• 제목/요약/키워드: Upper lumbar

검색결과 147건 처리시간 0.028초

신경과 먼 부위 근육 내 주사 후 발생한 좌골신경병증 (Sciatic Neuropathy after Intramuscular Injection at a Site Remote from the Nerve)

  • 윤수인;박지수;고윤담;송대헌;박지혜
    • Clinical Pain
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    • 제20권1호
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    • pp.43-48
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    • 2021
  • Sciatic nerve can be injured by various mechanism such as compression, traction during surgery, and direct trauma. This case reports a sciatic neuropathy caused by compression due to hematoma occurring after intramuscular injection in the gluteus medius muscle far from the nerve. In order to avoid occurrence of sciatic neuropathy after buttock injection, the injection was made in the upper outer quadrant of the buttock, but sciatic neuropathy occurred. Sciatic neuropathy can be confused with lumbar radiculopathy, so differential diagnosis is important.

요로결석 환자의 경정맥 요로조영 검사 시 압박 유무에 따른 영상평가 (Image Measurement on Influence from Application of Compression Band on Intravenous Urography for Urolithiasis Patient)

  • 김형균;홍동희
    • 대한방사선기술학회지:방사선기술과학
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    • 제38권3호
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    • pp.261-266
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    • 2015
  • 요로결석으로 인한 경정맥 요로조영 검사는 방사선 비 투과성 물질인 요오드 조영제를 사용하여 요관의 경로에 있는 결석을 진단하는 방사선학적 검사법이다. 그 검사 방법 중 엉덩뼈 능선 상단에 대한 압박으로, 조영제가 방광으로 배출되는 것을 막아, 상부요로의 묘출을 용이하게 하는 압박대 사용 유무는 병원마다 다른 방법을 적용하고 있다. 연구자들은 실험을 통하여 압박 과 압박을 하지 않은 상태에서 조영제 진행의 특이도를 관찰하여 상호 비교하고자 하였다. 본 연구는 조영제의 종류, 용량, 검사진행 기준이 동일한 일 병원에서 실시한 경정맥 요로조영 검사 60 례를 후향적 영상평가 방법으로 실시하였다. 영상평가는 5 분 영상으로 제한하여 압박 유무에 대한 조영제의 해부학적 주행 위치가 용이한 시간대로 하였으며, 콩팥 피라미드에서 콩팥깔때기까지를 "RP", 콩팥깔때기에서 요추 3 번째 종판까지를 "PL", 양쪽 엉덩뼈 능선을 기준으로 상부와 하부를 "IU"와 "IL"으로 해부학적 영역을 설정하였다. 분석방법은 피셔의 정확 검정에 의한 통계적 방법으로 압박과 압박을 하지 않은 상태에서 해부학적 위치의 분포차이가 있는지를 분석하였다. 압박그룹과 압박을 하지 않은 그룹 각 30 례의 영상평가에서 P 값이 왼쪽 0.580, 오른쪽 0.711, 양쪽에서 0.960 등으로 나타나 통계적으로 유의한 분포의 차이가 없음을 확인하였다. 이로서 요로결석 환자의 경 정맥 요로조영 검사 시 압박 대 사용유무는 조영제 진행에 차이를 주지 않는다는 통계적 결론을 얻었다.

The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

  • Lee, Yang Woo;Jang, Jae Ho;Kim, Jin Joo;Lim, Yong Su;Hyun, Sung Youl;Yang, Hyuk Jun
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.158-165
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    • 2017
  • Purpose: The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level. Methods: We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans. Results: For a total of 363 patients, the mean age was 56.65 (20-93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level. Conclusions: Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

정상 비글견에서 컴퓨터단층촬영술을 이용한 전립선의 부피 평가 (Volumetric Estimation of the Prostate Gland using Computed Tomography in Normal Beagle Dogs)

