• 제목/요약/키워드: Upper lumbar

검색결과 146건 처리시간 0.026초

개에서 실험적으로 유발한 척수압박에 대한 적외선 체열촬영술의 적용 (Use of Digital Infrared Thermography on Experimental Spinal Cord Compression in Dogs)

  • 김완태;김민수;김순영;서강문;남치주
    • 한국임상수의학회지
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    • 제22권4호
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    • pp.302-308
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    • 2005
  • 적외선 체열촬영술은 생리적, 기능적 이상유무를 평가하기 위해 수의와 인의에서 최근 사용되고 있다. 이 연구에서는 디지털 적외선 이미지 시스템을 사용하여 개의 등에서 피부의 절대온도와 상하 그리고 좌우 온도차를 알아보고, 실험적으로 유발한 척수 손상 시 적외선 체열촬영술의 임상적 유용성을 조사하기 위하여 실시되었다. 33마리의 건강한 비글견에서 등쪽 부분을 삭모한 후 정상체열상을 촬영하였으며, 7마리의 건강한 암컷에서 경막외 풍선카테터를 이용하여 척수손상을 유발하였다. 정상군은 체열영상에서 등고선과 같은 일정하면서도 대칭적인 양상을 보였으며, 상하, 좌우에 관계없이 유의적인 피부 온도차가 관찰되지 않았다 이와는 달리, 척수 손상군의 경우 척수손상부위 주위로 대칭적인 온도 감소가 있었다. 좌우의 온도차는 거의 없었으며 매우 안정적인 경향을 보였다. 특이한 점은 상하의 온도차 중에서 흉추부와 요추부 사이의 온도차가 현저하게 나타났으며, 수술 후 4주가 경과했을 때 거의 정상으로 회복되는 경향이 있었다. 이상의 결과로 보아 적외선 체열촬영술은 개의 척수 손상 시 진단 및 예후 평가를 위한 유용한 진단기법이며, 비정상 부위를 찾아내는 데 상하좌우의 정상 피부 온도차가 매우 유용할 것으로 사료된다. 또한 병변이 양측성인 경우, 좌우의 비교보다는 인접한 부위의 상하 온도차를 비교하는 것이 더 적절한 방법일 것으로 사료된다.

작업유형별 근골격계 증상 호소율에 관한 조사연구 (A Survey on the Prevalence of Musculoskeletal Symptom according to Work Task)

  • 오혜주;이덕희;박인근;장세한
    • Journal of Preventive Medicine and Public Health
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    • 제27권2호
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    • pp.230-241
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    • 1994
  • Though people occupationally exposed to machineries and automation in the industrialized society desire work involving decreased strength, due to the continuous and repetitive activities, a new industrial stress is present. Studies on prevalence of musculoskeletal disease and their related risk factors have evolved. In this study in relation to work tasks, we investigated the differences in musculoskeletal symptoms occurring In each body region. The results of the survey were as follows. 1. When comparing age, level of education, work duration, job satisfaction and leisure time activities according to work task, age in control group was $38.83{\pm}5.5$, in comparison to the other 2 groups was smaller(p<0.05), and level of education in control group was higher (p<0.05). Work duration in the cutting department was $8.04{\pm}4.99$ years longer than the other 2 groups (p<0.05), but there was no difference in the job satisfaction and leisure time activities. 2. The mean of symptom scores of each work task was 1.54 in the cutting department, 1.57 in the press department and 1.59 in the control group, and there was no significant differnce in the 3 groups. The mean of symptom scores for upper extremities in the control group was low but no statistically significant diffrence was shown. 3. When comparing the mean of symptom score according to work task in the each body region, in the shoulder region, the symptom score in the press department which desired strength was higher than the other 2 groups but no significant difference was shown. In the wrist region the cutting department scored 1.01 and in comparison to the other 2 groups was significantly increased (p<0.05). 4. The results of the univariate regression analysis on the major individual risk factors associated with musculoskeletal symptom relating work showed that previous symptom complaints in the same body region was significant risk factor(p<0.001) in the whole body Besides wrist, hip, and knee, psychological problem was shown to be a significant factor(p<0.05). And the body regions which work task was significant risk factor were wrist and neck region (p<0.05). 5. The results of the multiple regression analysis involving significant factors of each body region from the univariate regression analysis showed that previous symptom complaint in whole body region(p<0.001) and psychological problem in the shoulder, elbow and lumbar region (p<0.05) were significant factors, and work task was significant factor in the wrist (p<0.05).

