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Objective: To evaluate the reliability and validity of the Thai version of the modified Japanese Orthopaedic Association scale. Methods: The modified Japanese Orthopaedic Association scale was translated into Thai language to create the Thai version of the Modified Japanese Orthopaedic Association (Thai-mJOA) scale. Translation was performed according to international standards using a forward-backward translation protocol. Translation was performed by 2 expert translators and 1 physician, and the final version was approved by an expert committee. Thai patients with cervical spondylosis with myelopathy were enrolled and evaluated using the Thai-mJOA scale, Nurick Grading, the Thai version of the Neck Disability Index (Thai-NDI), and the Thai version of the Short Form-36 (Thai-SF-36). Reliability and validity of the Thai-mJOA were assessed via comparison with the Nurick Grading and the Thai-NDI. Results: Ninety-two patients were included. The most common compression level was C5-C6 vertebral disc. Cronbach’s alpha of the total Thai-mJOA showed excellent internal consistency (0.991). The intraclass correlation coefficient (ICC) for test-retest reliability was 0.981 (95% confidence interval [CI]: 0.972-0.988). Regarding concurrent validity, the motor dysfunction score of the lower extremities and the total score of the Thai-mJOA were strongly correlated with Nurick Grading (r=0.825, r=0.712, respectively). The total score of the Thai-mJOA was moderately correlated with the Thai-NDI (r=0.670). Conclusion: The Thai-mJOA was found to be a valid and reliable tool for evaluating symptom severity in Thai patients with cervical spondylosis with myelopathy.

Purpose Degenerative cervical myelopathy (DCM) is the most common non-traumatic cause of spinal cord dysfunction. Prediction of the neurological outcome after surgery is important. The aim of this study was to analyze the relationship between first symptoms of DCM and the neurological outcome after surgery. Methods A retrospective analysis over a period of 10 years was performed. First symptoms such as cervicobrachial neuralgia, sensory and motor deficits and gait disturbances were evaluated regarding the postoperative neurological outcome. The modified Japanese Orthopedic Association Score (mJOA Score) was used to evaluate neurological outcome. Results In total, 411 patients (263 males, 64%) with a median age of 62.6 ± 12.1 years were included. Cervicobrachial neuralgia was described in 40.2%, gait disturbance in 31.6%, sensory deficits in 19% and motor deficits in 9.2% as first symptom. Patients with cervicobrachial neuralgia were significantly younger (median age of 58 years, p = 0.0005) than patients with gait disturbances (median age of 68 years, p = 0.0005). Patients with gait disturbances and motor deficits as first symptom showed significantly lower mJOA Scores than other patients (p = 0.0005). Additionally, motor deficits and gait disturbance were negative predictors for postoperative outcome according to the mJOA Score. Conclusion Motor deficits and gait disturbances as the first symptom of DCM are negative predictors for postoperative neurological outcome. Nevertheless, patients with motor deficits and gait disturbance significantly profit from the surgical treatment despite poor preoperative mJOA Score.

For two decades, many scores, questionnaires, and rating systems have been used to evaluate the functional outcome of children with an upper extremity fracture (UEF). However, only a few of these were created specifically for children, and many assess only elbow function. In the absence of any published review on this topic, we set out to identify and categorize different scores used to evaluate the clinical and functional outcomes of surgically treated pediatric UEFs. A literature search was performed, and 38 studies were identified. The scores used more often were the shortened version of the Disability of the Arm, Shoulder and Hand questionnaire and the Mayo Elbow Performance Score/Index. In a lower number of studies, authors used other scoring systems, including the Mayo Wrist Score, the Patient-Rated Wrist Evaluation, the Patient-Rated Elbow Evaluation, the Metaizeau functional scoring system, the Oxford Elbow Score, the Price and Flynn criteria, the Hardacre Functional Score, the Neer Shoulder Score, the Constant-Murley Shoulder Score, the Modified Orthopedic Trauma Association Score, the Medical Outcomes Study Short Form-36, and the Pediatric Outcomes Data Collection Instrument. Some specific pediatric scoring systems to evaluate the functional outcome of children with a UEF have been suggested, but a single tool that is valid and reliable for skeletally immature patients of all ages is not yet available. Further studies are needed to identify specific pediatric measurements to increase validity, responsiveness, sensitivity, and interpretability of upper limb functional outcome scores in common clinical practice.

