• Physical Therapy Korea
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• v.7 no.3
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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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.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1298-1311
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• 2022

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.

• Journal of Veterinary Clinics
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• v.26 no.5
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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.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.373-379
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• 2018

The purpose of this study was to investigate quantitative data on the difference in breast entrance surface dose with changes in focus-film distance, patient posture (anteroposterior-posteroanterior), thoracic wall thickness, rib bone thickness, lung tissue thickness, tube voltage, and high-voltage rectification method in Whole Spine Scanography, which is necessary for the treatment of scoliosis patients. Given a tube voltage of 90 kVp, kerma of 0.1 mGy, focus-film distance of 260 cm, tube voltage ripple rate of 0, filter thickness of 3.5 mm, and thickness of patient's thoracic wall of 120 mm as an X-ray exposure condition, from the simulation results using the Simulation of X-ray Spectra program to confirm the reduction effect of breast entrance surface dose according to the patient's posture (AP and PA), there was a dose reduction effect in aluminum filter thickness of 2.6 times at 3.5 mm, 25.7 times the thoracic wall thickness at 120 mm, 1.43 times higher tube voltage, and 0 to 1.14 times the tube voltage ripple rate. The total dose reduction effect was about 109 times. In order to confirm the dose reduction effect of RANDO phantom posture (AP and PA), from the results of the measurements taken under the conditions that the focus-film distance was 260 cm, the tube voltage was 90 kVp, the tube current was 270 mA, the exposure time was 0.31 sec, and the tube voltage ripple rate of X-ray generators was 0, the entrance surface dose reduction effect of the breast in the PA position was found to be 20.56 times lower than that of the AP position.

• Journal of radiological science and technology
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• v.42 no.1
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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.

• Journal of radiological science and technology
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• v.30 no.2
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• pp.95-104
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• 2007

In this study, the analysis on findings from simple chest radiography(CXR) test with total 1,669 subjects without any special clinical symptom came to the following conclusions : 1. In terms of the general characteristics of subjects hereof, male and female group accounted for 55.2% and 44.8% respectively out of all 1,669 people. 2. Pulmonary disease cases amounted to 249 persons(14.9%) out of all subjects. 3. In the analysis on prevalence rate by age distribution, it was noted that the older age led to the more number of diseases, which was demonstrated by age 34 or younger(6.1%), age $35{\sim}39(9.7%)$, age $40{\sim}49(13.3\;%)$, and age 50 or older(30.8%). 4. In regard of pulmonary disease alone, the region of onset was represented primarily by right upper lobe, which was followed by both upper lobe and left upper lobe, respectively. 5. In terms of disease types, it was found that most cases were represented by pulmonary nodule(55.0%), which was followed by cardiomegaly(24.5%), CP angle blunting(4.8%), scoliosis(4.6%), tortuous aorta(2.8%), bronchial luminal dilatation(2.4%), and pleural thickening(2.0%). However, dextrocardia, cystic dilation of bronchus, cavitary lesion, and lung collapse accounted for relatively low rate(0.4% respectively). 6. In terms of disease types by sex, it was found that male group accounted for higher percentage of having pulmonary nodule than female group, while the latter accounted for higher percentage of having cardiomegaly, tortuous aorta and scoliosis than the former. 7. In terms of disease types by age distribution, it was noted that age 34 or younger group accounted for higher percentage of scoliosis than any other age groups, while age $40{\sim}49$ group, age $35{\sim}39$ group, and age 50 or older group represented the case of CP angle blunting, pulmonary nodule, and cardiomegaly/tortuous aorta, respectively.

• Asian Spine Journal
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• v.12 no.6
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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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• v.21 no.1
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• pp.40-50
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• 2004

Background: This study was conducted to analyze the height and width of the pedicle of the upper and lower levels on the concave and the convex sides. In addition, we checked for the appropriate pedicle screw size which could be screwed in without complications. Materials and Methods: Taking a simple AP radiography in a standing position, 99 vertebrae on the major curve with the possibility of 3-D reconstruction were analyzed after checking the CT in a supine position of 22 idiopathic scoliosis. We measured Cobb's angle from a simple radiograph, and measured the size of the isthmus by the Inner Space 3-D Editor after 3-D reconstruction with the Inner Space 3-D program in the DICOM file transformed from CT image. We then analyzed the size of pedicles of the upper and lower levels on the concave and the convex sides by measuring the height and width of the pedicle. Results: All pedicles on the concave side were smaller than those on the convex side. Their size increased as the measurement moved from the upper to lower vertebra, except for the upper thoracic vertebra. When the width of the pedicle through 3-D reconstruction was compared with the narrowest width of the pedicle measured by using CT, the width of the pedicles through 3-D reconstruction was statistically smaller (P<0.01). Most of the pedicles were tear-drop or kidney shaped rather than cylindrical. Conclusion: These results suggest that the use of the coronal plane through 3-D reconstruction would be necessary for an accurate measurement of the size of the pedicle. It is important to pay careful attention to the screw size and the screwing method considering the pedicle shape through 3-D reconstruction.

• The Journal of Korean Medicine
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• v.21 no.4
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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.