• Title/Summary/Keyword: Coccyx

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Reproducibility of Applicator Position with High dose rate brachytherapy in uterine cervical cancer (자궁경부암 환자의 근접치료시 재현성 평가)

  • Kim Jong-Hwa;Son Jung-Hae;Jung Chil;Kim Mi-Hwa
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.29-33
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    • 2003
  • I. Purpose Brachytherapy is the main component in treatment of patients with uterine cervical cancer. The reproducibility of applicator position in the same patient at repeated treatments was very important for accurate dose delivery. It was aimed to evaluate the change of applicator location between each high dose rate(HDR) brachytherapy insertion in the patients with uterine cervical cancer. II. Materials and Methods From January 1999 to October 2001, total 52 patients were treated with external beam radiotherapy and HDR brachytherapy (Microselectron, Nucletron). During six to seven times of brachytherapy, all patients had three treatment plans. From the orthogonal radiographs, we measured the following variables; height from upper border of pubic bone to os (HPO), distance from sacral promontory to tip of tandem (DST), distance from coccyx to os (DCO), distance from tip of right ovoid to os (DRO), distance from tip of left ovoid to os (DLO), and distance from center of the first tandem source to ovoid (DTO). To evaluate the reproducibility of applicator position, it was calculated the standard deviation of differences between three insertions for the 7 parameters in each patient. III. Results The ranges of standard deviations of interfractional differences for the variables were as follows. 1)HPO : $0{\sim}0.79cm$ 2)DST : $0{\sim}0.9cm$ 3)DCO : $0.06{\sim}0.76cm$ 4)DRO : $0{\sim}0.53cm$ 5)DLO : $0{\sim}0.45cm$ 6) DTO $0{\sim}0.36cm$ IV. Conclusions There was some change in applicator position on repeated implants in our study. But variation of the interfractional differences was minimal; in all parameters, there were less than 1 cm. We are continued to try for reducing the geometric variation between each procedure.

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Genetic and Phenetic Differentiation among Three Forms of Korean Salamander Hynobius Ieechii

  • Yang, Suh-Yung;Kim, Jong-Bum;Min, Mi-Sook;Suh, Jae-Hwa;Suk, Ho-Yung
    • Animal cells and systems
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    • v.1 no.2
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    • pp.247-257
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    • 1997
  • Genetic and morphological variations of Korean Hynobius leechii were surveyed. Starch gel electrophoresis was used to study genetic variation at 23 loci. H. leechii is genetically divided into three groups, each of which is named as Form-A, Form-B, and Form-C. These forms are clearly separated with 4-5 fixed or nearly fixed allelic differences. At a sympatry near Jangseong, Jollanam-do, a significant deviation from random mating between Form-A and Form-B was observed. Therefore, they are considered as two distinct taxi of specific rank. Form-A is widely distributed in the inland of Korea, whereas Form-B is distributed in the islands or near the coastal regions of Western and Southern Korea. Form-B had, in addition, a significant morphological difference from Form-A. On the other hand, Form-C was restricted to an area near Kori atomic power plant, Kyongsangnam-do, and the genetic similarities between this form and Form-A and Form-B were 0.742 and 0.736, respectively. Moreover, Form-C had a unique color pattern, short body and small coccyx. Thus, it seems reasonable to assign this form as another new species.

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Evaluating the Predictive Validity for the New Pressure Sores Risk Assessment Scale (수정욕창위험 사정도구의 예측타당도 평가)

  • Kim, Si-Sook;Choi, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.183-190
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    • 2004
  • Purpose: The purpose of this study was To exam the skin and pressure sore and To evaluate the predictive validity for the new pressure sores risk assessment scale. Method: There was finally 211 neurosurgery subject admitted in Chung-Ang Univ. Hospital from Nov, 11, 2002 to Feb, 11, 2003. Data was collected three times per week from 48-72hr after admission until incidence of pressure sores or discharge or die. Inclusion criteria were; (1) no pressure sores at admittance, (2) at least 3 times assessment, (3) adults older than 16yrs, (4) patients consent to participate in study. Result: 1. 34 case of 211 developed pressure sores(11.6%). 2. The coccyx area was the most common occurrence site of pressure sores. 3. At the cutoff point 23 of sensitivity 100%, specificity 76.3% was higher in 2003 than specificity 63.8% at the cutoff point 26 of sencitivity 100% in 1991. 4. "Moisture" of subscale for pressure sores risk factor was the strongest predictor. Conclusion: This study shows that the New Pressure Sores Risk Assessment Scale still predict the risk of developing pressure sores in neurosurgical subject.

