• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.340-344
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• 2019

A 14-month-old Thoroughbred colt with hind limbs lameness was referred to Equine Hospital of Jeju National University. During physical examination, the patient could not walk in a straight line but wobbled especially with hind limbs. He hesitated when backing and crossed hind limbs while circling tightly by protracting the outer hind limb keeping the inner hind limb stationed. Stenosis was observed between the 2nd (C2) and 3rd (C3), and the C3 and 4th (C4) cervical vertebrae on radiographs. The colt diagnosed as cervical stenotic myelopathy (CSM) based on the clinical signs and radiological findings. To confirm the diagnosis, postmortem computed tomography (CT) and histopathologic examination were performed after the euthanasia. The CT images revealed severe compression of the spinal cavity and cord between C3 and C4 cervical vertebrae. Grossly, there was compression of the spinal cord between the C3 and C4 cervical vertebrae. Histopathologically, severe axonal swelling and demyelination characterized by vacuolation and cavity formation were observed in the white matter of the spinal cord, especially in C3 and C4. CSM is problematic in the horse racing industry because of abnormal walking. This case report of CSM may offer information for diagnosis of the disease in the equine veterinary fields in the Republic of Korea.

• Journal of Interdisciplinary Genomics
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• v.1 no.2
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• pp.19-22
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• 2019

CATCH 22 syndrome is rare genetic disease that has various manifestations. Cervical vertebral anomaly, such as Klippel-Feil anomaly, is frequently observed in the patients with CATCH22 syndrome. We present the case of an 11-year-old female patient with CATCH22 syndrome and Klippel-Feil anomaly who had been treated torticollis using the customized soft neck collar. During the patient's first visit to our clinic, she presented with low ear set, skull deformity, intellectual disability, and tilting of the head to the left by approximately 25 degrees. Imaging studies revealed multisegmental fusion and C3 hemivertebrae of the cervical spine and left thoracic scoliosis at T4 with 50 degrees of Cobb's angle. We instructed passive stretching and applied the customized soft neck collar we invented. The ipsilateral aspect of the neck collar is designed to provide vertical support between the clavicle and mandibular angle and is adjustable in height. The Velcro was attached to the neck collar at the point of contact with the ipsilesional mandibular angle, which provides negative sensory feedback, inducing her to tilt neck to the contralesional side. We applied the neck collar for 2 hours a day. After 1 year of treatment, her neck inclination angle improved from 25 to 10 degrees. Providing negative sensory feedback using the customized soft neck collar can be one of the treatment options of postural management in patients with torticollis in cases of CATCH 22 syndrome combined with Klippel-Feil anomaly.

• Journal of Veterinary Clinics
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• v.39 no.5
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• pp.235-239
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• 2022

A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.703-715
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• 2023

Objective : This retrospective study investigated the factors that affect cage obliquity angle despite orthogonal maneuvers performed during oblique lateral interbody fusion (OLIF) and assessed the relationship between cage obliquity angle and radiological outcomes post-surgery. Methods : Twenty-nine males who underwent L4-L5 OLIF for lumbar degenerative disease between 2019 and 2021 with a followup duration greater than 12 months were analyzed. Radiological parameters were measured including psoas muscle volume, total psoas area index (total psoas muscle area [cm²]/height squared [m²]), distance from the iliac artery to the origin of the psoas muscle (DIAPM), angle between the origin of the psoas muscle and the center of the vertebral disc (APCVD), iliac crest height, disc height, lumbar flexibility (lumbar flexion angle minus extension angle), cage location ratio, cage-induced segmental lumbar lordosis (LL) (postoperative index level segmental LL minus used cage angle), foraminal height changes, fusion grade. Results : DIAPM, APCVD, iliac crest height, postoperative index level segmental LL, and cage-induced segmental LL were significantly correlated with OLIF cage obliquity angle. However, other radiological parameters did not correlate with cage obliquity. Based on multiple regression analysis, the predictive equation for the OLIF cage obliquity angle was 13.062-0.318×DIAPM+0.325×1APCVD+0.174×iliac crest height. The greater the cage obliquity, the smaller the segmental LL compared to the cage angle used. Conclusion : At the L4-L5 level, OLIF cage obliquity was affected by DIAPM, APCVD, and iliac crest height, and as the cage obliquity angle increases, LL agnle achievable by the used cage could not be obtained.

