Distinguishing CT and MR Imaging Features of Postprocedural Inflammation and Infectious Spondylodiscitis After Intradiscal Electrothermal Therapy

Purpose@#To investigate whether the signal or morphological changes in the adjacent bone or soft tissue after intradiscal electrothermal therapy (IDET) occur due to postprocedural inflammation or infectious spondylodiscitis. @*Materials and Methods@#Ten patients (female:male = 5:5; age range, 18–71 years; mean age: 36.5 years) who underwent lumbar IDET between January 2018 and December 2020 and complained of fever or pain were included in this study. The presence and extent of bone marrow and paraspinal soft tissue signal changes were evaluated using the first follow-up magnetic resonance imaging (MRI) after IDET. Signal changes in the treated discs and the presence and extent of epidural enhancement were evaluated. Additionally, we investigated the presence and margins of subchondral erosions in the vertebral body. @*Results@#Two radiologists analyzed the imaging findings by consensus. Six patients were diagnosed with postprocedural inflammation and four with infectious spondylodiscitis, which was confirmed by specimen culture after surgery. All 10 patients showed signal changes in the bone marrow of the vertebral bodies adjacent to the treated disc. Signal changes in the paraspinal soft tissue were observed in only five patients: three with infectious spondylodiscitis and two with postprocedural inflammation. In six patients with postprocedural inflammation, subchondral erosions had well-defined margins with a sclerotic rim and in four patients with infectious spondylodiscitis, subchondral erosions had ill-defined margins. Epidural enhancement showed an extensive pattern in all cases of infectious spondylodiscitis and localized patterns in cases of postprocedural inflammation. @*Conclusion@#MRI or computed tomography findings of well-defined subchondral erosions with a sclerotic rim and more localized signal changes in the paraspinal soft tissue or epidural space might aid in the differentiation of infectious spondylodiscitis and postprocedural inflammation in patients who underwent IDET.

Knowledge of atopic dermatitis and food allergies, as well as health information literacy, among North Korean refugee mothers: a descriptive survey study

Purpose@#This study investigated knowledge of atopic dermatitis and food allergies, as well as health information literacy, among North Korean refugee mothers with preschool-age children and explored how these variables were related to participants' characteristics. @*Methods@#A descriptive study design was used. Data from 130 North Korean refugee mothers were collected between January and March 2023. @*Results@#The mean scores were 14.48 of 30 for atopic dermatitis knowledge; 2.77 of 10 for food allergy knowledge, and 56.95 of 80 for health information literacy. Significant differences were observed in knowledge of atopic dermatitis based on breastfeeding duration (F=4.12, p=.009), and in knowledge of food allergies based on mixed feeding (F=3.11, p=.049). Health information literacy showed significant relationships with education level (F=3.76, p=.026), occupation (F=3.99, p=.021), checking nutritional information (t=2.91, p=.004), mixed feeding (F=4.50, p=.014), and atopic dermatitis diagnosis (t=6.86, p=.001). Significant positive correlations were observed between atopic dermatitis knowledge, food allergy knowledge, and health information literacy. @*Conclusion@#Personalized educational programs should be implemented to improve awareness of allergies and health information literacy among North Korean refugee mothers, which would help them find, evaluate, and understand health-related information. These programs should focus on providing nutrition and dietary education to promote healthy growth in children and prevent diseases.

Knowledge, confidence, and educational needs of newborn care among North Korean refugee women: a descriptive study

Purpose@#North Korean refugee women struggle with the double burden of adaptation and parenting as mothers in a new environment. This study aimed to identify the knowledge, confidence, and educational needs regarding newborn care among North Korean refugees, and to determine differences between these variables according to participants' characteristics. @*Methods@#Data were collected from September to October 2022, and 150 North Korean refugee women recruited using convenience sampling participated in the study. Descriptive statistics, the t-test, analysis of variance, and Pearson correlation analysis were used for data analysis. @*Results@#The mean scores were as follows: parenting knowledge, 14.97 out of 25; infection prevention knowledge and confidence, 20.09 out of 33 and 51.37 out of 80, respectively; and educational needs, 245.86 out of 310. Significant differences were observed in newborn care, knowledge, and confidence according to maternal age, educational level, family structure, and pregnancy history. Significant positive correlations were observed between the participants' newborn care knowledge, confidence, and educational needs. @*Conclusion@#Personalized educational programs should be implemented to enhance North Korean refugee women's confidence in newborn care, focusing on areas with low knowledge levels and high educational needs and enabling women to achieve healthy pregnancy and childbirth, and to parent well.

