• Title/Summary/Keyword: spine

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Bone Metastasis after a Curative Resection for Gastric Cancer (위암의 근치적 절제술 후 발생한 골 전이)

  • Kim Jin Jo;Song Kyo Young;Chin Hyung Min;Kim Wook;Chun Hae Myung;Park Cho Hyun;Park Seung Man;Park Woo Bae;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.23-28
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    • 2005
  • Purpose: Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer. Materials and Methods: Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed. Results: Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was $53\pm12$ years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients ($55.2\%$). The median survival time after recurrence of the patients who received treatment was seven (7) months ($0\∼75$ months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388). Conclusion: Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.

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ULTRASTRUCTURAL ANALYSIS OF TOOTH PULP AFFERENTS TERMINALS IN THE MEDULLARY DORSAL HORN OF THE RAT (치수유래 구심성 신경섬유의 삼차신경 감각핵군에서의 연접특성)

  • Bae, Yong-Chul;Lee, Eun-Hee;Choy, Min-Ki;Hong, Su-Hyung;Kim, Hyun-Jung;Na, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.219-227
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    • 2001
  • Little is known about processing mechanism of pain sensation of the oral cavity at the 1st synapse of trigeminal sensory nuclei. Serial ultrathin sections of tooth pulp afferent terminals, identified by the transganglionic transport of 1% wheatgerm agglutinin conjugated horseradish peroxidase, were investigated with electron microscope. Quantitative ultrastructural analysis was performed on digitizing tablet connected to Macintoshi personal computer (software; NIH Image 1.60, NIH, Bethesda, MD). Labeled boutons could be classified into two types by the shapes of containing vesicles : S bouton, which contained mainly spherical vesicles (Dia. 45-55 nm) and few large dense cored vesicles (Dia, 80-120nm), and LDCV bouton, which contained spherical vesicles as well as large number of large dense cored vesicles. Most of the parameters on the ultrastructural characteristic and synaptic organization of labeled boutons were similar between S and LDCV boutons, except shapes of containing vesicles. Majority of the labeled boutons showed simple synaptic arrangement. The labeled boutons were frequency presynaptic to dendritic spine, and to a lesser extent, dendritic shaft. They rarely synapsed with soma and adjacent proximal dendrite. A small proportion of labeled boutons made synaptic contacts with presynaptic, pleomorphic vesicles containing endings and synaptic triad. Morphometric parameters of labeled boutons including volume and surface area, total apposed area, mitochondrial volume, active zone area, vesicle number and density showed wide variation and these were not significantly different between S and LDCV boutons. The present study revealed characteristic features on ultrastructure and synaptic connection of pulpal afferents which may involved in transmission of oral pain sensation.

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The Effect of Kinesio Taping on the Change of Muscle Strength and Endurance in Trunk Flexion and Extension in Chronic Low Back Pain(CLBP) (만성요통 환자의 테이핑 적용 시체간의 굴곡과 선전의 근력과 지구력의 변화 측정)

  • Kim, Su-Hyung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.40-48
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    • 2005
  • In this study, the muscle strength and endurance of the lumbar at flexion and extension were determined using an isokinetic muscle strength meter (Biodex) in patients with chronic lumbar go (10 male and 10 females), and the changes in muscle strength and endurance of the lumbar at flexion and extension after application of Y-shaped sacrospinalis muscle taping, typically used for patient with lumbar go, were studied. In addition, the sacrospinalis muscle taping of a different shape (I-shaped taping) was applied bilaterally centering on the spine, and the muscle strength and endurance of the lumbar at flexion and extension were determined and compared with those before taping. In addition, the results after application of Y-shaped taping and I-shaped taping were also compared. 1. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio taping and after application of Y-shaped taping did not show the level of significance. 2. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and application of Y-shaped taping did not show the level of significance. The extensor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping did not show the level of significance. 3. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 4. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio taping and after application of I-shaped taping showed the level of significance. The extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 5. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $60^{\circ}$/ sec showed the level of significance (p<.05). 6. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not showed the level of significance (p<.05).

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Changes in Psoas Major and Quadriceps Cross Sectional Area in Elderly People after 12 Weeks of Exercise (고령자를 대상으로 12주간 운동이 대요근 및 대퇴부 근황단면적에 미치는 영향)

  • Tachi, Toshiki;Oguri, Kazuo;Torii, Suguru;Kobayashi, Kando;Fujii, Katsunori;Kim, Jun-Dong;Nho, Ho-Sung
    • Journal of Life Science
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    • v.21 no.1
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    • pp.1-8
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    • 2011
  • The purpose of this study was to investigate whether 12-weeks of movement training would increase the psoas major cross-sectional area (CSA) in senior men and women. Fifty eight men and women aged 65 to 80 years old ($69.6{\pm}3.7$, 30 male, 28 female) were divided into a control (n=19) and exercise group (n=39). Subjects were assessed before and after the training program for stature, body mass, and magnetic resonance imaging of the psoas major and the quadriceps muscle. The experimental group performed exercises using machines designed to improve the movement of the hip at a frequency of twice every week, with a total of 23 trainings in 12-weeks. Magnetic resonance images of both thighs and the abdomen and psoas major were obtained, aimed at 50% of the length of the greater trochanter and the lower edge of the femur and between the fourth (L4) and fifth (L5) lumbars. A 9.4% increase in the psoas major CSA in the training group was observed. In the male and female breakdown, a 11.5% and 8.4% change was observed in males and females, respectively. In the quadriceps, there was no significant statistical improvement in either males or females. Furthermore, in the control group, there was no significant change seen in either the psoas major or the quadriceps. As a result of conducting training that enables upkeep of posture and smooth linkage of the lumbar spine, the pelvis and thighbone, the psoas major CSA of older adults were improved in a short period of time. For this reason, the possibility of improving the psoas CSA, which decreases remarkably with increased age, by improving the linkage of the body trunk is also suggested.

