STUDY DESIGN: Ninty eight patients with multilevel spinal stenosis who were treated with posterior decompression and instrumented posterolateral fusion were reviewed retrospectively. All patients were divided two groups by pathologic level and surgery level. One is complete level decompression group (whole pathologic levels were decompressed) and the other is limited level decompression group (less than pathologic levels were decompressed). SUMMARY OF BACKGROUND DATA: Many patients with spinal stenosis haute multilevel pathology, which is very difficult problem to make surgical strategy for determination of decompression level. METHOD: Patients were reviewed using combination of clinical records, follow-up examinations and radiographs. Posterior decompression and instrumented posterolateral fusion were performed in all patients using pedicle screw fixation (TSRH 49 cases, Diapason 37 cases, CCD 12 cases) and either autogenous bone graft alone or autograft with allograft. The average follow-up period was 19.7 months. RESULTS: In the clinical results by the criteria of Kirkalldy-Willis, there was no difference between complete level decompression group and limited level decompression group. By the bone graft mothorts, fusion rate was no difference between autograft alone group and autograft with allograft group, but fusion periods were more shorter in autograft alone group than in autograft with allograft group(P>0.05). CONCLUSION: In multilevel spinal stenosis, the segments that associated with neurologic symptoms or seyeie stenosis on radiograph must be decompressed but the segments that not associated with neurologic symptoms and mild stenosis on radiograph do not need preventive decompression.
Allografts ; Autografts ; Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pathology ; Retrospective Studies ; Spinal Stenosis* ; Transplants*

The propose of this study was to identify fatigue, pain and coping of pain and to compare the variables between fibromyalgia and chronic arthritis. The sample consisted of 133 patients who visited H university hospital. Data were collected by questionnaire from May 1 to September 30, 1999. Data was analyzed by descriptive statistics. chi-test. pearson correlation coefficient. and ANOVA. As a results, most of all patients felt fatigue and the mean score of the fatigue was above average. The mean score of rheumatoid arthritis and fibromyalgia patients on pain was higher than Osteoarthritis patients. and there was the statistically significant difference among three groups on pain(F=10.63. p=0.00). There was also the statistical difference among three groups on coping of pain(F=4.74, p=0.01). The mean score of rheumatoid arthritis and fibromyalgia patients on coping of pain was higher than Osteoarthritis patients. Fatigue showed positive relationship with pain(r= .262, p= .002). and pain showed positive relationship with coping of pain(r=.319. p=.000). According to this finding, fibromyalgia patients and rheumatoid arthritis patients felt high fatigue and pain, therefore the development of nursing intervention for relieving fatigue and pain would be needed.
Arthritis* ; Arthritis, Rheumatoid ; Fatigue* ; Fibromyalgia* ; Humans ; Nursing ; Osteoarthritis ; Surveys and Questionnaires

Antioxidative function of uncooked powdered food (Sangsik) was evaluated in rats consuming nutritionally unbalanced diet including 1% cholesterol, high proportion of animal lipids (lard : soybean oil : 8 . 2) , sub-optimal levels of vitamin and mineral mixture along with 0.5% ethanol in drinking water. The uncooked powdered food tested in the present study was a mixture composed of 42 kinds of plant foods (cereals, legumes, seaweeds, vegetables, and fruits) supplemented with vitamins and minerals, and dietary fiber. Control rats were fed the semi-purified diet based on the AIN-93G composition, and nutritionally unbalanced rats were divided into 3 groups, and fed one of the following diets with 0.5% ethanol in drinking water for 5 weeks : unbalanced control diet (UC) ,20% Sangsik powder supplemented diet (S20), and 40% Sangsik powder supplemented diet (S40) . Food efficiency ratio was significantly higher in rats fed S40 compared to the value for rats fed UC (p<0.05). Hepatic level of thiobarbituric acid reactive substances (TBARS) was significantly lower in rats fed UC compared to that for control rats (p<0.05), and was not influenced by dietary supplementation of the Sangsik powder. Hepatic superoxide dismutase (SOD) activity was significantly higher in rats fed UC compared to that for control rats (p<0.05), and significantly reduced in rats fed S20 or S40 compared to the value for unbalanced control rats. Feeding unbalanced control diet significantly reduced the ratio of hepatic GSH-Px + catalase/SOD activities compared to the value for control rats, and this decrease in the ratio of antioxidant enzyme activities was reversed by adding the Sangsik powder to the diet at 20% (p<0.05) . Based on the results of antioxidant enzyme activities, feeding uncooked powdered diet appears to provide a favorable environment for body's antioxidative defense mechanism. Serum levels of Fe and Cu were significantly lower in rats fed the Sangsik powder supplemented diets compared to the value for unbalanced control rats (p<0.05), and levels of Se, Mn, and Zn were also tended to be decreased by dietary supplementation of the Sangsik powder. These results postulate the possibility that ingredients used in the uncooked powdered food may decrease the bioavailability of trace elements in rats.
Animals ; Biological Availability ; Cholesterol ; Diet* ; Dietary Fiber ; Dietary Supplements ; Drinking Water ; Ethanol ; Fabaceae ; Minerals ; Plants ; Rats* ; Soybean Oil ; Superoxide Dismutase ; Thiobarbituric Acid Reactive Substances ; Trace Elements ; Vegetables ; Vitamins

