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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

Evaluation of Preference by Bukhansan Dulegil Course Using Sentiment Analysis of Blog Data (블로그 데이터 감성분석을 통한 북한산둘레길 구간별 선호도 평가)

  • Lee, Sung-Hee;Son, Yong-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.3
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    • pp.1-10
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    • 2021
  • This study aimed to evaluate preferences of Bukhansan dulegil using sentiment analysis, a natural language processing technique, to derive preferred and non-preferred factors. Therefore, we collected blog articles written in 2019 and produced sentimental scores by the derivation of positive and negative words in the texts for 21 dulegil courses. Then, content analysis was conducted to determine which factors led visitors to prefer or dislike each course. In blogs written about Bukhansan dulegil, positive words appeared in approximately 73% of the content, and the percentage of positive documents was significantly higher than that of negative documents for each course. Through this, it can be seen that visitors generally had positive sentiments toward Bukhansan dulegil. Nevertheless, according to the sentiment score analysis, all 21 dulegil courses belonged to both the preferred and non-preferred courses. Among courses, visitors preferred less difficult courses, in which they could walk without a burden, and in which various landscape elements (visual, auditory, olfactory, etc.) were harmonious yet distinct. Furthermore, they preferred courses with various landscapes and landscape sequences. Additionally, visitors appreciated the presence of viewpoints, such as observation decks, as a significant factor and preferred courses with excellent accessibility and information provisions, such as information boards. Conversely, the dissatisfaction with the dulegil courses was due to noise caused by adjacent roads, excessive urban areas, and the inequality or difficulty of the course which was primarily attributed to insufficient information on the landscape or section of the course. The results of this study can serve not only serve as a guide in national parks but also in the management of nearby forest green areas to formulate a plan to repair and improve dulegil. Further, the sentiment analysis used in this study is meaningful in that it can continuously monitor actual users' responses towards natural areas. However, since it was evaluated based on a predefined sentiment dictionary, continuous updates are needed. Additionally, since there is a tendency to share positive content rather than negative views due to the nature of social media, it is necessary to compare and review the results of analysis, such as with on-site surveys.

Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis (무릎 내측 구획 골관절염에서 초음파 유도하 경 반월상 연골 주사의 임상적 효과)

  • Jung, Eui Yub;Wang, Joon Ho;Lee, Eui-Sub;Lee, Sung-Sahn;So, Sang-Yeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.418-425
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    • 2020
  • Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.

Comparison of Computed Diffusion-Weighted Imaging b2000 and Acquired Diffusion-Weighted Imaging b2000 for Detection of Prostate Cancer (전립선암 발견을 위한 계산형 확산강조영상 b2000과 실제 획득한 b2000 영상의 비교)

  • Yeon Jung Kim;Seung Ho Kim;Tae Wook Baek;Hyungin Park;Yun-jung Lim;Hyun Kyung Jung;Joo Yeon Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1059-1070
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    • 2022
  • Purpose To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm2), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results The study population's Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240-0.603) and 0.495 (95% CI, 0.308-0.683), respectively. Conclusion cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.