• Title/Summary/Keyword: Repair materials and methods

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The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair (COVID-19 폐렴의 다양한 CT 영상 소견: 급성 폐포 손상과 기질화 폐렴)

  • Yun Su Kim;Ung Rae Kang;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.359-370
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    • 2021
  • Purpose To analyze the findings and serial changes in chest CT lesions in 123 symptomatic patients with coronavirus disease 2019 (COVID-19). Materials and Methods From February 19 to April 7, 2020, a total of 123 confirmed COVID-19 patients (male, 44; female, 79; mean age, 59.2 ± 18.6) were enrolled in this retrospective study. A total of 234 CT scans were reviewed for the following patterns: acute alveolar insult (AAI) patterns: ground-glass opacity (GGO), crazy-paving appearance, mixed pattern, and consolidation; organizing pneumonia (OP) patterns: perilobular patterns, band opacity, curvilinear opacity, reversed halo opacity, and small nodular consolidation; resolving patterns: pure GGO, remnant curvilinear, small nodular consolidation, and serial changes of lung abnormalities. We compared the proportions of AAI pattern, OP pattern, or resolving pattern with time progression and analyzed the association between the patterns and disease severity using Pearson chi-square and Fisher's exact test. Results Predominant CT patterns were AAI pattern (87%) in the early hospital period group (0-10 days, after the onset of symptoms), OP pattern (45.7%) in the later hospital period group (after 10 days), and resolving pattern in discharge and follow-up group (47.2% and 84.8%, respectively). The difference in the proportions of predominant CT patterns with time progression was statistically significant (p < 0.001, Pearson's chi-square test). No statistically significant association was observed between the patterns and disease severity (p = 0.055, Fisher's exact test). No fibrous changes in the lesions were observed on follow-up CT scans. Conclusion The serial CT scans of COVID-19 patients showed the spectrum of COVID pneumonia CT manifestations as different phases of lung injury and repair.

Characteristics of Meniscus Tear in Tibial Plateau Fractures (경골 고평부 골절의 반월상 연골 파열 양상)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Kim, Jae-Hwa;Chung, Ju-Hwan;Lee, In-Sung;Lee, Jun-Ku;Lee, Soon-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.9-16
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    • 2012
  • Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.

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Management of Displaced Bucket-Handle tear - Differences Between Medial & Lateral Menisci - (전위된 양동이 손잡이형 파열의 치료 - 내측과 외측 반월상 연골의 비교 -)

  • Chung Shun Wook;Hahn Sung Ho;Yang Bo Kyu;Yi Seung Rim;Ha Jeong Hyun;Kim Min Seok;Yeo Yong Beom
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.153-159
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    • 2003
  • Purpose : The purpose of this study was to compare the pattern of displaced bucket-handle tear of lateral and medial menisci and the treatment modality and results from accompanying injury. Materials and Methods : Patients who were diagnosed for displaced bucket-handle tear of medial meniscus (group I: 52patients, 52cases) and lateral meniscus (group II: 31patients, 32cases) from September 1998 to December 2002. The mean ages were 25years $(16\~66)$ for Group I and 29years $(18\~63)$ for Group II, and the average follow-up period were 18months $(12\~44)$ and 13months $(6\~46)$, respectively. The zone of meniscus tear and the existence of accompanying injury were verified through intraoperative arthroscopy and discoid type meniscus was additionally examined for group II. The assessment was made according to the physical examination and clinical pattern at the postoperative last follow-up, and the 2nd look arthroscopy was performed in 19cases $(23\%)$ for the cases accompanying anterior cruciate ligament (ACL) injury in both groups. Results : There were 38cases $(73\%)$ in group I, 5cases $(16\%)$ in group II for associating ACL injury. We observed discoid type meniscus (19cases, $59\%$) in group II. At last follow-up clinical success in repair cases of group I and II are 22cases $(85\%)$, 2cases $(67\%)$, in resection cases are 26cases $(100\%)$, 26cases $(93\%)$ respectively. Reoperation is performed 2cases in repair cases of group I. One case is re-rupture, the other case is newly developed tear in white-white zone. Reoperation is performed 2cases due to remnant meniscal tear in resection cases of group II. All of 2cases are discoid type menisci. Conclusion : Displaced bucket-handle tear of medial & lateral menisci would be substantially different an aspect, considering on difference would help to select proper treatment modality.

