• Title/Summary/Keyword: Radiologic findings

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Diagnosis and Treatment of Chronic Medial Ankle Instability (만성 내측 족관절 불안정성에 대한 진단 및 치료)

  • Kim, Jin-Su;Young, Ki-Won;Lee, Han-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.37-41
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    • 2013
  • Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

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The Surgical Treatment of Type V Acute Acromioclavicular Joint Dislocation Using Suture Anchor and Kirschner Wire (봉합 나사못과 Kirschner 강선을 이용한 제 5형 급성 견봉 쇄골 관절 탈구의 수술적 치료)

  • Jung, Gu-Hee;Cho, Chyul-Hyun;Jang, Su-Jin;Jang, Jae-Ho;Kim, Jae-Do
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.217-222
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    • 2010
  • Purpose: We wanted to evaluate the clinical outcomes after operative treatment using two suture anchors and Kirschner wire for treating acute Rockwood type V acromioclavicular joint dislocation Materials and Methods: Between May 2006 and May 2009, 10 patients underwent surgical treatment for acute Rockwood type V acromioclavicular joint dislocation using two suture anchors and Kirschner wire and they were followed for a mean of 12.0 (range: 7-31) months. We analyzed the functional results by the Korean shoulder score, the Constant-Murley score and the reduction state of the acromioclavicular joint at the last follow-up. Results: All the cases achieved a satisfactory outcome. The mean Korean shoulder score was 89.9 (range: 81-100) points and the mean Constant-Murley score was 87.8 (range: 82-93) points. According to the radiologic findings, 8 patients achieved anatomical reduction of the acromioclavicular joint: there was a slight loss of reduction in one patient and a partial loss of reduction in one patient. None of the patients had deep infection or re-dislocation. Conclusion: The operative treatment using two suture anchors and Kirschner wire may be used for acute Rockwood type V acromioclavicular joint dislocation, and it has an advantage in that it can prevent chondral injury of the joint.

Treatment of Acromioclavicular Dislocation by Modified Phemister Operation Augmented with Coracoclavicular Sling (오구 쇄골간 슬링으로 보강된 변형 Phemister 술식을 이용한 견봉 쇄골 관절 탈구의 치료)

  • Kim, Deok-Weon;Kim, Sung-Tae
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.188-193
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    • 2010
  • Purpose: The purpose of this study was to evaluate the clinical and radiological results of a modified Phemister method reinforcing the 4 strands of an Ethibond sling for acromioclavicular joint dislocation. Materials and Methods: Between September 1999 and May 2007, 30 acromioclavicular joint dislocation cases underwent a modified Phemister method reinforcing the 4 strands of an Ethibond sling. The average follow-up period was 28.2 months (range: 24~33 months). Clinical outcomes were evaluated using the Weitzman classification; the state of coracoclavicular space reduction was done using radiologic findings. Results: According to the Weitzman classification, there were 24 excellent, 4 good and 2 fair case outcomes. The average coracoclavicular distance improved from 16.9 mm to 7.3 mm immediately after surgery. The average ratio of coracoclavicular distance comparing to the contralateral side at the final follow-up was 1.24 (range: 0.68~1.71). Complications included retraction of K-wires in 5 cases and restriction of joint motion in 4 cases. Conclusion: The modified Phemister operation using augmentation of the coracoclavicular ligament by 4 strands of Ethibond is an effective treatment modality in acromioclavicular joint dislocation.

One Case of Chronic Acquired Hepatocerebral Degeneration caused by a Spontaneous Spleno-renal Shunt (자발성 비신단락으로 유발된 만성후천성간뇌퇴행 1례)

  • Park, Jong-Hoon;Chung, Sun-Yong;Kim, Sang-Ho;Kim, Jong-Woo;Hwang, Ui-Wan
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.1
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    • pp.211-217
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    • 2004
  • Chronic acquired hepatocerebral degeneration(CAHD) is a heterogenous that can occur with a primary neurologic, hepatic, or combined presentation. Symptoms and signs of that included progressive dementia, dysarthria, involuntary movements(including tremor, asterixis, and choreoathetosis), ataxia of limb and gait, typically in a patient with chronic liver cirrhosis. Characteristic radiologic findings is high signal on globus pallidus on T1W1 MRI. Recently, we experienced a patients, a 73-year-old female with CAHD presenting mental change, cognitive deficits, and various involuntary movement. In our patient, T1 weighted MRI of the brain showed symmetric high signal intensity in both basal ganglia. Increased ammonia $level(226{\mu}g/dl)$ in whole blood and a multiple anomalous vessels with spleno-renal shunt on abdominal CT were found. But, liver cirrhosis is absent. In admission care, these mental change and involuntary movements had a good response to herbal medication. We report on patient with CAHD which had a spontaneous spleno-renal shunt without liver disease.

