• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.82-98
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• 2021

Sesamoid bones and accessory ossicles are normal anatomic variants with varying morphological appearances and incidences. They are usually small osseous fragments with well-corticated margins located adjacent to the joint space and bone. Patients with sesamoid bones and accessory ossicles are usually asymptomatic and commonly encountered in clinical practice. These sesamoids and accessory bones are occasionally painful because of fractures, dislocations, degenerative changes, avascular necrosis, accessory bone infections, or abnormalities of the adjacent tissue, such as nerve entrapment, tenosynovitis, or soft tissue impingement. This article aimed to illustrate the imaging features of symptomatic sesamoids bones and accessory ossicles at various anatomic locations and describe their clinical features and radiological differential diagnosis.

• The Korean Journal of Nuclear Medicine
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• v.35 no.6
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• pp.371-377
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• 2001

Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.6-12
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• 2011

Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

• The korean journal of orthodontics
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• v.34 no.2 s.103
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• pp.131-142
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• 2004

The movement of tooth-bone segments by osteotomy can simultaneously shift tooth and surrounding alveolar bone in a relatively short period. The purpose of this study was to evaluate the tissue changes in pulp, periodontal ligament, and alveolar bone in rapid tooth-bone movement with osteotomy. The mandibular 3rd premolar of a dog was extracted and cortical bones of the buccal and lingual area were eliminated, and then cortical bones around the mesial and distal area of root, and below the root apex of the mandibular 4th premolar were osteotomized. After a one-week latency period, a tooth-borne distraction device was activated for 6 days. And pulp, periodontal ligament and alveolar bone were evaluated clinically, radiologically, histologically and immunohistochemically at 0, 1, 2, 4, 6, 8 weeks of the consolidation Period and conclusions were roached as follows. 1. Latency period didn't affect total amount or tooth movement and healing process of tissue during consolidation period. 2. Bone formation continued through 8 weeks of consolidation in distracted side, with a high peak at 1-2 weeks, and the lowest at 6-8 weeks or consolidation. 3. At 1 week of consolidation, alveolar bone resorption, osteoclast appearance and inflammatory cell infiltration were the most active, and dentinoclasts characteristically appeared on the pulp and pressure side of the periodontal ligament. 4. The expression of $TGF-\beta$ was area-specific, as it was strong-positive at bone matrix, osteoblast osteoclast of alveolar bone, and dentinoclast inside pulp, but weak in pulp, cementoblast and acellular cementum. 5. The expression of $TGF-\beta$ was generally observed at the initial 1-2 weeks of consolidation at vessels, periodontal ligament cells, and osteoblast near alveolar bone on the distraction side of the periodontal ligament, and was significantly decreased after 6 weeks of consolidation.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.675-680
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• 2010

Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4651-4655
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• 2015

The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.427-436
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• 1998

Thirty two cases of patient with Thoracolumbar Compression Fracture were treated and observed clinically from November, 1997, to August, 1998, in the Dept. of Acupuncture and Moxibustion, Chon-an Oriental Medical Hospital, Taejon University. The results were obtained as follows; 1. The distribution of sex was male 6 cases(18.7%), female 26 cases(81.3%) and the distribution of age was seventies 17 cases(53.2%) the most. 2. The distribution of the causes was Slip-down 17 cases(53.2%) the most. 3. The distribution of the period before admission was within a week 19 cases(59.4%) the most. 4. The distribution of treatment duration in descending order: Under a week and two weeks under four weeks was the most number in 11 cases(59.4%) each. 5. The distribution of the injured level was L1 body 15 cases(18.3%) the most. 6. In the distribution of grading clinical severity on admission, the most cases were Gr.IV(18cases, 56.3%). 7. In the distribution of clinical symptoms on admission, 30 patients(21.9%) complained lower back pain and disturbance in turning over. 8. In the distribution of treatment result, the most cases(18 cases, 56.3%) was good. 9. The distribution of treatment duration according to the clinical grade on admission was as follows: Two weeks under four weeks was the most number in 8 cases(25%) in the group of Gr.IV, under two weeks was the most number in 6 cases(18.7%) in the group of Gr.III, and under four weeks was the most number in 2 cases(6.2%) in the group of Gr.II. 10. The distribution of treatment result according to the clinical grade on admission was as follows: Good was the most number in 10 cases(31.2%) in the group of Gr.IV, 6 cases(10.7%) in the group of Gr.III and 2 cases(6.2%) in the group of Gr.II. 11. The distribution of treatment result according to the treatment duration was as follows: Good was the most number in 4 cases(12.5%) under two weeks, 6cases(18.7%) two weeks under four weeks, and 6 cases(18.7%) four weeks under six weeks.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.35-48
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• 2002

Objective : The study was performed to evaluate the effect of treatment for thoracolumbar compression fracture by using Bee Venom Acupuncture that is well known for anti-inflammatory and analgesic effect. Methods : We investigated 39 cases of patient with thoracolumbar compression fracture. The patients with thoracolumbar compression fracture were treated at the department of acupuncture & moxibustion of Kyung-Won University Oriental Hospital from 1st January 2001 to 30th August 2002. We selected for two groups. One group was treated by Bee Venom Acupuncture therapy(Bee Venom Acupuncture Group : BAG), the other group was treated by Filiform Acupuncture therapy(None Bee Venom Acupuncture Group : NBAG). Results : 1. The distribution showed female predominance in sex and 70's predominance in age. The largest group was "accidental fall" and the next was "lifting heavy objects" in causes, and within 2 weeks in the duration of disease 2. In the duration of admission, the largest group was within 4 weeks. In regard to level of injury, T12 was found to be most predominant, followed in turn by L1, L2, L5. In regard to grade of clinical symptoms, Grade III was most predominant, followed by Grade II, Grade IV. 3. In the results of treatment, 87.5% were above "Good" in BAG and 47.8% in NBAG. 4. In the result of treatment due to the grade of clinical symptoms, BAG was more excellent than NBAG on the whols grade. 5. In the result of treatment due to duration of admission, the duration of admission was not in proportion to the results of treatment. 6. In the change of lumber flexion, the improvement above $80^{\circ}$ was 50% in BAG and 21.7% in NBAG 7. In the stability of treatment, the BAG and NBAG did't show any detrimental change in GOT, GPT, r-GTP, BUN, creatinine. Conclusions : In the treatment of thoracolumbar compression fracture, the Bee Venom Acupuncture can be regarded as more effective treatment than Filiform Acupuncture in the clinical practice. This is expected to be available for clinical use.

• Journal of Acupuncture Research
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• v.32 no.4
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• pp.147-156
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• 2015

Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.