• Title/Summary/Keyword: Musculoskeletal Cell

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The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone (거대세포종의 치료시 관절 기능의 보존)

  • Bae, Dae-Kyung;Han, Chung-Soo;Sun, Seung-Deok;Baek, Chang-Hee;Rhee, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.145-153
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    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

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Treatment Outcomes of Sacral Giant Cell Tumor (천골 거대 세포종의 치료 결과)

  • Kong, Chang-Bae;Lee, Kwang-Youl;Song, Won-Seok;Cho, Wan Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.43-49
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    • 2013
  • Purpose: We analyzed the treatment outcomes of patients with sacral giant cell tumor. Materials and Methods: We retrospectively reviewed 7 patients with giant cell tumor of the sacrum who were treated at out institution between 1990 and 2012. Results: There were 2 men and 5 women with mean age of 23.6 years. The average follow up was 52.3 months (range, 15-73 months). Six patients received surgical treatment. Intralesional curettage was performed for the 5 patients and marginal resection for another one patient. The remaining one patient was received radiation only. The patients who received radiation therapy and marginal excision had no residual or recurrent tumors. Of 5 patients with intra-lesional excision, one patient needs one more operation; two patients need two more operation for local control of the giant cell tumor. The remaining two patients failed to gain local control in spite of additional treatments. Conclusion: For the treatment of sacral giant cell tumor, intralesional resection can be one of the treatments option with minimal neurologic injury. Furthermore, radiation therapy can be recommended when complete excision or curettage is impractical.

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.

Tumor Prosthetic Replacement for the Metastatic Bone Tumors Involving the Proximal Femur (대퇴골 근위부 전이성 종양 환자의 종양 대치물 삽입술)

  • Sung, Ki-Sun;Chang, Moon-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.48-54
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    • 2007
  • Purpose: To evaluate clinical results of the tumor prosthetic replacement for pathologic fracture of the proximal femur with extensive bony destruction due to metastatic bone tumors. Materials and Methods: From 2005 October to 2006 October, resection of proximal femur and tumor prosthesis replacement was performed for metastatic bone tumors extensively involving trochanteric area in 6 patients. The mean age of overall patients was 61(range, 48~77). Mean clinical follow up was 10.5 months (range, 6~16). Primary tumor consisted with multiple myeloma in 2 patients, lung cancer in 1, breast cancer in 1, transitional cell carcinoma of the renal pelvis in 1, unknown origin in 1 patient. $MUTARS^{(R)}$ proximal femur (Implantcast, Munster, Germany) were used in all cases. The functional evaluation in the lower extremities was performed with Musculoskeletal Tumor Society 1993 scores. The degree of pain relief after surgical treatment was assessed with Visual Analogue Scale (VAS). Results: At the final follow up, all of the patients survived. The mean lower extremities functional score of Musculoskeletal Tumor Society 1993 was 17.8(59.3%)(range, 12~25). VAS was improved to 2.5 from 8.5 after the surgical treatment. Ambulation was encouraged as soon as possible and mean duration after surgery for ambulation was 7.3(range, 3~16) days. Post-operatively, there was no surgical infection, periprosthetic fracture or loosening. Dislocation occurred in one out of six cases. Conclusion: Resection of proximal femur and tumor prosthesis replacement for metastatic bone tumors around proximal femur extensively involving trochanteric area seems to be safe procedure in view of post-operative complication, and effective for functional restoration as well as pain relief. Thus, it is accordant to the treatment principle of the metastatic bone tumors.

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Treatment of Squamous Cell Carcinoma in Extremity (사지에 발생한 편평세포 상피암의 치료)

  • Lee, Doo-Hyung;Shin, Kyoo-Ho;Lee, Soo-Hyun;Hahn, Soo-Bong
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.126-133
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    • 2005
  • Purpose: to know the treatment result of squamous cell carcinoma in extremity had poor prognosis with risk factor including burn scar and chronic osteomyelitis. Material and Methods: Between Octorber 1993 and September 2002, 20 patients with squamous cell carcinoma in extremity had no distant metastasis was got operation and followed over 36 months. Amputation was done when it was hard to get enough wide margin or neurovascular structure was involved instead of wide excision. Mean age of patients was 57.2 years old and male to female was 16 to 4. TMN staging and histologic grading were performed. Results: There were 6 metastasis (30%) in 20 cases for mean 48.3 months (36-84 months). 3 metastasis to local lymph node and 3 distant metastasis were happened at lung (in 3 cases) and thorasic vertebra (in 1 case). Survival was 18 cases at last look. 5-year survival rate was 50%. 3 local recurrence was developed at average 11 months (4-18 months). Complication was focal skin defect after wide excision and skin graft in 2 cases. The patients by wide excision got average 1.9 time operation and by amputation got average 1.3 time. Conclusion: Squamous cell carcinoma at extremity in Korea had high metastasis rate due to burn scar and chronic osteomyelitis, and it showed equal treatment result which treated by wide excision compared with amputation.

