• Journal of Trauma and Injury
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• 제34권2호
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• pp.130-135
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• 2021

Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.

• The Korean Journal of Pain
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• 제34권3호
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• pp.339-345
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• 2021

Background: Ultrasound-guided caudal epidural injection (CEI) is limited in that it cannot confirm drug distribution at the target site without fluoroscopy. We hypothesized that visualization of solution flow through the inter-laminar space of the lumbosacral spine using color Doppler ultrasound alone would allow for confirmation of drug distribution. Therefore, we aimed to prospectively evaluate the usefulness of this method by comparing the color Doppler image in the paramedian sagittal oblique view of the lumbosacral spine (LS-PSOV) with the distribution of the contrast medium observed during fluoroscopy. Methods: Sixty-five patients received a 10-mL CEI of solution containing contrast medium under ultrasound guidance. During injection, flow was observed in the LSPSOV using color Doppler ultrasonography, following which it was confirmed using fluoroscopy. The presence of contrast image at L5-S1 on fluoroscopy was defined as "successful CEI." We then calculated prediction accuracy for successful CEI using color Doppler ultrasonography in the LS-PSOV. We also investigated the correlation between the distribution levels measured via color Doppler and fluoroscopy. Results: Prediction accuracy with color Doppler ultrasonography was 96.9%. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.7%, 100%, 100%, and 60.0%, respectively. In 52 of 65 patients (80%), the highest level at which contrast image was observed was the same for both color Doppler ultrasonography and fluoroscopy. Conclusions: Our findings demonstrate that color Doppler ultrasonography in the LS-PSOV is a new method for determining whether a drug solution reaches the lumbosacral region (i.e., the main target level) without the need for fluoroscopy.

• 대한물리치료과학회지
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• 제29권2호
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• pp.38-47
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• 2022

Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.

• 대한정형외과학회지
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• 제55권4호
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• pp.348-353
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• 2020

68세 남자 환자가 허리의 피부에서 고름을 동반한 욕창으로 내원하였다. 초진시 일반 방사선상 제4요추체의 광범위한 파괴 소견과 자기공명영상 촬영에서 제4요추 척추체의 결손 부위에 고인 조영 증강된 많은 양의 액체가 양측 요근 및 후관절까지 확장된 소견을 보였다. 신경병성 척추병증으로 일차 진단하였으나 농양을 동반한 감염성 척추염을 배제할 수 없어 정맥 항생제를 2주 투여하였다. 자기공명영상을 재촬영한 결과 농양의 크기는 줄어 들지 않아 수술적 치료로 진행하였다. 샤르코 척추 관절병증은 광범위한 척추체 파괴를 일으켜 감염성 척추염과 유사한 소견을 보일 수 있으며 특히 척추체 불안정으로 인한 경막 파열로 뇌척수액이 축적되면 감별이 어려울 수 있어 이 증례를 보고하는 바이다.

• 한방재활의학과학회지
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• 제32권1호
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• pp.125-131
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• 2022

This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

• 한국임상수의학회지
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• 제40권2호
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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.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1671-1679
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• 2021

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1-S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion: Spinal FF may help assess both AS disease activity and chronicity.

• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.86-94
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• 2024

Objective: To evaluate the changes in bladder capacity and storage through non-invasive neuromodulation by application of repetitive Trans magnetic stimulation (rTMS) and genital nerve stimulation (GNS) in traumatic spinal cord survivors. Design: A Single Case Study. Method: The Patient was registered in trail with the clinical trial registry of India (CTRI/2022/05/042431). The Patient was interposed with rTMS on lumbar area, from T11-L4 vertebrae with 1 Hz and the intensity was 20% below that elicited local paraspinal muscular contraction for 13 minutes. GNS was placed over dorsum of the penis with the cathode at the base and anode 2 cm distally at 20 Hz, 200 microseconds, Continuous and biphasic current was delivered and amplitude of stimulation necessary to elicit the genito-anal reflex. For assessment, Neurological examination was done for peri-anal sensation (PAS), voluntary anal contraction (VAC) and bulbocavernous reflex (BCR), deep anal pressure (DAP), and American Spinal Injury Association Impairment Scale (ASIA scale). Outcome assessment was done using Urodynamics, Spinal Cord Independence Measure Scale Version-III (SCIM-III), American Spinal Injury Association Impairment Score (ASIA Score), Beck's Depression Inventory Scale (BDI). The baseline evaluation was taken on Day 0 and on Day 30. Results: The pre-and post-data were collected through ASIA score, SCIM-III, BDI and Urodynamics test which showed significant improvement in bladder capacity and storage outcomes in the urodynamics study across the span of 4 weeks. Conclusion: rTMS along with GNS showed improvement in bladder capacity & storage, on sensory-motor score, in functional independence of individual after SCI.

