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Irreparable anterosuperior rotator cuff tears (IASRCTs) can result in a gradual loss of active elevation and internal rotation, superior and anterior translation of the humeral head, and cuff tear arthropathy. Joint-preserving treatment options for IASRCTs in young and high-demand elderly patients remain a subject of ongoing debate. The aim of the study was to evaluate the biomechanical efficacy of the combined latissimus dorsi and teres major tendon (LDTM) transfer and compare it to an isolated latissimus dorsi (LD) transfer in a cadaveric IASRCT model.Eight cadaveric shoulders (mean age, 68.3±5.2 years; range 58-71) were tested with a custom shoulder testing system. All specimens were tested at 0°, 30°, and 60° of glenohumeral abduction in the scapular plane under four conditions: (1) intact, (2) IASRCT, (3) combined LDTM transfer, and (4) isolated LD transfer. The superior and anteroinferior translation, and subacromial contact pressure were measured. The effects of three different LD and LDTM muscle loading conditions were investigated to determine the effectiveness of the muscle transfer conditions. A linear mixed effect model was used for statistical analysis, followed by a Tukey post hoc test.IASRCTs significantly increased superior translation, anteroinferior translation, and subacromial peak contact pressure. Combined LDTM transfer significantly decreased superior and anteroinferior translation compared with IASRCTs in all positions and muscle loadings. Isolated LD transfer did not significantly decrease superior (P0.115) and anteroinferior translation (P0.151) compared to IASRCT at any abduction and muscle loads except superior translation at 60° abduction, 90° of external rotation (ER) (P0.036). LDTM transfer also significantly decreased peak contact pressure from the IASRCT condition at every abduction angle (P0.046). However, isolated LD transfer significantly decreased subacromial peak contact pressure only at 30° abduction and 0° and 30° of ER with triple loading (P0.048), as well as at 60° abduction and 90° of ER (P0.003).Combined LDTM transfer decreased superior translation, anteroinferior translation and subacromial contact pressure compared with the IASRCT condition. Isolated LD transfer did not improve glenohumeral translation and subacromial contact pressure. Combined LDTM transfer may be a more reliable treatment option than isolated LD transfer in patients with an IASRCT.

Transforming growth factor-beta (TGF-β) is an important regulator of joint homeostasis, of which dysregulation is closely associated with the development of osteoarthritis (OA). In normal conditions, its biological functions in a joint environment are joint protective, but it can be dramatically altered in different contexts, making its therapeutic application a challenge. However, with the deeper insights into the TGF-β functions, it has been proven that TGF-β augments cartilage regeneration by chondrocytes, and differentiates both the precursor cells of chondrocytes and stem cells into cartilage-generating chondrocytes. Following documentation of the therapeutic efficacy of chondrocytes augmented by TGF-β in the last decade, there is an ongoing phase III clinical trial examining the therapeutic efficacy of a mixture of allogeneic chondrocytes and TGF-β-overexpressing cells. To prepare cartilage-restoring chondrocytes from induced pluripotent stem cells (iPSCs), the stem cells are differentiated mainly using TGF-β with some other growth factors. Of note, clinical trials evaluating the therapeutic efficacy of iPSCs for OA are scheduled this year. Mesenchymal stromal stem cells (MSCs) have inherent limitations in that they differentiate into the osteochondral pathway, resulting in the production of poor-quality cartilage. Despite the established essential role of TGF-β in chondrogenic differentiation of MSCs, whether the coordinated use of TGF-β in MSC-based therapy for degenerated cartilage is effective is unknown. We herein reviewed the general characteristics and mechanism of action of TGF-β in a joint environment. Furthermore, we discussed the core interaction of TGF-β with principal cells of OA cell-based therapies, the chondrocytes, MSCs, and iPSCs. Impact Statement Transforming growth factor-beta (TGF-β) has been widely used as a core regulator to improve or formulate therapeutic regenerative cells for degenerative joints. It differentiates stem cells into chondrocytes and improves the chondrogenic potential of differentiated chondrocytes. Herein, we discussed the overall characteristics of TGF-β and reviewed the comprehension and utilization of TGF-β in cell-based therapy for degenerative joint disease.

Latissimus dorsi transfer (LDT) and lower trapezius transfer (LTT) are effective treatment options for posterosuperior irreparable rotator cuff tears (IRCTs) in relatively young patients and elderly high-demand patients without arthritic changes. However, the optimal treatment option for patients with posterosuperior IRCT remains a subject of ongoing debate. This study aimed to compare clinical and radiologic short-term outcomes between arthroscopic-assisted LDT (aLDT) and arthroscopic-assisted LTT (aLTT) in patients with posterosuperior IRCT.This retrospective crossover study included patients who underwent aLDT or aLTT for posterosuperior IRCT and who had a minimum clinical follow-up time of 2 years after undergoing surgical procedures between January 2012 and June 2019. A total of 90 patients with posterosuperior IRCT were divided into 2 groups according to the surgical procedure: group D underwent aLDT (n = 48) and group T underwent aLTT (n = 42). Clinical outcomes comprised the visual analog scale score for pain, active shoulder range of motion (ROM), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, and activities of daily living that require active external rotation (ADLER) score. Radiologic outcomes included acromiohumeral distance (AHD). The progression of arthritis was evaluated using Hamada grade. Graft integrity was assessed using postoperative magnetic resonance imaging.Significant improvements in clinical outcomes were observed in both groups. Active shoulder external rotation (P .001), postoperative ASES score (P .001), and ADLER score (P .001) were significantly higher in group T than in group D. AHD at 2-year follow-up was significantly higher in group T than in group D (P .001). The rate of progression of arthritis was significantly higher in group D (31.3%) than in group T (7.1%) (P = .031).Although both LDT and LTT improved the overall clinical outcomes of patients with posterosuperior IRCT, LTT was superior to LDT in terms of shoulder ROM, functional improvement, and progression of arthritis. Our findings indicate that LTT may be the preferred treatment option for posterosuperior IRCT in relatively active and young patients.