  • 최지영;최수영;이기자;정우창;한우석;최호정;이영원
    • 한국임상수의학회지
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    • 제31권3호
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    • pp.175-179
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    • 2014
  • 전립선의 크기를 측정하는 것은 전립선 이상을 임상학적으로 인지하고 치료에 대한 반응을 모니터링 하는데 유용하다. 전립선 질환에서 일반적으로 나타나는 전립선의 형태와 크기 변화는 방사선, 초음파 및 컴퓨터단층촬영 (CT)과 같은 영상학적 방법을 통해 평가한다. 본 연구에서는 전립선의 크기를 평가하는데 가장 많이 사용되는 초음파와 실질 장기의 평가에 높은 정확도를 보이는 CT를 이용하여, 중성화 하지 않은 정상 비글견에서 전립선 크기를 측정하고 비교하는데 목적이 있다. 또한 CT를 이용하여 전립선의 크기를 측정하여 체중과 관계없이 전립선의 크기를 평가할 수 있는 간단하고 실용적인 기준을 확인하고자 한다. 비뇨기계 및 내분비계에 이상이 없고 세포학적 검사로 정상 전립선으로 평가된 8 마리 정상 비글견에서 초음파와 CT 촬영을 실시하여 전립선의 크기를 비교 및 평가하였다. 초음파를 이용한 전립선의 부피를 측정하기 위해 서로 다른 2가지 단면에서 각 측정치를 구하고 타원체 공식 (US1, US2)에 대입하였다. CT의 경우 freehand tracing 방법을 이용해 전립선의 부피를 측정하였다. 초음파를 이용한 2가지 방법 모두 CT를 이용한 방법보다 낮은 측정치를 보였으며, 특히 US1 방법이 CT방법에 비해 통계적으로 유의성 있게 낮은 결과치를 보였다. CT를 통해 촬영된 이미지의 재구성을 통해 전립선의 길이, 높이, 너비를 측정하여 부피와의 상관관계를 평가하였다. 측정된 수치 중 길이와 너비가 부피와 가장 높은 상관관계를 나타냈다. 또한 촬영된 이미지에서 6번째 요추체의 길이를 측정하고 각 전립선 크기 (길이, 높이, 너비)와의 비율을 분석하였다. 실험에서 요추 6번과 전립선의 길이 및 높이는 약 1:1의 비율을 보였으며, 길이와 높이의 상한선은 1.3배, 너비의 상한선은 1.7배로 고려되었다. 이러한 비율에 대한 결과 중 길이와 높이에 대한 비율은 방사선 사진에서도 적용이 될 수 있을 것으로 생각되며, 전립선 크기를 체중과 상관없이 평가할 수 있는 간단하며 유용한 지표로 사용될 수 있을 것으로 생각된다.

한국 성인에서 척수원추 위치의 다양성 - 자기 공명 영상 연구 - (The Variation of Position of the Conus Medullaris in Korean Adults - A Magnetic Resonance Imaging Study -)

  • 주성필;김수한;이정길;김태선;정신;김재휴;강삼석;이제혁
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.451-455
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    • 2001
  • Objectives : There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. Methods : we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. Results : The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions : The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.

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암성통증(癌性痛症)에 대(對)한 지주막하(蜘蛛膜下) 10% Phenol-Glycerine 차단(遮斷) (Intrathecal Block with 10% Phenol-Glycerine for Cancer Pain)

  • 오흥근;이윤우;윤덕미;백상기;방서욱;고신옥
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.47-52
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    • 1988
  • Since 1979 forty-three cancer patients have been given intrathecal block at the pain clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most of them were in the 4th and 5th decades of age. In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in 7 cases, bladder cancer in 4 cases and colon cancer in 3 cases. Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine block and rest of them had only test block. Fourteen patients whose pain sites were lumbar or lumbar and upper sacral dermatomes were put into the lateral recumbent position on the fluoroscopic table. The spinal puncture was performed as close to the spinal roots to be impregnated as possible. In 22 patients the pain sites were covered by the sacral dermatomes and so the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the affected site. Fifty one blocks were performed and their results are classified into three categories: good, fair antral poor. We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in 2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94.2% of patients. After intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7, defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present in 3 patients. The mean duration of pain relief was 2.5 months and longer than the mean survival time of 2.25 months. When patients are selected carefully and tile block is performed with great caution and good technique, the risk is minimal and a long lasting relief of intractable cancer pain achieves a painless life until death.

