• 대한방사선기술학회지:방사선기술과학
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• 제38권3호
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• pp.261-266
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• 2015

요로결석으로 인한 경정맥 요로조영 검사는 방사선 비 투과성 물질인 요오드 조영제를 사용하여 요관의 경로에 있는 결석을 진단하는 방사선학적 검사법이다. 그 검사 방법 중 엉덩뼈 능선 상단에 대한 압박으로, 조영제가 방광으로 배출되는 것을 막아, 상부요로의 묘출을 용이하게 하는 압박대 사용 유무는 병원마다 다른 방법을 적용하고 있다. 연구자들은 실험을 통하여 압박 과 압박을 하지 않은 상태에서 조영제 진행의 특이도를 관찰하여 상호 비교하고자 하였다. 본 연구는 조영제의 종류, 용량, 검사진행 기준이 동일한 일 병원에서 실시한 경정맥 요로조영 검사 60 례를 후향적 영상평가 방법으로 실시하였다. 영상평가는 5 분 영상으로 제한하여 압박 유무에 대한 조영제의 해부학적 주행 위치가 용이한 시간대로 하였으며, 콩팥 피라미드에서 콩팥깔때기까지를 "RP", 콩팥깔때기에서 요추 3 번째 종판까지를 "PL", 양쪽 엉덩뼈 능선을 기준으로 상부와 하부를 "IU"와 "IL"으로 해부학적 영역을 설정하였다. 분석방법은 피셔의 정확 검정에 의한 통계적 방법으로 압박과 압박을 하지 않은 상태에서 해부학적 위치의 분포차이가 있는지를 분석하였다. 압박그룹과 압박을 하지 않은 그룹 각 30 례의 영상평가에서 P 값이 왼쪽 0.580, 오른쪽 0.711, 양쪽에서 0.960 등으로 나타나 통계적으로 유의한 분포의 차이가 없음을 확인하였다. 이로서 요로결석 환자의 경 정맥 요로조영 검사 시 압박 대 사용유무는 조영제 진행에 차이를 주지 않는다는 통계적 결론을 얻었다.

• 동의생리병리학회지
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• 제18권6호
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• pp.1918-1926
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• 2004

Osteoporosis is defined as a progressive systemic skeletal disorder characterized by low bone mineral density, microarchitectual deteriorations of bone and susceptibility to fracture. numerous methods have been used for quantitative assessment of the skeleton in osteoporosis. QCT has been shown to measure changes in trabecular mineral content in the spine with great sensitivity and precision. To provide the normal reference values and changes of lumbar spinal bone mineral density in korean adult spinal bone mineral density was evaluated in 451 women (229 premenopausal and 222 postmenopausal women) and 206 men, aged 20 to 74 years old in Wonkwang hospital from 2000 to 2004, which was carried out by using QCT. women with oophorectomy, vertebral compression fracture, any history of endocrine disease and use of drugs that alter bone metabolism were excluded. According to the WHO definition, a patient is osteoporotic based on a bone mineral density(BMD) measurement that is 2.5 standard deviations (SDs) below typical peak bone mass of young healthy white women. This measurement of standard deviation from peak mass is called the T score. BMD values of normal women in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 168.95㎎/㏄ K₂PHO₄, 155.41㎎/㏄ K₂PHO₄, 166.87㎎/㏄ K₂PHO₄, 160.67㎎/㏄ K₂PHO₄, 154.06㎎/㏄ K₂PHO₄, 132.04㎎/㏄ K₂PHO₄, 114.05㎎/㏄ K₂PHO₄, 91.78㎎/㏄ K₂PHO₄, 78.61 ㎎/㏄ K₂PHO₄, 61.35㎎/㏄ K₂PHO₄, 50.53㎎/㏄ K₂PHO₄ Mean bone density of normal women was 115.77K₂PHO₄ K₂PHO₄. BMD values of normal men in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 171.46㎎/㏄ K₂PHO₄, 162.19㎎/㏄ K₂PHO₄, 155.62㎎/㏄ K₂PHO₄, 147.28㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 101.25㎎/㏄ K₂PHO₄, 109.00㎎/㏄ K₂PHO₄, 103.32㎎/㏄ K₂PHO₄, 91.53㎎/㏄ K₂PHO₄, 88.35㎎/㏄ K₂PHO₄ Mean density of normal men was 115.77㎎/㏄ K₂PHO₄. Peak bone density of women and men was in the age group of 20-24 years and 168.95㎎/㏄ K₂PHO₄, 171.46㎎/㏄ K₂PHO₄, respectively. Bone loss was increased with aging and was accelerated in postmenopausal women than that of premenopausal women. The total loss of BMD for women and men was 70.09% and 48.47%, respectively. Postmenopausal women(mean BMD : 85.83㎎/㏄ K₂PHO₄) had significantly lower BMD than premenopausal women(meand BMD : 144.80㎎/㏄ K₂PHO₄)(p<0.001). The annual loss of BMD of women and men was 2.702㎎/㏄ K₂PHO₄ and 1.795㎎/㏄ K₂PHO₄, respectively. This study provided the BMD reference data for normal korean adult. further studies on BMD in healthy adult and comparison with published data are needed.

