• Title/Summary/Keyword: Vertebra

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Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

Load Sharing Ratios Between the Cortex and Centrum in a Lumbar Vertebral Body with aging using Finite Element Method (유한 요소 법을 이용한 노화에 따른 요추의 피질 골과 해면 골 간의 하중 분담 비율)

  • Lim, JongWan
    • Journal of Biomedical Engineering Research
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    • v.37 no.2
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    • pp.90-103
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    • 2016
  • This research was aimed to analyze load sharing ratios between cortical shell and trabecular bone of a degraded lumbar vertebra with aging, and also evaluate elastic moduli assigned into an FE model, using finite element method. For the better analysis of trabecular bone, effective elastic moduli, that is, nominal elastic moduli divided by the volumetric porosities was used. The elastic moduli of the cortical shell suitable for the trabecular bone were obtained from the equations on the basis of idealized stress-strain relations, including areal porosities. To minimize numerical errors, p-element was used. Using eight parameters that refer to some published papers, the geometry of L3 with a removed posterior part. After the constant compressive displacement was applied, the load sharing ratios were obtained by using both every elastic strain energy and every vertical force between two bones in each 8-volume. As results, 1) according to an increase in age from 20-year to 80-year, load sharing ratios of trabecular bone decreased from 55% to 49%; 2) the maximal ratios of each bone were occurred in the mid-plane of centrums and the endplate of cortical shells, respectively; 3) effective elastic moduli assigned into a porous centrum/cortex were found to be adequate; 4) for load sharing ratios, the difference of two methods showed that the total ratios were almost same within less than 1% but the partial ratios at every depth were more or less different each other.

Therapeutic Plan for Traumatic Truncal Arterial Injury Associated with Truncal Organ Injury (체간부 장기 손상을 동반한 외상성 체간부 동맥 손상 환자의 치료 방침)

  • Jo, Choong Hyun;Jung, Yong Sik;Kim, Wook Hwan;Cho, Young Shin;Ahn, Jung Hwan;Min, Young Gi;Jung, Yoon Seok;Kim, Sung Hee;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.77-86
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    • 2009
  • Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

Retroperitoneal Abscess Caused by Staphylococcus intermedius in a Dog (개에서 Staphylococcus intermedius에 의한 복막후농양 발생례)

  • Lee, Sang-Gwan;Hoh, Woo-Phil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.176-180
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    • 2009
  • Two year-old female miniature schnauzer was presented with depression, abdominal pain and inappetence. Physical examination revealed tachypnea, fever, and abdominal pain. Leukocytosis with neutrophilia was shown in complete blood count. Radiograph revealed the increase of opacity in parallel to vertebra and dislocation of descending colon. Calculi and sludge in bladder, hydronephrosis and dilation of proximal ureter in right kidney were observed in ultrasonographic examination; also, irregular shape of structure in retroperitoneal cavity was observed. Urinalysis showed protein urine and hemtauria. Many epithelial cells, spindle cells, calcium oxalate dihydrate crystals, struvite crystals, amorphous crystals and granular casts, WBC, cocci were examined in urine sediment test. ERD-kit test result was highly positive. Based on those test and excretory urogram pyelonephritis and complete unilateral obstruction of ureter were confirmed. A balloon type structure in retroperitoneal cavity was found through the exploratory laparotomy. In cytologic examination of aspirated fluid from dilated area many degenerated neutrophils and phagocytized cocci were observed. Staphylococcus intermedius was cultured from aspirated fluid. Based on these clinical results retroperitoneal abscesses caused by Staphylococcus intermedius was diagnosed with ureter obstruction and concurrent cystic calculi. Nephrectomy of right kidney with ureter was performed.

Comparision of cardiovascular and analgesic effects of epidural administration of medetomidine, medetomidine-buprenorphine and medetomidine-fentanyl in dogs anesthetized with isoflurane (Isofourane으로 마취된 개에 medetomidine, medetomidine-buprenorphine, medetomidine-fentanyl의 경막외 투여 시 심혈관계 반응과 진통효과의 비교)

