Optimal parameters and location for diffusion-tensor imaging in the diagnosis of carpal tunnel syndrome: a prospective matched case-control study.

OBJECTIVE: The purpose of this study was to determine the optimal parameters and location for diffusion-tensor imaging in the diagnosis of carpal tunnel syndrome. SUBJECTS AND METHODS: A single 3-T MRI (single-shot echo-planar imaging pulse sequence; b value, 1000 s/mm(2)) and nerve conduction study were performed prospectively for patients with carpal tunnel syndrome and age- and sex-matched control subjects. Fractional anisotropy, apparent diffusion coefficient, radial diffusivity, and parallel diffusivity of the median nerve were measured at the inlet, middle, and outlet of the carpal tunnel and were compared with the nerve conduction study parameters. RESULTS: A total of 50 patients with carpal tunnel syndrome and 50 control subjects were enrolled. Demographic data were comparable between the groups. For all three locations, mean fractional anisotropy increased significantly, and the mean radial diffusivity and apparent diffusion coefficient decreased significantly in carpal tunnel syndrome (p < 0.05). The carpal tunnel inlet had the largest and most consistent changes in diffusion-tensor imaging parameters. Fractional anisotropy measured at the carpal tunnel inlet had the highest diagnostic accuracy, as measured with ROC curves (AUC, 0.82). For a fractional anisotropy threshold of 0.44 or less at the carpal tunnel inlet, sensitivity was 72%; specificity, 82%; positive predictive value, 80%; and negative predictive value, 75%. CONCLUSION: The use of fractional anisotropy measured at the carpal tunnel inlet is optimal for diagnosing carpal tunnel syndrome.

Fluoroscopic cervical paramidline interlaminar epidural steroid injections for cervical radiculopathy: effectiveness and outcome predictors.

OBJECTIVE: The purpose of this study is to analyze the effectiveness of fluoroscopic cervical paramidline interlaminar epidural steroid injection (ESI) as well as to assess outcome predictors. METHODS: One hundred forty-three patients (M:F = 89:54, mean age = 53.1 years old) who received cervical paramidline interlaminar ESIs in 2011 were included in this study. Initial improvements at 2 weeks were assessed. For possible outcome predictors, clinical and MR variables were statistically analyzed using the Mann-Whitney U, Chi-square, and Fisher's exact tests. RESULTS: Initial improvements after cervical paramidline interlaminar ESIs at 2 weeks were reported in 115 of 143 patients (80.8%). Patients with paresthesia only and no pain showed significantly fewer improvements after ESIs (11/19, 57.9%) than patients with pain (104/124, 83.9%) (p = 0.013). Other variables were not statistically significant outcome predictors. CONCLUSIONS: Fluoroscopic paramidline interlaminar cervical ESIs effectively managed cervical radiculopathy, irrespective of the cause or zone of nerve root compression, and patients with paresthesia only experienced fewer improvements.

Intramuscular diffuse-type tenosynovial giant cell tumor of the deltoid muscle in a child.

Tenosynovial giant cell tumors (GCTs) typically form in the joints or extra-articular soft tissues such as the tendon sheath, and are benign tumors that commonly occur in the hands or wrists in the third to fifth decades of life. However, the diffuse type of extra-articular GCT arising within muscle is a rare soft tissue tumor, especially in a pediatric patient. In this report, we describe the magnetic resonance imaging and sonographic findings of a rare case of intramuscular diffuse-type GCT in the deltoid muscle of a 9-year-old boy.

Association of Urine (pH < 5.5) with Community Periodontal Index (CPI) and the Number of Remaining Teeth in Korean Adults: A Cross-Sectional Study Using Data from Korea National Health and Nutrition Examination Survey 2016-2018.

