The anterior approach to arthrodesis of the cervical spine has become a widely accepted. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic deformity or nonunion. As an attempt to prevent this complications, anterior cervical plate after graft placement was introduced. Although, anterior cervical plates provide excellent fixation for the anterior column, potential risk for injury to the spinal cord, soft tissues or screw loosening leading to dysphagia has been reported. Morscher, of Switzerland, has developed an anterior cervical spine locking plate(CLSP) system that attempts to prevent the migration and looseing of screw by using a cross-split screw head that can be locked into the plate. The secondary advantage of this system is the limination of the required posterior cortex purchase. The authors reviewed 42 patients in whom the CLSP system was applied for the treatment of degenerative disease or trauma. With a mean followup of 18 months, all 42 patients went on to fusion. One patient had screws placed in the discal space, hardware failure occurred in two patients. There was no iatrogenic injury to the spinal cord or esophagus. In conclusion, the CLSP system provides a reliable fusion with minimal complications. It should be considered in multilevel anterior cervical arthrosis and cervical fractures.
Arthrodesis ; Congenital Abnormalities ; Deglutition Disorders ; Esophagus ; Follow-Up Studies ; Head ; Humans ; Spinal Cord ; Spine ; Switzerland ; Transplants

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.

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: This study examined structural relationships between parenting stress and mothers' relational variables such as marital satisfaction, marital conflict, husbands' parental involvement, and maternal identity. METHODS: A nine-pathway hypothetical model was developed based on literature reviews. Two exogenous variables (marital satisfaction and marital conflict) and three endogenous variables (husbands' parental involvement, maternal identity, and mothers' parenting stress) were included in this model. Participants were 170 mothers of 5~7 month old children who visited the Public Health Center to be vaccinated between January 19 and March 27, 2015. Data were analyzed using descriptive statistics, correlations, and structural equation modeling with PASW/WIN 22.0 and AMOS 22.0. RESULTS: The model fit indices for the modified model were suitable for the recommended level. Among mothers' relational variables, maternal identity, marital conflict, and husbands' parental involvement directly influenced mothers' parenting stress. Marital satisfaction did not have a direct and indirect influence on mothers' parenting stress, however, it directly affected maternal identity and husbands' parental involvement. These predictive variables of mothers' parenting stress explained 56.0% of the model. CONCLUSION: This study expanded the understanding of mothers' parenting stress and can be used to develop effective interventions to decrease stress.
Child ; Family Conflict ; Humans ; Mothers ; Parenting* ; Parents* ; Public Health

OBJECTIVE: Patients with brain disorder manifest hypermetabolism, increased energy expenditure, and increased protein loss. Nutritional support can prevent loss of immunocompetence, and can decrease morbidity and mortality associated with brain disorder. Thus, we aimed to determine the nutritional status by measuring body mass index (BMI) in patients with brain disorder during the first 6 months and identify factors related to malnutrition in this study. METHOD: We enrolled 244 patients from January 2008 to December 2009. The patients were classified into two groups: BMI under 18.5 were categorized as malnourished, while BMI over 18.5 as not malnourished. Extracted data includes demographic characteristics, type of brain disorder, functional independence measure (FIM) and Korea mini-mental status exam (K-MMSE) scores, history of diabetes mellitus (DM), and laboratory data. Feeding method was classified into oral and enteral tube feeding. RESULTS: The prevalence of malnourished patients was 13.1% (32 out of 244 patients). There was significant difference of total lymphocyte count (TLC) between the two groups. And there was no significant difference of correlation in other parameters. Analysis of feeding method showed that 11.4% of oral feeding patients were malnourished, compared to 17.4% of tube feeding patients who were categorized as malnourished. The tube feeding group tends to be more malnourished. CONCLUSION: The results of this study can be a guide for active rehabilitation of patients with brain disorder, and further studies regarding functional outcome and complications related to early nutritional status is needed.
Body Mass Index ; Brain Diseases* ; Brain Injuries ; Diabetes Mellitus ; Energy Metabolism ; Enteral Nutrition ; Feeding Methods ; Humans ; Immunocompetence ; Korea ; Lymphocyte Count ; Malnutrition ; Mortality ; Nutritional Status* ; Nutritional Support ; Prevalence ; Rehabilitation ; Stroke

