Epidemiologic Study of Shoulder Injuries in the PyeongChang 2018 Winter Olympic Games

Background

The purpose of this study is to describe and analyze the shoulder injuries in elite athletes during the 2018 Winter Olympics in Pyeongchang.

Methods

To collect the data of all Olympic athletes who visited venue medical centers, polyclinics, and Olympic-designated hospitals for shoulder injuries during the Olympic Games (February 9 through 25, 2018), we reviewed Olympic electronic medical records and patient information obtained from Olympic medical service teams about athletes who complained of shoulder pain.

Results

During the Olympics, a total of 14 athletes visited clinics for shoulder-related symptoms. Five athletes were injured in games and nine were injured in training. The injury was due to overuse in four patients. Ten patients had trauma-related symptoms: one after being hit by an opponent and the other nine after a collision with the ground or an object. There were no patients who complained of symptoms related to pre-existing shoulder conditions. The most common cause of shoulder pain was snow-boarding (one big air and three slopestyle). The most common diagnosis was contusion (n = 6), followed by rotator cuff injuries (n = 3), superior labrum from anterior to posterior lesion (n = 1), sprain (n = 1), acromioclavicular-coracoclavicular injury (n = 1), dislocation (n = 1), and fracture (n = 1).

Conclusions

To the best of our knowledge, this study is the first epidemiologic study of shoulder injury conducted during a huge sports event involving a variety of competitions for elite athletes. If the risk factors of shoulder injury can be established by continuing research in the future, it will be helpful to prevent injury and to prepare safety measures for athletes.

Intraosseous epidermoid cyst discovered in the distal phalanx of a thumb: a case report

Intraosseous epidermoid cyst is considered a rare benign inclusion cyst found mainly in the skull and phalanges. Once the cyst is differentiated from other similar lesions, the cyst can be treated with simple curettage, seldom requiring additional managements. We experienced this rare case that had been treated successfully without complication.

Primary cutaneous nocardiosis caused by Nocardia nova in a kidney transplant recipient

Nocardia nova is a rare aetiological pathogen for cutaneous nocardiosis. To the best of our knowledge, this is the first case of N. nova primary cutaneous infection in a kidney transplant recipient. Identification was performed using 16S rRNA and secA1 gene sequence analyses. The patient was not treated successfully by antibiotics alone. Surgical debridement was required for successful treatment.

Relationship between the extent of labral lesions and the frequency of glenohumeral dislocation in shoulder instability

PURPOSE

This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability.

METHODS

Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups.

RESULTS

The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels.

CONCLUSION

The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this.

LEVEL OF EVIDENCE

Retrospective comparative study, Level III.

Persistent organochlorine residues in estuarine and marine sediments from Ha Long Bay, Hai Phong Bay, and Ba Lat Estuary, Vietnam

To assess the organochlorine contamination in the northeast coastal environment of Vietnam, a total of 41 surface sediments were collected from Ha Long Bay, Hai Phong Bay, and Ba Lat estuary, and analyzed for their organochlorine content. Organochlorine compounds (OCs) were widely distributed in the Vietnamese coastal environment. Among the OCs measured, DDT compounds predominated with concentrations ranging from 0.31 to 274 ng g(-1). The overall contamination level of DDTs in coastal sediments from northern Vietnam is comparable with those from other Asian countries. However, concentrations exceeding 100 ng g(-1) are comparable with high concentrations reported from India and China, the largest DDT consumers in the world. The overall concentrations of PCBs, HCHs, and chlordanes in surface sediments were in the ranges of 0.04-18.71 ng g(-1), not detected (n.d.) - 1.00 ng g(-1), and n.d. - 0.75 ng g(-1), respectively. Ha Long Bay and Hai Phong Bay were relatively more contaminated with DDTs and PCBs than other regions, respectively. In contrast, the distribution of HCHs was relatively homogeneous. OCs contamination in the coastal environment of Vietnam is closely related to shipping and industrial activities. The levels of DDT compounds in harbors and industrial areas exceeded their sediment quality guideline values suggested by Environment Canada [CCME (Canadian Council of Ministers of the Environment), 2002. Canadian sediment quality guidelines for the protection of aquatic life. In: Canadian Environmental Quality Guidelines. Canadian Council of Ministers of the Environment, Winnipeg, MB] and Australian and New Zealand [ANZECC and ARMCANZ, 2000. National water quality management strategy. Paper No. 4, Australian and New Zealand Guidelines for Fresh and Marine Water Quality, vol. 1, The Guidelines. Australia. Document: http://www.deh.gov.au/water/quality/nwqms/volume1.html], indicating that adverse effects may occur to marine species in that areas.