INTRODUCTION AND OBJECTIVE:Accurate prediction of competing risks of mortality is a key component of prostate cancer treatment decision-making. We sought to compare the Prostate Cancer Comorbidity ...

Hanahan and Weinberg introduced the “hallmarks of cancer” and typified essential biological abilities acquired by human cancer. Since then, a growing understanding of hallmark principles associated with breast cancer has assisted knowledge-based therapeutics development; however, despite the rapidly increasing number of targeted therapeutics, enduring disease-free responses for most forms of breast cancer is rare. Invasion and metastasis are the most defining feature of breast cancer malignancy and the leading cause of patient mortality. Hence, we propose a modified hallmarks model adapted to breast cancer, in which invasion and metastasis are shifted to the center of attention, thereby emphasizing it as a potentially superior therapeutic target. Although the scientific community highly appreciates the importance of the invasion and metastasis hallmark, as can be demonstrated by the growing number of publications on breast cancer metastasis, very few clinical trials concentrate on testing anti-metastasis inhibitors and even fewer trials focus on inhibitors for breast cancer metastasis. Here, we discuss the obstacles of applying research on invasion and metastasis therapeutics into the clinic and present current developments that could provide a potential solution to this dilemma.

Background: Ultrasound-guided regional anesthesia has gained popularity over the last decade. This study aimed to assess whether YouTube videos sufficiently serve as an adjunctive tool for learning how to perform an ultrasound-guided brachial plexus block (BPB). Methods: All YouTube videos were classified, based on their sources, as either academic, manufacturer, educational, or individual videos. The metrics, accuracy, utility, reliability (using the Journal of American Medical Association Score benchmark criteria (JAMAS)), and educational quality (using the Global Quality Score (GQS) and Brachial Plexus Block Specific Quality Score (BSQS)) were validated. Results: Here, 175 videos were included. Academic (1.19 ± 0.62, mean ± standard deviation), manufacturer (1.17 ± 0.71), and educational videos (1.15 ± 0.76) had better JAMAS accuracy and reliability than individual videos (0.26 ± 0.67) (p &lt, 0.001). Manufacturer (11.22 ± 1.63) and educational videos (10.33 ± 3.34) had a higher BSQS than individual videos (7.32 ± 4.20) (p &lt, 0.001). All sources weakly addressed the equipment preparation and post-procedure questions after BSQS analysis. Conclusions: The reliability and quality of ultrasound-guided BPB videos differ depending on their source. As YouTube is a useful educational platform for learners and teachers, global societies of regional anesthesiologists should set a standard for videos.

Background Biological experiments have confirmed the association between miRNAs and various diseases. However, such experiments are costly and time consuming. Computational methods help select potential disease-related miRNAs to improve the efficiency of biological experiments. Methods In this work, we develop a novel method using multiple types of data to calculate miRNA and disease similarity based on mutual information, and add miRNA family and cluster information to predict human disease-related miRNAs (FCMDAP). This method not only depends on known miRNA-diseases associations but also accurately measures miRNA and disease similarity and resolves the problem of overestimation. FCMDAP uses the k most similar neighbor recommendation algorithm to predict the association score between miRNA and disease. Information about miRNA cluster is also used to improve prediction accuracy. Result FCMDAP achieves an average AUC of 0.9165 based on leave-one-out cross validation. Results confirm the 100, 98 and 96% of the top 50 predicted miRNAs reported in case studies on colorectal, lung, and pancreatic neoplasms. FCMDAP also exhibits satisfactory performance in predicting diseases without any related miRNAs and miRNAs without any related diseases. Conclusions In this study, we present a computational method FCMDAP to improve the prediction accuracy of disease related miRNAs. FCMDAP could be an effective tool for further biological experiments. Electronic supplementary material The online version of this article (10.1186/s12918-019-0696-9) contains supplementary material, which is available to authorized users.

