• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.36-39
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• 2014

Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.

• Molecules and Cells
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• 제24권2호
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• pp.177-184
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• 2007

Approximately 200 individual skeletal elements, which differ in shape and size, are the building blocks of the vertebrate skeleton. Various features of the individual skeletal elements, such as their location, shape, growth and differentiation rate, are being determined during embryonic development. A few skeletal elements, such as the lateral halves of the clavicle and parts of the skull are formed by a process called intramembranous ossification, whereby mesenchymal cells differentiate directly into osteoblasts, while the majority of skeletal elements are formed via endochondral ossification. The latter process starts with the formation of a cartilaginous template, which eventually is being replaced by bone. This requires co-regulation of differentiation of the cell-types specific for cartilage and bone, chondrocytes and osteoblasts, respectively. In recent years it has been demonstrated that Wnt family members and their respective intracellular pathways, such as non-canonical and the canonical $Wnt/{\beta}$-catenin pathway, play important and diverse roles during different steps of vertebrate skeletal development. Based on the recent discoveries modulation of the canonical Wnt-signaling pathway could be an interesting approach to direct stem cells into certain skeletal lineages.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.82-85
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• 2016

We report two cases of cleidocranial dysplasia, which was managed without significant craniofacial osteotomy. A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. In both patients, radiologic evaluation revealed the underdeveloped maxilla, persistent fontanelle opening, and cleidal aplasia. Clinical findings and radiologic studies were consistent with the diagnosis of cleidocranial dysplasia. Both patients underwent forehead plasty via bicoronal approach, augmentation rhinoplasty using tip plasty, and epicanthoplasty. In addition, the mother underwent malar augmentation using Medpor implantation and reduction genioplasty. The patients did not experience any postoperative complication and remained satisfied with the operation at 6-year follow-up.

• Journal of Chest Surgery
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• 제39권3호
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• pp.251-254
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• 2006

견관절의 골절 고정에 주로 이용되는 K-강선(Kirschner wire)은 드물게 흉곽 내, 또는 다른 장기로 원격 이동되는 것이 보고되었다. 흉곽 내로 이동된 K-강선은 대부분 개흉술을 통하여 제거되어 왔으나, 최근에는 종격동의 중요 장기를 침범하지 않은 K-강선에 한하여 흉강경을 이용한 제거가 가능한 것으로 보고되었다. 본원에서는 쇄골 고정에 이용되었던 K-강선이 흉곽 내 폐의 우상엽을 침범한 환자에게서 흉강경 수술로 성공적으로 제거하였기에 보고하는 바이다.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.47-50
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• 2019

Irreducible dislocation of the distal interphalangeal (DIP) joint is a rare traumatic condition commonly seen in sports injuries. Herein, we present a case with chronic dislocation of the DIP joint caused by high energy trauma accompanied by a fracture of the ipsilateral clavicle. The local deformity resulting from the dislocation can be trivial. Therefore, obtaining radiographs of all the interphalangeal joint injuries, regardless of the findings on inspection, is crucial for accurate diagnosis in the case of high energy trauma. The good functional improvement was obtained by open reduction and temporary wire fixation for 4 weeks.

• Journal of Breast Cancer
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• 제21권4호
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• pp.463-467
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• 2018

Metastasis from primary cancer to the thyroid is uncommon in breast cancer. Here we present a case of lobular breast carcinoma that metastasized to the thyroid. A 54-year-old woman without symptoms was admitted to our institution for staging of the lymph node above the left clavicle. An $^{18}F$-fluoro-deoxy-D-glucose positron emission tomography scan was performed for staging, and low uptakes were observed in the left supraclavicular and cervical lymph nodes. High uptake was seen in the posterior and lower left lobe of the thyroid. Histologic findings indicated lobular breast carcinoma (positive GATA3, loss of E-cadherin expression) metastatic to the thyroid with a luminal profile. Immunohistochemical analysis was negative for primary thyroid or parathyroid carcinoma. To our knowledge, this is the first report of a patient presenting a metastatic invasive lobular carcinoma in the thyroid and lymph nodes without a prior diagnosis of breast cancer.

• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.106-109
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• 2019

Acromial fractures are well-documented complications subsequent to reverse shoulder arthroplasty (RSA), and most appear as stress fractures with no history of single trauma. To date, no study has reported the occurrence of acute displaced acromial fracture due to sudden strong deltoid contraction during heavy work. Displacement of the fracture results in a challenging surgery since it is difficult to obtain adequate fixation in thin and osteoporotic bones. We report a rare case of acute displaced acromial fracture after successful RSA treatment, using a novel technique of open reduction and internal fixation, applying two 4.5 mm cannulated screws and lateral clavicle precontoured plate.