Ankylosing spondylitis (AS) is rarely accompanied by other autoimmune diseases and/or hematologic disorders. We herein report a 46-year-old man with AS coexisting with relapsing polychondritis (RP), antiphospholipid syndrome (APS) and myelodysplastic syndrome (MDS). While receiving anti-TNF therapy for AS, the patient developed anemia and was diagnosed with MDS. After six months, he developed swelling and redness of the nose and both auricles. RP was diagnosed by an ear biopsy. Afterward, during the evaluation of a repeated fever, APS was diagnosed. This case of AS with multiple autoimmune diseases and hematologic malignancy successfully responded to a Janus kinase inhibitor (baricitinib).

To evaluate the impact of graft thickness on clinical outcomes and graft retear after superior capsular reconstruction (SCR) using a hybrid graft combining both fascia lata autograft and dermal allograft in patients with massive rotator cuff tear (MRCT).Between January 2017 and February 2019, this study enrolled 58 patients with MRCT who underwent SCR using a hybrid graft combining both fascia lata autograft and dermal allograft. We evaluated clinical outcomes and compared differences between the graft intact and the graft retear group. Moreover, subgroup analysis was performed for patients having a preoperative acromiohumeral distance (AHD) less than or equal to the used graft thickness (group 1) and the results were compared with those for preoperative AHD greater than the used graft thickness (group 2).Fifty-five patients who underwent MRCT with a mean age of 65.1 ± 5.7 years old were followed up during a mean period of 30.5 ± 6.5 (range, 24-37) months. There were significant differences in clinical outcome measures preoperatively and postoperatively (P.05). There were no significant differences in clinical outcomes between the graft intact and graft retear groups (P.05). The subgroup analysis revealed that the retear (68.6% vs 30.4%, P = .004) and subacromial erosion rates (91.4% vs 60.9%, P = .005) were significantly greater in for patients having a preoperative AHD less than or equal to the used graft thickness (group 1).SCR using a hybrid graft combining both fascia lata autograft and dermal allograft is promising with improved clinical scores (P.05) irrespective of the graft integrity. The use of a graft with a thickness greater than a patient's preoperative AHD could increase graft retear and subacromial erosion rates after SCR. However, there was no significant difference in clinical outcomes according to the relationship between used graft thickness and preoperative AHD.Level IV, therapeutic case series.

Objectives Few studies have examined factors affecting steroid-free remission (SFR) in patients with immunoglobulin G4–related disease (IgG4-RD). The aim of this study was to investigate clinical factors affecting SFR in IgG4-RD. Methods The medical records of 68 patients who met the 2020 revised comprehensive diagnostic criteria for IgG4-RD were reviewed retrospectively. SFR was defined as remission maintained for at least 6 months without corticosteroids. Cox regression analysis was performed to examine the associations between SFR and various clinical factors. The relapse rate after SFR was examined using the log-rank test. Results After a median follow-up of 36 months, 30.9% (21/68) of patients with IgG4-RD achieved SFR. Multivariate Cox regression analysis revealed that IgG4-RD diagnosed by complete resection rather than by common diagnostic procedures was the only factor positively associated with SFR (hazard ratio, 7.41; 95% confidence interval, 2.23–24.60; P = .001). Furthermore, relapse after attainment of SFR was significantly less common in the group that underwent complete resection than in the group that did not undergo complete resection (log-rank P = .006). Conclusions Patients with IgG4-RD diagnosed by complete resection had a higher likelihood of achieving SFR and a lower rate of relapse after attaining SFR.

BackgroundThe aim of this study was to investigate the impact of rheumatoid arthritis (RA) on the prevalence of bronchial asthma and asthma-related comorbidities. We also aimed to identify the influence of RA on interrelationship between asthma and asthma-related comorbidities.MethodsFrom the Korean National Health and Nutrition Examination Survey, participants >40 years of age who completed questionnaires and spirometry tests were enrolled. Patient data on RA, asthma, allergic rhinitis, atopic dermatitis, chronic obstructive pulmonary disease (COPD), sinusitis, otitis media, and body mass index (BMI) were collected. Logistic regression and network analyses were performed.ResultsA total of 14,272 subjects were enrolled, among which, 334 (2.4%) had RA. RA was significantly associated with asthma (OR 2.32; 95% CI 1.51–3.57), allergic rhinitis (OR 1.51; 95% CI 1.08–2.10), and sinusitis (OR 1.64; 95% CI 1.08–2.50). The network analysis of total patients revealed a positive interrelationship between asthma and allergic rhinitis, sinusitis, otitis media, atopic dermatitis, BMI, and RA. The interrelationship between asthma and sinusitis was stronger in the RA group. Of note, the relationship between asthma and BMI was distinctively found only in the RA group (r = 0.214, P < 0.05). In patients with asthma, the prevalence of obesity was 64% in the presence of RA, and 40% in the absence of RA (P = 0.034).ConclusionThis study supports the positive association of RA with asthma, allergic rhinitis, and sinusitis. Our analysis suggests a notable interrelationship between the presence of asthma and higher BMI values in patients with RA, indicating that asthma is more obesity-related in patients with RA.

Background: Superior capsular reconstruction (SCR) and lower trapezius transfer (LTT) have recently been utilized to treat irreparable rotator cuff tears (IRCTs). There is still no clear guideline on which treatment method is a better fit for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus. Purpose: To compare the clinical and radiological outcomes between arthroscopic-assisted SCR (aSCR) and arthroscopic-assisted LTT (aLTT) in patients with posterosuperior IRCTs with high-grade (Goutallier grade 4) fatty infiltration in the infraspinatus muscle. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included patients who underwent aSCR or aLTT for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus and had a minimum follow-up of 2 years between 2017 and 2019. A total of 58 patients were divided into 2 groups according to the surgical procedure: aSCR group (n = 22) and aLTT group (n = 36). Clinical outcomes comprised the visual analog scale score for pain, active shoulder range of motion (ROM), the American Shoulder and Elbow Surgeons (ASES) score, and patient satisfaction. Radiological outcomes comprised the acromiohumeral distance (AHD). The progression of arthritis was evaluated via the Hamada grade. Graft integrity was assessed on postoperative magnetic resonance imaging scans. Results: Significant improvements in clinical outcomes were observed in both groups. However, active shoulder ROM (forward elevation: 165.7°± 22.3° vs 145.5°± 32.3°, respectively [ P = .015]; external rotation: 51.7°± 10.9° vs 41.1°± 7.0°, respectively [ P < .001]), the postoperative ASES score (84.8 ± 7.6 vs 76.8 ± 20.3, respectively; P = .045), and patient satisfaction (8.9 ± 1.2 vs 6.4 ± 2.1, respectively; P = .041) were significantly higher with aLTT than with aSCR. There was no significant difference between the groups in AHD at 2 years postoperatively. However, the rate of progression of arthritis was significantly higher with aSCR (22.7%) than with aLTT (2.8%) ( P = .027). Moreover, the graft retear rate was significantly higher with aSCR (63.6%) than with aLTT (8.3%) at 2 years postoperatively ( P < .001). Conclusion: Although aSCR and aLTT both provided improvements in overall clinical outcomes for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus, aLTT was superior in terms of functional improvement, patient satisfaction, progression of arthritis, and graft integrity. Therefore, we prefer aLTT for posterosuperior IRCTs under the condition of high-grade 4 fatty infiltration in the infraspinatus.

