• 대한영상의학회지
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• 제84권5호
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• pp.1176-1180
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• 2023

과립세포종은 신경 또는 신경 주위 세포에서 생기는 드문 연부조직 종양이다. 저자들은 유방암 과거력을 가진 69세 여자 환자에서 액와부 과립세포종 증례를 보고하고 다양한 영상 소견을 논의하고자 한다. 초음파에서 왼쪽 액와부에 경계가 분명한 타원형의 비균질한 등에코, 고에코의 종괴였으며, 흉부 전산화단층촬영에서 대흉근의 바깥쪽에 경계가 분명한 타원형의 약간 조영 증강되는 종괴로 보였다. 초음파 유도하 조직 생검을 통해 과립세포종으로 최종 진단되었다. 추적 초음파에서 변화는 없었다. 과립세포종에 대해 잘 알고 있다면 조기 진단과 후속 관리를 용이하게 할 수 있을 것이다.

• Anatomy and Cell Biology
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• 제57권1호
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• pp.18-24
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• 2024

The origin and distribution of median nerve varies among the different individuals. The median nerve variations in axillary region were reported by many authors previously. Understanding of these variations is especially necessary for clinicians to prevent iatrogenic nerve damage. The current work aimed to evaluate the possible anatomical variations of median nerve in the axillary region in a sample of the Iranian cadavers (Shiraz, Fars). We dissected 26 upper limbs from 13 male cadavers to investigate the different variations of median and musculocutaneous nerves according to Venieratos and Anagnostopoulou classification. In 23.07% of specimens (n=6), the medial root united with 2 lateral roots and formed the median nerve proximal to the coracobrachialis muscle. In one case, a communicating branch separated from the musculocutaneous nerve distal to the coracobrachialis and connected to the median nerve in upper arm. Our results suggest that there are anatomical variations of the median nerve in terms of its origin and its communication with the musculocutaneous nerve in the population of southern Iran. The anatomical knowledge of the median nerve variations is important for clinicians to improve patient health outcome. Theses variations of the median nerve should be considered during surgical procedures of the axillary region and nerve block of the infra clavicular part of the brachial plexus.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.17-42
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• 2002

The purpose of this study was to investigate the treatment effect of three interventions on the disuse atrophy of rat hindlimb after two weeks suspension. Forty-eight 11~12 weeks old female Sprague-Dawley white rats were divided into four intervention groups: 1) suspension only (S; n=10), 2) intensive weight bearing treadmill (IWBT; n=10), 3) electrical stimulation (ES; n=9), 4) 2)+3) (ES/IWBT; n=9). Another 10 rats received no intervention or hindlimb suspension and served as controls (C). After the interventions, 1) the cross-sectional area (CSA), 2) the ratio of white muscle fiber composition (WMFC), 3) isometric tetanic tension (ITT), and 4) muscle weights (MWs) were measured from the four calf muscle specimens. The results were as follows: 1. In all intervention groups, the CSAs of medial and lateral gastrocnemius (MG LG), soleus (SOL), and flexor digitorum superficialis (FDS) decreased when compared to the control (C) group (p<.05). The CSA increased in FDS and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group (p<.05). 2. The ratios of WMFC in MG, LG, SOL, and FDS increased compared to the C group for all interventions (p<.05). The ratios of WMFC decreased in SOL and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group, and decreased in SOL for the ES/IWBT group compared to the IWBT group (p<.05). 3. The ITT in the MG, LG, SOL, and FDS decreased compared to the C group for all interventions (p<.05). The ITT increased in MG LG/FDS, SOL, and the whole calf muscles (WCMs) in the IWBT, ES and ES/IWBT groups compared to the S only group (p<.05). 4. The MWs in MG LG/FDS, SOL, WCMs decreased compared to the C group for all interventions (p<.05). The MWs increased in MG LG/FDS and WCMs for the IWBT group, in SOL for the ES group, and in SOL for the ES/IWBT group compared to the S only group (p<.05). 5. In atrophied muscles, the IWBT group showed the best recovery and the ES/IWBT and ES groups followed in decreasing order. The most susceptible muscle to disuse atrophy was the SOL. But conversely, it showed the best recovery in the ES/IWBT group. After two weeks of hindlimb suspension, the calf muscles of rats atrophied and their isometric tension decreased. These changes were best reversed by hindlimb-focused treadmill activity. The next best results were achieved by electrical stimulation combined with the treadmill followed by only electrical stimulation. These findings indicate that full weight bearing treadmill activity alone or in combination with electrical stimulation are effective treatments for non-weight bearing induced muscle atrophy. Further study of the effect of different intensities of electrical stimulation and variations in the duration period of full weight bearing treadmill activity on disuse atrophy is recommended.

