• Title/Summary/Keyword: Vertebral

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MESIODENS EXTRACTION OF A PATIENT WITH ROBINOW SYNDROME UNDER GENERAL ANESTHESIA (로비노 증후군(Robinow syndrome) 환자의 전신마취 하 과잉치 발치)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.1-5
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    • 2016
  • Robinow syndrome is skeletal dysplasia with both autosomal dominant and recessive inheritance patterns. It is characterized by short-limbed dwarfism, abnormalities in the head and face, as well as vertebral segmentation. A 2-year-7-month old boy with Robinow syndrome had visited Seoul National University Dental Hospital, for the evaluation of tooth palatal eruption on maxilla. He had micrognathia, delayed tooth eruption, cleft lip with bifid uvula. He also had an erupted mesiodens on the palatal side of maxillary primary incisors, which was tuberculated and 8mm in major diameter. The patient was scheduled for mesiodens extraction under general anesthesia. He was a young child with delayed development, so general anesthesia was inevitable. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. There were no postoperative complications related to anesthesia and dental treatment. Robinow syndrome patients have craniofacial dysmorphism and eruption disorders. Therefore, he requires regular check-ups as well as dental managements.

The Effect of Left Subclavian Artery Coverage During Endovascular Repair of the Thoracic Aortic Aneurysm on Cerebral Hemodynamics: Two Cases of Flow Measurement by using 2D Phase Contrast Magnetic Resonance Imaging (흉부대동맥류의 혈관내치료 도중 좌측 쇄골하동맥 폐색이 뇌혈류역동에 미치는 효과: 2차원 위상차 대조 자기공명영상을 이용한 혈류 측정 2례 보고)

  • Baek, Seung-Hoon;Youn, Sung-Won;Kim, Ho-Kyun;Kwon, Oh-Choon;Lee, Sub;Lee, Jong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.159-168
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    • 2012
  • The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

Characteristic MRI Findings of Spinal Metastases from Various Primary Cancers: Retrospective Study of Pathologically-Confirmed Cases (다양한 원발성 암의 척추전이 병변의 특징적인 자기공명영상 소견들: 병리학적으로 확인된 병변들의 후향적인 분석)

  • An, Chansik;Lee, Young Han;Kim, Sungjun;Cho, Hee Woo;Suh, Jin-Suck;Song, Ho-Taek
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.8-18
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    • 2013
  • Purpose : The purpose of this study was to find and categorize the various magnetic resonance imaging (MRI) findings of spinal metastases that correlate with the type of primary cancer. Materials and Methods: We retrospectively reviewed gadolinium-enhanced magnetic resonance images of 30 patients with 169 spinal metastatic lesions from lung cancer (n = 56), breast cancer (n = 29), colorectal cancer (n = 20), hepatocellular carcinoma (HCC) (n = 17), and stomach cancer (n = 47). The size, location, extent of invasion, signal intensity, margin, enhancement pattern, and osteoblastic or osteolytic characteristics of each metastatic tumor were analyzed. Results: The metastatic lesions from HCC were larger than those from the other primary tumors (P < 0.05) except for colorectal cancer (P = 0.268). Well-defined metastatic tumor margins were more frequently seen in lung cancer and breast cancer (P < 0.01). All but HCC showed a tendency to invade the vertebral body rather than the posterior elements (P < 0.02). Colorectal cancer and HCC showed a tendency toward extraosseous invasion without statistical significance. HCC showed a characteristic enhancement pattern of 'worms-in-a-bag'. Rim enhancement with a sclerotic center was only seen in spinal metastases from stomach cancer. Conclusion: Despite many overlapping imaging features, spinal metastases of various primary tumors display some characteristic MRI findings that can help identify the primary cancer.

