• 제목/요약/키워드: lumbar diseases

검색결과 169건 처리시간 0.025초

고열을 동반한3개월 미만 요로 감염 영아에서 척추천자와 배뇨성 방광요도조영술의 필요성 (A Necessity for Lumbar Puncture and VCUG in Febrile UTI Infants less than 3 Months of Age)

  • 김지희;이준호
    • Childhood Kidney Diseases
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    • 제13권1호
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    • pp.33-39
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    • 2009
  • 목 적 : 3개월 미만 영아에서 요로감염(UTI)과 동반된 세균성 뇌수막염 및 방광 요관 역류(VUR)의 유병률을 확인하여 척추 천자 및 배뇨성 방광 요도 조영술(VCUG) 시행의 적용 대상 범위를 줄이고자 하였다. 방 법 : 2001년 1월에서 2008년 6월까지 고열을 주소로 입원한 3개월 미만의 영아를 대상으로 연구하였다. 이 중 UTI, 패혈증, 뇌수막염 및 UTI와 동반된 세균성 뇌수막염의 유병률을 알아보았다. UTI 영아에서 신장초음파, Technetium-99m dimercaptosuccinic acid (DMSA) 신스캔, VCUG검사 결과를 검토하여 신장초음파와 DMSA 신스캔 모두 정상인 경우를 1군, 그렇지 않는 경우를 2군으로 나누어 각각의 VUR의 유병률을 비교하였다. 또한, 1군 중 VUR이 있는 환아들의 임상 경과를 관찰하였다. 결 과: 총 1,962명의 영아 중 UTI는 620명(31.6%), 패혈증은 63명(3.2%), 세균성 뇌수막염은 8명(0.4%) 이었다. UTI환아 중 CSF천자 검사를 시행한 환자는 413명(66.6 %)이었고, 세균성 뇌수막염이 동반된 경우는 없었다. 신장초음파, DMSA신스캔, VCUG를 모두 시행한 환자는 348명(56.1%)이었다. Group 1은 110명(31.6%) 이었고, 이 중 VUR이 있는 경우는 4명(3.6%)이었으며 Group 2는 238명(68.4%)이었고, 이 중 VUR이 있는 경우는 51명(21.4%)이었다. 신장초음파 혹은 DMSA 의 이상 소견과 고도의 VUR사이에는 유의한 상관관계가 있었다. Group 1 중 VUR이 있었던 4명은 추적관찰기간 동안 대체로 양성경과를 밟았다. 결 론 : 고열을 동반한 3개월 미만의 영아들 중 입원 첫날 UTI로 진단된 경우에는 CSF천자 검사를 선택적으로 시행하는 것이 바람직하다고 사료된다. 또한, 침습적인 검사로 널리 알려진 VCUG의 시행에 대한 새로운 임상지침이 필요할 것으로 사료된다.

한방의료기관이용환자의 부작용 및 독성발생의 특성 - 2011년 한방의료이용실태조사(보건복지부)를 중심으로 - (Characteristics of Toxicity Occurring in Outpatients at Korean Medical Clinics in Korean)

  • 이기범;박영철;이선동
    • 대한한의학회지
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    • 제37권1호
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    • pp.135-150
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    • 2016
  • Research Methods: This research analyzed the data on those aged 20 and older from the Report on Korean Medicine Usage Research, which was conducted in 2011. The definitions of toxicity were defined by the presence of toxicity listed in the survey. The questions used in analysis were sex, age, household income, health insurance, medical fees, satisfaction rates on treatments, as well as the types of diseases and the presence of toxicity from treatments. The analysis was done through frequency analysis using SAS 9.2 and Fisher's Exact Test. Results: Toxicity occurred in 2.1% patients out of the 3518 studied. The types of toxicity were skin problems, such as hives and pruritus (34.7%), gastrointestinal problems (20.8%), neurological diseases (4.2%), liver(1.4%), kidney toxicity(1.4%), and others (22.2%). There were no differences in toxicity by sex, age, household income and the types of health insurances. However, toxicity were positively correlated with the increase in standard of education (p=0.0124). In addition, as treatment costs increased (p<0.0001) and satisfaction rates decreased, toxicity increased (p<0.0001). Toxicity increased in patients with low back pain (p=0.0429), hwabyung (p=0.0392), lumbar sprain (p=0.0004), correction body type (p=0.0118), growth (p=0.0045), and from motor accidents (p=0.0448). In logistic regression analysis, Toxicity were positively correlated with medical fees, and cancer treatment and negatively correlated with satisfaction rate on treatments. Conclusion: The toxicity that occurred in outpatients who used Korean medical clinics mostly happened in skin, digestive organs, nerves, livers, and kidneys toxicity. The occurrences differed by the Educational lengths, expensive costs of treatments, low satisfaction rates of the treatments, and cancer.

