• 제목/요약/키워드: Grade I

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GradeⅠ요추부 척추 전방 전위증의 치료 : 감압성 후궁절제술과 고정기구 삽입술의 비교 (Long Term Clinical and Radiological Follow-up Study in Spondylolisthesis, Grade I : Decompression with or without Instrument)

  • 정승영;김국기;임영진;김태성;임언;이봉암
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.235-241
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    • 2001
  • Objective : Controversy exists which surgical treatment better in lumbar grade I spondylolisthesis, decompressive laminectomy with or without lumbar instrumentation. Methods : Out of Sixty-four patients with lumbar spondylolisthesis underwent surgery, 18 patients operated with decompressive laminectomy alone and 44 patients with decompession and lumbar instrument, during recent 5-years between January, 1994 and December, 1998. The author studied a long term follow-up in the above two groups to analyzing the overall clinical outcomes in each group and to determining the incidence of pos-toperative radiologic instability. Results : 1) Overall postoperative symptoms improvement were not so different in both groups. 2) Postoperative progressive subluxation is more common after decompressive laminectomy without instrumentation than with instrumentation group. 3) Overall clinical outcomes were slightly better in decompressive laminectomy without instrumentation than with instrumentation group but there was no significant difference. 4) Postoperative radiologic changes did not seem to influence the patient-reported clinical outcomes. 5) Postoperative complications is more common in decompressive laminectomy with instrumentation group than without instrumentation group. Conclusion : In the surgical management of grade I spondylolisthesis, the efficiency and superiority of surgical treatments requires the cost effectiveness and risk/benefit analysis of decompressive laminectomy with or without instrumentation. Therefore, Further detailed studies of long term follow up in a large number of patients in each group are needed for choice of best treatment.

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A Morphometric Analysis of Neuroforamen in Grade I Isthmic Spondylolisthesis by Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation

  • Lee, Dong-Yeob;Lee, Sang-Ho;Kim, Seok-Kang;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • 제41권6호
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    • pp.377-381
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    • 2007
  • Objective : The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion [ALIF]. Methods : Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging [MRI] before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale [VAS] scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. Results : The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased [p<0.001], and the mean foraminal width was decreased [p=0.014] significantly after surgery. The mean epidural foraminal height [p<0.001], epidural foraminal width [p<0.001], and epidural foraminal area [p<0.001] showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery [p<0.001]. VAS scores for leg pain [p=0.001] and Oswestry disability index [p=0.001] was decreased significantly at one year after surgery. Conclusion : Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.

악관절 동통 환자에서 Bone SPECT의 유용성 (Utility of Bone SPECT in Temporomandibular Joint Pain)

  • 양동헌;성미숙;이정휘;정수교;신경섭
    • 대한핵의학회지
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    • 제31권3호
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    • pp.388-394
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    • 1997
  • 악관절 동통은 여러 가지 원인에 의해 발생하는 것으로서 동통을 호소하는 환자에서 Bone SPECT의 유용성을 알아보았다. 악관절 동통을 호소하여 Bone SPECT를 시행한 34명을 대상으로 하였으며 모든 환자에서 단순 촬영, planar 골스캔, Bone SPECT를 시행하였다. Bone SPECT에서 동위원소의 섭취 증가 정도에 따라 3가지로 분류하였다. Grade 0은 정상, Grade I은 후두골과 비슷한 섭취 증가, Grade II는 상악동과 비슷한 섭취 증가가 있는 것으로 정하여 각각 섭취 증가 정도에 따라 환자의 임상 증상과 치료 방법을 비교 분석했다. 34예중 27예 (80%)에서 악관절 Bone SPECT 시행시 섭취 증가가 있었고, 이중 21예 (78%)에서 하악과두에 섭취 증가가 있었고 나머지 6예 (22%)에서 하악궁과 상악궁에 섭취가 있었는데 이들은 치주질환으로 확인되었다. 총 34예중 Grade 0인 7예 (20%)에서는 관절 잡음이 3예 있었고 4예에서 약물 치료로 증상이 호전되었고 나머지 3예에서 치료 없이 증상이 호전되었다. Grade I 인 4예(12%)에서는 관절잡음이 3예 있었고 모두 약뭍 치료로 증상이 호전되었다. Grade II 23예(68%)중 관절 잡음은 7예 있었고 14예에서 약물치료 및 관절천자와 같은 감압술을 병행하여 증상이 호전되었다. 6예에서는 치주 치료로 증상이 호전되었다. 총 34예중 평면 골스캔에서는 11예(32%)에서 섭취 증가가 있었다. 단순 촬영에서는 16예(47%)에서 관절내강 협소 혹은 팽대, 골리란, 관절운동 제한 등이 관찰되었다. one SPECT는 악관절 동통 환자에서 유용하게 사용할 수 있는 진단적 방법이며, 치료방법을 결정하는 데 도움이 되었다. 동위원소 섭취 증가가 많을 수록 환자 치료에 보다 적극적인 치료를 필요로 하였으나 임상 증상과 동위원소 섭취증가는 밀접한 관계는 없었다.