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급성 술후 통증 조절을 위한 경막외차단 2,381예의 임상적 평가 (A Clinical Assessment of Epidural Block for Acute Postoperative Pain Control in 2,381 Cases)

  • 장문석;채병국;이혜원;임혜자;장성호
    • The Korean Journal of Pain
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    • 제8권2호
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    • pp.235-243
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    • 1995
  • A retrospective study was performed to evaluate the effects, and side effects, of epidural analgesia for postoperative pain relief of 2,381 surgical patients who received general-epidural, or epidural anesthesia only. Anesthesia records, patients charts, and pain control records were reviewed and classified according to: age, sex, body weight, department, operation site, epidural puncture site, degree of pain relief by injection mode & epidural injectate, and side effects(including nausea, vomiting, pruritus, urinary retention and respiratory depression). The results were as follows: 1) From the total of 2,381 patients, there were 1,563(66%) female patients; 1.032(43%) patients were from Obstetrics and Gynecology. 2) Lower abdomen, thorax, lower extremity and upper abdomen in the operation site; and lumbar, upper, lower thoracic in puncture site were order of decreasing frequency. Length of epidural injection for pain relief averaged $1.72{\pm}1.02$ days. 3) Ninety three percent of the patients experienced mild or no pain in the postoperative course. Analgesic quality was not affected by the kind of epidural injectate. 4) Nausea occurred in 3.2% of all patients, vomiting in 1.1%, pruritus 0.9%, urinary retention 0.6%, respiratory depression 0.08%. 5) Frequency of nausea was higher with female patients compared to male patients(p<0.05). 6) Pruritus frequency was higher with male patients than female patients(p<0.05); and more frequent with patients who received epidural injection with morphine than patients who received epidural injection without morphine(p<0.01). 7) Urinary retention was higher in female patients, and more frequent with patients who had received epidural injection with morphine than epidural injection without morphine(p<0.05). 8) There were two cases of respiratory depression. The course of treatment consisted of: cessation of epidural infusion, then administration of oxygen and intravenous naloxone. We conclude that postoperative epidural analgesia with a combination of local anesthetics and opiate is and effective method for postoperative pain relief with low incidence of side effects. However, patients should be carefully evaluated as rare but severe complications of respiratory depression may ensue.

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The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
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    • 제65권1호
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    • pp.96-106
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    • 2022
  • Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

로잉운동의 부하편차 방식 적용에 따른 상하지 생체 역학적 평가 (Evaluation of Bio-Mechanical Character istics According to Loading Deviation Methods dur ing Rowing Exercise)

  • 강승록;정구영;문동안;정장식;김정자;권대규
    • 한국운동역학회지
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    • 제21권3호
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    • pp.369-382
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    • 2011
  • The purpose of this study was to verify the validation of exercise effect with loading deviation during rowing exercise. We performed evaluation of based physical fitness and joint torque before the experiment for finding muscle unbalance. So we recruited twenty four subjects who have bigger muscle strength in more 20% than average one. Subjects divided two groups. One is dominant upper limbs(DU) and the other was dominant lower limbs(DL). Subjects performed rowing exercise using electric equipment (Robo.gym.Humonic.korea). Exercise is performed four sets a day including 25 times a set, and three days a week. Measurement consist of evaluation of based physical fitness and joint torque using biodex(biodex system3.USA). Evaluation of exercise effect performed each week in joint torque of shoulder, lumbar and knee joint and each month in based physical fitness. Also we adapted 30% of 1RM for muscular endurance and 70% of 1RM for muscle strength as exercise load. The results showed that the difference of maximal peak torque were getting increase significantly during exercise. Also difference of various factor in based physical fitness were getting increase significantly except flexibility and agility. This interpreted that rowing exercise with loading deviation types could provide muscle strength and muscular endurance exercise in same time. These results could be interpret to two ways. One is effect of improving physical fitness for rowing exercise and the other meaned validation of loading deviation in rowing exercise. Our study is going to verify the validation of loading deviation during rowing and we found out that loading deviation could provide muscle strength and muscular endurance exercise for improving muscle unbalance. Our study can be used development of exercise equipment and program for normal people with muscle unbalance. Also that provide effect of whole body exercise to anybody.