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Transection of the posterior horn of the medial meniscus at the posterior tibial attachment - Clinical features and A new repair technique (Pullout suture) - (내측 반월상 연골 후각의 후방 경골 부착부위의 절단 파열 - 임상 양상 및 새로운 봉합 수기(pullout suture) -)

  • Ahn, Jin-Hwan;Ha, Chul-Won;Kim, Ho;Kim, Sung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.109-114
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    • 1999
  • Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

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MRI Findings of the Repaired Anterior Cruciate Ligament (전방 십자 인대의 일차 봉합술 후 MRI 소견)

  • Kim, Jung-Man;Koh, In-Jun;Lee, Dong-Yeob;Lee, Yoon-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.14-21
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    • 2009
  • Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

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Is the UU Stitch Really Alternative to Modified MA (Mason-Allen) Stitch for Rotator Cuff Repair? - Biomechanical Comparative Study of UU to Modified MA Stitch - (회전근 개 파열의 봉합에서 UU 봉합법은 변형된 MA(Mason-Allen) 봉합법을 대치할 수 있는가? - UU 봉합법과 변형된 MA 봉합법의 생역학적 비교-)

  • Friedman, Darren J;Ko, Sang-Hun;Park, Ki-Bong;Jun, Hyung-Min;Kim, Tae-Won;Lim, Hyun-Woo;Yum, Young-Jin
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.207-214
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    • 2009
  • Purpose: In arthroscopic rotator cuff repairs there are generally weak link in tendon suture interface, arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of UU (Ulsan University) suture than open modified MA (Mason-Allen) suture when suture anchored into bone. Materials and Methods: The human supraspinatus tendons were harvested from the shoulder of the cadaver and split in 2 times, producing four tendons per one shoulder, for a total of 24 specimens. Two suture configurations (UU, MA) were randomized and checked on each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, mode of failure were checked. Results: No significant difference was found between two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no significant difference statistically between the UU suture and modified MA suture (109.4 N, 110.6 N). The most common mode of failure between both sutures was suture pull-out through the tendon. Conclusion: The UU suture and modified MA suture produced similar biomechanical properties.

Relationship between XRCC1 Polymorphism and Acute Complication of Chemoradiation Therapy in the Patients with Colorectal Cancer (대장, 직장암 환자에서 화학방사선치료의 급성 부작용과 XRCC1 유전자 다형성과의 상관관계)

  • Kim Woo-Chul;Hong Yun-Chul;Choi Sun-Keun;Woo Ze-Hong;Nam Jeong-Hyun;Choi Gwang-Seong;Lee Moon-Hee;Kim Soon-Ki;Song Sun-U.;Loh John-Jk
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.30-36
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    • 2006
  • Purpose: It is well known from clinical experience that acute complications of chemoradiation therapy vary from patients to patients. However, there are no known factors to predict these acute complications before treatment starts. The human XRCC1 gene is known as a DNA base excision repair gene. We investigated the possibilities of XRCC1 gene polymorphisms as a predictor for the acute complications of chemoradiation therapy in colorectal cancer patients. Materials and Methods: From July 1997 to June 2003, 86 colorectal cancer patients (71 rectal cancer, 13 sigmoid colon cancer and 2 colon cancer patients) were treated with chemoradiation therapy at the Department of Radiation Oncology, Inha University Hospital. Twenty-two patients were in stage B, 50 were in stage C, 8 were in stage D and 6 patients were unresectable cases. External radiation therapy was delivered with 10MV X-ray at a 1.8 Gy fraction per day for a total dose of radiation of $30.6{\sim}59.4 Gy$ (median: 54 Gy). All the patients received 5-FU based chemotherapy regimen. We analyzed the acute complications of upper and lower gastrointestinal tract based on the RTOG complication scale. The initial and lowest WBC and platelet count were recorded during both the RT period and the whole treatment period. Allelic variants of the XRCC1 gene at codons 194, 280 and 399 were analyzed in the lymphocyte DNA by performing PCR-RFLP. Statistical analyses were carried out with the SAS (version 6.12) statistical package. Results: When all the variables were assessed on the multivariate analysis, recurrent disease revealed the factors that significantly correlated with upper gastrointestinal acute complications. Arg399Gln polymorph isms of the XRCC1 gene, the radiation dose and the frequencies of chemotherapy during radiation therapy were significantly correlated with lower gastrointestinal complications. Arg399Gln polymorph isms also affected the decrease of the WBC and platelet count during radiation therapy. Conclusion: Although the present sample size was too small for fully evaluating this hypothesis, this study suggests that Arg399Gln polymorph isms of the XRCC1 genes may be used as one of the predictors for acute complications of chemoradiation therapy in colorectal cancer patients.

