• 한국전문물리치료학회지
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• 제7권3호
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• pp.1-18
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• 2000

The present study was performed to investigate the prevalence rate of idiopathic scoliosis and to determine the effect of exercise training on scoliotic angle in elementary school children. In this study, two out of five elementary schools in Seosan city were chosen by random sampling. Seven hundred sixty four students (from four grade to the sixth grade student) were selected in two schools. Screening tests were conducted to find idiopathic scoliosis. Among the 764 individuals, 139 subjects who showed positive sign in physical examination took whole spine radiography. Thirty six subjects who had a curve of 10 or greater and consented to participate in the exercise program were selected for the exercise program. The exercise program was performed four times a week for 5 months. The results of this study were as follows: 1) One hundred thirty nine subjects showed positive sign in the scoliosis screening test. 2) The overall prevalence of curve of $10^{\circ}or$ greater in X-ray finding was 8.15%. The prevalencies of curve of $10^{\circ}or$ greater in male and female were 7.1% and 9.2%, respectively. 3) Scoliosis curves were observed at thoracic area (48.4%), at thoracolumbar area (27.4%) and at lumbar area(24.4%). 4) Right side curve was 59.7%, and left side curve was 40.3%. 5) After the 5 month exercise program for scoliosis, the Cobb's angle was significantly decreased. 6) There was no significant difference of Cobb's angle change respect to sex, grades, and scoliosis curve site. Results shown here indicates that an early detection and early exercise for scoliosis can result in decreased the Cobb's angle in elementary school children.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.51-56
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• 2016

Background: The purpose of this study is to compare axis change during cervical flexion and extension according to lordosis angle to patients with scoliosis. Methods: Movement axis change was estimated during cervical flexion and extension in twenty-four scoliosis patients with hypolordosis using radiography. Subjects were divided into mild lordotic curve group (MLCG, n=12, $34{\sim}25^{\circ}$) and severe lordotic curve group (SLCG, n=12, less $25^{\circ}$) according to cervical lordosis angle. Results: During cervical flexion, both group showed movement axis change to upper part of cervical vertebra and SLCG showed greater than MLCG but there is no significant difference. During cervical extension, SLCG showed greater than MLCG and there is significant difference. Conclusion: It is considered that cervical hypolordosis acts as important factor to scoliosis and degenerative joint disease because it leads to change of movement axis and central route of joint.

• 대한영상의학회지
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• 제83권6호
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• pp.1298-1311
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• 2022

목적 흉부 X선 사진에서 척추측만증을 조기진단 할 수 있는 딥러닝 기반의 스크리닝 소프트웨어를 준지도학습(semi-supervised generative adversarial network; 이하 GAN) 방법을 이용하여 개발하고자 하였다. 대상과 방법 두 곳의 상급종합병원에서 촬영된 흉부 X선 사진에서 척추측만증을 조기진단할 수 있는 스크리닝 소프트웨어를 개발하기 위하여 GAN 방법이 이용되었다. GAN의 훈련과정에서 경증에서 중증의 척추측만증을 보이는 흉부 X선 사진들을 사용하였으며 upstream task에서 척추측만증의 특징을 학습하고, downstream task에서 정상과 척추측만증을 분류하도록 훈련하였다. 결과 수신자 조작 특성 곡선의 곡선하면적(area under the receiver operating characteristic curve), 음성예측도, 양성예측도, 민감도 및 특이도는 각각 0.856, 0.950, 0.579, 0.985, 0.285이었다. 결론 우리가 GAN 방법을 이용하여 개발한 딥러닝 기반의 스크리닝 소프트웨어는 청소년의 흉부 X선에서 척추측만증을 진단하는데 있어서 높은 음성예측도와 민감도를 보였다. 이 소프트웨어가 건강검진을 목적으로 촬영한 청소년의 흉부 X선 사진에 진단 스크리닝 도구로써 이용된다면 영상의학과 의사의 부담을 덜어주며, 척추측만증의 조기진단에 기여할 것으로 생각된다.

• 한국임상수의학회지
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• 제26권5호
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• pp.476-479
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• 2009

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with 0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery. After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, IV) was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration, abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia, so lidocaine (2 mg/kg, IV) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.

