• Title/Summary/Keyword: 골수 전이

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Analysis of Anatomical Conformity of Straight Antegrade Humeral Intramedullary Nail in Korean (한국인에서의 직선형 전향적 상완골 골수 내 금속정의 해부학적 적합성 분석)

  • Choi, Sung;Jee, Seungmin;Hwang, Seongmun;Shin, Dongju
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.498-503
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    • 2021
  • Purpose: The aim of this study were to find ideal entry point of straight antegrade humeral intramedullary nail (SAHN) for the treatment of proximal humerus fracture in Korean and to analyze anatomical conformity using computed tomography. Materials and Methods: From May 2014 to October 2016, the study was conducted retrospectively on 74 Korean patients who had taken computed tomography on both normal and affected shoulder joint as result of shoulder injury. The mean age of the patients was 64.5 years (range, 22-95 years). Radiologic evaluation was done using multiplanar reconstruction technique of the computer tomography on normal proximal humerus. We located ideal entry point of SAHN as the point where humerus intramedullary center axis and humeral head meet. Distance between the entry point and local anatomical landmark was measured. We defined the critical distance as the distance between entry point and the most medial point of the supraspinatus attachment site. For adequate fixation and avoidance of injury to rotator cuff, critical distance should be over 8 mm according to Euler, and we defined the critical type when it is less than 8 mm. Critical distance, sex, age, height, body weight, body mass index was evaluated for the statistical significance. Results: The ideal entry point was as follows: the mean anteroposterior distance, the sagittal distance to the lateral margin of bicipital groove, was 11.5 mm and the mean mediolateral distance, the coronal distance to the lateral margin of grater tuberosity, was 20.5 mm. The mean critical distance, distance from the entry point to the just medial to insertion of the supraspinatus tendon, was 8.0 mm. Critical type with critical distance less than 8 mm was found in 41 in 74 patients (55.4%). Conclusion: The ideal entry point of SAHN in Korean was located on 11.5 mm posteriorly from the lateral margin of bicipital groove and 20.5 mm medially from lateral margin of greater tuberosity. More than half of the cases were critical type. Since critical type can possibly cause rotate cuff injury during nail insertion on entry point, surgeon should consider anatomical variance before choosing surgical option.

The CNS Relapse of the Acute Lymphoblastic Leukemia: Radiotherapy Results (급성 림프모구성 백혈병의 중추신경계 재발의 방사선치료)

  • Kim Yong-Ho;Kim Il-Han
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.385-390
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    • 1995
  • Purpose : To assess the efficacy of craniospinal radiotherapy in patients with acute lymphoblastic leukemia (ALL) experiencing the CNS relapse. Materials and Methods: Thirty ALL patients with relapse in the central nervous system (CNS) were treated with radiotherapy and intrathecal chemotherapy. Age ranged 2 to 46. The number of males and females were all 15. Twenty-two cases were previously treated with presymptomatic radiotherapy to the whole brain. The extent of radiotherapy was the whole brain (18-24 Gy) and the whole spine (12 Gy) in 21 cases but the whole brain only in the 9 cases with poor performance. Results : The complete remission rate in the CNS was $100{\%}$. Among the 12 cases ($40{\%}$) who had secondary relapse, 9 cases had the bone marrow relapse alone, 2 cases had the CNS and bone marrow relapse, 1 cases had the CNS relapse alone. Higher CNS remission rate was observed when the initial remission duration was longer than 24 months or radiation was delivered to the whole brain and the whole spine. Survival rate at 2 year was $31.6{\%}$. Remission duration in the 10 living patients ragned from 9 to 87 months (median; 58 months).

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Role of MRI and Plain Radiograph to Diagnose Fibrous Dysplasia Mimicking Metastasis on PET/CT in a Patient with Breast Cancer (유방암환자의 양전자방출단층촬영술에서 암 전이로 오인된 섬유형성이상 진단의 자기공명영상과 단순촬영의 역할)

  • Cho, Song-Mee;Jee, Won-Hee;Yoo, Ie-Ryung;Lee, Ah-Won;Chung, Yang-Guk
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.47-50
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    • 2010
  • Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy.