• 한국운동역학회지
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• 제21권3호
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• pp.369-382
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• 2011

The purpose of this study was to verify the validation of exercise effect with loading deviation during rowing exercise. We performed evaluation of based physical fitness and joint torque before the experiment for finding muscle unbalance. So we recruited twenty four subjects who have bigger muscle strength in more 20% than average one. Subjects divided two groups. One is dominant upper limbs(DU) and the other was dominant lower limbs(DL). Subjects performed rowing exercise using electric equipment (Robo.gym.Humonic.korea). Exercise is performed four sets a day including 25 times a set, and three days a week. Measurement consist of evaluation of based physical fitness and joint torque using biodex(biodex system3.USA). Evaluation of exercise effect performed each week in joint torque of shoulder, lumbar and knee joint and each month in based physical fitness. Also we adapted 30% of 1RM for muscular endurance and 70% of 1RM for muscle strength as exercise load. The results showed that the difference of maximal peak torque were getting increase significantly during exercise. Also difference of various factor in based physical fitness were getting increase significantly except flexibility and agility. This interpreted that rowing exercise with loading deviation types could provide muscle strength and muscular endurance exercise in same time. These results could be interpret to two ways. One is effect of improving physical fitness for rowing exercise and the other meaned validation of loading deviation in rowing exercise. Our study is going to verify the validation of loading deviation during rowing and we found out that loading deviation could provide muscle strength and muscular endurance exercise for improving muscle unbalance. Our study can be used development of exercise equipment and program for normal people with muscle unbalance. Also that provide effect of whole body exercise to anybody.

• 대한예방한의학회지
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• 제14권2호
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• pp.91-104
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• 2010

The experiments were undertaken to evaluate the effects of herbal medicine, Bojungiggitang and Gwibitang in pregnant rats and their fetuses. Female Sprague-Dawley rats were orally administered with the Bojungiggitang and Gwibitang at dose of 5ml/kg/day for 20 days. Pregnant rats were sacrificed at 20th day of gestation, and the internal and reproductive organs. Approximately live fetuses in the 20th day of gestation were randomly selected and fixed in 95% ethanol. To observe skeletal malformations, fetuses were stained with alcian blue and alizarin red S. Maternal body weights of Bojungiggitang and Gwibitang treated group has a tendency to increase compared to that of control group. There were no significant differences in internal and reproductive organs. There were no significant changes between two groups in blood chemistry and hematological values. There were no significant changes in number of corpus luteum, implantation and live fetuses. But Bojungiggitang and Gwibitang administered group showed higher implantation rate than the control group. Also, Bojungiggitang and Gwibitang administered groups showed lower early resorption rate than the control group. And Gwibitang had the higher value in all the other groups in all items. From the sex ratio, the number of females were larger than the number of males in the control group, and more males than females in Gwibitang administered group. Neonatal body weight and the number of fetus of Bojungiggitang and Gwibitang group were higher than that of control group. The fetuses of dams treated with Bojungiggitang and Gwibitang did not show external malformation. Vertebral and sternal variations were observed in Bojungiggitang and Gwibitang administered group compared to the control group. Those variations were insignificant. There were no significant changes in number of ribs, cervical, thoracic, lumbar, sacral and caudal vertebras. From these results, it can be concluded that Bojungiggitang and Gwibitang showed no toxic effects on maternal body weight and the number of live fetuses. There were no significant changes in organ weight, hematological data, and reproductive organs. Although skeletal variations were shown in vertebra and sternum, Bojungiggitang, Gwibitang were shown insignificant changes in bone malformation.