• 한국방사선학회논문지
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• 제12권3호
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• pp.373-379
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• 2018

본 논문에서는 척추측만증 환자의 진료를 위하여 필요한 Whole Spine Scanography 검사에서 촬영거리, 환자자세(전후 후전 방향), 흉부벽두께, 갈비뼈두께, 폐조직두께, 관전압, 고전압정류방식의 변화에 따른 유방의 입사선량의 차이에 대한 정량적인 자료를 제시하고자 하였다. 환자의 자세(전후방향과 후전방향)에 따른 유방 입사선량의 저감효과를 확인하기 위하여 관전압 90 kVp, 커마 0.1 mGy, 촬영거리 260 cm, 관전압의 리플율이 0인 인버터정류방식, 필터의 두께 3.5 mm, 환자의 흉벽의 두께 120 mm를 조건으로 Simulation of X-ray Spectra program을 이용하여 시뮬레이션 하였다. 그 결과 알루미늄 필터 두께 3.5 mm에서 2.6배, 흉벽의 두께 120 mm에서 25.7배, 고 관전압에서 1.43배, 관전압 리플율 0에서 1.14배의 선량 저감효과가 있었다. 각각의 입사 선량저감효과의 총합은 약 109배이었다. RANDO phantom의 자세(전후방향과 후전방향)에 따른 선량 저감효과를 확인하기 위하여 촬영거리 260 cm, 관전압 90 kVp, 관전류 270 mA, 촬영시간 0.31 sec, 관전압의 리플율이 0인 인버터정류방식, 필터의 두께 3.5 mm을 조건으로 측정한 결과 유방의 입사선량은 전후 방향에 비하여 후전방향이 평균 20.56배의 선량 저감효과가 있었다.

• 대한방사선기술학회지:방사선기술과학
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• 제42권1호
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• pp.25-30
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• 2019

Whole Spine Scanography (WSS) using the Digital Radiography (DR) system is an examination that requires whole body X-ray exposure, which involves more exposure to radiation for patients than other general radiographies. This can affect the occurrence of breast cancer. This research measured radiation dose when breasts were shield and not shield using the Auto Exposure Control (AEC) mode. The radiation dose without a shield was 1.540 mGy, and that using a collimator was measured 0.506 mGy. Moreover, 0.733 mGy was measured when 1 shield (0.3 mm) was used, and $0.523{\mu}Gy$ when 5 of them (1.5 mm) were used. The results showed that the radiation dose with 5 shields and the radiation dose with a collimator were similar. Moreover, 0.233 mGy was measured when 8 shields (2.4 mm) were used. The standard deviation were 0.081 when using collimator and 0.014 when 5 shields were used. Also, when 8 shields were used, it was found to be 0.002. Most patients who go under a scoliosis test are children or young people who are highly sensitive to radiation. In the research results, the case where the organs sensitive to radiation, women's breasts, were shielded showed more distinct differences compared to without shields. It is considered that using shields can provide more constant shield than using a collimator and lower the risk of breast cancer caused by exposure to radiation.

• 대한방사선기술학회지:방사선기술과학
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• 제30권2호
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• pp.95-104
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• 2007