Nationwide monitoring of polychlorinated biphenyls and organochlorine pesticides in sediments from coastal environment of Korea

To assess the organochlorine contamination in the Korean marine environment, a nationwide monitoring study was conducted. A total of 138 surface sediments, covering the whole Korean coast, were collected and analyzed. Organochlorine compounds (OCs) were widely distributed in the Korean coastal environment, with PCB and DDT contamination being particularly prevalent. The overall concentrations of PCBs, DDTs, HCHs, CHLs, and HCB in surface sediments were in the range of 0.088-199ngg(-1) (median value: 1.56ngg(-1)), 0.006-135ngg(-1) (0.68ngg(-1)), not detected (ND)-5.46ngg(-1) (0.32ngg(-1)), ND-3.26ngg(-1) (0.14ngg(-1)), and ND-2.59ngg(-1) (0.05ngg(-1)), respectively. The southeastern coast was found to be highly contaminated. Overall contamination status of Korean coastal sediments with regard to OCs is lower than that of USA. With the exception of highly industrialized sites, Korean coastal areas in general showed similar OC concentrations to those of other Asian countries. There was a significant correlation between distributions of most organochlorine contaminants with each other. OC contamination is closely related to shipping and industrial activities. Of the 7 sites categorized as highly polluted, 4 are in a harbor zone. Adverse effects to benthic communities are expected at the levels of OC contamination observed from harbor and industrial areas.

Levels of persistent organochlorine contaminants in fish from Korea and their potential health risk

Organochlorine contaminants in the muscles of sport and market fish were determined to understand the potential risks to humans consuming fish originating in Korea's coastal waters. Polychlorinated biphenyls (PCBs; sum of 22 congeners) and DDTs were the dominant contaminants, and their concentrations were in the range of 2.96 to 96.6 and 0.84 to 27.0 ng/g (wet weight basis), respectively. The highest PCB concentrations were found in samples taken from an industrial complex. Hexachlorocyclohexanes, chlordane-related compounds, and hexachlorobenzene concentrations were relatively low and ranged from 0.64 to 5.6, 0.17 to 4.24, and 0.08 to 1.58, respectively. Sport fish had levels of PCBs and DDTs approximately two times higher than market fish, implying that sport fish posed high potential risk of contamination with OCs. Risk-based screening value (SV) based on U. S. Environmental Protection Agency (USEPA) method was calculated using the USEPA approach to identify the primary chemicals of concern. Total PCB concentrations in all sport and market fish exceeded the SV (5.04 ng/g based on total PCBs), but the other compounds were mostly below SV values. Based on the estimated SVs, PCB compounds were identified as potential chemicals of concern.

Spatio-temporal distribution and characteristics of PAHs in sediments from Masan Bay, Korea

The distribution of polycyclic aromatic hydrocarbons (PAHs) has been investigated in the surface and core sediments from Masan Bay, Korea. Total PAHs in the surface sediments ranged from 207 to 2670 ng/g dry weight with a mean value of 680 ng/g. Qualitative similarity and quantitative difference between inner and outer bay indicate that the main sources of PAHs are located in the inner bay and outer bay is also affected by the same sources. Vertical distribution of PAHs revealed that three distinctive stages could be differentiated with the help of PCA analysis. The highest concentration (industrialization stage) appeared between late 1950s and 1980, which was 10 years later than other developed countries. A strong pyrolytic source fingerprint has been detected with slight influence of petrogenic sources, and diagenetic PAH, perylene also contributed. Total organic carbon normalized PAHs (sum of 13 PAHs, 8.85-88.0 microg/g OC) were under the threshold effects concentration (TEC, 290 microg/g OC).

