• Title/Summary/Keyword: Vertebral

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Clinical Observation of Liver Scintigram (간(肝) Scintigram의 임상적(臨床的) 고찰(考察))

  • Moon, Sung-Soo;Oh, Kyoung-Sik;Kim, Yul-Za;Kim, Yong-Cheol;Lee, Chong-Suk;Lee, Hak-Choong
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.19-27
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    • 1980
  • Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

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The Effects of the Administration on Oriental Medicine, Antaeeum, in the Pregnant Rat and Their Fetuses (안태음이 임신랫드와 태자에 미치는 영향)

  • Kim, Chang-Seok;Park, Hae-Mo;Lee, Sun-Dong;Lee, Jang-Woo;Kim, Pan-Gyi;Shin, Heon-Tae
    • Journal of Environmental Health Sciences
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    • v.33 no.4
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    • pp.306-316
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    • 2007
  • This study have a object to found out the effects of oriental herb medicine, Antaeeum, to dams of rats and their offsprings. The Antaeeum was savaged to female Sprague-Dawley rats at a dose of 5 mg/kg/day for 3 weeks during gestation periods. Dams of rat were sacrificed at 20th day of gestation, and were observed major internal and reproductive organs. Approximately live fetuses in the 20th days of gestation were selected randomly and examined with stereo microscopes. Others offsprings were fixed with 95% ethanol for skeletal examinations. The fixed fetuses were stained with alcian blue and alizarin red S to observe skeletal variations or malformations. Maternal body weight of Antaeeum treated dams have a tendency of increasing compared with control dams. There were no significant difference in internal and reproductive organs of weight or findings. The spleenic organ relative weight of treated dams were decreased compared with the control significaltly (p<0.05). There were no significant changes between two groups in blood chemistry and hematological values. There were no significant changes in number of corpus luteum, implantation, live fetuses and implantation rate, delivery rate, late resorption rate and sex ratio. But in the Antaeeum treated group showed lower early resorption rate than that of the control dams. Fetal body weight and number of fetus a dam at Antaeeum treated group were higher than that of control group. The fetuses of dams treated with Antaeeum didn't induced external malformations. Vertebral and sternal variations were observed in Antaeeum group, but compared with the control, those variations were not significant. The ossification numbers of rib, cervical, thoracic, and lumber were normal. Fetuses treated with Antaeeum to the dams showed no significant difference in the number of caudal vertebra (P>0.01). From these results, it can be concluded that Antaeeum showed no toxicity effects on maternal side especially on body weight, early resorption rate, and number of live fetuses. Also there were no significant changes on maternal organ weights except spleen, hematological data, reproductive organs. Although skeletal variations were examined at vertebra and sternum, this Antaeeum could not induced significant choses in bone malformation.

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

  • Joo, Sung-Pil;Kim, Soo-Han;Lee, Jung-Kil;Kim, Tae-Sun;Jung, Shin;Kim, Jae-hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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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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Results of Microvascular Decompression in Hemifacial Spasm (편측안면경련에서 미세혈관감압술의 성적)

  • Kwak, Hyoung Jun;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.501-508
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    • 2001
  • Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

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A Mouse Model of Photochemically Induced Spinal Cord Injury

  • Piao, Min Sheng;Lee, Jung-Kil;Jang, Jae-Won;Kim, Soo-Han;Kim, Hyung-Seok
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.479-483
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    • 2009
  • Objective : A mouse model of spinal cord injury (SCI) could further increase our basic understanding of the mechanisms involved in injury and repair of the nervous system. The purpose of this study was to investigate whether methods used to produce and evaluate photochemical graded ischemic SCI in rats, could be successfully adapted to mice, in a reliable and reproducible manner. Methods : Thirty female imprinting control region mice (weighting 25-30 g, 8 weeks of age) were used in this study. Following intraperitoneal injection of Rose bengal, the translucent dorsal surface of the T8-T9 vertebral laminae of the mice were illuminated with a fiber optic bundle of a cold light source. The mice were divided into three groups; Group 1 (20 mg/kg Rose bengal, 5 minutes illumination), Group 2 (20 mg/kg Rose bengal, 10 minutes illumination), and Group 3 (40 mg/kg Rose bengal, 10 minutes illumination). The locomotor function, according to the Basso-Beattie-Bresnahan scale, was assessed at three days after the injury and then once per week for four weeks. The animals were sacrificed at 28 days after the injury, and the histopathology of the lesions was assessed. Results : The mice in group 1 had no hindlimb movement until seven days after the injury. Most mice had later recovery with movement in more than two joints at 28 days after injury. There was limited recovery of one joint, with only slight movement, for the mice in groups 2 and 3. The histopathology showed that the mice in group 1 had a cystic cavity involving the dorsal and partial involvement of the dorsolateral funiculi. A larger cavity, involving the dorsal, dorsolateral funiculi and the gray matter of the dorsal and ventral horns was found in group 2. In group 3, most of the spinal cord was destroyed and only a thin rim of tissue remained. Conclusion : The results of this study show that the photochemical graded ischemic SCI model. described in rats, can be successfully adapted to mice, in a reliable and reproducible manner. The functional deficits are correlated an increase in the irradiation time and, therefore, to the severity of the injury. The photothrombotic model of SCI, in mice with 20 mg/kg Rose bengal for 5 minutes illumination, provides an effective model that could be used in future research. This photochemical model can be used for investigating secondary responses associated with traumatic SCI.

