• Journal of the Korean Society of Radiology
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• v.15 no.6
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• pp.927-933
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• 2021

The purpose of this study was to compare and analyze the differences in scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the third lumbar vertebral region including the back fat, spinal cord, and cerebrospinal fluid using the mDixon, T2 TSE, and T2 spectral pre-saturation with inversion-recovery (SPIR) techniques. With the factors affecting the SNR fixed, the lumbar sagittal plane images of 30 adults were compared on mDixon, T2 TSE, and T2 SPIR imaging tests. The test times for mDixon, T2 TSE, and T2 SPIR were 115 seconds, 60 seconds, and 60 seconds, respectively. The mDixon T2 images showed higher SNR than the T2 TSE images at the third lumbar vertebral region (p<0.05), lower SNR in the back fat and cerebrospinal fluid (p<0.05) areas, and comparable SNR in the spinal cord (p>0.05). The CNR between the third lumbar vertebral area and back fat was higher in the mDixon T2 images, and the CNR of the cerebrospinal fluid and spinal cord images was higher in the T2 TSE images (p<0.05). The mDixon T2 FS images CNR was lower for the 3rd lumbar vertebral body region and back fat than the T2 SPIR images, and higher for the spinal cord and cerebrospinal fluid images (p<0.05). The CNR between the third lumbar body and back fat areas was higher in the mDixon T2 FS images (p<0.05), and there was no difference in the CNR in the images of the cerebrospinal fluid and the spinal cord (p>0.05). It is difficult to determine whether the mDixon technique is superior to the conventional T2 TSE and T2 SPIR techniques in terms of test time, SNR, and CNR. This study was confined to patients with simple lower back pain and was limited by controlled experimental conditions. Studies using clinically applied protocols are warranted in the future.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.64-73
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• 1988

Recent studios have shown that narcotic drags produce an unusually intense, prolonged and segmental analgesic action in man whoa injected into the spinal subarachnoid or epidural space (Wang et al, 1979; Behar et al, 1979; Cousins et al, 1979; Magora et a., 1980, Johnston and McCaughey, 1980). Since 1960, many investigators claimed that low molecular weight(LMW) dextran increased the clinical duration of lidocaine(Loder, 1960; Loder, 1962), tetracaine (Chinn and Wirjoatmadja, 1967) and bupivacaine(Kaplan et al, 1975) in man but the mechanism of the action of dextran was unclear. But Curtiss and Scurlock(1979), and Buckled and Fink(1979) claimed that LMW dextran has no effect on the duration of action of bupivacaine in animal studies. The present study was performed to evaluate the clinical efficacy of analgesia by the thoracic epidural injection of morphine and bupivacaine mixture for the relief of pain due to fractured or contused ribs, to evaluate the duration of analgesic effect by the use of the above mixture in a hypertonic solution(dextran 70 or 50% dextrose in water) and to observe the possibility of improvement in the lung function after the pain block. The complications following the pain block were also observed. The 50 single thoracic epidural injections of the mixture were divided into three groups : Group 1(n=15) served as a control group and drags used for the relief of pain were as follows(Mean$\pm$S.D.): morphine($2.13{\pm}1.64\;mg$), 0.5% bupivacaine($3.10{\pm}1.04\;ml$) and 0.9% saline($3.64{\pm}1.11\;ml$). Group 2(n=16) serves as an experimental group and drugs were as follows(Mean$\pm$S.D.): morphine($2.13{\pm}0.72\;mg$), 0.5% bupivacaine($3.06{\pm}0.77\;ml$) and dextran 70($3.75{\pm}1.29\;ml$). Group 3 (n=19) served as an experimental group and drags were as follows(Mean$\pm$S.D.) : morphine($2.42{\pm}0.51\;mg$), 0.5% bupivacaine($3.21{\pm}0.71\;ml$) and 50% dextrose in water($3.58{\pm}1.11\;ml$). The results are were follows: 1) The Dumber of patients who obtained excellent and good analgesic effects following the block were greater in the experimental Croup 2(94%) and Group 3 (90%) than theme of the control Group 1 (80%). 2) The duration of pain relief which lasted more than 3 days after the epidural block was longer in the experimental Group 2 (81%) and Group 3 (75%) than those of the control Croup 1(67%). 3) The pulmonary reserve(FVC%+FEV 1.0%) of 27 cases who were treated by the pain block between 1 and 31 drys following the chest injury was increased to about 13% than those before the block, and that of 13 cases between 32 and 82 days following the chest injury was decreased to about 4% than those before the block. 4) Of the complications following the pain block, there were 5 cased(10%) of nausea within 2 hours following the block, 4 cases(8%) of vomiting after 2 hours following the block, 10 cases(20%) of pruritus after 3~4 hours following the block, 17 cases(34%) of transient urinary retention which tasted 8 to 19 hours, 3 cases(6%) of headache within 2 hoers following the block and 2 cases(4%) of dural puncture. In conclusion, it is suggested that the clinical duration of analgesic effect produced by morphine and bupivacaine mixture can be prolonged by addition of the hypertonic solution to the mixture.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1336-1339
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• 2001

Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.5
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• pp.237-243
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• 2004