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Treatment Outcomes of Brain metastasis from Papillary Thyroid Cancer (갑상선 유두암 뇌전이의 치료 효과)

  • Bae, Hyeonwoo;Kim, Seok-Mo;Kim, Soo Young;Chang, Ho Jin;Kim, Bup-Woo;Lee, Yong Sang;Chang, Hang-Seok;Park, Cheong Soo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.9-13
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    • 2018
  • Background/Objectives: Brain metastasis (BM) is a rare form of distant metastasis with papillary thyroid cancer (PTC). Patients with BM of PTC carry a poor prognosis. The aim of this study was to contribute to the understanding of this disease by analyzing patients with BM of PTC. Materials & Methods: Between March 2003 and December 2013, the patient database was conducted to identify thyroid cancer patients treated. Among the 22,758 thyroid cancer patients, 14 (0.06 %) were identified to have metastasis to the brain during follow-up. The medical records of 14 patients with BM were retrospectively reviewed, focusing on the following: patient characteristics, synchronous or previous distant metastasis, treatments including whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) and surgery, and characteristics on radiologic findings, time interval between first diagnosis of primary thyroid cancer and BM and survival after BM. Results: The mean age at initial diagnosis and BM were $50.9{\pm}15.8years$ and $61.3{\pm}12.7years$. The mean duration between initial diagnosis and BM was $10.4{\pm}7.9years$. Patients were treated with varied combinations of surgery, SRS and WBRT except 4 patients who had refused treatment. The median overall survival (OS) time after BM diagnosis was 10 months (range 1 - 19). Patients receiving treatment (WBRT and/or surgery, SRS) had a significant longer median OS of 16.5 months in comparison to 3.5 months for those treated without treatment. (p = 0.005) Conclusion: Patients who received aggressive treatment had a longer OS than those with only supportive care. Treatment such as surgery, SRS and WBRT should be considered in patients with BM.

Fat Embolism Syndrome with Pulmonary Hemorrhage of Unknown Origin (원인을 알 수 없는 폐출혈을 동반한 지방색전 증후군 1예)

  • Jeong, Hye-Cheol;Jung, Ki-Hwan;Kim, Byung-Gyu;Kim, Kyung-Kyu;Lee, Sang-Youb;Park, Sang-Myun;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kim, Han-Gyum;Yoo, Sa-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.383-387
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    • 2000
  • Fat embolism syndrome is a rare but serious complication occurring mostly in patients with long bone fractures and occasionally in patients who have had an underlying disease. For example, pancreatitis, diabetes mellitus, alcoholic liver disease and connective tissue disease can be risk factors. The 44-year old woman with a sudden dry cough, blood tinged sputum, and exertional dyspnea visited the Korea University Hospital. Petechiae on her anterior chest wall was found. Chest X-ray and CT showed patchy opacities and multifocal ground-glass opacities in both lung fields. An open lung biopsy demonstrated diffuse pulmonary hemorrhage and intravascular macrovesicular fat bubbles. After conservative management, her symptoms and radiologic findings were significantly improved. A case of fat embolism syndrome without any known risk factors is reported.

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A Study of Spinal Curvature in Female and Male University Students (남녀 대학생의 척추만곡에 관한 연구)

  • Lee, Byung-Kyu;Nam, Ki-Seok;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.5 no.3
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    • pp.72-87
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    • 1998
  • This study examined the rates of spinal abnormal curvature and the correlation of the Body Mass Index (BMI), Low Back Pain (LBP) and spinal curvature by measuring scoliosis, kyphosis, and lordosis in university students. The study population included 67 male, 92 female university students, making a total of 159, in Wonju City. Spinal curvature was measured by an electrogoniometer in a computerized skeletal analysis system. Lateral curvature of spine of more than 10 degrees was considered as nonspostural scoliosis. The correlation of BMI, LBP and the spinal curvature was analysed by Pearson's correlation coefficient and t-test. The following results were obtained: 1. The overall incidence and rate of scoliosis in cases with a greater than 10 degree curve in males was an incidence of 8 and a rate of 11%. In females the incidence was 36 and the rate 39.2%. 2. The overall incidence and rate of kyphosis of less than 20 degrees in males was a rate of 9 and an incidence of 11.9%. In females, the rate was 5 and the incidence 5.4%. In kyphosis cases of more than 40 degrees, the male rate was 5 and the incidence 7.7%. For female the rate was 13 and the incidence 14.2%. 3. The overall incidence and rate of lordosis with curves of less than 20 degrees was a rate of 6 for males and an incidence of 9.0%. For females, the rate was 5 and the incidence 5.4%. In cases of more than 50 degrees lordosis, the female rate was 2 and the incidence 2.2%. There were no males in this category. 4. There was a negative correlation between kyphosis and BMI. The greater the kyphotic curve, the less the BMI in males (p<0.05). There was no significant BMI difference by gender in either scoliosis or lordosis. There was, however, a significantly decreased sacral angle in the female group with LBP. The results of this study cannot be generalized to the general population because the subjects were all from one university. The measurements were quite reliable because the angles determined by the Metrocom System were highly correlated with radiologic findings. This study shows the need for a regular screening system for spinal curvatures in university health examination procedures.