Implantation of bone marrow mononuclear cells using fibrin gels enhances neovascularzation in ischemia myocardium

  • Ryu, Ju-Hee;Kim, Il-Kwon;Cho, Seung-Woo;Cho, Myeong-Chan;Hwang, Kyung-Kuk;Piao, Shuguang;Piao, Hainan;Lim, Sang-Hyun;Yoo, Kyung-Jong;Hong, Yoo-Sun;Choi, Cha-Yong;Kim, Byung-Soo
    • 한국생물공학회:학술대회논문집
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    • 2003.10a
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    • pp.164-166
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    • 2003
  • Despite recent advances in the treatment of acute myocardial infarction, the ability to repair extensive myocardial damage is limited. Revascularization in ischemic myocardium is required to improve cardiac function and prevent further scar tissue formation. Bone marrow contains endothelial precursors that can be used to induce neovascularization in ischemic myocardium. To develop a new therapy for myocardial infarction, we investigated if implantation of bone marrow mononuclear cells (BM-MNCs) using biodegradable matrices could enhance neovascularization in ischemic myocardium. Eight weeks after implantation, the damaged myocardium implanted with BM-MNCs and fibrin gels exhibited significantly greater angiogenic responses than those implanted with either fibrin gels or BM-MNCs alone. Fibrin gels disappeared completely 8 weeks after implantation. Echocardiography revealed improved heart functions. These results suggest that implantation of BM-MNCs using fibrin gel matrix efficiently induces neovascularization and improved heart functions in ischemic myocardium.

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항암약물요법후 골수억제가 수반된 진행암환자에서 rhGM-CSF의 제2상 임상연구: rhGM-CSF의 용량에 대한 효과비교

  • 라선영;이경희;정현철;이혜란;유내춘;김주항;노재경;한지숙;김병수
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.313-313
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    • 1994
  • 대상환자는 40예중 37예에서 평가가 가능하였고 남녀비는 11:26. 중앙연령 42세 이었으며 대상질환은 위선암 12에, 유방암 10예. 골옥종 5예등 이었다. rhGM-CSF에 의한 부작용은 150.250 $\mu\textrm{g}$/$m^2$/d 용량군에서는 Grade I-II의 전신쇠약감, 근육통.심계항진등이 관찰되었으나 특별한 조치없이 회복되었다. 350$\mu\textrm{g}$/$m^2$/d 용량군에서는 8예에서 WHO grade II-III의 전신쇠약, 전신열감, 흉부압박감, 호흡곤란 등을 호소하였고 1예에서 투여 1일러 WHO gradeIII의 피부반응이 나타났으며, 이 중 2예에서는 rhGM-CSF를 250 $\mu\textrm{g}$/$m^2$/d로 감량투여후 상시 증상이 소실되었다. rhGM-CSF 투여전의 대조기와 투여기의 혈액학적 소견 비교시. 평균 중성구 최저치는 세 용량군에서 모두 관찰기에 비해 시험기어서 증가하였고. 평균 총 백혈군 최저치는 150.350 $\mu\textrm{g}$/$m^2$/d 용량군은 차이가 있었고 250 $\mu\textrm{g}$/$m^2$/d 용량군은 차이가 있었으나 통계적 유의성은 없었다. 비혈구치가 최저치에서 4.000/㎣ 이상으로 회복되는 평균일수와 호중구치가 최저치에서 2.000/㎣ 이상으로 회복되는 평균일수는 세 용량군 모두에서 관찰기어 비해 시험기에서 증가하였다. 고용량 항암약물요법후 중성구 감소에 의한 발열은 rhGM-CSF 비투여기에서 18예. rhGM-CSF 투여기에서 8예 관찰되었다고 발열기간은 각각 5-7일. 2-3일 이었다. 임상 양상은 세 용량군 간 차이가 없었으나, 시험기에서 발열의 발현율이 낮았으며, 발열일 수와 항생제 사용일 수가 짧았다. 결론: 골수억제 조절 효과는 용량에 따른 혈액소견에 미치는 영향, 부작용, 감염의 빈도, 감염발생에 따른 항생제 사용기간 등을 고려하여 그 임상 유효성 평가시, 제 3상 시험에 사용할 권장량 (recommended dose) 은 250 ug/$m^2$/d $\times$ 10d 으로 관찰되었다.

