Entire spine검사 시 Added filter종류에 따른 선량 및 화질평가에 대한 연구

김희연(Hee-Yeon Kim),최성현(Sung-Hyun Choi),강수홍(Soo-Hong Kang),이익표(YIk-Pyo Lee),이래곤(Rae-Gon Lee) 대한영상의학기술학회 2018 대한영상의학기술학회 논문지 Vol.2018 No.1

목 적:본 연구에서는 Entire spine검사 시 환자의 피폭선량을 줄이면서 진단에 적절한 영상을 얻을 수 있는 부가 여과판을 제시해 보고자 한다. 대상 및 방법:X선 장비로는 philips diagnost TH와 CT whole body Phantom (PBU-60)을 사용하였다. C-spine (81 kVp, 25 mAs), T-spine (85 kVp, 40mAs), L-Sspine (90 kVp, 40 mAs) 세 부분으로 나누어 부가 여과판(None, 0.1 mmCu+1 Al, 0.2 mmCu+1Al, 2 mmAl)종류에 따라 VICTOREEN NERO mAx 8000과 PCXMC program을 이용하여 입사표면선량 (Entrance surface Dose;ESD)과 각 장기 별, 전체 유효선량값을 구하였다. None Filter를 기준으로 부가 여과판 종류에 따른 영상을 획득하여 화질 평가를 위해 Image J Versing 1.45f를 이용하여 SNR (Signal to Noise Raio), PSNR (Peak Signal to Noise Ratio)등 을 측정하여 결과값을 비교하였다. 결 과:선량평가에서 C-spine의 ESD값은 1.11, 0.476, 0.361, 0.51 mGy (p<0.005)가 나타났고, 유효선량은 0.05, 0.041, 0.036, 0.035 mSv가 나타났다. T-spine 의 ESD값은 1.925, 0.957, 0.7, 0.958 mGy가 나타났고, 유효선량은 0.487, 0.286, 0.241, 0.227 mSv가 나타났으며, L-S spine의 ESD값은 2.056, 1.102, 0.812, 1.096 mGy이고, 유효선량은 0.33, 0.218, 0.193, 0.162 mSv가 나타나 부가 여과판에 따른 값이 달라지는 것을 알 수 있었다. 화질평가에서 None Filter 사용 영상을 기준으로 각 부가 여과판 변화에 따른 SNR 값은 22.36, 24.16, 27.7이 나타났고, PSNR값은 28.84, 30.64, 34.18 dB로 나타났다. 결 론:Entire spine 검사 시 영상의 질적 차이를 구분해 내기 어렵고 피폭선량을 가장 많이 줄일 수 있는 부가 여과판인 2 mmAl Filter의 사용을 권장한다. Purpose:In this study, we propose an additional filter plate for obtaining a proper image for diagnosis by giving a low dose to the patient during Entire spine examination. Materials and Methods:Philips diagnost TH and CT whole body Phantom (PBU-60) were used as X-ray equipment. (None, 0.1 mmCu + 1 Al, 0.2 mmCu + 1 Al, 2 mmAl) was prepared by dividing into three parts: C-spine (81 kVp, 25 mAs), T- spine (85 kVp, 40 mAs) L-S spine (90 kVp, 40 mAs) the ESD values of incident surface dose and the effective dose values of each organ were obtained using VICTOREEN NERO mAx 8000 and PCXMC program. We obtained Image according to the type of added filter plate based on None Filter and measured SNR (Signal to Noise Raio) and PSNR (Peak Signal to Noise Ratio) using Image J Versing 1.45f for image quality evaluation. Result:In the dose assessment, the ESD values of C-spine were 1.11, 0.476, 0.361, 0.51 mGy (p <0.005) and the effective dose was 0.05, 0.041, 0.036 and 0.035 mSv. The ESD values of T-spine were 1.925, 0.957, 0.7 and 0.958 mGy, and the effective doses were 0.487, 0.286, 0.241 and 0.227 mSv. The ESD values of L-S spine were 2.056, 1.102, 0.812 and 1.096 mGy , And the effective dose was 0.33, 0.218, 0.193, and 0.162 mSv. In the image quality evaluation, SNR values according to the variation of each added filter plate were 22.36, 24.16, 27.7 and 28.84, 30.64 and 34.18 dB. Conclusion:It is recommended to use the 2 mmAl filter, which is the added filter plate that reduce the quality difference of the image during entire spine examination and reduce the exposure dose.

