• 제목/요약/키워드: minimal disc

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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제38권2호
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

Radiographic Comparison of Four Anterior Fusion Methods in Two Level Cervical Disc Diseases : Autograft Plate Fixation versus Cage Plate Fixation versus Stand-Alone Cage Fusion versus Corpectomy and Plate Fixation

  • Kim, Min-Ki;Kim, Sung-Min;Jeon, Kwang-Mo;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.135-140
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    • 2012
  • Objective : To evaluate radiographic results of anterior fusion methods in two-level cervical disc disease : tricortical autograft and plate fixation (ACDF-AP), cage and plate fixation (ACDF-CP), stand-alone cage (ACDF-CA), and corpectomy and plate fixation (ACCF). Methods: The numbers of patients were 70 with a minimum 6 month follow-up (ACDF-AP : 12, ACDF-CP : 27, ACDF-CA : 15, and ACCF : 16). Dynamic simple X-ray and computed tomography were evaluated preoperatively, postoperatively, 6 month, and at the final follow-up. The fusion and subsidence rates at the final were determined, and global cervical lordosis (GCL), cervical range of motion, fused segment angle (FSA), and fused segment height (FSH) were analyzed. Results: Nonunion was observed in 4 (25%) patients with ACDF-CA, 1 (8%) patient with ACDF-AP, 1 (4%) patient with ACDF-CP. The number of loss of FSH (%) more than 3 mm were 2 patients (16%) in ACDF-AP, 3 patients (11%) in ACDF-CP, 5 patients (33%) in ACDF-CA, and 3 patients (20%) in ACCF. The GCL was decreased with ACDF-CA and increased with others. The FSA was increased with ACDF-AP, ACDF-CP, and ACCF, but ACDF-CA was decreased. At the final follow-up, the FSH was slightly decreased in ACDF-CP, ACDF-AP, and ACCF, but ACDF-CA was more decreased. Graft related complication were minimal. Screw loosening, plate fracture, cage subsidence and migration were not identified. Conclusion: ACDF-CP demonstrated a higher fusion rate and less minimal FSH loss than the other fusions in two-level cervical disc disease. The ACDF-AP and ACCF methods had a better outcome than the ACDF-CA with respect to GCL, FSA, and FSH.

Role of Matrix Metalloproteinases in Degenerative Lumbar Disc; Molecular and Immunohistochemical Study

  • Ryu, Kyeong-Sik;Cho, Sung-Jin;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.363-368
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    • 2006
  • Objective : Little is known about the comprehensive molecular and biological mechanism on the development of the degeneration of the intervertebral disc. Many kinds of matrix metalloproteinase[MMP] initiate the degradation of the extracellular matrix including several kinds of collagens and proteoglycans. We compared molecular and immunohistochemical features of degenerated intervertebral disc and normal counterparts in order to investigate the role of MMP-1, 2, 3, 9. Methods : We have evaluated MMP-1, 2, 3, 9 expression in 30 surgically resected lumbar disc from degenerative disc disease patients and 5 normal control cases. RT-PCR[reverse transcriptase-polymerase chain reaction] and immunohistochemistry were performed. Results : By RT-PCR, normal tissue samples showed merely scant expression of MMP-1, 2, 3, 9 mRNA, but degenerated disc samples revealed more pronounced expression. mRNA amplifications were detected in 60%, 63.3%, 70%, 53.3% cases By immunohistochemistry, normal tissue samples showed minimal protein expression of MMP-1, 2, 3, 9, but degenerated disc samples revealed more pronounced expression. Protein expressions were detected in 73.3%, 63.3%, 76.7%, 63.3% cases. Both the mRNA amplification and protein overexpression rates were significantly higher in degenerated disc than in the normal tissue. Concordance between both the mRNA amplification and protein expressions of MMP-1, 3, 9 were not observed, but there is well correlation in MMP-2 expression. Conclusion : We concluded that the over-expressions of the MMP-1, 2, 3, 9 may contribute to the development of degeneration of the intervertebral disc.

측두하악관절 자기공명영상에서의 삼출에 관한 연구 (Effusion in magnetic resonance imaging of the temporomandibular joint)

  • 나경수
    • Imaging Science in Dentistry
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    • 제33권1호
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    • pp.1-4
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    • 2003
  • Purpose : The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. Materials and Methods: On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Results: Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1 %) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Conclusion: Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

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조릿대 잎 분획 추출물의 식중독균에 대한 항균활성 (Antimicrobial Activity of Bamboo (Sasa borealis) Leaves Fraction Extracts against Food Poisoning Bacteria)