• Radiation Oncology Journal
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• 제20권2호
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• pp.130-138
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• 2002

목적 : 근 침윤성 방광암에서 생존율에 영향을 주는 예후 인자를 분석하고 방사선 치료의 역할을 알아보고자 하였다. 대상 및 방법 : 1986년 1월부터 1998년 12월까지 전남대학교병원에서 근 침윤성 방광암으로 진단 받고 계획된 치료를 완료한 28명의 환자를 대상으로 후향적 분석을 시행하였다. 전체 28명 중 남자가 21명 여자가 7명이었으며 환자의 연령은 49세에서 84세까지 분포하였고 중앙값은 72세였다. 조직학적으로 모두 이행상피암으로 확진되었으며 grade 1은 1명, grade 2는 15명, grade 3는 9명, 불명인 경우가 3명이었다. 방사선치료는 선형가속기의 6 MV 또는 10 MV X-ray를 이용하였으며 일회선량은 1.8 내지 2.0 Gy로 3문 내지 4문 조사를 시행하였다. 투여된 총방사선량은 59 내지 66.6 Gy였고 중앙값은 61.24 Gy였다. 생존율은 Kaplan-Meier법으로 산출하였고 두 군간의 비교는 Log-rank test를 이용하였다. 생존율에 영향을 미치는 요인들을 Cox 비례위험모델로 다변량 분석하였다. 결과 : 생존율은 1, 2, 3, 5년에 각각 76, 46, 33, $33\%$로 나타났다. 중앙 생존 기간은 19개월이었다. 생존율에 영향을 미치는 가능성 있는 예후 인자로서 연령(70세 미만 대 이상), 성별, 당뇨병, 고혈압, 수신증 동반 여부, T-병기 (T3a 대 T3b 이상), TUR, 항암화학요법 여부, 방사선치료기간, 방사선량(60 Gy 미만 대 60 Gy 이상), 방사선치료반응정도를 분석에 포함시켰으며, 이들 중 단변량분석에서 T-병기(p=0.078)와 방사선량(p=0.051)이 통계학적 의의에 접근하였으며 방사선치료반응 정도(p=0.011)가 통계학적으로 의의 있게 나타났다. 그러나 다변량분석에서는 통계학적 의의를 가지는 인자가 없었다. 결론 : 근 침윤성 방광암에서 생존율에 미치는 예후 인자로 방사선량, 방사선치료반응 정도가 단변량분석에서 의미있게 나타났으나 다변량 분석에서는 확인되지 못하였으며 향후 더욱 많은 증례를 대상으로 이에 대한 전향적 무작위 임상 시험이 필요할 것으로 생각된다.

• The Korean Journal of Physiology
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• 제8권2호
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• pp.1-17
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• 1974