Introduction: The modified Japanese Orthopaedic Association (mJOA) score is considered to be among the most comprehensive scores in the assessment of patients with cervical myelopathy. Hence, providing reliable, translated, and cross-culturally adapted versions in different languages is required to standardize the evaluation of patients. This study aimed to translate a reliable Arabic version of the mJOA score. Methods: A total of 65 patients of variable age and with etiologies for compressive cervical myelopathy were recruited. Both forward and backward translations were performed. Then, intraobserver and interobserver reliabilities were measured using the intraclass correlation coefficient and Cronbach's alpha coefficient. Results: The mean age of the patients was 58.08 years, and most of them were male (69.2%). The intraobserver and interobserver reliabilities were almost in perfect agreement for the different sections and the total score, which were 96.8% and 97.4%, respectively. Conclusions: In this study, a reliable, cross-culturally adapted Arabic version of the mJOA score for patients with cervical myelopathy is provided. Although the study was conducted on Egyptian patients, we believe that it could be implemented in majority of the Arabic-speaking population.

This paper presents a novel framework for fraud detection in healthcare systems which self-learns from the historical medical data. Historical medical records are required for training and testing of machine learning models. The main problem being faced by both private and government health supported schemes is a rapid rise in the amount of claims by beneficiaries mostly based on fraudulent billing. Detection of fraudulent transactions in healthcare systems is a strenuous task due to intricate relationships among dynamic elements including doctors, patients, service. In light of aforementioned challenges in health support programs, there is a need to develop intelligent fraud detection models for tracing the loopholes in procedures which may lead to successful reimbursement of fraudulent medical bills. In order to address the issue of fraud in healthcare programs our solution proposes a framework based on three entities (patient, doctor, service). Firstly, the framework computes association scores for three elements of the healthcare ecosystem namely patients, doctors or services. The framework filters out identified cases using association scores. The Confidence values, after G-means clustering of transactional data, are computed for each service in each specialty. Rules are generated based on the confidence values of services for each specialty. Then, an evaluation of identified cases is done using rule engine. The framework classifies cases into fraudulent activities based on the similarity bit&rsquo, s value. The validation of framework is performed on local hospital employees transactional data which includes many reported cases of fraudulent activities in addition to some introduced anomalies.

Background: The purpose of this study is to investigate the quality and reliability of YouTube videos regarding developmental dysplasia of the hip (DDH).YouTube is one of the most popular websites used as a source of information, but the variety in authorship and lack of a peer-review process are problems.Methods: The search string “developmental dysplasia of the hip” was inputted to the YouTube search engine, and the first 52 videos returned as a response were assessed. The Video Power Index (VPI) (like ratio*view ratio/100) was used to assess the popularity of the videos. Global Quality Score (GQS) and developmental dysplasia of the hip scores (DDHS) were used to evaluate the quality and educational quality of the videos, and The Journal of the American Medical Association Score (JAMAS) was used to evaluate the accuracy of the source of information.Results: According to our research, the mean duration time of the videos was 526 s (SD: 813), and the average view count of the videos was 34,644. The mean time since upload was 1907 days (SD: 1137). On average, the videos received 10.9 comments, 210.3 likes, and 6.8 dislikes. The mean like ratio and VPI were 92.9 (SD: 19.57) and 25.8 (SD: 53.43), respectively. The mean JAMAS, GQS, and DDHS of all videos evaluated were 1.37 (SD: 0.7), 2.46 (SD: 1.09), and 4.63 (SD: 5.00), respectively. The DDHS and GQS were positively correlated (p:0.001 r: 65.8%). The GQS and the DDHS were higher in the academic group than in the commercial group (p:0.01). (p:0.037).Conclusions: The videos regarding DDH on YouTube generally had poor quality. As a result, to maintain an optimal parent–physician or patient–physician relationship, we suggest that international health societies make their own educational videos for parents, patients, and fellow physicians.

Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic rotator cuff repair with tape-attached anchors would result in better clinical outcomes and reduce the retear rate compared with conventional suture anchors. Methods: We included 83 patients treated by arthroscopic rotator cuff repair with a minimum 1-year follow-up. We divided them into two groups: Use of the HEALICOILRG with ULTRATAPE (group T: 41 shoulders; mean patient age, 64.3 years) and use of the conventional suture anchor (group S: 42 shoulders; mean patient age, 68.9 years). We compared the University of California Los Angeles scores, Japanese Orthopaedic Association scores, range of motion, and retear rate between the two groups. The Student t test and chi-square test were used in statistical analyses. Results: At the 1-year postoperative follow-up, both groups showed improvement in the average University of California Los Angeles score, Japanese Orthopaedic Association score, and range of motion, although no significant difference was found in the retear rate between the two groups. Conclusions: Results of arthroscopic rotator cuff repair with the HEALICOILRG with ULTRATAPE were generally good. However, our results could not demonstrate efficacy of the HEALICOILRG with ULTRATAPE. Further detailed studies are needed to determine its treatment result.

We conducted an in silico analysis to search for important genes in the pathogenesis of Caseous Lymphadenitis (CL), with prospects for use in formulating effective vaccines against this disease. For this, we performed a survey of proteins expressed by Corynebacterium pseudotuberculosis, using protein sequences collected from the NCBI GenPept database and the keywords "caseous lymphadenitis" and "Corynebacterium pseudotuberculosis" and "goats". A network was developed using the STRING 10 database, with a confidence score of 0.900. For every gene interaction identified, we summed the interaction score of each gene, generating a combined association score to obtain a single score named weighted number of links (WNL). Genes with the highest WNL were named "leader genes". Ontological analysis was extracted from the STRING database through Kyoto Encyclopedia of Genes and Genomes (KEGG) database. A search in the GenPept database revealed 2,124 proteins. By using and plotting with STRING 10, we then developed an in silico network model comprised of 1,243 genes/proteins interconnecting through 3,330 interactions. The highest WNL values were identified in the rplB gene, which was named the leader gene. Our ontological analysis shows that this protein acts effectively mainly on Metabolic pathways and Biosynthesis of secondary metabolites. In conclusion, the in silico analyses showed that rplB has good potential for vaccine development. However, functional assays are needed to make sure that this protein can potentially induce both humoral and cellular immune responses against C. pseudotuberculosis in goats.

While variants of noncoding RNAs (ncRNAs) have been experimentally validated as a new class of biomarkers and drug targets, the discovery and interpretation of relationships between ncRNA variants and human diseases become important and challenging. Here we present ncRNAVar (http://www.liwzlab.cn/ncrnavar/), the first database that provides association data between validated ncRNA variants and human diseases through manual curation on 2650 publications and computational annotation. ncRNAVar contains 4565 associations between 711 human disease phenotypes and 3112 variants from 2597 ncRNAs. Each association was reviewed by professional curators, incorporated with valuable annotation and cross references, and designated with an association score by our refined score model. ncRNAVar offers web applications including association prioritization, network visualization, and relationship mapping. ncRNAVar, presenting a landscape of ncRNA variants in human diseases and a useful resource for subsequent software development, will improve our insight of relationships between ncRNA variants and human health.

A growing body of evidence indicates that circular RNAs (circRNAs) play a pivotal role in various biological processes and have a close association with the initiation and progression of diseases. Moreover, circRNAs are considered as promising biomarkers for disease diagnosis owing to their characteristics of conservation, stability and universality. Inferring disease–circRNA relationships will contribute to the understanding of disease pathology. However, it is costly and laborious to discover novel disease–circRNA interactions by wet-lab experiments, and few computational methods have been devoted to predicting potential circRNAs for diseases. Here, we advance a computational method (NCPCDA) to identify novel circRNA–disease associations based on network consistency projection. For starters, we make use of multi-view similarity data, including circRNA functional similarity, disease semantic similarity, and association profile similarity, to construct the integrated circRNA similarity and disease similarity. Then, we project circRNA space and disease space on the circRNA–disease interaction network, respectively. Finally, we can obtain the predicted circRNA–disease association score matrix by combining the above two space projection scores. Simulation results show that NCPCDA can efficiently infer disease–circRNA relationships with high accuracy, obtaining AUCs of 0.9541 and 0.9201 in leave-one-out cross validation and five-fold cross validation, respectively. Furthermore, case studies also suggest that NCPCDA is promising for discovering new disease–circRNA interactions. The NCPCDA dataset and code, as well as the detailed readme file for our code, can be downloaded from Github (https://github.com/ghli16/NNCPCD).