Effects of parenting education programs for refugee and migrant parents: a systematic review and meta-analysis

Purpose@#This systematic review and meta-analysis investigated the effects of parenting education programs (PEPs) for refugee and migrant parents. @*Methods@#A systematic review was conducted according to PRISMA guidelines. Relevant studies published from 2000 to 2020 were identified through a systematic search of six electronic databases (PubMed, Embase, Cochrane Library, CINAHL, RISS, KMBASE). A meta-analysis of the studies was then undertaken. @*Results@#Of the 14,996 published works identified, 23 studies satisfied the inclusion criteria, and 19 studies were analyzed to estimate the effect sizes (standardized mean differences) of the PEPs using random-effect models. PEPs were effective for parenting efficacy (effect size [ES]=1.40; 95% confidence interval [CI]: 1.14-1.66), positive parenting behaviors (ES=0.51; 95% CI: 0.30-0.73), parent-child relationships (ES=0.38; 95% CI: 0.22-0.53), and parenting stress (ES=0.64; 95% CI: 0.50-0.79). There were statistically significant differences in the effect sizes of PEPs that included mothers only (ES=0.93), included children under 7 years of age(ES=0.91), did not include child participation (0.77), continued for 19 or more sessions (ES=0.80), and were analyzed in quasi-experimental studies (ES=0.86). The overall effect of publication bias was robust. @*Conclusion@#PEPs were found to be effective at improving parenting efficacy, positive parenting behaviors, parent-child relationships, and parenting stress.

Clinical Significance of Redundant Nerve Roots of the Cauda Equina in Spine MRI

Purpose@#This study aimed to evaluate the association of redundant nerve roots of the cauda equina (RNRCEs) with the degree and duration of symptoms in patients with lumbar spinal canal stenosis. @*Materials and Methods@#Between January 2017 and December 2018, 224 patients demonstrating central canal stenosis on lumbar spine MRI were included. Various imaging findings associated with spinal canal stenosis were investigated, as were the presence, level, type, and length of RNRCEs, and the presence of nerve root swelling. Clinically, the degree of symptoms and symptom changes after treatment were investigated. Multinomial logistic regression was used for statistical analysis. @*Results@#RNRCEs were present in 142 patients (63.4%). Most RNRCEs were observed above the level of stenosis (47.3%). RNRCE was associated with the number of stenoses and symptom duration (p < 0.05). The presence, level, type, and length of RNRCE and nerve root swelling significantly affected the severity of symptoms (p < 0.05). The type of treatment influenced symptom changes (p < 0.05). @*Conclusion@#The recognition and assessment of RNRCEs on spinal MRI are clinically important because the presence, level, type, and length of a RNRCE may be associated with the degree of symptoms and help predict the clinical outcome according to treatment methods.

Malignant Tenosynovial Giant Cell Tumor Presenting as an Extra-Articular Superficial Soft-Tissue Mass in a Knee

Malignant tenosynovial giant cell tumor (TsGCT) is a rare disease that can arise as a recurrent lesion or co-exist with a benign TsGCT lesion. Here we report a rare case of malignant TsGCT in a 73-year-old male with a history of lymphoma. The tumor appeared as a superficial soft-tissue mass in the subcutaneous fat tissue of the left knee.

Transiting Nerve Rootlet Abnormalities on MRI after Lumbar Laminectomy: Associations with Persistent Postoperative Pain

Objective@#To determine whether changes in the transiting nerve rootlet or its surroundings, as seen on MRI performed after lumbar hemilaminectomy, are associated with persistent postoperative pain (PPP), commonly known as the failed back surgery syndrome. @*Materials and Methods@#Seventy-three patients (mean age, 61 years; 43 males and 30 females) who underwent single-level partial hemilaminectomy of the lumbar spine without postoperative complications or other level spinal abnormalities between January 2010 and December 2018 were enrolled. Two musculoskeletal radiologists evaluated transiting nerve rootlet abnormalities (thickening, signal alteration, distinction, and displacement), epidural fibrosis, and intrathecal arachnoiditis on MRI obtained one year after the operations. A spine surgeon blinded to the radiologic findings evaluated each patient for PPP. Univariable and multivariable analyses were used to evaluate the association between the MRI findings and PPP. @*Results@#The presence of transiting nerve rootlet thickening, signal alteration, and ill-distinction was significantly different between the patients with PPP and those without, for both readers (p ≤ 0.020). Conversely, the presence of transiting nerve rootlet displacement, epidural fibrosis, and intrathecal arachnoiditis was not significantly different between the two groups (p ≥ 0.128). Among the above radiologic findings, transiting nerve rootlet thickening and signal alteration were the most significant findings in the multivariable analyses (p ≤ 0.009). @*Conclusion@#On MRI, PPP was associated with transiting nerve rootlet abnormalities, including thickening, signal alterations, and ill-distinction, but was not associated with epidural fibrosis or intrathecal arachnoiditis. The most relevant findings were the nerve rootlet thickening and signal alteration.