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Abdominal Subcutaneous Fat Thickness Measured by Ultrasonography Correlates with Hyperlipidemia and Steatohepatitis in Obese Children

  • Lee, Sung Hyun;Kim, Dongwan;Baek, Min Young;Tchah, Hann;Kim, Yeon Sun;Ryoo, Eell;Kim, Yun Mi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권2호
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    • pp.108-114
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    • 2015
  • Purpose: The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. Methods: One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. Results: Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured $2.9{\pm}0.8cm$ and $1.9{\pm}0.7cm$ in the normal group, $3.3{\pm}0.8cm$ and $2.0{\pm}0.7cm$ in grade I, $3.8{\pm}0.8cm$ and $2.3{\pm}0.8cm$ in grade II, and $4.1{\pm}0.8cm$ and $2.8{\pm}1.4cm$ in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). Conclusion: Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.

Surgically Treated Anterior Communicating Artery Aneurysm

  • Koo, Sang-Keun;Song, Yeung-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • 제37권6호
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    • pp.405-409
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    • 2005
  • Objective: The purpose of this study is to assess the factors related to the outcome of 84 patients who underwent surgery for anterior communicating Artery(ACoA) aneurysms. Methods: The authors review 84 patients who were undertaken from January 1998 to May 2004. In the management of ACoA aneurysms, the outcome was based on several factors: Clinical condition, Distribution of hemorrhage, Time between aneurysmal rupture and surgery, Direction and shape of the aneurysm. Results: The incidence rate of the ACoA aneurysm was 35%. Seventy four patients were classified as those having a good recovery, but 5 patients suffered from some morbidity and 5 patients died. The rate of good outcome for the patients with Hunt and Hess grade was as follows 100% in grade I, 95% in grade II, 80% in grade III, IV and V. The rate of good outcome for the patients with Fisher grade was as follows 98% in grade I, II and 81% in grade III, IV. Nineteen of 22 patients who underwent early surgery were rated as good, while twenty six of 30 patients for whom surgery was delayed showed a favorable result. The unfavorable outcomes were also attributed by vasospasm or other medical problems. Conclusion: For further improvement of the overall surgical outcome: First, early surgical intervention is recommended for good grade patients. Second, active management of poor grade patients should be scrutinized with early surgery. Third, it is also important to step up the effort to minimize the risk of medical complications to enhance surgical results on top of the mainstay of prevention efforts for vasospasm and rebleeding.

우리나라 서·남해안에서 출현하는 다모류를 통한 해역의 생태등급 산정 (Assessment of Ecological Grade Based on Polychaete Fauna in the Western and Southern Coast of Korea)

  • 백상규;박흥식;윤성규;제종길
    • 한국습지학회지
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    • 제7권2호
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    • pp.89-104
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    • 2005
  • 우리나라 서 남해안에 위치한 59개 갯벌의 다모류 출현 양상을 바탕으로 갯벌의 생태등급을 평가하였다. 갯벌의 생태등급 평가는 다모류의 분포밀도, 다양성, 풍부성, 자원적 가치, 종 위험도 등의 생물학적인 자료와 해안선의 자연성, 훼손 가능성, 지형경관 등의 인문지리학적인 면을 평가기준으로 하였다. 조사지역에서 출현한 다모류는 총 14목 37과 181종이었으며, 각 조사지역의 생태등급은 다음과 같다. I 등급 4개 지역(충남 학암포, 전남 우이도와 거문도, 경남 비진도와 매물도), II 등급 30개 지역, III 등급 19개 지역, IV 등급 4개 지역이었다. 이번 조사 결과 생태등급 기준에 대한 보다 면밀한 검토가 필요할 것으로 생각되며, 선정된 각 해역의 생태등급에 따른 정기적인 생물 조사 및 생태계 위협요인의 제거와 같은 실질적인 관리 방안을 마련하여야 할 것으로 판단된다. 특히 생물상 및 자연성이 높은 생태등급 지역의 경우 보다 적극적인 보전 노력이 요구된다.

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학교급식 유형, 성별 및 학년에 따른 충남 일부지역 초등학생의 식행동에 관한 연구 (The Study on Dietary Behaviors of Elementary School Student in Chungnam Area According to the School Food Service Type, Gender and Grade)