Accumulation of tributyltin in olive flounder, Paralichthys olivaceus: its effect on hepatic cytochrome P450

Accumulation of tributyltin (TBT) was determined in liver of olive flounder exposed to TBT (3.65, 36.5, 365, 3,650, and 7,300 ng Sn/L) for 10 or 30 days, followed by 60 days depuration. Effect of TBT on hepatic cytochrome P450 content was also measured in liver of olive flounder. TBT was highly accumulated in liver of fish during the 10- to 30-day exposures, and hepatic cytochrome P450 content decreased with increasing TBT concentration. Hepatic cytochrome P450 contents were affected in olive flounder exposed to even environmentally relevant TBT concentrations, such as 3.65 ng Sn/L. In addition, the liver TBT levels demonstrated strong negative correlation to the hepatic cytochrome P450 content. The effects started to appear from 20 ng Sn/g dry weight of TBT in liver. Tributyltin concentrations and hepatic cytochrome P450 were also determined in feral fine-spotted flounder. The relationship between other organic pollutants known as cytochrome P450 inducers (e.g., polychlorinated biphenyls) as well as TBT and hepatic cytochrome P450 in the feral fish implied that TBT even at ppt level could impose antagonistic effects on hepatic cytochrome P450 induction.

PCB and PCDD/F totals, TEQs, and congener patterns in Korean coastal marine environments, 1987, 1988, 1990, and 1996-1999

Various mussel and oyster samples and select top sediment samples were taken over 27 industrial and pristine coastal sites form South Korea's west, south, and east coasts. Site-specific total PCB, PCDD/F, and organochlorine TEQ levels in biota were 1-306 ng/g ww, 3-9,400 pg/g ww, and 0.3-200 pg/g ww, respectively. Temporal trends showed a general decrease in total TEQ with an increase in TEQ contribution by PCDD/Fs at most locations over the past decade. Linear regression was used to establish a relationship between each contaminant total and the respective TEQ contribution. Principal component analysis was used to model the congener-specific PCB and PCDD/F data, and two three-component models were developed that describe the congener-specific patterns based on the variance between samples over the entire data set. Unique PCDD/F patterns were identified and discussed with respect to outliers identified in the previously established TEQ regressions and a distinct PCDD/F pattern was found that related to a single industrial source (i.e., steel mill). PCB patterns were explored in relation to those of common commercial mixtures of PCBs (i.e., Aroclors) and patterns were discussed with respect to TEQ. It was found that sites with relatively high PCB-TEQs showed an Aroclor 1254-like contamination.

Horizontal and vertical distribution of butyltin compounds in sediments from shipyards in Korea

Butyltin compounds were quantitatively determined in surface sediment and sediment core samples near shipyards in the south coast of Korea, which is one of the major ship building industries in the world. Tributyltin (TBT) concentrations reached up to 46100 ng Sn/g on a dry-weight basis at the front of the shipyard. Horizontal distribution of butyltin compounds was closely related to dry-docking activities. Butyltin concentrations were relatively low where remote from the sources. The vertical distribution of TBT in sediment cores showed active use of TBT in Korean peninsula for the past decades. The increase of TBT concentrations in sediment core according to estimated sediment age demonstrated a positive correlation with the increase of gross tonnage of ships built in the shipyard for 20 years. High TBT residue levels in sediment core samples raise concerns over persistence of the compound in the marine environment.