한국청년층(韓國靑年層)의 총지방양측정(總脂肪量測定)에 관(關)한 연구(硏究) (A Study of Measurement of the Fat Contents in Korean Youths by Mean of Skinfold Methods)

  • 차철환;박순영;조광수;현호섭;이영일
    • Journal of Nutrition and Health
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    • 제4권1호
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    • pp.29-40
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    • 1971
  • For the measurement on the fat content if University Students, an intensive examination was conducted on a total of 3,030 students(male 2,577, female 453), from 16 to 25 years of age. The subjects were all students who had passed the written entrance examination for Seoul National University. Total Body Fat amount was measurement by skin-fold thickness with a skin-fold caliper(Manufactured by Cambridge Scientific Industrial Inc. U.S.A.) at four sites of the body, and it was calculated by Kim's and Lee's regression equation. As a result of this survey, the following conclusions were obtained; 1. Physical Measurements: i) The average of body height by anthropometric was male $167.95{\pm}4.85cm$ and female $156.03{\pm}4.56cm$. ii) The average body weight by anthropometric was male $56.42{\pm}5.65kg$ and female $51.29{\pm}5.34kg$. iii) The average of chest-girth by anthropometric was male $89.95{\pm}5.33cm$ and female $81.36{\pm}4.89cm$. iv) The average of sitting-height by anthropometric was male $91.23{\pm}4.98cm$ and female $86.18{\pm}4.15cm$. v) The average of arm circumference by anthropometric was male $23.76{\pm}2.17cm$ and female $22.39{\pm}1.79cm$. In all cases the male measurements were higher than the female. 2. The mean skin-fold thickness measured with a large skin-fold caliper was; At the sub-scapular: male $11.54{\pm}4.84mm$ and female $14.07{\pm}4.49mm$, Abdominal: male $10.36{\pm}7.09mm$ and female $14.95{\pm}5.47mm$, Lumbar; male $12.55{\pm}6.44mm$ and female $17.02{\pm}6.57mm$, Upper arm: male $6.28{\pm}3.71mm$ and female $11.62{\pm}3.99mm$, Total average: male $10.18{\pm}5.52mm$ and female $14.41{\pm}5.13mm$, in all cases the female measurements were higher than the male. 3. Data on body fat amounts according to body fat weight regression equation were: in male: Fat weight=10.56kg, Fat free weight=45.86kg, Fat weight/Total body mass(%)=18.71%, (Body fat amount %), Fat weight/Fat free weight(%)=23.02%, Fat free weight/Total body mass(%)=81.29%. in female: Fat weight=12.23kg, Fat free weight=39.06kg, Fat weight/Total body mass(%)=23.85%, Fat weight/Fat free weight(%)=31.31%, Fat free weight/Total body mass(%)=76.15%. The females value was higher than the males.

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자발성 두개강내압 저하증 (Spontaneous Intracranial Hypotension)

  • 공두식;김종수;박관;남도현;어환;홍승철;신형진;김종현
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.240-248
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    • 2000
  • Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

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부분 장골과 장요추 인대를 포함한 요추 천추골의 유한 요소 모델링 및 비선형 해석 (Finite Element Modeling and Nonlinear Analysis of Lumbosacrum Including Partial Ilium and Iliolumbar Ligaments)

