• Journal of Korean Neurosurgical Society
• /
• v.59 no.3
• /
• pp.282-286
• /
• 2016

Objective : Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods : Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results : The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion : The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.

• Korean Journal of Veterinary Research
• /
• v.53 no.2
• /
• pp.73-76
• /
• 2013

The aim of this study was to produce a simple and inexpensive technique for estimating the obturator foramen area (OFA) from young calves based on the hypothesis that OFA can be extrapolated from simple linear measurements. Three linear measurements - dorsoventral height, craneocaudal width and total perimeter of obturator foramen - were obtained from 55 bovine hemicoxae. Different algorithms for determining OFA were then produced with a regression analysis (curve fitting) and statistical analysis software. The most simple equation was OFA ($mm^2$) = [3,150.538 + ($36.111^*CW$)] - [147,856.033/DH] (where CW = craneocaudal width and DH = dorsoventral height, both in mm), representing a good nonlinear model with a standard deviation of error for the estimate of 232.44 and a coefficient of multiple determination of 0.846. This formula may be helpful as a repeatable and easily performed estimation of the obturator foramen area in young bovines. The area of the obturator foramen magnum can thus be estimated using this regression formula.

• Journal of Korean Medicine Rehabilitation
• /
• v.20 no.2
• /
• pp.89-99
• /
• 2010

Objectives : This study was designed to analyze the pattern of asymmetrical alignment. Methods : This study was carried out with the data from comprehensive medical testing. 91 subjects aged 30-39 were evaluated by full spine AP X-ray. For pelvis, innominate measurement(IM), off centering measurement(OCM), ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) were analyzed. Spinal curvature and height of shoulder girdle were analyzed. Results : 1. In pelvis, It. posterior-inferior and it. inflare combination pattern was 38 cases(42.8%). 2. In spinal curvature, "reverse S" curve was 45 cases(49.4%) and "reverse C" curve was 30 cases(33%). 3. In shoulder girdle, It. superior pattern was 42 cases(46.1 %) and It. superior pattern was 39 cases(42.9%). 4. In whole body analysis, It. posterior-inferior and It. inflare pelvis, "reverse S" spinal curvature and It. superior shoulder girdle combination patten was 11 cases(12.1 %). This pattern is similar to Kendall's right handedness pattern and Zink's common compensatory pattern. Conclusions : Results from this investigation showed asymmetrical alignment in 30-39 years-old adults. This results are expected to contribute to classifying the alignment pattern in clinic and systemic treatment.

• Radiation Oncology Journal
• /
• v.16 no.4
• /
• pp.497-504
• /
• 1998

Purpose : To evaluate the usefulness of electronic portal imaging device through objective compare of the images acquired using an EPID and a conventional port film Materials and Methods : From Apr. to Oct. 1997, a total of 150 sets of images from 20 patients who received radiation therapy in the pelvis area were evaluated in the Inha University Hospital and Severance Hospital. A dual image recording technique was devised to obtain both electronic portal images and port film images simultaneously with one treatment course. We did not perform double exposure five to ten images were acquired from each patient. All images were acquired from posteroanterior (PA) view except images from two patients. A dose rate of 100-300 Mu/min and a 10-MV X-ray beam were used and 2-10 MUs were required to produce a verification image during treatment. Kodak diagnostic film with metal/film imaging cassette which was located on the top of the EPID detector was used for the port film. The source to detector distance was 140 cm. Eight anatomical landmarks (pelvic brim, sacrum, acetabulum. iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint) were assessed. Four radiation oncologist joined to evaluate each image. The individual landmarks in the port film or in the EPID were rated - very clear (1), clear (2), visible (3), not clear (4), not visible (5). Results : Using an video camera based EPID system. there was no difference of image quality between no enhanced EPID images and port film images. However, when we provided some change with window level for the portal image, the visibility of the sacrum and obturator foramen was improved in the portal images than in the port film images. All anatomical landmarks were more visible in the portal images than in the port film when we applied the CLAHE mode enhancement. The images acquired using an matrix ion chamber type EPID were also improved image qualify after window level adjustment. Conclusion : The quality of image acquired using an electronic portal imaging device was comparable to that of the port film. When we used the enhance mode or window level adjustment. the image quality of the EPID was superior to that of the port film. EPID may replace the port film.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.5 no.2
• /
• pp.169-180
• /
• 2010