면류 섭취 여부에 따른 영양소 섭취와 건강지표의 관련성 - 2010 국민건강영양조사 자료를 바탕으로 - (Comparison of Nutrient Intake and Health Indices by the Intake of Noodles - Using the Korea National Health and Nutrition Examination Survey (KNHANES, 2010) -)

  • 김주현;양윤경
    • 한국식생활문화학회지
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    • 제31권4호
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    • pp.373-380
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    • 2016
  • The purpose of this study was to evaluate the nutrient intake, diversity and prevalence of diseases according to noodle consumption using data from the Korean National Health and Nutrition Examination Survey (KNHANES) of 2010. Korean adults (>20) were classified into two groups, noodle group (NG) and non-noodle group (NNG). NG was found to have higher intakes of protein, calcium, iron, sodium, potassium, and niacin. The DVS and DDS according to noodle consumption were found to be 21.76 and 3.51 for NG, and 18.56 and 3.40 for NNG, this result was thought to show that the diet of NG was more satisfactory than that of NNG in terms of dietary diversity. In the bone mass of entire subjects, NG showed higher figures in the femoral neck and lumbar spine than NNG. For bone mineral density, NG exhibited higher figures in the femoral neck, and for T-scores, the values of NG was significantly higher in the femoral neck than those of NNG. However, the prevalence of osteoporosis of NG and NNG was 11.6% and 9.5%. The prevalence of osteopenia of NG and NNG was 43.0% and 51.7%. Thus, these results showed that overall bone health of NG was better than that of NNG. Dietary balance and quality were also more satisfactory in NG. These results showed that noodle consumption may have an impact on the prevalence of chronic diseases.

Posterior Thoracic Cage Interbody Fusion Offers Solid Bone Fusion with Sagittal Alignment Preservation for Decompression and Fusion Surgery in Lower Thoracic and Thoracolumbar Spine

  • Shin, Hong Kyung;Kim, Moinay;Oh, Sun Kyu;Choi, Il;Seo, Dong Kwang;Park, Jin Hoon;Roh, Sung Woo;Jeon, Sang Ryong
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.922-932
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    • 2021
  • Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis

  • Erdogan, Sinan;Polat, Baris;Atici, Yunus;Ozyalvac, Osman Nuri;Ozturk, Cagatay
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.577-585
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    • 2019
  • Objective : Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). Methods : Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. Results : Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. Conclusion : There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

혈관질환의 수술요법 (Surgical management of vascular disease : Clinical experience of 127 vascular surgery)

  • 안혁;김용진
    • Journal of Chest Surgery
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    • 제20권2호
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    • pp.261-269
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    • 1987
  • From 1976 through 1986, authors have experienced 127 cases of peripheral vascular surgery which had been done in this department. There were 29 cases of atherosclerosis obliterances including 7 Leriche syndrome, 32 Buerger`s diseases, 25 arterial thromboembolisms, 21 vascular injuries, 2 peripheral arterial aneurysms, 2 renovascular hypertensions, 1 congenital A-V malformation, 13 varicose vein of lower extremities, and 2 Jugular venous ectasia. Cases with vena caval disease and aortic disease were excluded. The mean age of ASO and Buerger`s disease was 56.1 yrs, 33.8 yrs respectively. The male to female ratio showed marked male preponderance [27:2, and 30:2], and almost every male patient was smoker. The indication of operation was similar in both disease entities. The method of operation for ASO were bypass procedure [17], thromboendarterectomy [6], and lumbar sympathectomy [5], and for Buerger`s disease were mainly sympathectomy and few bypass procedures and amputations. Seventeen patients with ASO were followed from 3 to 75 month and overall patency rate for bypass or endarterectomy in one and two months and 2 1/2 yr were 93%, 87%, and 31% respectively. Post operatively patient`s symptoms was relieved or alleviated in almost ASO patients, and about 60% of Buerger`s disease. We concluded that in patient with ischemic limb, we must revascularized aggressively for symptomatic relief. And choice of graft for bypass procedure was to be evaluated further.

