• 제목/요약/키워드: Midline

검색결과 567건 처리시간 0.023초

내장신경차단에 관한 임상적 연구 (A Clinical Evaluation of Splanchnic Nerve Block)

  • 김수연;오흥근;윤덕미;신양식;이윤우;김종래
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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삼차원 전산화 단층촬영술을 이용한 안모 비대칭환자의 골격 분석 (SKELETAL PATTERN ANALYSIS OF FACIAL ASYMMETRY PATIENT USING THREE DIMENSIONAL COMPUTED TOMOGRAPHY)

  • 최정구;민승기;오승환;권경환;최문기;이준;오세리;유대현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.622-627
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    • 2008
  • In orthognathic surgery, precise analysis and diagnosis are essential for successful results. In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry

Performance of Growing-finishing Pigs Fed Diets Containing Graded Levels of Biotite, an Alumninosilicate Clay

  • Thacker, P.A.
    • Asian-Australasian Journal of Animal Sciences
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    • 제16권11호
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    • pp.1666-1672
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    • 2003
  • The objective of this study was to evaluate the potential of an alumninosilicate clay, marketed under the trade name Biotite V, to improve growing-finishing pig performance and to determine its effects on nutrient digestibility and excretion. Sixty crossbred pigs (22.3${\pm}2.7kg$, Camborough 15 Line female${\times}$Canabred sire) were assigned on the basis of sex, weight and litter to one of four dietary treatments in a $2{\times}4$ (two sexes and four treatments) factorial design experiment. The experimental diets were based on barley and soybean meal and contained 0, 0.25, 0.5 or 0.75% biotite during the growing period (22.3-60.5 kg) and 0, 0.5, 1.0 or 1.5% biotite during the finishing period (60.5-110.3 kg). Each pig was allowed access to its own individual feeder for 30 min twice daily (07:00 and 15:00 h). Individual pig body weight, feed consumption and feed conversion were recorded weekly. The pigs were slaughtered at a commercial abattoir when they reached an average weight of 110.3 kg. Carcass weight was recorded and dressing percentage calculated. Carcass fat and lean measurements were obtained with a Destron PG 100 probe between the 3rd and 4th last ribs, 70 mm of the midline. Total tract digestibility coefficients for dry matter, energy, nitrogen and phosphorus were determined using three males and three females per treatment starting at an average weight of $52.2{\pm}3.8kg$. These pigs were housed under identical conditions as those used in the growing stage and were fed the same diets modified only by the addition of 0.5% chromic oxide as a digestibility marker. Over the entire experimental period (22.3-110.3 kg), daily gain was unaffected (p>0.05) by the inclusion of biotite in the diet. There was a cubic response for feed intake (p=0.06) and a quadratic response (p=0.07) for feed conversion due to biotite. Feeding biotite produced no significant (p>0.05) linear or quadratic effects on any of the carcass traits measured. Dry matter digestibility decreased linearly (p=0.02) with increasing levels of biotite in the diet. However, digestibility coefficients for energy, nitrogen and phosphorus were unaffected (p<0.05) by biotite inclusion. Lactobacilli and enterobacteria numbers were unaffected by inclusion of biotite while Salmonella was not detected in any of the fecal samples. The overall results of this experiment indicate that biotite inclusion did not reduce fecal excretion of nitrogen or phosphorus and failed to improve nutrient digestibility. Neither growth rate nor carcass quality was improved while a modest improvement in feed conversion was observed at lower levels of inclusion. Based on the results of this experiment, it would be difficult to justify the routine inclusion of biotite in diets fed to grower-finisher pigs. Whether or not a greater response would have been obtained with pigs of a lower health status is unknown.

한국산(韓國産) 민어과(科)(농어목(目)) 어류(魚類)의 분류학적(分類學的) 재검토(再檢詞) (Taxonomic Revision of the Family Sciaenidae (Pisces, Perciformes) from Korea)