Development and effects of a psychosocial adaptation program for North Korean adolescent defectors

Purpose@#This study aimed to develop and examine the effects of a psychosocial adaptation program for North Korean adolescent defectors. @*Methods@#This quasi-experimental study was conducted with 28 North Korean adolescent defectors who were recruited through alternative schools. The experimental and control groups consisted of 14 participants each. A program was conducted across eight sessions, each lasting about 90-120 minutes. The data were analyzed using the x2 test, t-test, paired t-test, and analysis of covariance. @*Results@#No significant differences were observed in the score changes for psychosocial adaptation (t=0.25, p=.808), post-traumatic stress symptoms (t=0.32, p=.749), cultural adaptation stress (t=0.05, p=.957), and self-efficacy (t=0.35, p=.726) in either group before and after the intervention. No intergroup differences were observed for psychosocial adaptation (t=0.12, p=.902), post-traumatic stress symptoms (t=0.07, p=.946), cultural adaptation stress (t=0.01, p=.994), and self-efficacy (t=0.58, p=.570). @*Conclusion@#These findings suggest that psychosocial adaptation, stress, and self-efficacy cannot be improved by a short-term intervention program alone. It was also determined that the cultural characteristics of the North Korean adolescent defectors were not sufficiently considered before implementing the program. Therefore, it is essential to provide an in-depth orientation for the participants before implementing the program.

Influence of parenting efficacy, parenting stress, and acculturation stress on parent-child relations among North Korean refugee mothers

Purpose@#This study assessed the levels of parenting efficacy, parenting stress, and acculturation stress of North Korean refugee mothers and analyzed their effects on parent-child relations. @*Methods@#A descriptive study design was used. Data were collected during 2019, and 124 North Korean refugee mothers participated. @*Results@#The mean score for parenting efficacy was 53.08 out of 90, that for parent-child relations was 37.84 out of 50, and that for parenting stress was 48.57 out of 90. The parental stress score was higher than that of child-related stress. The acculturation stress level was 90.66 out of 165, with the highest stress levels found for social isolation and distrust and the lowest found for perceived discrimination. Parenting efficacy, parenting stress, acculturation stress, and parent-child relations were significantly related in North Korean refugee mothers. Hierarchical regression analysis showed that the final model had an explanatory power of 35% for parent-child relations (F=17.68, p<.001). Parenting efficacy was the variable with the largest effect on parent-child relations (β=.36, p<.001), followed by parenting stress (β=-.24, p=.010). @*Conclusion@#The findings suggest the need to identify ways to decrease parenting stress and improve parenting efficacy. Parenting education can guide North Korean refugee mothers to strengthen their parent-child interactions.

Osteonecrosis of the Femoral Head in Korean Patients with Human Immunodeficiency Virus Infection

