• 한국방사선학회논문지
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• 제12권3호
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• pp.397-402
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• 2018

본 연구는 엉치엉덩관절의 골절, 탈구, 엉치엉덩 퇴행성관절염 진단을 위한 가장 좋은 영상을 얻기 위해 골반 팬톰과 엑스선관을 각도 변화를 주어 엉치엉덩관절의 Joint space 가장 잘 나타내는 영상을 얻어 방사선사에게 주관적 평가를 받아 보았다. 평가 결과 결론으로 엉치엉덩관절염과 퇴행성 관절염 발견을 위한 단순촬영에서는 엎드린상태에서 촬영은 검사반대쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어올리고 엑스선관을 앞엉덩뼈가 시에서 2.5 cm 안쪽을 지나는 시상면에 대해 수직촬영 하고 누운자세에서는 검사쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어 올리고 위앞엉덩뼈가시가 중앙에서 위앞엉덩뼈가시가 중앙에 대해 엑스선관 각도를 발쪽으로 $5^{\circ}$ 촬영 하며 반드시 양쪽 엉치엉덩관절후전사방향(RAO,LAO) 및 전후사방향(RPO, LPO) 모두 촬영을 하게 되면 관절염 진단을 내리는데 있어 많은 도움이 되리라 본다.

• Journal of Chest Surgery
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• 제44권6호
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• pp.399-405
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• 2011

Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

• The Korean Journal of Pain
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• 제14권2호
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• pp.214-217
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• 2001

Background: Intra-articular injection is a commonly performed procedure in patients with degenerative osteoarthritis of the knee. Several drugs are used for relief of pain in such cases. Local anesthetics, clonidine and steroids have been confirmed to be effective when used in an intra-articular injection. Ketorolac has recently become one of the most commonly used and potent NSAIDs. There have been many studies about the effect of ketorolac. Methods: Sixty-four patients were divided into 2 groups. In Group I (n = 31), 0.5% bupivacaine 3 ml and sodium hyaluronate 20 mg were used and in Group II (n = 33), 0.5% bupivacaine 3 ml, sodium hyaluronate 20 mg and ketorolac 5 mg were used. We observed the pain relief scale (PRS) at 15 minutes, 1 week and 1-3 months after injection. Results: After 15 minutes, PRS scores were $6.6{\pm}2.7$ (Group I) and $5.1{\pm}3.1$ (Group II), so there was a statistical difference between the two groups. After 1 week, the PRS scores were $5.9{\pm}2.0$ (Group I) and $5.8{\pm}2.4$ (Group II). At 1-3 months later, PRS scores were $5.6{\pm}3.0$ (Group I) and $5.1{\pm}2.7$ (Group II). Thus, there were no significant statistical differences between the two groups at 1 week or 1-3 months later, although some patients were more satisfied with pain relief in Group II at 1-3 months. Conclusions: Ketorolac provides more rapid pain relief of degenerative arthritis when used in intra-articular injection. And there was no statistical difference of effect after 1 week or 1-3 months later. Further studies are required on the effect of the intra-articular use of ketorolac.

• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.599-603
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• 2000

Objectives : In lumbar spine surgery it is observed that the ligamentum flavum(LF) is bilayered, and the inner layers can be left in situ to prevent peridural adhesion in open lumbar disc surgeries. The purposes of this study are to investigate ultrastructural differences between the inner and outer layer of lumbar LF by electron microscopic examination, and to see whether these differences are, if present, more prominent in chronic degenerative lumbar spinal disorders as compared with acute lumbar disc diseases. Methods : Biopsy specimens of LF were obtained from nine patients undergoing lumbar spine surgery, five of them for degenerative spinal stenosis and four for acute disc herniation. During the surgery the outer layers of LF were carefully dissected from the inner layer, and four pieces($1{\times}1{\times}1-mm$) of biopsy samples were made from each layer. These were examined with electron microscope for the morphologies and the contents of the elastic and the collagen fibers. Results : The outer layer of LF showed elastic fiber degeneration as evidenced and decreased fiber content, while the inner layer was relatively preserved in both cases of degenerative spinal stenosis and acute disc herniation. The ultrastructural changes of the layers were more evident in the outer layer. Conclusion : With these observations the authors believe that the LF degeneration may occur mainly in the outer layer, and that this fact may aid in making the rationale for using the inner layer as physiologic barrier to prevent peridural adhesion in open lumbar disc surgeries.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• 대한물리치료과학회지
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• 제9권3호
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• pp.67-75
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• 2002

