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Viachaslau Bradko,Heidi Castillo,Shruthi Janardhan,Benny Dahl,Kellen Gandy,Jonathan Castillo 대한척추신경외과학회 2019 Neurospine Vol.16 No.4
An estimated 60% of the world’s population lives in Asia, where the incidence of neural tube defects is high. Aware that tethered cord syndrome (TCS) is an important comorbidity, the purpose of this systematic review was to explore the treatment of TCS among individuals living with spina bifida (SB) in Asia. MEDLINE and Embase databases were searched for relevant studies published from January 2000 to June 2018. Search terms such as ‘spinal dysraphism,’ ‘spinabifida,’ ‘diastematomyelia,’ ‘lipomeningocele,’ ‘lypomyelomeningocele,’ ‘meningomyelocele,’ and ‘tethered cord syndrome’ were used in diverse combinations. Of the 1,290 articles that were identified in accordance with PRISMA (Preferred Items for Systematic Reviews and Meta-Analyses) guidelines, 15 Asia-based studies met the inclusion criteria. Significant differences in the diagnostic criteria and management of TCS were documented. As the surgical techniques for prenatal closure of the spinal defect continue to evolve, their adoption internationally is likely to continue. In this setting, a clear and evidence-based approach to the definition and management of TCS is essential. The recent publication by the Spina Bifida Association of America of their updated care guidelines may serve as a tool used to promote a systematized approach to diagnosing and treating TCS among individuals with SB in the region, as well as globally.
김문정 ( Kim Mun Jeong ),김미경 ( Kim Mi Gyeong ),박현주 ( Park Hyeon Ju ),설현주 ( Seol Hyeon Ju ),신지혜 ( Shin Ji Hye ),강문정 ( Kang Mun Jeong ),안현숙 ( An Hyeon Sug ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.7
The prenatal diagnosis of spina bifida includes the combined use of maternal serum α-fetoprotein (MSAFP) screening and fetal sonography. On ultrasonogram, spina bifida is characterized by visualization of the spinal defect and associated cranial abnomalities: the Lemon sign, the Banana sign, ventriculomegaly, small biparietal diameter, and obliteration of the cistema magna. We should now be able to rely on ultrasound as the main technique for diagnosis of spina bifida when MSAFP is elcvated. Recently, we have experienced three cases of spina bifida diagnosed with meningomyelocele, lemon sign, banana sign and ventriculomegaly on ultrasonogram at respectively 18^+3, 18, and 18^+6 weeks of gestation. We present these cases with a brief review of literatures.
김성(Sung Kim),이동민(Dong Min Lee),김호영(Ho Young Kim),김재연(Jae Yun Kim),최영렬(Young Ryoul Choi),유재경(Jae Kyoung Yoo),윤길중(Gil Jung Yoon),황인수(In Su Hwang) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.11
The prenatal diagnosis of spine bifida include the combined use of maternal serum α-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as splaying of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures
잠재 이분척추 환자에서의 사슬 척추 증후군 : 1례 보고 A Case Report
최기홍,강충남,왕진만,노권재,김용현 梨花女子大學校 醫科大學 醫科學硏究所 1988 EMJ (Ewha medical journal) Vol.11 No.2
Spina bifida occulta at the lumbosacral area of a growing child is often associated with a low lying spinal cord that is tethered by one or more forms of intradural abnormalities without producing overt clinical manifestation for a long time. The diagnosis therefore requires a strong clinical suspicision and aggressive investigarion. We reported one case of tethered core syndrome in spina bifida occulta woth brief review of literature.
이상희 ( Lee Sang Hui ),김종석 ( Kim Jong Seog ),김청미 ( Kim Cheong Mi ),김보욱 ( Kim Bo Ug ),황주연 ( Hwang Ju Yeon ),조희영 ( Jo Hui Yeong ),김두표 ( Kim Du Pyo ),이윤호 ( Lee Yun Ho ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.5
In prenatal diagnosis of neural tube defects, maternal serum α-fetoprotein (MSAFP) level in second trimester is used as a screening test. However, it shows low sensitivity with high false positive rate. Also, α-fetoprotein and acetylcholinesterase in amniotic fluid through amniocentesis is used, but it is an invasive technique with low sensitivity. Recently, due to improved prenatal sonography, typical sonographic findings of spina bifida are reported and contributed to early diagnosis and detection of possible co-existing abnormalities. We report a case of spina bifida detected at 21 weeks of pregnancy by prenatal sonograph at our institution with a brief review of literature.