미로(迷路) 각반규관(各半規管)과 각외안근간(各外眼筋間)의 기능적(機能的) 관계(關係)를 구명(究明)하여 미로반사성(迷路反射性) 안구운동(眼球運動)을 위한 신경기구(神經機構)를 이해하고져 마취가토(麻醉家兎)에서 골성(骨性) 반규관(半規管) 팽대부내(膨大部內)에 단전극(單電極)을 삽입하여 각(各) 팽대부신경(膨大部神經)을 전기자극(電氣刺戟)하였을 때 양안(兩眼)의 각(各) 외안근(外眼筋)의 반응(反應)을 등장성장력변화(等長性張力變化)와 근전도(筋電圖)로써 관찰하여 다음과 같은 결론(結論)을 얻었다. 1) 일측(一側) 미로(迷路)에서 한 반규관신경을 자극하면 양안(兩眼)에서 각각(各各) 3개의 안근(眼筋)은 흥분(興奮)하여 수축(收縮)하고 여기에 대(對)한 3개의 길항근(拮抗筋)은 억제(抑制)되어 이완(弛緩)하였다. 2) 일측(一側) 미로(迷路)의 어느 반규관신경을 자극하거나 동측안(同側眼)에서는 상직근(上直筋), 상사근(上斜筋) 및 내직근(內直筋)이 흥분(興奮)(수축(收縮))하고, 하직근(下直筋), 하사근(下斜筋) 및 외직근(外直筋)은 억제(抑制)(이완(弛緩))되었다. 반대측(反對側) 근(筋)에서는 하직근(下直筋), 하사근(下斜筋) 및 외직근(外直筋)이 흥분(興奮)하고 상직근(上直筋), 상사근(上斜筋) 및 내직근(內直筋)은 억제(抑制)되었다. 3) 일측(一側) 미로(迷路)의 3개 반규관자극을 중복(重複)시켰을 때는 한 안근(眼筋)이나 각안근(各眼筋) 길항근대(拮抗筋對)에 각반규관신경(各半規官神經)의 자극효과(刺戟效果)가 중첩(重疊)됨을 증명(證明)할 수 있었다. 4) 이상(以上)의 실험적 근거를 토대로 하여 각반규관(各半規官)과 각외안근(各外眼筋)의 기능적(機能的) 관계(關係)를 규정(規定)하는 법칙성(法則性)을 찾을 수 있었다. 즉(卽) ‘상직근(上直筋), 내직근(內直筋) 및 상사근(上斜筋)은 동측(同側) 미로(迷路) 반규관(半規管)으로부터 흥분적(興奮的) 충격(衝擊)을 받고 반대측(反對側) 반규관(半規管)들로부터는 억제적(抑制的) 충격(衝擊)을 받으며, 하직근(下直筋), 외직근(外直筋) 및 하사근(下斜筋)을 위하여는 이와 정반대(正反對)의 관계(關係)가 성립(成立)한다. 5) 본(本) 실험성적(實驗性績)을 Cohen 등(等)의 가묘(家猫)에서의 연구보고(硏究報告)와 비교하건데 사근(斜筋)에 대(對)한 반규관사배(半規管司配)는 동일(同一)하나, 내(內) 및 외직근(外直筋)과 상(上) 및 하직근(下直筋)에 대(對)한 반규관사배(半規管司配)는 일부(一部) 상이(相異)하였다. Cohen 등(等)의 성적을 분석(分析)하여 본 결과 이론적(理論的) 모순(矛盾)이 있음을 보았고 안근(眼筋)의 각(各) 길항근(拮抗筋)에 대한 반규관사배(半規管司配)의 양식(樣式)에 있어 일정(一定)한 법칙성(法則性)을 찾을수 없었으며 그들의 관찰에는 실험적(實驗的) 오류(誤謬)를 포함하고 있음을 증명(證明)하였다.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.288-293
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• 2008

