• Proceedings of the Korea Information Processing Society Conference
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• 2022.05a
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• pp.705-707
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• 2022

인체의 흉부 X-ray 영상으로부터 척추질환과 관련된 의료 진단지표를 자동으로 추출하는 과정을 위하여 흉추조직의 정확한 분할이 필요하다. 본 연구에서는 HRNet 기반의 학습을 통하여 흉추조직을 분할하는 방법을 고찰한다. 분할 과정에서 영상 내의 상대적인 위치 정보가 효과적으로 반영될 수 있도록, 계층별로 영상의 고해상도의 표현이 그대로 유지되는 구조와 저해상도의 특징 지도로 변환되는 구조가 병렬적으로 연결되는 형태의 심층 신경망 모델을 채택하였다. 흉부 X-ray 영상에서 콥각도(Cobb's angle)를 산출하는 문제를 대상으로 흉추 분할을 위한 학습 방법, 진단지표 추출 방법 등을 소개하며, 부수적으로 피사체의 위치 변화 및 크기 변화 등에 강인한 성능을 제공하기 위하여 학습 데이터를 증강하는 방법론을 제시하였다. 총 145개의 영상을 사용한 실험을 통하여 제안된 이론의 타당성을 평가하였다.

• Journal of Convergence Korean Medicine
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• v.2 no.1
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• pp.23-34
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• 2021

Objectives: This study aimed to review the effects of Daoyin exercise on scoliosis in clinical studies. Methods: In this study, we reviewed 9 electronic databases (Pubmed, CAJ, EMBASE, Cochrane Library, CiNii, KISS, KMBASE, OASIS, ScienceON) on May 22, 2021. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on scolisos. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results: After screening, eight RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value of Cobb's angle, SRS-22, pulmoary function, physiological curvature, muscle strength, effective rate in scoliosis patients. Conclusion: We concluded that Daoyin exercise has therapeutic effects in relief of imbalance, improvement of symptoms, improvement of function, muscle strength for scoliosis. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.224-232
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• 2018

Objective : Cervical ossification of the posterior longitudinal ligament (OPLL) can be treated via anterior or posterior approach, or both. The optimal approach depends on the characteristics of OPLL and cervical curvature. Although most patients can be successfully treated by a single surgery with the proper approach, renewed or newly developed neurological deterioration often requires repeat surgery. Methods : Twenty-seven patients with renewed or newly developed neurological deterioration requiring salvage surgery for multi-segment cervical OPLL were enrolled. Ten patients (group AP) underwent anterior approach, and 17 patients (group PA) underwent posterior approach at the initial surgery. Clinical and radiological data from initial and repeat surgeries were obtained and analyzed retrospectively. Results : The intervals between the initial and repeat surgeries were $102.80{\pm}60.08months$ (group AP) and $61.00{\pm}8.16months$ (group PA) (p<0.05). In group AP, the main OPLL lesions were removed during the initial surgery. There was a tendency that the site of main OPLL lesions causing renewed or newly developed neurological deterioration were different from that of the initial surgery (8/10, p<0.05). Repeat surgery was performed for progressed OPLL lesions at another segment as the main pathology. In group PA, the main OPLL lesions at the initial surgery continued as the main pathology for repeat surgery. Progression of kyphosis in the cervical curvature (Cobb's angle on C2-7 and segmental angle on the main OPLL lesion) was noted between the initial and repeat surgeries. Group PA showed more kyphotic cervical curvature compared to group AP at the time of repeat surgery (p<0.05). Conclusion : The reasons for repeat surgery depend on the type of initial surgery. The main factors leading to repeat surgery are progression of remnant OPLL at a different segment in group AP and kyphotic change of the cervical curvature in group PA.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.574-581
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• 2018

Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.20-23
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• 2012

Objective : To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor. Methods : Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position. Results : WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels. Conclusion : When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.83-88
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• 2013

Objective : The authors reviewed their experiences of combined surgery (open door laminoplasty with unilateral screw fixation) for unstable multi-level cervical stenosis, to clarify the situation regarding the surgical approach most appropriate for the treatment of diffuse unstable multi-level cervical stenosis. Methods : From January 2011 to January 2012, combined surgery was performed for unstable multi-level cervical stenosis by one surgeon at our institution. The subjects of this study were 6 men of mean age 53.7 years (range, 48-71) with a mean follow-up of 9.3 (range, 3-14) months. All imaging studies showed severe multi-level cervical stenosis with spinal cord signal change, and instability or kyphotic deformity. A retrospective review of clinical, radiological, and surgical data was conducted. Results : Average laminoplasty level was 4.8 and the average screw fixation level was 5.0. Japanese Orthopedic Association score improved from an average of 5.2 to 11.2 points. According to Nurick's grades and Odom's criteria, symptom improvement was statistically significant. On the other hand, Cobb's angle changes were not significant. Average operation time was 5.86 hours with an average blood loss of 460 mL. No significant surgical complication was encountered. Conclusion : Despite the small cohort and the short follow-up duration, the present study demonstrates that laminoplasty with unilateral screw fixation is a safe and effective treatment for unstable multi-level cervical stenosis.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.3
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• pp.37-60
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• 2010