Frequency and Causes of Life-long Labour Force Loss in Rural Population of Korea (한국농촌인구(韓國農村人口)의 종신적(終身的) 노동능력상실(勞動能力喪失) 빈도(頻度)와 원인(原因))

  • Loh, In-Kyu
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.1-10
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    • 1976
  • This study was conducted in order to observe some descriptive epidemiological findings and causes of life-long labour force loss in the rural population of Korea, and to consider, on the basis of these observations, some principles of the necessary control measures. The total number of subjects in the study was 27,172, all family members of 4,174 households. The study population was located in the 81 counties, out of a total of 138 counties, where the college students conducted service activities during the summer of 1974. In each village area where these service activities were conducted, one household per student interviewer was randomly selected. Student interviewers were instructed on the contents of the questionnaire prior to the survey. The main contents of the questionnaire form included address, name, sex and age of each family members, and present life-long labour force loss, if any, of each family member. In cases of current labour force loss, the age of onset and causes were recorded. Of the total households surveyed, 8.9% had family members (1-4 in number) with life-long labour force loss. Of the total persons surveyed, the crude prevalence rate for life-long labour force loss was 15.1 per 1,000; and the age-standardized prevalence rates for male and female were 16.3 per 1,000 and 13.4 per 1,000, respectively. The rates, in both sexes, were gradually increased as the ages were increased. The prevalence rates per 1,000, in order, for life-long labour force loss by the causes were 10.2 for senility, 2.4 for impairment of extremities, 1.2 for chronic diseases of internal organs, 0.5 for other conditions of muosculoskeletal system, 0.4 for blindness in both eyes, 0.2 for impairment of spine, 0.2 for psychoses, and 0.1 for epilepsy. Among them the causes of impairment of extremities were stroke, poliomyelitis, accidents, arthritis and injury due to war operation, in that order of higher relative frequency. The frequency ratios by age of onset were also observed by the causes and sex.

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Measurement of shoulder motion fraction and motion ratio (견관절 운동 분율의 측정)

  • Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.29 no.2
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    • pp.57-62
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    • 2006
  • Purpose : This study was to understand about the measurement of shoulder motion fraction and motion ratio. We proposed the radiological criterior of glenohumeral and scapulothoracic movement ratio. Materials and Methods : We measured the motion fraction of the glenohumeral and scapulothoracic movement using CR(computed radiological system) of arm elevation at neutral, 90 degree, full elevation. Central ray was $15^{\circ},\;19^{\circ},\;22^{\circ}$ to the cephald for the parallel scapular spine, and the tilting of torso was external oblique $40^{\circ},\;36^{\circ},\;22^{\circ}$ for perpendicular to glenohumeral surface. Healthful donor of 100 was divided 5 groups by age(20, 30, 40, 50, 60). The angle of glenohumeral motion and scapulothoracic motion could be taken from gross arm angle and radiological arm angle. We acquired 3 images at neutral, $90^{\circ}$ and full elevation position and measured radiographic angle of glenoheumeral, scapulothoracic movement respectively. Results : While the arm elevation was $90^{\circ}$, the shoulder motion fraction was 1.22(M), 1.70(W) in right arm and 1.31, 1.54 in left. In full elevation, Right arm fraction was 1.63, 1.84, and left was 1.57, 1.32. In right dominant arm(78%), $90^{\circ} and Full motion fraction was 1.58, 1.43, in left(22%) 1.82, 1.94. In generation 20, $90^{\circ} and Full motion fraction was 1.56, 1.52, 30' was 1.82, 1.43, 40' was 1.23, 1.16, 50' was 1.80, 1.28, 60' was 1.24, 1.75. There was not significantly by gender, dominant arm and age. Conclusion : The criterior of motion fraction was useful reference for clinical dignosis the shoulder instability.