• Journal of Nutrition and Health
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• 제35권7호
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• pp.779-790
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• 2002

Nutritional factors affecting bone mineral density (BMD) in the different age groups of Korean women were investigated to obtain baseline data for maintaining bone health. Information on diet and anthropometry were collected in 80 elementary school children (height 127.2 cm, weight 27.3 kg), 84 high school students (height 161.6 cm, weight 52.4 kg), 100 adults aged 25 to 35 years (height 159.4 cm, weight 52.7 kg) and 120 elderly people over 60 years of age (height 150.9 cm, weight 55.6 kg). Data for nutrient intake were obtained by 24-hour recall method. BMDs of lumbar spine (L$_2$-L$_4$) and femoral neck were measured by dual energy x-ray absorptiometry. The relationship between BMD of femoral neck and nutritional factors were analyzed. The average BMD of femoral neck for females was 0.61 g/$\textrm{cm}^2$ in children, 0.88 g/$\textrm{cm}^2$ in adolescents, 0.90 g/$\textrm{cm}^2$ in adults, 0.64 g/$\textrm{cm}^2$ in elderly people. Among the adult subjects, 11.0% was classified as osteopenia in the femoral neck. For the elderly, the prevalence of osteopenia and osteoporosis were 34.2% and 47.5% of the subjects. It was shown the intake of energy, protein, plant protein, animal protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, niacin, vitamin C, carbohydrate energy percent and fat energy percent influenced bone health status in all age groups. In the MAR on bone health status, children, adult and elderly subjects were significantly different among groups classified by bone health status and the MAR of the groups with good in bone health was higher. The RDA percent of each nutrient was influence factor on BMD. Nutrient intake of energy, protein, P, Fe, thiamin, niacin were lower BMD on below 75% of Korean RDA. Stepwise multiple regression analysis revealed that several dietary factors were influence on BMD. MAR on femoral neck BMD of children and elderly subjects was the highest influence factor. Beyond this, the most influential dietary factors on BMD were the vitamin A, total Ca and vegetable Ca. The above results have confirmed that dietary factors influence BMD in various age groups. Energy, protein, Ca, P, Fe, thiamin, riboflavin, niacin, vitamin C as well as MAR were important dietary factors influencing BMD. The results of this study revealed that people who received sufficient nutrients intake showed healthy bone status. The MAR mainly influenced the bone health status.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.281-287
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• 2012

Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

• 한국콘텐츠학회논문지
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• 제11권6호
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• pp.270-278
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• 2011

이 연구는 20대와 40대의 급성과 만성 요통환자를 대상으로 척추 주위근육의 단면도를 비교하는 것이다. 20대(남자-9, 여자-10)와 40대(남자-8, 여자9)의 대상자들은 MRI로 요추(4번 하부 종단판) 단면도의 척추주위근육(장요근, 다열근, 척추기립근)들의 크기를 PACS(free-handling technique of the picture archiving and communication system(PACS)을 이용하여 측정하였다. 연구 결과 20대 급성과 만성 요통 환자들의 척추 주위근들의 차이는 통계학적으로 유의성이 없게 나타났으나, 40대 급성과 만성 요통환자들의 척추 주위근들의 차이는 만성 요통환자들이 근 위축이 통계학적으로 유의성 있게 나타났다. 또한 20대와 40대의 만성요통환자 척추 주위근들의 차이도 40대 만성요통 환자들에게 유의성 있게 나타났다. 연구에서 20대 만성환자들의 근 위축은 나타나지 않았으나 40대 만성환자들은 다양한 이유로 근 위축이 나타났다. 따라서 40대의 만성 요통환자들은 조기의 다양한 요부 근력 운동 및 기능적 활동 등으로 허리 주위근육의 위축을 감소시키는 것이 필요하다.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.894-898
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• 2011

