• Tuberculosis and Respiratory Diseases
• /
• v.63 no.4
• /
• pp.372-377
• /
• 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 Journal of Korea CHUNA Manual Medicine
• /
• v.3 no.1
• /
• pp.153-166
• /
• 2002

Objective : There is no case report on the ossification of the posterior longitudinal ligament(OPLL) treated by CHUNA manual therapy in oriental medicine. We experienced a patient(32-year-old female) with OPLL improved by CHUNA manual therapy in X-ray image and visual analogue scale(VAS), and we report it clinically. Methods : During the patient with OPLL was treated CHUNA manual therapy, acupuncture, and physical therapy, we examined cervical X-ray, CT and Moire topography and evaluated the patient's symptoms by VAS. And we observed whether the changes exist or not in X-ray and VAS. Results : VAS in symptoms was improved significantly(p<0.05), and the radiologic X-ray image in OPLL patient was improved. Conclusion : OPLL was generally treated conservative treatment and operation in severe case. But CHUNA manual therapy may be more effective in conservative treatment of OPLL, if more clinical studies and reaches are accomplished.

• Transactions of the Korean Society of Mechanical Engineers B
• /
• v.39 no.3
• /
• pp.215-221
• /
• 2015

The elbow reflex, a principal reflex in the upper extremity, plays an important role in the diagnosis of cervical spine syndromes. In this study, the muscle activations of brachial biceps and triceps, and the kinematics of upper extremities were predicted using an activation model for the stretch reflex. The muscle activations that equated the simulation results estimated by the analysis model with the experimental results were obtained first, and the activations obtained from the simulations were compared with the electromyography signals obtained from the experiments, for model validation. The root mean squares error of the joint angles (obtained from experiments and simulation using the suggested model) was 0.056, a value that is half of that obtained using the previous model. This demonstrates that the suggested model corresponded well with the actual reflex.

• The Journal of the Korean bone and joint tumor society
• /
• v.19 no.2
• /
• pp.78-82
• /
• 2013

Langerhans cell histiocytosis is known as one of the diseases related to excessive proliferation of normal monocytes and has the variety of clinical courses and treatment. Especially, in cases with the spine, it shows a feature of single or multiple osteolysis. According to the location, disease progression and concomitant symptom, variety of treatments (observation, radiotherapy, chemotherapy, surgery, etc.) have been attempted, however, appropriate treatment has not been established yet. The authors introduce the case of single system Langerhans cell histiocytosis which involves cervical and lumbar vertebrae simultaneously with bone marrow destruction and pathologic fracture.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1484-1490
• /
• 2000

Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.3
• /
• pp.228-233
• /
• 2012

Objective : Chronic neck or back pain can be managed with various procedures. Although these procedures are usually well-tolerated, a variety of side effects have been reported. In this study we reviewed cases of unexpected temporary adverse events after blocks and suggest possible causes. Methods : We reviewed the records of patients treated with spinal pain blocks between December 2009 and January 2011. The types of blocks performed were medial branch blocks, interlaminar epidural blocks and transforaminal epidural blocks. During the first eight months of the study period (Group A), 2% mepivacaine HCL and triamcinolone was used, and during the last six months of the study period (Group B), mepivacaine was diluted to 1% with normal saline. Results : There were 704 procedures in 613 patients. Ten patients had 12 transient neurologic events. Nine patients were in Group A and one was in Group B. Transient complications occurred in four patients after cervical block and in eight patients after lumbar block. Side effects of lumbar spine blocks were associated with the concentration of mepivacaine (p<0.05). The likely causes were a high concentration of mepivacaine in five patients, inadvertent vascular injection in three patients, intrathecal leak of local anesthetics in one, and underlying conversion disorder in one. Conclusion : Spinal pain blocks are a good option for relieving pain, but clinicians should always keep in mind the potential for development of inevitable complications. Careful history-taking, appropriate selection of the anesthetics, and using real-time fluoroscopy could help reduce the occurrence of adverse events.

• Journal of Korean Neurosurgical Society
• /
• v.51 no.3
• /
• pp.127-134
• /
• 2012

Objective: To analyze the prognostic factors thought to be related with survival time after a spinal metastasis operation. Methods: We retrospectively analyzed 217 patients who underwent spinal metastasis operations in our hospital from 2001 to 2009. Hematological malignancies, such as multiple myeloma and lymphoma, were excluded. The factors thought to be related with postoperative survival time were gender, age (below 55, above 56), primary tumor growth rate (slow, moderate, rapid group), spinal location (cervical, thoracic, and lumbo-sacral spine), the timing of radiation therapy (preoperative, postoperative, no radiation), operation type (decompressive laminectomy with or without posterior fixation, corpectomy with anterior fusion, corpectomy with posterior fixation), preoperative systemic condition (below 5 points, above 6 points classified by Tomita scoring), pre- and postoperative ambulatory function (ambulatory, non-ambulatory), number of spinal metastases (single, multiple), time to spinal metastasis from the primary cancer diagnosis (below 21 months, above 22 months), and postoperative complication. Results: The study cohort mean age at the time of surgery was 55.5 years. The median survival time after spinal operation and spinal metastasis diagnosis were 6.0 and 9.0 months. In univariate analysis, factors such as gender, primary tumor growth rate, preoperative systemic condition, and preoperative and postoperative ambulatory status were shown to be related to postoperative survival. In multivariate analysis, statistically significant factors were preoperative systemic condition (p=0.048) and postoperative ambulatory status (p<0.001). The other factors had no statistical significance. Conclusion: The factors predictive for postoperative survival time should be considered in the surgery of spinal metastasis patients.

• Journal of Oral Medicine and Pain
• /
• v.23 no.2
• /
• pp.127-141
• /
• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

• Journal of Korean Medicine Rehabilitation
• /
• v.24 no.2
• /
• pp.115-130
• /
• 2014

Objectives The objective of this study is to interpretate Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" in a modern kineologic approach Methods Based on the interpretation of "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" and implementation of its kinesiology, this study presents similar kineologies and their purposes, with the reference to various documents on modern kinesiology. Results 1) Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" is similar to stretching, active exercise and resistance exercise. 2) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to resistance exercise, can be used for isometic exercise of cervical extensor. 3) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to Stretching exercise, has its purpose to stretch quadratus Lumborum, lateral side of body, gluteus Maximus, quadriceps femoris, shoulder extensor, hamstrings, hip joint, ankle dorsi flexor, thoracic rotator,inferior shoulder joint. 4) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to active exercise, can be used for strengthen exteral oblique. 5) Doctors can make various applications of Yansaeng-Doinbub. For example, it can be used to correct improper low back and neck exercise patterns. 6) Yangsaeng-Doinbub also describes breathing methods, which help normalization of breathing exercises and increase the efficiency of spine exercises. Conclusions The modern interpretation on kinesiology of Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" leads to a conclusion that Yangsaeng-Doinbub consists of numourous exercises for various body parts. In particular, breathing methods increase efficiency of such exercises. Plus, the exercises in Yangsaeng-Doinbub can be applied to various uses by doctors.

• Tuberculosis and Respiratory Diseases
• /
• v.69 no.1
• /
• pp.52-55
• /
• 2010

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.