• Archives of Plastic Surgery
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• v.37 no.6
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• pp.827-830
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• 2010

Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.51-58
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• 2024

Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

• Korean Journal of Acupuncture
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• v.18 no.1
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• pp.105-116
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• 2001

We examined and referred to some literatures on the meaning, Dai meridian and Meridian points of joining with circulation of Dai meridian through literatures of every generation. And then we came to get a few conclusions as follows. 1. Dai meridian starts below the hypochondriac region. Running obliquely downward, it runs transversely around the waist like a belt. Its function is to bind up all the meridians to circulate in a proper way. 2. The coalescent points of dai meridian are $D\grave{a}im\grave{a}i$(帶脈), $W\check{u}sh\bar{u}$(五樞) and $W\acute{e}id\grave{a}o$(維道). 3. Location of $D\grave{a}im\grave{a}i$(帶脈) is on the lateral side of the abdomen, 1.8 cun below $Zh\bar{a}ngm\grave{e}n$(章門), at the crossing point of vertical line through the free end of the 11th rib and a horizontal line through the umbilicus. Location of $W\check{u}sh\bar{u}$(五樞) is on the lateral side of the abdomen, anterior to the anterosuperior iliac spine, 3 cun below the level of the umbilicus. Location of $W\acute{e}id\grave{a}o$(維道) is on the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine, 0.5 cun anterior and inferior to $W\check{u}sh\bar{u}$(五樞). 4. Indication of $D\grave{a}im\grave{a}i$(帶脈) is irregular menstruation, leukorrhea with reddish discharge, hernia, pain in the lumbar and hypochondriac region. Indication of $W\check{u}sh\bar{u}$(五樞) is prolapse of the uterus, leukorrhea with reddish discharge, irregular menstruation, hernia, pain in the lower abdomen, constipation and lumbosacral pain. Indication of $W\acute{e}id\grave{a}o$(維道) is edema, pain in the side of the lower abdomen, prolapse of the uterus, hernia and morbid leukorrhea. 5. The Dai meridian binds all meridians, produces pregnancy, grasps lumbar and abdomen region and controls leukorrhea. 6. Diseases of the Dai meridian manifested as distention and fullness in the lumbar region and abdomen, leukorrhea with reddish discharge, pain the navel, lumbar and spinal regions, flaccidity and hypoactivity of the lower limbs, etc.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.414-421
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• 2019

Objective : To evaluate 3-dimensional magnetic resonance imaging (MRI) of Kambin's safe zone to calculate maximum cannula diameter permissible for safe percutaneous endoscopic lumbar discectomy. Methods : Fifty 3D MRIs of 19 males and 31 females (mean, 47 years) were analysed. Oblique, axial and sagittal views were used for image analysis. Three authors calculated the inscribed circle (cannula diameter) individually, within the neural (original) and bony Kambin's triangle in oblique views, disc heights on sagittal views and root to facet distances at upper and lower end plate levels on axial views and their averages were taken. Results : The mean root to facet distances at upper end plate level measured on axial sections increased from $3.42{\pm}3.01mm$ at L12 level to $4.57{\pm}2.49mm$ at L5S1 level. The mean root to facet distances at lower end plate level measured on axial sections also increased from $6.07{\pm}1.13mm$ at L12 level to $12.9{\pm}2.83mm$ at L5S1 level. Mean maximum cannula diameter permissible through the neural Kambin's triangle increased from $5.67{\pm}1.38mm$ at L12 level to $9.7{\pm}3.82mm$ at L5S1 level. The mean maximum cannula diameter permissible through the bony Kambin's triangle also increased from $4.03{\pm}1.08mm$ at L12 level to $6.11{\pm}1mm$ at L5S1 level. Only 2% of the 427 bony Kambin's triangles could accommodate a cannula diameter of 8mm. The base of the bony Kambin's triangle taken in oblique view (3D MRI) was significantly higher than the root to facet distance at lower end plate level taken in axial view. Conclusion : The largest mean diameter of endoscopic cannula passable through "bony" Kambin's triangle was distinctively smaller than the largest mean diameter of endoscopic cannula passable through "neural" Kambin's triangle at all levels. Although proximity of exiting root to the facet joint is always taken into consideration before PELD procedure, our 3D MRI based anatomical study is the first to provide actual maximum cannula dimensions permissible in this region.