• Title/Summary/Keyword: Osteolysis

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Osteolytic Lesion of the Fibular Head after Cemented Total Knee Arthroplasty (슬관절 전치환술 후 비골 두에 발생한 골용해성 병변)

  • Lee, Chae-Chil;Park, Ki-Bong;Hwang, Il-Yeong;Yang, Doo-Guen
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.87-92
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    • 2021
  • The radiographic findings of an osteolytic lesion in the knee may indicate numerous possible impressions. Furthermore, osteolysis is a possible cause if there is a surgical history of total knee arthroplasty (TKA). The authors diagnosed osteolysis of the fibular head after aseptic loosening of the tibial component of a cemented TKA in an 83-year-old female patient who visited with right knee pain and report their treatment with revision TKA along with a literature review.

Review of Literatures for Development of Clinical Trial Guideline for Total Ankle Arthroplasty (인공발목관절의 임상시험 가이드라인 개발을 위한 문헌적 고찰)

  • Park, Jin Oh;Lee, Moses;Lee, Jin Woo;Lee, Soo Bin;Han, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.195-201
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    • 2014
  • Purpose: The purpose of this study is to develop guidelines for clinical trial of the total ankle replacement system for premarket approval. Materials and Methods: We selected and analyzed nine peer-reviewed articles whose quality had been proven in a previous phase. Two investigators extracted parameters for guideline criteria, including number of cases, patient age, follow-up period, failure rate, radiographic osteolysis rate, residual pain rate, and percentage of satisfaction. In addition, the inclusion and exclusion criteria were analyzed and developed. Results: Eight level IV studies and one level II study were included. The average number of cases was 159 cases and the mean patient age was 63.5 years. The mean follow-up period was 4.2 years, ranging from two to nine. The average failure rate of total ankle replacement in mid- to long-term follow-up was approximately 13% (2%~32.3%). The rate of osteolysis was approximately 18%. Residual pain was common (21.4%~46%), but overall patient satisfaction was approximately 85.6% (67.5%~97%). Conclusion: The results could be used as criteria for designing the clinical studies, such as number of cases, patient age (over 60 years), and follow-up period (minimum two years). The clinical scoring system and 36-item short form health survey (SF-36) was the most commonly used method for clinical evaluation for total ankle arthroplasty. In addition, the overall results, including failure rate, osteolysis rate, and patient satisfaction, could be used as a parameter of guidelines for premarket approval.

A Novel Fluoroscopic View for Positioning the AO Clavicle Hook Plate Decreases Its Associated in situ Complications

  • Hyun, Yoon-Suk;Kim, Gab-Lae;Choi, Sang-Min;Shin, Woo-Jin;Seo, Dong-Yeon
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.25-32
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    • 2016
  • Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.

Clinical and Radiological Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Hook Plate Fixation with Single Tight Rope Technique

  • Lee, Sung Hyun;Kim, Jeong Woo;Kook, Seng Hwan
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.153-161
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    • 2017
  • Background: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. Methods: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. Results: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. Conclusions: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).

Brodie's Abscess in a Pit Bull Terrier Dog (핏불테리어 견에서 발생한 브로디씨 농양)

  • Choi, Ho-Jung;Lee, Young-Won;Wang, Ji-Whan;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.183-185
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    • 2010
  • A 3-year-old Pit bull terrier dog had left hindlimb lameness for 3-weeks. On plain radiographs, geographic osteolysis with well-defined edges and marginal sclerosis was identified in medial aspect of left proximal tibialmetaphysis. Surgical debridement and curettage was performed. Coagulase negative Staphylococcus spp. grew on a culture specimen obtained during surgery, and Brodie's abscess was diagnosed.

Gastrointestinal Tract Involvement of Gorham's Disease with Expression of D2-40 in Duodenum

  • Choi, Bong Seok;Hong, Suk Jin;Chu, Mi Ae;Lee, Seok Jong;Lee, Jong-Min;Bae, Han Ik;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.1
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    • pp.52-56
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    • 2014
  • We present a case of a 13-year-old boy with Gorham's disease involving the thoracic and lumbar spine, femur, and gastrointestinal (GI) tract, which was complicated by recurrent chylothorax and GI bleeding. The presenting symptoms were intermittent abdominal pain, back pain, and melena. Esophagogastroduodenoscopy and colonoscopy showed no abnormal lesions, but duodenal biopsy showed marked dilation of the lymphatics in the mucosa and submucosa, which revealed positive staining with a D2-40 immunohistochemical marker. In cases of GI bleeding with osteolysis, the expression of a D2-40 marker in the lymphatic endothelium of the GI tract may help to diagnose GI involvement in Gorham's disease. To the best of our knowledge, this is the first case report to pathologically demonstrate intestinal lymphatic malformation as a cause of GI bleeding in Gorham's disease.

