Ultrasonographic identification of lateral femoral cutaneous nerve anatomical variation in persistent meralgia paresthetica: A case report.

BACKGROUND: Meralgia paresthetica (MP) is an entrapment mononeuropathy of the lateral femoral cutaneous nerve (LFCN). Although structural abnormalities in nerve tissues can be confirmed using ultrasonography, this is not routinely performed. CASE SUMMARY: Herein, we present the case of a 52-year-old woman who developed MP after laparoscopic gynecological surgery. The patient was referred to our clinic from an obstetrics and gynecology clinic with symptoms of numbness and a tingling sensation in the left anterolateral thigh, which developed after surgery performed 5 mo earlier. Tests were performed to assess the disease status and determine the underlying causes. Ultrasonographic examination revealed an anatomical variation, where the left LFCN was entrapped within the inguinal ligament. This case suggests that performing ultrasonographic examination before and after surgery in the lithotomy position could help prevent MP. CONCLUSION: This case demonstrates the value of ultrasonography in detecting anatomical variation and diagnosing persistent MP. Ultrasonography should be considered an adjunct to electromyography for optimal MP management. Further, this case would help other clinicians determine patient prognosis and decide on targeted treatment strategies.

Enzyme-Immobilized Chitosan Nanoparticles as Environmentally Friendly and Highly Effective Antimicrobial Agents.

Highly effective and minimally toxic antimicrobial agents have been prepared by immobilizing glucose oxidase (GOx) onto biocompatible chitosan nanoparticles (CS-NPs). CS-NPs were prepared via ionotropic gelation and used for the immobilization of GOx via approaches of covalent attachment (CA), enzyme coating (EC), enzyme precipitate coating (EPC), and magnetic nanoparticle-incorporated EPC (Mag-EPC). EPC represents an approach consisting of enzyme covalent attachment, precipitation, and cross-linking, with CA and EC being control samples while Mag-EPC was prepared by mixing magnetic nanoparticles (Mag) with enzymes during the preparation of EPC. The GOx activities of CA, EC, EPC, and Mag-EPC were 8.57, 17.7, 219, and 247 units/mg CS-NPs, respectively, representing 26 and 12 times higher activity of EPC than those of CA and EC, respectively. EPC improved the activity and stability of GOx and led to good dispersion of CS-NPs, while Mag-EPC enabled facile magnetic separation. To demonstrate the expandability of the EPC approach to other enzymes, bovine carbonic anhydrase was also employed to prepare EPC and Mag-EPC samples for their characterizations. In the presence of glucose, EPC of GOx generated H2O2 in situ, which effectively inhibited the proliferation of Staphylococcus aureus in both suspended cultures and biofilms, thereby demonstrating the potential of EPC-GOx as environmentally friendly and highly effective antimicrobial materials.

The effect of glenohumeral internal rotation deficit on the isokinetic strength, pain, and quality of life in male high school baseball players.

OBJECTIVE: To investigate the effects of glenohumeral internal rotation deficit (GIRD) on the isokinetic strength, body pain, and the quality of life in male high school baseball players of Korea. METHODS: Fifty-six male high school baseball players were divided into either group A (GIRD≥20°, n=12) or group B (GIRD<20°, n=44). The range of motion in the shoulder and the isokinetic strength were measured. Questionnaires were administered regarding the body pain location by using the visual analogue scale, and the quality of life was measured by using the SF-36 Form. RESULTS: All subjects had increased external rotation range of motion and decreased internal rotation in the throwing shoulder. The incidence of GIRD (≥20°) was 21.43% in the present study. In the isokinetic strength test, a significantly weaker muscular state at an angular velocity of 180°/s was observed in group A, compared to group B. For the comparison of the pain, the frequency of shoulder pain was higher (33.93%) than other body pain, among the study subjects. CONCLUSION: GIRD is one of the main risk factors of glenohumeral joint damage, and it is correlated with reduced isokinetic strength and quality of life. High school baseball players will need appropriate shoulder rehabilitation programs for the improvement in their quality of life and performance.

Sonography of the median nerve in carpal tunnel syndrome with diabetic neuropathy.

OBJECTIVE: The aim of this study was to determine the criteria for ultrasonographic measurement of the cross-sectional area (CSA) of the median nerve and differential diagnosis of patients with carpal tunnel syndrome (CTS) with or without diabetic polyneuropathy (DPN). DESIGN: One hundred eighty-seven patients were divided into five groups: healthy controls, CTS, diabetes with CTS but without DPN, DPN only, and both DPN and CTS. The CSAs of the median nerve were measured at four levels, and cutoff values to diagnose CTS with DPN were obtained. RESULTS: All the CSAs were larger in the DPN group compared with those in the control group. The CSAs of the median nerve at the wrist revealed no significant differences among the groups with CTS; however, these groups demonstrated larger CSAs at the wrist and a higher wrist/forearm ratio compared with the DPN only group. The cutoff value for the CSA at the wrist that yielded the highest sensitivity and specificity was 11.6 mm. CONCLUSIONS: The CSA of the median nerve at the wrist and the wrist/forearm ratio could be useful for diagnosing the comorbidity of CTS with DPN.

[Does living nearby a garbage dumping site degrade the quality of life? A case study based on Shin-dong Myeon residents, Chun-cheon Si].

OBJECTIVES: This study aims to examine if a garbage dumping site has real and negative influence on the quality of life (QOL) for the nearby residents. The net effects of the residential distance from the garbage dumping site and from the garbage truck route were investigated for five domains of the QOL. METHODS: Two hundred fifty seven Shin-dong Myeon residents, Chun-cheon Si, participated in a self-administrated survey. The Shin-dong Myeon garbage dumping site began operating in 1996. ANCOVA with generalized linear models and multiple regression analysis were performed. RESULTS: Descriptive analyses show that a residence nearby a garbage dumping site is negatively associated with the physical and environmental domains of the QOL. The residential distance from the garbage truck route does not exert any significant effect on various domains of QOL, except for the environmental domain. On the multivariate analysis, the residents living near the garbage dumping site tended to have a significantly negative QOL in the physical and environmental domains. However, the distance from the garbage truck route did not show a significant nor substantial effect on the QOL. The demographic and socioeconomic control variables are associated with a number of the QOL domains, and their patterns are consistent with the general expectations. CONCLUSIONS: The results indicated that a garbage dumping site is considered to be an environmental hazard among the nearby residents according to the lower scores on the physical and environmental domains of the QOL. The findings from this study provide comprehensive\ understanding on the residents' QOL, and they may help politicians and policy makers make decisions for appropriate interventions.