• Journal of Trauma and Injury
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• 제37권2호
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• pp.158-160
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• 2024

Arterial thoracic outlet syndrome (TOS) resulting from thoracic trauma is an exceedingly rare condition, typically caused by a fracture of the first rib or clavicle. In this report, the author presents a case of traumatic arterial TOS precipitated by multiple left rib fractures, notably excluding the first rib, following a fall from a 2-m high stepladder. The patient was treated successfully with first rib resection via a transaxillary approach, and the postoperative course was uneventful. The literature includes no known reports of traumatic arterial TOS in patients with multiple fractures that spare the first rib, making this the first documented case of its kind. In this instance, the patient sustained fractures to the fourth and fifth ribs. The TOS was likely not a direct result of the multiple rib fractures, which were located some distance from the thoracic outlet. Rather, it is hypothesized that the trauma from these fractures caused a soft tissue injury within the thoracic outlet, which ultimately led to the development of TOS.

• 대한방사선치료학회지
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• 제29권2호
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• pp.109-117
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• 2017

목 적: 두경부 환자가 입체적 세기변조 회전 방사선치료 시 변화하는 체형과 환자 정열 상태를 조사하고 그에 따라 치료 시 발생하는 선량분포의 변화와 적절한 재 CT 모의치료의 필요성을 평가하고자 한다. 대상 및 방법: 근치적 목적으로 방사선 치료를 시행한 두경부암 89명에 대해 입체적 세기변조 방사선치료계획을 수립하고 치료 기간 동안의 체중을 측정하였다. 그 중 10명의 환자에 대하여 체형변화를 평가하였다. ARIA software(Offline review)를 이용하여 ramus, chin, posterior neck, clavicle 등의 landmark를 지정한 후 skin까지의 거리를 측정하여 차이를 분석하였다. 결 과: 남성 60명을 대상으로 치료시행 $17{\pm}4$회에서 re-CT 모의치료를 시행한 결과 체중 감소율이 $-6.47{\pm}3.5%$로 나타났으며, 여성 29명은 경우는 $17{\pm}5$회에서 체중 감소율이 $-5.73{\pm}2.7%$로 나타났다. 피부위축(Skin shrinkage) 변화를 관찰한 결과 대표 landmark에서의 표준편차는 C1(${\pm}0.44cm$), C3(${\pm}0.83cm$), C5(${\pm}1.35cm$)로서 0.5 kg 감소 당 약 1 mm shrinkage 발생함을 알 수 있었다. 치료 횟수에 따른 피부위축은 1~4 fx (변화 없음), 5~13 fx (-2 mm), 14~22 fx(-4 mm), 23~30 fx(-6 mm)로 나타났다. 결 론: 체형이 약 5 mm 변화하게 되면 중심부 선량은 약 3 % 이상 차이나기 시작하게 되므로 적응증치료에 필요한 CT 모의치료를 추가로 진행하여야만 한다. 또한 적극적으로 lower neck의 CT 모의치료 방법 및 set up 방법에 관하여 연구하고 새로운 고정용구(Immobilization device)의 사용도 검토할 필요가 있다.

• 한국어류학회지
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• 제13권2호
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• pp.129-135
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• 2001

강원도 춘천시 소양호의 2개소와 강원도 홍천강 지류에서 채포한 쏘가리 친어로부터 받은 수정난을 부화 사육하면서 성장에 따른 골격 발달을 조사하였다. 부화 후 3일째 전장 6.17 mm 자어에서 부설골 (parasphenoid), 쇄골 (clavicle), 설악골 (hyomandibular), 전새개골 (preopercle), 주새개골 (opercle), 악골과 7~8개의 송곳니(canine teeth)가 골화하기 시작하였다. 부화 후 10일째 전장 6.85 mm인 자어는 턱부분 중 윗턱이 신출 가능한 구조로 발달하였으며 양턱에 각각 19, 23개의 이빨이 형성되었다. 척추골은 앞에서부터 5~7개가 골화하기 시작하였다. 부화 후 22일째 전장 10.99 mm의 치어는 척추골이 12+16=28개로 골화가 완성되었다. 골격은 부화 후 3일째 전기자어기에 최초로 골화가 시작되어, 부화 후 22~24일째 전장 10~12mm인 치어기에 완료되었다.