Background@#Osteonecrosis of the femoral head (ONFH) is a disabling condition that often necessitates total hip arthroplasty (THA). Although ONFH occurs more frequently among patients with human immunodeficiency virus (HIV) than among the general population, there is little epidemiological information regarding ONFH in Korean patients with HIV. In the present study, we aimed to investigate the incidence and clinical features of ONFH among Korean patients with HIV. @*Materials and Methods@#In this retrospective study, we reviewed the medical records of 1,250 Korean patients with HIV treated from January 1990 to December 2019. A standardised data collection sheet was used to obtain clinical information. Imaging data were analysed by a radiologist in accordance with the 2019 revised version of the Association Research Circulation Osseous (ARCO) staging system for ONFH. @*Results@#Among the 1,250 included patients, 13 patients (1.04%; 3 women, 10 men) were diagnosed with ONFH. The overall incidence of ONFH was 1.29 per 1,000 person-years (PYs) (95% confidence interval [CI]: 0.7 – 2.4 per 1,000 PYs). Median age among the 13 patients with ONFH was 47 years (interquartile range [IQR]: 41 – 57 years). The median duration since HIV diagnosis was 4.8 years (IQR: 2.3 – 10.1 years). The median CD4 cell count at the time of ONFH diagnosis was 381 cells/ mm3 (IQR: 161 – 551 cells/mm3 ). At the initial diagnosis of ONFH, 83.3% of patients exhibited bilateral involvement. ARCO stage 3 or 4 osteonecrosis was observed in 83% of patients. Among 22 hips, stage 1 ONFH was noted in 2 (9.1%), stage 2 ONFH was noted in 7 (31.8%), stage 3 ONFH was noted in 9 (40.9%), and stage 4 ONFH was noted in 4 (18.2%). THA was eventually performed in 84.6% of patients.Five (38.5%) patients had a history of steroid use, 4 (30.8%) patients had a history of alcohol abuse and 10 (76.9%) were smokers. Eight (61.5%) patients had a history of acquired immune deficiency syndrome-defining illness, including 7 with tuberculosis and 1 with pneumocystis pneumonia. Nine patients (69.2%) had a nadir CD4 cell count <200/µL, and 3 (23.1%) had a history of bone fracture. Overall, 84% of patients were exposed to antiretroviral therapy, while 54% had taken protease inhibitors for more than 1 year. @*Conclusion@#Considering that relatively high incidence of ONFH in patients with HIV, a high index of suspicion for those with risk factors and those with groin or hip pain for is required in HIV-infected patients.

Spine Computed Tomography to Magnetic Resonance Image Synthesis Using Generative Adversarial Networks : A Preliminary Study

Objective@#: To generate synthetic spine magnetic resonance (MR) images from spine computed tomography (CT) using generative adversarial networks (GANs), as well as to determine the similarities between synthesized and real MR images. @*Methods@#: GANs were trained to transform spine CT image slices into spine magnetic resonance T2 weighted (MRT2) axial image slices by combining adversarial loss and voxel-wise loss. Experiments were performed using 280 pairs of lumbar spine CT scans and MRT2 images. The MRT2 images were then synthesized from 15 other spine CT scans. To evaluate whether the synthetic MR images were realistic, two radiologists, two spine surgeons, and two residents blindly classified the real and synthetic MRT2 images. Two experienced radiologists then evaluated the similarities between subdivisions of the real and synthetic MRT2 images. Quantitative analysis of the synthetic MRT2 images was performed using the mean absolute error (MAE) and peak signal-to-noise ratio (PSNR). @*Results@#: The mean overall similarity of the synthetic MRT2 images evaluated by radiologists was 80.2%. In the blind classification of the real MRT2 images, the failure rate ranged from 0% to 40%. The MAE value of each image ranged from 13.75 to 34.24 pixels (mean, 21.19 pixels), and the PSNR of each image ranged from 61.96 to 68.16 dB (mean, 64.92 dB). @*Conclusion@#: This was the first study to apply GANs to synthesize spine MR images from CT images. Despite the small dataset of 280 pairs, the synthetic MR images were relatively well implemented. Synthesis of medical images using GANs is a new paradigm of artificial intelligence application in medical imaging. We expect that synthesis of MR images from spine CT images using GANs will improve the diagnostic usefulness of CT. To better inform the clinical applications of this technique, further studies are needed involving a large dataset, a variety of pathologies, and other MR sequence of the lumbar spine.

Clinical Efficacy of Real-Time Sonoelastography for the Follow-Up of Congenital Sternocleidomastoid Muscle Torticollis

PURPOSE@#To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity.@*MATERIALS AND METHODS@#Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis.@*RESULTS@#Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor.@*CONCLUSION@#RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

Osteonecrosis of the Femoral Head in Korean Patients with Human Immunodeficiency Virus Infection