Purpose: Coverage of full-thickness large flank defect is a challenging procedure for plastic surgeons. Some authors have reported external oblique turnover muscle flap with skin grafting, inferiorly based rectus abdominis musculocutaneous flap, and two independent pedicled perforator flaps for flank reconstruction. But these flaps can cover only certain portions of the flank and may not be helpful for larger or more lateral defects. We report a case of large flank defect after resection of extraskeletal Ewing's sarcoma which is successfully reconstructed with reverse latissimus dorsi myocutaneous flap. Methods: A 24-year-old male patient had $13.0{\times}7.0{\times}14.0$ cm sized Ewing's sarcoma on his right flank area. Department of chest surgery and general surgery operation team resected the mass with 5.0 cm safety margin. Tenth, eleventh and twelfth ribs, latissimus dorsi muscle, internal and external oblique muscles and peritoneum were partially resected. The peritoneal defect was repaired with double layer of Prolene mesh by general surgeons. $24{\times}25$ cm sized soft tissue defect was noted and the authors designed reverse latissimus dorsi myocutaneous flap with $21{\times}10$ cm sized skin island on right back area. To achieve sufficient arc of rotation, the cephalic border of the origin of latissimus dorsi muscle was divided, and during this procedure, ninth intercostal vessels were also divided. The thoracodorsal vessels were ligated for 15 minutes before divided to validate sufficient vascular supply of the flap by intercostal arteries. Results: Mild congestion was found on distal portion of the skin island on the next day of operation but improved in two days with conservative management. Stitches were removed in postoperative 3 weeks. The flap was totally viable. Conclusion: The authors reconstructed large soft tissue defect on right flank area successfully with reverse latissimus dorsi myocutaneous flap even though ninth intercostal vessel that partially nourishes the flap was divided. The reverse latissimus dorsi myocutaneous flap can be used for coverage of large soft tissue defects on flank area as well as lower back area.

• 대한의용생체공학회:의공학회지
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• 제28권3호
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• pp.397-409
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• 2007

Owing to needs of biomechanical comprehension and analysis to obtain various medical treatment designs which are related with the spine in order to cure and diagnose LBP patients, the FE modeling and nonlinear analysis of lumbosacrum including a partial ilium and iliolumbar ligaments, were carried out. First, we investigated whether the geometrical configuration of vertebrae displayed by DICOM slice files is regular and normal condition. After constructing spinal vertebrae including a partial ilium, a sacrum and five lumbars (from L1 to L5)with anatomical shape reconstructed using softwares such as image modeler and CAD modeler, we added iliolumbar ligaments, lumbar ligaments, discs and facet joints, etc.. And also, we assigned material property and discretized the model using proper finite element types, thus it was completely modeled through the above procedure. For the verification of each segment, average sagittal ROM, average coronal ROM and average transversal ROM under various loading conditions(${\pm}10Nm$), average vertical displacement under compression(400N), ALL(Anterior Longitudinal Ligament) and PLL(Posterior Longitudinal Ligament) force at L12 level, strains of seven ligaments on sagittal plane at L45 level and maximal strain of disc fibers according to various loading conditions at L45 level, etc., they were compared with experimental results. For the verification of multilevel-lumbosacrum spine including partial ilium and iliolumbar ligaments, the cases with and without iliolumbar ligaments were compared with ROM of experiment. The results were obtained from analysis of the verified FE model as follows: I) Iliolumbar ligaments played a stabilizing role as mainly posterior iliolumbar ligaments under flexion and as both posterior and anterior iliolumbar ligaments of one side under lateral bending. 2) The iliolumbar ligaments decreased total ROM of 1-8% in total model according to various motion conditions, which changed facet contact forces of L5S level by approximately 0.8-1.4 times and disc forces of L5S level by approximately 0.8-1.5 times more than casewithout ilioligaments, under various loading conditions. 3) The force of lower discs such as L45 and L5S was bigger than upper discs under flexion, left and right bending and left and right twisting, except extension. 4) It was predicted that strains of posterior ligaments among iliolumbar ligaments would produce the maximum 16% under flexion and the maximum 10% under twisting. 5) It's expected that this present model applies to the development and design of artificial disc, since it was comparatively in agreement with the experimental datum.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.