Objective : Bone cement leakage is a well-known potential complication of percutaneous vertebroplasty (PVP) in patients with osteoporotic compression fracture. Even though there has been a controversy in the efficacy of antecedent venography to prevent this complication, many authors have performed intra osseous venography before bone cement injection. The goal of this study was to classify the venous drainage patterns of spine before PVP, and compare their patterns at different vertebral levels. Methods : The authors retrospectively reviewed 1,042 intraosseous venographic patterns in 321 patients with 574 osteoporotic compression fractures during six-year period in one institution. To classify venogram patterns, we selected simple lateral X-ray of spine taken immediately after injection of the contrast dye. We classified the venography patterns according to contrast leakage pattern and leakage direction as follows; trabecular (TR), trabecular anterior (TA), trabecular posterior (TP), trabecular anterior-posterior (TAP), trabecular lateral (TL), venous anterior(VA), venous posterior (VP), venous anterior-posterior (VAP), soft tissue (ST). Also, we compared venogram patterns according to different spinal levels. Results : In overall, the most common pattern was TP type accounting for 37.4% (390/1042) of all intraosseous venograms. This is followed by TAP in 21.5%, TR 17.4%, TA 116%, TL 5.8%, ST 4.1%, VA 1.2%, VP 0.6%, and VAP 0.4% in descending order of frequency. According to the spinal level, TR and TAP types were most common in thoracic spine (T6-T10), TP type was most common in thoraco-Iumbar spine (T11-L2), and TP and TAP types were most common in lumbo-sacral spine (L3-S1). Contrast dye leakage to soft tissue such as psoas muscle or disc were detected in 43 (4.1%) venograms. Direct venous drainage without staining of vertebral body was found in 23 (2.2%) venograms. The 8.3% of thoracic venogram showed direct venous drainage. Thoracic level showed a more tendency of direct venous drainage than other spine levels (p<001). Conclusion : The authors propose a new classification system of intra osseous venography during PVP. The trabecular-posterior (TP) type is most common through all spine, and venous-filling (V) type was most frequent in thoracic spine. Further study would be necessary to elucidate the efficacy of this classification system to prevent bone cement leakage during PVP.

• PNF and Movement
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• 제14권3호
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• pp.185-193
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• 2016

Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.Purpose: This study investigates how abdominal muscular exercise based on proprioceptive neuromuscular facilitation (PNF) can affect chronic low back pain patients in terms of their pulmonary function, pain, and functional disability indexes. Methods: Fourteen target subjects with chronic low back were randomly assigned to the control group (n = 7) that performed abdominal muscle exercises and the experimental group (n = 7) that performed PNF abdominal muscular exercises. The exercises were performed five times a week for six weeks. To check the change in pulmonary function, the forced expiratory volume at one second (FEV1) and visible analogue scale (VAS) were measured to check the pain level. The disability level caused by back pain was measured by the Oswestry Disability Index (ODI). A paired t-test was applied to compare the differences between the groups before and after the intervention, and an independent t-test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: Before and after the intervention, the experimental group showed a significant change in FEV1 (p < 0.01), and both the experimental and the control groups showed significant changes in VAS and ODI (p < 0.01). A comparison of the differences between the groups indicated that the experimental group showed more significant changes in FEV1 (p < 0.05). Conclusion: According to the study results, PNF abdominal muscular exercise effectively improved pulmonary function, pain, and functional disability indexes in subjects with chronic back pain. The proposed program can be applied to chronic back pain patients as a useful therapy.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.163-169
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• 2013

Purpose: This study was conducted to confirm the anatomic conformity of the new periarticular locking plates designed by Zimmer on Korean adult bones and to identify the structures at risk during the application of these implants. Methods: The study was performed on the humerus, radius, and tibia of 10 adult cadavers(6 males and 4 females) procured from the cadaveric lab of our hospital. Anteroposterior (AP) and lateral X-rays were taken to confirm that the cadavers were free of any unusual lesions or anatomic variations. We used the 3.5-mm proximal humerus plate, 2.7-mm distal radius plate, 3.5- and 5.0-mm proximal tibia plates, and 3.5-mm distal tibia plate developed by Zimmer, Inc. (Zimmer periarticular locking plate). The longest plate from each group was used to confirm anatomical conformity. Standard approaches were used for each area, and soft tissue was retracted in order to pass the plate beneath the muscle. The position of the plate was confirmed using standard AP and lateral view X-rays. After this procedure had been completed, the region was dissected along the length of the implant to determine the conformity of the implant to bone and the penetrations of screws into the articular surface or violations of any vital structures, such as nerves, blood vessels, or tendons. Results: Excellent anatomical conformity was observed with Zimmer periarticular locking plates for Korean adults. The tibial nerve and the posterior tibial artery were found to be structures at risk when applying a distal tibial plate. Conclusion: Additional posterolateral fixation is recommended when dealing with cases of tibial plateau fracture when the fracture line extends to the posterolateral cortex. We recommend taking proper views using 10~15 degrees of internal rotation to ensure correct screw length and, thus, avoid penetration of vital structures and tendons.