Coexisting Spine Lesions on Whole Spine T2 Sagittal MRI in Evaluating Spinal Degenerative Disease

Jae Hong Ha,Ji-Ho Lee,Jae Hyup Lee 대한의학회 2021 Journal of Korean medical science Vol.36 No.7

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine. Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings. Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine. Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients. Conclusion: Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.

Conservation and diversity of genes expressed in the spines of the sea urchin

Guang August,Pieplow Cosmo,Wessel Gary M. 한국유전학회 2026 Genes & Genomics Vol.48 No.2

Background Echinoids, known as sea urchins, are a benthic family of marine invertebrates named for their spiny projections. Echinodermata translates from Greek to “Spiny Skin,” yet in the laboratory setting, it is the embryos, not the spines, of these animals that are subjected to a wealth of molecular analyses. Objective In this study, we test the identity of genes expressed in the spines and identify conservation between four distant species. Methods We generated several transcriptomes de novo from four selected sea urchin species with a great diversity in size, color, and shape, representing 255 MYA of evolution (Strongylocentrotus purpuratus, Hemicentrotus pulcherrimus, Lytechinus variegatus, Eucidaris tribuloides). From de novo spine transcriptomes, we test for orthologous gene families, generating a wealth of orthogroups, as well as a species tree constructed from the available transcripts of only the spine. Results Core families of transcripts shared between all species, reveal that pathways involved in cell surface antigen-recognition, protein turnover, and cytoskeletal structure are each shared by diverse species of Echinoids. A basal branching species, Eucidaris tribuloides, contained a large number of unique transcripts, reflecting its unique spine morphology. When the spine transcriptome from Lytechinus variegatus was depleted of transcripts expressed elsewhere from the adult sea urchin, the resulting enriched spine transcriptomes were used for Orthofinder analysis, DEG analysis, and GO pathway analysis. Conclusion Regardless of species, the spines are an organ with an abundance of gene expression for sensory, structural, and defense functions, well attuned to its habitat in the benthos. Background Echinoids, known as sea urchins, are a benthic family of marine invertebrates named for their spiny projections. Echinodermata translates from Greek to “Spiny Skin,” yet in the laboratory setting, it is the embryos, not the spines, of these animals that are subjected to a wealth of molecular analyses. Objective In this study, we test the identity of genes expressed in the spines and identify conservation between four distant species. Methods We generated several transcriptomes de novo from four selected sea urchin species with a great diversity in size, color, and shape, representing 255 MYA of evolution (Strongylocentrotus purpuratus, Hemicentrotus pulcherrimus, Lytechinus variegatus, Eucidaris tribuloides). From de novo spine transcriptomes, we test for orthologous gene families, generating a wealth of orthogroups, as well as a species tree constructed from the available transcripts of only the spine. Results Core families of transcripts shared between all species, reveal that pathways involved in cell surface antigen-recognition, protein turnover, and cytoskeletal structure are each shared by diverse species of Echinoids. A basal branching species, Eucidaris tribuloides, contained a large number of unique transcripts, reflecting its unique spine morphology. When the spine transcriptome from Lytechinus variegatus was depleted of transcripts expressed elsewhere from the adult sea urchin, the resulting enriched spine transcriptomes were used for Orthofinder analysis, DEG analysis, and GO pathway analysis. Conclusion Regardless of species, the spines are an organ with an abundance of gene expression for sensory, structural, and defense functions, well attuned to its habitat in the benthos.