Geographical distribution and accumulation features of organochlorine residues in bivalves from coastal areas of South Korea

As a part of Mussel Watch Program in Korea, the contamination levels and accumulation features of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were assessed for 82 bivalve samples collected from 66 sites along the entire coast of Korea. The dry weight based sigmaPCBs and sigmaOCPs ranged from 4.4 ng g(-1) to 422.0 ng g(-1) (geometric mean = 36.9 ng g(-1)) and from 9.95 ng g(-1) to 131.37 (34.88) ng g(-1), respectively. PCB was predominant in Korean coast, followed by DDTs, HCHs, and Chlordanes. From the observed log normal distribution of PCB and each OCP, low- and high-levels were defined as geometric mean +/- 1 S.D., respectively. The levels at the sites near urban and/or industrial areas often exceeded the high-levels and the spatial distributions of sigmaDDTs and sigmaCHLs were correlated with that of sigmaPCBs, indicating terrestrial input pathways. Even distribution of sigmaHCHs suggested a possibility of atmospheric input pathway of HCHs. The observed isomer ratios of DDTs, HCHs, and CHLs indicated that aging has occurred.

Silyl derivatization of alkylphenols, chlorophenols, and bisphenol A for simultaneous GC/MS determination

A fast silyl derivatization technique for simultaneous GC/ MS analysis of alkylphenols, chlorophenols, and bisphenol A was developed. The analytes were silylized with an excess amount of bis(trimethylsilyl)trifluoroacetamide (BSTFA) followed by hydrolysis of excess silyl reagent with water. Reaction rates of derivatization were studied in various solvents and found to be fastest in acetone. Derivatization reaction in acetone was completed quantitatively within 15 s at room temperature while it took more than 1 h in other solvents studied. Similar results were obtained in mixed solvents with acetone if the content of acetone was higher than 60% (v/v). Since water-immiscible solvents such as dichloromethane or hexane are frequently used in the extraction of phenolic analytes in various sample matrixes, acetone can be added to the extracts in order to accelerate the reaction rate of derivatization. Stability of the derivatives in sample for long-term storage was ensured by hydrolyzing excess derivatizing reagent, BSTFA, with a spike of water followed by dehydration using anhydrous sodium sulfate. On the basis of the above results, a derivatizing treatment kit was designed to improve the convenience of analysis. It was possible to treat sample within several minutes successfully by using the kit. So fast simultaneous determination of those anlaytes by GC/MS was possible with improved convenience as well as sensitivity and reproducibility.

Horizontal distribution of butyltins in surface sediments from an enclosed bay system, Korea

Tributyltin (TBT), dibutyltin (DBT), and monobutyltin (MBT) compounds were quantitatively determined from surface sediment samples (total 59 stations) covering a whole basin where harbors, shipyards, and aquaculture farms were located. Butyltin compounds were detected from all the stations covering 640 km(2) of an enclosed bay system. TBT concentrations ranged from 4 to 382 ng/g as tin on a dry weight basis, and total butyltin concentrations, from 27 to 1763 ng/g. Horizontal distribution of TBT concentration showed apparent negative gradients from harbors and shipyards, indicating that its contamination was closely related to boating and dry-docking activities. However, TBT concentrations were decreased steeply from source areas. Elevated DBT and MBT levels in creeks imply the possible input of DBT from industrial wastewater. Total butyltin concentrations in sediments are significantly correlated with particulate organic carbon concentration for the subset of stations that are distant from source areas.

Accumulation of tributyl- and triphenyltin compounds in Pacific oyster, Crassostrea gigas, from the Chinhae Bay System, Korea

Butyl- and phenyltin residues were quantified in seawater and Pacific oyster (Crassostrea gigas) from the Chinhae Bay System, Korea. Butyltin compounds were detected in all the seawater and C. gigas samples, whereas phenyltin compounds were not detected in any seawater samples. Tributyltin (TBT) concentrations in seawater ranged <8-35 ng Sn L-1. TBT and triphenyltin (TPhT) concentrations in oysters ranged 95-885 and 155-678 ng Sn g-1, respectively. Spatial distribution of TBT was closely related to boating and dry-docking activities. However, spatial distribution of TPhT was not consistent with that of TBT. The estimated biological concentration factor (BCF) for TBT in C. gigas was about 25,000. Furthermore, 19 and 28% of total body burdens of TBT and TPhT were found in gonadal mass of C. gigas just prior to the spawning period, indicating that a proportional amount of TBT and TPhT would be released with a following reproductive process.