• Title/Summary/Keyword: Secondary-Joint

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Avascular Necrosis of Femoral Head on Bone Scan (대퇴골두 무혈성 괴사의 뼈스캔상의 병기)

  • Yang, Hyung-In;Kim, Eui-Jong;Kim, Deog-Yoon;Ryu, Kyung-Nam;Cho, Kyung-Sam
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.206-213
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    • 1994
  • We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

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CARE OF TRISMUS AND OROCUTANEOUS FISTULA BY ODONTOGENIC INFECTION IN A DISABLED PATIENT (장애환자에서 치성감염에 의한 아관긴급과 구강피부누공의 관리)

  • Oh, Ji-Hyeon;Son, Jeong-Seog;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.111-117
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    • 2013
  • Some odontogenic infections erode into fascial spaces directly and spread toward lymphatic tissues and blood streams. The principal maxillary primary spaces are the canine, buccal, and infratemporal space, the next secondary spaces are the masseteric, temporal and pharygeal space. As a result of the infection, trismus and orocutaneous fistula may be occurred. Trismus is owing to conditions not associated with temporomandibular joint itself and may be of myogenic, neurogenic, or psychogenic nature. Muscular trismus is due to infection adjacent to the elevator muscles of the jaw. The four principles of treatment of infection are as follows: (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including rest, nutrition and physiotherapy. Jaw physiotherapy is necessary to increase the amount of mouth opening and regain normal muscle tone. If proper care of odontogenic infection could be attained, the orocutaneous fistula will heal and close spontaneously by wound contraction mechanism of natural homeostatic response. This is a case report of the care of trismus and orocutaneous fistula due to fascial space abscess by advanced odontogenic infection in a physically disabled patient.

Osteomyelitis following Domestic Animal Bites to the Hand: Two Case Reports and Practical Guidelines

  • Lim, Jung Soo;Byun, Jin Hwan;Min, Kyung Hee;Lee, Hye Kyung;Choi, Yun Sun
    • Archives of Plastic Surgery
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    • v.43 no.6
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    • pp.590-594
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    • 2016
  • Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

Study on the Introduction of Spectrum Policy to Revitalize the Domestic Spectrum Sharing (국내 주파수 공동사용 활성화를 위한 정책 도입방안 연구)

  • Choi, Joo-Pyoung;Lee, Won-Cheol
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.29 no.3
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    • pp.200-213
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    • 2018
  • Herein, we survey the current state of the recent legal revision of the Citizens Broadband Radio Service, a type of city spectrum-sharing service used in the United States of America, and the introduction of spectrum sharing in the frequency ranging from 3.8~4.2 GHz, based on the United Kingdom framework for spectrum sharing. Specifically, the subjects of topical interest, including the radio station licensing of the spectrum-sharing service system face-to-face multitier user structure, regional frequency allocation, and applicable service types, are discussed. Furthermore, factors to be considered while selecting candidate channels for joint use are suggested, emphasizing their importance for introducing spectrum sharing in Korea and revitalizing the related industrial sectors. In addition, methods of introducing a radio station license system for spectrum sharing, techniques of introducing incentive auctions, and the types of services where spectrum sharing is applicable are discussed.

A Study on the Fracture Behavior of Composite Laminated T-Joints Using AE (AE를 이용한 복합재료 T 조인트부의 파괴거동에 관한 연구)

  • Kim, J.H.;Ahn, B.W.;Sa, J.W.;Park, B.J.
    • Journal of the Korean Society for Nondestructive Testing
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    • v.19 no.4
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    • pp.277-287
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    • 1999
  • Quasi-static tests such as monotonic tension and loading/unloading tension were performed to investigate the bond characteristics and the failure processes for the T-joint specimens made from fiber/epoxy composite material. Two types of specimens, each consists of two components, e. g. skin and frame. were manufactured by co-curing and secondary bonding. During the monotonic tension test, AE instrument was used to predict AE signal at the initial and middle stage of the damage propagation. The damage initiation and progression were monitored optically using m (Charge Coupled Device) camera. And the internal crack front profile was examined using ultrasonic C-scan. The results indicate that the loads representing the abrupt increase of the AE signal are within the error range of 5 percent comparing to the loads shown in the load-time curve. Also it is shown that the initiation of crack occurred in the noodle region for both co-cured and secondarily bonded specimen. The final failure occurred in the noodle region for the co-cured specimen. but at the skin/frame termination point for the secondarily bonded specimen. Based on the results, it was found that two kinds of specimen show different failure modes depending on the manufacturing methods.