Development of Ergonomic Backrest for Office Chairs

Chang Yong Kim,Gyung Yong Song,Yeon Sik Jang,Hyo Eun Ko,Hee Dong Kim,Gemus Park,Jung Bo Hwang,Hwa Shik Jung 대한인간공학회 2015 대한인간공학회지 Vol.34 No.2

Objective: This study aims to develop and scientifically investigate the efficacy of the Spine S-curve Reactive Backrest that responds to the spine curvature of the user when seated, and maintains and enhances the natural S-curve of the lower back, thereby helping to relieve fatigue, correct posture and prevent spine deformities. Background: The focus of current development, design guidelines and/or standards for office chairs is mainly placed on the chair"s dimensions, incline angle, adjusting features and lumbar support. Research and development was called for developing a chair backrest that maintains and improves the S-curve of the full spine. Method: The Spine S-curve Reactive Backrest was ergonomically designed to maintain correct posture and enhance user comfort. When leaned on, the backrest responds to the user"s spine line and the whole lower back sits closely against the backrest, thereby aligning the user"s lower back and backrest as one to maintain and improve the natural S-curve formation of the spine. In order to evaluate the efficacy of the newly designed chair (new design) and the comparison target (chair), five male college students of standard body type with normal spine curvature were selected as test subjects, and a motion analyzer and electromyography were utilized to measure Scurve and erector spinae muscle activity when seated. Results: The spine S-curve was better maintained and improved when sitting in the new design than in the comparison chair. Particularly notable was the greater displacement gap of the thoracic spine than the cervical spine, and also that of the lumbar more than the thoracic spine, with the increase of the backrest tilting angle. Furthermore, the electromyogram results showed the new design caused a lower fatigue level of the erector spinae muscles compared to the comparison chair, and also earned a higher preference in the subjective opinion results. Conclusion: The newly designed chair in this study responds to the user"s spine curvature and maintains and enhances the lower back"s natural S-curve, and thereby relieves fatigue, promotes better posture, and helps to prevent spine deformities better than existing office chairs. There is a need to widely introduce and supply this new design. Application: The new design is applicable to office and student chairs, and is expected to improve concentration and work efficiency.

Subaxial Cervical Spine Injuries: WFNS Spine Committee Recommendations

Salman Sharif,Muhammad Yassar Jazaib Ali,Ibet Marie Y. Sih,Jutty Parthiban,Óscar L. Alves 대한척추신경외과학회 2020 Neurospine Vol.17 No.4

To formulate specific guidelines for the recommendation of subaxial cervical spine injuries concerning classification, management, posttraumatic locked facets and vertebral artery injury. Computerized literature was searched on PubMed and google scholar database from 2009 to 2020. For classification, keywords “Sub Axial Cervical Spine Classification,” resulting in 22 articles related to subaxial cervical spine injury classification system (SLICS) system and 11 articles related to AO (Arbeitsgemeinschaft für Osteosynthesefragen, German for “Association for the Study of Internal Fixation”) Spine system. The literature search yielded 210 and 78 articles on “management of subaxial cervical spine injuries” and the role of “SLICS” and “AO Spine” respectively. Keywords “management of traumatic facet locks” were searched and closed reduction, traction, approaches and techniques were studied. “Vertebral artery injury and cervical fracture” exhibited 2,328 references from the last 15 years. The objective was to identify the appropriate diagnostic tests and optimal treatment. Up-to-date information was reviewed, and statements were produced to reach a consensus in 2 separate consensus meetings of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Based on the most relevant literature, panelists in Moscow consensus meeting conducted in May 2019 drafted the statements, and after a preliminary voting session, the consensus was identified on various statements. Another meeting was conducted at Peshawar in November 2019, where in addition to previous statements, few other statements were discussed and voted. Specific recommendations were then formulated guiding classification, management, locked facets and vertebral artery injuries. This review summarizes the WFNS Spine Committee recommendations on subaxial cervical spine injuries.

상지의 움직임과 저항 적용에 따른 Formetric 4D를 이용한 척추의 3차원적 분석

김현진 ( Hyun-jin Kim ),신원섭 ( Won-seob Shin ) 대한물리의학회 2020 대한물리의학회지 Vol.15 No.3

PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.