  • 장혜순;김명자
    • 대한지역사회영양학회지
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    • 제11권5호
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    • pp.608-617
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    • 2006
  • This study compared the food habits and attitudes towards dietary life culture in types of feeding management, gender and grade. The subjects were 352 elementary school students who lived in Seocheon, Chungnam. The independently managed school students were better than jointly managed school students in food habits (p<0.05). In skipping school meals, upper grade students were skipped more than lower grade students (p<0.05). In rate of eating school meals, boys were faster than girls (p<0.001). The independently managed school students and the jointly managed school students were different on distasteful food. Boys disliked vegetables and girls disliked cereals and beans (p<0.05). Upper grade students ate more well-balanced meals than lower grade students (p<0.05). As for the question 'what you will do if the distasteful foods are provided through school meals', they responded. the highest percent of students, 'I will try once or twice'. And the response 'I have them for health' was higher independently in managed school students than the jointly managed school students (p<0.05), girls than boy (p<0.05), and the lower grades than the upper grades (p<0.05). As for the question 'what you will do if the distasteful foods are provided, after the guide for school meals was performed', the response, 'I will make an effort to have it' accounted for the highest percents, and there were differences in lower grade students who were high percents than upper grade students (p<0.01). As for the recognition for unbalanced diets, most of the students recognized that it is a 'bad habit'; the girl students accounted for more percentage than boys (p<0.05). The criterion of food choice were different in gender and grade (p<0.01). As for the factor of influences for the food habits formation, lower grade students were 'school education' and upper grade students were 'parents' (p<0.05). Thus, the systematic guide for proper intakes of nutrition should be performed. Also, the time when students can be educated by an expert of nutritional education, which is connected with school meals and students can grow healthily.

호텔직원의 인구통계적특성에 따른 자기효능감에 대한 인식; 서울지역 특급호텔을 중심으로 (Recognition for Self-efficacy by Demographic Characteristics of Hotel Staffs; Deluxe Hotels in Seoul)

  • 김재곤;김연선
    • 한국콘텐츠학회논문지
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    • 제10권6호
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    • pp.450-459
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    • 2010
  • 본 연구는 특급호텔 직원이 지각하는 자기효능감에 대한 인식의 차이를 연구하고자 하였다. 본 연구의 과제는, 첫째, 서울지역의 특1급 호텔과 특2급 호텔에 근무하는 직원들을 대상으로 인지하고 있는 자기효능감을 측정한다. 둘째, 측정된 자기효능감은 본 연구를 위해 요인분석 한다. 셋째, 특1급 호텔과 특2급 호텔 직원들 간의 자기효능감의 차이를 연구한다. 넷째, 근무하고 있는 호텔직원들의 각각의 인구통계적 특성에 따라 자기효능감의 인식에 차이가 있는지 연구한다. 본 연구를 위해 모집단은 서울 지역 특급호텔에 근무하고 있는 직원들을 대상으로 하였고, 400부를 배포하여 총 352부를 분석 자료로 사용하였다. 연구결과 첫째, 특1급 호텔과 특2급 호텔 직원들의 자기효능감의 인식은 유의수준에서 유의한 차이가 있었다. 둘째, 인구통계적 특성 중 결혼유무, 전공학과, 학력, 재직기간 그리고 소득수준에 따라서 유의한 차이가 있는 것으로 확인되었다.

The Use of Pedicle Screw-Rod System for the Posterior Fixation in Cervico-Thoracic Junction

  • Cho, Won-ik;Eid, Ahmed Shawky;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제48권1호
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    • pp.46-52
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    • 2010
  • Objective : In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. Methods : Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. Results : The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were $6.9{\pm}1.34\;mm$, $8.23{\pm}1.18\;mm$, $30.93{\pm}4.65\;mm$, $26.42{\pm}7.91$ degrees, $25.9{\pm}4.83$ degrees, and $10.6{\pm}3.39$ degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. Conclusion : C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.

Protein Expression of Stromelysin-2 in Head and Neck Squamous Cell Carcinomas

  • Kadeh, Hamideh;Heydari, Fatemeh;Saravani, Shirin;Ghodsi, Iman Najafi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7843-7846
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    • 2015
  • Background: Some matrix metalloproteinases (MMPs) are involved in invasion and metastasis of head and neck squamous cell carcinoma (HNSCC). However, there are few studies on association between stromelysin-2 (ST-2) and invasive behavior of HNSCC. The purpose of this study was to investigate Stromelysin-2 expression by immunohistochemistry. Materials and Methods: This study was conducted on 81 specimens, including 61 HNSCC and 20 non neoplastic epithelium. Sections with 5 micron thickness were prepared and stained with immunohistochemistry technique. Then expression of ST-2 was evaluated according to percentage of stained cells and intensity of staining. Data were analyzed by SPSS (V.21) using Kruskal-Wallis and Tukey tests (P<0.05). Results: The 61 HNSCC specimens were grades I 36.1%, II 34.4% and III 29.5%. The level of ST-2 expressions were moderate (++) and intensive (+++) in 21.3% and 78.7% of tumors, respectively. The ST-2 expression level was only significant between the tumors with grade I and grade III (P=0.016). Tumors presented ST-2 expression with staining intensity of mild 6.6%, moderate 26.2% and strong 67.2%. Staining intensity of ST-2 in grade I tumors was significantly lower than grade II and grade III (P<0.05), and there was no significant difference between grades II and III (P=0.99). Conclusions: According to this study, the expression of ST-2 is associated with histopathological grade and tumor differentiation in HNSCCs.