• Title/Summary/Keyword: 흉추

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The Usefulness of Bone Scintigraphy in SAPHO Syndrome (SAPHO 증후군에서 골신티그라피의 유용성)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • 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.

Percutaneous Polymethylmethacrylate Vertebroplasty in the Treatment of Osteoporotic Thoracic and Lumbar Vertebral Body Compression Fractures : Outcome of 159 Patients (159명의 골다공증성 흉추 및 요추부 골다공증성 추체 압박골절 환자에 대한 경피적 척추성형술 후 치료결과)

  • Lee, Jae-Un;Ryu, Kyeong-Sik;Park, Chun-Kun;Choi, Yeong-Kun;Park, Chun-Kun;Ji, Chul;Cho, Kyung-Suk;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.173-179
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    • 2001
  • Purpose : To assess therapeutic effects of percutaneous polymethylmethacrylate(PMMA) vertebroplasty on the pain caused by osteoporotic thoracic and lumbar vertebral body compression fractures in a large scale of a prospective clinical design, and to determine clinical factors influencing its therapeutic effects. Methods : A prospective clinical study was carried out in 349 vertebral levels of 159 patients between April 1998 and July 1999. The compression fractures were confirmed with bone scan and spine CT, and bone marrow density was measured. Visual analogue scale(VAS) score was used for pre- and post-operative assessments of the pain. All 159 patients were assessed immediately after surgery, and 140 patients of them were followed-up for about 6 months in average. Results : Partial and complete pain relief was sustained immediately after operation in 73%, through follow-up period in 88% of the patients. Pain relief was not proportional to the amount of PMMA or the rate of increase in the height of the compressed vertebral body. It appears that 3 to 6cc of PMMA was proper enough to sustain pain relief. Better clinical improvement was achieved in the patients treated within 6 months after occurrence of vertebral body fracture. The most frequent surgical complication was epidural leakage of PMMA, and the most serious complication was extravertebral leakage into the paravertebral muscles, which appeared to exert the worst influence on the outcome. However, surgery was not required in these patients. Conclusion : Therapeutic effects of PMMA percutaneous vertebroplasty on osteoporotic vertebral body compression fractures were confirmed in a relatively large scale of prospective clinical study. It appears that good outcome can be achieved in patients treated within 6 months after fracture, treated each level with 3 to 6cc of PMMA in amount. without serious complications.

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A Comparative Study on the Pain and Treatment Satisfaction between Korean Medical Treatment Combined with Ultrasound Guided Soyeom Pharmacopuncture Therapy in Thoracic Paravertebral Space and Non-Guided Soyeom Pharmacopuncture Therapy on Patients with Ribs Fracture: A Retrospective Study (늑골 골절 환자에서 초음파 유도하 흉추 주위 공간(TPVS) 소염약침 치료를 시행한 한방치료군과 촉지하 소염약침 치료를 시행한 한방치료군의 통증 및 치료만족도 비교 연구: 후향적 연구)

  • Kim, Yeon Hee;Oh, Tae Young;Lee, Eun Jung;Oh, Min Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.103-112
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    • 2019
  • Objectives The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - thoracic paravertebral space (TPVS), and also compare to the patients with non-guided pharmacoacupuncture. Methods We studied medical records of 6 patients hospitalized with rib fractures were analyzed retrospectively at department of Korean Medicine Rehabilitation from March 1, 2019 to May 31, 2019, The 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance with Korean Medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc) and the other 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS through non-guided. We used numeric rating scale to assess improvements in pain and the five-point likert scale was used to assess treatment satisfaction. Statistical analysis was carried out using the IBM SPSS Statistics 24 program. Results The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - TPVS, and also compare to the patients with non-guided pharmacoacupuncture. Conclusions After analyzing 6 studies, we could imply that the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance could be more effective on pain reduction and improvement of treatment satisfaction with rib fracture compared to those who were treated with non-guided pharmacoacupuncture.

Investigation of Tube Voltage Range using Dose Comparison based on Effective Detector Exposure Index in Chest Radiography (흉부 X-ray 검사 시 선량 비교를 활용한 유효 Detector Exposure Index 기반의 적절한 관전압 범위 제안)

  • Shim, Jina;Lee, Youngjin
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.139-145
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    • 2021
  • This study is to confirm the range of tube voltage for Chest X-ray in DR system by comparing with dose area product (DAP) and effective dose in efficient detector exposure index (DEI) range. GE definium 8000 was used to for the phantom study. The range of tube voltage is 60~130 kVp and of mAs is 2.5~40 mAs. The acquired images were classified into efficient DEI groups, then calculated effective dose with DAP by using a PC-Based Monte Carlo Program 2.0. The signal to noise ratio (SNR) was measured at 4 regions, including the thoracic spine, the lung area with the ribs, the lung area without the ribs, and the liver by using Picture Archiving and Communication System. The significance of the group for each tube voltage was verified by performing the kruskal-wallis test and the mann-whitney test as a post-test. When set to 4 groups dependned on the tube voltage, DAP showed significant differences; 60 kVp and 80 kVp, and 60 kVp and 90 kVp (p= 0.034, 0.021). Effective dose exhibited no statistically significant differences from the all of the group (p>0.05). SNR exhibited statistically significant differences from the all of the group in the liver except compared to 80 kVp and 90 kVp (p<0.05). Therefore, high tube voltages of 100 kVp or more need to be reconsidered in terms of patient dose and imaging in order to represent an appropriate chest X-ray image in a digital system.