Studies on the Fishery Biology of Pomfrets, Pampus spp. in the Korean Waters 3. Age and Growth of Korean Pomfret, Pampsu echinogaster, from the East China Sea (한국근해 병어류의 자원생물학적 연구 3. 동지나해산 덕대의 연령과 성장)

  • KANG Yong Joo;LEE Dong Woo;HONG Byung Que;KIM Young Sub
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.22 no.5
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    • pp.281-290
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    • 1989
  • Growth of the Korean pomfret, Pampus echinogaster, captured in the East China Sea from January to December 1987, was estimated by annual rings on the vertebral centrum. The time of annual ring formation was approximately during September and October. Von Ber-talanffy growth equations derived from the mean back-calculated fork length(cm) at each age were as follows: for females, $L_{t}=29.17(1-e xp(-0.3213(t+0.7601)))$, for males, $L_t=28.21(1-e xp(-0.3169(t+0.8284)))$, and for sexes combined, $L_t=29.00(1-e xp(-0.3228(t+0.7361)))$, Seasonal growth equations derived from the mean observed fork length (cm) at age by month were as follows: for females, $L_t=29.2(1-e xp(-0.3458(t+0.8182)+(0.3458/2\pi)sin2\pi(t+0.027)))$, and for males, $L_t=28.2(1-e xp(-0.2789(t+1.5913)+(0.2789/2\pi)sin2\pi(t-0.1062)))$.

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Changes of Head Posture in Standing and Sitting Posture (서 있는 자세와 앉은 자세에서 두부자세의 변화)

  • Sang-Chan Lee;Kyung-Soo Han;Myung-Seok Seo
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.305-315
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    • 1996
  • This study was performed to investigate the changes of head posture according to natural standing or sitting posture. Twenty seven healthy dental students without any signs and symptoms of temporomandibular disorders participated in this study. Cervical resting posture (CRP) of the head in sagittal plane was measured by Cervical-Range-of-Motion $^\textregistered$(CROM, U.S.A.) and lateral cephalograph was taken in natural posture. The items related to angle in cephalograph were the angles of cranial and cervical inclination to true vertical line(VER/NSL, VER/AML), the angles of cervical inclination to nasion-sella line(CVT/NSL, OPT/NSL), the angles of comical inclination to horizontal line(CVT/HOR, OPT/HOR), the angle of cervical lordosis(CVT/OPT). The items related to line measurement were the distance from subocciput to Cl(Dl), Cl to C2(D2), C2 to C3(D3), C3 to C4(D4), the upper(PNS to posterior pharyngeal wall) and the lower(tongue base to posterior pharyngeal wall) pharyngeal space, the distance from nation to mention(Na-Me), and the radius of comical curvature from the first comical vertebra(Cl ) to the fifth cervical vertebra(C5). The data were analyzed with SAS/STAT program. The obtained results were as follows : 1. Most items related to angular measurement showed significant difference between in standing and sitting posture. The angles of CRP, CVT/NSL, OPT/NSL, CVT/HOR, OPT/HOR, and CVT/OPT were high in sitting posture, but the angles of VER/NSL, VER/NSL were low in sitting posture. 2. In vertebral distance, only the distance between C3 and C4 was differed by the posture, which decreased in sitting posture. In sitting posture, the distance from nasion to menton(Na-Me) was longer, but the radius was shorter than in standing posture. 3. Correlationship in angular measurements was almost same in both postures. Ceervical resting posture(CRP) was correlated with VER/NSL, VER\ulcornerNSL was correlated with CRP, CVT/NSL, and OPT/NSL, VER/AML was correlated with CVT/HOR, OPT/HOR, CVT/OPT, and the angle of cervical lordosis(CVT/OPT) was correlated with the radius. 4. Correlationship in linear measurement was observed only in among D3, D4, and radius. And the Na-Me was not correlated with any other items. From this results, The author concluded that the head posture in sitting was mote backward extended than in standing.

