A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.
Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.
Objective: The purpose of this study was to compare concurrent validity and test-retest reliability based on Craniovertebral angle of 'Angles video goniometer', a smart phone application for convenient range of motion measurement, and 'Image J', an analysis software with high reliability and validity. This was conducted to find out whether 'Angle video goniometer' can be used clinically. Design: Cross-sectional study Methods: Fifty subjects were imaged laterally, and the angle of the head and spine was measured using Image J and the Angles video goniometer, respectively, in a resting posture and a chin in posture. The level of concurrent validity between the two measurement methods and the level of inter-rater reliability and intra-rater reliability were analyzed. Results: For forty participants, the concurrent validity between Image J and Angles video goniometer showed very high validity with ICC of 0.997(0.995~0.999) and 0.994(0.994~0.998), CVME% 0.71~0.72%, SEM% 0.31~0.34, MDC% 0.86~0.94. The test-retest intra-rater reliability showed very high reliability ICC 0.994(0.991~0.996), CVME% 0.71%, SEM% 0.31~0.43, MDC% 0.86~1.19%. The test-retest inter-rater showed very high reliability ICC 0.995(0.992~0.997), CVME% 0.71%, SEM% 0.43~0.59%, MDC% 1.20~1.62% Conclusions: Angles video goniometer', a smartphone application, is a device with very high reliability and validity for craniovertebral angle measurement in healthy adults, and it is a device that can be easily used in clinical practice.
Kyung Suk Lee;Jae Bong Shin;Jun Sik Kim;Gi Cheol Do;Min Hyung Kim;Nam Gyun Kim
Korean Journal of Head & Neck Oncology
/
v.39
no.1
/
pp.19-21
/
2023
Lipomas are a common soft-tissue tumor of mesenchymal origin, but intermuscular lipomas are very infrequently found especially in the cervical region. Although lipoma itself rarely causes complications, an accurate diagnosis and appropriate treatment are important. Surgical excision is indicated for deep lipomas that are 5 cm or larger, grow, or are accompanied by symptoms such as pain. It is also important to differentiate malignant tumors through pathological examination. Since the size of the lipoma was large, lipoma was divided into several pieces to successful removal, and the patient in this case showed successful recovery after surgery.
Park, Yung;Ha, Joong Won;Kie, Jeong Hae;Hong, Seung-Pyo
Journal of the Korean Orthopaedic Association
/
v.54
no.6
/
pp.562-566
/
2019
Osteochondroma is a common benign bone tumor, but relatively rare in the spine. Spinal osteochondroma originates mainly from the posterior column and sometimes invades the spinal canal causing cord compression and myelopathy. A 36-year-old man was admitted to the authors' institution with a two-year history of neck pain. A radiology examination revealed osteochondroma, arising from the left superior articular process of the T1 vertebra with significant central canal narrowing. Most cases of the spinal osteochondroma originate in the cervical vertebra, but there are few reports of an origin of the cervicothoracic junction. This paper reports a case of osteochondroma at the cervicothoracic junction with a review of the relevant literature.
The Journal of the Korean bone and joint tumor society
/
v.15
no.2
/
pp.138-145
/
2009
Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.
Objectives : The purpose of this survey is the development on the neck pain for acupuncture and moxibustion clinical guideline. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results and Conclusions : 1. The first selected pattern identification on the neck pain This study shows that the meridian pattern identification was selected 35 times(61.4%), the pattern identification based on cause of disease was selected 8 times(14.0%), the visceral pattern identification was selected 7 times(12.3%), the other pattern identification was selected 4 times(7.0%), Qi blood yin yang pattern identification was selected 2 times(3.5%), according to symptoms was selected 1 time(2.4%). 2. Meridian pattern identification Small intestine meridian of hand Taeyang was used 39 times(18.1%), Large intestine meridian of hand Yangmyeong and Bladder meridian of foot Taeyang was used 34 times(15.7%), Gall-bladder meridian of foot Soyang was 32 times(14.8%), Tripple energizer meridian of hand Soyang was used 31 times(14.4%), Governor meridian was used 30 times(13.9%), Lung meridian of hand Taeeum was used 8 times(3.7%), Heart meridian of hand Soeum and Pericarduim meridian of hand Gworeum was used 4 times(1.9%). 3. Pattern identification based on cause of disease Wind-Cold-Dampness was used 31 times(17.5%), Accumulation of the collateral by Phelgm-Dampness was used 16 times(14.0%), affection by exopathogen Wind-Cold(stiff neck, sprain of cervical) was used 13 times (11.4%), Defecient-Cold was used 10 times(8.8%), affection by exopathogen Wind-Dampness was used 9 times(7.9%), Deep Invasion by Wind-Cold was used 8 times(7.0%), Wind-Cold was used 7 times (6.1%), Wind-Cold was used 6 times(5.3%), Accumulation in the Center by Phelgm-Dampness, Imparement of bou fluid by Pathogenic Heat, Wind-Heat with Dampness was used 5 times(4.4%), affection by exopathogen Wind-Dampness and Accumulation of the collateral by Wind-Cold was used 4 times(3.5%), Invasion of Dampness-Heat was used 2 times(1.8%). 4. Visceral pattern identification Rising of the Liver yang was used 16 times(41%), Yin deficiency of Liver and Kidney+pathogens was used 15 times(38.5%), Yin deficiency of Liver and Kidney was used 8 times(20.5%) on this survey.
Ruggeri, Joao Batista;Agnolo, Catia Millene Dell;Gravena, Angela Andreia Franca;Demitto, Marcela de Oliveira;Lopes, Tiara Cristina Romeiro;Delatorre, Silvana;Carvalho, Maria Dalva de Barros;Consolaro, Marcia Edilaine Lopes;Pelloso, Sandra Marisa
Asian Pacific Journal of Cancer Prevention
/
v.16
no.15
/
pp.6521-6526
/
2015
Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.
From December 1991 to March 1992, 34 anejacuratory patients with spinal cord injury underwent 90 of electric stimulations with Seager NRH model 12. The average patient age was 43.5 years with a range of 23 to 48 years. The level of cord injury was cervical in 7, thoracic in 6, lumbar in 11, lumbosacral in 7 and conus medullaris in 3. The average number of electric stimulation per a patient was 2.65 with a range of 1 to 4. The average voltage and amplitude per a stimulation were 17.72 volts and 309. 89 mAmp with ranges of 5 to 25 volts and 50 to 500 mAmp. The total and motile sperm number were evaluated microscopically and analyzed statistically by paired t-test according to the frequency of electroejaculation, level of cord injury and voiding pattern. The results were obtained as follows. 1. An overall success rate of electroejaculation was 85.3% among 34 patients and 82.2% among 90 electric stimulations. 2. The total and motile sperm number per a stimulation were not correlated the frequency of electric stimulation, level of cord injury and voiding pattern. 3. Complications occured in 10 cases; severe low abdominal pain in 5, hypertension in 2, sweating in 1, headache in 1 and neck stiffness in 1. All the copmlications subsided spontaneously within 5 to 10 minutes after transient interruption of the electric stimulation. In summary, rectal probe electroejaculation is an accepted safe means of procuring sperm from spinal cord injury patients with ejaculatory incompetence. However very poor sperm motility was found and it was not related with the frequency of electroejaculation, level of cord injury and voiding pattern. Further investigation would be needed to conclude and to identify the reasons for impaired sperm motility.
Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.
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