Objectives : The purpose of this study was to investigate the relationship between masseter and cervical muscle activity and temporomandibular disorder in female office workers. Methods : Experimental group of 24 healthy subjects complained of temporomandibular joint related to computer use which lasted more than 3 months in the past year and was present in the past 7 days as well as on the day of test. Control group of 20 healthy subjects had no complaints of minimal discomfort on the day of test, and had no discomfort in the past 7 days. If they had reported discomfort in the past 12 months, it was of a short duration(<3 months) and resolved at least 3 months prior to participation. Outcomes were assessed by meridian-electromyography(MEMG), whole spin x-ray, mandibular function impairment questionnaire(MFIQ), neck disability index(NDI), visual analog scale(VAS), Beck depression inventory(BDI), stress reaction inventory(SRI) and Holmes & Rahe social readjustment rating scale(SRRS). Results : The contraction power of masseter muscle, upper trapezius, sternocleido-mastoid muscle and erector spinae by MEMG was significantly higher in the experimental group. The muscle fatigue of masseter muscle and sternodeido-mastoid muscle by MEMG was significantly higher in the experimental group. SRI was significantly higher in experimental group. There was no significant difference between two groups in the Jackson's angle, Cobb's method and cranio-cervical posture. Conclusions : The results suggest that temporomandibular disorder related mental stress but physical stress does not change cervical structure significantly.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.89-97
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• 2021

PURPOSE: This study examined the effects of coordinative locomotor training on the spine appearance and quality of life of patients with idiopathic scoliosis. METHODS: This study included two patients with idiopathic scoliosis: one with a thoracic and lumbar type scoliosis and the other with thoracic type scoliosis. The study design was a single case study (A-B-A'), with a baseline-intervention/phase-post-intervention. The baseline (A) was designed and measured five times, intervention phase (B) ten times, and post-intervention (A') five times. The coordinative locomotor training program was divided into 10 minutes of warm-up exercise, 30 minutes of the main exercise, and 10 minutes of the finishing exercise, for 50 minutes each time. The primary outcome measurements were measured using the Cobb's angle, Adam's test, and Gait view pro 2.0 to determine the changes in the spine appearance. The secondary outcome measurements were compared before and after using the SRS-22 questionnaire to determine the quality of life of the scoliosis patients. A statistical test analyzed the mean and standard deviation, and the rate of change was presented by a visual analysis method using descriptive statistics and graphs. RESULTS: The findings showed that the spine appearance and quality of life of the two subjects were improved compared to the baseline measurements during the intervention phase, and the improved state was maintained during the post-intervention period. CONCLUSION: These findings indicate that coordinative locomotor training may help improve the spine appearance and quality of life of patients with idiopathic scoliosis.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.1
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• pp.37-51
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• 2017

Objectives This study was designed to identify the effect of acupuncture combined with wooden neck pillow self-exercise program (WSP). Methods 25 eligible subjects with chronic neck pain were recruited from September 2015 to August 2016. Subjects were treated by acupuncture twice a week for 4 weeks, also were educated WSP and exercised every day for 4 weeks. They were assessed using PI-NRS, NDI and the maximum muscle strength of deep cervical flexor muscles (DCF) before and after treatment. Also the Cobb's angle (C1-C7), Ishihara index, Park method were assessed for evaluating the radiographical changes. Variables were compared using paired t-test. And correlates analysis was used for analyzing relationship between differentials in the maximum muscle strength of DCF and differentials in cervical spine curvature measurement methods. Results Among the 25 subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on NRS, NDI and the maximum muscle strength of DCF were seen after treatment (p<0.001). In radiological finding, cervical spine curvature measurement methods were significantly increased (p<0.001, p<0.05, p<0.05). Differentials in the maximum muscle strength of DCF significantly correlates to differentials in Ishihara index (R=0.479, p<0.05). Conclusions Acupuncture combined with WSP may decrease neck pain intensity and associated disability, and also increase the muscle strength of DCF and cervical lordosis, in patients with chronic neck pain. Especially, Improving the muscle strength of DCF has a relationship with improving Ishihara index. However, due to the design of this study, this treatment can not be compared with other treatments. Future randomized project should be needed.