This study aims to determine the association between UpH (<5.5), Community Periodontal Index (CPI), and the number of remaining teeth-cumulative indicators of oral health-using data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES, 2016-2018), which represents the Korean population. Data from 12,689 adults aged 19 years and older who had periodontal examinations were analyzed. Logistic regression analysis was performed after adjusting for demographic, health, and health-related behavioral factors as covariates to determine the association between UpH, CPI, and the number of remaining teeth. This study found that UpH (<5.5) was associated with CPI and the number of remaining teeth. For UpH (<5.5), the odds ratio for CPI (≥4 mm) was 1.19 times (95% CI: 1.06-1.33). The risk of tooth loss was 1.25 times (95% CI: 1.06-1.48) for those with 0-19 remaining teeth and 1.20 times (95% CI: 1.07-1.34) for those with 20-27 teeth. The results revealed an association between UpH, CPI, and the number of remaining teeth. However, further longitudinal research on UpH and oral status is necessary.

Lumbar facet joint injection: feasibility as an alternative method in high-risk patients.

OBJECTIVE: To evaluate the effectiveness of therapeutic facet joint steroid injections for symptoms caused by lumbar spinal stenosis in patients who are at risk of bleeding. METHODS: We analysed 134 patients who had previously undergone one-level bilateral facet joint steroid injections for lumbar radiculopathy caused by spinal stenosis from January 2011 to December 2012. All patients had a bleeding tendency due to several medical conditions. A retrospective chart review was conducted by one radiologist. Response was measured by using a five-point patient satisfaction scale. Evaluations of the relationship between possible outcome predictors were made using the chi-squared or Fisher's exact test, as appropriate. RESULTS: Among the 42 enrolled patients (male/female = 14/28; mean age, 58 years; range, 41-88 years), 25 patients (59.5 %) were classified to have received effective treatment; in 17 patients treatment was classified as ineffective. Eighteen (72 %) of the 25 patients with mild-to-moderate central canal stenosis had symptom relief, and 7 of the 17 (41.2 %) patients with severe central canal stenosis had symptom relief (P < 0.05). Other outcome predictors were not statistically significant. CONCLUSION: Therapeutic facet joint steroid injection is potentially effective for lumbar radiculopathy caused by spinal stenosis. This could be helpful in patients at risk of bleeding. KEY POINTS: • Epidural injection of steroids is a conventional treatment for lumbar radiculopathy. • Facet joint steroid injections showed similar therapeutic effects in lumbar spinal stenosis. • No serious complications, including bleeding, occurred with facet joint injections. • Facet joint steroid injection offers an alternative therapy in patients with bleeding risk.

A Study on the Relationship between Food Security and the Number of Remaining Teeth in Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018.

Food security is important for human health and quality of life. This study investigated the association between food security and the number of remaining teeth in Korean adults. Raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) were analyzed, including data from 13,199 adults aged 19 years or older. The associations between food security and number of teeth were assessed using multiple multinomial logistic regression models after adjusting for demographic and health factors as covariates. In the model adjusted for all socioeconomic, medical, and behavior variables, the odds ratio of tooth loss (16-20 teeth) was 3.80 (95% confidence interval [CI] 1.56-9.21) in the group of people that reported often feeling insecurity regarding various food groups compared to those who reported feeling food security. The results of this study demonstrated an association between food security and the number of remaining teeth in Korean adults. Therefore, food security is essential for improving lifelong oral health.

Association between Healthy Lifestyle (Diet Quality, Physical Activity, Normal Body Weight) and Periodontal Diseases in Korean Adults.

This study aimed to investigate the association between healthy lifestyle (HLS; i.e., diet quality, physical activity, normal weight) and periodontal diseases in Korean adults. Studying this association may help inform future intervention programs aimed at preventing the development of periodontal diseases. Raw data of the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) were used. Data from 12,689 adults aged 19 years and over who had a periodontal examination were analyzed. The associations between HLS and periodontal diseases were analyzed using multivariate logistic regression after adjusting for demographic and health factors as covariates. We found that each of the HLS (diet quality, physical activity, normal body weight) practices was significantly associated with periodontal diseases (OR: 1.32, 95% CI: 1.13-1.55; OR: 1.16, 95% CI: 1.04-1.30; OR: 1.26, 95% CI: 1.14-1.40, respectively). In particular, having poor HLS practices was identified as a risk factor for periodontal diseases (OR: 1.54, 95% CI: 1.10-2.15). HLS was associated with periodontal diseases. Thus, in addition to improving oral hygiene-the primary focus in the past-improving HLS should be emphasized for patients with periodontal diseases.

