• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.258-266
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• 2018

Objective : The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. Methods : Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males. All patients had a computer tomography of the pelvic ring, two patients had a magnetic resonance imaging additionally : localization and involvement of the fracture lines into the sacroiliac joint, neural foramina or the spinal canal were identified. Results : Patients were aged between 46 and 98 years (mean, 79.8 years). Seventy-seven patients had an unilateral fracture of the sacral ala, 41 bilateral ala fractures and 12 patients showed a fracture of the sacral corpus : a total of 171 fractures were analyzed. The first group A included fractures of the sacral ala which were assessed to have no or less mechanical importance (n=53) : fractures with no cortical disruption ("bone bruise") (A1; n=2), cortical deformation of the anterior cortical bone (A2; n=4), and fracture of the anterolateral rim of ala (A3; n=47). Complete fractures of the sacral ala (B; n=106) : parallel to the sacroiliac joint (B1; n=63), into the sacroiliac joint (B2; n=19), and involvement of the sacral foramina respectively the spinal canal (B3; n=24). Central fractures involving the sacral corpus (C; n=12) : fracture limited to the corpus or finishing into one ala (C1; n=3), unidirectional including the neural foramina or the spinal canal or both (C2; n=2), and horizontal fractures of the corpus with bilateral sagittal completion (C3; n=8). Sixty-eight fractures proceeded into the sacroiliac joint, 34 fractures showed an injury of foramina or canal. Conclusion : The new classification allowes the differentiation of fractures of less mechanical importance and a risk assessment for possible polymethyl methacrylate leaks during sacroplasty in the direction of the neurological structures. In addition, identification of instable fractures in need for laminectomy and surgical stabilization is possible.

• Advances in pediatric surgery
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• 제6권1호
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• pp.32-39
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• 2000

Evaluation of the sacrum in anorectal malformations (ARMs) is important because there is an association between sacral abnormalities and poor functional outcome after corrective surgery for ARM. Sacral defects are not easily detected because of immaturity of sacrum in children and defects are often overlooked by pediatric surgeons. The authors utilized the sacral ratio in normal children (N=61) and patients with ARMs (N=26). In normal children, the mean true sacral ratio and mean sacrococcygeal ratio were $0.60{\pm}0.08$ and $0.72{\pm}0.13$ respectively. The sacral ratio was not correlated with age and did not changed with age in the same patient. However, true sacral ratio and sacrococcygeal ratio were significantly lower in patients with high type ARMs than those of normal children (p<0.001). There was no difference between patients with low type ARMs and normal children. These results suggest that abnormal sacrums are more frequently encountered in patients with high type ARMs than in normal children, and that true sacral ratio and sacrococcygeal ratio can be used in the evaluation of the abnormal sacrum.

• 대한인간공학회지
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• 제32권4호
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• pp.345-353
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• 2013

Objective: This research measured physiological and psychological effects of Vibroacoustic stimulation(VA) to scapular and sacrum of supine position on the mattress. Background: When vibroacoustic stimulation applies to human body, it has a positive influence on physiological and psychological effects by stimulating the organs, tissues and cells of whole body. Method: This experiment was conducted to 10 normal males in two conditions: no stimulation and vibroacoustic stimulation. No stimulation experiment was executed as a supine position for 30 minutes without any vibrational stimulus, while vibroacoustic stimulation was transmitted by the vibrational speaker, which uses 40Hz frequency. Subjects had a laser Doppler flowmeter probe in scapular, sacrum, and also had 8 channel electroencephalogram(EEG) measurement sensor in the scalp. Blood pressure and skin temperature were measured in two conditions with an underlying posture for 30 minutes. Additionally, blood flow rate and EEG were measured before and after for two minutes on two conditions. Results: According to the vibroacoustic stimulation, blood flow rate and skin temperature were increased, while blood pressure was decreased. When using vibroacoustic stimulation compared to no stimulation, blood flow rate went approximately two times higher, and skin temperature also higher 3~4 times. Furthermore, the relative alpha power of brain wave was significantly increased when we applied to vibroacoustic stimulation. Conclusion: This experiment tested the VAT embedded in mattress in two conditions. According to this experiment, VAT decreases blood pressure, improves not only a physiological effect on blood flow rate as well as skin temperature, but also psychological functions by increasing relative alpha power. Application: The results of the publishing trend analysis might help physiological and psychological effects of vibroacoustic stimulation.

• Asian Spine Journal
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• 제12권6호
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• pp.967-972
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• 2018

Study Design: Biomechanical study. Purpose: To investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum. Overview of Literature: The reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures. Methods: To simulate a vertically unstable fractured sacrum, 12 synthetic pelvic models were prepared. In each model, a 5-mm gap was created through the left transforaminal zone (Denis zone II). The pubic symphysis was completely separated and then stabilized using a 3.5-mm reconstruction plate. Four each of the unstable pelvic models were then fixed with two iliosacral screws, a tension band plate, or a transiliac fixation plus one iliosacral screw. The left hemipelvis of these specimens was docked to a rigid base plate and loaded on an S1 endplate by using the Zwick Roell z010 material testing machine. Then, the vertical displacement and coronal tilt of the right hemipelves and the applied force were measured. Results: The transiliac fixation plus one iliosacral screw constructions could withstand a force at 5 mm of vertical displacement greater than the two iliosacral screw constructions (p=0.012) and the tension band plate constructions (p=0.003). The tension band plate constructions could withstand a force at $5^{\circ}$ of coronal tilt less than the two iliosacral screw constructions (p=0.027) and the transiliac fixation plus one iliosacral screw constructions (p=0.049). Conclusions: This study proposes the use of transiliac fixation in addition to an iliosacral screw to stabilize vertically unstable sacral fractures. Our biomechanical data demonstrated the superiority of adding transiliac fixation to withstand vertical displacement forces.

