SUMMARY OF LITERATURE REVIEW: Many authors haute described the association between lumbar disc degeneration and segmental instability but it has not been delineated in detail. OBJECTIVES: To compare the MRI assessment of disc degeneration with the conventional plain X-ray evaluation of the intervertebral disc, in order to study lumbar segmental instability. MATERIALS AND METHODS: In 75 patients with low back pain and/or sciatica, we analyzed disc space height, angular displacement, and horizontal displacement on plain radiographs of the lumbar spine. These parameters were compared with the grade of disc degeneration as evaluated by magnetic resonance Imaging. STUDY DESIGN: We analyzed the association between grade of disc degeneration as evaluated by magnetic resonance imaging assessment and segmental instability as evaluated by plain radiographs of the lumbar spine. RESULTS: Disc space height was decreased In proportion to the grade of disc degeneration. Angular displacement was increased according to the grade of disc degeneration, but significantly less with severe degeneration, accompanied by a tendency to stabilization of the motion segment. Horizontal displacement was not correlated with the grade of disc degeneration CONCLUSIONS: The incidence of lumbar segmental instability increased in proportion to the grade of disc degeneration but significantly decreased with severe disc degeneration.
Humans ; Incidence ; Intervertebral Disc ; Intervertebral Disc Degeneration* ; Low Back Pain ; Magnetic Resonance Imaging ; Sciatica ; Spine

No abstract available.
Allopurinol* ; Animals ; Liver* ; Rats* ; Reperfusion Injury* ; Verapamil*

Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femoral neuropathy associated with a patella fracture.
Adult ; Electromyography ; Female ; Femoral Nerve ; Femoral Neuropathy ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Muscle Weakness ; Paralysis ; Paresthesia ; Patella ; Peripheral Nervous System Diseases ; Walking

This research aimed to survey foodservice hygiene management practices performed by principals and teachers as well as examine foodservice employees' hygiene knowledge in kindergartens. Surveys were administered to principals, teachers, and foodservice employees at 392 kindergartens. The total average score of six categories was 4.28 out of 5.0. Average score of the production process management category was the lowest at 3.90 while safety management was the highest at 4.69. Other average scores were as follows: facilities and equipment 4.20, personal hygiene 4.14, food ingredient control 4.35, and environmental sanitation 4.39. Teachers' foodservice hygiene management practices scored 3.8 points out of 5 on average. Hygiene knowledge of foodservice employees was also tested. The mean score of foodservice hygiene knowledge was 76.29%. The lowest scoring category was personal hygiene, suggesting that foodservice employees require more knowledge on proper personal hygiene practices. Possession rates of dish sterilizer, ultraviolet sterilizer, and hand washing facilities in the kitchen were low. These equipment installation rates should be raised accordingly. To enhance control of foodservice hygiene, kindergarten management should pay more attention to education and training related to foodservice sanitation.
Hand Disinfection ; Humans ; Hygiene ; Safety Management ; Sanitation

The purposes of this study were to develop the standard indicators to evaluate the food and nutrition systems in hospitals and to test the validity of those items scientifically. The results were as follows: First, the conceptual validity was examined with recognition degrees of importance from the hospital nutrition department managers. All of the hospital nutrition department's operation evaluation standards and the indicators' conceptual validity tested were in the range of 3.71~4.93 out of 5.0, and the mean score was 4.36. Therefore, the conceptual validity was verified. Second, to verify the factor validity of the items of the standards and indicators for the hospital nutrition department's operation evaluation, the standards and indicators were analyzed as key-factors. Key-factor analysis after vertical rotation showed that four factors appeared and were composed of (a) facilities management, (b) sanitation management, (c) operation & foodservice management, and (d) nutrition management. Third, the reliability of the standards and indicators for the hospital nutrition department's operation evaluation was analyzed and resulted in a score of 0.98, which showed good internal consistency. Fourth, the discriminative power of each item of the standards for the hospital nutrition department's operation evaluation was tested by checking the differences between groups with first quartile and forth quartile of total evaluation scores. The indicators having low distinction power were modified into obligatory items or eliminated for better differentiation.
Sanitation