The Effectiveness of Ultrasound-Guided Thoracic Paravertebral Block for Percutaneous Radiofrequency Ablation of Hepatic Tumors: A Pilot Study (간종양의 경피적 고주파 열치료에서 초음파 유도하 흉부 방척추블록의 효용성: 예비 연구)

  • Kim, Hyungtae;Kim, Youngjun;Kim, Beum Jin;Shin, Sung In;Yim, So Mang;Lee, Ju-Hyung
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.323-331
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.

A Comparative Study of Patient Dose and Image Quality according to the Presence or Absence of Grid During Chest PA Radiography using an Auto Exposure Control System (자동 노출 조절장치를 사용한 흉부 후·전 방향 방사선 검사 시 격자 유·무에 따른 환자 선량과 영상품질 비교 연구)

  • So-min Lee;Han-yong Kim;Dong-hwan Kim;Young-Cheol Joo
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.573-579
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    • 2023
  • This study compares dose difference between the presence or absence of grid in Chest PA radiography using auto exposure control and compares image quality among presence, absence or virtual grid, and proposes a new clinically useful grid combination for chest radiography. The human body phantom was placed Chest PA position and the dosimeter was placed at T6. The same irradiation conditions and field size were applied. 30 images were obtained in the state in which grid was applied and in the state in which grid was not applied, and an additional 30 images in which the virtual grid was applied to the image without the grid were obtained. Radiation dose was presented to entrance surface dose. The image quality was analyzed by comparing the signal-to-noise and contrast-to-noise ratio. ESD decreased by 48% when the grid was not used, compared to when the grid was used. SNR and CNR increased by 32% and 30% compared to grid use when grid was not used, respectively. In the case of using the virtual grid, it increased by 18% and 16% respectively, compared to the case of using the grid. As a result of this study, it is believed that when using a virtual grid instead of a grid, the quality of the image can be maintained while reducing the patient dose.

Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis (소아 척추 결핵: 투약 후의 병의 정지와 치유점, 그리고 후만 변형)

  • Moon, Myung-Sang;Kim, Dong-Hyeon;Kim, Sang-Jae;Moon, Hanlim;Kim, Sung-Soo;Kim, Sung-Sim
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.73-82
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    • 2017
  • Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

Effects of Thoracic Mobility Exercise on the Range of Motion, Pain, Disability Index and Quality of Life in Middle-Aged Women with Chronic Back Pain (흉추 가동성 운동이 만성 요통 중년 여성 환자의 가동 범위, 통증, 장애 지수 및 삶의 질에 미치는 효과)

  • Dong-Ki Hwang;Ho-Young Jang;Suk-Min Lee;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.15-29
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    • 2024
  • Background: This study investigated the effects on the range of motion, pain, disability index, and quality of life when applying thoracic mobility exercise in middle-aged women with chronic back pain. Design: pretest-posttest control group design Methods: The study subjects were 32 patients with chronic back pain of 3 months or more among middle-aged women divided 2 groups. All groups were tested thrice a week for 30 minutes per session for four weeks. Each subject was evaluated using the thoracic rotation Range of Motion, the numerical pain rating scale and pressure pain threshold, Disability Index(Oswestry Disability Index), the Quality of Life(SF-36) before and after treatment. Results: As a result of the study, the range of motion at T1 and T2 of the exercise group to which thoracic mobility exercise was applied was significantly increased in both left and right rotations(p<0.05). In the evaluation of pain, the number pain rating scale(NPRS) score decreased significantly(p<0.05), and the pressure pain threshold was significantly increased (p<0.05), but there was no significant difference from the control group. In the evaluation of the disorder index, the Oswestry disorder index decreased significantly after the experiment (p<0.05), and there was a significant difference in group comparison with the control group (p<0.05). In quality of life, there was a significant increase in PCS of SF-36(p<0.05), but there was no significant difference from the control group. Conclusion: Through this study, thoracic mobility exercise can be used as an effective exercise therapy intervention method to improve and promote physical factors of range of motion, pain and disability index, and physical components of quality of life when treating middle-aged women with chronic back pain in the future.