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Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

Load Sharing Ratios Between the Cortex and Centrum in a Lumbar Vertebral Body with aging using Finite Element Method (유한 요소 법을 이용한 노화에 따른 요추의 피질 골과 해면 골 간의 하중 분담 비율)

  • Lim, JongWan
    • Journal of Biomedical Engineering Research
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    • v.37 no.2
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    • pp.90-103
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    • 2016
  • This research was aimed to analyze load sharing ratios between cortical shell and trabecular bone of a degraded lumbar vertebra with aging, and also evaluate elastic moduli assigned into an FE model, using finite element method. For the better analysis of trabecular bone, effective elastic moduli, that is, nominal elastic moduli divided by the volumetric porosities was used. The elastic moduli of the cortical shell suitable for the trabecular bone were obtained from the equations on the basis of idealized stress-strain relations, including areal porosities. To minimize numerical errors, p-element was used. Using eight parameters that refer to some published papers, the geometry of L3 with a removed posterior part. After the constant compressive displacement was applied, the load sharing ratios were obtained by using both every elastic strain energy and every vertical force between two bones in each 8-volume. As results, 1) according to an increase in age from 20-year to 80-year, load sharing ratios of trabecular bone decreased from 55% to 49%; 2) the maximal ratios of each bone were occurred in the mid-plane of centrums and the endplate of cortical shells, respectively; 3) effective elastic moduli assigned into a porous centrum/cortex were found to be adequate; 4) for load sharing ratios, the difference of two methods showed that the total ratios were almost same within less than 1% but the partial ratios at every depth were more or less different each other.

Effects of Electrotherapy on Blood Velocity of Cranial Artery in Tension-Type Headache subjects (전기치료가 긴장형 두통환자의 뇌 혈류 속도에 미치는 영향)

  • Park Rae-Joon;Kim Jin-Sang;Lee In-Hak;Park Jang-hwan;Han Dong-Uck
    • The Journal of Korean Physical Therapy
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    • v.12 no.3
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    • pp.349-359
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    • 2000
  • The aim of study was to evaluated the possible role of cranial artery velocity in headache pathogenesis. The present study was studied of five headache(F=5. Mean $age=29.80\pm6.76yrs$) were compared to 4 controls(F=4, Mean $age=29.00\pm5.48yrs$). Transcranial doppler ultrasonography(TCD) is a new non-invasive and easily applicable method to evaluate flow velocities of the intracranial and extracranial cerebral arteries. TCD was performed with standard method to measure the mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the internal carotid artery, the vertebral and the basilar artery. We reviewed the whole TCD results performed at Taejon Veterans Hospital from October. 11. 2000 to November. 10. 2000. Mean flow velocities in headaches and controls at their 6 decades are $28.00\pm3.61cm/sec$ and $41.25pm1.71cm/sec$ in lent PCA (P<0.01), $50,000\pm23.07cm/sec$ and $82.75\pm15.59cm/sec$ in right MCA(P<0.05), $26.20\pm4.82cm/sec$ and $45.50\pm4.51cm/sec$ in fight PCA(P<0.01). $26.60\pm4.56cm/sec$ and $38.25\pm4.92cm/sec$ in right VAC(P<0.01). After treatment for 2 weeks, mean of velocity on pre treatment and post treatment and post treatment are $28.00\pm3.61cm/sec$ and $38.20\pm5.81cm/sec$ in left PCA (P<0.05), $26.20\pm4.827cm/sec$ and $39.20\pm5.54cm/sec$ in right PCA(P<0.05), $40.60\pm9.18cm/sec$ in right VA(P<0.01). It is concluded that Electrical Therapy for two weeks was effected to promote Mean Flow of Velocity in cranial artery. Mean of velocity in cranial artery with headaches observed in this study was lower than controls, but MFV was promote after treatment for 2 weeks.

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Diagnostic Usefulness of Computed Tomography Compared to Conventional Chest X-Ray for Chest Trauma Patients (흉부 외상 환자에서 일반흉부촬영과 비교한 흉부단층촬영의 진단적 유용성)

  • Choi, Kyu Ill;Seo, Kang Suk;Ryoo, Hyun Wook;Park, Jung Bae;Chung, Jae Myung;Ahn, Jae Yoon;Kang, Seong Won;Yi, Jae Hyuck
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.142-147
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    • 2009
  • Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn' be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn' be found on CXR to be verified, which helped us to could accurately evaluate patients.

Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.