Photographic images of the Samseong-version (三省本: Korea’s Treasure No. 758-1) and the Gongin-version (空印本: Korea’s Treasure No. 758-2) of Nammyeongcheon Hwasangsong Jeungdoga (南明泉和尙頌證道歌: Nanmingquan Song Zhengdaoge) were compared and analyzed to investigate the differences between the two versions. According to a report in 2012 at the time of the designation of the Gongin-version as Korea’s treasure, both versions were printed from the same woodblocks. The Gongin-version is presumed to be a later print than the Samseong-version. The two versions are very similar in format and shape of border lines and characters. It is difficult to determine the differences with the naked eye, even for experts. In this study, based on the printing characteristics observed from each version through image analysis, useful evidence to determine whether it was printed using the same or different woodblocks and the order of printing was collected. As a result of careful image comparison and analysis, we concluded that the Samseong- and the Gongin-version were printed from different woodblocks, or possibly different typesetting. It was difficult to agree with the content of the report that the Gongin-version was a later print than the Samseong-version. In addition, it was noted that the Gongin-version print has characteristics quite different from the typical characteristics of woodblock printing seen in the Samseong-version. Additional investigations and follow-up studies on the printing technology used for Gongin-version print and the timing of printing are recommended.

A novel method of extracting color information on a pixel-by-pixel basis or by the average of the regions of interest (ROIs) from digital images is proposed and demonstrated using newly developed and customized image-processing/analysis software (PicMan). For quantitative and statistical analyses of color, the newly developed software can be used for digital archive or digital forensic applications in various fields. The color differences between unrelated, similar, or identical scenes and or objects were quantified in various formats of desired color spaces such as RGB, HSV, XYZ, CIE L*a*b*, Munsell color, and hexadecimal color values. The color differences were visualized as images of pixel-by-pixel mapping of the ΔL*, Δa*, Δb*, ΔERGB, ΔEHSV, and ΔE*L*a*b* values and block comparison images of desired block sizes. Various color analyses and color-difference mapping examples using an aged and damaged oil painting before and after restoration were introduced. The effects of the image file format differences between PNG and JPG on color distortion are demonstrated by statistics and pixel-by-pixel color-difference mapping. A portrait of Chuk-ki Yoo (兪拓基, 1691–1767) on silk from the 18th century from Korea was used for further color analysis for whole and selected areas. A collector’s ownership stamp of Chuk-ki Yoo stamped in red ink on the text areas in one of his book collections was extracted using the image-processing software and superimposed on the original image as a visualization enhancement example. Image analysis, processing, modification, enhancement, and highlighting, as well as statistical color analysis of digital images in most formats, can conveniently and efficiently be performed using one piece of dedicated software (PicMan). The pixel-by-pixel color information extraction and color comparison technique can be very effective for a variety of applications in art and cultural heritage objects.

The history of printing technology in Korea is studied by investigating existing ancient documents and records and comparing accumulated data and knowledge. Cultural property research requires non-destructive testing and observation with the naked eye or aided by a microscope. Researchers’ experience and knowledge are required even though they cannot guarantee the outcome. For ancient documents and records that are presumed to consist of woodblock printing, wood type printing, metal type printing, or their combinations, each researcher draws various opinions and conclusions. This often causes confusion and divides the opinions of ordinary citizens and field specialists. Among them, the criteria for judging ancient documents or books printed using woodblock and metal movable material are ambiguous. Academic research on the development history of printing technology in ancient Korea has been stagnant, and conflicts among researchers have also erupted. Involvement of national investigative agencies not specialized in cultural properties has exacerbated the situation. In this study, we investigated printing characteristics that are likely to serve as more objective judgment criteria by quantitatively analyzing the experiments of retrieving several sheets of Korean paper (Hanji) using a replicated Hunminjeongeum (訓民正音) woodblock and quantitatively analyzing the images of the printed papers. In addition, the validity and questions for the typical phenomena presented as a method for distinguishing between woodblock and metal print are reviewed. We investigated the possibility of developing new objective judgement criteria through quantitative analysis using image analysis and investigating the printing characteristics of Korean paper through a reproduction experiment of woodblock printing.

Gwanghwamun Gate of Gyeongbokgung Palace was dismantled and relocated during the Japanese colonial period, destroyed during the Korean War, reconstructed with reinforced concrete in 1968, and finally erected at its present location in 2010. A pair of Haechi statues located in front of Gwanghwamun was dismantled and relocated several times, and the statues have yet to be returned precisely to their original positions. This study assesses the historical accuracy of their current placement under the Gwanghwamun Square Restructuring Project of the Seoul Metropolitan Government and the Cultural Heritage Administration based on archival photos from the early 1900s, and proposes a method to estimate the original positions of the Haechi through image analysis of contemporary photographs and recent digital camera photos. We estimated the original position of the Haechi before the Japanese colonial period by identifying the shooting location of the archival photo and reproducing contemporary photographs by calculating the angle and distance to the Haechi from the shooting location. The leftmost and rightmost Haechi were originally located about 9.6 m to the east and 7.4 m to the north and about 1.9 m to the west and 8.0 m to the north, respectively, of their current location indicators. As the first attempt to determine the original location of a building and its accessories using archival photos, this study launches a new scientific methodology for the restoration of cultural properties.

