• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.372-377
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• 2007

Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.211-218
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• 1991

1983년 1월부터 1991년 2월까지 서울대학교 병원에서 진단된 위 암환자를 대상으로 시행한 359예의 골스캔을 후향적으로 재검토하여 골전이 빈도와 양상을 관찰하였으며 환자들의 의무기록을 검토하여 위암의 임상상과 비교하였다. 그 결과는 다음과 같았다. 1) 359예의 골스캔 중에서 골전이에 부합되는 이상소견은 167예(46.5%)이었다. 2) 관찰된 167예의 이상소견 빈도는 척추(66%)에 가장 많이 관찰되었고, 늑골(58%), 골반부(43%), 대퇴골(31%), 두개골(22%)순이었다. 3) 척추전이에서 흉추(65.6%)와 요추(64.5%)의 전이빈도는 거의 비슷하였고, 경추(23.6%)는 낮았다. 4) 골전이 빈도는 임상적 병기 3기 환자에서 진단후 1년 이내에 급격히 증가되었고 그 이후는 증가되지 않았다. 5) 골전이는 임상적 병기가 증가됨에 따라 증가되었으나, 조직학적 세포형태와는 무관하였다. 6) 혈청 alkaline phosphatase 치와 골스캔 상의 골전이 유무와 통제적으로 유의 한 상관관계가 관찰되었다. 이상의 결과로 위암환자의 상당 수에서 골전이가 진단되었으며 위 암환자, 특히 진행암 환자에서 골전이에 대한 주기적인 추적 검사가 필요할 것으로 생각된다.

• Korean Journal of Animal Reproduction
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• v.23 no.1
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• pp.69-73
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• 1999

A calf with derodidymus was delivered from a 3-year old Korean-native cow with abortion last ime at Jangheong area in Chonnam Province. The anomaly with body weight of 35 kg was born t the normal time of parturition. During the parturition, however, the calf with twin head was onfirmed and the complete amputation between fore and hind limb was inevitably carried out or safety of the dam. The calf had normal skeleton and extremities but had two heads and cervical vertebrae divided from upper thoracic part. At necropsy, there were found totally 3 pairs of ore limbs including two pairs of hypoplastic ones hided in the thoracic limb and also found one air of sternum. One head had incomplete torsion or unilateral hypoplasia of mandible with artly hypoplastic skull. There were marked fusion and torsion from cervical to 3rd thoracic vertebra. No abnormality was found on all organs in the pleural and abdominal cavities except a rectal stricture formed at 5 cm away from the atresia ani.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1210-1219
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• 2001

Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.4
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• pp.414-424
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• 2021

The purpose of this retrospective study was to evaluate the skeletal and dental maturity according to the vertical facial type and sex in Korean children in the developmental stage. In total, 184 participants aged 8 - 14 years were selected and divided into three groups based on the mandibular plane angle. For the comparison between the sexes, the three groups were each divided into male and female subgroups. The skeletal and dental maturity were assessed using lateral cephalograms, hand-wrist radiographs and panoramic radiographs. The vertical growth group showed significantly greater cervical vertebral and hand-wrist maturity than that in the horizontal growth group. Dental maturity was the highest in the vertical growth group. Girls showed greater skeletal maturity than boys, and no distinct difference was observed between the dental maturity of the sexes. Analysis of the vertical facial type in children can provide ancillary indicators that may help determine the optimal timing for orthodontic treatment initiation. Earlier initiation of orthodontic treatment may be considered for patients with vertical facial growth patterns.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.844-848
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• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• Journal of radiological science and technology
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• v.28 no.4
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• pp.327-332
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• 2005