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초음파와 자기공명영상으로 발견된 족근관 주위 결절성 낭종 -증례보고- (A Ganglion Cyst around the Tarsal Tunnel Detected by Ultrasonography and MRI -A case report-)

  • 박수영;남상건;안상범;김용철;이상철
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.65-67
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    • 2009
  • Tarsal tunnel syndrome is often misdiagnosed it shares clinical features with other diseases of the lower extremity such as lumbar radiculopathy and arthritis. Failure to diagnose and treat neuropathies effectively can cause permanent neuropathic pain. We report a case of a ganglion cyst detected early using ultrasonography and MRI in a 51-year-old man who complained of rapidly aggravating pain, numbness and paresthesia on the great toe and the first metatarsal area in the sole, symptoms that resembled tarsal tunnel syndrome. Surgical treatment could be performed early with no permanent sequelae. We could also avoid repeated steroid injections or prescription medications.

방사선 조사후 골무기질 함량의 변화에 관한 실험적 연구 (An Experimental Study on the Change of Bone Mineral Metabolism After Irradiation)

  • 홍성운;임상무;장자준;이진오;강태웅
    • 대한핵의학회지
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    • 제24권2호
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    • pp.307-316
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    • 1990
  • Irradiation is widely used for the treatment of malignant diseases, and possibly cause the osteoporosis. The densitometry and bone scintigraphy are valuable when used to monitor the patients longitudinally to access the progression of osteoporosis and risk of osteoradionecrosis. To evaluate the osteoporosis after irradiation of Cobalt-60 gamma ray on the lumbar spines of New Zealand white rabbits, bone densitometry by dual photon absorptiometry and bone scintigraphy were performed weekly. The decrease of bone density began at the first week after irradiation, and were in the nadir at 4-6th week. The osteoblastic activity measured by bone scintigraphy decreased in the first week, and was in the nadir at 4-6th week. The severity of these changes were related to the radiation dose. In conclusion, the osteoporosis before the presentation of the osteoradionecrosis can be diagnosed early with the dual photon absorptionmetry and bone scintigraphy.

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통증관리 159예의 통계적 고찰 (Pain-control Experiences with 159 patients)

  • 변진관;박진우;이상영;박주열
    • The Korean Journal of Pain
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    • 제1권2호
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    • pp.207-210
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    • 1988
  • To evaluate recent trend of pain management at our pain clinic, the pain-contol experiences of 159 patients performed at the Inje Medical College Paik Hospital from May 1987 through August 1988 were analyzed statistically according to age, sex, combined diseases, techniques performed and clinical effects. The results are as follows: 1) Most of the 159 patients, including 104 males and 55 females, were in the 4th, 5th, and 6th decades of life. 2) The most common complaint of the patients was low back pain in 94 cases (59.1%) 3) The lumbar epidural block was the most frequently performed pain block (62.5%) 4) The period of the treatment generally ranged from 3 weeks to 2 months. 5) The number of patients who obtained good and excellent analgesic effects following the block was 110 (69.2%) 6) The most common complications following the pain block were pruritus (23.9%), urination difficulty (20.1 %), and nausea and vomiting (16.4 %).

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Image J를 활용한 뼈의 노화도 예측법 (Prediction of Bone Aging by Adapting Image J)

  • 정홍문;원도연;정재은
    • 대한디지털의료영상학회논문지
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    • 제14권2호
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    • pp.63-67
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    • 2012
  • Calcium density in human bones decreases as people are getting older due to the interior or exterior environmental factors. Bone aging forms osteoporosis. And this can bring out various spine fractures which develops a complications. Thus the prediction of seniliy is one of the important factors in spine diseases. Once spine aged, diverse fractures occur such as compression fracture and micro fracture. Side images of the spine by the digital radiography (DR) were prepared, and pixel arbitrary unit with Image J was measured from one spot in the lumbar bone part. By calculating pixel arbitrary unit of the simple contrast, it was obtained that the value of pixel arbitrary unit decreased as seniliy of bones increased. By simply applying Image J to the seniliy of patient's spine, the seniliy of bones predicts the level of danger with only digital radiography(2D) image. consequently we show that Image J value of pixel arbitrary unit index for predicts the level of precaution of osteoporosis patient.

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