• Title/Summary/Keyword: 골 괴사

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Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

A HISTOPATHOLOGIC STUDY ON THE PULPAL RESPONSE TO DEMINERALIZED FREEZE-DRIED BONE IN DOGS (탈회냉동건조골에 대한 성견의 치수조직반응에 관한 연구)

  • Jung, Moon-Yong;Lee, Chang-Seop;Park, Joo-Chul;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.318-332
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    • 2000
  • The purpose of this study was to investigate the effects of demineralized freeze-dried bone (DFDB) on mechanically exposed pulp of dog by evaluating the pulpal inflammation and healing process, formation of dental hard tissue, and structural changes of fibroblasts of the remaining pulp tissue. Teeth of 4 dogs, weighing 10kg, were used in this study. Class V cavities were prepared followed by exposed the pulp tissue mechanically by sterilized round bur. In control group, exposed pulps were capped with calcium hydroxide paste followed by sealed with IRM. In experimental groups, the exposed pulps of one group were capped with the collagen and those of the other group were capped with DFDB. All cavities were sealed with same manor as control group. The animals were sacrificed at the intervals of 3, 7, 14, and 28 days for histopathlogic evaluation. The specimens were observed by the light microscope and trans-electron microscope. The results were as follows: 1. Pulp necrosis was not observed in all groups. Inflammatory response was disappeared from 1 week in control group and group 2. But it was not disappeared until 2 weeks and also irregular arrangement of odontoblasts was showed at the lateral walls of root canal just beneath the amputated site of the pulp in group 1. 2. Dentinal bridge was formed incompletely at 2 weeks but it was formed completely at 4 weeks in control group. Odontoid tissue was also found in control group at 4 weeks from treatment. Amputated site of pulp was encapsulated with fibrous tissue and odontoblast and dentinal bridge was not found in group 1. Preodontoid tissue and reparative dentin which were formed by odontoblast differentiated around DFDB were found, but dentinal bridge was not found in group 2. 3. Cell with large basophillic-stained nuclei infiltrated to amputated site and DFDB at 1 week from treatment in control group and group 2. They were found more in group 2 than in control group. Odontoblasts arranged more regularly and reparative dentin was found more as time elapsed. 4. Dentin-formative odontoblasts which showed ultramicrostructure of cytoplasm with polarized nucleus, rEM, Golgi complex, secretory granules, secretion of organic matrix in control of group and group 2. In regards to above results, the demineralized freeze-dried bone(DFDB) induce odontoblastic differentiation and further come up to the dentin formation in amputated pulp.

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Shoulder Replacement Arthroplasty after Failed Proximal Humerus Fracture (상완골 근위부 골절의 치료 실패 후 견관절 치환술)

  • Park, Jin-Young;Seo, Beom-Ho;Lee, Seung-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.110-119
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    • 2019
  • Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.

Kohler's Disease of the Tarsal Navicular: Long-Term Follow-up of 12 Years - A Case Report - (족부 주상골 무혈성 괴사: 12년 장기 추시 결과 -1예 보고-)

  • Moon, Gi-Hyuk;Nam, Il-Hyun;Jang, Jong-Hoon;Kim, Hak-Jun;Yun, Ho-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.204-208
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    • 2005
  • Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.

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Solitary Ancient Schwannoma in Lower leg -Case Report- (하퇴부에 발생한 고립성 퇴행성 신경초종 -증례 보고-)

  • Kim, Taek-Seon;Kim, Hak-Jun;Kim, Wan-Tae;Kim, Yoon-Jung;Yoon, Jae-Eun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.89-94
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    • 2006
  • When the old schwannoma has the degenerative changes, it is named as the ancient schwannoma which was rarely reported. The degenerative changes are perivascular hyalinization, calcification, cystic necrosis, marked decrease of Antoni type A area, and degenerative nuclei and the ancient schwannoma may be misinterpreted as sarcomatous pleomorphisms. We experienced the ancient schwannoma which has massive hemorrhage and hematoma, cystic change, calcification, and marked decrease of Antoni A area in leg on 75 year old male patient, and report it.