Teratological Evaluation of Azinphos-Methyl in Rat Fetuses (Azinphos-methyl이 랫트 태아에 미치는 기형학적 연구)

  • Cho, Myung-Haing;Lee, Chang-Eop;Lee, Yong-Soon
    • Toxicological Research
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    • v.4 no.1
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    • pp.55-84
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    • 1988
  • This study was carried out to investigate the teratological potential of azinphos-methyl in the rat fetuses and to establish the nature of the effects on organogenesis and intrauterine development. The Sprague-Dawley female rats (180-210g) without previous litter were used in this study. Azinphos-methyl dosages of 0.094mg/kg, 0.4mg/kg, 1.5mg/kg were selected based on the acute intragastric $LD_{50}$ of 15mg/kg in the rat. Azinphos-methyl in water (Treatment Group), non-treatment control (Negative Control), water control (Sham Control), were administered by oral route and aqueous solution of acetyl salicylic acid (Positive Control) was administered by gavage at rate of 10 ml/kg of body weight from day 6 through 15. The results obtained were summarized as follows. 1. Decreased body weight of dams was observed in animals treated with aspirin and azinphos-methyl 1.5 mg/kg from day 7 through 14. (P<0.01) 2. There was an apparent decrement in the absolute liver weight in the azinphos-methyl 1.5 mg/kg treated group (P<0.05). However, the absolute and relative kidney weight in aspirin group (P<0.05, P<0.01) and the absolute and relative ovary weight in aspirin, azinphos-methyl treatment groups (P<0.01, P<0.05) were increased. 3. Decreased protein contents of dam's liver was observed in the aspirin and high dose azinphos-methyl treated group of animals (P<0.01). 4. The number of male-female ratio per dam increased in azinphos-methyl 1.5 mg/kg group but there was an apparent decrement in the body weight of fetuses in aspirin and high dose azinphos-methyl group (P<0.01, P<0.05). Total immature and resorbed fetuses were increased in aspirin group and the number of dead fetuses were also increased in azinphos-methyl 1.5mg/kg treated group of animals. (P<0.01, P<0.05). 5. In soft tissue defects, diaphragmatic hernia in diaphragm, anophthalmia, enlarged olfactory bulb, hydrocephalus, absence of third and lateral ventricle in skull, hydronephrosis in kidney, atrophy of left ventricle wall, enlarged apex in heart were observed. Especially, defects of diaphragm, heart and eye ball showed peak incidences in the high dose azinphosmethyl and aspirin group. (P<0.01). 6. Variations in the ossification patterns of skull, sternebrae, tail, forelimbs and hindlimbs showed peak incidences in the aspirin and high dose azinphos-methyl group. (P<0.01). 7. In the developmental indices of offspring, the mortality of aspirin and azinphos-methyl 1.5mg/kg treated group was higher than that of negative control. And, there was an apparent decrement in the body weight of fetuses (P<0.01) and considerable differences were obtained in pivoting, development of fur, auditory function, vision, quadrupled muscle development and testes descent in aspirin and azinphos-methyl 1.5mg/kg group. (P<0.01).

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Studies About the Effect of Excitatory Amino Acid Receptor Antagonist on Traumatic Spinal Cord Injury (척수신경손상에 대한 흥분성 아미노산 수용체 길항제의 효과에 대한연구)

  • Kim Jong-Keun
    • The Korean Journal of Pharmacology
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    • v.31 no.1 s.57
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    • pp.1-9
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    • 1995
  • The slow development of histopathological changes and long period required for stabilization of lesions have suggested that secondary injury processes exacerbate the effect of initial mechanical insult after traumatic spinal cord injury (SCI). The importance of glutamate receptors in the normal functions of spinal cord, in concert with the large body of evidence that points to their involvement in neurotoxicity due to both ischemic and traumatic insults to the CNS, suggested a probable role of glutamate receptors in secondary injury process after traumatic SCI. In order to investigate the involvement of excitatory amino acid in the secondary injury process after SCI, this study examined the effect of dextrorphan, a noncompetitive NMDA receptor antagonist, on the recovery of hindlimb function and the residual tissue at injury site following SCI. Locomotor function was assessed using open field test (21 point scale). At 8 weeks spinal cord tissue was examined using quantitative histopathologic technique. Prior to surgery female Long-Evans rats were adapted to the test environment. Rats received laminectomies (T9/T10), and spinal cord contusions (NYU impactor) were produced by a 10 gm weight dropped 25 mm. DXT (15 or 30 mg/kg, i.p.) or saline was injected 15 min before contusion. Behavioral testing resumed 2 days post-injury and continued twice a week for 8 weeks. No differences between DXT and saline groups were found for hindlimb function and sparing tissue at the lesion site. These results suggest that NMDA receptor might not be involved in secondary injury processes after traumatic SCI.

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