• 대한수의학회지
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• 제42권2호
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• pp.131-136
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• 2002

The vertebrae of female African elephant (Loxodonta africana) of twenty-eight years old were observed macroscopically. The result was summarized as follows; the vertebral formula of African elephant was $C_7$ $T_{21}$ $L_3$ $S_4$ $Cd_{21}$. The total length of the vertebral column removed intervertebreal disks was 353 cm. The length of each segment of vertebral column was 44 cm in cervical, 142 cm in thoracic, 21 cm in lumbar, 27 cm in sacral and 119 cm in caudal vertebrae. The 17th and 18th thoracic vertebrae (T) were partially fused each other in four parts: the transverse processes of 17th and 18th T, caudal articular process of 17th T and cranial articular process of 18th T, left mammilary process of 18th T and left transverse process of 17th T, and vertebral arch of 17th and 18th T, respectively. Others partial fusions also observed among the third luwbar, sacrum and ilium. These were in between transverse process of third lumbar vertebra and cranial parts of wing of sacrum, lateral part of sacrum and tuber sacrale, respectively. The sternum was consisted of three pieces; one is a part of anterior prestemum, two is the part from caudal demifacet at second facet to cranial demifacet at third facet in middle mesosternum, which is divided vertically into an half at second and third facets, respectively, and the last is the part between caudal demifacet of third facet in middle mesosternum and the posterior xiphisternum. There are 21 pairs of ribs, six sternal, ten asternal ribs and the last five being floating ribs.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.139-144
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• 2012

Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

• 한국수정란이식학회지
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• 제30권4호
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• pp.341-344
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• 2015

A 4-day-old, male Poodle dog was presented with dull, depressed and exhausted activity after the birth. On physical examination, the puppy showed arthrogryposis, muscular atrophy and no movement of hindlimbs. Palpation on dorsum revealed an absence of lumbar and sacral vertebrae. On prenatal and postnatal radiography, lumbar vertebrae, sacrum and coccygeal vertebrae were not visualized. On ultrasonography, bilateral kidney and urinary bladder were observed. On computed tomography, there were no apparent abnormalities in the forelimbs, cervical vertebrae or head, while lumbar vertebrae, sacrum and coccygeal vertebrae were not observed. At necropsy examination, the liver, stomach, intestine, kidney and urinary bladder were normal. This congenital anomaly was consistent with Perosomus elumbis. Perosomus elumbis in dogs is a rare condition of unknown etiology. In this report, Perosomus elumbis was evaluated with radiography, ultrasound and computed tomography.

• 대한암한의학회지
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• 제19권1호
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• pp.43-51
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• 2014

This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating breast cancer metastasized to several portion. A 55-year-old woman who was diagnosed breast cancer and treated by breast conservation surgery (BCS) IN 2002. (pT2M0N0), adjuvant chemotherapy and radiotherapy till Jan. in 2013. But cancer had metastasized to sacrum (2009), liver (2012) and ribs (2013). Finally cause of several side effects of Xeloda(neuralgia and vommiting), she gave up to be treated by Xeloda and started to receive IMT including Abnoba Viscum, Vitamin C therapy Xeloda again, Korean herbal medicine and pharmacopuncture from Jul. in 2013. The effect was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and cancers to ribs, their size decreased after 12 months and pain of sacrum maintained VAS 2 continually. These results suggest that IMT is a therapeutic method to treat metastatic tumor originated from breast cancer.

• 척추신경추나의학회지
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• 제2권2호
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• pp.17-32
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• 2007

Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

• 한국동물위생학회지
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• 제30권3호
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• pp.429-436
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• 2007

This study was performed to make helpful standard for discrimination of cows from heifers by uterine and ovarian section inspection. A total of 3,736 heifers and 249 cows were inspected from January to November 2006 in Karak Market Slaughter house. Firstly, it was obvious that non-corpus albicans were observed in almost heifers(3,597/3,736, 96.3%), but there were distinctive corpus albicans in all cows (249/249 100%). Secondly, another evident was that the length and diameter of the horn in uterus was below 30mm in 94.5% (3,267/3,736) heifers, but above 30mm in 90.4% (225/245) cows, and it was easy to distinguish between right and left horn by difference of size in 87.6% (218/249) cows. Thirdly the diameters of pelvic cavity was below 220mm in 96.8% (3,615/3,736) heifers, but was over 200mm in 85.1% (212/249) cows. Fourthly another difference was found in second sacrum union condition and 13th thoracic vertebral process's states. In case of heifers, it was distinctive five lines in each second sacrum, but it was non-distinctive or united in the same each lines of the sacrum in cows. Fifthly in the results of 13th thoracic vertebral colors, the ratio between red color and white color was 7 : 3 in heifers (3,385/3,736, 90.6%), but that was 2 : 8 in cows (199/249, 79.9%). Consequently, it was possible to use the method which discriminated cows from heifers by uterine and ovarian section inspection in large scaled field slaughter house.