• Journal of Microbiology and Biotechnology
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• 제34권2호
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• pp.415-424
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• 2024

This study reveals that low-molecular-weight collagen peptide (LMWCP) can stimulate the differentiation and the mineralization of MC3T3-E1 cells in vitro and attenuate the bone remodeling process in ovariectomized (OVX) Sprague-Dawley rats in vivo. Moreover, the assessed LMWCP increased the activity of alkaline phosphatase (ALP), synthesis of collagen, and mineralization in MC3T3-E1 cells. Additionally, mRNA levels of bone metabolism-related factors such as the collagen type I alpha 1 chain, osteocalcin (OCN), osterix, bone sialoprotein, and the Runt family-associated transcription factor 2 were increased in cells treated with 1,000 ㎍/ml of LMWCP. Furthermore, we demonstrated that critical bone morphometric parameters exhibited significant differences between the LMWCP (400 mg/kg)-receiving and vehicle-treated rat groups. Moreover, the expression of type I collagen and the activity of ALP were found to be higher in both the femur and lumbar vertebrae of OVX rats treated with LMWCP. Finally, the administration of LMWCP managed to alleviate osteogenic parameters such as the ALP activity and the levels of the bone alkaline phosphatase, the OCN, and the procollagen type 1 N-terminal propeptide in OVX rats. Thus, our findings suggest that LMWCP is a promising candidate for the development of food-based prevention strategies against osteoporosis.

• 대한영상의학회지
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• 제83권1호
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• pp.102-111
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• 2022

목적 요추 중심부 협착증(central lumbar spinal stenosis; 이하 CLSS)에 대하여 Lee grading system과 외과적 수술과의 상관관계를 평가하고 이것이 CLSS에 대하여 치료 방법을 정하기 위한 의사 결정 도구로 사용될 수 있는지 평가하고자 하였다. 대상과 방법 이 후향적 연구에는 290명의 환자가 포함되었다(남:여 = 156:134; 평균 연령, 46 ± 16세). 영상의학과 전문의들은 CLSS를 4등급으로 분류하는 Lee grading system에 따라 협착 지점에서 CLSS의 유무와 등급을 평가했다. Spearman 순위 상관관계를 사용하여 Lee의 등급과 수술 시행 여부 간의 상관 계수를 계산했다. 결과 수술을 시행한 환자에서 2등급이 가장 흔했고(50%-58%), 3등급이 다음으로 흔했으며(35%), 0등급이 가장 흔하지 않았다(2%-3%). 수술을 받지 않은 환자의 경우 1등급이 가장 흔했고(63%-65%), 0등급이 그 다음(15%-16%), 3등급이 가장 흔하지 않았다(8%). 등급 분포는 수술 치료군과 비수술 치료군 사이에서 유의하게 차이가 있었다(p < 0.001). 수술을 받은 환자의 25% 미만에서 0과 1등급이 있었던 반면 2등급과 3등급이 88% 이상이었다. 등급과 수술 사이에 중간 정도(moderate)의 상관관계가 있었다(r_s = 0.632 and r_s = 0.583). 결론 Lee grading system은 수술적 치료 시행과 중간 정도의 상관관계가 있었다. Lee grading system은 CLSS의 치료 방법 결정에서 유용하게 사용할 수 있다.