• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.352-357
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• 2010

Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.163-166
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• 2011

Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

• 한국운동역학회지
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• 제24권2호
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• pp.95-101
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• 2014

The purpose of this study was to investigate the training and detraining effects of a 8-week water exercise on lower extremities coordination during obstacle gait in the female elderly. Eight elderly participants (age: $76.58{\pm}4.97$ yrs, height: $148.88{\pm}7.19$ cm, body mass: $56.62{\pm}6.82$ kg, and leg length: $82.36{\pm}2.98$ cm), who stayed at the Seoul K welfare center, were recruited for this study. All participants had no history of orthopedic abnormality within the past 1 year and completed the aquatic exercise program which lasted for 8 weeks. To identify the training and detraining effect of 8 weeks of water exercise, a 3-D motion analysis with 7 infrared cameras and one force plate sampling frequency set at 100 Hz and 1,000 Hz, respectively, was performed. A two-way ANOVA was performed to find training and detraining effects among diferent obstacle heights. In this study significant level was set at .05. Significant training effects of LTS (lead foot thigh and shank) coordination in all obstacle height were found (p<.05). It is also found that the training effect of LTS remained 37%, 58%, and 25% in obstacle height of 30%, 40%, and 50%, respectively. Lead foot showed the greater detraining effect of coordination compared with trail foot, and SF (shank and foot) coordination revealed better detraining effects of coordination compare with TS (thigh and shank) in both feet. Based on the findings, a 8 week water exercise give an positive effects to the elderly in terms of segment cooperation which potentially helps reducing their accident falls. The magnitude of detraining may also help the elderly to find the retraining moment.

• Journal of Animal Science and Technology
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• 제65권2호
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• pp.336-350
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• 2023

Two experiments were conducted in this research. Experiment 1 investigated the spatial expression characteristics of calcium (Ca) and phosphorus (P) transporters in the duodenum, jejunum, and ileum of 21-day-old broilers provided with adequate nutrient feed. Experiment 2 evaluated the effects of dietary vitamin D₃ (VD₃) concentration (0, 125, 250, 500, 1,000, and 2,000 IU/kg) on growth performance, bone development, and gene expression levels of intestinal Ca and P transporters in 1-21-day-old broilers provided with the negative control diet without supplemental VD₃. Results in experiment 1 showed that the mRNA levels of calcium-binding protein 28-kDa (CaBP-D28k), sodium-calcium exchanger 1 (NCX1), plasma membrane calcium ATPase 1b (PMCA1b), and IIb sodium-phosphate cotransporter (NaPi-IIb) were the highest in the broiler duodenum. By contrast, the mRNA levels of inorganic phosphate transporter 1 (PiT-1) and 2 (PiT-2) were the highest in the ileum. Results in experiment 2 showed that adding 125 IU/kg VD₃ increased body weight gain (BWG), feed intake (FI), bone weight, and percentage and weight of Ca and P in the tibia and femur of 1-21-day-old broilers compared with the negative control diet (p < 0.05). The rise in dietary VD₃ levels from 125 to 1,000 IU/kg further increased the BWG, FI, and weights of the bone, ash, Ca, and P (p < 0.05). No difference in growth rate and leg bone quality was noted in the broilers provided with 1,000 and 2,000 IU/kg VD₃ (p > 0.05). Supplementation with 125-2,000 IU/kg VD₃ increased the mRNA abundances of intestinal Ca and P transporters to varying degrees. The mRNA level of CaBP-D28k increased by 536, 1,161, and 28 folds in the duodenum, jejunum, and ileum, respectively, after adding 1,000 IU/kg VD₃. The mRNA levels of other Ca and P transporters (PMCA1b, NCX1, NaPi-IIb, PiT-1, and PiT-2) increased by 0.57-1.74 folds by adding 1,000-2,000 IU/kg VD₃. These data suggest that intestinal Ca and P transporters are mainly expressed in the duodenum of broilers. Moreover, the addition of VD₃ stimulates the two mineral transporter transcription in broiler intestines.

