• Title/Summary/Keyword: 골 전이

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Analysis of the Micro-Structural and Mechanical Properties in Human Femoral Head Trabecular Bone with and without Osteoporosis (대퇴골두 해면골의 미세구조 특성과 기계적 특성의 분석)

  • Won Ye-Yeon;Baek Myong-Hyun;Cui WenQuan;Chun KeyoungJin;Kim Man Kyung
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.519-523
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    • 2004
  • This study investigates micro-structural and mechanical properties of trabecular bone in human femoral head with and without osteoporosis using Micro-CT and finite element-model. 15 cored trabecular bone specimens with 20min of diameter were obtained from femoral heads with osteoporosis (T-score > -2.5 ) resected for total hip arthroplasty, and 5 specimens were removed from femoral head of cadavers, which has no history of musculoskeletal diseases. A high-resolution micro-CT system was used to scan each specimen to obtain histomorphometry indices. Based on obtained micro-images(pixel size=21.31㎛), a FE-model was created to determine mechanical property indices. While non-osteoporosis group had increases trabecular thickness, bone volume, bone volume fraction, degree of anisotropy and trabecular number compared with those of non-osteoporotic group, the non-osteoporotic group showed decreases in trabecular separation and structure model index. Regarding the mechanical property indices, reaction force, apparent stress and young's modulus were 1ower in osteoporotic group than in non-osteoporotic group. Our data shows salient deteriorations in trabecular micro-structural and mechanical properties in human femoral head with osteoporosis.

Open Techniques for Bone Defect in Anterior Shoulder Instability (골 결손이 동반된 전방 견관절 불안정성에서 개방적 수술 술기)

  • Lee, Bong-Gun;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.255-263
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    • 2009
  • Purpose: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. Materials and Methods: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. Results: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. Conclusion: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.

FIXATION OF FRACTURED ORBITAL BONE USING AUTOGENOUS CALVARIAL BONE PLATE (자가 두개골 플레이트(autogenous calvarial bone plate)를 이용한 골절된 안와골의 고정)

  • Yang, Yun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.377-382
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    • 1997
  • Miniplate의 사용은 Champy등의 보고 이후 구강외과 영역에 있어서 외상 혹은 악교정수술등 많은 분야에 이용되기 시작했다. 전통적인 악간고정 방법에 비해 miniplate는 사용하기 쉽고, 정확한 해부학적 정복 및 고정을 가능케 하며 결과적으로 빠른 치유를 가능케 한다는 장점들을 갖고 있다. 그러나 감염, wound dehiscence, 부식, 나사의 헐거워짐, 주위조직의 변색 그리고 stress shielding effect등의 후유증들이 보고되어 왔으며 가장 무해한 금속이라고 알려진 titanium 또한 주위조직 및 lung, spleen, liver 그리고 kidney 등과 같은 조직으로 metal을 전이시키는 것으로 보고되고 있다. 특히 안와골 주변과 같은 상부 연조직이 얇은 곳에 miniplate를 사용할 경우 miniplate가 만져지거나 보일수도 있다는 점이 보고되었으며 따라서 술후 사용되었던 miniplate를 제거 해야만 할 것인가가 또한 주된 관심사로 보고되고 있다. 이에 저자는 이러한 금속성 miniplate의 단점을 개선하고자 자가 두개골을 이용한 플레이트를 고안하였다. '자가 두개골 플레이트'의 적응증은, enophthalmos 개선의 목적으로 두개골을 채취해 임플란트로 사용하는, enophthalmos를 동반한 관골 및 안와골의 복합골절환자에 있어 두개골의 추가채취가 가능한 경우가 될 수 있겠다. 자가 두개골을 이용해 플레이트를 고안하려고 본 증례에서의 시도는 구강외과 영역에 있어서 자가 두개골이 골편이 고정재료로도 쓰일 수 있다는 가능성을 보여주었다는 점에서 의미가 있다고 저자는 생각한다.

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Chondrosarcoma of the Pubic Bone (치골에 발생한 연골육종 - 증례 보고 -)

  • Song, Won-Seok;An, Joon-Hwan;Cho, Wan-Hyeong;Byun, Woo-Jin;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.136-140
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    • 2006
  • Pelvic bone is location with the worst prognosis in primary malignant bone tumor. Malignant bone tumor around symphysis pubis is extremely rare, and although small size, it is difficult to excise because of anatomical location. The authors report a case of intra-pelvic chondrosarcoma of the pubic bone with good functional result through resection by both superior & inferior pubic ramus osteotomy.

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Early Imaging Findings of Hypertrophic Osteoarthropathy Mimicking Bone Metastasis from Extrathoracic Malignancy (뼈 전이로 오인될 수 있는 흉강 외 악성 종양으로 인한 비대성 골관절증의 초기 영상 소견)

  • Ji Yeon Hwang;Jang Gyu Cha;Yu Sung Yoon;Ahrim Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1606-1612
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    • 2021
  • Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, periosteal bone formation, and synovial effusions. Secondary HOA is associated with intrathoracic malignancy in most cases; however, in rare cases, HOA can be caused by extrathoracic conditions. We report early ultrasound, computed tomography, magnetic resonance imaging, and bone scintigraphy findings of HOA in a patient with breast cancer. Its ambiguous clinical and imaging findings that mimicked malignant conditions are particularly interesting and informative.

Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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A Semilongitudinal Study on Cranial Base, Maxillary and Mandibular Growth of Korean Children Aging 7 to 17 Years Old (한국인 7-17세 아동의 두개저, 상악, 하악의 성장에 관한 준종단적 연구)

  • Sohn, Byung-Wha;Kim, Hyung-Soon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.23-35
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    • 1999
  • Lateral cephalograms or 251 males md 286 females were taken and pubertal growth pattern or cranial base, maxillary and mandible of 7 to 17 years old Korean children was evaluated. 10 landmarks and 16 analytical measurements were evaluated. Analytical measurement and annual difference for each age group was calculated and tested for statistical significance. Analytical measurements were classified into three groups which were cranial base, maxillary and mandibular measurements and also classified into make and female measurements. Following results were achieved. 1. The circumpuberal growth spurt was earlier in Korean females than in males. 2. Cranial base, maxilla and mandible showed circumpuberal growth. The cranial base showed a relatively smaller amount of growth than the facial complex. 3. Middle and posterior cranial base length showed a floater increase than anterior cranial base length and circumpuberal growth spurt was also more definite. 4. the forward and downward growth or maxilla results from maxillary growht itself and transposition or the maxilla due to circumsutural growth aroud the maxilla. Ar-ANS and Ar-Pr which represent maxillary position relative to the cranial base showed more growth than ANS-PNS which represents maxillary bone growth. 5. mandible showed more vertical growth than horizontal growth but without significance. 6. Alveolar gwoth of maxilla and mandible show maximum growth rate of the time of permanent teeth eruption following loss of deciduous teeth . After this period alveolar growth shows a decreasing tendency.

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A Case Report : TMJ Osteoarthritis in a Patient with Renal Osteodystrophy (턱관절의 골관절염을 동반한 신성골이영양증 환자 증례보고)

  • Lee, Gi-Ho
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.247-253
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    • 2013
  • Renal osteodystrophy(RO) is characterized by skeletal changes in patients with renal disease and developed as a result of alterations in the metabolism of calcium, phosphate and secondary hyperparathyroidism. Bony changes in the craniofacial region include decreased bone density, radiolucent lesions(brown tumors), depletion of cortical bone and loss of lamina dura, but such changes rarely occur in the temporomandibular joint(TMJ). We report an uncommon case of bony changes and pain of both TMJs in a patient with RO. A 41-year-old man with RO came to our clinic due to TMJ pain and sounds. Occlusal change was also reported. Radiographs revealed degenerative changes of the both condyles. The patient had medical history of renal cancer therapy and hemodialysis. The patient was diagnosed with TMJ arthritis of RO and referred for systemic management through medication of calcium and vitamin D and parathyroidectomy. At 15-month follow-up, most of TMD symptoms disappeared and second radiographs revealed that bone density and cortical thickness of the mandible increased and the skeletal outline of the both condyles became relatively clear. As bony changes may begin in the early stage of the renal disease, dentists should be alert to detect the sign of the disease. In addition, it is important to differentiate TMJ arthritis of systemic cause because the treatment protocol is quite different.

Significance of tibial intra-tunnel fixation at Arthroscopic ACL Reconstruction with hamstring tendon (Second-look Arthroscopic Evalution) (자가 슬괵건을 이용한 전방 십자인대 재건술시 경골측 골 터널내 고정의 의의 (이차관절경 검사의 평가))

  • Kim, Young-Chang ;Seo, Seung-Suk;Jung, Kyung-Chil;Gwak, Hey-Chul;Kim, Yoon-Jun;Kim, Jin-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.165-172
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    • 2006
  • Purpose: The purpose of this study is to evaluate the effects of intratunnel fixation in the tibial side on the arthroscopic ACL reconstruction with quadruple hamstring tendon at the second look arthroscopy. Materials and Method: From Dec 1999 to May 2005, we arthroscopically reexamined 32 cases who had been done arthroscopic ACL reconstruction with quadruple hamstring tendons. Hamstring tendons of all cases were fixed at femoral side with RigidfixTM. At the tibial side hamstring tendons were fixed only Post-tie (Group I) or Post-tie combined with IntrafixTM (Group II). At the time of second look arthroscopy mean age of cases was 30 years and mean duration for second look arthroscopy was 21.3 months. We analyzed the results with IKDC score, KT-1000 arthrometer under anesthesia, Telos stress radiography, tibial tunnel widening on the radiography and second look arthroscopic findings. Results: Group II had more superior than group I at side to side differences with KT-1000 and Telos stress radiograph, IKDC score, but the differences were insignificant. At arthroscopic evaluation, Group ll also had more superior than group I at graft tension and graft appearance, graft synovialization, but the differences were insignificant. Tibial tunnel widening in the knee AP radiograph was 2.3 mm in Group I and 1.7 mm in Group II and the difference was significant. (P=0.042) Conclusions: Additional procedure of tibial intratunnel fixation in arthroscopic ACL reconstruction with autogenous hamstring tendon significantly prohibited from tibial tunnel widening but clinical results, radiologic joint stability, findings in second look arthroscopy were insignificantly different. We concluded that Post-tie itself induced satisfactory clinical results, joint stability and graft maturation and that tibial tunnel widening did not affect the results.

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