Glial cells are activated in neuropathy and play a key role in hyperalgesia and allodynia. This study was performed to determine whether minocycline could attenuate heat hyperalgesia and mechanical allodynia, and how glial cell activation and nuclear factor kappa B (NF-kappaB) were regulated by minocycline in a model of chronic constriction of sciatic nerve (CCl). When minocycline (50 mg/kg, oral) was daily administered from 1 day before to 9 days after ligation, heat hyperalgesia and mechanical allodynia were attenuated. Furthermore, when minocycline treatment was initiated 1 or 3 days after ligation, attenuation of the hypersensitive behavior was still robust. However, the effect of attenuation was less when minocycline was started from day 5. In order to elucidate the mechanism of pain attenuation by minocycline, we examined the changes of glia and NF-kappaB, and found that attenuated hyperalgesia and allodynia by minocycline was accompanied by reduced microglial activation. Furthermore, the number of NF-kappaB immunoreactive cells increased after CCI treatment and this increase was attenuated by minocycline. We also observed translocation of NF-kappaB into the nuclei of activated glial cells. These results suggest that minocycline inhibits activation of glial cells and NF-kappaB, thereby attenuating the development of behavioral hypersensitivity to stimuli.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.76-81
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• 1999

Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.389-392
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• 2015

Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.177-181
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• 2012

We present a case of an athetoid cerebral palsy with quadriparesis caused by kyphotic deformity of the cervical spine, severe spinal stenosis at the cervicomedullary junction, and atlantoaxial instability. The patient improved after the first surgery, which included a C1 total laminectomy and C-arm guided righ side unilateral C1-2 transarticular screw fixation. C1-2 fixation was not performed on the other side because of an aberrant and dominant vertebral artery (VA). Eight months after the first operation, the patient required revision surgery for persistent neck pain and screw malposition. We used intraoperative VA angiography with simultaneous fluoroscopy for precise image guidance during bilateral C1-2 transarticular screw fixation. Intraoperative VA angiography allowed the accurate insertion of screws, and can therefore be used to avoid VA injury during C1-2 transarticular screw fixation in comorbid patients with atlantoaxial deformities.

• Korean Journal of Oriental Medicine
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• v.16 no.2
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• pp.119-124
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• 2010

Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathy. The most common symptom of cervical disc herniation is neck pain that spreads down to the upper limb in various locations. There can also be associated with weakness and movement disorders of upper limb. In Oriental medicine, cervical disc herniation is treated with herb-med, physical therapy, acupuncture, Chuna, etc, but the Bee Venom therapy is the most common and effective. In this case, we used the Bee Venom therapy at cervical hyeopcheokhyeol for about 2 months to a patient who was diagnosed with disc herniation at Cervical 5-6, 6-7 and appealed weakness, limited elevation and abduction of the left upper limb. As a result, left upper limb disability was improved. Using the Bee Venom therapy at cervical hyeopcheokhyeol that are effective on movement disorders and neurological diseases of upper limb is an effective treatment to upper limb disability diagnosed with cervical disc herniation, and suggests the direction of the treatment to upper limb weakness and movement disorders diagnosed with cervical disc herniation.

• Journal of Electrical Engineering and Technology
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• v.10 no.6
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• pp.2413-2419
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• 2015

Core spinal muscles are related to trunk stability and assume the main role of stabilizing the spine during daily activities; strengthening of core muscles around the spine can therefore reduce the chance of back pain. The objective of the study was to investigate the effect of core muscle strengthening in the spine during spine stabilization exercise using a whole body tilt device. To achieve this, a validated musculoskeletal (MS) model of the whole body was used to replicate the input motion from the whole body tilting exercise. An inverse dynamics analysis was executed to estimate spine loads and muscle forces depending on the tilting angles of the exercise device. The activation of long and superficial back muscles such as the erector spinae (iliocostalis and longissimus) were mainly affected by the forward direction (-40°) of the tilt, while the front muscles (psoas major, quadratus lumborum, and external and internal obliques) were mainly affected by the backward tilting direction (40°). Deep muscles such as the multifidi and short muscles were activated in most directions of the rotation and tilt. The backward directions of the tilt using this device could be carefully applied for the elderly and for rehabilitation patients who are expected to have less muscle strength. In this study, it was shown that the spine stabilization exercise device can provide considerable muscle exercise effect.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.308-313
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• 2011

Posterior cervical foraminotomy is an attractive therapeutic option in selected cases of cervical radiculopathy that maintains cervical range of motion and minimize adjacent-segment degeneration. The focus of this procedure is to preserve as much of the facet as possible with decompression. Posterior cervical inclinatory foraminotomy (PCIF) is a new technique developed to offer excellent results by inclinatory decompression with minimal facet resection. The highlight of our PCIF technique is the use of inclinatory drilling out for preserving more of facet joint. The operative indications are radiculopathy from cervical foraminal stenosis (single or multilevel) with persistent or recurrent root symptoms. The PCIFs were performed between April 2007 and December 2009 on 26 male and 8 female patients with a total of 55 spinal levels. Complete and partial improvement in radiculopathic pain were seen in 26 patients (76%), and 8 patients (24%), respectively, with preserving more of facet joint. We believe that PCIF allows for preserving more of the facet joint and capsule when decompressing cervical foraminal stenosis due to spondylosis. We suggest that our PCIF technique can be an effective alternative surgical approach in the management of cervical spondylotic radiculopathy.