Objective Patients are increasingly referring to the Internet after a diagnosis of vascular disease. This study was performed to quantitatively define the accuracy and reliability of information on YouTube regarding abdominal aortic aneurysms (AAA). Methods A systematic search of YouTube was conducted using multiple AAA-specific keywords. The default YouTube search setting of “relevance” was used to replicate an average search attempt, and the first 50 results from each keyword search were reviewed and analyzed by two independent reviewers. Descriptive characteristics, Journal of the American Medical Association Score, modified DISCERN score, Video Power Index, and a novel scoring system for the management of AAAs, the AAA-Specific Score (AAASS), were used to record data. Inter-rater agreement was analyzed using intraclass correlation coefficient estimates and the Kruskal-Wallis test was used for intergroup comparisons. Results Fifty-one videos were included for analysis. The mean Journal of the American Medical Association Score, DISCERN, and AAASS values among videos were 1.74/4.00 (standard deviation [SD], 0.84), 2.37/5.00 (SD, 0.97), and 6.63/20.00 (SD, 3.23), respectively. Of all the included videos, 78% were educational in nature, 14% were patient testimonials, and 8% were news programs. Based on the AAASS, the majority of analyzed videos fell into the poor category (41%), followed next by the very poor (31%), moderately useful (25%), very useful (2%), and exceptional (0%) categories. Videos by nonphysicians were significantly more popular (P Conclusions Although variable in source and content, the completeness and reliability of information offered on YouTube for AAA diagnosis and treatment is poor. Patients watching YouTube for information on their AAA diagnosis are receiving an incomplete and perhaps misleading picture of available diagnostic and treatment options. Given that vascular surgeons are likely to be affected by unrealistic treatment expectations from patients accessing online materials regarding AAA, it is important to acknowledge the nature of content on these platforms.

MicroRNAs (miRNAs) have been proved to be targeted by the small molecules recently, which made using small molecules to target miRNAs become a possible therapy for human diseases. Therefore, it is very meaningful to investigate the relationships between small molecules and miRNAs, which is still yet in the newly-developing stage. In this paper, we presented a prediction model of Graphlet Interaction based inference for Small Molecule-MiRNA Association prediction (GISMMA) by combining small molecule similarity network, miRNA similarity network and known small molecule-miRNA association network. This model described the complex relationship between two small molecules or between two miRNAs using graphlet interaction which consists of 28 isomers. The association score between a small molecule and a miRNA was calculated based on counting the numbers of graphlet interaction throughout the small molecule similarity network and the miRNA similarity network, respectively. Global and two types of local leave-one-out cross validation (LOOCV) as well as five-fold cross validation were implemented in two datasets to evaluate GISMMA. For Dataset 1, the AUCs are 0.9291 for global LOOCV, 0.9505, and 0.7702 for two local LOOCVs, 0.9263 ± 0.0026 for five-fold cross validation; for Dataset 2, the AUCs are 0.8203, 0.8640, 0.6591, and 0.8554 ± 0.0063, in turn. In case study for small molecules, 5-Fluorouracil, 17β-Estradiol and 5-Aza-2'-deoxycytidine, the numbers of top 50 miRNAs predicted by GISMMA and validated to be related to these three small molecules by experimental literatures are in turn 30, 29, and 25. Based on the results from cross validations and case studies, it is easy to realize the excellent performance of GISMMA.

International audience; We propose a method for joint unsu-pervised discovery of multiword expressions (MWEs) and their translations from parallel corpora. First, we apply independent monolingual MWE extraction in source and target languages simultaneously. Then, we calculate translation probability , association score and distributional similarity of co-occurring pairs. Finally, we rank all translations of a given MWE using a linear combination of these features. Preliminary experiments on light verb constructions show promising results.