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Endoscopic Assisted Treatment of Acute Osteomyelitis with Extensive Subperiosteal Abscess in a Child - A Case Report - (광범위 골막하 농양을 동반한 소아 급성 골수염의 내시경적 치료 - 1예 보고 -)

  • Song, Kyeong-Seop;Jeon, Ho-Seung;Jeon, Seung-Joo;Kim, Hyung-Gyu;Cho, In-Kee
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.199-202
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    • 2006
  • The effects of acute hematogenous osteomyelitis vary with a patient's age because of the differences in the blood supply and structure of the bone. In children older than 2 years of age, this process results in extensive abscess formation when both the endosteal and periosteal blood supply are destroyed. Thorough drainage of abscess cavity and removal of all dead or necrotic material are not always possible although large skin incision is made along the abscess. Authors successfully managed acute osteomyelitis of the tibia with extensive large abscess in a 11 year-old female, using minimal incisions and 4-mm endoscope.

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The Clinical Study of Oriental Medicine on Spontaneous Osteonecrosis of the Knee (자발성 슬관절 골괴사 환자에 대한 한방치료 증례연구)

  • Lee, Sang-Wook;Yang, Jae-Cheol;Ok, So-Yoon;Bang, Chan-Hyuk;Shin, Woo-Suk
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.189-196
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    • 2015
  • Objectives The purpose of this study was to report the effect of Oriental medicine on spontaneous osteonecrosis of the knee. Methods Patients received Oriental treatment such as Bee-Venom therapy and acupuncture & moxibustion. The improvement of the pain intensity and recovery of gait was observed. Results During five weeks of treatment, patient's knee pain and gait disturbance were improved. Conclusions In this case, Oriental treatment on spontaneous osteonecrosis was effective to reduce pain and recover gait.

A CLINICAL CASE OF UNILATERAL MAXILLARY DEFECT RECONSTRUCTION USING NASOLABIAL FLAP (비순 피판을 이용한 상악골 편측 괴사환자의 치험례)

  • Lee, Eun-Young;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.167-172
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    • 2009
  • The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

Cervical Mediastinotomy on the Complication of the Esophageal Foreign Body (경부 종격절제술에 의한 식도이물 합병증의 치험례)

  • Lee, Jong-Won;Jung, Kwang-Sik;Jung, Myung-Kyun;Cho, Sook;Cho, Sung-Woon
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.1-5
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    • 1983
  • Esophageal foreign body is not uncommon problem among the esophageal disease and it is cured by removal of foreign body under the esophagoscopy in the most case. But it can cause esophageal perforation, periesophageal abscess, mediastinitis, pneumothorax, pyothorax, lung abscess and subcutaneous emphysema, and then may threat the life if early diagnosis and prompt management is not carried out. Esophageal perforation can be developed by sharp pieces of metal, bone or long term lodgement of foreign bodies in the esophagus. The authors have experienced the patient with periesophageal abscess after drawing out the sharp fish bone, and achived the good result by drainage via cervical mediastinotomy with continuous irrigation.

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A review of pathophysiological mechanism of Bisphosphonate-related osteonecrosis of the jaw (임상가를 위한 특집 1 - 비스포스포네이트 관련 골괴사의 병태생리학적 기전에 대한 검토)

  • Kwon, Tae-Geon
    • The Journal of the Korean dental association
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    • v.52 no.4
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    • pp.192-202
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    • 2014
  • Bisphosphonate(BP) significantly influence the hone remodeling process. Increasing number of patients with osteoporosis and metastatic bone disease need high dose or long term bisphosphonate therapy. Major adverse effect is jaw bone necrosis and now the bisphosphonate-related necrosis of the jaw(BRONJ) is the major concern of dental practitioner. This study intended to perform the review of the current understandings concerning the pathophysiology of BRONJ. Even though pathophysiological mechanism of BRONJ is not clearly elucidated but now suggested as largely two different concepts; so-called "inside-out" or "outside-in" theory. Inside-out theory emphasize the osteonecrosis of the jaw is the initial major event and subsequent infection and inflammation is the second event that accompanies bone exposure and death of overlying mucosa. However, in "outside-in" theory, infection or inflammation initiated by traumatized oral epithelium is the major event of BRONJ. Both theory would be partially explain BRONJ. Recent research reveals the immune modulating effect and influence of microcrack accumulation by BP. These findings and those of others might explain the missing part of outside-in theory.