The purpose of this Study was to investigate the prevalence rate of idiopathic scoliosis to the students from the elementary to the university in S city of Chung-Nam using 100 mm Mirror Camera radiation indirect examination units, with on age range of between eight and thirteen (1.526 subjects), fourteen and sixteen (462 subjects), seventeen and eighteen (291 subjects), nineteen and twenty four(508 subjects) and total of 2,787 participants with the 590 male subjects and 2,197 female subjects. The results of this study can be summarized and compared the primary examination with the secondary test of greater than $10^{\circ}$of Cobb's Angle were obtained as follows; 1. Indirect Examination were conducted to find idiopathic scoliosis amomg total 2.787 subjects, 257 subjects (9.2%) who showed positive sign greater than $10^{\circ}$in the Cobb's Angle ; below age of thirteen (132 subjects), between fourteen and sixteen (52 subjects), seventeen and eighteen (35 subjects), nineteen and twenty four (38 subjects). The $x^2-test$ analysis of Indirect Examination showed no statistical significant difference association between the age range and $10^{\circ}$Cobb's Angle of spinal curve(P>0.059). 2. The numbers of idiopathic scoliosis of greater than $10^{\circ}$Cobb's Angle of spinal curve in the primary examination were observed in 147 subjects (57.2%) at the Thoracolumbar region, 81subjects (31.5%) at the Thoracic region, 20 subjects (7.8%) at the Cervicothoracic region, 7 subjects (2.7%) at the Lumbar region, 2 subjects (0.8%) at the Cervical region. So, the large numbers were Thoracolumbar region, 183 participants (71.2%) showed the right side curve of scoliosis and 74 participant (28.8%) showed the left side curve of scoliosis. 3. The main region of the pain in one's own self more than $10^{\circ}$ Cobb's angle of spinal curve were no pain 219 subjects (85.2%), 18 subjects (7.0%) at the Lumbar region, 9 subjects (3.5%) at the Cervical region, 7 subjects (2.7%) at the Thoracic region, 2 subjects (0.7%) at the shoulder girdle region, 1 subjects (0.39%) at the pelvis and whole body region. There was statistical significant difference association between the Cobb's Angle of spinal curve and the main pain region of one's (P<0.006). This study may be significant to an early stage investigate of the prevalence rate of idiopathic scoliosis in the juveniles using 100 mm Mirror Camera radiation indirect examination units. The results of this study help that the students in a stage on growth the basis of data early discovery and therapy of idiopathic scoliosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.235-247
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• 2020

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and posttreatment (T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this study indicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.3
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• pp.146-157
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• 2017

Objectives: This study was performed to assess the effectiveness of Korean medicinal treatments including Antaeeum-gamibang on posterior neck pain and lower back pain caused by traffic accidents during pregnancy. Methods: Patients were treated by Antaeeum-gamibang, acupuncture and Chuna manual therapy. To measure treatment outcomes, Numerical rating scale (NRS), Oswestry disability index (ODI), Neck disability index (NDI), European Quality of Life-5 Dimensions (EQ-5d), and range of motion (ROM) were used. Results: After treatment, the average NRS of posterior neck pain significantly decreased from $4.20{\pm}1.30$ to $1.80{\pm}0.45$ and the average NRS of lower back pain significantly decreased from $6.40{\pm}1.14$ to $2.20{\pm}0.84$. ODI significantly decreased from $41.42{\pm}17.79$ to $28.29{\pm}14.69$, NDI significantly decreased from $34.93{\pm}9.85$ to $20.27{\pm}8.96$. EQ-5d and ROM improved at all cases. Conclusions: Korean Medicinal treatments including Antaeeum-gamibang may be effective in the treatment of posterior neck pain and lower back pain caused by traffic accidents during pregnancy. However, more case reports and studies are required to identify exactly what treatment is more efficient.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.38-44
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• 1995

Metastatic bone tumor is the most common bone tumor and 32.5% of all primary malignant tumors are eventually metastasize to bone. Metastatic bone tumor has been more frequently encountered disease in the orthopedic fields due to the greater longevity of life of the patients with primary visceral cancers by major advances in early detection, diagnosis, and surgical/radiotherapeutic/chemotherapeutic treatment of primary and metastatic lesions. Therefore, the epidemiologic data about the incidences and the patterns of bone metastasis is important. We reviewed 417 patients who were diagnosed and treated for metastatic bone tumor at Kosin University Medical Center from 1985 to 1993 to analyse the primary lesion, age and sex distributions, location of bone metastasis, patterns of metastasis according to the primary. The results were as follows : 1. The common origin of bone metastasis were lung(29.5%), stomach(15.3%), breast(11.3%), unknown(7.7%), cervix(5.3%), liver(4.8%) in order of frequency. 2. There were 251 men and 166 women and their mean age was 54.8 years and the peak age incidence was in 6th decades. Most cases(85.3%) were occured beyond 5th decades. 3. The preferred sites of metastatic deposits were spine(64.0%), pelvis(40.5%), rib(38.8%), femur(36.7%), skull(21.1%), humerus(13.9%), scapula(13.0%) in order of frequency. In the spine, thoracic(42.1%), lumbar(39.1%), cervical(13.2%), sacral(5.6%) vertebrae were involved in order of frequency. 4. Multiple bone metastases were more common(73.1%) than single metastasis(26.9%). 5. In the lung cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, pelvis, femur. 6. In the stomach cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, femur, pelvis. 7. In the breast cancer, the peak age incidence was 5th decades, and the preferred sites of bone metastasis were spine, rib, pelvis. 8. In the bone metastasis with unknown primary site, the peak age incidence was 7th decades, the preferred sites of bone metastasis were spine, femur, pelvis, and the common histologic types were adenocarcinoma and squamous cell carcinoma.