  • 박연옥;임현숙
    • 한국식품영양과학회지
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    • 제39권12호
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    • pp.1745-1752
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    • 2010
  • 본 연구에서는 조릿대 잎의 70% ethanol 조추출물과 이의 분획추출물 5종이 식품부패균과 식중독균 7종에 대해 나타내는 항균활성과 최소저해농도 및 생육억제효과를 수행하였다. 70% ethanol 조추출물과 분획추출물 모두 1% 농도에서는 항균활성을 보이지 않았으나 5% 농도에서는 aqueous분획을 제외하고 대부분의 균주에 대해 항균활성이 나타났다. 즉 70% ethanol 추출물과 chloroform과 ethyl acetate 및 n-butanol 분획은 본 연구에서 실험한 7종의 모든 균에 대해 항균활성을 보였으며, 특히 chloroform 분획은 5종의 균에 대해, ethyl acetate 분획은 3종의 균에 대해 그리고 70% ethanol 추출물은 1종에 대해서 높은 항균활성을 보였다. 반면에 n-hexane 분획은 M. luteus와 B. subtilis 2종의 균에 대해서만 강한 항균활성을 나타냈다. 이들 조릿대 잎 추출물이 항균작용을 나타낸 최소저해농도는 70% ethanol 추출물은 S. aureus를 제외한 6종의 균에 대해 $50{\mu}L$/disc이었고, n-hexane 분획은 항균활성을 나타낸 M. luteus와 B. subtilis에 대해서만 $100{\mu}L$/disc의 최소저해농도를 보였으며, chloroform 분획은 3종의 균에 대해서는 $35{\mu}L$/disc의 낮은 최소저해농도를 보였고 나머지 4종에 대해서는 $50{\mu}L$/disc이었으며, ethyl acetate 분획은 7종 모든 균에 대해 $50{\mu}L$/disc가 최소저해농도이었다. 한편 n-butanol 분획은 S. aureus에 대해서는 $35{\mu}L$/disc가 그리고 나머지 6종에서는 $50{\mu}L$/disc가 최소저해농도이었다. 항균활성이 보이지 않았던 aqueous 분획은 S. aureus와 L. monocytogens에 대해 $200{\mu}L$/disc의 최소저해농도를 나타내었다. Ethyl acetate 분획의 생육저해효과는 0.1% 처리 시에는 2종의 균만 생육을 8시간 이상 저해하였고, 0.25% 처리는 2종에 대해서는 8시간까지 그리고 5종의 균에 대해서는 12시간까지 생육을 저해하였으며, 0.5% 처리는 7종 모든 균의 생육을 24시간까지 저해하였다. 이러한 생육저해효과는 용매로 사용된 70% ethanol의 기여도 있었지만 ethyl acetate 분획추출물에 함유된 항균물질의 작용임이 확인되었다. 결론적으로 본 연구 결과는 조릿대 잎이 천연 항균 소재로서의 활용 가능성이 있음을 확인해주었다.

대나무 기름의 항균효과 (Antimicrobial Activity of Bamboo(Phyllostachys bambusoides) Essential Oil)

  • 이숙경
    • 한국식품위생안전성학회지
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    • 제15권1호
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    • pp.55-59
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    • 2000
  • Bamboo oil의 천연 보존료로서의 가치를 평가하기 위해 합성 보존료인 BHA와 이미 수입되어 사용되고 있는 천연보존료인 tea tree oil을 비교하기 위하여 disc diffusion법과 broth dilution 법으로 S. aureus와 E. coli대한 항균력을 검토한 결과를 요약하면 다음과 같다. 1. Disc diffusion법으로 S. aureus에 대한 항균력을 조사한 결과 BHA>tea tree oil>bamboo oil 순이었고 E. coli에 대한 항균력은 bamboo oil이 가장 강하게 나타났으며 다음은 BHA>tea tree oil순으로 나타났다. 2. Broth dilution법으로 S. aureus와 E. coli모든 시료 6.0$\mu$l/ ml 이상에서 모두 측정되지 않아 모든 시료에서 동일하게 최소억제농도가 6.0$\mu$l/ ml 이상 필요한 것으로 나타났다. 3. Bamboo oil의 이용 개발 시 경제적 조건은 동일한 항균력을 기대할 때 tea tree oil에 비하여 약 20%정도 저렴하여 경제성이 충분히 있는 것으로 나타났다.

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목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료 (Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy)

  • 노학재;이상헌;김병조
    • Annals of Clinical Neurophysiology
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    • 제10권2호
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    • pp.83-97
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    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

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THE LOCATION FOR EIGENVALUES OF COMPLEX MATRICES BY A NUMERICAL METHOD

  • Wu, Junliang;Zhang, Pingping;Wang, Yong
    • Journal of applied mathematics & informatics
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    • 제29권1_2호
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    • pp.49-53
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    • 2011
  • In this paper, we adopt a numerical method to establish the smallest set to contain all Ger$\v{s}$gorin discs of a given complex matrix and its some similar matrices. With the smallest set, a new estimation for all eigenvalues of the matrix is obtained.

Posterior Microscopic Lesionectomy for Lumbar Disc Herniation with Tubular Retraction Using $METRx^{TM}$ System

  • Choi, Yu-Yeol;Yoon, Seung-Hwan;Ha, Yoon;Kim, Eun-Young;Park, Hyung-Chun;Park, Chong-Oon
    • Journal of Korean Neurosurgical Society
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    • 제40권6호
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    • pp.406-411
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    • 2006
  • Objective : The authors have developed a procedure, termed posterior microscopic lesionectomy, that creates a minimal laminotomy site according to the location of the shifted disc using the $METRx^{TM}$ system in the lumbar spine. This study compared the usefulness and surgical outcomes of this procedure with those of traditional standard lumbar discectomy. Methods : From June 2003 to June 2004, Twenty-two patients with one-level radiculopathy due to lumbar disc herniation underwent posterior microscopic lesionectomy with the assistance of an operating microscope and the $METRx^{TM}$ tubular retractor. Surgical results of the new procedure were compared to those of 39 patients who underwent traditional lumbar discectomy from April 2003 to September 2004. All patients were evaluated for pain score, clinical assessment according to the VAS, and Roland-Morris scores pre-operatively and at 1, 3, 6, and 12 months post-operatively. Results : Mean blood loss, operation time, and admission date showed significant improvements for microscopic lesionectomy compared to traditional lumbar discectomy [P < 0.001]. Also, both measures of short-term functional improvement, the Visual Analogue Scale[VAS] and Roland-Morris[RM] scores, were statistically better for microscopic lesionectomy than for traditional discectomy [P < 0.001]. Conclusion : Posterior microscopic lesionectomy can be performed more safely and provide greater benefit than traditional discectomy. The procedure is associated with less post-operative pain, shorter hospital stays, and quicker rehabilitation.