PURPOSE: The purpose of this study was to identify the levels of customer orientation in nurses whose work experience was between 1 and 5 years and to examine factors associated with customer orientation and nursing productivity. METHODS: For this descriptive correlational study, nurses (N=164) were recruited from a University Hospital in B city, from November 1 to 23, 2012. Questionnaires included measures of customer orientation, nursing productivity, organizational commitment, job stress, and turnover intention. Data were analysed with the SPSS/WIN 18.0 program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression. RESULTS: The mean age of participants was 25 years, 96% were single, and 54.9% had a bachelor degree. Organizational commitment (beta=.387) and job stress (beta=.280) significantly explained the variance in customer orientation (R2=15.8). Customer orientation (beta=.479), education level (beta=.196), and turnover intention (beta=-.184) significantly explained the variance in nursing productivity (R2=35.3). Customer orientation was the most important factor in explaining the variance in the nursing productivity. CONCLUSION: This study highlighted the relationship between customer orientation and nursing productivity. Improving the customer orientation could result in increasing nursing productivity. Future managerial intervention to improve customer orientation is warranted.
Education ; Efficiency* ; Efficiency, Organizational ; Intention ; Nursing* ; Surveys and Questionnaires

This study was designed to offer descriptive data for nursing intervention for relief of fatigue and pain, and to distinguish by the characteristic difference and the symptoms such as fatigue and pain on Ankylosing Spondylitis (AS), Fibromyalgia(FM), and Systemic Lupus Erythematosus(SLE) patients. The sample consisted of 92 patients(AS 29; FM 30; SLE 33) who visited H-University Rheumatism Hospital in Seoul. The data were collected by a structured questionnaire from May 1, 1999 to April 30, 2000. The results were as follows: Patients of 95% experienced fatigue in the last week and a fatigue score of three disease groups were above average. The fatigue score of FM patients was highest in the other disease, but which was not a statistically significant difference(F=1.417, p=.248). The mean score of AS and FM patients in pain was higher than the SLE patients, and there was the statistical significance among the three groups on pain (F=8.239, p=.001). There wasn't a statistical difference among three groups on coping wtih pain(F=1.451, p=.240). There wasn't any correlation between fatigue and pain in each disease (AS: r=.008, p=.966; FM: r=.328, p=.077; SLE: r=.237,p=.185). Therefore, morning stiffness and pain management during sleeping is needed through good body alignment in the AS patients. Adequate rest for fatigue and multiple coping strategies for pain maybe basic nursing intervention in FM and SLE. According to their fatigue rhythm, a regular exercise program is needed for rheumatic disease because they complained of fatigue above average and their fatigue was repeated better and worse only during the one week.
Fatigue* ; Fibromyalgia ; Humans ; Nursing ; Pain Management ; Rheumatic Diseases ; Seoul ; Spondylitis, Ankylosing ; Surveys and Questionnaires

BACKGROUND: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. METHODS: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg + lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. RESULTS: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of 2.4 +/- 2.1 points, which was lower, with statistical significance, than the VAS score of group 2, which was 4.4 +/- 3.1 points (p<0.001). CONCLUSIONS: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.
Bursitis* ; Follow-Up Studies ; Humans ; Joints ; Lidocaine ; Motion Therapy, Continuous Passive ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder ; Visual Analog Scale

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

No abstract available.
Granular Cell Tumor* ; Tongue*

Purpose: To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods: A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results: For the total patient group, the AUC of the ‘total significant features model’ (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the ‘selected feature model’ (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the ‘selected feature model’ (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.

Purpose: To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods: A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results: For the total patient group, the AUC of the ‘total significant features model’ (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the ‘selected feature model’ (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the ‘selected feature model’ (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.