Tube angle을 이용한 요추 사방향 (Lumbar spine oblique) 검사의 유용성 평가

성동찬(Dong-chan Sung),정지상(Ji-sang Jung),김성식(Sung-sik Kim):박남이(Nam-lee Park),박순규(Sun-kyu Park),안치복(Chi-bok Ahn),임재식(Jae-sik Lim) 대한영상의학기술학회 2017 대한영상의학기술학회 논문지 Vol.2017 No.1

목 적:요추 사방향 검사의 검사 자세는 척추 손상을 가진 환자 또는 그 손상이 의심되는 환자가 하기엔 다소 무리가 있다. 또한 검사과정에서 손상부위의 척추에 무리를 주게 되어 오히려 상태를 더 악화 시킬 가능성 또한 존재한다. 이에 본 연구는 환자의 자세 변화를 최소화하며, tube의 angle을 이용해 진단에 유용한 L-spine oblique 영상을 획득하는 데 목적이 있다. 대상 및 방법:abdomen phantom을 사용하여 약 40° oblique 시킨 후 영상을 획득하였다. 검사 조건은 80kV, 32mAs, 50msec로 고정하였으며, tube angle 은 0°, SID(Source-to-Image-Distance, 이하 SID)는 110 cm로 기준 영상을 획득하였다. 이에 비교 영상으로 SID는 110 cm으로 고정하고, tube의 축을 90° 회전 시켜, phantom을 oblique 시키는 대신 tube angle을 detector에 15~30°까지 5°씩 상승시키며 영상을 획득하였다. 또한, angle에 의한 영상의 확대율을 확인하기 위해 본원에서 수술 전 검사 시 이용하는 측정 device 2개를 이용하여 동일한 방법으로 영상을 획득하였다. 결 과:기준이 되는 tube angle 0°의 영상과 15~30°까지 각각 tube angle을 5°씩 올려 획득한 영상을 비교해본 결과 tube angle 20° 영상이 pelvic bone과 spine의 모양, scotty dog’s sign의 모양 등에 있어 가장 근접했다. 하지만 25° 이상의 angle이 들어간 영상의 경우 기준 영상과 달리 큰 확대를 보였다. 결 론:본 연구에서 제시한 tube angle을 이용한 L-spine oblique 검사는 응급환자, 자세가 불가능한 환자, 검사 시 혹시 모를 2차적 손상의 가능성을 내포한 환자에게 있어 유용한 방법이다. 뿐만 아니라, fracture 유무의 관찰이 목적인 L-spine oblique의 검사 목적에도 적합하며 그 진단적 가치 또한 부족하지 않다. 특히 20° tube angle을 주어 검사하게 되면, 기존의 방법으로 얻은 영상과 유사한 oblique 영상을 얻을 수 있다. Purpose:Lumbar spine oblique is not so easy to make patients with spine injuries those who are suspected to have the damage take position for the examination. Also, it might strain the damaged spine during examination and could lead to deterioration of condition. Therefore, this study aims to obtain L-spine oblique image useful to diagnosis by using angle of tube and minimizing the posture change of patient. Materials and Methods:The abdomen phantom was conducted 40° oblique to obtain image. The examination condition was set as 80 kV, 32 mAs, 50 msec, 0° for tube angle, and SID (Source-to- Image-Distance) was vertically incised from 110cm to obtain image. As for the comparative image, SID was set as 100 cm, and rotated 90° for tube axis to increase 5° from 15~30° of detector to tube angle rather than conducting phantom oblique to obtain image. Also, in order to verify the magnification ratio of image by angle, 2 measuring devices used in the hospital for preoperative examination were utilized to change tube angle in same method to obtain image. Result:As for the result of comparison between 0° tube angle image which is the standard and images obtained by increasing 5° tube angle each from 15~30°, the 20° tube angle image was the closest one regarding the shape of pelvic bone, spine and scotty dog s sign. However, the images with 25° or larger angle showed larger magnification compared to standard image. Conclusion:L-spine oblique using tube angle proposed by this study is a useful examination method for emergency patients, patients who are unable to make poses, or patients who have potentials for second damage during examination. Furthermore, it fits the purpose of L-spine oblique examination which is to observe the condition of fracture, and its diagnostic value is sufficient. Especially, if the examination is conducted at 20° tube angle, oblique image similar to image obtained by previous method is available.