• Journal of Acupuncture Research
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• 제17권2호
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• pp.231-246
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• 2000

Acupuncture has been used for treatment of numerous diseases, especially for pain control in the oriental culture. However, the mechanism of pain control by acupuncture was not clear so far. The present study was examined that the effects of electro-acupuncture (EA) applied to the acu-point of extra-segmental area on modulation of formalin induced pain in Sprague - Dawley rats. In order to apply EA to acu-points in the plantar area of right fore paws, a pair of teflon - coated stainless steel wires were implanted in HT 7 (shin-mun) and PC 7 (dae-neong) 5 days before behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\mu}l$) into the lateral plantar region of left hind paw. EA was delivered by a constant current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. The electromyographic activities were recorded in the biceps femoris muscle under chloral hydrate anesthesia. Test stimuli with 1~9mA were applied to the sural nerve territory including the medial portion of the 4th toe and the lateral portion of the 5th toe. Behavioral responses including favoring, flinching and bitting were occured in the biphasic pattern, such as the lst phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited Che behavioral responses. EMG activities of flexor reflex had a latency of 100~300 ms and thresholds of test stimuli for EMG were 4~5 mA in normal rats. Injection of formalin decreased threshold of test stimuli and increased EMG activities for 2hrs after injection. However, EA significantly inhibited EMG activities of flexor reflex increased by formalin and recovered EMG evoked thresholds. These results suggest that contralateral extra-segmental EA inhibits the first and second phases of formalin induced pain but their mechanism be needed to examine additionally.

• Korean Journal of Acupuncture
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• 제17권1호
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• pp.101-121
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• 2000

The purpose of this morphological studies was to investigate the relation to the meridian, acupoint and nerve. The common locations of the spinal cord and brain projecting to the the gallbladder, GB34 and common peroneal nerve were observed following injection of transsynaptic neurotropic virus, pseudorabies virus(PRV), into the gallbladder, GB34 and common peroneal nerve of the rabbit. After survival times of 96 hours following injection of PRV, the thirty rabbits were perfused, and their spinal cord and brain were frozen sectioned($30{\mu}m$). These sections were stained by PRV immunohistochemical staining method, and observed with light microscope. The results were as follows: 1. In spinal cord, PRV labeled neurons projecting to the gallbladder, GB34 and common peroneal nerve were founded in thoracic, lumbar and sacral spinal segments. Densely labeled areas of each spinal cord segment were founded in lamina V, VII, X, intermediolateral nucleus and dorsal nucleus. 2. In medulla oblongata, The PRV labeled neurons projecting to the gallbladder, GB34 and common peroneal nerve were founded in the A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nucleus, rostroventrolateral reticular nucleus, medullary reticular nucleus, dorsal motor nucleus of vagus nerve, nucleus tractus solitarius, raphe obscurus nucleus, raphe pallidus nucleus, raphe magnus nucleus, gigantocellular nucleus, lateral paragigantocellular nucleus, principal sensory trigeminal nucleus and spinal trigeminal nucleus. 3. In Pons, PRV labeled neurons were parabrachial nucleus, Kolliker-Fuse nucleus and cochlear nucleus. 4. In midbrain, PRV labeled neurons were founded in central gray matter and substantia nigra. 5. In diencephalon, PRV labeled neurons were founded in lateral hypothalamic nucleus, suprachiasmatic nucleus and paraventricular hypothalamic nucleus. 6. In cerebral cortex, PRV labeled neuron were founded in hind limb area.This results suggest that PRV labeled common areas of the spinal cord projecting to the gallbladder, GB34 and common peroneal nerve may be first-order neurons related to the somatic sensory, viscero-somatic sensory and symapathetic preganglionic neurons, and PRV labeled common area of the brain may be first, second and third-order neurons response to the movement of smooth muscle in gallbladder and blood vessels.These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory system monitoring the internal environment, including both visceral sensation and various chemical and physical qualities of the bloodstream. The present morphological results provide that gallbladder meridian and acupoint may be related to the central autonomic pathways.