• 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.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.27-33
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• 1990

In the past decades there has been a growth of interest in the use of stellate ganglion block (SGB) as part of the diagnosis and therapy for the disease of the head, neck and upper extremities. For the evaluation of changes in hemodynamics and temperature of the affected extremity after the SGB, unilateral SGB (either right or left) was performed by local injection of 10 ml of 1% lidocaine without epinephrine in 45 patients (right side SGB: 25, left side SGB: 20) with various diseases. Systolic and diastolic blood pressure, pulse rate and skin temperature of the ipsilateral hand were studied before and 1, 2, 3, 4, 5, 10, 15, 30 and 60 minutes after the block. The results were as follows: 1) Changes of blood pressure: Systolic and distolic blood pressure after either right or left side SGB showed no statistically significant change. 2) Changes of pulse rate: While the left side SGB showed a mild decrease without statistical significance, the right side SGB showed a statistically significant decrease at 30 and 60 minutes after the block (p<0.05). 3) Changes of skin temperature of the blocked hand: Either side SGB produced a gradual increase in temperature with time and showed statistical significance from 10 minutes in the left side block (p<0.01), and a from 10 minutes after the block in the right side (p<0.01). Both sides SGB showed a maximal increase at 30 minutes after the block and a small decrease at 60 minutes after the block compared to the 30 minutes value. 4) Despite the successful SGB. 4 of 45 patients failed to produce a significant increase in skin temperature on the affected upper extremity. In conclusion, unilateral SGB with 1% lidocaine at the 6th cervical vertebral level is a safe method for use on an outpatient basis, and an increase in skin temperature in the affected upper extremity is necessary to confirm the successful therapeutic effect on disease of the upper extremity.

• Journal of the Korean Society of Radiology
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• v.1 no.3
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• pp.35-40
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• 2007

The purpose of this study was to investigate in S city of Chung-Nam using direction radiation Cervical spine among patient enforcing AP view, lateral view, total 113 subjects(40-year-old low)by target examine and got following as: 1) Distribution of age 14~40 years old 57 men (50.4%), woman 56subjects(49.6%)be, and age group 30~40year old 80subjects(70.8 %), 20~29year old 27subjects(23.9%). 2) It appeared most by 81subjects(71.7%) that can not know cause though traffic accident, misstep, cause ignorantness were investigated to revealed by the chronic 87subjects(77%) appeared by thing which statistical significance is with occurrence cause. 3) 20 Among whole 113subjects 20~29years old 27 subjects(23.9%), 30~40years old 80 subjects(70.8%) manifestationacute form of a disease, the chronic all high distributionsee. 4) This investigator left shoulder region pain among 39 subjects whole 113 subjects (left to direction that could know that is each main pain in 34.5 %), cervical vertebral portion upside 31 subjects(27.4%), both shoulder region pain 20 subjects(17.7%), and becomes left side scoliosis 62 subjects(54.9%)by the most frequencies appear. 5) Appeared antespondylolisthesis by all curve 48 subjects(42.5 %) in curve direction and at Systolic blood pressure from 160mmHg to all 19 subjects (before total 69 subjects (61.0 %) at 16.8 %), Diastolic blood pressures curve 31 subjects(27.4 %) by 100 mmHg appear.

• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.255-260
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• 2002

Purpose: SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Materials and Methods: Five patients (M:F=5.0, Age $22.8{\pm}4.78$ yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extort of spinal lesion. Results: All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. Conclusion: As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

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

• KIPS Transactions on Software and Data Engineering
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• v.12 no.1
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• pp.51-58
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• 2023

In this paper, we propose an organ segmentation technique for the automatic extraction of medical diagnostic indicators from X-ray images. In order to calculate diagnostic indicators of heart disease and spinal disease such as VHS(vertebral heart scale) and Cobb angle, it is necessary to accurately segment the thoracic spine, carina, and heart in a chest X-ray image. A deep neural network model in which the high-resolution representation of the image for each layer and the structure converted into a low-resolution feature map are connected in parallel was adopted. This structure enables the relative position information in the image to be effectively reflected in the segmentation process. It is shown that learning performance can be improved by combining the OCR module, in which pixel information and object information are mutually interacted in a multi-step process, and the channel attention module, which allows each channel of the network to be reflected as different weight values. In addition, a method of augmenting learning data is presented in order to provide robust performance against changes in the position, shape, and size of the subject in the X-ray image. The effectiveness of the proposed theory was evaluated through an experiment using 145 human chest X-ray images and 118 animal X-ray images.