Objectives : The objectives of this report is to introduce PTA. Methods : The examination of the leg length inequality gives us a useful tool for diagnosis of body imbalance. especially pelvic distortion. There are four steps in the process of the leg analysis, according to "The Standard Manual of Chuna Society (2nd ed., Seoul:KCA Press. 2001)". In the last step of the analysis, knee-flexing over $90^{\circ}$, we have often experienced a specific sign that the lower legs are attracted toward one side spontaneously. The authors call it 'Lower Leg Lateral Attraction'. This is a very significant sign that gives us which is the major part between pelvis and the upper parts over sacrum. Thus it is definded as "Pelvic Twist Analysis, PTA" by the authors. With PTA, first, you must check the side of short leg and next, check the side of lateral attraction in lower leg over-flexing. If both sides coincide with each other, then the major part you can correct first is pelvic distortion. If not, you must find another part for primary correction, instead of pelvis. Conclusions : PTA becomes a useful complement to the examination of the leg length inequality.
Objective: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). Materials and Methods: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. Results: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. Conclusion: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.
The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.
Purpose: There are no detailed reports on the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Korean population. Methods: The cases of 67 Korean patients with pelvic and acetabular fractures treated at our hospital from January 2009 to February 2012 were analyzed retrospectively. Until May 2010, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded $20{\mu}g/ml$ at 5 days after trauma and surgery, or increased to greater than $20{\mu}g/ml$ after a period of decline. After May 2010, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed on all patients. The effects of the presence of a pelvic and/or acetabular fracture, and the effects of fracture type, accompanying injuries, and screening strategies on the incidences of VTE were investigated. Results: Overall, 26 patients(38.8%) were diagnosed with VTE and PTE in 14(20.9%). All were asymptomatic. Significantly higher incidences of VTE and PTE were observed in trauma patients with pelvic and acetabular fractures than in trauma patients without pelvic and acetabula fractures treated during the same period. No significant differences were observed in the incidences of VTE and PTE between patients with pelvic fractures, and patients with acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates for VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance. Conclusion: In the Korean population, we should be vigilant for a high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures.
The Journal of Korean Society for Radiation Therapy
/
v.2
no.1
/
pp.81-85
/
1987
It has been evident since 1972 that computed tomography(CT) can play an important role in treatment and managment of the cancer patients as four steps; diagnosis, satging Treatment and follow-up. In this paper, we intended to investigate the availability of CT scan and treatment planning computer in 700 cancer patients who have undergone radiation therapy at the division of radiation therapy, Kangnam St. Mary's Hospital, Catholic Medical College between Mar. 1983 and Dec. 1985. The result were as follow; 1. Of 700 irradiated cancer patients, 342 patients ($48.9\%$) were performed CT scan prior to radiation therapy. 2. The distribution of lesions in 342 patients having CT scans was like this; CNS (83 of 104 patients, $79.8\%$), abdomen (44 of 76 patients, $57.9\%$), pelvis (100 of 188 patients, $53.2\%$) etc. in order. 3. The treatment planning computer were used in 280 cancer patients ($40\%$). 4. Of the 280 cancer patients using treatment planning computer, 167 patients ($59.6\%$) applied diagnostic CT scan and remaining 113 patients ($40.4\%$) were made body contour to be used for radiation therapy planning by the treatment planning computer. Authors also made some magnification devices used for small multiformat CT images to magnify into life size, consisting of overhead projector (3M) I.V. stand and mirror. These enabled us to make less errors in tracing the small-sized CT images during input of the anatomical data into the treatment planning computer.
Chondromyxoid fbroma (CMF) is a rare, benign tumor of the bone that represents fewer than $2\%$ of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.
The uterus, one of women's reproductive organs, is also closely related to women's health. Among them, hemorrhagic luteal cysts, one of the causes of pelvic pain that women often experience, were observed through CT and ultrasound, and the quality of images was evaluated through quantitative and qualitative evaluations. This study sought to find out whether the test method is more helpful to patients during CT and ultrasound. This study was conducted on 15 adolescent women and 15 adult women(21.31±3.45 average age). The equipment used for filming used EC3-10X (3~10 MHZ) and Philips Mx8000 iCT 256 among Endocavity Probes among Ecube Platinum. After setting a constant ROI on the cyst and the interface as a quantitative analysis method, SNR and CNR values were measured on a 5-point scale based on image quality, lesion clarity, image distortion, clarity of the interface, and motion artifacts (p<0.05). Independent t-test and Mann Whiteny U were performed, and the statistical program used was noted when SPSS (Version 22.0 for windows software package, Chicago, IL, USA) was statistically less than 0.05. Comparing the SNR and CNR values for this experiment, it can be seen that the SNR value was higher in the case of CT images(p<0.05). As a result of the qualitative evaluation, the quality of the image, the clarity of the lesion, the distortion of the image, the clarity of the interface, and the clarity of the boundary were measured on a 5-point scale based on the movement artifact. Comparing each score, CT images scored higher with a finer difference than ultrasound images(p<0.05). In conclusion, both test methods showed excellent results in finding the patient's lesions. However, in quantitative and qualitative evaluations, CT produced higher results in detecting lesions than ultrasound. However, for cyst tests that require continuous observation, ultrasonography, a non-invasive method that is advantageous for patients, will be clinically useful. Therefore, observing the patient's lesions by appropriately distributing these two test methods will provide optimal diagnostic information. These results will be useful for providing clinical basic data and educational materials to CT and US users in the future.
For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.
Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.
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