• Title/Summary/Keyword: Bone Disease

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Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases (무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고)

  • Chang, Sei-Kyung;Kim, Jae-Hwa;Ha, Doo-Hoe;Kang, Hae-Youn;Chong, So-Young;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.201-206
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    • 2006
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

Vertebral Osteosarcoma Causing Compression of the Lumbar Spinal Cord in a Dog (개에서 요추부 척수를 압박하는 척추 골육종 발생례)

  • Kang, Byung-Jae;Ryu, Hak-Hyun;Park, Sung-Su;Rahman, Md. Mizanur;Sung, Gyu-Jin;Kim, Yong-Sun;Park, Jun-Won;Kim, Wan-Hee;Yoon, Jung-Hee;Kim, Dae-Yong;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.588-592
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    • 2010
  • A 15-year-old neutered male Yorkshire terrier was presented with a gait disorder of the pelvic limbs. For differential diagnosis of neural disease, magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. CT showed bone defect in the 4th lumbar vertebra and adjacent soft tissue mass. MRI revealed a mass in left side of the 4th lumbar vertebra. The mass was uniformly enhanced on contrast-enhanced T1-weighted imaging (T1W1). Excision of the mass alleviated back pain. Vertebral osteosarcoma was identified by the histopathological examination. Therefore, CT and MRI were helpful to diagnose vertebral osteosarcoma in the dog and to plan surgical excision of the mass.

Biomechanical Analysis of a Combined Interspinous Spacer with a Posterior Lumbar Fusion with Pedicle Screws (척추경나사못을 이용한 유합술과 동반 시술된 극돌기간 삽입기구의 생체역학적 연구)

  • Kim, Y.H.;Park, E.Y.;Lee, S.J.
    • Journal of Biomedical Engineering Research
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    • v.36 no.6
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    • pp.276-282
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    • 2015
  • Recently, during the multi-level fusion with pedicle screws, interspinous spacer are sometimes substituted for the most superior level of the fusion in an attempt to reduce the number of fusion level and likelihood of degeneration process at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the interspinous spacer combined with posterior lumbar fusion with a previously-validated 3-dimensional FE model of the intact lumbar spine (L1-S1). The post-operative models were made by modifying the intact model to simulate the implantation of interspinous spacer and pedicle screws at the L3-4 and L4-5. Four different configurations of the post-op model were considered: (1) a normal spinal model; (2) Type 1, one-level fusion using posterior pedicle screws at the L4-5; (3) Type 2, two-level (L3-5) fusion; (4) Type 3, Type 1 plus Coflex$^{TM}$ at the L3-4. hybrid protocol (intact: 10 Nm) with a compressive follower load of 400N were used to flex, extend, axially rotate and laterally bend the FE model. As compared to the intact model, Type 2 showed the greatest increase in Range of motion (ROM) at the adjacent level (L2-3), followed Type 3, and Type 1 depending on the loading type. At L3-4, ROM of Type 2 was reduced by 34~56% regardless of loading mode, as compared to decrease of 55% in Type 3 only in extension. In case of normal bone strength model (Type 3_Normal), PVMS at the process and the pedicle remained less than 20% of their yield strengths regardless of loading, except in extension (about 35%). However, for the osteoporotic model (Type 3_Osteoporotic), it reached up to 56% in extension indicating increased susceptibility to fracture. This study suggested that substitution of the superior level fusion with the interspinous spacer in multi-level fusion may be able to offer similar biomechanical outcome and stability while reducing likelihood of adjacent level degeneration.

Outcomes of Treatment for Squamous Cell Carcinoma Originating as a Marjolin's Ulcer (Marjolin 궤양으로 발생한 편평 상피암의 치료결과)

  • Kim, Jong-Kil;Yu, Chang-Eun;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.1-6
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    • 2012
  • Purpose: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. Materials and Methods: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. Results: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. Conclusion: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.