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The Results of Combined Modality Treatment with Transurethral Resection, Cisplatin and Radiation Therapy for Invasive Bladder Cancer (침윤성 방광암에서 경요도적절제술 및 Cisplatin과 방사선의 병용치료의 효과)

  • Oh, Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.311-317
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    • 1991
  • Ten patients with deep muscle-invading bladder carcinoma (clinical stages T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the tumors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a, 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60$\%$ for all patients. The complete responses were achieved in 4 of 5(80$\%$) with stage cT3a, in 2 of 3(67$\%$)with stage cT3b and in none of 2(0$\%$) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80$\%$. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher grade tumors showed partial responses in 2 and no response in 2, and all died of their bladder cancer. Six patients who showed complete responses after treatment are alive and only one of them showed a local recurrence 10 months after treatment. Distant metastases developed in 3 patients: lungs in 2(cT4b) of those who were never locally free of disease and spine in 1 patient (cT3b) among those with a partial response. Two patients died of metastases to lungs. During the follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Posterior Lumbar Interbody Fusion Using Posterolateral Placement of A Single Cylindrical Threaded Cage and Two Regular Cages : A Biomechanical Study (단일 나사형 Cage를 이용한 후방 요추체간 융합술과 두개의 나사형 Cage를 이용한 PLIF의 생체 역학적 비교)

  • Park, Choon Keun;Hwang, Jang Hoe;Ji, Chul;Kwun, Sung Oh;Sung, Jae Hoon;Choi, Seung Jin;Lee, Sang Won;Kim, Moon Kyu;Park, Sung Chan;Cho, Kyeung Suok;Park, Chun Kun;Yuan, Hansen;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.883-890
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    • 2001
  • Objectives : An in vitro biomechanical study of posterior lumbar interbody fusion(PLIF) with threaded cage using two different approaches was performed on eighteen functional spinal units of bovine lumbar spines. The purpose of this study was to compare the segmental stiffnesses among PLIF with one long posterolateral cage, PLIF with one long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages. Methods : Eighteen bovine lumbar functional spinal units were divided into three groups. All specimens were tested intact and with cage insertion. Group 1(n=12) had a long threaded cage($15{\times}36mm$) inserted posterolaterally and oriented counter anterolaterally on the left side by posterior approach with left unilateral facetectomy. Group 2(n=6) had two regular length cages($15{\times}24mm$) inserted posteriorly with bilateral facetectomy. Six specimens from group 1 were then retested after unilateral facet joint screw fixation in neutral(group 3). Likewise, the other six specimens from group 1 were retested after fixation with a facet joint screw in an extended position(group 4). Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and torsion. Results : PLIF with a single cage, group 1, had a significantly higher stiffnesses than PLIF with two cages, group 2, in left and right torsion(p<0.05). Group 1 showed higher stiffness values than group 2 in pure compression, flexion, left and right bending but were not significantly different. Group 3 showed a significant increase in stiffness in comparison to group 1 for pure compression, extension, left bending and right torsion(p<0.05). For group 4, the stiffness significantly increased in comparison to group 1 for extension, flexion and right torsion(p<0.05). Although there was no significant difference between groups 3 and 4, group 4 had increased stiffness in extension, flexion, right bending and torsion. Conclusion : Posterior lumbar interbody fusion with a single long threaded cage inserted posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. In combination with a facet joint screw fixation, adequate postoperative stability can be achieved. We suggest that posterolateral insertion of a long threaded cage is biomechanically an ideal alternative to PLIF.

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Effect of High Calcium Diet on the Zinc and Copper Balance in Korean Female Adolescents (청소년기 여자에서 고칼슘 섭취가 아연과 구리 평형에 미치는 영향)

  • 최보영;남혜경;황용주;김선희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.5
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    • pp.894-899
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    • 2001
  • Intakes and excretions of zinc and copper were determined for 8 female adolescents (aged 16.4$\pm$0.5 y; body mass index 20.4$\pm$1.3kg/$m^2$; body fat 33.3$\pm$2.5%; bone mineral density of lumbar spine in L2-L4; 0.96$\pm$0.08g/$\textrm{cm}^2$) when they consumed diets basal and high in calcium for 6 days each. All subjects consumed a basal Ca diet containing 800 mg, Korean RDA level of the subjects, and a high Ca diet containing 1200mg, RDA plus 2 SDs of calcium intake. The diets provided 58% of energy intake as carbohydrate, 25% as fat, and 17% as protein. Food, urine and fecal samples were collected during the last 3 days of each feeding period and were assayed. Mean daily intakes on the basal and high calcium diets, respectively, were 6.57 and 6.37 mg for zinc and 910 and 812 $\mu\textrm{g}$for copper. Fecal excretion of copper and zinc in relation to intake was significantly greater on the high calcium than on the basal calcium diet. Hence, apparent absorption rate was significantly lowered from 98.7% on the basal calcium diet to 97.9% on the high calcium diet for zinc from 66.3% to 56.4% for copper, respectively. Urinary loss of copper was not detectable but that of zinc was 0.38mg on the basal diet and 0.47mg on the high calcium diet. Copper retention was 899$\pm$105$\mu\textrm{g}$/day on the basal calcium diet and 792$\pm$20.8$\mu\textrm{g}$/day on the high calcium diet, and zinc retention was 3.95$\pm$0.91mg/day and 3.11$\pm$0.89mg/day. Thus, copper and zinc retention was significantly decreased on the high calcium diet (p<0.05). Summarizing the results, apparent absorption and retention of zinc and copper were significantly decreased by calcium supplementation. Therefore, it is suggested that interactions among minerals should be considered in determining RDA.

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