Clinical Study Is Hardware Removal Recommended after Ankle Fracture Repair?

The indications and clinical necessity for routine hardware removal after treating ankle or distal tibia fracture with open reduction and internal fixation are disputed even when hardware-related pain is insignificant. Thus, we determined the clinical effects of routine hardware removal irrespective of the degree of hardware-related pain, especially in the perspective of patients' daily activities. This study was conducted on 80 consecutive cases (78 patients) treated by surgery and hardware removal after bony union. There were 56 ankle and 24 distal tibia fractures. The hardware-related pain, ankle joint stiffness, discomfort on ambulation, and patient satisfaction were evaluated before and at least 6 months after hardware removal. Pain score before hardware removal was 3.4 (range 0 to 6) and decreased to 1.3 (range 0 to 6) after removal. 58 (72.5%) patients experienced improved ankle stiffness and 65 (81.3%) less discomfort while walking on uneven ground and 63 (80.8%) patients were satisfied with hardware removal. These results suggest that routine hardware removal after ankle or distal tibia fracture could ameliorate hardware-related pain and improves daily activities and patient satisfaction even when the hardware-related pain is minimal

Directions for and prospects of the Environmental Health Study in Korean National Industrial Complexes (EHSNIC): A proposal for the third phase of the EHSNIC

The Environmental Health Study in the Korean National Industrial Complexes (EHSNIC) is a project that aims to monitor the exposure and health effects of environmental pollution among residents of national industrial complexes, as well as propose appropriate environmental health measures. Since its launch in 2003, this project has been initiated in eight national industrial complexes. Currently, it is necessary to review the accomplishments and limitations of the phases 1 and 2 of this project, and establish the direction of the upcoming the phase 3. Thus, the present study has developed principles and goals for the phase 3, considering the rationale and justification of the EHSNIC, and presented specific research contents accordingly. In the phase 3, it is important to improve the methods for exposure assessment and evaluation of health effects, in order to identify clearly the association between the pollutants released from industrial complexes and their health impacts, to develop and to reinforce communication strategies to promote participation of residents of communities near industrial complexes. Nonetheless, it is also important to maintain the basic goal of continuously monitoring the level of exposure to and health effects of environmental pollutants

Effects of Intronic and Exonic Polymorphisms of Paraoxonase 1 (PON1) Gene on Serum PON1 Activity in a Korean Population

Paraoxonase 1 (PON1) hydrolyzes a number of toxic organophosphorous compounds and reduces lipid peroxide accumulation, and PON1 genetic polymorphisms in the coding region modulate serum PON1 activity. In this study, we investigated the association between 3 polymorphisms of PON1 located in intron 5 (17899insdelTT and 17974CT) and exon 6 (192QR) and serum PON1 activity. The genetic polymorphisms and serum activity of PON1 were analyzed in 153 healthy Koreans by using a direct sequencing assay and spectrophotometric method, respectively. A significant linkage disequilibrium (LD) was observed between all tested single nucleotide polymorphisms, with the strongest LD observed between 17899insdelTT and 192QR (D' = 0.984). The 17899insdelTT, 17974CT and 192QR genetic polymorphisms were associated with significant differences in serum paraoxonase activity. In multiple regression analyses, smoking, triglyceride level, high-density lipoprotein (HDL) level, and the 17899insdelTT and 192QR genetic polymorphisms were significant determinants of serum paraoxonase activity, while age, smoking, triglyceride level, HDL level, and the 192QR genetic polymorphism were significant determinants of serum arylesterase activity. These results suggest that although the 192QR genetic polymorphism in the coding region of PON1 is primarily associated with serum PON1 activity, the intronic polymorphisms are also involved in serum PON1 activity, and this association may be mediated by LD

Ultrasonographic scoring system score versus liver stiffness measurement in prediction of cirrhosis

Background/AimsWe compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis.MethodsTwo hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4±9.5 y, mean±SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated.ResultsThe mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS ≥6: LSM ≥17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4.ConclusionsThe results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis

Comparison of first-line treatment with CHOP versus ICED in patients with peripheral T-cell lymphoma eligible for upfront autologous stem cell transplantation

