• Title/Summary/Keyword: Lumbar Region

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Effect of Pelvic Irradiation on the Bone Mineral Content of Lumbar Spine in Cervical Cancer (자궁경부암 환자에서 방사선 치료가 골무기물 함량에 미치는 영향)

  • Youn Seon Min;Choi Tae Jin;Koo Eun Sil;Kim Ok Bae;Lee Seung Moon;Suh Soo Jhi
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.145-151
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    • 1997
  • Purpose : To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. Method and materials : Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using Photon energy of 120 and 80kVp, The numbers of Patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth and 11 in seventh decade, those of patient group were 14 in filth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for Pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer, Results : The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about $13\%\;to\;40\%$ maximally. The BMC of L3 and L4 a region that is out of a radiation field for the Patient group demonstrated $119.5\pm30.6,\;117.0\pm31.7\;for\;fifth,\;83.3\pm37.8,\;88.3\pm46.8\;for\;sixth\;and\;61.5\pm18.3,\;56.2\pm26.6mg/cc$ for seventh, Contrasted by the normal control group has shown $148.0\pm19.9,\;153.2\pm23.2\;for\;fifth,\;96.1\pm30.2,\;105.6\pm26.5\;for\;sixth\;and\;73.9\pm27.9,\;77.2\pm27.2mg/cc$ for seventh decade, respectively The BMG of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In Particular, the BMC of L5 within the radiation field was significantly decresed to $33\%,\;31\%,\;40\%$ compared with the control group of the fifth, sixth and seventh decades, respectively. Conclusion : The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in Patient group with Pelvic irradiation in contrast to that of the normal control groups.

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Vertebroplasty for the Treatment of Compression Fractures in the Upper and Middle Thoracic Spine

  • Kim, Seok Won;Lee, Seung Myung;Shin, Ho;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.142-145
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    • 2005
  • Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level

  • Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.363-366
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    • 2007
  • Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

The clinical study of the 47 traffic accident victims (교통사고 환자 47례에 대한 임상적 고찰)

  • Kim, Min-jeong;Lee, Su-hong;Kim, Kyung-ho
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.250-264
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    • 2000
  • A retrospective study has been carried out for 47 cases of traffic accident victims which was entered to the Dongguk Bundang O. M. Hosp. from Jan 1, 1999 to May 4, 2000. This study was focused on finding out the distribution, pattern of the traffic accidents, clinical characteristics of the patients, motives of their choosing oriental medical treatments, the kinds of oriental medical treatment. This results were as follows : 1. The highest incidence was shown in the age of twenties to thirties as much as 59.6% and the ratio of male to female was 17:30. 2. 80.9% of all patients was injured by car accidents. 68.2% of all patients was injured as drivers and passengers and 19.2% was injured as pedestrians. The highest type in the collision between cars, was rear impact. 3. The number of patient(61.7%) via other hosp. was more than that of the first visitor(38.3%) to our hosp. 4. In admission motives, The patients who had been treated by western medical treatment, expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. Also The others wanted to be treated by oriental medical methods in the reason of no deep surgical, orthopaedical lesions 5. C-spine sprain(80.9%) was the most frequent out of all patients's diagnosis and then L-spine sprain(51.1%), contusion(46.8%), etc. 6. Head Cervix(80.9%) was the commonest pain region of all patients. and then shoulder back(70.2%), lumbar region(61.7%), etc. 7. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 8. After discharge, Duration of OPD treatment was long as much as that of admission treatment. 9. At first stage of admission period, Herb medication was frequently prescribed for hwalhyultonglakgige(活血通絡之劑). but As going to end stage, was frequently used for bogi(補氣) bohyul(補血), gudam(祛痰), ansin(安神).

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Effects of Caloric Restriction on Endocrine Functions and Body Fat Distribution in Overweight Premenopausal Women, Related to their UCP3 (Uncoupling Protein 3) Genotypes

  • Lee, Jong-Ho;Kim, Oh-Yoen;Kim, Ji-Young;Park, Kyoung;Yangsoo Jang
    • Nutritional Sciences
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    • v.5 no.1
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    • pp.13-19
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    • 2002
  • A mutation in the promoter region of uncoupling protein 3 (UCF3), specifically the -55C longrightarrow T transition, may influence an individual's energy metabolism and body weight. The objective of this study was to investigate the effect of a weight reduction program on endocrine functions and body fat distribution, related to UCP3 promoter genotype. Ninety overweight pre-menopausal female subjects participated in the weight reduction program at Yonsei University Hospital, and were placed on a calorie-restricted diet (300 kcal less than their daily requirements) for 12 weeks. After 12 weeks, all subjects on the program lost approximately 5% of their initial body weights and had lower Body Mass Index (BMI) values. Among the 90 women, 56 had a normal (without mutation) UCP3 genotype, while 34 women had mutations in the promoter region of UCP3. Despite similar weight reductions in both groups, a significantly higher decrease in abdominal adipose tissue was observed in the normal UCP3 genotype group, compared to the group with mutations. In particular, there was a significant reduction of fat at the lumbar 1 (Ll) level in the without-mutation group. Serum levels of total cholesterol, apolipoprotein Al were significantly decreased in the without-mutation group, by 4.4% and 5.7% respectively. Serum levels of hormones were not significantly changed in both groups artier the intervention. However, in the group without the mutations, the leptin level significantly reduced by 23.4% (p<0.001). Serum free fatty acid (FFA) concentration was significantly increased in the group with mutation following the weight reduction program. On the other hand, FFA responses were shown similar increases in both groups. In conclusion, although no difference was found in the magnitude of weight reduction in both groups, there were significant differences in body fat distribution and in endocrine function between the groups.

