Feasibility and reliability of various morphologic features on magnetic resonance imaging for iliotibial band friction syndrome

Background@#To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI). @*Methods@#A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the “study group” and 232 patients without knee pathology on both physical examination and MRI were included in the “control group”. Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a). @*Results@#Patients in the study group had significantly higher lateral epicondyle height (13.9 mm vs. 12.92 mm, P = 0.003), ITB-d (2.9 mm vs. 2.0 mm, P = 0.022), and ITB-a (38.5 mm2 vs. 23.8 mm2 , P < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm2 cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the interreader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent. @*Conclusions@#Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS.

Optimization of MRI Protocol for the Musculoskeletal System

Magnetic resonance imaging (MRI) is an essential modality for the diagnosis of musculoskeletal system defects because of its higher soft-tissue contrast and spatial resolution. With the recent development of MRI-related technology, faster imaging and various image plane reconstructions are possible, enabling better assessment of three-dimensional musculoskeletal anatomy and lesions. Furthermore, the image quality, diagnostic accuracy, and acquisition time depend on the MRI protocol used. Moreover, the protocol affects the efficiency of the MRI scanner. Therefore, it is important for a radiologist to optimize the MRI protocol. In this review, we will provide guidance on patient positioning; selection of the radiofrequency coil, pulse sequences, and imaging planes; and control of MRI parameters to help optimize the MRI protocol for the six major joints of the musculoskeletal system.

Types of Attitudes of Nursing Students in Korea Toward Bucket Lists Q-Methodological Approach / 한국간호교육학회지

PURPOSE: The purpose of this study was to analyze the types of attitudes of nursing students in Korea toward bucket lists. METHODS: The Q-methodology, which provides a method for analyzing the subjectivity of each item was used. From each of the 37 subjects, 34 selected Q-statements were classified into the shape of a normal distribution, using a 9-point scale. The collected data were analyzed using a QUANL PC program. RESULTS: Four types of attitudes toward the bucket list of subjects were identified in Korean nursing students. Typeis a pursuit of money type, Type II is a pursuit of relationship type, Type III is a pursuit of self-centered type, and Type is a pursuit of others-centered type. CONCLUSION: The results of this study indicate that different approaches toward educational programs for students in the human service area are recommended based on the four types of nursing students' attitudes toward the bucket list.

Intraoperative Pulmonary Embolism: A case report / 대한마취과학회지

A 62 year old female patient was transferred to the operating room for open reduction and internal fixation of the left femur fracture under general anesthesia. At 15min. after femur tourniquet application, there were suddenly decreased oxygen saturation, end-tidal CO2 concentration and blood pressure. We suspected a pulmonary embolism, and attempted vigorous emergency treatment and intensive care including ventilator care, vasopressor drug use, pulmonary artery pressure monitoring. At the 5th day after intensive care unit, she was transferred to general ward and she discharged without any sequelae after 17th day postoperatively.

Use of the Cell Saver in Orthopedic Spinal Surgery / 대한마취과학회지

BACKGROUND: Methods to reduce the amount of blood transfusion include perioperative hemodilution, hypotensive anesthesia, the transfusion of previously deposited autologous blood, and intraoperative autotransfusion used the cell saver. The purpose of this study is to evaluate the effect of the use of the cell saver in orthopedic spinal surgery. METHODS: One hundred and one patients for orthopedic spinal surgery were involved in this study and divided into two groups: group 1 (no used cell saver, n=51) and group 2 (used cell saver, n=50). We checked transfusion amounts during operation and the changes of hematocrit after operation. RESULTS: The amount of blood obtained from cell saver apparatus was 1220 +/- 651 ml (mean SD). Hematocrit of the autologous blood from this apparatus was 48.5 +/- 2.5%. Amounts of blood transfusion during operation were 4.1 +/- 0.9 IU (400 ml/IU) in group 1 and 2.5 +/- 0.7 IU in group 2 (p<0.05). The hematocrit was markedly decreased at the postoperative 2 and 3 days in group 2 (p<0.05). CONCLUSIONS: This study suggested that intraoperative salvage technique with cell saver apparatus could decrease the use of bank blood by 40% in orthopedic spinal surgery. However, we should be prepare the blood for the decrease of the hematocrit at the postoperative 2 and 3 days.