• Journal of radiological science and technology
• /
• v.41 no.1
• /
• pp.7-12
• /
• 2018

Patients who visit the emergency room with urinary stones have difficulty lying down in a supine position due to severe pain when performing the KUB test. The purpose of this study was to find methods to reduce the patients' pain and image distortion, and obtain medical images with high diagnostic values. After checking the standard classification of disease and cause of death, the target group consisted of 121 patients who had clearly distinguished stones from computed tomography. Patients with stones in the ureteralvesical junction were excluded. Qualitative image evaluation was performed by confirming the location of the stone in the computed tomography images. and evaluated the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray. Quantitative image evaluation was performed on the KUB, abdominal plain X-ray images. The transverse process of the first lumbar vertebrae served as the standard point, and the length from this point to the lower part of the stone was measured. Results from looking at the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray showed: 94 patients (77.6%) for KUB images and 91 patients (75.2%) for computed tomography images. The standard deviation for KUB and abdominal X-ray was 3 (2.4%). Comparing and analyzing the location from KUB images and abdominal plain X-ray images, the stone position was 10.1 mm in the kidney, 10.5 mm in the ureteropelvic junction, and 9.7 mm in the ureters. It was shown that the stone moved 10 mm on average with significant statistical difference (P<0.05). In cases where the pain is so severe that it is impossible to perform the test in the supine position, an alternative may be to check the stone position by performing a modified KUB test by having the patient stand in a vertical position. In the future, this will provide convenience to both the examiner and the patient when performing the examination, and it will contribute with its reproducibility.

• Archives of Plastic Surgery
• /
• v.38 no.5
• /
• pp.695-698
• /
• 2011

Purpose: Since spinal tuberculosis is increasing in prevalence, it appears that a repair of spinal soft tissue defect as a complication of spinal tuberculosis can be a meaningful work. We report this convenient and practical reconstructive surgery which use bilateral latissimus dorsi musculocutaneous advancement flap. Methods: Before the operation, $13{\times}9.5$ cm sized skin and soft tissue defect was located on the dorsal part of a patient from T11 to L3. And dura was exposed on L2. Under the general endotrachel anesthesia, the patient was placed in prone position. After massive saline irrigation, dissection of the bilateral latissimus dorsi musculocutaneous flaps was begun just upper to the paraspinous muscles (at T11 level) by seperating the paraspinous muscles from overlying latissimus dorsi muscles. The plane between the paraspinous muscles fascia and the posterior edge of the latissimus dorsi muscle was ill-defined in the area of deformity, but it could be identified to find attachment of thoracolumbar fascia. The seperation between latissimus dorsi and external oblique muscle was identified, and submuscular plane of dissection was developed between the two muscles. The detachment from thoracolumbar fascia was done. These dissections was facilitated to advance the flap. The posterior perforating vasculature of the latissimus dorsi muscle was divided when encountered approximately 6 cm lateral to midline. Seperating the origin of the latissimus dorsi muscle from rib was done. The dissection was continued on the deep surface of the latissimus dorsi muscle until bilateral latissimus dorsi musculocutaneous flaps were enough to advance for closure. Once this dissection was completely bilateraly, the bipedicled erector spinae muscle was advanced to the midline and was repaired 3-0 nylon to cover the exposed vertebrae. And two musculocutaneous units were advanced to the midline for closure. Three 400 cc hemovacs were inserted beneath bilateral latissimus dorsi musculocutaneous flaps and above exposed vertebra. The flap was sutured with 3-0 & 4-0 nylon & 4-0 vicryl. Results: The patient was kept in prone and lateral position. Suture site was stitched out on POD14 without wound dehiscence. According to observative findings, suture site was stable on POD55 without wound problem. Conclusion: Bilateral latissimus dorsi musculocutaneous advancement flap was one of the useful methods in repairing of large spinal soft tissue defect resulting from spinal tuberculosis.