  • Chang, Hwa-Seok;Kim, Hye-Jin;Choi, Chi-Bong;Lee, Jung-Sun;Kim, Hwi-Yool
    • Korean Journal of Veterinary Research
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    • v.47 no.1
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    • pp.103-115
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    • 2007
  • The aim of this study was to compare the reaction of the cardiovascular system, and the anesthetic effect among 3 experimental groups, epidural administration of medetomidine as a single agent, the combination of buprenorphine and medetomidine, and the combination of fentanyl and medetomidine. Twenty one dogs were anesthetized with isoflurane and allowed to breathe spontaneously. Epidural, arterial, and venous catheters were inserted. The tip of epidural catheter was positioned at the level of the space between the sixth and seventh lumbar vertebra. After a stable plane of anesthesia was achieved, these dogs were each administered one of the following treatments epidurally : medetomidine $10{\mu}g/kg$ (Group M), a combination of medetomidine $5{\mu}g/kg$ and buprenorphine $10{\mu}g/kg$ (Group M/B), and a combination of medetomidine $5{\mu}g/kg$ and fentanyl $10{\mu}g/kg$ (Group M/F). Heart rate (HR), Respiratory rate (RR), End-tidal carbon dioxide (EtCO2), and arterial blood pressure were measured before drug administration (base line) and 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min postinjection. Blood gas analysis was performed before injection and 5, 15, 25, 35, 45, 60 min postinjection. Isoflurane was discontinued 80 min postinjection and pain/motor function were evaluated up to 260 min postinjection every 15 min. At the early stage of drug introduction (until 5 min), the HR was decreased significantly in all 3 groups compared with base line. In Group M, HR was significantly decreased compared with the other 2 groups. With time (starting 20 min after drug introduction), the HR was decreased significantly in Group M/B in respect to base line. However, no significant difference was seen number-wise in all 3 groups. During 60 min after drug introduction, the systolic, diastolic and mean arterial pressures were highest in Group M and lowest in Group M/F. Among 3 groups, drug action and motor loss duration were longest in Group M/F. Analgesic effect observed in the M/F group was the most prominent and long-lasting, compared to those seen in the other 2 groups. Given the fact that the recovery of motor function takes place in a short period of time after analgesic effects disappeared, additional use of M/F depending on the patient's condition would be a good way to achieve effective pain management. However, proper care should be taken to ensure the function of cardiovascular system in the patient because the administration of M/F under isoflurane anesthesia results in a significant decline in arterial blood pressure ($65{\pm}10mmHg$).

Comparison of Marbling Fleck Characteristics and Objective Tenderness Parameters with Different Marbling Coarseness within Longissimus thoracis Muscle of High-marbled Hanwoo Steer

  • Lee, Boin;Yoon, Sungho;Lee, Younkyung;Oh, Eunmi;Yun, Yun Kyung;Kim, Byoung Do;Kuchida, Keigo;Oh, Hee Kyung;Choe, Jeehwan;Choi, Young Min
    • Food Science of Animal Resources
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    • v.38 no.3
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    • pp.606-614
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    • 2018
  • It is important to understand how marbling traits and tenderness differ among beef steaks from the carcass grading site and other regions within the longissimus thoracis (LT) muscle, as these characteristics are closely associated with consumer acceptability and willingness to purchase. Thus, the aim of this study was to compare the marbling fleck traits and objective tenderness parameters in the groups classified by the coarseness index (CI) of marbling fleck (high and low groups) at the carcass grading site ($13^{th}$ thoracic vertebra; 13T) and three different locations (13T, 9T, and 6T) within the LT muscle from well-marbled (marbling score 7 to 9) Hanwoo steer. Image analysis showed that the longitudinal locations had a significant effect on marbling fleck traits. The total area of large marbling fleck divided by the total marbling area (coarseness) was higher at the central region (13T to 12T) compared to the front thoracic region (6T to 5T) in the high CI group (0.23 vs. 0.17, p<0.05), whereas no significant differences were observed in the total number of marbling fleck within the LT muscle in the high or low CI groups (p>0.05). Location effect on objective tenderness parameters within the LT muscle was somewhat limited, although the high CI group had a lower Warner-Bratzler shear force (WBS) value than did the low group (p<0.05). Taken together, the degree of coarseness of marbling fleck decreased from the carcass grading site to the front thoracic site, whereas the objective tenderness parameters, including WBS and hardness, of the grading site did not differ from the other regions within the LT muscle.

Effect of First-Aid Drugs on Internal Contamination of Radiostrontium (방사성(放射性) 스트론듐의 체내오염(體內汚染)에 대한 응급처치제(應急處置劑)의 효과(效果))

  • Chung, In-Yong;Kim, Tae-Whan;Chin, Soo-Yil
    • Journal of Radiation Protection and Research
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    • v.14 no.1
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    • pp.16-23
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    • 1989
  • To obtain the basic data for protective roles and first-aid of radiation hazard, the present studies were carried out to evaluate the decontamination of radiostrontium by the First-Aid drugs. Each mouse was administered intraperitoneally dose of sodium alginate 5mg, $CaNa_3DTPA$ 8.4mg and saline 5ml following the internal contamination with 1 $\mu$Ci of strontium as $^{85}SrCl_2$. $^{85}Sr$ was determined by the radioactivity of body burden, urinary excretion, fecal excretion and organ distribution by Ge-detector and MCA. The results are summarized as follows. 1. Effective half life on whole body retention $^{85}Sr$ was determined at 33 hours. 2. The decontamination effect of First-Aid durgs on the body $^{85}Sr$ burden were increased $CaNa_3DTPA$ (4.7 times), sodium alginate (1.7 times) and saline (2.4 times) respectively. 3. Strontium were excreted through urine (35.4%), feces (64.4%) and other (0.2%). But on the $^{85}Sr$ excretion routes following First-Aid drugs treatment, strontium-85 mainly were excreted through urine after $CaNa_3DTPA$ and saline treatment, and was excreted through feces after sodium alginate treatment. 4. The organ distribution of strontium-85 is vertebra, femur, sternum and liver in order Finally, the extrapolations from these data to victims were suggested that the rapid administration of $CaNa_3DTPA$, sodium alginate and saline simultaneously were markedly increased the decontamination effects on the internal contamination of radiostrontium.

