phase, pitcher and catcher, past history of throwing shoulder injury, abnormality of scapula-humeral rhythm, heel-buttock distance were thought to be the risk factors which were near-related to the onset of throwing shoulder injury. We calculated regression formula using the medical checkup findings of asymptomatic phase and we could predict the onset of throwing shoulder injury with 82.5% accuracy.In order to prevent this injury, the method used in this study could be useful for field players to predict the onset of throwing shoulder injury.

PURPOSE : To determine the patterns of electromyographic (EMG) responses and torques of upper extremity muscles in overhead throwers during maximal, eccentric muscle action for shoulder flexion (Flex_Ecc), abduction (Abd_Ecc) and diagonal activities (Dia_Ecc) with full glenohumeral internal rotation, at 60, 120, and 180°/s on the dynamometer.METHODS : Seven asymptomatic subjects (7 men, 4 women) who participate in overhead sports at least three days a week volunteered to participate in this study. Subjects were randomly performed with the test procedure which consisted of at least 5 grade maximal-effort repetitions on the three different testing conditions, at 60, 120, and 180°/s on the dynamometer, while we assessed muscle activation of the anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and biceps brachii (BB) muscles by surface electromyography. EMG data was expressed as a percentage of maximum voluntary isometric contraction (%MVIC) that was obtained from the highest root mean square (RMS, 50 ms) of each muscle and was normalized and averaged.RESULT : AD muscle elicited lower muscle activity during Dia_Ecc than Flex_Ecc and Abd_Ecc (P＜0.05) while the MD, PD, UT, MT, and LT muscles elicited overall greater muscle activities during Dia_Ecc. MD and MT muscle activities were significantly greater for the faster speed than for the slower speed as 60°/s during Abd_Ecc (P＜0.05). Peak torque generated greater muscle strength for Dia_Ecc than Flex_Ecc and Abd_Ecc, and it was significantly greater for the faster speed than slower speed during Dia_Ecc (P＜0.05).CONCLUSION : Posterior upper extremity muscle activities and peak torque values were found to be dependent on eccentric muscle action for diagonal shoulder activity at the faster speed. This study provided evidence that isokinetic eccentric muscle strength testing of the posterior upper extremity muscle was effective to develop of a proper program for overhead sports athletes require forceful stability during deceleration phase.

The aim of this study is to examine the potential of the two-dimensional posture evaluation method as a screening tool for detecting the high-risk population for anterior cruciate ligament injury.Eleven healthy adults participated in this study. They jumped from a 31 cm-high box and landed on their dominant leg. Three-dimensional knee flexion/extension, knee valgus/varus and hip adduction/abduction angle during single-legged landing were calculated. At the same time, the Frontal-plane Knee Displacement index (FKD)-the knee joint position relative to the line between the hip and ankle joint-was measured.FKD reflects the time variation of three-dimensional knee valgus and hip adduction angle very well.Our results suggest that FKD has potential as a screening tool particularly for movement occurring primarily in the frontal-plane.

The purpose of this study was to investigate the pathologic changes of jumper's knee before and after jumping and effects of icing after jumping. Sixteen healthy college students and sixteen collegiate volleyball players with jumper's knee were divided into two groups by eight, without icing group and with icing group after jumping exercise. Without icing groups rested for 20 minutes, while with icing groups were treated with ice for 20 minutes after eighty times of jumping. Signal to noise ratio (SNR) and sectional area of patellar tendon with Magnetic Resonance Imaging and the tenderness of patellar tendon with visual analog scale were measured before and after exercise, following with or without icing and 24 and 48 hours later from the treatment. In jumper's knee group, significant increase was found in the SNR, sectional area of patellar tendon, and tenderness of patellar tendon after exercise compared to before exercise. In addition, in jumper's knee with icing group, significant decrease was found in the SNR, sectional area of patellar tendon after icing and 24 and 48 hours after icing, and the tenderness of patellar tendon after icing compared to after exercise. These results suggested that icing was an effective treatment for jumper's knee after exercise.

[Objective] The aim of this investigation was to evaluate bone metabolism responses to acute resistance exercise during the menstrual cycle. [Methods] Subjects were young healthy sedentary women (n=7) with regular menstrual cycles. The subjects performed acute resistance exercise in each phase (follicular and luteal) of the menstrual cycle. Bone metabolism markers (bone formation marker BAP and bone resorption marker ICTP), bone metabolism related hormones (parathyroid hormone, calcitonin, calcium and inorganic phosphorus) and lactate were determined. Blood samples were collected before (Pre) and immediately following the exercise (Post), 1 hour (P1h) and 24 hours (P24h) after the exercise. [Results] BAP significantly increased at Post compared with Pre both in the follicular and luteal phases (p<0.05), but significantly decreased at P1h and P24h in the luteal phase. ICTP significantly increased at Post in the follicular phase (p<0.05) and significantly decreased at P1h and P24h in the luteal phase. The bone metabolism responses in the luteal phase moved to low-bone turnover at P1h and P24h. [Conclusion] The bone metabolism response to acute resistance exercise was different between menstrual phases. These results suggest that bone metabolism is influenced by the menstrual cycle.

The higher anterior cruciate ligament (ACL) injury rate of females is one of the most sever athletic-related problems today. The purpose of this study is to compare the lower extremity kinematics between male and female during single leg landing.Six male and four female healthy subjects participated in this study. They jumped from a 32 cm high box and landed with the dominant leg. The landing action was filmed with three video cameras. The knee flexion, knee valgus/varus, and hip adduction/abduction angle and angle velocity were calculated.In female subjects, the knee flexion angle and hip adduction angle were greater compared to males. Also, the knee valgus velocity and hip adduction velocity were higher in females.Our results suggest that knee valgus kinematics may be related to hip adduction. It is important to evaluate hip kinematics when considering knee kinematics to prevent knee ligament injuries.

[Objective] The purpose of this study is to examine the relationships between shoulder's function and damage for handball players. Subjects were nine female handball players with dominant shoulder pain.[Methods] Clinical diagnosis was done from the medical doctor's opinion and MRI. Then, the shoulder joint movement was measured with X rays.[Results] Most of them had admitted a lot the impingement syndrome and the subacromial bursitis. The trunk rotation angle at zero-positions was significantly larger in the symptomatic shoulder (dominant shoulder) than in the asymptomatic shoulder (nondominant shoulder). That is, it was obvious that the damage of the shoulder changed tilting angle of scapula medially.[Conclusion] It is reported that the damage of the shoulder causes abnormality to the “scapulohumeral rhythm” by the previous research. But, these results, suggested to need to understand not only “scapulohumeral rhythm” but also movement to the position of the scapula, when the shoulder joint function was observed for the handball player mainly composed of throwing motion.