PURPOSE: The purpose of this study was to evaluate the use of hinged external fixation in management of complex elbow injury. MATERIALS AND METHODS: We retrospectively reviewed clinical outcomes in 10 patients with elbow dislocation and associated fractures of both the radial head and the coronoid process from January 2007 to December 2013. All ten patients were treated by hinged external fixation after open reduction and internal fixation. The indication for use of a hinged external fixator was persistent instability after fixation of the fractures. Early mobilization was started at 1 week (6.5 days) after surgery. The external fixator was removed at 6 weeks after surgery. Cassebaum classification and Mayo elbow performance score were used for clinical and functional evaluation. The follow-up period was at least 1 year. RESULTS: At the last follow-up, the average further flexion was 127degrees, and the average flexion contracture was 16degrees. The average pronation was 83degrees and the average supination was 78degrees. By the Cassebaum classification after 1 year follow-up, patients were classified as 4 excellent, 4 good, and 2 poor. According to the Mayo elbow performance score, the average score was 87 points (65-100 points) with 3 excellent, 6 good, and 1 fair. Stability was restored in all patients at the last follow-up. There was no case of nonunion and the average union period was 11.5 weeks. CONCLUSION: This study advocated the additional use of a hinged external fixator in the treatment of complex elbow instability, especially when fixation of fractures and repair of soft tissues were not sufficient. Providing adequate stability and allowing early motion, additional external fixation could improve the functional outcome.
Classification ; Contracture ; Dislocations ; Early Ambulation ; Elbow* ; External Fixators ; Follow-Up Studies ; Head ; Humans ; Pronation ; Retrospective Studies ; Supination

A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

PURPOSE: A minimally invasive surgical technique has been introduced to treat carpal tunnel syndrome that causes less pain, minimal scaring, and a rapid recovery. This study was designed to evaluate the safety and effectiveness of the double minimal incision release compared with the open surgery technique. METHODS: A study was performed on 175 cases in 111 patients who were operated on for carpal tunnel syndrome from January 2010 to December 2014. The patients were classified into 2 groups according to the type of surgical technique: 82 cases underwent standard open surgery in group A and 93 cases underwent double minimal incision release in group B. Grip strength and postoperative pain were evaluated 4 and 8 weeks and 6 and 12 months after surgery, and the period of numbness and time needed to resume normal activities were investigated. RESULTS: Group B patients showed better outcomes during the 2 first months after surgery than those of group A patients in numbness, pain, stiffness (p<0.05), less scar pain and tenderness (p<0.001), and shorter time needed to resume normal activities. However, no differences in these parameters were observed between the 2 groups after 6 months (p>0.05). CONCLUSION: Double minimal incision release offered better clinical outcomes until 2 months after surgery compared to the standard open surgery technique and reduced incipient postoperative pain and allowed for earlier resumption of normal activities.
Carpal Tunnel Syndrome* ; Cicatrix ; Hand Strength ; Humans ; Hypesthesia ; Minimally Invasive Surgical Procedures ; Pain, Postoperative

PURPOSE: We evaluated clinical outcomes after treating patients with proximal interphalangeal (PIP) joint fracture-dislocation with dynamic external fixator with which early joint motion can be undertaken to prevent joint stiffness effectively and fixate joints firmly. METHODS: Dynamic external fixators were applied for 20 fracture-dislocation of the PIP joints in 19 patients. The joints involved were 2nd PIP joint in two patients, 3rd PIP joint in three patients, 4th PIP joint in five patients, 5th PIP joint in eight patients. One patient had both 3rd and 4th PIP joint fracture-dislocation. Surgery was performed at least within four weeks. The mean age of the patients was 30.5 years (range, 15-54 years) and the mean follow-up duration was 1.85 years (range, 1-2.3 years) years. All patients were clinically and radiologically assessed on an outpatient basis after being discharged. RESULTS: At the final follow-up, the mean range of motion of PIP joints in flexion was 100.1° (flexion range, 88°-110°), the mean extension lag was 3.0° (extension range, 0°-10°), and the mean visual analogue scale score was 0.8. On anterior-posterior and lateral radiographs, congruity of the joint was satisfactory and 1 mm step off was present in three cases. CONCLUSION: We attained satisfactory clinical outcomes on the recovery of joint movement and joint congruity after treating PIP joint fracture-dislocation injury with dynamic external fixator.
Dislocations* ; External Fixators ; Fingers ; Follow-Up Studies ; Humans ; Joints* ; Outpatients ; Range of Motion, Articular

Biceps long head tendon rupture is relatively common and requires approximately four weeks of splintage as a general treatment. Musculocutaneous nerve entrapment is commonly caused by excessive exercise or direct external force. Musculocutaneous nerve syndrome has barely been reported; however, association of biceps long head tendon rupture and musculocutaneous nerve entrapment syndrome has never been reported. The authors experienced a 70-year-old male patient, who suffered a traffic accident and was hospitalized due to shoulder joint pain caused by direct external force, delayed forearm lateral aspect hypoesthesia and elbow flexion weakness. For identification of the cause, magnetic resonance imaging, electromyography, and surgical opinion were synthesized, resulting in diagnosis of delayed musculocutaneous nerve entrapment syndrome occurring after biceps long head tendon rupture. With surgical treatment, pain, sense, and elbow flexion weakness were recovered, a showing successful treatment result.
Accidents, Traffic ; Aged ; Diagnosis ; Elbow ; Electromyography ; Forearm ; Head* ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Male ; Musculocutaneous Nerve* ; Rupture* ; Shoulder Joint ; Tendons*