퇴행성 요추부 질환의 병태생리

유재원,손홍문 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Age-related changes in the lumbar spine manifest as a pathologic, symptomatic disease process in some patients. As the population ages and symptomatic spine diseases are becoming- ubiquitous, much more concern has been concentrated on the cause of spine degeneration. Many asymptomatic population shows spine degeneration on MRI study. So, the degeneration itself is not the only pain generator. The spectrum of changes seen in the normal aging spine anatomically, biochemically, biomechanically, and radiographically may also occur, to an exaggerated extent in the pathologically degenerated spine. But the precise cause and sequence of spine degeneration in the spine remain unknown. The degenerative changes of spine causes many symptomatic diseases such as disc hei-niation, spinal stenosis, internal disc disruption, and degenerative scoliosis. Clinical manifestations of these diseases are low back pain, radiating pain and referred pain. The degenerative changes that occur in the various components of the spine are reviewed here along with various mechanisms that might cause these changes.

운동생리학 : 청소년기 여학생들의 척추측만에 대한 재활운동프로그램이 척추운동기능 및 형태에 미치는 영향

이강옥(KangOkLee),정성국(SungKugJeong),김영국(YoungKookKim),전준석(JoonSeokJeon) 한국체육학회 2005 한국체육학회지 Vol.44 No.6

The purpose of this study was to examine the effect of spine rehabilitation exercise using resistance exercise to regulate contraction and relax and stretching gymnastics to develop flexibility, and was to help to carry on healthy life studying formation of a spine, and finding elevation methods of lumbar function. The subjects were scoliosis patients. First of all, the spine scoliosis was examined using computer physical frame system in sorting students. And, the subject, 50 spine scoliosis patients, were decided to participate in this experiment. The subject were trained 12 week spine rehabilitation exercise and stretching exercise, and were measured to correction effect and ability of spine. The Metrecom was used to analyze correction effect and the Medx was used to analyze ability of spine. The spine scoliosis of juveniles have increasingly become one of the most common topics in sport prescription. At this point of time, through rehabilitation exercise and stretching exercise, scoliosis angle associated with scoliosis patients and extension strength of lumbar was been improving. The program used a spine rehabilitation exercise and stretching exercise should be helped spine functions, and reached a conclusion to get good result with a prevention and medical treatment about scoliosis patients.

Clinical Relationship of Degenerative Changes between the Cervical and Lumbar Spine

Yuichiro Morishita,Zorica Buser,Anthony D’Oro,Keiichiro Shiba,Jeffrey C. Wang 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2

Study Design: Retrospective, observational, case series. Purpose: To elucidate the prevalence of degenerative changes in the cervical and lumbar spine and estimate the degenerative changes in the cervical spine based on the degeneration of lumbar disc through a retrospective review of magnetic resonance (MR) images. Overview of Literature: Over 50% of middle-aged adults show evidence of spinal degeneration. However, the relationship between degenerative changes in the cervical and lumbar spine has yet to be elucidated. Methods: A retrospective review of positional MR images of 152 patients with symptoms related to cervical and lumbar spondylosis with or without a neurogenic component was conducted. The degree of intervertebral disc degeneration (IDD) was assessed on a grade of 1–5 for each segment of the cervical and lumbar spine using MR T2-weighted sagittal images. The grades across all segments were summed to produce the degenerative disc score (DDS) for the cervical and lumbar spine. The patients were divided into two groups based on the IDD grade for each lumbar segment: normal (grades 1 and 2) and degenerative (grades 3–5). Results: DDSs for the cervical and lumbar spine were positively correlated. Significant differences in cervical DDSs between the groups were observed in all lumbar segments. Although there were no significant differences in cervical DDSs among the degenerative lumbar segment, cervical DDSs at the L1–2 and L2–3 segments tended to be higher than those at the L3–4, L4–5, and L5–S degenerative segments. Conclusions: Our study shows that participants with degenerative changes in the upper lumbar segments are more likely to have a certain amount of cervical spondylosis. This information could be used to lower the incidence of a missed diagnosis of cervical spine disorders in patients presenting with lumbar spine symptomology.