  • 이충렬;박미혜
    • 한국어류학회지
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    • 제4권1호
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    • pp.29-53
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    • 1992
  • 1989년부터 1992년 5월까지 우리나라 서남연안에서 채집된 한국산 민어과 Sciaenidae 어류의 분류학적 위치를 재검토하였다. 지금까지 한국산 민어과 어류는 5속(屬) 13종(種)으로 보고되어 왔으나 조사 결과 강달이속(屬) Collichthys에는 황갈달이 C. lucidus와 눈강달이 C. niveatus, 조기속(屬) Pesudosciae-na에는 부세 P. crocea와 참조기 P. polyactis, 수조기속(屬) Nibea에는 수조기 N. albiflora, 동갈민어 N. mitsukurii, 그리고 꼬마민어 N. diacanthus, 민태속(屬) Johnius에는 민태 J. grypotus, 민어속(屬) Miichthys에는 민어 M. miiuy, 백조기속(屬) Argyrosomus에는 보구치 A. argentatus, 흑조기속(屬) Atrobucca에는 흑조기 A. nibe, 라강달이속(屬) Larimichthys에는 라강달이 L. rathbunae 등 모두 8속(屬) 12종(種)으로 분류되었다. 우리나라에서 지금까지 보고되었던 종(種) 중에서 Peseudosciaena manchurica는 P. polyactis로, Nibea goma는 N. diacanthus로, Johnius belengerii는 J. grypotus로, Nibea imbricatus는 Miichthys miiuy로, Nibea argentatus는 Argyrosomus argentatus로, Nibea nibe는 Atrobucca nibe로 확인되어 모두 12종(種) 중 6종(種)의 학명이 재정리되었다. 또한 지금까지 Collichthys속(屬) 중에서 우리나라에서 가장 많이 출현한다는 C. fragilis는 C. lucidus와 동일종(種)으로 확인되었다. 아울러 이들 종(種)들의 각종 분류학적 주요 형질을 중심으로 하여 한국산 민어과 어류의 속(屬), 종(種) 검색표(檢索表)를 작성하였고, 각종(各種)들의 형태적 특징 및 계수 계측 형질을 기재하면서 한국산 민어과 어류의 분류학적 위치를 재검토하고 이들의 지리적 분포에 대하여 논의하였다.

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안면비대칭에 대한 주관적 인지도와 정모두부방사선사진 분석치의 연관성 (Relationship between Perception of Facial Asymmetry and Posteroanterior Cephalometric Measurements)

  • 안정순;황현식
    • 대한치과교정학회지
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    • 제31권5호
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    • pp.489-498
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    • 2001
  • 본 연구는 한자의 비대칭 인지도에 영향을 미치는 정모두부방사선사진 계측치를 알아보기 위하여 시행하였다. 전남대학교병윈 교정과에 내원한 환자 중 정모두부방사선사진 촬영이 필요한 12세 이상의 환자 100명을 대상으로 "본인의 얼굴이 좌우 비대칭이라고 생각하고 있는가" 를 물어보아 비대칭 인지 정도에 따라 5개 군(아니다. 아니라고 생각한다. 모르겠다. 비대칭이라고 생각한다. 분명히 비대칭이다)으로 분류하였다. 각 대상자의 정모두부방사선사진 투사도에서 계관(crista galli)과 전비극첨 (anterior nasal spine)을 연결한 선을 기준으로 하여 비대칭 정도를 나타내는 9개의 선 계측치와 4개의 각도 계측치를 비교분석하여 다음과 같은 결과를 얻었다. 1. Menton의 변위와 상$\cdot$하악 정중선차이가 클수록 안면비대칭에 대한 본인의 인지도가 높음을 알 수 있었다. 2. "모르겠다" 라고 응답한 군의 모든 계측치는 "아니다", "아니라고 생각한다" 군과 통계적 유의차를 보이지 않았다. 3. "비대칭이라고 생각한다" 라고 응답한 군의 모든 계측치는 "분명히 비대칭이다" 군과 통계적 유의차를 보이지 않았다. 이상의 결과는 안면비대칭에 대한 환자 본인의 인지 정도를 물어보는 것이 교정진단에 도움이 됨을 시사하였다.

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하악에서 부착치은의 폭경과 소대에 관한 연구 (The width of keratinized gingiva and the frenum in mandible)

  • 정진형
    • Journal of Periodontal and Implant Science
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    • 제28권4호
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    • pp.785-797
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    • 1998
  • This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

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토양별 지표, 지하배수간 토양수분 변화에 대하여 (The soil moisture fluctuation between surface and subsurface drained plots in the different soil characteristics)