The purpose of this study was to evaluate the effects of quadriceps femoris flexibility exercise which would improve the degree of knee flexion range of motion, extension torque, and the activities of daily living (ADL) in elderly subjects with degenerative knee arthritis. Fourteen elderly patients (two men and twelve women) with degenerative knee arthritis participated and had a quadriceps femoris flexibility exercise intervention program in this study. The mean age of the patients was 70.00 years for men and 71.16 years for women. This study carried out the experimental study of one group pretest-posttest design, which evaluated the degree of knee flexion range of motion, extension torque, the ADL ability of the patients before and after applying the exercise intervention for five weeks. The results of this study are as follow: 1. The knee flexion ranges of motion of the patients were measured before and after the intervention and the ranges increased significantly both in the left and right knee flexion range of motion (p < 0.05). 2. The peak torque of the knee muscle, the peak torque/body weight, and average power of the patients showed significant increases in both in the left and right knee after applying the intervention (p < 0.05). 3. The intervention produced a significant reduction in pain of the patients (p < 0.05). Their functional activities of ADL improved significantly compared with before the intervention (p < 0.05). It has been shown that the quadriceps femoris flexibility exercise intervention program increased significantly the knee flexion range of motion, and extension torque, as well as an increase in performance of functional activities of ADL of the patients. Thus, the quadriceps femoris flexibility exercise should be considered as one of the therapeutic exercises for the elderly patients with degenerative knee arthritis applied.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.422-426
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• 2005

Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.

• 대한치과교정학회지
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• 제21권1호
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• pp.53-76
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• 1991

The study was designed to analyse the reorganization of the rabbit TMJ meniscus which was anteriorly displaced by surgery. The author compared the anteriorly displaced groups with control group. After surgical opening of the left rabbit TMJ space, cut the posterior attachment of the meniscus, and pushed it under the undercut area of the condyle head. Experimental groups were sacrificed by 1, 2, 4, 8 weeks after surgery. The samples were analysed with light microscope under T-B stain and electron microscope. The results were as follows: 1) The rabbit TMJ meniscus consisted of thick anterior and posterior band running different way, and comparative thin intermediate band runining antero-posteriorly. 2) Round oval shape chondrocyte-like cells were imbeded between the collagen fiber bundles and composed of proteoglycan granules, that showed metachromasia with toluidine blue, around the cell matrix. 3) Type II collagen fiber bundles in experimental group occured degenerative changes in organic patterns at 8 weeks, but those of type I collagen fiber bundles sustained longer, 4) The typical fibrocartilage of the rabbit TMJ meniscus was changed into fibrotic mode in process of time and showed the degenerative changes, which contained hyperplasia, calcification, resorption and hyalinization in the connective tissue. 5) The hyperplastic change of the synovial membrane in 4 week group and transitional change from fibrocyte to chondrocyte in cell type in 8 week group were observed. 6) The diameters of collagen fibers were diminished with the degenerative changes, the shape of the fibers became wavier and more nonorganic in running pattern and fiber bundle spaces widened.

• Journal of Oral Medicine and Pain
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• 제23권2호
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• pp.127-141
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• 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.

• 한국환경보건학회지
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• 제12권2호
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• pp.1-9
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• 1986

The purpose of this study is to determine the antidotal effects of thiamine in phenylmercury poisoning rats. Sixty-six rats were divided into six groups the control group, the $40{\gamma}$ thiamine-only-dosed group, the 6 ppm phenylmercury-only-dosed group, the simultaneously-dosed-group with 6 ppm mercury & $20{\gamma}$ thiamine, and with 6 ppm mercury & $40{\gamma}$ thiamine, and with 6 ppm mercury & $80{\gamma}$ thiamine. The thiamine was put into pellet by various concentrations, and phenylmercury was mixed in drinking water by 6 ppm concentration. The rats were sacrificed for observing the histopathological changes of brain, liver and kidney. The remits summarized are as follows 1. In the group dosed with only $40{\gamma}$ thiamine, the tissues of brain, liver and kidney did not show any abnormal architecture. 2. The phenyhnercury-only-dosed group and the simultaneoulsy-dosed group with mercury and $20{\gamma}$ thiamine showed remarkable degenerative or necrotic hepatic cells. In addition, a remarkable swelling and necrosis on epithelium of proximal tubules in kidney were found. 3. The simultaneously-dosed group with mercury and $40{\gamma}$ thiamine showed moderate degeneration and necrosis of Purkinje cells in cerebellum. A moderate necrosis and swelling on epithelium of proximal tubules and a large amount of tubular casts were found as well. 4. The simultaneously-dosed group with mercury and $80{\gamma}$ thiamine showed a slight degenerative change of Purkinje cells. A slight degenerative change on epithelium of proximal tubules and a small amount of tubular casts were also found.