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"Conlplex Pneuwlonectonly" in Lung Cancer (폐암의 "Conlplex Pneuwlonectonly")

  • Baek, Hyo-Chae;Bae, Gi-Man;Lee, Du-Yeon
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.614-620
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    • 1996
  • The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, peri- cardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy" From March 1990 to February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial re- section, and one patient had resection of diaphragm Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years) with male to female ratio of 17 to 1. The chief complaints of the patients on admission were cough (13), dyspnea on exertion (11), chest pain (10), weight loss (9), general fatigue (9), and sputum production (4 . Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3NO MO, 4 TIWIMO, 6 T3N2MO, 5 T4N2MO, and 1 TIWIMO. There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07 $\pm$ 4.82 months. One patient with stage TINOMO who had chest wall resection is alive at 35 months follow-up and a patient with T3N2MO who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "complex pneumonec- tomy" is very important, and a long term survival is possible.ong term survival is possible.

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The Role of Bone Cement Augmentation in the Treatment of Chronic Symptomatic Osteoporotic Compression Fracture

  • Kim, Hyeun-Sung;Kim, Sung-Hoon;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.490-495
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    • 2010
  • Objective : Bone cement augmentation procedures such as percutaneous vertebroplasty and balloon kyphoplasty have been shown to be effective treatment for acute or subacute osteoporotic vertebral compression fractures. The purpose of this study was to determine the efficacy of bone cement augmentation procedures for long standing osteoporotic vertebral compression fracture with late vertebral collapse and persistent back pain. Methods : Among 278 single level osteoporotic vertebral compression fractures that were treated by vertebral augmentation procedures at our institute, 18 consecutive patients were included in this study. Study inclusion was limited to initially, minimal compression fractures, but showing a poor prognosis due to late vertebral collapse, intravertebral vacuum clefts and continuous back pain despite conservative treatment for more than one year. The subjects included three men and 15 women. The mean age was 70.7 with a range from 64 to 85 years of age. After postural reduction for two days, bone cement augmentation procedures following intraoperative pressure reduction were performed. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period after bone cement augmentation procedures was 14.3 months (range 12-27 months). The mean injected cement volume was 4.1 mL (range 2.4-5.9 mL). The unipedicular approach was possible in 15 patients. The mean pain score (visual analogue scale) prior to surgery was 7.1, which decreased to 3.1 at 7 days after the procedure. The pain relief was maintained at the final follow up. The kyphotic angle improved significantly from $21.2{\pm}4.9^{\circ}$ before surgery to $10.4{\pm}3.8^{\circ}$ after surgery. The fraction of vertebral height increased from 30% to 60% after bone cement augmentation, and the restored vertebral height was maintained at the final follow up. There were no serious complications related to cement leakage. Conclusion : In the management of even long-standing osteoporotic vertebral compression fracture for over one year, bone cement augmentation procedures following postural reduction were considered safe and effective treatment in cases of non-healing evidence.

Effects of Ballet Program Training of Royal Academy of Dance on Body Composition, Physical Fitness and Bone Mineral Density in College Women (로얄 아카데미 발레댄스 프로그램 수행이 여자 대학생의 신체조성, 체력 및 골밀도에 미치는 영향)

  • Kim, Jong-Won;Lee, Mi-Ran;Lee, Kyung-Hee;Kim, Hyung-Jun;Choi, Mun-Ki;Kim, Do-Yeon;Kim, Tae-Un
    • Journal of Life Science
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    • v.19 no.8
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    • pp.1093-1103
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    • 2009
  • The purpose of this study was to analyze the effects of ballet program training at the Royal Academy of dance (RAD) on body composition (BC), physical fitness (PF) and bone mineral density (BMD) in college women. The subjects for this study were 14 females aged 19 to 22, who were divided into the Experimental group (n=7, EG) and the Control group (n=7, CG). The RAD ballet program training was done by 7 subjects (EG), 60 minutes per day, three times a week for 12 weeks. The TBF and %fat significantly decreased and LBM increased in the Experimental group, but all the variables of Body composition in the Control group did not significantly changed. The AMS, Sit ups, STF, SLJ CFB and 1,200 m R & W in the EG significantly increased, but 1,200 m R & W in the CG decreased. The lumbar vertebra (LV), femoral neck (FN), greater trochanter (GT) and ward's triangle (WT) did not significantly change in the EG, but LV, GT and WT in the CG decreased. There was no significant difference in osteopenia for EG, but there were increases in GT and WT for the CG. There was significant correlation between BMDs and body weight, TBF, LBM, %fat, BMI, AMS. There was significant correlation between LV and FN and LV and whole body. In conclusion, regular and continuous RAD training was effective in improving the body composition, physical fitness and bone mineral density. Consequently, RAD training will be effective for preventing osteopenia and osteoporosis, and for improving the health-related fitness for college and middle-aged women.