No abstract available.
Elbow*

There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.
Antibodies ; Antibodies, Monoclonal ; Antigens, CD5 ; B-Lymphocytes* ; Biomarkers ; Classification ; Cyclin D1 ; Hyperplasia ; Immunohistochemistry* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Paraffin*

Ankle and foot injuries are endemic to all sports that involve running, jumping, cutting, or kicking. Ankle injuries, especially ligament sprains are the most common injuries seen at all levels of athletic participation. Although many of ankle and foot injuries are well recovered after short-term conservative managements, there are not uncommon patients with chronic pain and dysfunction after acute injury because of improper diagnosis and rehabilitation. In this chapter, a brief review of functional anatomy, biomechanics, and clinical aspects are presented, followed by a special discussion of rehabilitation of various injuries that may involve the ankle and foot.
Animals ; Ankle ; Ankle Injuries ; Athletic Injuries ; Biomechanics ; Chronic Pain ; Foot ; Foot Injuries ; Humans ; Ligaments ; Running ; Sports ; Sprains and Strains

Ankle and foot injuries are endemic to all sports that involve running, jumping, cutting, or kicking. Ankle injuries, especially ligament sprains are the most common injuries seen at all levels of athletic participation. Although many of ankle and foot injuries are well recovered after short-term conservative managements, there are not uncommon patients with chronic pain and dysfunction after acute injury because of improper diagnosis and rehabilitation. In this chapter, a brief review of functional anatomy, biomechanics, and clinical aspects are presented, followed by a special discussion of rehabilitation of various injuries that may involve the ankle and foot.
Animals ; Ankle ; Ankle Injuries ; Athletic Injuries ; Biomechanics ; Chronic Pain ; Foot ; Foot Injuries ; Humans ; Ligaments ; Running ; Sports ; Sprains and Strains

PURPOSE: The purpose of this study was to investigate factors which effect clinical nurses' exhaustion. METHODS: This research was conducted targeting 140 clinical nurses. Data were collected from 18 September to 30 September 2015. Data were analyzed using the program SPSS/WIN 18.0. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and Stepwise multiple regression analysis were used. RESULTS: Burnout was significantly different by age (F=7.99, p=.001), marital status (t=8.69, p=.004), department area (F=7.65, p<.001), frequency of night work in a month (F=7.65, p=<.001), and clinical career (F=3.68, p=.028). There was positive correlations between menstrual attitudes of participants and premenstrual syndrome (r=34, p<.001), menstrual attitudes and stress (r=.40, p<.001), and menstrual attitudes and burnout (r=.16, p=.031). There were positive correlations between premenstrual syndrome and stress (r=.46, p<.001), between premenstrual syndrome and burnout (r=.35, p<.001), and between stress and burnout (r=.36, p<.001). Factors influencing burnout were premenstrual syndrome (β=.335) and age (β=.216), with an explanatory power of 18.0%. CONCLUSION: There is a need to develop and apply program for reducing clinical nurses' pre-menstrual syndrome. In addition, policies are needed to allow for menstruation leave, thereby making it legal.
Female ; Marital Status ; Menstruation ; Premenstrual Syndrome*

The posterior tibial muscle is considered a plantar flexor as well as an invertor of the foot, which acts as a key muscle to the medial longitudinal arch by locking the talar joints in normal gait. Rupture of the posterior tibial tendon can cause a valgus deformity of the hindfoot and an abduction deformity of the forefoot which produces a typical flat foot and a talar dislocation in severe cases. The tendon of posterior tibial muscle can be ruptured spontaneously after the age of 40 from chronic stress at the ankle joint, or by sports injury and trauma. Severe foot deformity which can be prevented by early diagnosis and appropriate treatment often occurs from misdiagnosis as a chronic ankle sprain or a congenital flat foot. We report two cases of foot deformities caused by spontaneous and traumatic rupture of posterior tibial tendons with their clinical manifestations and MRI findings.
Ankle Injuries ; Ankle Joint ; Athletic Injuries ; Congenital Abnormalities ; Diagnostic Errors ; Dislocations ; Early Diagnosis ; Flatfoot* ; Foot ; Foot Deformities ; Gait ; Joints ; Magnetic Resonance Imaging ; Rupture* ; Tendons*

