• 제목/요약/키워드: Articular branch

검색결과 9건 처리시간 0.021초

족부와 족관절에서의 신경내 결절종 (Intraneural Ganglion Cyst in Foot and Ankle)

  • 최장석;김광희;곽지훈;박홍기;이신우
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.223-231
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    • 2011
  • Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

유산양에서 관절염.뇌염 발생 (Outbreak of carprine arthritis-encephalitis in dairy goat flocks)

  • 손소연;류대열;손현수;강신석;박재명;변현섭;최해연
    • 한국동물위생학회지
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    • 제29권3호
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    • pp.309-316
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    • 2006
  • This is a case report on the occurrence of caprine arthritis-encephalitis (CAE) disease among dairy goats in a local farm located in Yeongdong-gun, Chungbuk. Previously, it was reported that the farm experienced intermittent deaths numbering 15 of the 97 goats raised for 5 months. Most of the goats less than 6 months of age were suffering from ataxia and posterior paresis, body tremor and abnormal head posterior. Affected animals frequently had stunted growth and had a rough coat. Goats more than 6 months of age were affected with an insidious, chronic arthritis characterized by articular swelling ('big knee') of the carpal, hock, and stifle joints. Necropsy revealed severely swollen mesenteric lymph nodes, under- flow of 2-3ml synovial fluid in the articular space and fibrous proliferation of synovial membrane. Histopathological examination showed perivascular accumulations of mononuclear inflammatory cells in the white matter of the brain, proliferative synovitis characterized by villous hypertrophy, synovial cell hyperplasia and infiltration by mononuclear inflammatory cells. Pulmonary lesions consists of patchy interstitial pneumonia with hyperplasia of lymphoid tissues and an extensive mononuclear inflammatory cell infiltration into the alveolar septa. Confirmation by nested PCR involves amplification of a 296 bp (lst PCR) and 184 bp (2nd PCR) fragments corresponding to the gag region of the CAE virus. This is the first time CAE has been reported in a local farm in Korea and emphasizes the importances of developing preventive measures against CAE.

초음파 유도하에서의 요추부 후관절 내측지 차단술을 위한 주요 척추 구조물의 거리 측정 (Ultrasound-guided Distance Measurements of Vertebral Structures for Lumbar Medial Branch Block)

  • 문진천;심재광;조광연;윤경봉;김원옥;윤덕미
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.111-115
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    • 2007
  • Background: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an altemative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. Methods: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process, We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). Results: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. Conclusions: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.

Survey of Sonoanatomic Distances For Lumbar Medial Branch Nerve Blocks in Healthy Volunteers

  • Gharaei, Helen;Imani, Farnad;Solaymani-Dodaran, Masoud
    • The Korean Journal of Pain
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    • 제27권2호
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    • pp.133-138
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    • 2014
  • Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3-L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P < 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P < 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.

Malignant Neoplasm Prevalence in the Aktobe Region of Kazakhstan

  • Bekmukhambetov, Yerbol;Mamyrbayev, Arstan;Jarkenov, Timur;Makenova, Aliya;Imangazina, Zina
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8149-8153
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    • 2016
  • An oncopathological state assessment was conducted among adults, children and teenagers in Aktobe region for 2004-2013. Overall the burden of mortality was in the range of 94.8-100.2 per 100,000 population, without any obvious trend over time. Ranking by pathology, the highest incidences among women were registered for breast cancer (5.8-8.4), cervix uteri (2.9-4.6), ovary (2.4-3.6) and corpus uteri, stomach, esophagus, without any marked change over time except for a slight rise in cervical cancer rates. In males, the first place in rank was trachea, bronchus and lung, followed by stomach and esophagus, which are followed by bladder, lymphoid and hematopoietic tissues pathology. Agian no clear trends were apparent over time. In children, main localizations in cancer incidence blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin's disease), brain and central nervous system, bones and articular cartilages, kidneys, and eye and it's appendages, in both sexes. Similarly, in young adults, the major percentage was in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin's disease) a significant percentage accruing to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. This initial survey provides the basis for more detailed investigation of cancer epidemiology in Aktobe, Kazakhstan.

신경 성형술 후 초음파 유도하 내측 분지 차단술의 유용성 (Benefit of Ultrasound-guided Therapeutic Medial Branch Blocks after Percutaneous Epidural Neuroplasty)