Postoperative Deep Infection after Arthroscopic Knee Surgery (슬관절 관절경 수술 후 발생한 심부 감염)

  • Kim, Key-Yong;Ha, Dong-Jun;Shim, Hyung-Nam;Seo, Seung-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.20-23
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    • 2007
  • Purpose: The purpose of this study is to evaluate characteristics of a deep infection after arthroscopic knee surgery. Materials and Methods: We selected 894 patients who underwent arthroscopic knee surgery between February 1994 and August 2006. We analyzed the results of the patients with definite infection. Results: Seven cases out of the 894 knee arthroscopic surgery which was performed by one surgeon during 12 years were diagnosed as postoperative deep infection (0.9%). Infection developed in one repair case among the meniscal surgeries (1419=0.2%). There were six infection cases in intraarticular ligament reconstruction (6/343=2%); 3 in ACL surgeries (3/152), 2 in PCL surgeries (2/70) and 1 in combined cruciate ligament surgery and extra-articular reconstruction (l/26). Conclusion: Postoperative infection rate of arthroscopic knee surgery was relatively low. However an attention for the prevention of postoperative deep infection should be paid in intraarticular ligament reconstruction because of its relatively high risk of infection.

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The Effect of Placing Biomembrane cover following Microfracture on Cartilage Repair: Comparison with Conventional Microfracture Technique in a Prospective Randomized Trial (미세골절술 후 생체막 덮개가 연골 재생에 미치는 영향 : 고식적인 미세골절술과의 전향적 비교 연구)

  • Son, Kwang-Hyun;Kim, Jin-Ho;Kwak, Kyu-Sung;Park, Jang-Won;Yoon, Kyoung Ho;Min, Byoung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.83-91
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    • 2011
  • Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

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The Effect of Safflower Seed Extract on the Bone Formation of Calvarial Bone Model in Sprague Dawley rat (백서 두개골 결손부에서 홍화씨 추출물의 골조직 재생 유도 효과)

  • Kim, Sung-Tae;Jhon, Gil-Ja;Lim, So-Hyoung;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.835-852
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    • 2000
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue and repair of function. For more than a decade there have been many efforts to develop materials and methods of treatment to promote periodontal wound healing. Recently many efforts are concentrated on the regeneration potential of material used in oriental medicine. In some in vitro and in vivo experiments, there have been many evidences that these materials have an effect on bone regeneration. The purpose of this study was to evaluate histologically and radiologically in Sprague-Dawley rats the effects of safflower seed extracts on the regeneration of the calvarial defects surgically produced. So in this study, the critical size defects were surgically produced in the calvarial bone of 30 Sprague-Dawley rats using the 8mm trephine bur. The safflower seed extract was applied into the defect of each rat in experimental group, whereas nothing was applied into the defect of each rat in control group. Rats were sacrificed at 2, 4, 8 weeks following operation and histomorphometric and radiodensitometric analysis were performed. 1. The newly formed bone length was $102.91{\pm}22.05$, $178.29{\pm}24.40$ at 2 week in the each control, experimental group, $130.95{\pm}39.24$, $242.62{\pm}50.33$ at 4 week and $181.53{\pm}76.35$, $240.36{\pm}22.00$ at 8 week($unit,{\mu}m$). In the 2, 4 week, there were statistically significant difference between control and experimental group(P<0.05). 2. The newly formed bone area was $2962.06{\pm}1284.48$, $10648.35{\pm}1284.48$ at 2 week, $5103.25{\pm}1375.88$, $9706.78{\pm}1481.81$ at 4 week, $8046.02{\pm}818.99$, $12057.06{\pm}740.47$ at 8 week($unit,{\mu}m^2$). In every week, there were statistically significant difference between control and experimental group(P<0.05). 3. The radiopacity was $14.26{\pm}.33$, $25.47{\pm}4.33$ at 2 week, $20.06{\pm}9.07$, $26.61{\pm}2.78$ at 4 week, $22.99{\pm}3.76$, $27.29{\pm}1.54$ at 8 week(unit, %). In the 2 week, there was statistically significant difference between control and experimental group(P<0.05). In conclusion, the results of the present study suggest that safflower seed extract initially has an effect on the newly formed bone area, length and radiopacity when it is applied to the calvarial defect of Sprague - Dawley rat. Then. the material has an effect on newly formed bone area and length.

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