OBJECTIVE: To document the outcome of the conservative treatment in plantar heel pain patients. Specific objectives included the evaluation the difference of outcome between patients, who revealed the different clinical menifestation, and the evaluation of prognostic factors. METHOD: We devided the plantar heel pain patients to two groups by the location of maximal tenderness on the heel(Group A - localized severe tenderness over the medial calcaneal tuberosity, Group B - diffuse tenderness over the central heel) and performed the conservative treatment according to a standard protocol(relative rest,nonsteroidal anti-inflammatory medications and stretching exercise during initial 2 weeks. And then viscoelastic polymer heel cushion, functional custom-made insole for all patients. Steroid injections were used for the patients of Group A who suffer from pain despite of standard treatment. In order to evaluate the results, we reviewed all charts and conducted the follow-up survey by questionnairs. 21 patients(8 males, 13 females; 26 heels; average age, 47.9 years; 15 group A, 6 group B) were available for review. RESULTS: The average follow-up was 9 months. Clinical results were classified as good(resolution of symptoms) for 3 patients, fair(continued symptoms but no limitation of activity) for 13 patients, poor(continued symptoms limiting activity) for 5 patients. The overall successful improvement(including good and fair) were 76.2% within 2.6 months. There were no significant difference of the successful improvement between two groups, which were 73.3% in group A, 83.3% in group B. The overweight was the only predictive factor of poor result. CONCLUSION: The outcome of a conservative treatment in patients with plantar heel pain is successful. But it is not different in spite of difference of clinical menifestation.
Female ; Follow-Up Studies ; Heel* ; Humans ; Male ; Overweight ; Polymers

OBJECTIVE: To study the relationship between plantar pressure and diabetic foot ulcer and the assessment the usefulness of plantar pressure measurement in diabetic patients. METHOD: The total 94 diabetic patients were enrolled in this study. The plantar pressure was measured by using EMED-SF. And the nerve conduction studies, physical examination, and history taking were done. Patients were divided into 3 subgroups, Group A: without neuropathy and past ulcer history (n=31), Group B: with neuropathy and without past ulcer history (n=44), Group C: with neuropathy and past ulcer history (n=19). RESULTS: 1) There were significant increase in the maximum peak pressure (MPP) and the pressure-time integral (PTI) values in the Group C as compared with the Group A and B (p<0.05). 2) As compared among the groups for each areas, the MPP and the PTI significantly higher in group C for heel, medial fore-foot, and lateral fore-foot area than in another two groups (p<0.05). CONCLUSION: The high plantar pressure was significantly related with diabetic foot ulcer history. The plantar pressure measurement may be useful in diabetic patients as a predictive and management aids of diabetic foot ulcer.
Diabetes Mellitus ; Diabetic Foot ; Heel ; Humans ; Neural Conduction ; Physical Examination ; Ulcer

This study aimed to examine nutritional status and similarities of diets between Vietnamese female immigrants and Korean spouses and dietary changes of Vietnamese females after immigration. Subjects were 608 couples visiting 13 medical centers for the Cohort of Intermarried Women in Korea from November 2006 to November 2007. Anthropometric and biochemical measurements were obtained and dietary intakes were assessed using one-day 24-hour recall. Sixty-eight percent of wives answered there have been changes in their diets and consumptions of meats, fish, dairy products, vegetables, and fruits increased after immigration. Energy intakes of wives and spouses were 1491.7 kcal and 1788.8 kcal, respectively, showing most couples (80.1%) consumed less than the Korean estimated energy requirements. More than half of the couples were below the Korean estimated average requirements of zinc, vitamin B2, and folate. The correlation coefficients between couples ranged 0.15-0.38 for unadjusted, 0.22-0.35 for per 1000 kcal, and 0.21-0.40 for energyadjusted, respectively. The proportions of couples in the same quartiles of each nutrient intake and in the same answers of each question of Mini Dietary Assessment were about 30% across nutrients and around 50% across questions. The length of residence is related to similarities of nutrient intakes between couples: similarities decreased after 3 years of residence in Korea. In conclusion, nutritional intakes of inter-married couples were inadequate although wives reported that their dietary intakes increased after immigration. Inadequate nutrient intakes of wives were partly explained by similar diets between couples because these wives without enough adjustment to Korean culture were more likely to follow what their spouses ate. Findings from this study may be helpful to improve the nutritional status of inter-married couples and make policies and programs for them. A follow-up study should identify factors affecting inadequate nutritional status of intermarried couples and similarities of their diets.
Asian Continental Ancestry Group ; Cohort Studies ; Dairy Products ; Diet ; Eating ; Emigrants and Immigrants ; Emigration and Immigration ; Family Characteristics ; Feeding Behavior ; Female ; Folic Acid ; Fruit ; Humans ; Korea ; Marriage ; Meat ; Nutritional Status ; Riboflavin ; Spouses ; Vegetables ; Zinc

Syringoid eccrine carcinoma (SEC) is a rare cutaneous malignant tumor thought to be derived from eccrine sweat glands. It is usually present in the scalp and face and often occurs in the fourth to seventh decades of life. A 76-year-old female patient visited our department with a 3-year history of a lesion showing a 5×4 cm-sized erythematous firm plaque with ulceration on her right shoulder. Histological findings revealed a tumor consisting of numerous proliferating tubular structures with two layers of basaloid cells with cellular atypia. Some ductal structures showed a tadpole appearance. Based on these findings, the final diagnosis was SEC. The patient was treated with slow Mohs micrographic surgery and a full-thickness skin graft and did not show any recurrence during the follow-up period of 6 months. Herein, we report a very rare case of a 76-year-old woman diagnosed with SEC that developed on the right shoulder.