• Journal of Veterinary Clinics
• /
• v.25 no.6
• /
• pp.529-532
• /
• 2008

The object of this study was to evaluate the durations from onset of neurological sign until surgery and regaining of the deep pain perception (DPP) after decompression as prognostic indicators for the outcome of decompression surgery in dogs with thoracolumbar intervertebral disc disease (IVDD). The compression lesions in the thoracolumbar vertebrae were localized by plain radiograph, computed tomography and neurological examination in 28 dogs with hindlimb paralysis. The follow up was carried out for 6 months after laminectomy. During the follow up, regaining DPP and walking ability were evaluated. Improvement to normal or paretic gait after surgery was judged as success of the surgical treatment.The success rate of surgical treatment was 70 % (7 out of 10 dogs) when surgical intervention was carried out within 24 hours but 38.9 % (7 out of 18) over 24 hours (P<0.05). The success rate of surgical treatment was 87.5 % (14 out of 16 dogs) when DDP was regained within 5 weeks after surgery but there was 0 % (0 out of 12 dogs) when DDP was not regained within 5 weeks after surgery (P<0.05). Other parameters such as compression rate in CT scan and laminectomy methods did not related with the success of the surgery. These results suggested that the time of surgery after onset and duration of regaining of DPP after decompression were useful parameter to predict the success of surgical treatment for thoracolumbar disc herniation in dogs.

• The Korean Journal of Nuclear Medicine
• /
• v.24 no.1
• /
• pp.37-48
• /
• 1990

Detection of deep-seated abscesses is sometimes difficult with ultrasonogrpahy or computed tome graphy alone. Indium-111-labeled leukocyte has widely used in the localization of abscesses after introduction by Segal and Thakur in 1976. But there are some difficulties in using indium-111-oxine in our country because of hardness to get the radiopharmaceutical timely and long time for labeling leukocytes. So we peformed the indium-111-labeled leukocyte scan for establishment of the labeling procedure and clinical application. We labeled the mixed leukocytes from 36 ml of patient's blood using 4 ml of ACD solution, 7 ml of 6% hydroxyethyl starch solution $(HESPAN^{(R)})$, 1 mCi of indium-111 oxine, 5 ml of normal saline and centrifuge. It took about 2 hours for the preparation of radiolabeled leukocytes and attention for contamination was needed. The average injected dose of labeled mixed leukocytes was 465 uCi. The average number of injected leukocytes was $2.5\times10^8$ and the labeling ratio was $57{\pm}13%$ (Table 2, Fig. 5). These number and ratio were sufficient for the localization of abscess. About twenty per cent of indium was labeled to red blood cells and platelets (Fig. 6) and the half-life of injected radiolabeled leukocytes was 8.3 hours. Scan was performed in 9 patients who were suspected to have abscesses clinically or radiologically. Three patients were positive, in one patient who had abscess close to lower lumbar vertebrae was surgically drained and another 2 positive cases did not show abscess clearly on computed tomography, so only antibiotics were administrated and treated successfully. The negative 6 patients were improved without specific treatment. In conclusion, the use of indium-111 oxine labeled leukocytes for localization of abscesses were very specific and helpful in the decision of treatment considering its relatively simple labeling method, and could be easily performed providing timely supply of the radiopharmaceutical.

• Korean Journal of Ecology and Environment
• /
• v.42 no.2
• /
• pp.172-182
• /
• 2009

This study was to analyze characteristics based on tolerance and trophic guilds and to determine the level of total mercury in tissues of sentinel species, Zacco platypus at 3 sampling sites of the Mangyeong River in 2007. Total sampled fishes were 26 species and the most dominant species was Zacco temminckii (47%). Fish community analysis was resulted that eveness index and diversity index showed low value at S1. However, diversity index and richness index at other sites showed high. According to various guilds analysis, relative abundance of sensitive species was 70% and 42% at S1 and S2, respectively. While sensitive species were decreased (1%) and tolerant species were increased (60%) at S3. It was mainly carried to the impacts of wastewater treatment plants near the location. Relative abundance of insectivore species was decreased from up (S1) to midstream area (S3). In addition, chemical water quality, based on analyses of BOD, COD, TP, TN, EC, MPN and SS concentration showed similar trends. Qualitative Habitat Evaluation Index (QHEI) was averaged 164, judged as "good" habitat condition. Average concentrations of total [Hg] was 146.9 ${\mu}g$ $kg^{-1}$. In the muscles of total [Hg] was the highest, and then followed by kidney, vertebrae, liver, and gills. According to FDA standards (500 ${\mu}g$ $kg^{-1}$) of Korea, total [Hg] has not affected to the individual fish health.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.5
• /
• pp.577-583
• /
• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.5
• /
• pp.597-603
• /
• 2017

Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

• Experimental and Molecular Medicine
• /
• v.50 no.11
• /
• pp.3.1-3.11
• /
• 2018