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Diagnosis, Treatment and Prognosis of Low Grade Central Osteosarcoma (저등급 중심부 골육종의 진단, 치료 및 예후)

  • Song, Won Seok;Cho, Wan Hyeong;Lee, Kwang-Youl;Kong, Chang-Bae;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.47-53
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    • 2014
  • Purpose: We analyzed the diagnosis and the treatment outcomes of patients with central low grade osteosarcoma. Materials and Methods: We retrospectively reviewed 16 patients with central low grade osteosarcoma were treated at out institution between 1994 and 2011. Results: There were 4 men and 12 women with mean age of 26 years. Eleven patients were correctly diagnosed but 5 patients were misdiagnosed as osteoid osteoma, non ossifying fibroma, aneurysmal bone cyst, desmoplastic fibroma. 15 patients finally received wide margin en bloc excision and one of them treated under neoadjuvant chemotherapy. Final survival status was continuous disease free in 14 and 1 patient died of renal cell cancer. Remaining 1 with multifocal lesions is alive with disease for 7 years only treated radiation therapy on residual tumors. Nine (56%) of 16 tumors showed extra-osseous extension of tumor (56%) and 1 of them showed extra-compartmental tumors. Conclusion: The diagnosis of central low grade osteosarcoma is challenging, however, considering of the clinical suspicion, the typical findings of radiologic and pathologic features, proper diagnosis is needed. This tumor should be treated with wide excision, even after an intralesional excision, to avoid local recurrence or transformation to higher histologic grade.

A Case of Pheochromocytoma Accompanied with Alveolar Hemorrhage and Cardiogenic Pulmonary Edema (심인성 폐부종과 폐포성 출혈을 보인 갈색세포종 1예)

  • Jeong, Jong Pil;Ban, Hee Jung;Kim, Soo Ock;Son, Jun Gwang;Ju, Jin Yung;Kwon, Yong Soo;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.219-223
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    • 2008
  • Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.

An Analysis of Relationship Between Personal Factors of Radiological Technologists and Job Stressors (방사선사의 개인적 요인이 직무스트레스원에 영향을 주는 관련성 분석)

  • Jung, Hong-Ryang;Kim, Jeong-Koo;Lim, Cheong-Hwan;Kim, Myeong-Soo;Kwon, Dae-Cheol;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.28 no.1
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    • pp.45-53
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    • 2005
  • This study is aimed at analyzing the relationship between personal factors of radiological technologists and their job stressors. For this aim, a survey was conducted by means of 890 questionnaires from the middle of July to the end of August 2003 to the subjects of radiological technologists who are working for 44 general hospitals in 16 cities and provinces across the country. The results of the survey could be summed up as follows: 1. The biggest stressor that affects a radiological technologist personally under the working situation turned out to be position, job satisfaction and physical symptom(p<0.001), while job satisfaction and physical symptom also played an important role in personal relationship(p<0.001). 2. In terms of job conflicts, colleagues, immediate seniors, job satisfaction and physical symptoms appeared to exercise great impact(p<0.001), As for job autonomy, age, position and job satisfaction were known to be heavily influential(p<0.001). 3. With regard to job load, job satisfaction and behavioral symptom turned out to have great influence while, in job stability, position and job satisfaction seemed to be immensely influential(p<0.001). The present study has a limit in that it covers only radiological technologists who are working at the 3rd reference hospitals but excludes those who are working at the first and second reference hospitals. The findings, however, are surely believed to be able to serve as basic data to improve the medical service quality as they will help reduce the stressors of and enhance mental and physical health for radiological technologists who play important roles as teammates with expertise in the medical field. These outcomes could also be referred to in future studies in this area.

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