Objectives: This study was carried out to investigate the relationship of leg length analysis and X-ray finding according to positions and valuation bases on diagnosis of pelvic malpositions. Methods: Twenty-two people who get $33.09{\pm}10.73$ as average were evaluated by leg length analysis and X-ray findings. After measuring innominate measurement(IM), femur head line. distance between S2 and posterior superior iliac spine(PSIS). ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) and distance between off centering measurement and symphysis pubis, those were analyzed. Results: 1. In assessment of posterior rotation malposition ilium(PI), it was showed the best coincidence between leg length analysis and X-ray analyzed by 1M in supine position(11 cases, 50.5%). 2. In assessment of inflare, coincidence index between leg length analysis and X-ray were not good($4.00{\pm}3.03$ cases, $18.15{\pm}13.82%$). And leg length analysis were not sensitive. 3. On the whole, coincidence index between leg length analysis and X-ray were not good(best: 1 case, 45.5%; worst: 11 cases, 50.0%). Conclusions: Results form this investigation showed the relationship of leg length analysis and X-ray according 10 positions and valuation bases on diagnosis of pelvic malpositions. This results are expected to contribute to establish method of assessment in diagnosis of pelvic malpositions.

• Journal of Korean Medicine Rehabilitation
• /
• v.18 no.4
• /
• pp.161-169
• /
• 2008

Objectives : This study was carried out to investigate the relationship of pelvic alignment between AP view of the pelvis in standing and supine position. Methods : Sixteen healthy peoples who get $51.59{\pm}4.14$ as average in SF-36 were evaluated by X-ray findings. After measuring innomiate measurement, off centering measurement, sacral ala measurement, illium shadow measurement, the area of obturator foramen, those were analyzed statistically. Results : It was not all to be corresponded to distort pelvic alignment of AP view of the pelvis in standing and in supine. Sometimes it was the opposite result. Conclusions : These results suggest that the diagnosis of pelvic alignment to go through on each position is brought about disagreement with each other.

• Korean Journal of Veterinary Research
• /
• v.28 no.1
• /
• pp.1-16
• /
• 1988

The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.10 no.1
• /
• pp.75-86
• /
• 2015

Objectives : The purpose of this study is to compare the effect of Chuna manual treatment and Chuna manual treatment with self muscle energy techniques on patients with pelvic malposition Methods : Random allocation was done. We used Chuna manual treatment to control group and Chuna manual treatment with self muscle energy techniques to experimental group. These patient's pelvic malposition were checked by Leg length analysis, measuring Innominate measurement length, obturator foramen size and height of femur head. Results : 1)After the 3 weeks treatment, patients' inequality of leg length and Innominate measurement length were significantly reduced. 2)There was no significant difference between control group and experimental group. Conclusions : Chuna manual treatment and Chuna manual treatment with self muscle energy techniques are considered to be effective and useful in patients with pelvic malposition. But there was no significant difference between control group and experimental group.

• Journal of Veterinary Clinics
• /
• v.24 no.1
• /
• pp.26-28
• /
• 2007

An 11-year-old castrated male, Shih-tzu dog was admitted for progressive weight-bearing lameness and mass on the right hindlimb. Radiography and ultrasonography revealed a large well-marginated multinodular mass with mixed echogenicity. On T1 and T2-weighted magnetic resonance imaging (MRI), the mass has a heterogenous signal intensity similar to or higher than muscle. The masses were extended to the pelvic cavi쇼 through obturator foramen and displaced the rectum dorsally. It was diagnosed as synovial sarcoma which was composed with mesenchymal and epithelial elements on histopathological findings of the multifocal biopsied specimen. MRI was helpful to determine the definitive margin for surgical resection of the mass. The mass was recurred at the 6th month after surgery. On the 10th month, the patient was euthanasiuzed by owner's request.

• Journal of Korean Medicine Rehabilitation
• /
• v.32 no.2
• /
• pp.83-94
• /
• 2022

Objectives This systematic review aimed to analyze research about pelvic deviation diagnosis for Chuna manual therapy (CMT) and to review the diagnosis methods, indices, and results of diagnosis. Methods Ten electronic databases were systematically searched up to January 4th 2022. Clinical studies and reviews containing pelvic deviation diagnosis for CMT or using CMT as a treatment of pelvic deviation were selected and evaluated. CMT diagnosis in clinical studies and reviews were isolated and analyzed by 2 independent reviewers. Results Thirteen clinical studies and three reviews were included in the evaluation. X-ray analysis and manual testing were the two main methods used in CMT diagnosis of pelvic deviation. For manual testing in clinical studies, leg length insufficiency testing was the most frequently used measurement index and the most common diagnostic results were anterior and posterior rotation. In the X-ray analysis, Obturator foramen and femur head line were the most frequently used measurement index and the most common diagnostic results were anterior rotation and posterior rotation. Conclusions The systematic review found that manual testing and X-ray analysis were mainly used for the diagnosis of pelvic deviation in CMT among clincial and review articles. As there was little research about diagnosing pelvic deviation in CMT and any existing research presented only low standards of evidence, further research should be updated with using a more standardized approach.