Role of Lymphatic Embolization in Chylothorax Associated with Gorham-Stout Disease: A Case Report (고함-스타우트병과 연관된 유미흉 치료에서 림프관 색전술의 역할: 증례 보고)

  • Min-Hyuk Yu;Dongho Hyun;Sun-Hye Shin;Sang-Yun Ha
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.451-455
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    • 2024
  • A 45-year-old male patient with spontaneous chylothorax and osteolysis in the right 1st and 2nd ribs was diagnosed with Gorham-Stout disease based on clinical manifestations and bone biopsy. The chylothorax temporarily decreased after a successful selective lymphatic embolization. The patient presented with recurrent chylothorax, mild chest discomfort, and progressive osteolysis (despite administering sirolimus) during the follow-up period of 15 months.

Osteoclasts in the Inflammatory Arthritis: Implications for Pathologic Osteolysis

  • Youn-Kwan Jung;Young-Mo Kang;Seungwoo Han
    • IMMUNE NETWORK
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    • v.19 no.1
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    • pp.2.1-2.13
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    • 2019
  • The enhanced differentiation and activation of osteoclasts (OCs) in the inflammatory arthritis such as rheumatoid arthritis (RA) and gout causes not only local bone erosion, but also systemic osteoporosis, leading to functional disabilities and morbidity. The induction and amplification of NFATc1, a master regulator of OC differentiation, is mainly regulated by receptor activator of NF-κB (RANK) ligand-RANK and calcium signaling which are amplified in the inflammatory milieu, as well as by inflammatory cytokines such as TNFα, IL-1β and IL-6. Moreover, the predominance of CD4+ T cell subsets, which varies depending on the condition of inflammatory diseases, can determine the fate of OC differentiation. Anti-citrullinated peptide antibodies which are critical in the pathogenesis of RA can bind to the citrullinated vimentin on the surface of OC precursors, and in turn promote OC differentiation and function via IL-8. In addition to adaptive immunity, the activation of innate immune system including the nucleotide oligomerization domain leucine rich repeat with a pyrin domain 3 inflammasome and TLRs can regulate OC maturation. The emerging perspectives about the diverse and close interactions between the immune cells and OCs in inflammatory milieu can have a significant impact on the future direction of drug development.

Possible Role of Matrix Metalloproteinase in Osteolytic Intracranial Meningiomas

  • Moon, Hyung-Sik;Jung, Shin;Jung, Tae-Young;Cao, Van Thang;Moon, Kyung-Sub;Kim, In-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.11-16
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    • 2010
  • Objective: Abnormalities of the bone are frequently encountered in patients with meningioma, and hyperostosis and endostosis are common bone alterations in these tumors. Extensive bony destruction is very unusual in patients with meningioma. We report six cases of intracranial meningioma associated with an osteolytic lesion of the skull and discuss the underlying mechanisms that may be responsible for bone destruction in patients with meningioma. Methods: Six patients were classified into three groups, severe, moderate and mild, according to the degree of osteolytic bony destruction. The tumor was classified as intracranial or extracranial, depending on its location. We investigated the potential role of matrix metalloproteinase (MMP) in meningioma-associated osteolysis. The levels of MMP expression were determined by gelatin zymography, reverse transcription-quantitative PCR analysis (RT-PCR) and immunohistochemical analysis. Results: Complete surgical removal of the lesion was performed in each patient. Histological examination revealed benign meningioma in four cases, and two cases of atypical meningioma. Patients did not have a poor prognosis except one case of recurred atypical meningioma. Gelatin zymography and RT-PCR detected high levels of MMP-2 in almost all extracranial masses in comparison with the intracranial masses and MMP9 in two. There was no difference in the severity of bone destruction. Immunohistochemical analysis revealed MMP-2 expression in the vicinity of the bone destruction, and a few MMP-9-positive stainings were observed. Conclusion: Osteolysis of the skull in patients with meningiomas might not be indicative of malignant pathological features and poor prognosis. Invasion to the extracranial portion and osteolysis might be associated with MMP-2 expression in meningioma.