• Title/Summary/Keyword: 하지통증

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Synovial Sarcoma of the Anterior Chest Wall: A Case Report (앞가슴벽에 생긴 윤활막육종: 증례 보고)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1227-1233
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    • 2020
  • Synovial sarcoma is a malignant soft tissue tumor that usually involves the extremities, particularly near the knees; a synovial sarcoma originating in the chest wall is extremely rare. We describe a 26-year-old woman diagnosed with a synovial sarcoma originating in the chest wall, based on CT and MRI findings. Contrast-enhanced CT images revealed a small, well-defined enhancing mass with calcification, in the subpleural area. This lesion was initially diagnosed as a benign tumor; however, the patient developed sudden severe pain with spontaneous bleeding and hemothorax, suggesting the possibility of malignancy. MRI revealed a multilobulated mass with a fluid-fluid level, which characterizes a synovial sarcoma.

Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

A Study on Awareness of Dental Treatment and Oral Health Management during the Period of Pregnancy-(Focusing on Women of Childbearing Ages and Women of Childbirth Experience) (임신 중 구강진료 및 구강건강관리의 인지도에 관한 연구 (가임여성과 출산경험이 있는 여성을 대상으로))

  • Park, Myung-Suk;Kim, Jung-Hee
    • Journal of dental hygiene science
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    • v.9 no.2
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    • pp.231-239
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    • 2009
  • The study distributed the total 210 questionnaires to women of childbearing age in Seoul, Gyeonggi and North Chungcheng from March 26, 2008 to April 16, 2008 and made them draw up them directly. The study applied 208 copies excepting two copies not suitable to data process to data analysis. The purpose of the study was to investigate/analyze awareness of dental treatment, oral health conditions and oral health management during the period of pregnancy and to serve the analyzed data as basic data of oral health education program development to improve expectant mothers' behaviors of oral health management: 1. According to the survey by age with regard to a question 'Should expectant mothers take dental treatment during the period of pregnancy?', women of 18~29 years old (41.9%) and more than 50 years old (52.0%) answered 'They should not take dental treatment'. Women of 30~39 years old (53.6%) and 40~49 years old (54.7%) answered 'They should take dental treatment'. According to pregnant experience, expectant mothers (63.9%) and women with their parity (46.3%) answered 'They should take dental treatment'. 34.8% women without their parity answered 'They should take dental treatment' and 34.8% women with Out their parity answered 'They should not take dental treatment'(p < 0.05). 2. According to the survey by age with regard to a question 'Do you brush your teeth lifter having morning sickness during the period of pregnancy?', women of 18~29 years old (67.3%), 30~39 years old (47.3%) answered 'Brush my teeth' and women of 40~49 years old (51.0%) and more than 50 years old (52.0%) answered 'Don't brush my teeth'(p < 0.001). According to pregnant experience, expectant mothers (72.2%) and women with their parity (43.0%) answered 'Brush my teeth'(p < 0.05). 3. With regard to a question 'Are oral aid hygiene supplies required?', women of 18~29 years old (47.3%) and 30~39 years old (46.4%) answered 'Required' and women of 40~49 years old (41.5%) and more than 50 years old (48.0%) answered 'do not know'(p < 0.05). 4. According to the survey by age with regard to a question 'What are you anxious about during the period of dental treatment?', women of more than 50 years old (56.0%) answered 'Expenses' and women of 18~29 years old (39.2%), 30~39 years old (44.6%) and 40~49 years old (41.5%) answered 'Pain'(p < 0.05). According to pregnant experience, expectant mothers answered 'Pain (38.9%), abort ion (27.8%) and expenses (22.2%)' and women with their parity, answered 'Pain (45.0%), expenses (22.8%) and abortion (14.8%). Women without their parity answered 'Expenses (52.2%) and pain (13.0%)'(p < 0.05).

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Accelerated Rehabilitation After Arthroscopic Bankart Repair - A Prospective Randomized Clinical Study - (관절경적 Bankart 봉합술후 적극적 재활치료 - 전향적 임상연구 -)

  • Kim Seung-Ho;Ha Kwon-Ick;Jung Min-Wook;Lim Moon-Sup;Kim Young-Min;Park Jong-Hyuk;Cho Yang-Bum
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.79-88
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    • 2002
  • Purpose: In this prospective, randomized study, we compared the results of early motion versus conventional immobilization after the arthroscopic Bankart repair. Materilal and Methods : We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic anterior shoulder instability and randomized them into two groups; Group 1 (n=28; mean age, 28 years) underwent three-week of immobilization and conventional rehabilitation program, while Group 2 (n=34; mean age, 29 years) underwent an accelerated rehabilitation program with staged range of motion and strengthening exercises starting from the immediate postoperative day. Selected patients were non-athletes with a classic Bankart lesion and a robust labrum. Analysis of outcome included pain scores (6-week and follow-up: 31(9 months), range of motion, return to activity, recurrence, patients’ satisfaction with each program, and shoulder scores (ASES, UCLA, and Rowe). Results : The recurrent rate was not different between the two groups (2 anterior apprehension from each group) (p=0.842). Patients with accelerated rehabilitation resumed functional range-of-motion faster and returned earlier to the functional level of activity (p<0.05). Accelerated rehabilitation decreased postoperative pain and more patients were satisfied with this program (p<0.05). No differences were found between the two groups at the follow-up with regards to the shoulder scores, return to activity, pain score, and the range-of-motion. Conclusions : Early mobilization after arthroscopic Bankart repair does not increase the recurrence rate in selected patients. Although the final outcomes are similar in both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which enables patients an early institution of desired activities.