  • 하성규;임종완
    • 대한의용생체공학회:의공학회지
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    • 제28권3호
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    • pp.397-409
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    • 2007
  • Owing to needs of biomechanical comprehension and analysis to obtain various medical treatment designs which are related with the spine in order to cure and diagnose LBP patients, the FE modeling and nonlinear analysis of lumbosacrum including a partial ilium and iliolumbar ligaments, were carried out. First, we investigated whether the geometrical configuration of vertebrae displayed by DICOM slice files is regular and normal condition. After constructing spinal vertebrae including a partial ilium, a sacrum and five lumbars (from L1 to L5)with anatomical shape reconstructed using softwares such as image modeler and CAD modeler, we added iliolumbar ligaments, lumbar ligaments, discs and facet joints, etc.. And also, we assigned material property and discretized the model using proper finite element types, thus it was completely modeled through the above procedure. For the verification of each segment, average sagittal ROM, average coronal ROM and average transversal ROM under various loading conditions(${\pm}10Nm$), average vertical displacement under compression(400N), ALL(Anterior Longitudinal Ligament) and PLL(Posterior Longitudinal Ligament) force at L12 level, strains of seven ligaments on sagittal plane at L45 level and maximal strain of disc fibers according to various loading conditions at L45 level, etc., they were compared with experimental results. For the verification of multilevel-lumbosacrum spine including partial ilium and iliolumbar ligaments, the cases with and without iliolumbar ligaments were compared with ROM of experiment. The results were obtained from analysis of the verified FE model as follows: I) Iliolumbar ligaments played a stabilizing role as mainly posterior iliolumbar ligaments under flexion and as both posterior and anterior iliolumbar ligaments of one side under lateral bending. 2) The iliolumbar ligaments decreased total ROM of 1-8% in total model according to various motion conditions, which changed facet contact forces of L5S level by approximately 0.8-1.4 times and disc forces of L5S level by approximately 0.8-1.5 times more than casewithout ilioligaments, under various loading conditions. 3) The force of lower discs such as L45 and L5S was bigger than upper discs under flexion, left and right bending and left and right twisting, except extension. 4) It was predicted that strains of posterior ligaments among iliolumbar ligaments would produce the maximum 16% under flexion and the maximum 10% under twisting. 5) It's expected that this present model applies to the development and design of artificial disc, since it was comparatively in agreement with the experimental datum.

여대생의 우유와 유제품 섭취실태 및 골밀도와의 관계 연구 (Relation between Milk Consumption and Bone Mineral Density of Female College Students in Korea)

  • 이정숙;유춘희;정진은
    • Journal of Nutrition and Health
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    • 제39권5호
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    • pp.451-459
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    • 2006
  • The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and 8MI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and $20.0\;kg/m^2$ respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed $50{\sim}200\;g$ of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD $(g/cm^2)$of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ. and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.

척추안정화 운동이 민간 경호.경비원들의 허리통증에 미치는 영향 (Effects of spinal stabilization training on Chronic Low Back Pain in Private Guard and Security)

  • 김성호;이완희
    • 시큐리티연구
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    • 제20호
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    • pp.71-93
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    • 2009
  • 이 연구는 만성요통을 가진 민간 경호 경비원들을 대상으로 척추안정화 운동을 실시하여, 허리통증, 일상생활제한, 척추심부근육의 근단면적 변화에 미치는 영향을 비교 분석하고자 실시하였다. 연구 대상자는 서울 경기 지역 경호 경비업체에 종사하는 직원 중 만성요통(3개월 이상)을 호소하는 42명을 대상으로 일반적인 척추강화운동그룹, 척추안정화 운동 그룹으로 21명씩 무선 할당하여, 주 3회, 10주간 운동을 실시하였다. 실험 전 후 설문지를 이용하여 허리통증과 요통장애지수를 조사하였으며, 컴퓨터 단층촬영(CT)을 실시하여 다열근과 대요근의 근단면적을 측정하였으며, 실험 전 후 변화된 값을 비교 측정하여 다음과 같은 결과를 얻었다. 1. 통증강도와 요통장애지수는 두 그룹 모두 통계학적으로 유의하게 감소한 것으로 나타났다(p<0.01). 그룹 간 비교에서는 척추안정화 운동그룹이 일반적인 척추강화 운동그룹에 비하여 통증 및 일상생활제한의 감소폭이 더 큰 것으로 나타났다(p<0.05). 2. 두 그룹 간 다열근과 대요근의 근단면적 변화는 척추안정화 운동그룹이 일반적인 척추강화 운동그룹 보다 통계학적으로 유의하게 증가하였다(p<0.05). 이 연구 결과를 볼 때, 만성요통을 호소하는 민간 경호 경비원들을 대상으로 다열근과 대요근과 같은 심부근육 강화에 초점을 둔 척추안정화 운동프로그램이 일반적인 척추강화 운동프로그램 보다 통증 및 요통장애지수 감소와 심부근육의 근력 증가(근단면적)에 더 효과적인 것으로 나타났다. 따라서 척추안정화 운동이 만성요통 민간 경호 경비원들의 요통감소와 기능 회복에 효과적이라고 할 수 있겠다.

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