• 제목/요약/키워드: Osteolysis

검색결과 74건 처리시간 0.031초

인공고관절 치환술에서 대퇴주대 회전에 따른 시멘트막 두께 변화 (Change of the Cement Mantle Thickness According to the Movement of the Femoral Stem in THRA)

  • 박용국;김진곤
    • 한국정밀공학회지
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    • 제24권2호
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    • pp.140-148
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    • 2007
  • THRA(Total Hip Replacement Arthroplasty) has been widely used for several decades as a viable treatment of otherwise-unsolved hip problems. In THRA surgery, cement mantle thickness is critical to long-term implant survival of femoral stem fixed with cement. Numerous studies reported thin or incomplete cement mantle causes osteolysis, loosening, and the failure of implant. To analyze the effect of femoral stem rotation on cement thickness, in this study, we select two most popular stems used in THRA. Using CAD models obtained from a 3D scanner, we measure the cement mantle thickness developed by the rotation of a femoral stem in the virtual space created by broaching. The study shows that as the femoral stem deviates from the target coordinates, the minimum thickness of cement decreases. Therefore, we recommend development of a new methodology for accurate insertion of a femoral stem along the broached space. Also, modification of the stem design robust to the unintentional movement of a femoral stem in the broached space, can alleviate the problem.

Afatinib ameliorates osteoclast differentiation and function through downregulation of RANK signaling pathways

  • Ihn, Hye Jung;Kim, Ju Ang;Bae, Yong Chul;Shin, Hong-In;Baek, Moon-Chang;Park, Eui Kyun
    • BMB Reports
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    • 제50권3호
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    • pp.150-155
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    • 2017
  • Non-small-cell lung cancer (NSCLC) is the third most common cancer that spreads to the bone, resulting in osteolytic lesions caused by hyperactivation of osteoclasts. Activating mutations in epidermal growth factor receptor-tyrosine kinase (EGF-TK) are frequently associated with NSCLC, and afatinib is a first-line therapeutic drug, irreversibly targeting EGF-TK. However, the effects of afatinib on osteoclast differentiation and activation as well as the underlying mechanism remain unclear. In this study, afatinib significantly suppressed receptor activator of nuclear factor ${\kappa}B$ (RANK) ligand (RANKL)-induced osteoclast formation in bone marrow macrophages (BMMs). Consistently, afatinib inhibited the expression of osteoclast marker genes, whereas, it upregulated the expression of negative modulator genes. The bone resorbing activity of osteoclasts was also abrogated by afatinib. In addition, afatinib significantly inhibited RANKL-mediated Akt/protein kinase B and c-Jun N-terminal kinase phosphorylation. These results suggest that afatinib substantially suppresses osteoclastogenesis by downregulating RANK signaling pathways, and thus may reduce osteolysis after bone metastasis.

프라이버그병과 중족지 관절 불안정 (Freiberg's Disease and Metatarsophalangeal Joint Instability)

  • 양기원;김진수;조주원
    • 대한족부족관절학회지
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    • 제17권1호
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    • pp.11-16
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    • 2013
  • Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

  • Kim, Kwang-Yul;Kim, Hyung-Chun;Cho, Sung-Jun;Ahn, Su-Han;Kim, Dong-Seon
    • Clinics in Shoulder and Elbow
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    • 제18권1호
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    • pp.21-27
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    • 2015
  • Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Malignant Metastatic Plasma Cell Tumor in a Dog

  • Park, Jae-Hoon;Kim, Jin-Hyun;Lee, Jung-Kenn;Youn, Hwa-Young;Yoon, Jung-Hee;Kim, Dae-Yong
    • 한국수의병리학회:학술대회논문집
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    • 한국수의병리학회 2001년도 추계학술대회 및 정기총회
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    • pp.28-28
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    • 2001
  • A primary metastatic malignant plasma cell tumor was diagnosed in a 7-year-old, female mixed breed dog. The dog was admitted to Veterinary Teaching Hospital at College of Veterinary Medicine, Seoul National University after suffering from depression, anorexia, and dyspnea. In radiographic examination, a large occupying mass was found at the right cranial thorax. Due to poor prognosis, the dog was euthanized. At surgery, numerous, firm, round, nodules, 1 to 2 cm in diameter were noted in the ribs. The nodules were often confluent and had cylindrical appearance. Osteolysis was associated with the nodules. A large amount of clear fluid was present in the thoracic cavity. The spleen and liver were markedly enlarged and congested. Histologically, the mass was diagnosed as plasma cell tumor which was believed to be originate from the rib. Evidence of metastasis was observed in the spleen, liver, and kidney.

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A Successfully Treated Case of Gorham-Stout Syndrome with Sternal Involvement

  • Kim, Bong Jun;Kim, Tae Hoon;Kim, Do Jung;Noh, Dongsub;Haam, Seok Jin;Lee, Sungsoo
    • Journal of Chest Surgery
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    • 제48권1호
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    • pp.90-94
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    • 2015
  • Gorham-Stout Syndrome (GSS) is a rare disease characterized by localized bone resorption. Any part of the skeleton may be affected; therefore, symptoms can vary depending on the site involved. Pathological analysis reveals lymphovascular proliferation and osteolysis in the affected lesion, but the etiology of the disease is poorly understood. When GSS occurs in the chest, chylothorax or respiratory failure may occur. Thus far, a standard treatment for GSS has not been established, and the prognosis remains unknown. The following case report describes a successfully treated case of GSS in a 16-year-old boy with an affected sternum and ribs.