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Connective Tissue Massage (Bindegewebs massage) (결합조직 맛사지)

  • Kim, Jong-Soon;Ryoo, Jae-Kwan
    • Journal of Korean Physical Therapy Science
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    • v.4 no.3
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    • pp.475-489
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    • 1997
  • Connective tissue massage(CTM, Bindegewebs massage) are developed and named by Mrs. Elizabeth Dicke, a German physical therapist. The CTM is used primarily for internal disorder such as myocarditis, coronary insufficiency, high blood pressure, functional stomach and intestinal disorders, inflamma-tion of the gallbladder, and hepatitis, arterial circulatory problems, venous disorders, headache, particularly trauma to the head, and some gynecologic disorder, etc. Which is performed with special stroking technique of the subcutaneous tissue of the trunk, extremities, and face. The mechanism of effectiveness of CTM is based on a viscerocutaneous reflex. The stroking stimulates the nerve end-ings of the autonomic nervous system. The impulses activated by stroking travel to the sympathetic trunk and the spinal cord and brain, which causes a change in reaction susceptibility. The most important for apply CTM is necessary to know the reflex zone (Head's zone, Mackenzie's zone and Dicke's connective tissue zone). Dicke's connective tissue zones are only found by the special dia-gnostic stroking. Because the connective tissue zones no discomfort when unmanipulated, and thus the patient is unaware of them. It is characterized by diagnostic stroking that causes a sharp pain in the tissue. As a general rule, all treatment are preceded by the basic stroke from the level of the coccyx to the first lumbar vertebra and each stroke is done three times. The right side is done first, then the left side.

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Anatomical Study on the Dogmaek-Gyeong and Immaek-Gyeong of the Oriental Medicine (독맥경과 임맥경에 대한 해부학적 고찰)

  • Kim, Soo-Myung
    • Journal of Haehwa Medicine
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    • v.7 no.2
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    • pp.601-607
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    • 1999
  • The human body consists of the twelve main meridians and the eight extra meridians including Dogmaek-Gyeong and Immaek-Gyeong. This study is on twenty-eight acupuncture points Dogmaek-Gyeong and twenty-four acupuncture points Immaek-Gyeong among the eight extra meridians. It is very important to know the accurate acupuncture points, which is the fundamental subject in the Oriental Medicine. From now on they have expressed in Chinese letters and old anatomical terms, acupuncture points are difficult and confused to learn. In order to understand acupuncture points easily, they are translated into Korean anatomical terms focused on osteology in this study. Dogmaek-Gyeong is the meridian of this vessel run along the posterior meridian line of the body. The boundary commences at the coccyx, mounts the length of the vertebral column, contours the skull of the vertex along the philtrum to terminate upon the upper gum. It has twenty-eight acupuncture points. Immaek-Gyeong is the meridian of this vessel run along the anterior meridian line of the body. The boundary commences at the perineum mounts the pubic symphysis along the umbilicus, mandible and the terminates at concave of the lower lip. It has twenty-four acupuncture points.

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Pharmacoacupuncture Treatment of Coccygodynia Caused by Perforating Cutaneous Nerve Entrapment Syndrome: Two Cases Report (관통피부신경 포착으로 발생한 꼬리뼈 통증 환자 약침치료 치험 2예)

  • Moon, Sori;An, Sunjoo;Choi, Seonghwan;Park, Seohyun;Keum, Dongho
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.149-156
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    • 2019
  • This study was performed to evaluate the effectiveness of pharmacoacupuncture treatment of coccygodynia caused by perforating cutaneous nerve entrapment syndrome. Two patients were diagnosed as coccygodynia caused by perforating cutaneous nerve entrapment syndrome which pain was within the anatomical field of the nerve, worsened by pressure-inducing posture, no objective sensory loss and in presence of pin-point tenderness. They were treated by pharmacoacupuncture at perforating cutaneous nerve region penertrating the sacrotuberous ligament and local tenderness point of coccyx. The evaluation of clinical outcome was done by pain intensity numerical rating scale (PI-NRS), pressure pain threshold (PPT) and EuroQol five dimensions questionnaire (EQ-5D) index. After treatment, their PI-NRS was decreased, PPT and EQ-5D index were increased. The pharmacoacupuncture therapy at entrapment point of perforating cutaneous nerve could be an effective way to treat coccygodynia caused by perforating cutaneous nerve entrapment syndrome.