Analysis of the In-Patients Who were Admitted due to Bicycle Related Injuries (자전거 사고로 입원한 환자에 대한 분석)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Yoon, Hyung-Ku;Shin, Dong-Eun;Lee, In-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.58-64
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    • 2010
  • Purpose: Bicycle riding is an increasingly popular sports and leisure activity in Korea. The aim of this study was to identify injury patterns of admitted patients who were injured from bicycle riding. Materials and Methods: This study examined 71 patients from Jan. 2008 to May 2009. There were 54 male and 17 female patients. We investigated the injured body parts, mechanisms of injury, location of injury, types of bicycles, purpose of bicycle riding, any concomitant luggage or passenger on rear seat, injury seasons and the helmet use. We analyzed the data using Injury Severity Score(ISS). Results: There were 11 cases of ISS 1, 41 cases of ISS 4, 2 cases of ISS 5, 13 cases of ISS 9, one case of ISS 13, two cases of ISS 16 and one case of ISS 29 among the 71 patients. 36 patients(50.7%) underwent surgery for upper and lower extremity injuries, two patients for vertebral body fractures, 8 patients for facial bone injuries and one patient for abdominal organ injury. There were 10 head injuries among whom three patients received treatment in ICU(4.2%). Conclusion: Bicycle riding can cause severe injuries with subsequent admission and major surgeries. Several measures including constructing more bicycle road, public campaign and wearing protective gears should be instituted.

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An 18-year experience of tracheoesophageal fistula and esophageal atresia

  • Seo, Ju-Hee;Kim, Do-Yeon;Kim, Ai-Rhan;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo;Kim, Ki-Soo;Yoon, Chong-Hyun;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.705-710
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    • 2010
  • Purpose: To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit. Methods: A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007. Results: The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were $37^{+2}$ weeks and $2.5{\pm}0.7kg$, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age. Conclusion: Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.

Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

A Clinical Evaluation of Repeated Splanchic Nerve Block (내장신경 반복차단예에 대한 임상적 연구)

  • Sung, Nak-Soon;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.3 no.2
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    • pp.108-118
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    • 1990
  • Splanchnic nerve block (SNB) is performed to relieve intractable upper abdominal pain caused by carcinoma of the upper G-I tract. Not all patients achieve satisfactory pain relief; therefore, a second or third nerve block trial may need to be performed. In this study, an attempt was made to analyze the possible factors which might affect the result of repeated SNB in 42 the patients among 264 patients who received SNB at Severance Hospital during the period from January 1985 to December 1989. The results are as follows: 1) Among the 42 patients, including 30 males and 12 females, the fifties and forties were the major age groups. 2) Among the underlying diseases, stomach cancer was the most common (18 cases) and pancreatic cancer was next (14 cases). 3) The main locations of pain were the upper abdomen, epigastrium and entire abdomen in decreasing order. 4) Among the thirty-nine cases of first SNB combined with ascites, 13 cases received a repeat block, 81.0% of whom had had metastatic lesion. 5) There were 54.2% who had had single or combined treatment, operation, chemotherapy or radiotherapy before SNB. 6) Twently seven cases (64.3%) had received opioid medication for pain control. 7) In the 75% alcohol group, 11.7% of patients required a second block, and in the pure and 50% alcohol group, 9.6% of patients required a second block within two weeks of the first block. Three cases in both of these repeated block groups required a third block; representing 3.9%, of the 75% alcohol group and 1.6% of the pure and 50% alcohol group. 8) The volume of alcohol used was more than 16 ml bilaterally in both cases. 9) The points of the inserted needle were positioned in the upper and anterolateral part of the $L_1$ vertebra on both sides on the anteroposterior roentgenogram. The contrast media was spread upward along the anterior margin of the vertebral body and posteriorly in repeat block. The frequency of repeat block was higher in cases with ascites or metastasis. The instance of repeat block within 2 weeks of the first block was lower in the pure and 50% alcohol group than in the 75% alcohol group. Thus, alcohol concentration and patient status may be considered factors which influence the result of repeated SNB. We suggest early application of SNB in upper abdominal cancer patients.

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Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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