• Title/Summary/Keyword: 중정형

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Treatment of Cervical Perineural Cyst by the Transforaminal Epidural Steroid Injection (경추간공 경막외 스테로이드 주사를 통한 경추부 신경초 낭종의 치료)

  • Hwang, Jae-Kwang;Choi, Shin Woo;Kim, Chung-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.183-187
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    • 2020
  • Perineural cysts are usually discovered incidentally; only approximately one percent of such cysts are symptomatic. Symptomatic cervical perineural cysts, of which only five case reports have been found in the literature, are extremely rare and there is no consensus regarding treatment. When a cervical perineural cyst is discovered in a patient with cervical radiculopathy without the cause of other apparent compression, the cyst can be considered as a possible cause of cervical radiculopathy. In such cases, non-surgical conservative treatment can be considered before any surgical intervention. We reported the successful treatment of case of a 40-year-old woman with a symptomatic cervical perineural cyst by oral steroids and transforaminal epidural steroid injection.

Decision-Making and Principle of Management in Periprosthetic Femoral Fracture after Total Hip Arthroplasty (고관절 치환술 후 삽입물의 안정성 판단과 대퇴 삽입물 주위 골절의 치료 원칙)

  • Kim, Beom-Soo;Lee, Kyung-Jae;Min, Byung-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.200-207
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    • 2021
  • Periprosthetic femoral fractures remain as one of the most challenging complications following total hip arthroplasty. A thorough clinical and radiographic evaluation, precise classification, and understanding of modern management principles are essential to obtain optimal results for these fractures. The Vancouver classification system is a simple, effective, and reproducible method for the planning treatments of these injuries. The fractures associated with a stable femoral stem can be treated effectively with osteosynthesis, but periprosthetic femoral fractures associated with a loose stem require revision arthroplasty. This paper describes the principle of the treatment of patients with periprosthetic femoral fractures and how to assess the stability of the femoral stem.

Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.117-124
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    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Current Update of Cartilage Regeneration Using Stem Cells in Osteoarthritis (골관절염에서 줄기세포를 이용한 연골 재생의 최신 지견)

  • Seon, Jong-Keun;Choi, Ik-Sun;Ko, Jee-Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.478-489
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    • 2019
  • Osteoarthritis is a disease characterized by the progression of articular cartilage erosion, that increases pain during joint motion and reduces the ability to withstand mechanical stress, which in turn limits joint mobility and function. Damage to articular cartilage due to trauma or degenerative injury is considered a major cause of arthritis. Numerous studies and attempts have been made to regenerate articular cartilage. In the case of partial degenerative cartilage changes, microfracture and autologous chondrocyte implantation have been proposed as surgical treatment methods, but they have disadvantages such as insufficient mutual binding to the host cells, inaccurate cell delivery, and deterioration of healthy cartilage. Stem cell-based therapies have been developed to compensate for this. This review summarizes the drawbacks and consequences of various cartilage regeneration methods and describes the various attempts to treat cartilage damage. In addition, this review will discuss cartilage regeneration, particularly mesenchymal stem cell engineering-based therapies, and explore how to treat future cartilage regeneration using mesenchymal stem cells.

Carpal Tunnel Syndrome Caused by Persistent Median Artery and Bifid Median Nerve in an Adolescent (청소년에서 정중동맥과 이분정중신경에 의해 발생한 수근관 증후군)

  • Lee, Sang-Uk;Lee, Hyun Woo;Joo, Sun Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.452-456
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    • 2019
  • Carpal tunnel syndrome is rare in children. When it does occur in children, the most common causes reported are mucopolysaccharidosis and mucolipidosis. The median artery is a transitory vessel that develops from the axillary artery in early embryonic life and does not normally survive until postfetal life. In a small percentage of individuals, however, it persists into adulthood and is frequently accompanied by a bifid median nerve. A persistent median artery can be a cause of carpal tunnel syndrome in adults, but it is extremely rare in children and adolescents. This paper reports a case of a carpal tunnel syndrome caused by a persistent median artery and bifid median nerve in a 13-year-old girl.