Late-Onset Spinal Subdural Hematoma after Acupuncture (침술치료 후 발생한 지연성 척추 경막하 혈종)

  • Park, Hyo Sik;Kim, Jong Keun;Bae, Jin Seok;Jeong, Yong Sung;Lim, Jong Youb
    • Clinical Pain
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    • v.18 no.2
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    • pp.130-132
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    • 2019
  • Acupuncture is generally regarded as a safe procedure and as a popular treatment for patients with musculoskeletal disorders. We report a case of a 47-year-old male patient with late-onset tetraplegia, developed after acupuncture. He had no trauma, medical, and social history relevant to tetraplegia. Right after the acupuncture, he felt discomfort in his right arm. After 6 days, all 4 extremity weakness developed. Whole-spine magnetic resonance imaging revealed the presence of spinal subdural hematoma extending from the C5 vertebra to the coccyx level. Hand coordination dysfunction, neurogenic bladder, and neuropathic pain were other symptoms. After the management, he recovered muscle strength, but incomplete bladder control and neuralgia were sustained. It is important to be aware of the possibilities of severe complications after acupuncture.

Effects of Abdominal Muscle and Pressure on the Spine Stability during Upright Stance Posture - For the Case where Intervertebral Disc Plays the Role of Mechanoreceptor (추간판이 물리적 자극의 수용기 역할을 하는 경우 기립 상태에서 복압 및 복근의 역할이 척추 안전성에 미치는 영향)

  • Choi, Hae-Won;Kim, Young-Eun
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.1
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    • pp.115-122
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    • 2011
  • Recently, we have proposed a hypothesis that spinal structures have a stress sensor driving feedback mechanism, In the human spine, spinal structure could react to modify muscular action in such a way so as to equalize stress at the disc, therefore reduce the risk of injury, In this analysis, abdominal muscle and abdominal pressure, which were not included in the previous study, were added to identify those effects in spine stability during upright stance posture for the case where the intervertebral disc plays the role of mechanoreceptor, The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Muscle architecture with 46 local muscles containing paraspinal muscle and 6 rectus abdominal muscles were assigned according to the acting directions. The magnitude of 4kPa was considered for abdominal pressure. Minimization of the nucleus pressure deviation and annulus fiber average tension stress deviation was chosen for cost function. Developed model provide nice coincidence with in-vivo measurement (nucleus pressure). Analysis was conducted according to existence of co-activation of abdominal muscle and abdominal pressure. Antagonistic activity of abdominal muscle produced stability of spinal column with relatively small amount of total muscle force. In contrast to the abdominal muscle, effect of abdominal pressure was not clear that was partly depending on the assumption of constant abdominal pressure.

Posterior Vertical Approach for Sacrococcygeal Teratomas in Children (소아의 천미추부 기형종 수술시 후방종단식 술식의 이용)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.102-109
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    • 1996
  • Pediatric surgeons are familiar with the posterior sagittal approach to the rectum at sacrococcygeal area and well oriented with the anatomy because of the Penal procedure for imperforate anus. The author utilized the posterior vertical elliptical incisions in 12 cases of sacrococcygeal teratoma since 1987. For presacral tumor(type IV)$^2$, the incision was exactly same as the posterior sagittal procedure for imperforate anus. But the out-growing(type I) or dumbbell-shaped(type II & III) tumors, a vertical elliptical incision was required. For the laterally deviated tumors, a vertical and half-chevron incision was utilized in one case, but an unbalanced vertical elliptical incision was acceptable for the remaining two cases, with shrinkage of the overlying skin. In dumbbell-shaped tumors(type II & III), the narrow waist of the tumor was at the level of the levator muscle, which formed a muscle-belt on the tumor waist. A careful dissection to save the muscle-belt seemed to be the most important point during this procedure, utilizing the nerve-stimulator. After complete removal of the tumor and the coccyx, the levator muscles and the skin were closed in vertical fashion along the midline. For the caudally extending tumors in 3 cases, the muscle complex was divided in midline. Nothing by mouth and total parenteral nutrition was maintained for 1 week and then laxatives were given for 2 weeks in order to give the sphincters rest. Operative scars were acceptable resembling natural vertical midline folds, and the sphincter function was continent in all cases. In conclusion, vertical elliptical incision in sacrococcygeal teratoma is recommended because of the acceptable scar, functional restoration, and because it is a familiar procedure particularly for the pediatric surgeons who are accustomed performing posterior sagittal approach for imperforate anus.

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Two cases of Antley-Bixler syndrome caused by mutations in different genes, FGFR2 and POR

  • Woo, Hyewon;Ko, Jung Min;Shin, Choong Ho;Yang, Sei Won
    • Journal of Genetic Medicine
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    • v.13 no.1
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    • pp.31-35
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    • 2016
  • Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.