• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.282-286
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• 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.

• 대한수의학회지
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• 제53권2호
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• pp.73-76
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• 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.

• 한방재활의학과학회지
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• 제20권2호
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• pp.89-99
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• 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
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• 제16권4호
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• pp.497-504
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• 1998

목적 : matrix ion chamber type의 EPID와 video camera based EPID를 이용한 portal image와 기존의 film을 이용한 port film의 영상의 질을 객관적으로 비교 평가하여 EPID의 유용성을 알아보고자 본 연구를 계획하였다. 대상 및 방법 : 1997년 4월부터 10월까지의 인하대 병원과 세브란스 병원에서 방사선 치료를 받은 골반강내 치료 환자 각 10명씩을 대상으로 환자 1명 당 5-10회의 port film과 EPID를 이용한 portal image를 동시에 얻어 비교하였다. 환자의 나이는 32세에서 79세이었고 2명의 AP영상을 제외하고는 모두 PA영상을 얻었다. 환자의 두께는 17cm에서 20cm으로 비교적 균일하였다. beam energy는 10MV X-ray를 사용하였고 dose rate은 100-300MU/min으로 2-10MU을 주어 영상을 얻었다. port film은 Kodak diagnostic film을 사용하였고 film을 넣는 cassette는 납을 전후에 부착한 것을 이용하였다. source to detector(film) distance는 140cm으로 하였다. 영상의 판독은 4명의 치료방사선과 의사에 의해서 시행되었으며 pelvic brim, sacrum, acetabulum, iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint를 각각 very clear(1), clear(2), visible(3), not clear(4), not visible(5) 다섯 단계로 나누어 점수를 주었다. 결과 : video camera based EPID를 이용하여 얻은 영상을 비교하여 보았을 때 film을 이용한 port film과 enhancement를 시행하지 않은 portal image는 각 해부학적 구조에서는 차이를 보이지 않았다. 그러나 portal image를 window level로 영상의 변화를 주었을 때는 sacrum과 obturator는 영상의 판독에 도움이 되었다. 또한 portal image를 CLAHE로 enhance를 하였을 때는 모든 해부학적 구조물의 판독이 film보다 용이한 것으로 나타났다. matrix ion chamber type의 EPID를 이용하여 얻은 영상에서도 역시 port film과 영상의 변화를 주지 않은 portal image간에는 커다란 차이를 보이지 않았으나, portal image를 window level로 변화를 주었을 경우는 portal film에 비하여 영상의 질이 더욱 좋아지을 알 수 있었다. 결론 : 방사선 치료를 받는 환자 중에서 골반강의 영상에서는 EPID의 영상의 질은 기존의 port film과 비교하여 차이가 없었으며, window level로 영상에 변화를 주거나 enhance를 하였을 경우는 port film보다 더 나은 영상을 얻을 수 있어 기존의 port film을 대체 할 수 있을 것으로 생각된다.

• 척추신경추나의학회지
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• 제5권2호
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• pp.169-180
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• 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.

• 한방재활의학과학회지
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• 제18권4호
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• pp.161-169
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• 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.

• 대한수의학회지
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• 제28권1호
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• pp.1-16
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• 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.

• 척추신경추나의학회지
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• 제10권1호
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• pp.75-86
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• 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.

• 한국임상수의학회지
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• 제24권1호
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• pp.26-28
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• 2007

우측 후지가 점진적인 파행을 보이는 11년령의 수컷 시츄견이 내원하였다. 신체검사 결과 부정형의 종괴가 촉진 되었다. 방사선 촬영에서는 균질한 연부 조직성 밀도를 보였으며, 초음파 검사에서는 혼합성 에코를 보이는 경계가 명료한 특징을 갖고 있었다. MRI 검사에서는 주변 근육과 비교한 결과 유사 또는 강한 비균질성 신호강도를 보였다. 종괴는 주로 대퇴부 주변에 형성되어 있었으며, 일부는 골반뼈 폐쇄구멍을 통해 골반강내에서 직장의 변위를 일으키고 있음이 확인할 수 있었다. 병리조직 검사 결과 중간엽 세포와 상피세포로 구성된 활막육종으로 진단되었다. 종괴는 외과적으로 적출하였으나, 지속적인 근위축으로 있었으며 인해 파행은 개선되지 않았다. 적출 후 6개월에 종괴가 형성됨이 확인되었으며 점진적으로 그 크기 비대해져 10개월이 되는 시점에서 견주의 요청으로 안락사 하였다. MRI는 활막육종 형성됨이 확인되었으며 이에 대한 특징적인 소견은 내포하고 있지 않지만 종괴의 수술적 적출과 종괴의 범위를 확인하는데 있어 유용한 정보를 제공함을 알 수 있었다.

• 한방재활의학과학회지
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• 제32권2호
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• pp.83-94
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• 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.