특별한 임상적 증상이 없는 대상자 총 1,669명의 단순 흉부방사선영상(simple chest radiography, CXR) 소견을 분석한 결과 다음과 같은 결론을 얻었다. 1. 연구대상자의 일반적 특성은 총 1,669명 중 남자 55.2%, 여자 44.8%이었다. 2. 흉부 질환이 있는 경우는 총 1,669명 중 14.9%인 249명이었다. 3. 연령에 따른 질환의 분석에서는 35세 미만 6.1%, $35{\sim}39$세 9.7%, $40{\sim}49$세 13.3%, 50세 이상 30.8%로 연령이 많을수록 질병이 많았다. 4. 질환의 발생부위는 폐질환만을 고려할 때 right upper lobe가 가장 많았고, both upper lobe, left upper lobe의 순이었다. 5. 질환의 종류는 유소견자 249명 중 pulmonary nodule를 가지고 있는 경우가 55.0%(총 1,669명의 대상자에서 유소견자 249명 중 137명으로 전체 대상자를 기준으로 할 경우 8.2%)로 가장 많았으며, 다음으로 cardiomegaly 24.5%, CP angle blunting 4.8%, scoliosis 4.6%, tortous aorta 2.8%, bronchial luminal dilatation 2.4%, pleural thickening 2.0% 순으로 나타났고, dextrocardia와 cystic dilation of bronchus, cavitary lesion, lung collapse 등은 각각 0.4%로 매우 적었다. 6. 성별에 따른 질환의 종류는 남자가 여자보다 pulmonary nodule이 많았고, 여자는 남자보다 cardiomegaly와 tortous aorta, scoliosis가 더 많았다. 7. 연령에 따른 질환의 종류는 35세 미만이 다른 연령대보다 scoliosis가 많았고, $40{\sim}49$세는 CP angle blunting, $35{\sim}39$세는 pulmonary nodule, 50세 이상은 cardiomegaly와 tortous aorta가 많았다.

• Asian Spine Journal
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• 제12권6호
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• pp.1060-1068
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• 2018

Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

• Journal of Yeungnam Medical Science
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• 제21권1호
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• pp.40-50
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• 2004

특발성 척추측만증 환자에서 3차원적인 재구성을 이용한 관상면에서 척추경의 폭을 측정하는 것이 오차를 줄일 수 있는 방법이고 척추경 나사못의 삽입 시 척추경의 크기를 술 전에 측정한 후 그 값의 최대치보다 작은 최대 크기의 원추형 나사못을 삽입하는 것이 안전한 방법이라 사료된다. 척추경 나사못을 삽입할 시에는 척추경의 모양이 원주 형태가 아닌 낙루 형태나 신장 형태 등 추체마다의 다양한 모양을 고려하여 나사못 크기와 삽입 방법에 세심한 주의가 필요할 것으로 사료된다.

• 대한한의학회지
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• 제21권4호
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• pp.148-158
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• 2000

Objective : The purpose of this study was to investigate the back shape of school children using the phase-shifting scanning grating projection moire interferometer, which was developed by the Korea Advanced Institute of Science and Technology and is useful in evaluating three dimensional back shape. Methods : In this study the subjects consisted of 1,358 pupils [711 boys(52.36%), 647 girls(47.64%)] attending elementary and middle schools in Seoul. Their ages ranged from nine to fifteen and the average age was 12.2. With the phase-shifting scanning grating projection moire interferometer, the posterior view of the body were taken to see if there are correlations of moire fringe number, width difference between left and right, and correlation between differences in moire fringe number and width on both sides in the scapular, lumbar and gluteal regions. Results : The results were as follows : I. More frequent findings of fringe were observed on the right in all regions : in the scapular region, 309 boys(43.4%) and 156 girls(24.2%) had more fringe numbers on the right side; in the lumbar region, 68 boys(9.5%) and 11 girls(1.7%); and in the gluteal region, 160 boys(22.4%) and 63 girls(9.8%). Such tendency was striking especially in the scapular and lumbar regions, and in boys rather than in girls. In the scapula, 661 subjects(48.7%) with one moire fringe on either side need further attention and 110 subjects(8.I %) with two or more are required to do follow-up radiography for scoliosis. 2. In an analysis of width difference in the trunk, the left side is wider in all regions except for the gluteal region in boys : in the scapular region 21 boys(3.0%) and 103 girls(15.9%); in the lumbar region, 87 boys(12.2%) and 250 girls(38.6%); and in the gluteal region 197 girls(30.4%) had a wider left side and 45 boys(6.3%) showed a wider right side. 3. In correlation analysis of the number of moire fringe and width difference in each region, the side where more moire fringes were observed was significantly wider in the lumbar and gluteal regions, but not in the scapular region.(p<0.01) Conclusions : From these results, it is concluded that the back shape of elementary and middle school students in Seoul shows that the right side had more moire fringes; the left side was wider; and especially in the lumbar and gluteal regions the side where more moire fringes were observed was wider.