The First Neurosurgical Analysis of 8 Korean Children with Sotos Syndrome
Lim, Jae-Joon,Yoon, Soo-Han The Korean Neurosurgical Society 2008 Journal of Korean neurosurgical society Vol.44 No.4
Objective : Sotos Syndrome is characterized by macrocephaly, overgrowth, and developmental delay, and more than 300 patients have been reported worldwide to date. The authors reviewed the clinical characteristics of 8 patients with Sotos Syndrome in Korea for a new understanding and treatment strategies. Methods : The medical records of a total of eight Korean children with Sotos Syndrome were reviewed. All patients underwent developmental checkup, lumbar punctures for measurement of intracranial pressure (ICP), brain and spine magnetic resonance imaging and computerized tomography. Results : All 8 patients showed macrocephaly and the characteristic craniofacial features of Sotos Syndrome. Other clinical characteristics shown were overgrowth (7/8), developmental delay (7/8), congenital heart defect (3/8), flat foot (8/8), scoliosis (4/8), spina bifida (8/8), hydrocephalus (4/8), cavum vergae (3/8), and increased subdural fluid collection (5/8). Mean ICP measured via lumbar puncture was $27.35{\pm}6.25\;cm$ $H_2O$ (range 20 to 36 cm $H_2O$). Two patients received ventriculo-peritoneal shunt, and 1 patient underwent subduro-peritoneal shunt with improvement. Spinal orthosis was applied to 4/5 patients with scoliosis and 4/8 children with flat foot were provided with foot orthosis. Conclusion : In this first Korean study of 8 Sotos Syndrome patients we demonstrated the presence of spina bifida and increased ICP, which had not been previously described. The authors therefore suggest that all patients with Sotos Syndrome should undergo examination for the presence of spina bifida, and that shunt procedures would improve development and alleviate clinical symptoms.
Jun Wei Wu,Yu Rong Xing,Yi Bo Wen,Tian Fang Li,Quan De Feng,Xiao Ping Shang,Yun Long Li,Jin Jin Feng,Xin Xin Wang,Rong Qun Zhai,Xiang Fei He,Tao Chen,Xin Jian Liu,Jian Guo Wen 대한배뇨장애요실금학회 2016 International Neurourology Journal Vol.20 No.2
Purpose: To investigate the prevalence of spina bifida occulta (SBO) and its relationship with the presence of overactive bladder (OAB) in middle-aged and elderly people in China. Methods: A cross-sectional community-based survey was carried out at 7 communities in Zhengzhou City, China from December 15, 2013 to June 10, 2014, where residents aged over 40 years were randomly selected to participate. All of the participants underwent lumbosacral radiographic analysis and relevant laboratory tests. A questionnaire including basic information, past medical history and present illness, and the OAB symptom score was filled out by all participants. Chi-square tests and logistic regression were used for data analysis with a P-value of <0.05 denoting statistical significance. Results: A total of 1,061 subjects were qualified for the final statistical analysis (58.8±11.7 years; male, 471 [44.4%]; female, 590 [55.6%]). The overall prevalence of SBO was 15.1% (160 of 1,061): 18.3% (86 of 471) in men and 12.5% (74 of 590) in women. Among these subjects, 13.7% (145 of 1,061) had OAB: 13.2% (62 of 471) in men and 14.1% (83 of 590) in women. The results of logistic regression showed that age, SBO, history of cerebral infarction (HCI), and constipation were risk factors for OAB (P<0.05), while sex, history of childhood enuresis (HCE), body mass index (BMI), and diabetes mellitus (DM) were not (P>0.05). In men, age, SBO, and constipation were risk factors for OAB (P<0.05), while HCE, BMI, DM, HCI, and benign prostate hyperplasia were not (P>0.05). In women, age, SBO, and HCI were risk factors for OAB (P<0.05), while HCE, BMI, DM, vaginal delivery, and constipation were not (P>0.05). Conclusions: The prevalence of SBO is high and it is related to OAB in middle-aged and elderly people in China.
Yohei Bamba,Masahiro Nonaka,Natsu Sasaki,Tomoko Shofuda,Daisuke Kanematsu,Hiroshi Suemizu,Yuichiro Higuchi,Ritsuko K. Pooh,Yonehiro Kanemura,Hideyuki Okano,Mami Yamasaki 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.6
Study Design: We established induced pluripotent stem cells (iPSCs) and neural stem/progenitor cells (NSPCs) from three newborns with spina bifida aperta (SBa) using clinically practical methods. Purpose: We aimed to develop stem cell lines derived from newborns with SBa for future therapeutic use. Overview of Literature: SBa is a common congenital spinal cord abnormality that causes defects in neurological and urological functions. Stem cell transplantation therapies are predicted to provide beneficial effects for patients with SBa. However, the availability of appropriate cell sources is inadequate for clinical use because of their limited accessibility and expandability, as well as ethical issues. Methods: Fibroblast cultures were established from small fragments of skin obtained from newborns with SBa during SBa repair surgery. The cultured cells were transfected with episomal plasmid vectors encoding reprogramming factors necessary for generating iPSCs. These cells were then differentiated into NSPCs by chemical compound treatment, and NSPCs were expanded using neurosphere technology. Results: We successfully generated iPSC lines from the neonatal dermal fibroblasts of three newborns with SBa. We confirmed that these lines exhibited the characteristics of human pluripotent stem cells. We successfully generated NSPCs from all SBa newbornderived iPSCs with a combination of neural induction and neurosphere technology. Conclusions: We successfully generated iPSCs and iPSC-NSPCs from surgical samples obtained from newborns with SBa with the goal of future clinical use in patients with SBa.