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Evidence for VH Gene Replacement in Human Fetal B Cells

  • Lee, Jisoo;Cho, Young Joo;Lipsky, Peter E.
    • IMMUNE NETWORK
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    • v.2 no.2
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    • pp.79-85
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    • 2002
  • Background: In contrast to evidences of Ig H chain receptor editing in transformed cell lines and transgenic mouse models, there has been no direct evidence that this phenomenon occurs in human developing B cells. Methods: $V_HDJ_H$ rearrangements were obtained from genomic DNA of individual $IgM^-$ B cells from liver and $IgM^+B$ cells from bone marrow of 18 wk of gestation human fetus by PCR amplification and direct sequencing. Results: We found three examples of H chain receptor editing from $IgM^+$ and $IgM^-human$ fetal B cells. Two types of $V_H$ replacements were identified. The first involved $V_H$ hybrid formation, in which part of a $V_H$ gene from the initial VDJ rearrangement is replaced by part of an upstream $V_H$ gene at the site of cryptic RSS. The second involved a gene conversion like replacement of CDR2, in which another $V_H$ gene donated a portion of its CDR2 sequence to the initial VDJ rearrangement. Conclusion: These data provide evidence of receptor editing at the H chain loci in developing human B cells, and also the first evidence of a gene conversion event in human Ig genes.

Development of wearable Range of Motion measurement device capable of dynamic measurement

  • Song, Seo Won;Lee, Minho;Kang, Min Soo
    • International journal of advanced smart convergence
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    • v.8 no.4
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    • pp.154-160
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    • 2019
  • In this paper, we propose the miniaturization size of wearable Range of Motion(ROM) and a system that can be connected with smart devices in real-time to measure the joint movement range dynamically. Currently, the ROM of the joint is directly measured by a person using a goniometer. Conventional methods are different depending on the measurement method and location of the measurement person, which makes it difficult to measure consistently and may cause errors. Also, it is impossible to measure the ROM of joints in real-life situations. Therefore, the wearable sensor is attached to the joint to be measured to develop a miniaturize size ROM device that can measure the range of motion of the joint in real-time. The sensor measured the resistance value changed according to the movement of the joint using a load cell. Also, the sensed analog values were converted to digital values using an Analog to Digital Converter(ADC). The converted amount can be transmitted wireless to the smart device through the wearable sensor node. As a result, the developed device can be measured more consistently than the measurement using the goniometer, communication with IoT-based smart devices, and wearable enables dynamic observation. The developed wearable sensor node will be able to monitor the dynamic state of rehabilitation patients in real-time and improve the rapid change of treatment method and customized treatment.

Periosteal Ganglion of the Distal Fibula - A Case Report - (원위 비골에서 발생한 골막하 결절종 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.178-181
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    • 2008
  • In contrast to ganglion of the soft tissue, periosteal ganglion occurring within or beneath the periosteum is a rare disorder. The differential diagnosis includes periosteal chondroma, lipoma, giant cell tumor of tendon sheath and periosteal osteosarcoma. Most common location for periosteal ganglion is the tibia, followed by radius, femur and ulna. To our knowledge, only 1 case of periosteal ganglion of the fibula has been reported in the literature. We report a case of periosteal ganglion of the distal fibula in a thirty-year-old woman treated with excision of the cyst and the adjacent periosteum.

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The Guideline Construction for the Manufacturing Process of Working Environment Applying Ergonomic Engineering (인체공학을 적용한 제조공정 작업환경에 대한 가이드라인 구축)

  • Kim, Hwa-Sik;Choi, Seong-Dae
    • Journal of the Korean Society of Industry Convergence
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    • v.13 no.4
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    • pp.219-225
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    • 2010
  • A structure of line for producing products is variously changing to be automatic and one-person Cell-Line considering the physical burden for workers in manufacturing industry of electronic goods. However, workers tend to still accuse Work-related Musculoskeletal Disorders (including shoulder, waist, hand, wrist, leg etc.) as a simply repeated work by accelerating of the production speed for productivity improvement in the assembly line. Thus manufacturing engineers in charge of changing and set up newly for an assembly line are necessary to the construct of the guideline on human engineering. Especially. There is no standardized engineering-guide and it is difficult to create the exact work environment because the risk factor analysis and the improvement for assembly line are executed once a year on the current situation. I'd like to reduce the physical burden on workers through the effective improvement of processing by the guideline on working environment fit for a characteristic on manufacturing process when the process is changed or newly installed.

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Malignant Transformation to Osteosarcoma from GCT (골육종으로 악성 전환된 거대 세포종 - 증례 보고 -)

  • Cho, Wan-Hyung;Lee, Seung-Jun;Cho, Sang-Hyeon;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.167-172
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    • 2007
  • Malignant transformation of giant cell tumor (GCT) is known to be rare. Most of malignant transformation is reported to occur after radiation and malignant transformation without prior radiation is extremly rare. Both radiographic and pathologic findings are confusing to make a correct diagnosis. Due to the poor prognosis, early aggressive treatment is mandatory. We report this rare case together with the review of the literature.

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