Maxillary Ameloblastic Carcinoma in a Shih Tzu Dog

  • Jang, Seong-Hwan;Park, Dae-Sik;Lee, Eun-Sung;Kim, Jae-Hoon
    • 한국임상수의학회지
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    • 제36권4호
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    • pp.233-237
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    • 2019
  • A 10-year-old castrated male Shih Tzu dog was submitted to a local animal hospital with a mass from gingiva to maxillofacial skeleton. Computed tomography revealed that strong invasion of the mass result in osteolysis in orbit and frontal bone. The excised mass was presented to the Pathology Department of the Veterinary Medicine, Jeju National University. Surgically excised mass was rubbery to firm in consistency. Histologically, the neoplastic mass was composed of irregular or interdigitating cords, islands or pseudo-glandular structures of stratified epithelial cells. These cords or islands showed typical palisading pattern of neoplastic epithelial cells to periphery without intercellular bridge (desmosome) and surrounded by eosinophilic immature collagenous matrix. Some area showed islands of well differentiated keratinizing squamous cell foci. Some lumen of glandular structures contained fibrin-like materials and RBC. These neoplastic cells showed marked invasive tendency to adjacent connective tissues and bony tissues, therefore solitary neoplastic cells were widely distributed throughout the surround connective tissue. The neoplastic cells showed positive reactions for pan-CK and CK14, weakly positive reaction for CK5/6. And the surrounding immature collagenous matrix was only labeled for vimentin.

Recent updates for biomaterials used in total hip arthroplasty

  • Hu, Chang Yong;Yoon, Taek-Rim
    • 생체재료학회지
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    • 제22권4호
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    • pp.259-270
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    • 2018
  • Background: Total hip arthroplasty (THA) is probably one of the most successful surgical interventions performed in medicine. Through the revolution of hip arthroplasty by principles of low friction arthroplasty was introduced by Sir John Charnley in 1960s. Thereafter, new bearing materials, fixation methods, and new designs has been improved. The main concern regarding failure of THA has been the biological response to particulate polyethylene debris generated by conventional metal on polyethylene bearing surfaces leading to osteolysis and aseptic loosening of the prosthesis. To resolve these problems, the materials of the modern THA were developed since then. Methods: A literature search strategy was conducted using various search terms in PUBMED. The highest quality articles that met the inclusion criteria and best answered the topics of focus of this review were selected. Key search terms included 'total hip arthroplasty', 'biomaterials', 'stainless steel', 'cobalt-chromium', 'titanium', 'polyethylene', and 'ceramic'. Results: The initial search retrieved 6921 articles. Thirty-two articles were selected and used in the review. Conclusion: This article introduces biomaterials used in THA and discusses various bearing materials in currentclinical use in THA as well as the newer biomaterials which may even further decrease wear and improve THA survivorship.

A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra;Jung, Seung Wook;Jung, Hwi-Dong;Lee, In Yong;Yong, Tai-Soon;Jeong, Su Jin;Kim, Hyun Sil
    • Parasites, Hosts and Diseases
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    • 제55권4호
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    • pp.433-437
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    • 2017
  • Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

Clinical and panoramic radiographic features of osteomyelitis of the jaw: A comparison between antiresorptive medication-related and medication-unrelated conditions

  • Shin, Jeong Won;Kim, Jo-Eun;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • 제49권4호
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    • pp.287-294
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    • 2019
  • Purpose: This study was performed to analyze the clinical and imaging features of contemporary osteomyelitis(OM) and to investigate differences in these features on panoramic radiography according to patients' history of use of medication affecting bone metabolism. Materials and Methods: The records of 364 patients(241 female and 123 male, average age 66.8±14.9 years) with OM were retrospectively reviewed. Panoramic imaging features were analyzed and compared between patients with medication-related OM(m-OM) and those with conventional, medication-unrelated OM(c-OM). Results: The age of onset of OM tended to be high, with the largest number of patients experiencing onset in their 70s. The 2 most frequent presumed causes were antiresorptive medication use (44.2%) and odontogenic origin (34.6%). On panoramic radiographs, a mix of osteolysis and sclerosis was the most common lesion pattern observed (68.6%). Sequestrum, extraction socket, and periosteal new bone formation were found in 143(42.1%), 79 (23.2%), and 24 (7.1%) cases, respectively. The m-OM group exhibited sequestrum and extraction socket more frequently and displayed significantly higher mandibular cortical index values than the c-OM group. Conclusion: We observed some differences in imaging features as shown on panoramic radiography according to the history of antiresorptive medication use. This study may help elucidate the predictive imaging features of medication-related osteonecrosis of the jaw.