Associated Injuries in Spine Trauma Patients: A Single-Center Experience

  • Yu, Seunghan;Choi, Hyuk Jin;Lee, Jung Hwan;Kim, Byung Chul;Ha, Mahnjeong;Han, In Ho
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.242-247
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    • 2020
  • Purpose: The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma. Methods: Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively. Results: Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common. Conclusions: Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.

Computed Tomographic Findings in a Foal with Acute Hindlimb Lameness

  • Seyoung Lee;Eun-bee Lee;Kyung-won Park;Taeyoung Kang;Hyohoon Jeong;Jong-pil Seo
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.135-138
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    • 2023
  • A one-month-old Thoroughbred colt presented with left hindlimb lameness grade 5/5, according to the American Association of Equine Practitioners' lameness scale. The colt started showing signs of lameness two weeks earlier without being involved in an accident. A local veterinarian examined the foal; radiography revealed no significant findings under the hip joint. No improvement was noted after 15 days of non-steroidal anti-inflammatory drugs (NSAIDs) medication. On presentation at our hospital, ultrasonography was performed, which revealed no significant findings in the iliac wings. The foal underwent a computed tomography (CT) scan under general anesthesia. CT revealed bone cysts in the following that could have caused the lameness: the left transverse process of the 5th, 6th lumbar, and the 1st sacrum vertebrae; osteophytes in the auricular surface of the ilium, suggestive of sacroiliac arthritis. The foal recovered smoothly from anesthesia with assistance. The foal was treated with NSAIDs and rested for more than six months. The owner reported that the foal showed no lameness one year later. CT revealed bony changes in the lumbosacral region that were not detected by radiography and ultrasonography, suggesting that CT could be useful for detecting abnormalities in the pelvic region of horses.

The Involvement of Protein kinase C in Glutamate-Mediated Nociceptive Response at the Spinal Cord of Rats (흰쥐의 척수에서 Glutamate가 매개하는 Nociceptive Response에 있어서 Protein kinase C의 관련성)

  • 김성정;박전희;이영욱;양성준;이종은;이병천;손의동;허인회
    • YAKHAK HOEJI
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    • v.43 no.2
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    • pp.263-273
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    • 1999
  • When glutamate was infected intrathecally, the result is similar to those produced by TPA injected. The involvement of protein kinase C (PKC) in the nociceptive responses in rat dorsal horn neurons of lumbar spinal cord was studied. In test with formalin, a PKC inhibitor (chelerythrine) inhibited dose-dependently the formalin-induced behavior response. Neomycin also inhibited it significantly. But, a PKC activator (12-O-tetradecanoylphorbol-13-ester, TPA) showed reverse effect. When gluatamate was injected intrathecally, we observed the result is smilar to those produced by TPA injection. On the other hand, intrathecal injection of glutamate induced thermal and mechanical hyperalgesia. In Tail-flick test, we examined the involvement of PKC on the glutamate-indeced thermal hyperalgesia. Chelerythrine showed an inhibitory effect and TPA enhanced thermal response. Glutamate decreased the mechanical threshold significantly. A pretreatment of chelerythrine and neomycin inhibited glutamate-induced mechanical hyperalgesia, but the effect of neomycin was not significant. TPA had little effect on the mechanical nociceptive response. These results suggest that the PKC activation through metabotropic receptor at postsynaptic region of spinal cord dorsal horn neurons may influence on the persistent nociception produced by chemical stimulation with formalin, thermal and mechanical hyperalgesia induced by glutamate.

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Effects of Interferential Current Treatment on Pain, Functional Ability, and Health-Related Quality of Life in Chronic Stroke Patients with Lumbago; A Randomized Controlled Study

  • Jung, Kyoung-Sim;In, Tae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.25-32
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    • 2020
  • PURPOSE: This study examined the efficacy of an interferential current (IFC) treatment on the improvement of pain, disability, and quality of life in stroke patients with lumbago. METHODS: A double-blind, randomized clinical trial was conducted on 40 stroke patients with lumbago. The patients were allocated randomly into two groups: the IFC treatment group (n= 20) and the placebo treatment group (n= 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment but without real electrical stimulation. The intervention was administered five days a week for four weeks. The primary outcomes of pain intensity were measured using a visual analogue scale. The secondary measurements included the Barthel Index, Oswestry Disability Index (ODI), and health-related quality of life (HRQoL). RESULTS: The measurements were conducted before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in the pain intensity (p<.05), ODI (p<.05), and SF-36 (p<.05) at the end of the intervention. No significant differences in the Barthel Index were found between the two groups. CONCLUSION: These findings show that an IFC treatment can improve pain, functional ability, and quality of life, highlighting the benefits of somatosensory stimulation from IFC in stroke patients with lumbago.

Aneurysmal Bone Cyst of the Thoracic Spine with Scoliosis - Case Report - (척추 측만증을 동반한 흉추에 발생한 동맥류성 골낭종 - 증례 보고 -)

  • Han, Chung-Soo;Kim, Ki-Tack;Cho, Chang-Hyun;Yang, Hyoung-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.76-81
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    • 1999
  • Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

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