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Benefit of Ultrasound-guided Therapeutic Medial Branch Blocks after Percutaneous Epidural Neuroplasty (신경 성형술 후 초음파 유도하 내측 분지 차단술의 유용성)

  • Moon, Sang Ho;Lee, Song;Jung, Jae-Hyun;Shin, Won Shik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.33-38
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    • 2014
  • Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

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Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report (척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고)

  • Hyunjin Choi;Seung Ho Yu;Sangjoon An;Seyun Kim;Woochul Shin;Jae-Heung Cho;Won-Seok Chung;Mi-Yeon Song;Hyungsuk Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.243-249
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    • 2023
  • This case study showed improvement both in pain and gait disturbance caused by SCH. KM can be a positive treatment for reducing pain or improving gait disturbance caused by SCH, and it can be considered a treatment option for SCH. Future studies with a larger number of cases and longer period of follow-up in SCH with gait disturbance and rigidity are needed.

Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

The Validity of a Combined High Saphenous Division and Sclerotherapy for Varicose Vein (하지정맥류의 치료에 있어서 복재정맥 분리 결찰 및 혈관 경화요법 병용의 유용성)

  • Choi Se-Yong;Yang In-Suk;Won Tae-Hee
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.544-548
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    • 2006
  • Background: The purpose of this study is to evaluate the validity of a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein. Material and Method: Between August 2004 and October 2005, 70 limbs in 50 patients were treated by a combined high saphenous vein division and sclero-therapy. The operative indication is valvular incompetence of femoral-saphenous or popliteal-saphenous junction. Patients received local anesthesia and were treated by a combined high saphenous vein division, ligation of incompetent perforating vein and $1{\sim}3%$ sclerosant. Patients received 1 day hospitalization and applied in com-pression stocking for 6 weeks. Patients followed after 1 week, 1 and 3 months. Result: Mean age of patients was $50{\pm}11$. The female was more common. 8 patients was no symptom, another 42 patients complained of pain, heaviness and fatigue of limbs. The symptoms of varicose vein disappeared 1 month after the procedure in all symptomatic patients. 8 patients needed a adjuvant sclerotherapy for residual varicose vein on 1 week after the procedure. There were only minor complications such as hematoma (1), wound infection (1), thrombophlebitis (20), skin blister (10), hyper-pigmentation (1), and skin ulcer (1). Conclusion: We concluded that a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein is simple, less invasive, economical, and effective treatment for primary varicose vein, and it has a special advantage that saphenous vein can be used as a bypass conduit later. The method was selective in old aged patients.

Quality of Life in Korean Patients with Burning Mouth Syndrome (한국인을 대상으로 한 구강작열감증후군 환자의 삶의 질 평가)

  • Park, Ju-Hyun;Kwon, Jeong-Seung;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.81-89
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    • 2011
  • The purpose of this study was to evaluate the individually perceived quality of life in Korean patients with BMS using two questionnaires : the Medical Outcome Short Form Health Survey Questionnaire (SF-36) and the Oral Health Impact Profile (OHIP-49). This cross-sectional study included sixty subjects diagnosed with BMS and sixty healthy subjects as controls. All subjects in this study completed two questionnaires: the Medical Outcome Short Form Health Survey Questionnaire (SF-36) and the Oral Health Impact Profile (OHIP-49), which had been translated into Korean and subsequently validated for use in Korea. All of the subscales in the SF-36 exhibited significantly lower scores in BMS patients than control groups. Comparison of the mean SF-36 scores between the two groups revealed the greatest differences to be for the subscales of physical pain and role emotional (role limitations due to emotional problems). The mean score on each subscale of the OHIP-49 was significantly higher in BMS patients than control groups. Comparison of the mean OHIP-49 scores between the two groups revealed the greatest difference to be for the subscale of physical pain. These findings demonstrated that BMS had an impact on various components of a patient's quality of life. BMS patients exhibited more impaired results and a poorer quality of life than control groups.

Debridement or Tuberoplasty for Massive Rotator Cuff Tear (광범위 회전근 개 파열에 대한 변연절제술 및 결절성형술)

  • Cho, Nam-Su;Oh, Hyun-Sup;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.146-152
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    • 2010
  • Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than $90^{\circ}$ on flexion and abduction.