• Radiation Oncology Journal
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• 제16권4호
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• pp.497-504
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• 1998

목적 : matrix ion chamber type의 EPID와 video camera based EPID를 이용한 portal image와 기존의 film을 이용한 port film의 영상의 질을 객관적으로 비교 평가하여 EPID의 유용성을 알아보고자 본 연구를 계획하였다. 대상 및 방법 : 1997년 4월부터 10월까지의 인하대 병원과 세브란스 병원에서 방사선 치료를 받은 골반강내 치료 환자 각 10명씩을 대상으로 환자 1명 당 5-10회의 port film과 EPID를 이용한 portal image를 동시에 얻어 비교하였다. 환자의 나이는 32세에서 79세이었고 2명의 AP영상을 제외하고는 모두 PA영상을 얻었다. 환자의 두께는 17cm에서 20cm으로 비교적 균일하였다. beam energy는 10MV X-ray를 사용하였고 dose rate은 100-300MU/min으로 2-10MU을 주어 영상을 얻었다. port film은 Kodak diagnostic film을 사용하였고 film을 넣는 cassette는 납을 전후에 부착한 것을 이용하였다. source to detector(film) distance는 140cm으로 하였다. 영상의 판독은 4명의 치료방사선과 의사에 의해서 시행되었으며 pelvic brim, sacrum, acetabulum, iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint를 각각 very clear(1), clear(2), visible(3), not clear(4), not visible(5) 다섯 단계로 나누어 점수를 주었다. 결과 : video camera based EPID를 이용하여 얻은 영상을 비교하여 보았을 때 film을 이용한 port film과 enhancement를 시행하지 않은 portal image는 각 해부학적 구조에서는 차이를 보이지 않았다. 그러나 portal image를 window level로 영상의 변화를 주었을 때는 sacrum과 obturator는 영상의 판독에 도움이 되었다. 또한 portal image를 CLAHE로 enhance를 하였을 때는 모든 해부학적 구조물의 판독이 film보다 용이한 것으로 나타났다. matrix ion chamber type의 EPID를 이용하여 얻은 영상에서도 역시 port film과 영상의 변화를 주지 않은 portal image간에는 커다란 차이를 보이지 않았으나, portal image를 window level로 변화를 주었을 경우는 portal film에 비하여 영상의 질이 더욱 좋아지을 알 수 있었다. 결론 : 방사선 치료를 받는 환자 중에서 골반강의 영상에서는 EPID의 영상의 질은 기존의 port film과 비교하여 차이가 없었으며, window level로 영상에 변화를 주거나 enhance를 하였을 경우는 port film보다 더 나은 영상을 얻을 수 있어 기존의 port film을 대체 할 수 있을 것으로 생각된다.

• 대한골관절종양학회지
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• 제1권1호
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• pp.1-6
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• 1995

Giant cell tumors are primary bone tumors originating from non-osteoblastic connective tissue. The sites of involvement were commonly distal femur, proximal tibia, proximal humerus, distal radius and others (including os calcis, ilium and sacrum). Giant cell tumor located around knee joint has been difficult to treat because of local recurrence following curettage with or without bone graft. Although primary resections reduce recurrence of the lesion, the joint function will be markedly impaired. Marginal excision was very often complicated by a loss of joint integrity since all the giant cell tumors occupy juxtaarticular positions. Techniques involving physical adjuncts(high speed burr and electric cauterization) have been used in the hope of decreasing the rate of local recurrence and avoiding the morbidity of primary resection. A meticulous clinical, radiological and histological evaluation is needed to choose the correct treatment, keeping in mind the possibility of recurrence after each treatment modality.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.107-110
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• 2006

Malignancy in a chronic pressure sore is rare among Marjolin's ulcers. Carcinomas arising in pressure sores are highly aggressive and usually fatal. Although carcinomas in pressure sores are generally well-differentiated squamous carcinomas, they can show quite an aggressive course and do not respond either to chemotherapy or radiotherapy. The mortality rate is high despite wide surgical resection. Extensive surgical excisions with wide surgical margins are necessary and elective lymph node dissection should be considered for optimal therapy. We report a squamous carcinoma arising in a pressure sore. The related literature was reviewed.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.537-539
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• 2013

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.

• The Korean Journal of Pain
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• 제11권1호
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• pp.134-137
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• 1998

The presence of an enlarged transverse process on one or both sides of the last lumbar vertebra is a common congenital anomaly of the lumbar vertebra. It is thought to be a genetic or developmental anatomical variant. The first reported assimilation of the fifth lumbar vertebra into the sacrum associated with low back pain was in 1917 by Bertolotti. However, clinical significance of lumbosacral transitional vertebra has not been fully considered due to lack of scientific investigations dealing with it. We experienced a case of symptomatic lumbosacral transitional vertebra during management of low back pain. Low back pain was relieved after infiltration of local anesthetics and steroid into the false joint of lumbosacral transitional vertebra. This result may possibly indicate a significant correlation between low back pain and lumbosacral transitional vertebra.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.105-108
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• 2012

Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was completely removed, with intraoperative neurophysiologic monitoring. Histopathologic examination showed that the tumor was a schwannoma. The patient's postoperative course was uneventful, with urinary function and numbness gradually improving. Although a giant schwannoma accompanied by dystrophic calcification is extremely rare, such a tumor can be removed safely and completely by meticulous dissection and careful neuromonitoring of the cauda equina spinal nerves involved in the tumor.

• Radiation Oncology Journal
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• 제17권1호
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• pp.52-56
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• 1999

척삭종은 notochordal remants에서 발생하는 비교적 드문 질환으로 천미골에서 약 50$\%$정도 발생한다. 이들은 주위 조직으로 깊숙히 침윤하여 마비증세를 일으키며 수술에 의한 완전절제가 어려워 국소재발을 겪게 된다. 천미골에서 발생하는 척삭종은 이와 같은 국소재발 외에 원격전이가 잘 발생하는 것으로 알려져 있으며 본 저자 역시 유사한 2예를 경험하였기에 이에 대한 문헌고찰과 함께 보고하고자 한다.

• 척추신경추나의학회지
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• 제15권1호
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• pp.115-119
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• 2020

Objectives : This study aimed to introduce a new sacral lumbar joint distraction technique in the prone position in Chuna manual therapy for effective lumbar distraction. Methods : The patient was placed in the prone position. Next, clinicians contacted the sacrum and L1, L2, L3, L4 and L5 spinal processes. Then they were pulled in the direction of the head and leg respectively while pressing down with 30% force to maintain the lumbar lordosis. This is a more effective and safer lumbar distraction technique according to the latest knowledge. Conclusions : This technique can be used for lumbar disc herniation in addition to relaxing the existing lumbar muscles, and is suggested to be used as a safe and effective Chuna manual therapy.

• Archives of Reconstructive Microsurgery
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• 제23권1호
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• pp.25-28
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• 2014

One of the most frequently used flaps for coverage of sacral skin and soft-tissue defects is the gluteus maximus musculocutaneous flap. These authors encountered two cases of sacral pressure sore, for which reconstructive surgery was performed, using the hatchet-shaped gluteus maximus musculocutaneous flap - a modified flap type. We report on our experience in treatment of these two cases, with an excellent outcome.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.166-169
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• 2008

Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.