BACKGROUND: Osteoporosis is developed by progressive decrease of bone rnass from decreased collagen content of bone. Accurate measurement of bone collagen is necessary for the diagnosis of osteoporosis and it is possible by bone biopsy, however bone biopsy is not easy in clinical practice. Skin collagen is consist with type I collagen which is same type of bone collagen and progressive decrease of bone collagen is reflected by decrease of skin collagen. Since skin thickness reflect skin collagen amount, skin thickness measurement may be a useful method for the evaluation of osteoporosis. So ultrasonic skin thickness measurement was developed for the evaluation of osteoporosis. METHODS: A randomly selected 200 women aged fram 30 to 71 years old were asked to have their skin thickness measured as well as lumbar vertebral DXA(Norland, USA) bone densitometry. Except for the two women who failed to complete the study, 45(22.7%) of these women were diagnosed as normal, 74(37.4%) were osteopenic and 79(39.9%) were diagnosed as osteoporosis patients using the WHO criteria. Skin thickness was measured using 20MHz Osteoson DCIII (Minhorst, Germany) at the medial side of the upper arm. A minimal of Two scans were measured and the mean value was cakulated automatically. RESULTS: The correlation coefficient of skin thickness and age was -0.121(ns), DXA BMD(bone mineral density) and age was -0.420(P<0.01), skin thickness and DXA BMD L2-L4 was 0.181(P<0.05). Skin thickness was significantly correlated with body weight(correlation coefficient 0.254, P<0.01) and BMI(correlation coefficient 0.195, P<0.01). Furthermore, the mean and standard deviation of skin thickness in normal BMD group was 0.94+-0.021mm, osteopenic group was 0.92+-0.006mm, and osteoporotic group was 0.89+-0.018mm. There was statistically significant difference in the mean values of skin thickness between the three groups even adjusted with age and BMI(P<0.05). The mean and standard deviation of skin tbickness of healthy 20-40 year old women was 1.11+-0,023mm and their mean and standard deviation of L2-L4 mean BMD was 1.17+-0.145mg/cm2. The diagnostic predictability of skin thickness less than 1mm as the risk of osteoporosis(BMD T score less than -1.0) was evaluated. The sensitivity and the specificity of skin thickness less than 1mm being osteoporotic were 78,2% and 57.8% respectively. The positive and negative predictive value of the skin thickness less than 1mm being osteoporotic were 82.2% and 36.5% respectively. CONCLUSION: This study indicate that the skin thickaess measured with the ultrasound method show good correlatian with the bone density measured with conventional DXA at the lumbar vertebra and the skin thickness less than 1mm on the medial side of the opper arm is relatively sensitive in diagnosing osteoporosis risk in Korean women. The authors suggested that a large randomized control study to define the relationship between the skin thickness and the other determinants of bone turnover in the near future.
Aged ; Arm ; Biopsy ; Bone Density ; Collagen ; Collagen Type I ; Densitometry ; Diagnosis* ; Female ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Sensitivity and Specificity ; Skin* ; Spine ; Ultrasonics ; Ultrasonography

Purpose: : This study aimed to identify the moderating and mediating effects of resilience on the relationship between role conflict and job satisfaction among nurses working in a comprehensive nursing care service ward. Methods: : Participants were 130 comprehensive nursing care service ward nurses from four hospitals. Data were collected using structured questionnaires and analyzed by t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression analysis, using SPSS 25.0. The mediating effect of resilience on the relationship between role conflict and job satisfaction was analyzed using multiple regression analysis according to Baron and Kenny’s procedure. Results: : Statistically significant negative correlations were found between role conflict and resilience (r=-.25, p<.007) and between role conflict and job satisfaction (r=-.38, p<.001). A significant positive correlation was found between resilience and job satisfaction (r=.54, p<.001). A partial mediating effect of resilience was found between role conflict and job satisfaction (Z=-2.53, p=.012) but no moderating effect was found. Conclusion : To improve the job satisfaction of comprehensive nursing care service ward nurses, interventions for alleviating role conflict and improving resilience as well as evaluations of the two variables are necessary.

Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

PURPOSE: To evaluate the specif!c radiologic findings of the dysgenesis of corpus callosum(CCD) on CT and/or MR images. MATERIALS AND METHODS: The authors reviewed retrospectively CT and/or MR images of 10 patients with CCD. After classifying CCD into partial and total type according to the degree of its development, we investigated structural abnormalities on CT and/or MR images resulting from or related to CCD and then associated anomaly. RESULTS: The most common findings of CCD on axial planes of CT and/or MR images were dilatation of posterior part of the lateral ventricles(8/10) and feature of the bodies of the both lateral ventricles(8/10) in parallel. Sagittal and coronal planes of MR demonstrated exact extent of dysgenesis of the corpus callosum(5/5) and radiating pattern of gyri in medial surface of cerebral hemisphere extending to the 3rd ventricle without interruption by cingulate sulcus(4/5). CONCLUSION:MR image of mid-sagittal plane appeared most useful in diagnosis of CCD because of its direct depiction of the whole length of corpus callosum. In most cases, however, CCD can be easily diagnosed with CT scan by characteristic findings of dilatation of the posterior part of lateral ventricles and paralleling of the lateral ventricles.
Cerebrum ; Corpus Callosum ; Diagnosis ; Dilatation ; Humans ; Lateral Ventricles ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Plasmids* ; Shigella* ; Virulence Factors* ; Virulence*

STUDY DESIGN: A case of brain infarction due to occlusion of vertebral artery after cervical spine fracture is reported. OBJECTIVES: Documentation of possibility and clinical significances of brain infarction as one of grave complications after cervical spine injury. SUMMARY OF LITERATURE REVIEW: Occlusion of vertebral artery and consequent brain infarction can be associated with cervical spine injuries because vertebral arteries course through the transverse foramina from sixth to second corvical vertebrae. Infarction of vertebrobasilar system may cause impairment of cerebral, cerebellar, or brain stem function and can occasionally bring grave functional loss, even death. MATERIALS AND METHODS: A case of occlusion of vertebral artery and consequent cerebral infarction after cervical spine fracture in a 66 year-old man. Brain CT and angiogram were performed. He was managed with anticoagulants. RESULTS: Neurologic deficits from brain infarction disappeared after 2 weeks. CONCLUSIONS: Attention to the possibility of these complications and awareness of their clinical features seem to be mandatory in managing cervical spine injury patients.
Aged ; Anticoagulants ; Brain ; Brain Infarction ; Brain Stem ; Cerebral Infarction* ; Humans ; Infarction ; Neurologic Manifestations ; Spine* ; Vertebral Artery*

No abstract available.
Escherichia coli* ; Escherichia* ; HeLa Cells* ; Humans ; Virulence Factors* ; Virulence*

PURPOSE: The purpose of this study is to evaluate the findings of magnetic resonance imaging(MRI) of posterior fossa hemangioblastoma and usefulness of contrast enhancement with Gd-DTPA. MATERIALS AND METHODS: Seven patients with posterior fossa hemangioblastoma were studied with both pre- and post-enhanced MRI. The MR images were reviewed regarding the location, size, signal intensities of cysts and mural nodules, and their contrast enhancement pattern. RESULTS: Five tumors were located in cerebellar hemisphere, one in vermis, and one in posterior part of medulla. One patient with von HippeI-Lindau disease had a medullary hemangioblastoma with multiple pancreatic cysts. In 6 cases, the major portion of the tumor was cysts and had small mulkal nodules. The solid portion was relatiely lange in one case, cemprising half of the tumor Cysts were oval shaped and their sizes were 3--6.7cm in diameter. In five cases(71%), septations were noted within the cysts. Cysts were isointense or slightly hyperintense on Tl-weighted image and hyperintense on T2-weighted image compared with cerebrospinal fluid. Mural nodules were oval or rounded appearance in five cases and flattened appearance in two, and their size was 0.5--2.5cm in diameter. Mural nodules were isointense to gray matter. They were detected in five cases on Tl-weighted images and one case on T2-weighted images. In two cases, vascular signal void area was noted in mural nodules. On contrast-enhanced Tl-weighted images, all mural nodules were intensely enhanced. CONCLUSION: MRI proved to be a good diagnostic method to detect and characterize posterior fossa hemangioblastoma. The most common finding is Cystic posterior fossa lesion with enhancing mural nodule. Contrast enhancement is essential for specific diagnosis.
Cerebrospinal Fluid ; Diagnosis ; Gadolinium DTPA ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Pancreatic Cyst