Distal Radius Osteosarcoma (원위 요골 골육종)

  • Song, Won-Seok;Won, Ho-Hyun;Lee, Jeong-Dong;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.55-61
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    • 2010
  • Purpose: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. Materials and Methods: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. Results: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. Conclusion: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.

Effects of Bia-hwan (Féiér-wán) on the Ovariectomized Rat Model of Osteoporosis (비아환(肥兒丸)이 난소적출로 유발된 흰쥐의 골다공증 모델에 미치는 영향)

  • Cho, Chang-Young;Kim, Eun-Young;Kim, Dong Hee;Kim, MinBeom;Kim, Sang-bae;Yang, KyuJin;Sohn, Youngjoo;Jung, Hyuk-Sang
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.2
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    • pp.19-27
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    • 2017
  • Objectives Osteoporosis is a common disease in adults with prevalence rate of more than 40%, and occurs more to female than to male. The purpose of this study is to identify the effect of Bia-hwan ($F{\acute{e}}i{\acute{e}}r$-$w{\acute{a}}n$) on the osteoporosis of ovariectomized rats. Methods 24 female rats were randomly assigned to a SHAM group, a control group, and a BAH group. Ovaries of the control group and the BAH group were extracted. After than, general animal feed were given to the SHAM group and the control group, animal feed contained BAH were given to the BAH group through mouths of them. After 8 weeks, rats were sacrificed and their weight, calcium, phosphorus, estradiol, total-cholesterol, triglyceride, ALP, albumin, AST, ALT, the weight of femur and tibia ash per body ratio, both area and thickness of trabecular bone, the area of osteoblast and the number of osteoclast were measured. Results The level of calcium, phosphorus, AST in the serum of the BAH group increased significantly compared to the control group. There was no significant difference between the control group and the BAH group in the level of estradiol, total-cholesterol, triglyceride, ALP, albumin, and ALT in the serum. There was no significant difference between the control group and the BAH group in the weight of femur and tibia ash per body ratio. The thickness of trabecular of the BAH group increased significantly compared to the control group, but there was no significant difference in the trabecular area. The area of osteoblast and the number of osteoclast of the BAH group decreased significantly compared to the control group. Conclusions From the results of the above study, oral intake of BAH can inhibit the decrease of calcium, phosphorus in blood and prevent the thinning process of the trabecular by suppressing activation of osteoclast. Thus, BAH may have effects on the treatment and prevention of osteoporosis.

A Clinical Study of Distant Metastasis in Adenoid Cystic Carcinoma (원격전이를 동반한 선양낭포암에 대한 고찰)

  • Kwon, Soon-Young;Kim, Hyung-Jin;Jo, Sung-Dong;Baek, Seung-Kuk;Jung, Kwang-Yoon;Choi, Geon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.29-33
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    • 2001
  • Background and Objectives: Adenoid cystic carcinoma (ACC) is an aggressive, often indolent tumor, with a high incidence of distant metastasis (DM). Relatively little has been written about the factor that influence distant spread and subsequent survival because it is uncommon and has protracted clinical course. We attempted to reemphasize the biologic behavior of ACC by investigating the relationship between the clinical features and prognosis. Materials and Methods : We have retrospectively studied 24 determinate patiens who received definitive treatment in our hospital between 1984 and 1995 for ACC in all salivary sites. Inclusion criteria were no prior treatment elsewhere other than excisional biopsy and eligibility for follow-up of at least 5 years. Variables assessed for their impact on distant metastasis included age, gender, size, node status, stage, histologic pattern, locoregional treatment failure. Results : Treatment failure occurred in a total of 16 of 24 determinate Patients (64%), 12 of whom had DM (50%). This was usually associated with locoregional recurrence (8 patients), but DM was the only indication of failure in 4 whose primary tumor was controlled. Of the 12 patients with known DM, the lung was recored as the only involved site in 7 Patients, lung was involved in addition to other sites in 1, bone and liver metastasis occurred in 2 respectively. Disease-free intervals varied from 3 month to 14 years (median 3 years). The only significant factors influencing survival were the size of the primary tumor, locoregional recurrence. Conclusion : The high incidence of DM with locoregional failure confirms the importance of aggressive initial surgery. combined with irradiation, for high-stage tumors or involved surgical margins. Large tumor size and locoregional recurrence, rather than microscopic appearance, were predictive of DM.