IntroductionUpfront autologous stem cell transplantation (ASCT) has been recommended for patients who are newly diagnosed with peripheral T-cell lymphoma (PTCL), and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), an anthracycline-based chemotherapy has been the frontline chemotherapy for PTCL. However, it is not clear whether anthracycline-based chemotherapies such as CHOP could be standard induction therapy for PTCL.MethodsWe conducted a randomized phase II study to compare CHOP with fractionated ifosfamide, carboplatin, etoposide, and dexamethasone (ICED) for patients eligible for ASCT. The primary endpoint was progression-free survival (PFS) and secondary endpoints included objective response rate, overall survival (OS), and safety profiles.ResultsPatients were randomized into either CHOP (n = 69) or ICED (n = 66), and the characteristics of both arms were not different. PTCL-not otherwise specified (NOS, n = 60) and angioimmunoblastic T-cell lymphoma (AITL, n = 53) were dominant. The objective response rate was not different between CHOP (59.4%) and ICED (56.1%), and the 3-year PFS was not different between CHOP (36.7%) and ICED (33.1%). In AITL patients, CHOP was favored over ICED whereas ICED was associated with more cytopenia and reduced dose intensity. Patients who received upfront ASCT after achieving complete response to CHOP or ICED showed 80% of 3-year OS.DiscussionIn summary, our study showed no therapeutic difference between CHOP and ICED in terms of response and PFS. Thus, CHOP might remain the reference regimen especially for AITL based on its better outcome in AITL, and upfront ASCT could be recommended as a consolidation of complete response in patients with PTCL

Particulate Matter Exposure after a Cancer Diagnosis and All-Cause Mortality in a Regional Cancer Registry-Based Cohort in South Korea

Although particulate matter (PM) is a Group 1 carcinogen, few studies have evaluated the effect of PM exposure after a cancer diagnosis on survival. Herein, we evaluated the effect of exposure to ambient PM10 after a cancer diagnosis on survival using data from the Regional Cancer Registry cohort in Chungbuk Province, Korea. A total of 44,432 patients with cancer who survived for >1 year after being diagnosed between 2005 and 2018 were followed until 31 December 2019; there were 32,734 survivors (73.7%) and 11,698 deceased (26.3%). The average follow-up period was 67.7 months, and the cumulative average concentration of PM10 exposure of patients with cancer after a diagnosis was 49.0 µg/m3. When PM10 concentration increased by 1 standard deviation (5.2 µg/m3), the all-cause mortality risk increased 2.06-fold (95% CI: 2.02–2.11). This trend was most pronounced in the younger patient group and in patients with local-stage cancer. This study demonstrates that exposure to PM10 after cancer diagnosis might influence the survival of patients with cancer, requiring environmental preventive measures such as lower pollutant exposure

Highly Sensitive Textile-Based Capacitive Pressure Sensors Using PVDF-HFP/Ionic Liquid Composite Films

Textile-based pressure sensors have garnered considerable interest in electronic textiles due to their diverse applications, including human–machine interface and healthcare monitoring systems. We studied a textile-based capacitive pressure sensor array using a poly(vinylidene fluoride)-co-hexafluoropropylene (PVDF-HFP)/ionic liquid (IL) composite film. By constructing a capacitor structure with Ag-plated conductive fiber electrodes that are embedded in fabrics, a capacitive pressure sensor showing high sensitivity, good operation stability, and a wide sensing range could be created. By optimizing the PVDF-HFP:IL ratio (6.5:3.5), the fabricated textile pressure sensors showed sensitivity of 9.51 kPa−1 and 0.69 kPa−1 in the pressure ranges of 0–20 kPa and 20–100 kPa, respectively. The pressure-dependent capacitance variation in our device was explained based on the change in the contact-area formed between the multi-filament fiber electrodes and the PVDF-HFP/IL film. To demonstrate the applicability and scalability of the sensor device, a 3 × 3 pressure sensor array was fabricated. Due to its matrix-type array structure and capacitive sensing mechanism, multi-point detection was possible, and the different positions and the weights of the objects could be identified

Highly Sensitive Textile-Based Capacitive Pressure Sensors Using PVDF-HFP/Ionic Liquid Composite Films

Textile-based pressure sensors have garnered considerable interest in electronic textiles due to their diverse applications, including human–machine interface and healthcare monitoring systems. We studied a textile-based capacitive pressure sensor array using a poly(vinylidene fluoride)-co-hexafluoropropylene (PVDF-HFP)/ionic liquid (IL) composite film. By constructing a capacitor structure with Ag-plated conductive fiber electrodes that are embedded in fabrics, a capacitive pressure sensor showing high sensitivity, good operation stability, and a wide sensing range could be created. By optimizing the PVDF-HFP:IL ratio (6.5:3.5), the fabricated textile pressure sensors showed sensitivity of 9.51 kPa−1 and 0.69 kPa−1 in the pressure ranges of 0–20 kPa and 20–100 kPa, respectively. The pressure-dependent capacitance variation in our device was explained based on the change in the contact-area formed between the multi-filament fiber electrodes and the PVDF-HFP/IL film. To demonstrate the applicability and scalability of the sensor device, a 3 × 3 pressure sensor array was fabricated. Due to its matrix-type array structure and capacitive sensing mechanism, multi-point detection was possible, and the different positions and the weights of the objects could be identified