This study aimed to verify the effects of estrogen on the onset and development of adolescent idiopathic scoliosis and the mechanisms associated with these effects by constructing a pubescent bipedal rat model. Experiments were conducted to investigate whether scoliosis progression was prevented by a Triptorelin treatment. One hundred twenty bipedal rats were divided into female, OVX (ovariectomy), OVX + E2, Triptorelin, sham, and male groups. According to a spinal radiographic analysis, the scoliosis rates and curve severity of the female and OVX + E2 groups were higher than those in the OVX, Triptorelin, and male groups. The measurements obtained from the sagittal plane of thoracic vertebrae CT confirmed a relatively slower growth of the anterior elements and a faster growth of the posterior elements between T11 and T13 in the female and OVX + E2 groups than in the OVX and Triptorelin groups. Histomorphometry and immunohistochemistry revealed a significantly longer hypertrophic zone of the vertebral cartilage growth plates that expressed more type X collagen and less type II collagen in the OVX and Triptorelin groups than in the female and OVX + E2 groups. Ki67 immunostaining confirmed an increase in the proliferation of vertebral growth plate chondrocytes in the OVX group compared with the female and OVX + E2 groups. In conclusion, estrogen obviously increased the incidence of scoliosis and curve severity in pubescent bipedal rats. The underlying mechanism may be a loss of coupling of the endochondral ossification between the anterior and posterior columns. Triptorelin decreased the incidence of scoliosis and curve magnitudes in bipedal female rats.

• Korean Journal of Applied Biomechanics
• /
• v.31 no.4
• /
• pp.308-313
• /
• 2021

Objective: The purpose of this study was to investigate the effect of different kettlebell mass (30%, 40%, and 50% of the body mass) on kinematics and kinetic variables of kettlebell swing. Method: Total of 16 healthy male who had at least 1 year of kettlebell training experience were participated in this study (age: 31.69 ± 3.46 yrd., height: 173.38 ± 4.84 cm, body mass: 74.53 ± 6.45 kg). In this study, a 13-segments whole-body model (upper trunk, lower trunk, pelvis, both side of forearm, upperarm, thigh, and shank) was used and 26 reflective markers were attached to the body to identify the segments during the movement. A 3-dimensional motion analysis with 8 infrared cameras and 4 channeled EMG was performed to find the effect of kettlebell mass on its swing. To verify the kettlebell mass effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at 𝛼=.05. Results: Firstly, in all lower extremity joints and thoracic vertebrae, a statistically significant change in angle was shown according to an increase in kettlebell mass during kettlebell swing (p<.05). Secondly, in both the up-swing and down-swing phases, the knee joint and ankle joint ROM showed a statistically significant increase as the kettlebell mass increased (p<.05) but no statistically significant difference was found in the hip joint and thoracic spine (p>.05). Lastly, the hamstrings muscle activity was statistically significantly increased as the kettlebell mass increased during up-swing phases (p<.05). Also, as the kettlebell mass increased in P4 of the down swing phase, the gluteus maximus showed a statistically significantly increased muscle activation, whereas the rectus femoris showed a statistically significantly decreased muscle activation (p <.05). Conclusion: As a result of this study, hip extension decreased and knee extension increased at 40% and 50% of body mass, and the spine also failed to maintain neutrality and increased flexion. Also, when kettlebell swings are performed with 50% of body mass, synergistic muscle dominance appears over 30% and 40% of body mass, which is judged to have a risk of potential injury. Therefore, it is thought that for beginners who start kettlebell exercise, swing practice should be performed with 30% of body mass. In addition, even in the case of experienced seniors, as the weight increases, the potential injury risk may increase, so it is thought that caution should be exercised when performing swings with 40% and 50% of body mass. In conclusion, it is thought that increasing the weight after sufficiently training with 30% of the weight of all subjects performing kettlebell swing is a way to maximize the exercise effect as well as prevent injury.

• Journal of Convergence for Information Technology
• /
• v.11 no.10
• /
• pp.223-229
• /
• 2021

This study analyzed the effects of an exercise program that combined lumbar stabilization exercise and muscle strengthening exercise and an exercise program that applied only lumbar muscle strengthening exercise on multifidus muscle cross-sectional area, static posture control ability, and low back pain in patients with CLBP. For the study method, 28 patients with CLBP were divided into two exercise propram groups and exercised three times a week for 8-weeks. The data analysis of this study used the t-test to compare before and after group exercise program application, and between each group (p<.05). As a result of the study, significant results were found before and after application of the exercise program within each group, such as multifidus muscle cross-sectional area, static posture control ability, and low back pain (p<.05). Between each group, the exercise program that combined lumbar stabilization exercise and muscle strengthening exercise was found to be more effective (p<.05). In conclusion, it was found that the exercise program with additional lumbar stabilization exercise improved the structure and function of various lumbar vertebrae and reduced lumbar pain.