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Giant Cell Tumor of Proximal Phalanx of the Hand - A case report - (수부 근위지골에 발생한 거대세포종 - 1례 보고-)

  • Park, Yong-Koo;Lim, Sung-Jig;Kim, Youn-Wha;Han, Chung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.30-34
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    • 2000
  • Giant cell tumor of the small bones of the hands and feet is rare. Giant cell tumors in these locations develop at young age, are more commonly multifocal, and show the higher risk of recurrence than those at the end of the long bone. It should be differentiated from the other lesions of the hands, such as giant cell reparative granuloma, aneurysmal bone cyst and enchondroma. We experienced a case of giant cell tumor in the proximal phalanx of the left hand with swelling and pain. Curettage and bone graft were performed. Histologically large number of giant cells were distributed diffusely in the highly cellular stroma containing sheets of mononuclear cells. Secondary aneurysmal bone cyst and hemorrhage were associated.

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Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

  • Lim, Tae Kang;Shon, Min Soo;Ryu, Hyung Gon;Seo, Jae Sung;Park, Jae Hyun;Ko, Young;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.175-180
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    • 2014
  • Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder ($8.2{\pm}7.9mm$ versus $7.3{\pm}3.4mm$, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. Conclusions: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.

Surgical Treatment of Pathologic Fracture of the Long Bone due to Metastatic Tumor (골전이로 인한 장골의 병적 골절의 수술적 치료)

  • Shin, Kyoo-Ho;Kim, Dong-Soo;Hahn, Soo-Bong;Han, Dae-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.52-59
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    • 1995
  • Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

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Dedifferentiated Parosteal Osteosarcoma of the Femur - A Case Report - (대퇴골에 발생한 역분화성 방골성 골육종 - 증례보고 -)

  • Park, Hye-Rim;Park, Yong-Koo;Jang, Joon-Dong;Nam, Eun-Sook;Sohn, Jin-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.70-75
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    • 1999
  • We present a case of parosteal osteosarcoma of the femur with secondary dedifferentiation. This 57-year-old woman was radiologically diagnosed as a parosteal osteosarcoma in 1987. In 1992, excisional biopsy revealed a classical parosteal osteosarcoma with diploidy DNA pattern. In 1998, she revisited due to a recurrent tumor with pathologic fracture. The resected specimen showed a classic parosteal osteosarcoma with area of dedifferentiation, showing high-grade spindle cell sarcoma. This dedifferentiated area revealed aneuploidy cell population on DNA flow cytometry. This case reminds us that not all parosteal osteosarcomas are low-grade lesions. Some low-grade lesions may dedifferentiate to become high-grade tumors after inadequate excision.

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c (종골의 골연골종에서 발생한 연골육종 - 1예 보고 -)

  • Han, Chung-Soo;Park, Yong-Koo;Jeong, Sun-Teak;Kyung, Kwon-Boo;Rho, Jun-Ha
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.52-56
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    • 2006
  • There are some malignant changes in multiple osteochondroma to chondrosarcoma, but secondary chondrosarcomas rarely develop in 1~2% of patients with solitary osteochondromas. Chondrosarcomas of the bones of hands and feet are rare, in comparison with their occurrence at other sites. The calcaneus was most commonly involved in the feet, but malignant transformation of solitary osteochondroma of the calcaneum to chondrosarcoma is extremely rare. We report one case of solitary calcaneal mass that grows slowly without pain from 6 years ago. He was 38 aged old man and surgical excision of the mass revealed chondrosarcoma arising from osteochondroma of the calcaneum.

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