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우슬(牛膝)의 관절염(關節炎) 치료(治療) 효능(效能)에 관(關)한 서지학적(書誌學的) 고찰(考察) (A Bibliographic Study on the Therapeutic Effects of Achyranthis Radix in Arthritis)

  • 박희수;신선호;장통영
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.697-704
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    • 2000
  • According to herbalogical bibligraphy and literature, therapeutic effects of Achyranthis Radix on arthritis was as follows, 1. Achyranthis Radix of Amaranthaceae is divided into five species-Achyranthes japonica, A. bidentata, A. longifolia, A. fauriei, Cyathula capitata, C. officialis and the characteristic, taste, channel entry, effects and main treatments were alike. 2. Winefrying stood for repairing treatement method for Achyranthis Radix Before repairing treatment method, Achyranthis Radix had three tastes(bitter, sour, and sweet) and calm and not poisoning characteristic. After repairing treatment method, the bitter taste was disappeared, and calm and not poisoning characteristic was changed into warm characteristic. 3. Effects of Achyranthis Radix were quicking the blood and dispelling stasis, liver-kidney supplement and strengthening musculo-skeletal system. Main treatments were relief of lumbar and knee joint pain, static menstrural block and wind-cold- damp impediment. 4. Contraindication of Achyranthis Radix was sympthom caused by spleen-kidney yang vacuity, upper burner disease and lower burner hemorrhage etc. Being used in pregnant woman, it could incur abortion. 5. Contraindication of Achyranthis Radix was beef, milk and mutton. It's fear was Radix Cynanchi Stauntonii and Semen Plantaginis. It's aversion was the firefly. Herba Taraxaci, Carapax Amydae, Carapax Testudinis and Radix Cynanchi Stauntonii. From above results, I suppose Achyranthis Radix has enough herbalogical foundation and could be used to treat arthritis and it is necessary to make a profound study of it.

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국가대표 여자 필드하키 선수들의 스포츠 손상 역학조사 (Injuries in Female Elite Korean Field Hockey Athletes: an Epidemiological Study)

  • 김찬우;박기준
    • 대한물리의학회지
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    • 제14권4호
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    • pp.163-171
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    • 2019
  • PURPOSE: This study examined the incidence, location, and characteristics of sports injuries according to the position in Korean female national field hockey athletes. METHODS: Eighteen female national field hockey athletes (two goal keepers, five forwards, six midfielders, and five defenders) who trained at the national training center between January 2018 and December 2018 were enrolled. The event, position, and location of injury were recorded per IOC's daily injury reports form. The incidence of sports injuries was examined with the 95% confidence interval (CI), and the difference in the incidence of injury according to the position was presented as the rate ratio (RR). Moreover, differences in the location of sports injury according to the position were examined using χ2 tests. RESULTS: A total of 92 sports injuries occurred among field hockey players, with an incidence of 6.47 cases per 1,000 hours of training (95% CI 4.98-7.96). In addition, 29.12 cases of injuries occurred per 1,000 exposures (95% CI 23.17-35.07), and the incidence of injury was highest among the defenders, followed by forwards, midfielders, and goal keepers. The most common location of sports injury was the lower extremity, followed in order by the trunk, upper extremity, head, and neck, and there were significant differences in the location of the sports injury according to the position (p=.046). In addition, lumbar spine/lower back, thigh, ankle, lower leg, knee, and foot/toe were common sites of sports injury among female field hockey players. CONCLUSION: These results provide a baseline for predicting sports injuries in athletes during games, and would provide useful information for developing performance enhancement and injury prevention programs.