Background: There are a number of surgical treatment options for cervical spondylotic myelopathy (CSM). In this study, the authors present their clinical results with cervical laminectomy and fusion for the treatment of patients with CSM. Methods: This retrospective study included 58 consecutive patients who underwent cervical laminectomy and fusion for CSM. There were 38 males and 20 females, with a mean age of 64 (range 42-92) years. The Japanese orthopedic association score (mJOA) scale was used as the functional outcome measurement. Both the absolute increase in mJOA and the neurological recovery rate of mJOA were analyzed. The mean clinical follow-up was 17 months (range 5-52 months). Results: There was a statistically significant improvement between mean preoperative (13.2, range 7-17) and postoperative (16.1, range 11-18) mJOA scores following surgery. The average improvement in mJOA score was 2.9 points. The mean neurological recovery rate was 56.6%. Overall 85.5% of patients improved with surgery (n = 51) and the remaining 14.5% of patients had no change in their mJOA score after surgery (n = 7). Fusion was documented in all 58 patients. There was a 10.3% overall complication rate (n = 6). The most common complications were C5 nerve palsies which occurred in 6.9% of the cohort (n = 4); all completely resolved. Conclusion: Cervical laminectomy and fusion is a safe and efficacious procedure for the treatment of CSM. The clinical outcomes appear to be quite reproducible, and this technique is an important part of a spine surgeon's armamentarium.

Purpose: To evaluate the prognostic factors that affect the surgical outcome of laminoplasty in patients with cervical compressive myelopathy. Methods: This is a retrospective review of 43 cases of multi-level cervical compressive myelopathy treated operatively with expansive laminoplasty (Itoh surgical technique), from June 1989 to August 2008. The mean follow-up duration was 7 years. The Japanese Orthopaedic Association score, Hirabayashi recovery rate and improvement of Pavlov's ratio were used to assess the clinical results after laminoplasty. Results: The mean Japanese Orthopaedic Association score improved from 9.7 to 13.7 points after laminoplasty (p

Reconstructing metabolic and signaling pathways is an effective way of interpreting a genome sequence. A challenge in a pathway reconstruction is that often genes in a pathway cannot be easily found, reflecting current imperfect information of the target organism. In this work, we developed a new method for finding missing genes, which integrates multiple features, including gene expression, phylogenetic profile and function association scores. Particularly, for considering function association between candidate genes and neighboring proteins to the target missing gene in the network, we used Co-occurrence Association Score (CAS) and PubMed Association Score (PAS), which are designed for capturing functional coherence of proteins. We showed that adding CAS and PAS substantially improve the accuracy of identifying missing genes in the yeast enzyme-enzyme network compared to the cases when only the conventional features, gene expression, phylogenetic profile, were used. Finally, it was also demonstrated that the accuracy improves by considering indirect neighbors to the target enzyme position in the network using a proper network-topology-based weighting scheme.

Objective: The aim of this study was to evaluate the relationship between knee pain and various indicators of the combined performance of the lower extremity (including gait parameters, functional performance such as timed up and go, and functional reach test) and to determine whether the classification of vertical ground reaction forces correlates with gait parameters and functional performance. Subjects and Methods: Simultaneous analysis of gait, timedistance parameters and vertical ground reaction force. Timed up and go, and functional reach test were examined in 130 elderly women. The vertical component of the ground reaction force was grouped into 2 categories: M-shaped and non-M-shaped. Results: No significant association was found between knee pain and timed up and go, functional reach test, or gait parameters in elderly female participants. There were significant differences between subjects with M- and nonM-shaped vertical ground reaction forces with regard to timed up and go, functional reach test and Japan Orthopaedic Association score. There were also significant differences between the 2 groups (M shaped and non-Mshaped) in gait parameters. Conclusion: Evaluation of the vertical ground reaction force to determine its shape may be a useful and simple tool in the analysis of gait and functional performance.

Purpose: To clarify the cut-off value of the Japanese Orthopaedic Association (JOA) score corresponding to rotator cuff tear outcome as evaluated by the Constant score. Methods: The subjects were 230 patients with rotator cuff tear. The Constant and JOA scores on the first examination in our hospital were evaluated. After investigation of the correlation between the Constant and JOA scores, the cut-off JOA score was calculated, corresponding to excellent, good and fair outcomes as evaluated by the Constant score. Results: The Constant and JOA scores on the first examination were 49.64 ± 12.84 and 72.52 ± 12.84, respectively, with a strong correlation ( r = 0.87, p < 0.01). Receiver operating characteristic analysis revealed that the cut-off JOA score was 87.0 for excellent outcome (area under the curve, AUC: 0.93; sensitivity: 100%; specificity: 88.6%; p < 0.01), 84.0 for good outcome (AUC: 0.94; sensitivity: 100%; specificity: 83.4%; p < 0.01) and 78.0 for fair outcome (AUC: 0.88; sensitivity: 100%; specificity: 71.3%; p < 0.01). Conclusions: In patients with rotator cuff tear, good outcome as judged by a Constant score of ≥80 corresponds to a JOA score cut-off of 84.0. Judgement of the treatment outcomes and evaluation of the surgical method may be more accurate when using clear cut-off values for the scoring system employed, such as those determined in our study.