  • 문상호;이송;정재현;신원식
    • 대한정형외과 초음파학회지
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    • 제7권1호
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    • pp.33-38
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    • 2014
  • 목적: 신경성형술로 치료한 추간판 탈출증 환자들 중 호전되지 않은 환자들을 대상으로 초음파 유도하 내측 분지 차단술을 시행하여 치료적으로 유용한가를 분석하고자 하였다. 대상 및 방법: 2011년 11월에서 2013년 2월까지 추간판 탈출증으로 신경성형술을 받은 만성 요통 환자 559명 중 시술후에도 요통 혹은 하지 연관통 증상을 보여, 초음파 유도하 내측 분지 차단술을 시행받고 1개월 추시가 가능하였던 88명과 이 중 6개월 추시가 가능하였던 39명의 환자들을 대상으로 하였다. 한 명의 의사가 모든 증례를 시술하였으며 방사선 피폭의 위험을 없애고자 방사선 투시 하가 아닌, 초음파 유도하에 23 G, 10 cm 주사 바늘을 삽입하고 약제를 주사하였다. 내측 분지를 목표로 하기 위하여 횡축 영상에서 상 관절 돌기와 횡 돌기의 교차점에 바늘이 놓이도록 하였다. 시술 후 각 시점에서 Visual Analog Scale (VAS) score와 Oswestry Disability Index (ODI)를 측정하여 시술 전과 통증의 정도와 기능의 변화를 비교 분석하였다. 의미 있는 통증 및 기능의 호전 기준은 VAS 50% 이상의 감소, ODI 40% 이상의 감소를 기준으로 하였다. 결과: 시술 전 VAS는 평균 $7.35{\pm}1.68$점, ODI는 평균 $32.82{\pm}8.77$점이었다. 이에 대하여 시술 후 1개월에 VAS는 평균 $3.36{\pm}2.98$점, ODI는 평균 $15.14{\pm}14.01$점으로 의미있게 감소하였으며(p<0.05) 시술후 6개월에는 VAS는 평균 $3.05{\pm}2.27$점, ODI는 평균 $12.97{\pm}8.82$점으로 의미있게 감소하였다(p<0.05). 1개월 군에서는 통증이 64.49%에서 의미있게 감소하였으며 59.81%에서 기능이 유의하게 향상되었다. 3개월 군에서는 통증이 64.10%에서 의미있게 호전되었고 61.54%에서 의미있게 기능이 향상되었다. 결론: 초음파 유도하 내측 분지 차단술은 추간판 질환으로 인해 이차적으로 발생한 후방 관절의 문제에 대한 치료로서 효과적이라고 생각한다.

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Anatomical Observation on Components Related to Foot Gworeum Meridian Muscle in Human

  • Park, Kyoung-Sik
    • 대한한의학회지
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    • 제32권3호
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    • pp.1-9
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    • 2011
  • Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

The Incidence of Malignant Tumors in Environmentally Disadvantaged Regions of Kazakhstan

  • Mamyrbayev, Arstan;Djarkenov, Timur;Dosbayev, Askar;Dusembayeva, Nailya;Shpakov, Anatolyi;Umarova, Gulmira;Drobchenko, Yelena;Kunurkulzhayev, Temirgali;Zhaylybaev, Mukhtar;Isayeva, Gulnar
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5203-5209
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    • 2016
  • Objective: To explore the prevalence of malignant tumors in the adult population through 2003-2014 in parts of the Aral Sea region: a zone of ecological disaster, a zone of ecological crisis and a zone of precritical conditions. Methods: The long-time average annual levels of cancer morbidity stratified by zones of the Aral Sea region and trends of long-time average annual incidence indicators of malignant tumors were identified. Leading cancer localizations in the adult population was established and associations between cancer incidence and environmental pollution were analyzed. In addition, associations between individual risk factors and cancer incidence in the adult population was established. Correlations between a hazard index and the cancer incidence in the adult population were calculated. Results: In all three Aral Sea regions, as well as in Zhanaarkinskii district, leading cancer in adult population was esophageal, stomach, tracheal, lung, hepatobiliary, and breast. Long-time average annual levels of cancer morbidity in adult population living in the Aral sea region is 1.5 times higher comparing to the control region. In particular, long-time average annual levels of cancer morbidity in adult population living in the zone of ecological disaster was 57.2% higher, in the zone of ecological crisis - 61.9% higher, and in the zone of precritical condition - 16.8% higher. Long-time average annual levels in the adult population of the Aral Sea region significantly exceeded control levels for brain and central nervous system cancer, cancer of bone and articular cartilage, and thyroid cancer. Conclusion: It has was established that the total cancer morbidity depended on the total hazard index associated with the inhalation of nickel and the combined cadmium intake (r=0.8).

요추 및 천추부에 대한 초음파 유도하 중재 시술 (Ultrasound-Guided Injections in the Lumbar and Sacral Spine)

  • 고광표;송재황;김환정;김상범;민영기
    • 대한척추외과학회지
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    • 제25권4호
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    • pp.185-195
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    • 2018
  • 연구 계획: 문헌 조사 목적: 초음파를 이용한 중재 시술은 임상적으로 흔하게 경험할 수 있는 하요추부 통증이 보존적 치료에 실패한 경우 수술적 치료 이전에 흔하게 시행하게 되는 치료이다. 이 연구의 목적은 요추 및 천추부에 대한 초음파 유도하 중재 시술에 대해 고찰해 보고자 함에 있다. 선행 연구문헌의 요약: 초음파를 이용한 중재 요법은 근육, 인대, 건, 혈관, 신경 등의 연부조직을 직접 관찰할 수 있으며, 환자나 시술자에게 방사선 노출이 없고, 컴퓨터 단층 촬영이나 C형 투시검사 장비처럼 넓은 장소를 필요로 하지 않는 장점들을 가지고 있기 때문에 점차 그 사용이 늘고 있다. 대상 및 방법: 요추부의 정상, 비정상 초음파 소견과 요추 및 천추부에서 시행할 수 있는 초음파 유도하 중재 요법에 대하여 문헌 고찰과 함께 기술을 하였다. 결과: 요천추부의 정확한 초음파 중재 시술을 위해서는 검사 시 환자의 자세 및 해부학과 정상, 비정상 초음파 소견 등에 대한 숙지가 필요하다. 초음파를 이용하면 후방 관절 내 주사 및 내측 분지 차단술, 경막외 차단술, 선택적 신경근 차단술, 천장관절 주사를 효과적으로 시행할 수 있다. 결론: 요추 및 천추부에서 초음파 유도하 중재 요법은 요천추부 통증의 치료에서 효과적으로 사용할 수 있는 술기이다.