소프트 골프 클럽을 이용한 골프 스윙 동작과 인체 작용 하중 분석 (Analysis of Golf Swing Motion and Applied Loads on the Human Body Using Soft-$Golf^{TM}$ Club)

  • 곽기영;소하주;김성현;김남균;김동욱
    • 비파괴검사학회지
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    • 제31권5호
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    • pp.472-478
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    • 2011
  • 본 연구의 목적은 소프트 골프 용구가 인체에 미치는 역학적 효과를 분석하는 것이다. 이를 위해 골프 스윙 동작을 캡처하여 스윙 모델을 생성하였고 시뮬레이션을 통해 손목, 팔꿈치, 어깨, 허리 관절의 토크를 도출하였다. 총 5명이 실험에 참여하였고 아연 합금 헤드의 소프트 골프 클럽과 기존 아이언 7번 클럽을 사용하였으며, 클럽당 5번씩 스윙을 수행하였다. 3대의 포지션 센서, 적외선 발광마커와 힘판을 사용하여 골프 스윙 동작을 캡처하였다. 인체 모델 생성 및 동역학 해석 프로그램을 통해 스윙 모델을 생성하여 시뮬레이션 하였고 관절의 토크를 도출하였다. 결과로 소프트 골프 클럽을 이용한 스윙에서 손목 관절 토크는 기존 골프 클럽을 이용한 스윙의 48.83 % 수준이며, 팔꿈치는 61.10 %, 어깨는 74.74 %, 허리는 102.46 %이다. 따라서 소프트 골프 클럽을 이용하여 스윙할 때, 기존 골프 클럽을 이용할 때보다 작은 힘으로 스윙 동작을 수행할 수 있기 때문에 관절에 부하가 적을 것이며, 관절 부상의 감소에 기여할 것이다.

일부도시지역(一部都市地域)의 여자중고등학생(女子中高等學生)들의 총지방량(總脂肪量) 및 영양상태(營養狀態)에 관(關)한 연구(硏究)(I) (A Study on the Fat Contents and Nutritional Status of Urban High School Girls)

  • 이병갑;박순영
    • Journal of Nutrition and Health
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    • 제4권3호
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    • pp.5-12
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    • 1971
  • For the measurement of the fat contents and nutritional status of urban High School girls, an intensive examination was conducted on a total of 2,085 students from 13 to 19 years of age groups. Total body fat cotents were measured by Skin-fold thickness with a Skin-fold Caliper manufactured by Cambridge Scientific Industrial Inc. at four sites of the body and it was calculated by Kim's regression equation. And Heights, Weights, and Chest circumferences were measured with Martin's Anthropometer. As the results of this study, the following conclusions were obtained: 1. The averages of heights, weights and chest girths were 153.1 cm, 46.2 kg and 76.6 cm. respectively. 2. The mean Skin-fold thicknesses of each site measured with a Lange skin-fold Caliper were: Sub-scapular: $13.44\;mm{\pm}4.41\;mm$. Abdominal : $10.55\;mm{\pm}4.02\;mm$. Lumbar: $10.56\;mm{\pm}4.06\;mm$. Upper arm: $15.35\;mm{\pm}4.37\;mm$. Total Average: $12.46\;mm{\pm}4.48\;mm$. 3. The average Skin-fold thicknesaes by age were as follow: ·9.02 mm at 13 years of age. 10.04 at 14, 11.82 at 15, 14.43 at 16, 15.12 at 17, 16.48 at 18, and 16.61 at 19 respectively. 4. The mean of fat contents calculated according to regression equation was 11.04kg. (9.14 at 13, 9.98 at 14, 11.12 at 15, 11.74 at 16, 12.21 at 17, 12.96 at 18, 13.29 at 19 respectively.)

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