Objectives‘Invasive pannus’ is a pathological hallmark of rheumatoid arthritis (RA). This study aimed to investigate secretome profile of synovial fibroblasts of patients with RA (RA-FLSs), a major cell type comprising the invasive pannus.MethodsSecreted proteins from RA-FLSs were first identified using liquid chromatography-tandem mass spectrometry analysis. Ultrasonography was performed for affected joints to define synovitis severity at the time of arthrocentesis. Expression levels of myosin heavy chain 9 (MYH9) in RA-FLSs and synovial tissues were determined by ELISA, western blot analysis and immunostaining. A humanised synovitis model was induced in immuno-deficient mice.ResultsWe first identified 843 proteins secreted from RA-FLSs; 48.5% of the secretome was associated with pannus-driven pathologies. Parallel reaction monitoring analysis of the secretome facilitated discovery of 16 key proteins related to ‘invasive pannus’, including MYH9, in the synovial fluids, which represented synovial pathology based on ultrasonography and inflammatory activity in the joints. Particularly, MYH9, a key protein in actin-based cell motility, showed a strong correlation with fibroblastic activity in the transcriptome profile of RA synovia. Moreover, MYH9 expression was elevated in cultured RA-FLSs and RA synovium, and its secretion was induced by interleukin-1β, tumour necrosis factor α, toll-like receptor ligation and endoplasmic reticulum stimuli. Functional experiments demonstrated that MYH9 promoted migration and invasion of RA-FLSs in vitro and in a humanised synovitis model, which was substantially inhibited by blebbistatin, a specific MYH9 inhibitor.ConclusionsThis study provides a comprehensive resource of the RA-FLS-derived secretome and suggests that MYH9 represents a promising target for retarding abnormal migration and invasion of RA-FLSs.

Image-based colorimetry has been gaining relevance due to the wide availability of smart phones with image sensors and increasing computational power. The low cost and portable designs with user-friendly interfaces, and their compatibility with data acquisition and processing, are very attractive for interdisciplinary applications from art, the fashion industry, food science, medical science, oriental medicine, agriculture, geology, chemistry, biology, material science, environmental engineering, and many other applications. This work describes the image-based quantification of color and its machine vision and offline applications in interdisciplinary fields using specifically developed image analysis software. Examples of color information extraction from a single pixel to predetermined sizes/shapes of areas, including customized regions of interest (ROIs) from various digital images of dyed T-shirts, tongues, and assays, are demonstrated. Corresponding RGB, HSV, CIELAB, Munsell color, and hexadecimal color codes, from a single pixel to ROIs, are extracted for machine vision and offline applications in various fields. Histograms and statistical analyses of colors from a single pixel to ROIs are successfully demonstrated. Reliable image-based quantification of color, in a wide range of potential applications, is proposed and the validity is verified using color quantification examples in various fields of applications. The objectivity of color-based diagnosis, judgment and control can be significantly improved by the image-based quantification of color proposed in this study.

Middle trapezius tendon (MTT) transfer has been proposed as a feasible option for managing isolated irreparable supraspinatus tears (IISTTs). However, no clinical study has been attempted. This study aimed to evaluate clinical and radiologic outcomes of arthroscopic-assisted MTT transfer in patients with IISTTs.This retrospective study included patients who underwent arthroscopic-assisted MTT transfer using fascia lata autograft for IISTTs. Clinical outcomes, including pain visual analog scale (VAS), Constant, American Shoulder and Elbow Society (ASES), University of California Los Angeles (UCLA) shoulder scores and active range of motion (aROM), were assessed. Radiographic analyses included the acromiohumeral distance (AHD), Hamada grade, and transferred tendon integrity at the final follow-up.Twenty-two patients (mean age: 63.3 ± 6.8 [51‒74] years; mean follow-up period: 28.9 ± 4.9 [24‒44] months) met the study criteria. The mean VAS, Constant, ASES, and UCLA scores improved postoperatively at the final follow-up (p 0.001). The mean aROMs for forward flexion and abduction were significantly increased postoperatively. No significant changes of AHD (p = 0.105) and Hamada grade (p = 0.815) were observed postoperatively. One patient had a re-tear of the transferred tendon at the footprint site at the final follow-up.In this minimum 2-year follow-up study of the novel aMTT transfer using fascia lata autograft, we found significant improvement in pain relief, clinical scores, and active forward flexion and abduction. Additionally, no significant progression of cuff tear arthropathy was observed at the final follow-up. Therefore, aMTT transfer could be a promising treatment option for patients with IISTTs. However, further multicenter and long-term trials are needed to verify its effectiveness.Retrospective case series, level IV.

For advanced application specific devices, combinations of Si/Ge, Ge/Si, Si1-xGex/Si are frequently introduced in the device fabrication process. Epitaxy, condensation and annealing processes are commonly used for controlling the Ge content to a desired level. Strain and crystallinity can be affected by a small variation in composition or Ge content, which can result in device performance deterioration or failure. Thus, the composition, strain and crystallinity must be carefully monitored and controlled throughout the manufacturing process. The electrode formation process is also very critical for successful device fabrication. Any spikes and/or electrically active defects near junctions can be fatal to the device yield. Silicidation processes and resulting silicides must be investigated as much as possible using various non-invasive material characterization techniques. In this study, we report the thermal silicidation characteristics of Ni/Si1-xGex with various Ge content under different annealing temperatures in the range of 225oC ~ 400oC in N2 ambient. Thermal silicidation was performed in a stacked hotplate-based SAO-302LP system designed for 300mm wafers. For resulting silicide characterization, measurements of sheet resistance, Raman spectra, X-ray diffraction curves as well as scanning electron microscopy (SEM) observations were performed. We have studied Ge content and annealing temperature dependence on the resulting electrical and crystallographic silicide characteristics. Figure 1 shows 647nm excited Raman spectra and X-ray diffraction (XRD) curves from reference Si, and resulting silicide from Ni/Si0.75Ge0.25 before and after annealing under at 235oC, 310oC and 400oC. Raman spectra and sheet resistance measurements showed silicide formation and silicide layer thickening with increasing annealing temperature. XRD curves clearly indicated the change of crystalline phase of resulting silicide with annealing temperature increase. Various aspects of thermal silicidation and its characterization will be discussed at the conference. Figure 1