Background@#Osteonecrosis of the femoral head (ONFH) is a disabling condition that often necessitates total hip arthroplasty (THA). Although ONFH occurs more frequently among patients with human immunodeficiency virus (HIV) than among the general population, there is little epidemiological information regarding ONFH in Korean patients with HIV. In the present study, we aimed to investigate the incidence and clinical features of ONFH among Korean patients with HIV. @*Materials and Methods@#In this retrospective study, we reviewed the medical records of 1,250 Korean patients with HIV treated from January 1990 to December 2019. A standardised data collection sheet was used to obtain clinical information. Imaging data were analysed by a radiologist in accordance with the 2019 revised version of the Association Research Circulation Osseous (ARCO) staging system for ONFH. @*Results@#Among the 1,250 included patients, 13 patients (1.04%; 3 women, 10 men) were diagnosed with ONFH. The overall incidence of ONFH was 1.29 per 1,000 person-years (PYs) (95% confidence interval [CI]: 0.7 – 2.4 per 1,000 PYs). Median age among the 13 patients with ONFH was 47 years (interquartile range [IQR]: 41 – 57 years). The median duration since HIV diagnosis was 4.8 years (IQR: 2.3 – 10.1 years). The median CD4 cell count at the time of ONFH diagnosis was 381 cells/ mm3 (IQR: 161 – 551 cells/mm3 ). At the initial diagnosis of ONFH, 83.3% of patients exhibited bilateral involvement. ARCO stage 3 or 4 osteonecrosis was observed in 83% of patients. Among 22 hips, stage 1 ONFH was noted in 2 (9.1%), stage 2 ONFH was noted in 7 (31.8%), stage 3 ONFH was noted in 9 (40.9%), and stage 4 ONFH was noted in 4 (18.2%). THA was eventually performed in 84.6% of patients.Five (38.5%) patients had a history of steroid use, 4 (30.8%) patients had a history of alcohol abuse and 10 (76.9%) were smokers. Eight (61.5%) patients had a history of acquired immune deficiency syndrome-defining illness, including 7 with tuberculosis and 1 with pneumocystis pneumonia. Nine patients (69.2%) had a nadir CD4 cell count <200/µL, and 3 (23.1%) had a history of bone fracture. Overall, 84% of patients were exposed to antiretroviral therapy, while 54% had taken protease inhibitors for more than 1 year. @*Conclusion@#Considering that relatively high incidence of ONFH in patients with HIV, a high index of suspicion for those with risk factors and those with groin or hip pain for is required in HIV-infected patients.

Prognostic Indicators of Extremity Liposarcoma / 대한정형외과학회잡지

Purpose@#The aim of this retrospective study was to define the prognostic factors for liposarcoma to aid in the selection of effectivetreatments. @*Materials and Methods@#This study analyzed 41 cases out of 45 cases diagnosed with and treated for liposarcoma 2002 to 2015; 4 casesof well-differentiated liposarcoma were excluded. The effects of sex, age, site, stage, and histological classification on survival wereanalyzed retrospectively. For 28 cases diagnosed with myxoid liposarcoma, additional analysis was performed after the inclusion of roundcell components. @*Results@#The mean age at diagnosis was 52.05 years (range 25–82 years) and the average follow-up period was 63.7 months. The diseasefreesurvival rate was 43.2%. Most factors, including sex and age, were not significantly associated with the survival rate. On the otherhand, the stage (Musculoskeletal Tumor Society stage) was significantly associated with the survival rate. The survival rate of patients withmyxoid liposarcoma was 69% and the local recurrence and metastasis results varied according to the presence of round cells. @*Conclusion@#The stage of liposarcoma and the sex of the patient were found to be effective factors for prognosis. When planning thetreatment for liposarcoma, the treatment outcome for liposarcoma differs according to several prognostic factors.

Treatment of Enchondroma in the Hands and Feet / 대한정형외과학회잡지

Purpose@#The purpose of this study was to suggest an appropriate treatment method by comparing nonsurgical treatment and surgical treatment for enchondroma in the hands and feet. @*Materials and Methods@#Seventy four cases with enchondroma of the hands and feet from January 1996 to March 2017 were selected to evaluate the functional outcomes. Thirty cases were treated with nonsurgical treatment, and 44 cases were treated with surgical treatment, such as curettage only or curettage with a bone graft. The mean follow-up period was 18.1 months. The functional results were analyzed using the Wilhelm and Feldmeier formula. @*Results@#The mean age was 38 years, and the age range was between eight and 69 years. According to the Wilhelm and Feldmeier formula, the mean score of hand enchondroma was 3.09±0.85 and 3.20±0.91 in the non-operative and operative group, respectively. The mean scores of the foot except for the grip strength were 2.57±0.79 and 2.75±0.50, respectively. No significant difference was observed according to the functional results. Among the 18 cases of enchondroma with pathological fractures, nine cases were treated non-surgically and nine cases were treated by surgically. In all 18 cases, complete bone healing was observed at the final follow-up. @*Conclusion@#Relatively satisfactory results were obtained in both surgical and nonsurgical treatment and there was no significant difference in functional outcomes. In cases of enchondroma in the hands and feet, nonsurgical treatment can also be a good treatment option.