The Relationship Between Periodontal Disease and Nutrient Intake in Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES VII) from 2016-2018.

PURPOSE: To examine the association between the intake of various nutrients (phosphorus, riboflavin, thiamine, niacin, vitamin C, calcium, protein, carbohydrates, and fat) and the prevalence of periodontal disease in Korean adults. MATERIALS AND METHODS: The data used for analysis were obtained from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Data from 12,689 adults aged ≥ 19 years who had a periodontal examination were analysed. Data were analysed using the Chi2 and t-tests. Multiple regression analysis was used to assess the association between the selected nutrients and periodontal diseases. RESULTS: After adjusting for sex, age, income, body mass index, diabetes, smoking, alcohol consumption, and toothbrushing frequency, a statistically significant relationship between phosphorus, carbohydrate, and fat intake and the risk of periodontal disease was identified by multiple logistic regression analysis (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.66-0.97; OR: 0.85, 95% CI: 0.70-0.98, OR: 1.41, 95% CI: 1.13-1.75, respectively). CONCLUSION: Phosphorus, carbohydrates and fat were associated with periodontal disease. Therefore, the improvement of diet should be emphasised to prevent and manage periodontal disease. Further research is needed based on various nutrients related to periodontal disease in the future.

Factors Influencing Protective Behaviors for Dental Radiation Exposure among Female Korean Dental Hygienists Using Health Belief Model.

This study aimed to identify the associated factors for protective behaviors for dental radiation exposure (PBDRE) among dental hygienists using the health belief model (HBM). The HBM, which is composed of perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, and cues to action, explains preventive behavior. In this study, self-efficacy and modifying factors were additionally applied to the HBM. The subjects of the study were 204 dental hygienists who were working at hospitals or clinics in Korea. An online survey was conducted to measure PBDRE-related factors based on the HBM and self-efficacy. The collected data were analyzed using frequency analysis, t-tests, ANOVA, Pearson's correlation analysis, and hierarchical multiple regression analysis. Regarding modifying factors, performance was found to be high when protection facilities were sufficient (ß = 0.24, p < 0.001) and low when radiation education was not received (ß = -0.16, p < 0.05). Among the HBM factors, cues to action for PBDRE (ß = 0.28, p < 0.001) was the most influential factor in the performance of PBDRE, and the effect of its perceived benefits on radiation exposure was also high (ß = 0.17, p < 0.001). Regarding the performance of PBDRE according to the HBM, providing education programs on protection can stimulate appropriate cues to action to perform PBDRE. In addition, if the benefits of PBDRE are highlighted, the performance of PBDRE by dental hygienists is increased.

The Effects of Prolonged Water-Only Fasting and Refeeding on Markers of Cardiometabolic Risk.

(1) Background: Cardiometabolic disease, including insulin resistance, hyperlipidemia, and hypertension, are major contributors to adverse health outcomes. Fasting has gained interest as a nonpharmacological therapeutic adjunct for these disorders. (2) Methods: We conducted a prospective, single-center study on the effects of prolonged water-only fasting followed by an exclusively whole-plant-food refeeding diet on accepted measures of cardiovascular risk and metabolic health. Participants were recruited from patients who had voluntarily elected to complete a water-only fast in order to improve their overall health according to an established protocol at an independent, residential medical center. Median fasting and refeed lengths were 17 and 8 days, respectively. The primary endpoint was to describe the mean glucose tolerance as indicated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) scores at baseline, end-of-fast (EOF), and end-of-refeed (EOR) visits. Secondary endpoints were to describe the mean weight, body mass index (BMI), abdominal circumference (AC), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid panel, and high-sensitivity C-reactive protein (hsCRP) at the same time points. (3) Results: The study enrolled 48 overweight/obese non-diabetic participants, of which 26 completed the full study protocol. At the EOF visit, the median SBP, AC, low-density lipoprotein (LDL), and hsCRP were decreased and triglycerides (TG) and HOMA-IR scores were increased. Conclusion: Prolonged water-only fasting and whole-plant-food refeeding holds potential as a clinical therapy for cardiometabolic disease but increased TG and HOMA-IR values after refeeding necessitate further inquiry.