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A Case of Pulmonary Intravascular Lymphomatosis (폐를 침범한 혈관내 림프종증 1예)

  • Park, Sang-Jong;Bae, Sang-Su;Cheon, Eun-Mi;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Kim, Jin-Guk;Lee, Kyung-Soo;Ko, Young-Hye
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1390-1395
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    • 1997
  • Intravascular lymphomatosis(IVL) which was first described by pfleger and Tappeiner in 1959 is rare malignancy characterized by neoplastic proliferation of lymphoid cell lineage within the vascular lumen with little or no adjacent parenchymal involvement Its usual sites of involvement are central nervous system and skin or infrequently heart, lungs, pancreas, liver, spleen, kidney, adrenal glands, genitourinary tract, and bone marrow. Pulmonary involvement of IVL is not common. Symptoms of pulmonary involvement include dyspnea, cough and fever. Radiologicially, the disease is manifested with diffuse interstitial infiltrates. We report a recently experienced case of pulmonary intravascular lymphomatosis which was manifested with fever and chest pain.

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Regulation of cementoblast differentiation and mineralization using conditioned media of odontoblast (상아모세포의 조건배지를 이용한 백악모세포의 분화와 석회화 조절)

  • Moon, Sang-Won;Kim, Hye-Sun;Song, Hyun-Jung;Choi, Hong-Kyu;Park, Jong-Tae;Kim, Heung-Joong;Jang, Hyun-Seon;Park, Joo-Cheol
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.385-396
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    • 2006
  • For the regeneration of periodontal tissues, the microenvironment for new attachment of connective tissue fibers should be provided, At this point of view, cementum formation in root surface plays a key role for this new attachment. This study was performed to figure out which factor promotes differentiation of cementoblast Considering anatomical structure of tooth, we selected the cells which may affect the differentiation of cementoblast - Ameloblast, OD11&MDPC23 for odontoblasts, NIH3T3 for fibroblsts and MG63 for osteoblasts. And OCCM30 was selected for cementoblast cell line. Then, the cell lines were cultured respectively and transferred the conditioned media to OCCM30. To evaluate the result, Alizarin red S stain was proceeded for evaluation of mineralization. The subjected mRNA genes are bone sialoprotein(BSP), alkaline phosphate(ALP) , osteocalcin(OC), type I collagen(Col I), osteonectin(SPARC ; secreted protein acidic and rich in cysteine). Expression of the gene were analysed by RT-PCR, The results were as follows: 1. For alizarin red S staining, control OCCM30 didn't show any mineralized red nodules until 14 days. But red nodules started to appear from about 4 days in MDPC-OCCM30 & OD11-OCCM30. 2. For results of RT-PCR, ESP mRNAs of control-OCCM30 and others were expressed from 14 days, but in MDPC23-OCCM30 & OD11-OCCM30 from 4 days. Like this, the gene expression of MDPC23-OCCM30 & OD11-OCCM30 were detected much earlier than others. 3. For confirmation of odontoblast effect on cementoblast, conditioned media of osteoblasts(MG63) which is mineralized by producing matrix vesicles didn't affect on the mineralized nodule formation of cementoblasts(OCCM30). This suggest the possibility that cementoblast mineralization is regulated by specific factor in dentin matrix protein rather than matrix vesicles. Therefore, we proved that the dentin/odontoblast promotes differentiation/mineralization of cementoblasts. This new approach might hole promise as diverse possibilities for the regeneration of tissues after periodontal disease.

ORTHODONTIC TREATMENT OF THE PALATALLY IMPACTED MAXILLARY CANINE (구개측 매복된 상악 견치의 교정적 치험례)

  • Kam, Dong-Hoon;Kim, Jung-Wook;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.1
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    • pp.127-133
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    • 1998
  • An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

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