The Related Factors to Urgent Disease in Triaging Patients with Acute Abdominal Pain in Emergency Department

PURPOSE: Abdominal pain is the most common symptom of patients visiting the emergency department (ED). Abdominal pain is caused by a variety of causes, so it is difficult for a triage nurse to determine the urgency of a patient, but it is still a must. The purpose of this study was to identify the related factors to the urgent diseases of patients with abdominal pain visiting ED.METHODS: This study was a retrospective descriptive study. The study setting was an ED in a tertiary hospital in Korea. Data were collected from September 1, 2017 to October 15, 2017. During the study period, of a total of 6,181 patients visiting the ED, 731 complained of abdominal pain. Patients with obvious cause of pain and patients who could not express detailed symptoms were excluded. The 573 patients were included in the final analysis. We collected demographics, clinical characteristics, and final diagnosis. We divided final diagnoses into urgent diseases which were more likely to be life-threatening without treatment and non-urgent diseases. We identified the related factors to the urgent diseases of patients with abdominal pain using the logistic regression.RESULTS: 173 (30.2%) patients had urgent diseases. Age (OR=1.02, 95% CI=1.00~1.03), referral from other clinics (OR=2.92, 95% CI=1.86~4.60), ambulance utilization (OR=2.00, 95% CI=1.27~3.15), diarrhea (OR=0.44, 95% CI=0.25~0.76), and tachycardia (OR=2.27, 95% CI=1.44~3.58) were related to urgent diseases.CONCLUSION: Triage nurse should take into account the patient's age, mode of visiting, and route of visiting ED; and check the symptom of tachycardia or diarrhea.

Cervical Spine CT Using Spectral Shaping: Can It Be a Solution to Overcome Artifacts in the Lower Cervical Spinal Region?

OBJECTIVE: To investigate the image quality, radiation dose, and intermodality agreement of cervical spine CT using spectral shaping at 140 kVp by a tin filter (Sn140-kVp) in comparison with those of conventional CT at 120 kVp. MATERIALS AND METHODS: Patients who had undergone cervical spine CT with Sn140-kVp (n = 58) and conventional 120 kVp (n = 49) were included. Qualitative image quality was analyzed using a 5-point Likert scale. Quantitative image quality was assessed by measuring the noise and attenuation within the central spinal canals at C3/4, C6/7, and C7/T1 levels. Radiation doses received by patients were estimated. The intermodality agreement for disc morphology between CT and MRI was assessed at C3/4, C5/6, C6/7, and C7/T1 levels in 75 patients who had undergone cervical spine MRI as well as CT. RESULTS: Qualitative image quality was significantly superior in Sn140-kVp scans than in the conventional scans (p < 0.001). At C7/T1 level, the noise was significantly lower and the decrease in attenuation was significantly less in Sn140-kVp scans, than in the conventional scans (p < 0.001). Radiation doses were significantly reduced in Sn140-kVp scans by 50% (effective dose: 1.0 ± 0.1 mSv vs. 2.0 ± 0.4 mSv; p < 0.001). Intermodality agreement in the lower cervical spine region tended to be better in Sn140-kVp acquisitions than in the conventional acquisitions. CONCLUSION: Cervical spine CT using Sn140-kVp improves image quality of the lower cervical region without increasing the radiation dose. Thus, this protocol can be helpful to overcome the artifacts in the lower cervical spine CT images.

Erratum: Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children

No abstract available.

A Rare Manifestation of Solitary Primary Bone Lymphoma of the Finger: a Case Report

Primary extranodal bone lymphoma involving the peripheral extremities is extremely rare. Here, we report a definitive case of diffuse large B-cell lymphoma involving the phalangeal bone of the 3rd finger. Systemic evaluation revealed the lesion as the only site of lymphoma involvement.

Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children

BACKGROUND/OBJECTIVES: Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS: The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS: The subjects' TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and −1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS: The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.