  • 이순혁
    • 물과 미래
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    • 제7권2호
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    • pp.75-82
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    • 1974
  • 본시험은 관개 및 배수 설계를 위한 기초자료 제공을 목적으로 토양수분 및 지하수위의 변화상태를 구명하고자 하는 것으로 카나다 퀴백(Quebec) 지방 저지대의 대표적인 2종의 태양인 점토와 사질로움 토양에 대해서 일차적으로 지표, 지하배수간의 토양수분과 지하수위의 변화를 연구분석한 것으로 그 결과를 요약하면 다음과 같다. 1. 2종의 토양(점토, 사질로움)에 있어서 공히 토양수분은 지표로부터 지하로 내려갈수록 증가되는 상태를 나타냈으면 이는 하층토로 내려감에 따라 팽창된 치밀한 토양 조직을 가지고 있음을 시사하며 2. 동기에 있어서는 지표로부터 12inch 깊이의 토양수분이 더 깊은 18inch나 24inch 깊이의 토양수분보다 증가된 상태를 유지하였다. 이는 토양내의 빙결막이나 지표면의 눈 또는 어름에 영향으로 생각되며 이 경향은 점토질 토양에서 보다 토양내 빙결막으로의 수분 이종을 조장해주는 투수 계수가 큰 사질로움 토양에서 더 높았다. 3. 양식험구 공히 지표에서 얕은 지하 0∼3inch 이내의 토양수분은 항우를 전후해서 급격한 변화를 가져왔다. 여기에서 수분의 급상승은 호우시나 표층토가 하층토의 토양수분에 영향을 주는 항우이전에 포장용수량(Field capacity)에 달했기 때문에 급항하는 지표면의 물 분자가 열에너지에 의해 증발산되고 천층에 산재한 초, 수근에 의해 소비되는 때문인 것으로 사료된다. 4. 지하수위하의 토양수분은 포화에 달하여 거의 일정할 것으로 기대되었지만 실제로 많은 변화를 가져왔다. 이들 변화에는 부분적으로 토양사극이 지하수위하이라도 채워지지 않았거나(Capillary pressure가 작을 시) 혹은 관측기간 중에 토양의 융기와 수축에 기인된다고 생각된다. 5. 지하배수구가 지표배수구에 비해 지하수위항하가 빨랐음은 물론 사질로움 토양에서는 보다 높은 투수계수로 인해서 지하수위의 항하가 점토질 토양에서 보다 훨씬 빨랐음을 보여주고 있다.표시할 수 있다.된다.acid $0.41{\sim}0.65%$, 오미자는 malic acid $1.51{\sim}3.90%$, citric acid $2.40{\sim}3.92%$로 주요 유기산이 있다. 타닌은 물보다 에탄올 추출물이 다소 함량이 높았으며 특히 오갈피는 $3.35{\sim}3.85%$로 매우 높은 함량이었다.a 6 cases, etc. 2. The retroperitoneal space including kidneys were the most commonly involved site (43.5%), of which Wilms' tumor was the commonest. 3. About 2/3 of tumors developed under the age of 6 and the commonest lesion was Wilms' tumor and the next being neuroblastoma, teratoma, ovarian cyst and so forth. 4. In all tumors except ovarian tumor and choledochal cyst, male was more frequently affected. 5. In plain abdomen 75% of neuroblastoma crossed the mid line while in Wilms' tumor only 2 cases (14%) showed midline cross. Calcific density was 입력불가 in all 6 cases of teratoma (100%) as dense and discrete ossification, in 3 case of neuroblatoma (38%) characteristically in diffuse stippled appearance and in one case

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의도적인 견갑골 외전이 Sit-and-Reach Test에 미치는 영향 (Effect of a Intentional Scapular Abduction on the Sit-and-Reach Test)

  • 김선엽;지창연;김광수
    • 대한정형도수물리치료학회지
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    • 제6권1호
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    • pp.15-26
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    • 2000
  • Purpose : This study was done to examine the actual effect of the scapular position in these flexibility tests. The purpose of this study was to examine the differences between the measurement of SRT(Sit-and-Reach Test) without intentional abduction of the scapular (pre-test) and with intentional abduction of the scapular (post-test). The hypothesis is: 1. There is no differences in the SRT result of the pre-test and the post-test. 2. There is no differences in the HJA(Hip Joint Angle) result of the pre-test and the post-test. 3. There is no differences in the Spine Motion Test(SMT) result of the pre-test and the post-test. Method : The total 60 people (30 men, 30 women) were participated in this study. In the pre-test, the subjects were asked to sit on the examination table and try the SRT motion; and then the HJA, SRT and the SMT numerical values were taken. In the post-test. the subjects were instructed to intentionally bring the scapula outward from the midline; and the HJA, SRT and the SMT numerical values were taken. Result : In the pre-test. the SRT result averaged 34.17cm. and in the post-test. the SRT result averaged 36.68cm. The difference was about 2.81cm which showed a significant mean statistically (p<0.01). The measurement increased by 8.22%. The HJA was $85.9^{\circ}$ in pre-test, and it was $85.5^{\circ}$ in post-test. giving the $0.4^{\circ}$ differences. Therefore, it didn't have a statistical mean (p>0.05). The SMT value was 69.56cm in the pre-test. and it was 69.28cm in the post-test, about 0.28cm decreased. Therefore, it didn't have a statistical mean (p>0.05). SRT values and HJA values were correlated (p<0.01). SMT values and SRT values (p<0.01), and SMT values and HJA values(p<0.05) were each in counter correlation. Conclusion : The result of the SRT without intentional scapular abduction (34.17cm) and with intentional scapular abduction (36.68cm) showed a significant increase about 8.22% (p<0.01). In SRT, the effect of the intentional scapular abduction on SMT showed no significant means, the pretest value being 69.56cm and the post-test value being 69.28cm (p>0.05).