Vanadium doped semi-insulating (SI) 6H-SiC {0001} substrates and their wetting properties were characterized using precisely dispensed de-ionized (DI) water drops. Radius, contact angle, width (chord), height and cap volume of a DI water drop on the SiC surface were quantitatively determined by analyzing sideview images of DI water drop in contact with SI 6H-SiC {0001} substrates using image processing software. The average of ten (10) contact angle measurements showed approximately 4 ° difference between the Si-face (48.48°) and the C-face (44.33º). Contact angle on the Si-face (0001) measured after native oxide removal showed significant decrease of contact angle, from 55° to 25° and recovered over time by room temperature oxidation in air. In contrast, contact angle on the C-face (000-1), measured after native oxide removal, showed significant increase of contact angle, from 40° to 54°, and continue to increase contact angle up to 71° after room temperature oxidation for 24 hours in air. Contact angle is found to be very sensitive to SiC surface polarity and specific surface conditions. Contact angle measurement, using image analysis techniques, can be applied as an in-line identification and surface condition characterization technique for SiC polytypes of specific surface polarities.

There has been a strong and urgent demand to diagnose community transmission-driven coronavirus disease 2019 (COVID-19) after it crossed borders. A large number of rapid and accurate tests and diagnoses are required at drive-through test stations, community clinics and hospitals. Isothermal amplification technology, such as loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA), provides excellent alternatives for resource limited test environments. LAMP has been shown to be comparable with polymerase chain reaction (PCR) and can be performed in less than 30 min by non-laboratory staff without ribonucleic acid (RNA) extractions commonly associated with PCR. LAMP tests on assays with SARS-CoV-2 and other pathogenic microorganisms, such as Dengue, Malaria, and Influenza viruses and Helicobacter pylori show color changes allowing test results to be interpreted by the color change of the assays. However, visual inspection of a large number of assays is prone to human error and manual record keeping makes test result tracking for an epidemiologic investigation very difficult and inefficient. The epidemiologic investigation is an essential part of the fight against community transmission-driven viruses. We have developed a very accurate and reliable, human error free, tablet PC-based portable device for colorimetric determination of assays including SARS-CoV-2 and other pathogenic microorganisms.

Colorimetric sensing techniques for point(s), linear and areal array(s) were developed using image sensors and novel image processing software for chemical, biological and medical applications. Monitoring and recording of colorimetric information on one or more specimens can be carried out by specially designed image processing software. The colorimetric information on real-time monitoring and recorded images or video clips can be analyzed for point(s), line(s) and area(s) of interest for manual and automatic data collection. Ex situ and in situ colorimetric data can be used as signals for process control, process optimization, safety and security alarms, and inputs for machine learning, including artificial intelligence. As an analytical example, video clips of chromatographic experiments using different colored inks on filter papers dipped in water and randomly blinking light-emitting-diode-based decorative lights were used. The colorimetric information on points, lines and areas, with different sizes from the video clips, were extracted and analyzed as a function of time. The video analysis results were both visualized as time-lapse images and RGB (red, green, blue) color/intensity graphs as a function of time. As a demonstration of the developed colorimetric analysis technique, the colorimetric information was expressed as static and time-series combinations of RGB intensity, HSV (hue, saturation and value) and CIE L*a*b* values. Both static and dynamic colorimetric analysis of photographs and/or video files from image sensors were successfully demonstrated using a novel image processing software.

Irreparable anterosuperior rotator cuff tears (IASRCTs) can result in loss of active elevation, loss of internal rotation, and pseudoparalysis. Joint-preserving treatment options for IASRCTs in young and high-demand elderly patients are limited. The purpose of this study was to evaluate the clinical and radiologic outcomes of combined anterior latissimus dorsi and teres major (aLDTM) tendon transfer in patients with IASRCTs without reconstruction of the superior rotator cuff and capsular portion.This retrospective study was conducted between 2015 and 2018. We included patients who underwent combined aLDTM tendon transfer for IASRCTs. Clinical outcomes included visual analog scale for pain, Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder scores, activities of daily living requiring active internal rotation score, active range of motion, subscapularis-specific physical examination, and rate of return to work. Radiographic analyses included the assessment of acromiohumeral distance, Hamada grade for cuff tear arthropathy, rate of anterior glenohumeral subluxation reduction, and transferred tendon integrity at 2 years postoperatively.The mean follow-up period was 38.1 ± 13.7 (range: 24-63) months. Of the patients, 30 (mean age: 64.1 years) met the study criteria. Postoperatively, mean Constant, American Shoulder and Elbow Surgeons, University of California Los Angeles, and activities of daily living requiring active internal rotation scores improved from 47.4 to 69.9 (P .001), 44.9 to 79.2 (P .001), 20.0 to 28.7 (P .001), and 13.2 to 26.9 (P .001), respectively. The mean active range of motion was significantly increased postoperatively for both forward elevation (P .001) and internal rotation at the back (P .001). Of the patients, 24 (83%) returned to their previous work. No significant progression of cuff tear arthropathy was observed at final follow-up (Hamada grade: preoperative 1.3 ± 0.5 to postoperative 1.5 ± 0.7; p=0.155). Fifteen of 30 patients (50%) restored the anterior glenohumeral subluxation that was apparent preoperatively. One patient presented with transient axillary nerve palsy after surgery. Two patients presented with partial nonretracted tears of the transferred tendon.This minimum 2-year follow-up study demonstrated that combined aLDTM tendon transfer without reconstruction of the superior rotator cuff and capsular portion was a viable treatment option with favorable clinical and radiologic outcomes for patients with IASRCTs.

Colour is a primary characteristic of visual perception and a very important characteristic to describe cultural heritage works in a variety of shapes, sizes and materials. To quantify colours, portable colorimeters are often carried and used for measuring colour of interest. Spatial resolution of colorimeters is manufacturer and model dependent and typically worse than 3 - 10 mm in diameter. The colour measurement has to be done on site at the time of interest. It poses very significant limitations in colorimetric characterization of cultural heritages. In this paper, the possibility of extraction of colour information from digital photographs, scanned images and video files using customized image processing/analysis software (PicMan) was investigated for cultural heritage characterization applications. As colour information extraction examples, a commercial Gouache paint colour card, a digital photograph, a portrait of a Korean scholar of Joseon Dynasty and a severely deteriorated old medical text book before and after restoration were examined. Colour information from various digital images was successfully extracted from points and regions of interest in RGB, HSV, L*a*b*, Munsell colour and hexadecimal colour code formats. The spatial resolution of colour information extraction is as small as a single pixel in a digital image.