Background: Prevention of chronic diseases such as hypertension and diabetes is important, but few studies have identified barriers to healthy lifestyle practices among adults in their 30-50s. Therefore, this study is intended to be used as basic data for establishing a prevention and control strategy for chronic diseases. Methods: This study is a qualitative content analysis study using the focus group interview methodology. According to the inductive content analysis method, data were analyzed through the steps of ‘making sense of the data and whole’, ‘open coding’, ‘grouping’, ‘categorization’, and ‘abstraction’. Results: The categories of barriers to healthy lifestyle practice were derived as follows. ‘Low interest in health care’ in the intrapersonal domain, ‘absence of an assistant’ in the interpersonal domain, ‘organizational environment in which it is difficult to a healthy lifestyle practice’ in the organizational domain, ‘lack of infrastructure’ and ‘restrictions on use of public health centers’ in the community domain. Conclusions For the prevention and management of chronic diseases, adults in their 30-50s should be encouraged to take an interest in healthy lifestyle practices and increase their will. For healthy lifestyle practice, it is necessary to allow family members and friends to participate as helpers. In addition, at work, employers should pay attention to workers' health management, adjust working hours, and reduce the burden of company dinner to create an organizational environment for healthy lifestyle practice. Lastly, infrastructure such as public sports facilities should be additionally expanded, and the contents of public health centers' programs should be promoted.

The purpose of this study was to investigate the frequency of the meniscal flounce on MR imaging in patients who underwent arthroscopy or open surgery due to symptoms related to internal derangement of the knee, and to investigate associated findings in patients with meniscal flounce by comparing and analyzing the findings from MR imaging and surgery. MR images obtained from 116 knees before surgery were reviewed retrospectively. Seven medial menisci showed buckled, wavy flounce on sagittal MR images. None of the lateral menisci showed flounce. We reviewed the surgical records of all seven patients and the videotapes of six of the patients undergoing arthroscopy or open surgery. The frequency of flounce on sagittal MR images was 6.0% in the medial meniscus and was completely absent in the lateral meniscus. On coronal MR images, the truncated appearance of the affected meniscus was demonstrated in five patients, and a valgus deformity was seen in three patients. Five patients showed a moderate to large amount of joint effusion. On MR imaging and in surgery, ligament injuries were found in six patients (six medial collateral ligament injuries, five anterior cruciate ligament injuries, and two posterior cruciate ligament injuries). Non-specific synovitis was found in the one remaining patient. In the surgery of all seven patients, no tears were found at the meniscus itself showing flounce. In conclusion, the meniscal flounce seen on sagittal MR imaging can be a rare appearance of a transient distortion of a normal meniscus due to a valgus deformity caused by a MCL tear and/or due to an external rotation induced by cruciate ligament injury or positioning of knee joint within the magnet. The meniscal flounce should be interpreted carefully because it frequently appears truncated on the coronal scan and can simulate a meniscal tear.
Arthroscopy ; Human ; Knee Joint/surgery* ; Magnetic Resonance Imaging ; Menisci, Tibial/pathology*