• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.154-161
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• 2017

Purpose: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. Materials and Methods: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. Results: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = -0.45 and -0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0-99.0) and 95.3% (95% CI: 90.0-100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0-100.0) and 70.4% (95% CI: 60.0-80.0), respectively. Conclusion: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.275-279
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• 2013

Objective : This study was designed to determine the most reliable cephalometric measurement technique in the normal population and patients with basilar invagination (BI). Methods : Twenty-two lateral radiographs of BI patients and 25 lateral cervical radiographs of the age, sex-matched normal population were selected and measured on two separate occasions by three spine surgeons using six different measurements. Statistical analysis including intraclass correlation coefficient (ICC) was carried out using the SPSS software (V. 12.0). Results : Redlund-Johnell and Modified (M)-Ranawat had a highest ICC score in both the normal and BI groups in the inter-observer study. The M-Ranawat method (0.83) had a highest ICC score in the normal group, and the Redlund-Johenll method (0.80) had a highest ICC score in the BI group in the intra-observer test. The McGregor line had a lowest ICC score and a poor ICC grade in both groups in the intra-observer study. Generally, the measurement method using the odontoid process did not produce consistent results due to inter and intra-observer differences in determining the position of the odontoid tip. Opisthion and caudal point of the occipital midline curve are somewhat ambiguous landmarks, which induce variable ICC scores. Conclusion : On the contrary to other studies, Ranawat method had a lower ICC score in the inter-observer study. C2 end-plate and C1 arch can be the most reliable anatomical landmarks.

• 대한물리치료과학회지
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• 제29권2호
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• pp.38-47
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• 2022

Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.293-299
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• 2007

Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

• 한국방사선학회논문지
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• 제12권4호
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• pp.443-450
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• 2018

Geant4 코드는 직선 가속기의 헤드 구조를 사용하여 이전에 구현된 BEAMnrC 데이터를 기반으로 선형가속기 (VARIAN CLINAC.)를 시뮬레이션하였다, 10MV 광자 선속에서 물팬텀의 심부선량백분율과 측면선량의 측정값과 Geant4를 비교 평가하였다. 선량 계산을 인체부위에 적용하기 위해 실제 환자의 Lung 부위를 5mm 간격으로 스캔하였다. Water phantom의 조사야($5{\times}5cm^2$), SAD 100cm에서 10MV 광자를 조사하여 Geant4 선량분포를 구하였다. 이 결과는 실제 환자의 폐(lung)에 흡수되는 선량을 측정하기는 어렵다 그래서 치료계획 시스템에 의한 선량을 비교하였다. 물 팬텀에서 측정된 심부선량 곡선과 Geant4에 의해 계산된 심부선량 곡선은 build-up 영역을 제외한 대부분의 깊이에서 ${\pm}3%$ 이내로 잘 일치하였다. 그러나 5cm와 20cm 지점에서 2.95%와 2.87%로 Geant4를 사용한 선량 계산에서 다소 높은 값을 보이고 있다. 이 두 지점은 Genat4의 geometry 파일을 통해 확인할 수 있었으며, 흉추와 흉골이 위치되어 선량이 증가된 것으로 알 수 있었다. 또한, cone beam CT를 적용한 결과에서 폐(lung)의 선량분포 오차는 3% 이내로 유사한 값을 얻었다. 따라서 Geant4를 이용하여 선량을 계산할 때 DICOM 파일에 직접 선량의 contour map이 표현될 수 있다면 Geant4의 임상적 적용이 다양하게 사용될 것이다.

• 한국전문물리치료학회지
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• 제5권3호
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• pp.72-87
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• 1998

This study examined the rates of spinal abnormal curvature and the correlation of the Body Mass Index (BMI), Low Back Pain (LBP) and spinal curvature by measuring scoliosis, kyphosis, and lordosis in university students. The study population included 67 male, 92 female university students, making a total of 159, in Wonju City. Spinal curvature was measured by an electrogoniometer in a computerized skeletal analysis system. Lateral curvature of spine of more than 10 degrees was considered as nonspostural scoliosis. The correlation of BMI, LBP and the spinal curvature was analysed by Pearson's correlation coefficient and t-test. The following results were obtained: 1. The overall incidence and rate of scoliosis in cases with a greater than 10 degree curve in males was an incidence of 8 and a rate of 11%. In females the incidence was 36 and the rate 39.2%. 2. The overall incidence and rate of kyphosis of less than 20 degrees in males was a rate of 9 and an incidence of 11.9%. In females, the rate was 5 and the incidence 5.4%. In kyphosis cases of more than 40 degrees, the male rate was 5 and the incidence 7.7%. For female the rate was 13 and the incidence 14.2%. 3. The overall incidence and rate of lordosis with curves of less than 20 degrees was a rate of 6 for males and an incidence of 9.0%. For females, the rate was 5 and the incidence 5.4%. In cases of more than 50 degrees lordosis, the female rate was 2 and the incidence 2.2%. There were no males in this category. 4. There was a negative correlation between kyphosis and BMI. The greater the kyphotic curve, the less the BMI in males (p<0.05). There was no significant BMI difference by gender in either scoliosis or lordosis. There was, however, a significantly decreased sacral angle in the female group with LBP. The results of this study cannot be generalized to the general population because the subjects were all from one university. The measurements were quite reliable because the angles determined by the Metrocom System were highly correlated with radiologic findings. This study shows the need for a regular screening system for spinal curvatures in university health examination procedures.

• Parasites, Hosts and Diseases
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• 제23권2호
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• pp.221-229
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• 1985

우리나라 참붕어의 아가미에서 검출되는 Echinochasmus속 피낭유충을 마우스에서 실험감염 시킨 후 성충을 얻어 종을 동안하고 마우스내에서의 간단한 발육상황을 관찰하였다. 1. 참붕어에서 수집한 Echinochasmus속 피낭유충은 타원형으로 $0.073~0.078{\times}0.054~0.065{\;}mm$의 크기이었고 탈낭시킨 표본에서 두관(head crown) 및 두극(collar spine)이 뚜렷하며 두극은 좌우 12개씩 총 24개가 구흡반 주위를 일열로 둘러싸고 있었으나 구흡반배측에서 연결이 끊어져 있었다. 2. 마우스로부터의 충체회수율은 감염 1일부터 21일까지 평균 19.5%이었고 감염기간 경과에 따른 감소는 관찰되지 않았다. 충체는 주로 마우스의 소양하부에서 회수되었다. 3. 마우스 체내에서 충체는 5일후면 모든 생식기관이 성숙되었고 충체 길이는 7일에 최대에 달한 후 21일까지 큰 변화가 없었다. 생식기관의 감염 7일까지 성장은 비생생기관과는 달리 {$\ulcorner}S자{\Ircorner}$형 곡선을 보였다. 감염 5~6일 후 마우스의 대변에서 크기 평균 $0.0865{\times}0.0608mm$인 충란이 검출되었고 감염 5일에 회수된 충체 자궁에서 1~2개의 충란이 발견되었다. 4. 감염 7일째의 성충을 관찰한 바 충체외형은 란원형으로 크기 $0.54~0.69{\times}0.29~0.34{\;}mm$이었고 잘 발달된 두관과 좌우 12개씩 총 24개의 두극을 가지고 있므려, 란황선이 복흡반 부위에서 충체 후단까지 분포하는 점 등으로 Echinochasmus japonicus Tanabe, 1926으로 동정되었다. 이상의 결과로 참붕어가 우리나라에서 E. japonicus 중간숙주 중 하나임이 확증되었다.