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Additive Manufacturing of Patient-specific Femur Via 3D Printer Using Computed Tomography Images (CT 영상을 이용한 3D 프린팅으로 환자 맞춤형 대퇴골 첨삭가공)

  • Oh, Wang Kyun;Lim, Ki Seon;Lee, Tea Soo
    • Journal of the Korean Society of Radiology
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    • v.7 no.5
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    • pp.359-364
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    • 2013
  • Femur is the largest bone in the human body which supports the weight of body. A long pipeline shape of femur has little cancellous bone, so that regeneration is difficult when fracture happens. The fracture caused by an accident most frequently occurs at diaphysis. IM Nailing is the surgical method that implants an IM Nail into a medullary cavity for the fixation of fracture parts. However, a secondary fracture may happen if an IM Nail does not penetrate at the center of femur. In this study, a patient-specific femur was manufactured by a 3D printer using the computed tomography images scanned before surgery, which was used for the simulation of IM Nailing. It is expected that this result may prevent the secondary damage, reduce surgical operation time, and increase the precision.

"의종금감(醫宗金鑑).정골심법요지(正骨心法要旨)"의 "외치법(外治法)"에 대한 연구

  • Kim, Yeong-Ha;Yuk, Sang-Won
    • Journal of Korean Medical classics
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    • v.19 no.3
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    • pp.47-64
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    • 2006
  • 籬위제고화가심대청대정골추나요법적인식화이해(爲提高和加深對淸代正骨推拿寮法的認識和理解), 특선어차방면의의교심차유의사문환가치적(特選於此方面意義較深且有醫史文歡價値的) ${\ulcorner}$의종금감(醫宗金鑑) 정골심법요지(正骨心法要旨)${\lrcorner}$ 중적(中的) ${\ulcorner}$외치법(外治法)${\lrcorner}$ 진행료연구(進行了硏究), 획득여하연구결과(獲得如下硏究結果). 기수법총론부분(其手法總論部分), 파요지규정료정골수법적정의급기중요성(擺要地規定了正骨手法的定義及其重要性), 후유증적예방(後遺症的預防), 안환자원기강약이수요주의적사항(按患者元氣强弱而需要注意的事項), 정골의생적기본공화심이소질등문제(正骨醫生的基本功和心理素質等問題). 기정골수법부분(其正骨手法部分), 포괄모(包括模) 접(接) 단(端) 제(提) 접(按) 나(摩) 추(推) 나등팔법(拿等八法), 각법지적응증용현대용어해석여하(各法之適應症用現代用語解釋如下): 모법용어촉진(模法用於觸診), 접법용어골절치료(接法用於骨折治療), 단법용어탈위치료(端法用於脫位治療), 제법용어견인법(提法用於牽引法), 안마법용어연조직손상화골착건적치료(按摩法用於軟組織損傷和骨錯鍵的治療), 추나법용어절적운동(推拿法用於節的運動) 부리화관절적부완전결합적치료(不利和關節的不完全結合的治療). 기기구총론부분(其器具總論部分), 개소료십종정골치료용기구(介紹了十種正骨治療用器具), 각종기구적적응증급기효능용현대용어해석여하(各種器具的適應症及其效能用現代用語解釋如下): 이렴구유보호환부적효과(裏簾具有保護患部的效果), 진정용어동통(振挺用於疼痛) 부종(浮鍾) 경결적치료(硬結的治療), 피견용어견관절탈구적고정료법(被肩用於肩關節脫臼的固定療法), 격색속어리용자아체중적견인료법(擊索屬於利用自我體重的牽引療法), 루관속어분부동계단이용자아체중진행견인적료법(壘觀屬於分不同階段利用自我體重進行牽引的療法), 통목속어포추지압축성골절적래목치료용구(通木屬於胞推之壓縮性骨折的來木治療用具), 요주구유대요추골급기근육이상적부가보호대효과(腰柱具有對腰推骨及其筋肉異常的附加保護帶效果), 죽렴용어골절적고정치료(竹簾用於骨折的固定治療), 삼리구유대골절적쌍중고정효과(杉籬具有對骨折的雙重固定效果), 포슬구유대슬관절적고정효과(抱膝具有對膝關節的固定效果).