We reviewed ninety-two patients who were more than forty years old when they underwent arthroscopic meniscectomy. Their mean age was 56.7 years (range: 40 to 80 years). These patients were evaluated using the Japanese Orthopaedic Association Score for meniscus injuries. There was no correlation between age, grade of osteoarthritis on preoperative radiograghs, grade of articular cartilage degeneration, and surgical results. Arthroscopic meniscectomy was proven to be an effective procedure for patients over the age of 40.

We investigated 4 cases of femoral fractures after bipolar hemiarthroplasty and total hip arthroplasty. All 5 cases were female ranging in age from 55 to 90 years (average, 75 years). According to Johansson's classification, 2 cases were type 2; and the others were type 3. Peroprosthetic fractures in 4 femurs were fixed using a plate with cables, long stem with CCG band, supracondylar plate with cables, and Mennen plate with kuntcher nail. After operation, X-ray revealed that all casess resulted in union. The Postoperative Japanese Orthopedic Association score ranged from 46 to 65 points (average: 55.3 points).Open reducation can be a good choice for the treatment of periprosthetic fractures.

The purpose of this study was to investigate the relationship between the restoration of the spinal cord just after decompression surgery and preoperative MRI findings. 13 patients underwent posterior decompression surgery at the cervical and thoracic level. The frontal diameter of the spinal cord was measured using pre-operative MRI and intra-operative ultrasonography. The restoration rate was calculated according to Kataoka's method from the pre and intra-operative diameters. Clinical results were also recorded using the Japanese Orthopedic Association score. Correlation between the restoration rate, clinical results, and MRI findings was evaluated. Significant correlation was observed between the restoration rate and clinical results (R=0.61). Also the spinal cord which indicated high signal intensity on the T2 WI preoperative MRI had a tendency to show a low restoration rate. These results suggest that the combination of the low restoration rate and high signal intensity of the spinal cord indicates severe spinal cord damage.

40 primary uncemeneted total knee arthroplasties (MG II) were performed in 32 patients with osteoarthritis. The average age was 73.0 years at the time of surgery. The follow-up period was an average of 5.6 years (range; 5 to 6.6 years). Clinical evaluations based on the Japanese Orthopedic Association score indicated significant improvements from preoperative to the most recent follow-upexamination. There was no evidence of rentogenographic failure in the femoraland tibial component. None of the knees required revision surgery. The flexion angle at the last follow-up correlated well with the last clinical score, especially in the ability of stairs. The clinical score of patients with flexionangle over 110° was significantly better than that under 110°. These mid-term results of uncemented MG II TKAs proved satisfactory in osteoarthritis. However, a longer follow-up period is necessary for problems related to the patellarcomponent even in MG II TKAs, because mal-alignment of the patella-femoral jointhas been observed in 4 knees.

ObjectiveTo determine functional outcome of anterior cervical decompression and fusion using tricortical iliac bone graft (ACDF) for degenerative cervical spondylotic myelopathy with modified Japan...

Eighty-two patients underwent discectomy for herniated nucleus pulposus between 1985 and 1989. Of these, 49 patients were diagnosed having a ruptured disc herniation. All ruptured disc herniations were removed from the posterior approach without fusion. The average improvement rate by the Japanese Orthopedic Association Score was 79.7%. We consider the surgical treatment should be done as early as possible after clinical and imaging assessment of ruptured disc herniation. This attributes a good result.

Lumbar disc herniation in aged patients is relatively rare. Eighteen cases of lumbar disc herniation over 60 years of age treated by Love's operation were evaluated.Pre-operative clinical findings were relatively severe. All patients complained of lumbago and pain of the lower extremity. The average improvement rate by the Japanese Orthopaedic Association Score was 62 percent.