To investigate whether initial whole spine magnetic resonance imaging (MRI) predicts radiographic progression and inflammatory activity in patients with axial spondyloarthritis (axSpA).A retrospective analysis of spine MRI and X-rays from 70 axSpA patients was conducted. The number of affected discovertebral units was determined according to the definition of pathologic lesions on spine MRI set down by the ASAS/OMERACT group. Radiographic progression was defined as an increase in the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) of≥2 compared with baseline. The association of spine MRI with radiographic progression, cumulative C-reactive protein (CRP), and cumulative erythrocyte sedimentation rate (ESR) was investigated.The axSpA-relevant lesions on spine MRI at baseline were independent predictors of radiographic progression. Arthritis of the costovertebral and costotransverse joints on MRI showed the highest odds ratio at 3years (OR [95% CI]: 2.54 [1.29-5.02]). Receiver operating characteristic curve analysis revealed that the area under the curve (AUC) for radiographic progression at 2years was 0.89 [95% CI: 0.81-0.96] for structural lesions and 0.83 [95% CI: 0.72-0.94] for inflammatory lesions. Notably, subgroup analysis of 26 patients with mSASSS=0 showed that fatty metaplasia on MRI were highly predictive of radiographic progression at 3years (AUC [95% CI]: 0.87 [0.61-1.00]). Moreover, 3-year cumulative ESR and CRP values increased in proportion to the extent of inflammatory lesions on initial MRI.Initial MRI assessment of the whole spine may predict radiographic progression and subsequent systemic inflammatory burden in axSpA patients, particularly those without axSpA-relevant abnormalities on spine X-rays.

Reverse shoulder arthroplasty (RSA) for irreparable massive rotator cuff tear (mRCT) and cuff tear arthropathy (CTA) demonstrates satisfactory clinical outcomes. However, many studies have reported no significant improvements in internal and external rotation. To our knowledge, there have been no studies on new attempts to restore active internal rotation following RSA. The purpose of this study was to compare RSA alone and RSA with anterior latissimus dorsi and teres major (aLDTM) tendon transfer in patients with CTA and mRCT with combined loss of active elevation and internal rotation (CLEIR).This retrospective cohort study included patients who underwent RSA with a lateralized design and had CLEIR between October 2014 and January 2019. Two groups were classified: patients who underwent RSA alone (group R, n = 36) and patients who underwent RSA with aLDTM tendon transfer (group T, n = 24). Clinical outcomes, including the visual analog scale score, Constant score, American Shoulder and Elbow Surgeons score, active range of motion, score for activities of daily living requiring active internal rotation (ADLIR), and ability to perform toileting activity, were compared. Moreover, radiologic outcomes and complications were compared.The mean follow-up period was 36.8 ± 11.6 months (range, 24-67 months). Both group R and group T showed significant improvements in clinical scores and active range of motion preoperatively and postoperatively. In group T, the Constant score (65.2 ± 7.5 vs. 58.1 ± 12.3, P = .008), ADLIR score (26.1 ± 3.1 vs. 20.3 ± 5.0, P .001), internal rotation level with the arm behind the back (P .001), and subscapularis-specific physical examination findings (P .001) were significantly better than in group R. However, no significant difference in the American Shoulder and Elbow Surgeons score, forward flexion, and external rotation at 0° and 90° of abduction were found at final follow-up. Transient axillary nerve palsy was found in 2 patients in group T. However, there were no significant differences in complication rates between 2 groups.Lateralized RSA with aLDTM tendon transfer for patients with CTA and mRCT with CLEIR restored shoulder function and improved clinical outcomes, especially the ability to perform ADLIR and toileting activity.

Introduction Acromial pathologies (AP), such as acromial stress reaction (ASR), acromial stress occult fracture (ASOF), and acromial stress fracture (ASF), are known as complications that deteriorate the clinical score and patient satisfaction after reverse total shoulder arthroplasty (RSA). Several factors that increase stress on the acromion have been reported as risk factors for AP, but this is also unclear. Thecoracoacromial ligament (CAL) is a structure that distributes the stress loading on such an acromion, although its importance has been mentioned, there is a lack of research. Therefore, we investigated the incidence of AP according to the preservation of the CAL and whether it is a risk factor. Methods The study was retrospectively conducted on patients who underwent RSA from 2016 and 2018. Patients with CAL transection was classified into group 1 and CAL preservation was classified into group 2. ASR and ASOF were identified through symptoms and ultrasound, and ASF identified through simple radiograph or computed tomography. The incidence of AP in each group was checked and compared. Results Of the total of 265 patients. Among 197 cases of group 1, 21 cases of ASR(10.7%), 28 cases of ASOF (14.2%),10 cases of ASF (5.1%), and 59 cases of total AP (29.4%). Among 68 cases in group 2, 2 cases (2.9%) of ASR, 6 cases of ASOF(8.8%), 1 case of ASF (1.5%), and 9 cases of total AP (13.2%). It was confirmed that ASR and ASOP were significantly decreased in the group preserving CAL. (P = .008) Conclusion In the case of preservation of CAL during surgery, it was confirmed that the incidence of ASR, ASOF was reduced. Therefore, preservation of CAL can be regarded as a modifiable risk factor that can reduce the risk of AP by distributing the stress applied to acromion after RSA surgery.