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Dose Distribution of Total Body Irradiation for Bone Marrow Transplantation in Leukemia (백혈병에서 골수이식을 위한 전신방사선조사시 선량분포 특성)

  • 김성규;김명세;신세원
    • Progress in Medical Physics
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    • v.7 no.2
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    • pp.47-55
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    • 1996
  • Total Body Irradiation(TBI) is one of the essential treatment modalities in bone marrow transplantation for leukemia and lymphoma. Various techniques and dose regimens were introduced with sevelal advantages and disadvantages. In TBI, lung block could reduce lung dose to 75% of original beam for decreasing lung dose with homogenous total body irradiation. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. When performed in total body irradiation, the problem obtain uniform dose distribution in brain, neck, lung, umbilicus, pelvis and leg. Authors compared to dose distribution with method 1 and method 2. The method 1 used compensating filters for homogeneous dose distribution(Minesota University Method). The method 2 used fixing frame made in aeryl developing authors. Results were following. 1. Method 1 was showed dose distribution from 95.6% to 100%, method 2 showed dose distribution from 95.4% to 100%. 2. Method 2 was showed different to 3.4% at skin region and midline in the brain. In the neck, showed different to 1.5%. In the umbilicus. showed different to 2.3%.

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The Clinical Study on a Case of Acute Myelogenous Leukemia (급성 골수성 백혈병 10세 환아의 한방적 처치에 대한 증례보고)

  • Ha, Kwang-Su;Song, In-Sun;Shin, Ji-Na;Lee, Jeong-Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.49-59
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    • 2004
  • Objective : The purpose of this study is to demonstrate the therapeutic effect of oriental treatment on Acute Myelogenous Leukemia. Methods : The patient was treated by Acupuncture, Indirect Moxibustion, Herb Medicine (Seogakjihwangtang-gamibang), and had significant improvement in the Acute Myelogenous Leukemia. Results : 1. Acute Leukemia is one of the most common malignant neoplasm of pediatrics, and is chracterised by anemia, infections, bleeding, debility, paleness, fever, anorexia, lymphoadenia, hepatomegaly, splenomegaly, etc. 2. The management of Acute Myelogenous Leukemia consists of the challenge of optimizing chance for prolonged remission and cure, while minimizing the toxicity to the patients. Therefore oriental medical treatment may be useful for this. 3. We experienced a case of the 10-year-old male patient with Acute Myelogenous Leukemia, after oriental medical treatment his chief symptoms(anemia, bleeding, purpura, debility, paleness, fever, anorexia, insomnia, etc)and general condition were improved. Conclusion : A 10-year-old male patient with Acute Myelogenous Leukemia, after oriental medical treatment his chief symptoms and general condition were improved. This oriental medical treatment may be possible or effective in Acute Myelogenous Leukemia. The more clinical study about oriental medical treatment on Acute Myelogenous Leukemia will be needed.

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High Grade Surface Osteosarcoma - Case Report - (고등급 표면(High Grade Surface) 골육종 - 증례 보고 -)

  • Lee, Bong-Jin;Lee, Sung-Rak;Yoo, Tae-Yeul;Eom, Ki-Seong;Ha, Chang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.32-37
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    • 2002
  • High grade surface osteosarcoma is the most rare subtype of osteosarcoma arising on the surface of bone, accounting for less than 1% of the total number of osteosarcomas. Only a few case reports and studies have been reported in the world. In Korea, only one case out of 127 osteosarcomas has been described up to now, but there was no information about the patient, clinicopathologic features and treatment. We experienced a case of high grade surface osteosarcoma in the subtrochanteric area of a 66-year-old female and treated her with neoadjuvant chemotheraphy, wide resection and limb salvage operation with tumor prosthesis and adjuvant chemotheraphy. This tumor is identical to conventional high grade intramedullary osteosarcoma in histology, treatment and prognosis. So, this tumor should be differentiated from other surface osteosarcomas such as parosteal osteosarcoma and periosteal osteosarcoma.

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