We evaluated the clinical characteristics of acute myocarditis children, especially chief complaints on first visit at a hospital and prognosis. A retrospective descriptive study was conducted to identify patients with myocarditis who presented over a 10-year span at a regional tertiary hospital. Patients were identified based on the international classification of diseases 10, diagnostic codes. Total 18 patients were enrolled in the study. The patients had a median age of 16 months and 61% of them were male. Common chief complaints were shortness of breath, lethargy, cough or palpitation. Of the patients, 5 patients showed gastrointestinal symptoms such as vomiting, abdominal pain and loose stool as initial symptoms. Eighty nine percent of patients had cardiomegaly on chest x-ray, and 72% of patients had an abnormal electrocardiogram results. On first admission, 4 patients were died and 3 of them showed vomiting and abdominal pain as first chief complaints. These data suggest that abdominal pain and vomiting may be chief complaints of acute myocarditis. And myocarditis patients who showed gastrointestinal symptoms initially had poor prognosis. In addition, to distinguish an acute myocarditis, cardiomegaly on chest x-ray and an abnormal electrocardiogram may be useful.
Abdominal Pain ; Cardiomegaly ; Child* ; Cough ; Dyspnea ; Electrocardiography ; Humans ; International Classification of Diseases ; Lethargy ; Male ; Myocarditis* ; Prognosis* ; Retrospective Studies ; Shock ; Tertiary Care Centers ; Thorax ; Vomiting

OBJECTIVES: Research on workplace violence has been conducted, but rarely has been organized systematically. In this study, we summarize the definition and classification of workplace violence studies and review the literature on workplace violence. METHODS: Using academic search engines PubMed, Google Scholar and DBpia, we found 856 papers including “workplace violence” and “adverse social behavior” AND workplace in the title published until December 2018, and 208 papers were selected. The selected papers were classified by continent and country, year of publication, occupation, classification criteria of workplace violence, and research topic. RESULTS: By country, the number of articles in the United States was the most with 40 (19.2%), followed by China 27 (13%), Korea 16 (7.7%), and Taiwan and Australia 15 (7.2%). By job category, healthcare workers accounted for the largest portion with 162 (79.0%) of the total, and 80 of them were conducted on nurses. Other occupations included civil servants, manufacturing workers, toll collectors and wageworkers. Among the classification methods of workplace violence, 147 (67.4%) articles were classified as type and there was a difference in the type of violence defined for each article. In the research topic, 114 (44.2%) articles analyzed the effects of workplace violence, and 105 (40.7%) articles describe the prevalence and characteristics of workplace violence, and 23 (8.9%) articles analyzing the causes of violence. CONCLUSION: The research topic is biased toward the field of healthcare, so it is necessary to expand to include various occupations or other specified occupations. It is also necessary to prepare appropriate measures against workplace violence.
Australia ; Bias (Epidemiology) ; China ; Classification ; Delivery of Health Care ; Exposure to Violence ; Korea ; Occupations ; Prevalence ; Publications ; Search Engine ; Taiwan ; United States ; Violence ; Workplace Violence

With the evolution of the computer-aided design/computer-aided manufacturing (CAD/CAM) technology, the intraoral scanners are playing an increasingly important role, as they are the first step towards a completely digital workflow. The CAD/CAM double scanning technique has been used to transfer the information from provisional restorations to definitive restorations. In this case, a 67-year-old male with esthetically compromised anterior teeth, generalized severe attrition of teeth, and reduced vertical dimension was treated with full mouth rehabilitation including a re-establishment of the lost vertical dimension of occlusion assisted by the crown lengthening procedure. The provisional restorations were fabricated using an intraoral scanner and the CAD/CAM double scanning technique. After the period of adaption, the definitive monolithic zirconia restorations were delivered. The CAD/CAM double scanning technique successfully transferred the occlusal and morphological characteristics, obtained from the provisional restorations, to the definitive restorations.
Aged ; Crown Lengthening ; Dentition ; Humans ; Male ; Mouth Rehabilitation ; Mouth ; Tooth ; Tooth Wear ; Vertical Dimension

OBJECTIVE: To assess head posture using cervical spine X-rays to find out whether forward head posture is related to myofascial pain syndrome (MPS) in neck and shoulder. METHODS: Eighty-eight participants who were diagnosed with MPS in neck and shoulder were evaluated in this study. Four parameters (distance among head, cervical spines, and shoulder, and cervical angle) were measured from lateral view of cervical spine X-ray. The location and number of trigger points in the neck and shoulder and symptom duration were evaluated for each patient. RESULTS: Both horizontal distances between C1 vertebral body and C7 spinous process and between the earhole and C7 vertebral body were negatively correlated with cervical angle reflecting cervical lordosis (p<0.05). Younger patients had significantly (p<0.05) less cervical angle with more forward head posture. There was no relationship between MPS (presence, location, and number of trigger points) and radiologic assessments (distance parameters and the cervical angle). CONCLUSION: Forward head posture and reduced cervical lordosis were seen more in younger patients with spontaneous neck pain. However, these abnormalities did not correlate with the location or the number of MPS. Further studies are needed to delineate the mechanism of neck pain in patients with forward head posture.
Animals ; Cervical Vertebrae ; Female ; Head* ; Humans ; Lordosis ; Myofascial Pain Syndromes* ; Neck ; Neck Pain ; Posture* ; Shoulder ; Spine ; Trigger Points