BACKGROUND/OBJECTIVES To date, sodium intake has been evaluated based on spot urine instead of 24-hour (hr) urine collection. Nevertheless, the optimal method for assessing daily sodium intake remains unclear. SUBJECTS/METHODS Fifteen male (age 32.7 ± 6.5 years) participants were offered 3 meals with a total of 9-10 g salt over 24 hours, and 24-hr urine was collected from the second-void urine of the first day to the first-void urine of the second day. Twenty-four-hr urinary sodium (24UNa) was estimated using Tanaka's equation and the Korean formula, and spot urine Na, potassium (K), chloride (Cl), urea nitrogen (UN), creatinine (Cr), specific gravity (SG) and osmolality (Osm) were measured. The ratios of urinary Na to other parameters were calculated, and correlations with total measured 24UNa were identified. RESULTS Average 24-hr urine volume was 1,403 ± 475 mL, and measured 24UNa was 143.9 ± 42.1 mEq (range, 87.1-239.4 mEq). Measured 24UNa was significantly correlated with urinary Na/UN (r = 0.560, P < 0.01), urinary Na/Osm (r = 0.510, P < 0.01), urinary Na/Cr (r = 0.392, P < 0.01), urinary Na/K (r = 0.290, P < 0.01), 24UNa estimated using Tanaka's equation (r = 0.452, P < 0.01) and the Korean formula (r = 0.414, P < 0.01), age (r = 0.548, P < 0.01), weight (r = 0.497, P < 0.01), and height (r = 0.393, P < 0.01) in all spot urine samples. Estimated 24UNa based on the second-void spot urine of the first day tended to be more closely correlated with measured 24UNa than were estimates from the other spot urine samples. The significant parameters correlated with the second-void urine of the first day were urinary Na/K (r = 0.647, P < 0.01), urinary Na/Cr (r = 0.558, P < 0.05), and estimated 24UNa using Tanaka's equation (r = 0.616, P < 0.05) and the Korean formula (r = 0.588, P < 0.05). CONCLUSIONS Second-void urine is more reliable than first-void urine for estimating 24UNa. Urinary Na/K in the second-void urine on the first day is significantly correlated with 24UNa. Further studies are needed to establish the most reliable index and the optimal time of urine sampling for predicting 24UNa.

n-type SiC wafers with localized 4H, 6H, and 15 R polytype grains were photographed and their colors were analyzed to find correlations among polytypes, carrier concentration and apparent color. The SiC wafers were photographed and the color information of different colored regions from the photographs was extracted, both for RGB (red, green, and blue) and HSV (hue, saturation, and value) color space formats using image processing software (PicMan). Polytype and carrier concentration of n-type SiC wafers were identified from Raman spectra for correlation with the color analysis results. The carrier concentration of SiC wafers was estimated to be in the range of 2 × 1017 cm−3 to 1 × 1019 cm−3 from a line-shape analysis of measured Raman spectra. The color analysis revealed that there is very strong correlation between polytype and hue value. The carrier concentration strongly affects saturation and value of apparent color. SiC wafers with lower carrier concentration showed higher clarity (lower saturation (or colorless) and higher value (higher transparency)). As the carrier concentration is increased, the wafer becomes translucent (high saturation or colored) and dark or opaque (low value). The polytype and carrier concentration of SiC wafers can conveniently be estimated from their apparent color.

Introduction Bisphosphonates are effective in preventing osteoporotic fractures. However, their limited efficacy of bisphosphonates has been suggested as a result of these drugs, which prevent the resorption of bone without improving bone connectivity. The trabecular microarchitecture in patients with osteoporotic hip fractures was evaluated according to their history of bisphosphonate treatment (BT). Methods One hundred thirty-three patients with hip fractures admitted and treated between November 2014 and September 2016. The patients were divided into two groups based on whether they had received treatment with bisphosphonates for > 3 years or not [non-bisphosphonate-treated patients (NT)]. One-to-one propensity score matching generated 15 matched pairs of patients. Microstructural parameters of femoral head were measured by using micro-computed tomography (μCT). Mechanical compression test (Young's modulus, yield strength, and maximum compressive force) was performed following μCT. Results Trabecular bone pattern factor (1.15 ± 0.7 mm − 1 versus 1.61 ± 0.5 mm − 1 , p = 0.037) and specific bone surface (14.1 ± 0.8 mm − 1 versus 15.4 ± 1.9 mm − 1 , p = 0.050) were significantly lower in the BT group than in the NT group. Furthermore, Young's modulus was significantly higher in the BT group than in the NT group (72.14 ± 30.75 MPa versus 47.89 ± 29.89 MPa, p = 0.037). In both groups, trabecular bone pattern was the most closely correlated microstructural parameter to bone strength. Microstructural analysis demonstrated that bone connectivity was better preserved in the BT group than in the NT group. Conclusions Bisphosphonate treatment preserves bone mass and bone quality. The factors influencing osteoporotic hip fractures in patients treated with bisphosphonates warrant further research.

Two-inch diameter 6H-SiC wafers were sliced from a SiC ingot and the wafers were ground and polished using different diamond slurries (1 μm and 0.1 μm in particles size) to investigate their dependence on wetting on surface roughness (Ra) and polarity using precisely dispensed de-ionized (DI) water drops. The Ra of the Si-face (0001) SiC wafer, after grinding and polishing, was 5.6 and 1.6 nm, respectively, as measured by atomic force microscopy (AFM). For C-face (000–1) SiC wafers, the Ra was 7.2 nm after grinding and 3.3 nm after polishing. The average contact angle measurement of the SiC wafers after final polishing showed clear differences between surface polarity; the contact angle for the Si-face (0001) was ~7o greater than that for the C-face (000–1). The difference in contact angles between the Si-face (0001) and the C-face (000–1) tends to increase as the reduction of surface roughness approaches the final stage of polishing. The uniformity of Raman peak intensity in the folded transverse optical phonon band at ~780 cm−1 in scanned areas correlated well with the surface roughness measured by AFM. The contact angle measurement can be used as a convenient surface polarity and surface roughness testing technique for SiC wafers.

To investigate the effect of implantation temperature on the damage to a Si lattice, room temperature photoluminescence (PL) spectra were measured from highly-channeled MeV 11B+ implanted Si wafers with different implant temperatures (25 °C and 450 °C) after annealing at 950 °C for 3 min in N2. Small pieces from the wafers were used for PL characterization. The implanted Si wafer piece at the elevated temperature resulted in higher overall PL intensity under both excitation wavelengths suggesting lesser lattice damage than the Si wafer implanted at room temperature. Unexpectedly large PL intensity variations were observed from PL area mapping of both wafer pieces. In addition, strange behaviors of localized PL intensity variations, with opposite trends between 670 nm and 827 nm excitation PL measurements were observed near the scribe lines and sample number markings on the backside. The PL intensity was increased under 670 nm excitation while it was decreased under 827 nm excitation. Possible reasons for this strange behavior were discussed based on experimental results and analysis. PL measurement is verified to be very sensitive to the surface condition, interface, bulk and backside conditions of the Si. For reliable PL measurement, backside contamination and scratches, such as scribe lines, should be avoided.