Study Design Prospective cohort study. Purpose To identify differences in time-dependent perioperative changes between the Japanese Orthopaedic Association (JOA) score and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) score in patients with cervical spondylotic myelopathy (CSM) and posterior longitudinal ligament (OPLL) who underwent cervical laminoplasty. Overview of Literature The JOA score does not take into consideration patient satisfaction or quality of life. Accordingly, the JOACMEQ was designed in 2007 as a patient-centered assessment tool. Methods We studied 21 patients who underwent cervical laminoplasty. We objectively evaluated the time-dependent changes in JOACMEQ scores and JOA scores for all patients before surgery and at 2 weeks, 3 months, 6 months, and 1 year after surgery. Results The average total JOA score and the recovery rate improved significantly after surgery in both groups, with a slightly better recovery rate in the OPLL group. Cervical spine function improved significantly in the CSM group but not in the OPLL group. Upper- and lower-extremity functions were more stable in the CSM group than in the OPLL group. The effectiveness rate of the JOACMEQ for measuring quality of life was quite low in both groups. In both groups, the Spearman contingency coefficients were dispersed widely except for upper- and lower-extremity function. Conclusions Scores for upper- and lower-extremity function on the JOACMEQ correlated well with JOA scores. Because the JOACMEQ can also assess cervical spine function and quality of life, factors that cannot be assessed by the JOA score alone, the JOACMEQ is a more comprehensive evaluation tool.

A fundamental issue in biology and medicine is illustration of the overall drug impact which is always the consequence of changes in local regions of metabolic pathways (subpathways). To gain insights into the global relationship between drugs and their affected metabolic subpathways, we constructed a drug-metabolic subpathway network (DRSN). This network included 3925 significant drug-metabolic subpathway associations representing drug dual effects. Through analyses based on network biology, we found that if drugs were linked to the same subpathways in the DRSN, they tended to share the same indications and side effects. Furthermore, if drugs shared more subpathways, they tended to share more side effects. We then calculated the association score by integrating drug-affected subpathways and disease-related subpathways to quantify the extent of the associations between each drug class and disease class. The results showed some close drug-disease associations such as sex hormone drugs and cancer suggesting drug dual effects. Surprisingly, most drugs displayed close associations with their side effects rather than their indications. To further investigate the mechanism of drug dual effects, we classified all the subpathways in the DRSN into therapeutic and non-therapeutic subpathways representing drug therapeutic effects and side effects. Compared to drug side effects, the therapeutic effects tended to work through tissue-specific genes and these genes tend to be expressed in the adrenal gland, liver and kidney; while drug side effects always occurred in the liver, bone marrow and trachea. Taken together, the DRSN could provide great insights into understanding the global relationship between drugs and metabolic subpathways.

High tibial osteotomy (HTO) is a general procedure for the treatment of degenerative gonarthrosis. In recent years, it has been reported that opening wedge high tibial osteotomy (OWHTO) has become widespread with good results. Despite these facts, HTOs tend to be avoided due to the need for long-term postoperative treatment. To investigate the treatment period for total recovery (healing period) after OWHTO and the factors affecting it. There were 47 cases of medial type degenerative gonarthrosis who underwent OWHTO from 2008 through 2011. The definition of the healing period was based on the time-dependent changes of the Japanese Orthopaedic Association score, focusing especially on pain on walking and pain on ascending/descending stairs. This score was defined as the Ability score. In this study, the healing period ended when the Ability score reached its maximum or when it showed a perfect score. Patients’ characteristics were examined to determine their effect on the healing period. The Ability score was 36.7 ± 10.1 (mean ± SD) before surgery and 51.6 ± 5.4 12 months after OWHTO. The healing period was 6.3 ± 3.9 months. Factors correlated with a longer healing period included female sex (correlation coefficient −0.35) and high BMI (correlation coefficient 0.33). Our study suggested that the healing period after OWHTO is approximately 6 months, and patients’ BMI and sex appear to be related to this period. This information is expected to be helpful for counseling patients undergoing treatment for gonarthrosis. Level of evidence Therapeutic study, Level IV.