Identification of Mycobacteria Using Polymerase Chain Reaction and Sputum Sample (객담을 이용한 Mycobacteria의 검출과 중합효소 연쇄반응의 민감성 비교)

  • Jang, Hyung Seok
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.2
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    • pp.83-89
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    • 2015
  • Although Mycobacterium tuberculosis complex strains remain responsible for the majority of diseases caused by mycobacterial infections worldwide, the increase in HIV (human immuno deficiency virus) infections has allowed for the emergence of other non-tuberculous mycobacteria as clinically significant pathogens. M. tuberculosis was detected by two-tube nested polymerase chain reaction (PCR) and non-tuberculous mycobacteria was detected by PCR-restriction fragment length polymorphism (RFLP) with Msp I. Result of niacin test is equal to result of two-tube nested PCR after culture for M. tuberculosis. In this study, acid fast bacilli stain (AFB. stain) >2+ case, Detection of Mycobacteria is similar to result before culture and after culture. AFB. stain <1+ case, result of mycobacteria is distinguished. Conclusionly, these results suggest that identification of mycobacteria must go side by side both culture and PCR for more fast and accuracy.

Vibration Control Performance Evaluation of Smart TMD for a Tilted Diagrid Tall Building (경사진 다이어그리드 비정형 초고층 건물에 대한 스마트 TMD의 제진성능평가)

  • Kim, Hyun-Su;Kang, Joo-Won
    • Journal of Korean Association for Spatial Structures
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    • v.11 no.4
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    • pp.79-88
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    • 2011
  • Recently, complex-shaped tall buildings represented by 3T(Twisted, Tapered, Tilted) are planed largely. A diagrid structural system is one of the most widely used structural system for complex-shaped tall buildings because of its structural efficiency and formativeness. Plans for tilted tall buildings are largely presented because of beauty of a sculpture and many of buildings use diagrid structural systems. Lateral displacements of tilted tall buildings are induced by not only lateral loads but also self weight. Therefore, reduction of lateral responses of tilted tall buildings is as important as typical tall buildings. In this study, a smart TMD is introduced to reduce seismic responses of tilted diagrid tall buildings and its control performance is evaluated. MR damper is employed for the smart TMD and ground-hook controller is used as a control algorithm for the smart TMD. 100-story tall building is used as an example structure. Control performances of uncontrolled case, controlled case with TMD and controlled case with smart TMD are compared and investigated. Numerical simulation has shown that smart TMD presented good control performance for displacement response but acceleration response was not controlled well.

De-identifying Unstructured Medical Text and Attribute-based Utility Measurement (의료 비정형 텍스트 비식별화 및 속성기반 유용도 측정 기법)

  • Ro, Gun;Chun, Jonghoon
    • The Journal of Society for e-Business Studies
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    • v.24 no.1
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    • pp.121-137
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    • 2019
  • De-identification is a method by which the remaining information can not be referred to a specific individual by removing the personal information from the data set. As a result, de-identification can lower the exposure risk of personal information that may occur in the process of collecting, processing, storing and distributing information. Although there have been many studies in de-identification algorithms, protection models, and etc., most of them are limited to structured data, and there are relatively few considerations on de-identification of unstructured data. Especially, in the medical field where the unstructured text is frequently used, many people simply remove all personally identifiable information in order to lower the exposure risk of personal information, while admitting the fact that the data utility is lowered accordingly. This study proposes a new method to perform de-identification by applying the k-anonymity protection model targeting unstructured text in the medical field in which de-identification is mandatory because privacy protection issues are more critical in comparison to other fields. Also, the goal of this study is to propose a new utility metric so that people can comprehend de-identified data set utility intuitively. Therefore, if the result of this research is applied to various industrial fields where unstructured text is used, we expect that we can increase the utility of the unstructured text which contains personal information.