Osteoid osteoma frequently requires surgical treatment, especially among young, active patients. However, surgeons are reluctant to perform open surgery for an osteoid osteoma of the femoral neck area because the conventional surgical approach requires a large incision in muscular patients, and percutaneous resection with a trephine has the attendant risk of subsequent fracture. Recently, arthroscopic excision of an osteoid osteoma has been reported as a less invasive, safer procedure than traditional open curettage. Hip arthroscopy using the burr-down technique under C-arm guidance to locate and remove the lesion of the femur neck has also shown promise. The presented technique minimizes muscle damage around the femur and enables surgeons to confirm complete resection of the lesion through direct, detailed visualization. Furthermore, early return to previous activity can be achieved after excising the lesion located at the calcar femorale, which is an area with a heavy weight-bearing load. The objective of this Technical Note was to describe our preferred technique for the surgical excision of osteoid osteoma located at the base of the femoral neck through the use of arthroscopy.

Pancreatic adenocarcinoma may account for more than 80% of all pancreatic neoplasms. Occasionally, other rare tumors such as lymphoma, metastatic tumor, and solid pseudopapillary neoplasm can be considered in the differential diagnosis. We report the case of an 82-year-old man with a pancreatic solid mass. This case suggests that endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) with biopsy, that is, EUS-FNA is recommended in the differential diagnosis of the pancreatic solid mass apart from pancreatic adenocarcinoma. In particular, the histologic core obtained by EUS-guided biopsy is helpful for the immunostaining of molecular markers to confirm the final diagnosis.

We studied the feasibility of image-based quantitative analysis of foxing stains on collections of old (16th&ndash, 20th century) European books stored in the Rare Book Library of the Seoul National University in Korea. We were able to quantitatively determine the foxing affected areas on books from their photographs using a newly developed image processing software (PicMan) including cultural property characterization applications, specifically. Dimensional and color analysis of photographs were successfully done quantitatively. Histograms of RGB (red, green, blue) pixels of photographs clearly showed the change in color distribution of foxing stains compared to the other areas of the photographs. Several sample images of quantitative measurement of foxing stains and virtually restored images were generated to provide easy visual inspection and comparison between restored images and the original photographs. Image quality, resolution, and digital file format requirements for quantitative analysis are described. Image-based quantitative analysis of foxing stains on paper documents are found to be very promising towards automation for objective characterization of photographs of cultural properties. This technique can be used to create a cultural property digital database. Quantitative and statistical analysis techniques can be introduced to monitor the effect of storage and conservation environment on the cultural properties.

Formation of high integrity junctions with low junction leakage and defects is essential for fabricating high performance devices with advanced node devices. Understanding of implant activation and implant damage recovery mechanisms during annealing process steps is limited. Development of noncontact implant activation and residual damage monitoring techniques would be beneficial.

Microcolumns have a stacked structure composed of an electron emitter, electron lens (source lens), einzel lens, and a deflector manufactured using a micro electro-mechanical system process. The electrons emitted from the tungsten field emitter mostly pass through the aperture holes. However, other electrons fail to pass through because of collisions around the aperture hole. We used Raman scattering measurements and X-ray photoelectron spectroscopy analyses to investigate the influence of electron beam bombardment on a Si electron lens irradiated by acceleration voltages of 0, 20, and 30 keV. We confirmed that the crystallinity was degraded, and carbon-related contamination was detected at the surface and edge of the aperture hole of the Si electron lens after electron bombardment for 24 h. Carbon-related contamination on the surface of the Si electron lens was verified by analyzing the Raman spectra of the carbon-deposited Si substrate using DC sputtering and a carbon rod sample. We report the crystallinity and the origin of the carbon-related contamination of electron Si lenses after electron beam bombardment by non-destructive Raman scattering and XPS analysis methods.

The present research is focused to investigate a role of the porous graphite (PG) plate that could improve the quality of 4H-SiC crystal. The grown crystal in porous graphite inserted crucible showed the lower intensity of Al, B and Ti impurity concentration than SiC crystal grown in conventional crucible. The porous graphite plate before and after the growth process has been investigated by a Raman spectroscopy and a photoluminescence spectrum (PL). According to the analysis result, it was confirmed that the porous graphite plate had the effect of suppressing impurities supplied to SiC single crystal during the growth process.

Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. Combination therapy of pegylated interferon-alpha (PEG-IFN-α) and ribavirin (RBV) is a current standard treatment for chronic HCV infection in Korea, which has considerable adverse effects. Acute pancreatitis is a rare complication of PEG-IFN-α administration. We report a case of a 62-year-old female who experienced acute pancreatitis after 4 weeks of PEG-IFN-α-2a and RBV combination therapy for chronic HCV infection. The main cause of the acute pancreatitis in this case was probably PEG-IFN-α rather than RBV for several reasons. A few cases have been reported in which acute pancreatitis occurred during treatment with PEG-IFN-α-2b. This is the first report of acute pancreatitis associated with PEG-IFN-α-2a in Korea.

A SiC crystal mixed with 4H-, 6H-, and 15R-SiC polytypes and their wetting properties were characterized using precisely dispensed de-ionized (DI) water drops. Contact angles of a DI water drop on SiC surfaces were quantitatively determined by analyzing the sideview image of a DI water drop in contact with the SiC substrate with mixed polytypes using image analysis software. The contact angle measurements showed that the contact angle for the Si-face (0001) was approximately 4o ∼ 8o greater than that for the C-face (000-1) regardless of polytype. The surface roughness of both Si-face and C-face was measured using atomic force microscopy and confirmed to be nearly identical. Due to the difference in surface energy of polarity of SiC basal planes, the contact angle measured from the Si-face (0001) after native oxide removal showed significant decrease and it recovered over time by room temperature oxidation in air. In contrast, the contact angle measured from the C-face (000-1) after native oxide removal, showed significant decrease and it was maintained, even after room temperature oxidation for 24 h in air. We found that there is correlation between the wetting property of SiC polytypes of 4H-, 6H-, and 15 R and a difference in their surface potential energy corresponding to the hexagonality of each SiC polytype determined by the atomic arrangement.