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가토에서 심낭이완술에 관한 실험적 연구 (Experimental Studies of the Pericardial Releasing Technique in Rabbits)

  • 박만실
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.451-457
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    • 1987
  • Reoperations following cardiac surgery have an increased risk of the danger of damaging the heart, great vessels or extracardiac grafts because of adhesions to the sternum. We experimentally evaluated 3 different methods for pericardial closure. A standardized procedure for induction of pericardial adhesions was carried out in 30 rabbits. For closure of pericardium, animals were divided into 3 groups, 10 animals respectively: Croup 1 [simple pericardial closure]The pericardium was primarily resuture; Group 2 [Core-Tex surgical membrane as a pericardial substitute]- A Gore-Tex surgical membrane was interposed between the sternum and the heart; and Group 3 [pericardial tension releasing technique]-Three longitudinal overlapping incisions were made on the right side of the pericardium while the midline incison was sutured. Animals were put to death 4 weeks postoperatively and the pericardial space was examined for pericardial adhesions and epicardial reactions. The extent of adhesions and reactions were graded as: I-none; II-minimal; III-moderate; and IV-severe. Histologic studies of the pericardium, the pericardial substitute and the epicardium were also performed. The results were as follows: 1. In group 1 [simple pericardial closure], the degree of pericardial adhesions were grade I in 1 animal, grade II in 2, grade III in 4 and grade IV in 3. Epicardial reactions were grade I in 1 animal, grade II in 3, grade III in 5 and grade IV in 1. Histologic examination revealed thick fibrous tissue that obliterated the pericardial space in 7 animals. 2. In group 2 [Gore-Tex surgical membrane as a pericardial substitute], the degree of pericardial adhesions were grade I in 3 animals, grade II in 3, grade III in 2 and grade IV in 2. The degree of epicardial reactions were grade II in 1 animal, grade III in 5 and grade IV in 4. Histologic studies revealed a thin layer of dense fibrous tissue which covered the Gore-Tex surgical membrane and thick loose fibrous tissue on the epicardium just beneath the substitute. 3. In group 3 [pericardial tension releasing technique], the degree of pericardial adhesions were grade I in 3 animals, grade II in 4, grade III in 2 and grade IV in 1. The degree of epicardial reactions were grade 1 in 4 animals, grade II in 4 and grade III in 2. Severe epicardial reactions were not observed in this group. Histologic examination showed normal epicardium in 4 animals and the epicardium of the other 6 animals only revealed very thin fibrous layer compared to group I and group II. Pericardial adhesions more than grade III were 70% in group 1, 40% in group 2 and 30% in group 3. Pericardial adhesions were reduced in group 2 and group 3 compared to group 1, but statistically not significant. Epicardial reactions more than grade III were 60% in group 1, 90% in group 2 and 20% in group 3. Epicardial reactions were significantly reduced in group 3 compared to group 2. Author`s modified pericardial releasing technique provides marked augment of pericardial surface area and facilitates tension-free pericardial closure. Furthermore, pericardial adhesion and epicardial reaction will be reduced with the pericardial tension releasing technique.

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한국 성인에서 척수원추 위치의 다양성 - 자기 공명 영상 연구 - (The Variation of Position of the Conus Medullaris in Korean Adults - A Magnetic Resonance Imaging Study -)

  • 주성필;김수한;이정길;김태선;정신;김재휴;강삼석;이제혁
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.451-455
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    • 2001
  • Objectives : There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. Methods : we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. Results : The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions : The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.

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