Analysis of the Risk Factors for Posterior Migration of Single Cage after Transforminal Lumbar Interbody Fusion (경추간공 요추 추체간 유합술 후 단일 케이지 후방이동의 위험인자에 대한 분석)

  • Ko, Young-Chul;Ha, Dong-Jun;Park, Man-Jun;Huh, Jung-Wook;Park, Joon-Hyung;Lee, Woo-Myung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.237-243
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    • 2019
  • Purpose: To analyze the risk factors for posterior migration of a single cage after transforminal lumbar interbody fusion (TLIF). Materials and Methods: This study was conducted retrospectively on 48 patients (60 discs) who were followed-up for 1 year after TLIF from January 2015 to January 2017. The patients were divided into two groups: group 1 containing 16 patients (17 discs) with cage migration and group 2 containing 32 patients (43 discs) without it. Information related to cage migration, such as the demographic factors, shape of disc, level and location of the cage inserted, and disc height change, was acquired from the medical records and radiologic images, and the possibility for generating posterior migration of cage was evaluated statistically. Results: The demographic factors and cage-inserted level were similar in the two groups (16 patients in group 1, 32 patients in group 2). In the migration group, number of patients with a pear-type disc, 9 patients, was significantly larger; the disc height change, 1.8 mm, was significantly smaller; and the cage was located frequently on non-center in the anteriorposterior view and center in the lateral view in 9 and 15 out of 16 patients, respectively. Conclusion: A pear-type disc shape, small disc height change, cage with non-center on the anteriorposterior view and non-anterior on the lateral view are the risk factors for posterior migration. These factors are important for preventing posterior migration of the cage.

Giant Schwannoma May Mimic Soft Tissue Sarcoma (악성 연부 종양으로 오인하기 쉬운 신경 및 연부조직의 거대 신경초종)

  • Kim, Yongsung;Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kim, Kyunghoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.511-519
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    • 2020
  • Purpose: Schwannoma is a benign tumor that occurs mainly in the peripheral nerve. If the tumor is large or is in areas other than the nerves, it is likely to be mistaken for malignant soft tissue tumors. The authors reviewed 50 cases of giant schwannomas and assessed the distribution of the primary locations, clinical symptoms, radiological and pathological diagnosis, and diagnostic accuracy. Materials and Methods: Of the 214 pathologically confirmed schwannomas, 50 cases with a maximum diameter of 5 cm or more were extracted. The entire cohort was classified into three subgroups (major peripheral nerve, intramuscular, bone) according to the primary location, and the anatomical locations were specified. Results: When the entire cohort was classified according to the primary location, 14 tumors occurred in the major peripheral nerve, 31 cases in the muscle, and 5 cases in the bone. The mean size of the tumor in the entire cohort was 7.0 cm, and the intramuscular subgroup had the largest size with 8.0 cm. The radiological diagnosis revealed 33 out of 50 cases to be benign schwannoma (66.0%), 15 cases as low-grade malignancy (30.0%), and the remaining two cases (4.0%) as a suspicious tuberculosis abscess and tenosynovial giant cell tumor, respectively. On the clinical symptoms, Tinel sign was the most common in the peripheral nerve group with 78.6% (11/14), while 93.5% of the intramuscular group had palpation of the mass with a mean duration of 66.6 months. In the bone group, one out of five cases was reported as a low-grade malignancy. Two cases of postoperative complications were encountered; one was bleeding after tumor excision, which required hemostasis, and the other was peroneal nerve palsy after surgery. Conclusion: When assessing the large-sized soft tissue tumors in the muscles, the possibility of a benign schwannoma should be considered if 1) there is a long period of mass palpation and 2) non-specific findings in MRI. Preoperative pathology confirmation with a biopsy can help reduce the risk of overtreatment.