• 한국체육학회지인문사회과학편
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• 제57권3호
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• pp.345-356
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• 2018

이 연구의 목적은 여성 노인들을 대상으로 낙상자와 비낙상자 간 보행 시 하지의 국부적 안정성과 근 활동 양상을 후향성 접근을 통해 규명하고자 했다. 이를 위해 보행 시 낙상 경험이 있는 20명과 낙상 경험이 없는 20명이 선정되었다. 트레이드밀 보행 시 3차원 운동 캡쳐 시스템과 무선 근전도 장비를 이용해 운동학적 좌표와 근전도 신호를 수집했다. 운동좌표를 이용해 무릎과 발목 관절의 3차원 각 변위를 산출했으며, 이들의 국부적 안정성을 Lyapunov 지수를 통해 계산했다. 근 활성도는 근전도 신호를 이용해 대퇴직근과 대퇴이두근, 전경골근과 비복근을 살펴봤으며, 또한 이들의 동시 수축 지수를 정량화했다. 연구 결과 무릎 관절의 내·외전 움직임의 국부적 불안정성은 비낙상자 집단이 낙상자 집단보다 컸으며(p<.05), 전경골근의 근활성도는 낙상자 집단이 비낙상자 집단보다 적게 나타났다(p<.05). 또한 비복근과 전경골근의 동시 수축 지수는 낙상자 집단이 비낙상자 집단보다 컸다(p<.05). 그 밖에 낙상자 집단에서 비복근과 전경골근의 동시 수축 지수와 발목 관절의 굴신 움직임에 대한 국부적 안정성과는 유의한 상관관계를 보였다(p<.05). 따라서 보행 시 낙상을 예방하기 위해서는 무릎 관절의 내·외전 움직임에 관여하는 근들을 강화하고, 발목 관절의 굴신에 작용하는 비복근과 전경골근을 균형적으로 강화할 필요가 있다고 판단된다.

• 대한정형외과학회지
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• 제55권6호
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• pp.520-526
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• 2020

목적: 척추 유합술을 받은 환자 중에서 척추 유합 재수술을 받는 경우가 증가하고 있다. 척추 유합 재수술을 위해 기존 장치와 연결기를 통해 연결하여 고정술을 연장하는 revision rod를 새롭게 개발하였다. 본 연구에서는 revision rod를 이용하여 척추 유합 재수술을 시행한 후 임상적·방사선적 결과를 분석하였다. 대상 및 방법: 2개의 대학병원에서 척추 유합술 후 유합 연장술을 시행하고 최소 1년 추적관찰이 가능했던 21명의 환자가 포함되었다. 진단명은 인접 분절 병증 16명, 흉요추 골절 4명, 황색인대골화 1명이었다. 임상 결과는 Oswestry Disability Index (ODI)와 수치평가척도(numerical rating scale, NRS)로 평가하였고, 방사선 결과는 요추 전만각, 흉추 후만각, 재수술 부위의 시상면 각도, 그리고 근위부 인접부의 후만각 및 골유합률을 평가하였다. 결과: 수술 전 평균 ODI는 54.6±12.5에서 최종 추시 시 29.8±16.5로 향상되었다. 허리 통증과 다리 통증 NRS는 5.0±1.7, 6.4±2.0에서 2.9±1.6, 2.9±2.2로 향상되었다. 요추 전만각은 수술 전 18.1±11.9도가 최종 추시 시 21.1±10.3도였고, 근위부 인접부 후만각은 수술 전 10.8±10.1도가 최종 추시 시 9.2±10.5도로 유의미한 차이를 보이지는 않았다. 골유합률은 후외측 골유합을 시행한 1명을 제외하고는 모든 예에서 성공적인 유합이 이루어졌다. 결론: Revision rod를 사용한 흉요추의 재유합술에서 우수한 임상 결과를 보였다. 새롭게 개발된 revision rod와 관련된 문제는 발생하지 않았고 방사선상 골유합은 성공적이었다.