• 제목/요약/키워드: orthopedic surgery

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전완 원위부 심 수지 굴근에 발생한 선천성 혈관 외피세포종 - 증례 보고 - (Congenital Hemagiopericytoma in the Flexor Digitorium Profundus Muscle of the Distal Forearm - A Case Report -)

  • 김정렬;장규윤;이상용
    • 대한골관절종양학회지
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    • 제13권2호
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    • pp.146-151
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    • 2007
  • 혈관 외피 세포종은 드문 악성 혈관 종양으로 대부분 성인에서 발생한다. 영아에서 발생하는 경우는 선천성 또는 영아형 혈관 주변 세포종이라 불리우며, 아주 드물게 발생하고 성인형에 비해 양호한 예후를 보이지만 재발을 막기 위해서는 충분한 절제연을 가지고 절제 되어져야 한다. 본 증례는 출생후 1일째 내원하여, 65일째 광범위 절제술을 시행한 좌측 전완부의 혈관 외피 세포종의 증례를 보고하고자 한다.

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자발적 약물 이상반응 보고 분석을 통한 수술 후 통증 조절에 사용된 Fentanyl의 약물사용적정성 (Fentanyl PCA Monotherapy and Fentanyl TTS Combination Therapy in Post-Operative Pain Management: Analyses of Spontaneous Adverse Drug Reaction Reports)

  • 박수정;정경혜;김은영
    • 한국임상약학회지
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    • 제28권2호
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    • pp.81-87
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    • 2018
  • Objective: There have been many cases of spontaneous adverse drug reactions to fentanyl at a regional pharmacovigilance center in the hospital. To assess the factors causing the adverse drug reactions reported in patients receiving fentanyl patient-controlled analgesia (PCA) monotherapy or in combination with fentanyl transdermal therapeutic system (TTS) for acute post-operative pain management. Methods: We conducted a retrospective cohort study with all patients prescribed fentanyl PCA for pain management after orthopedic surgery at a single university hospital from June 2012 to May 2013. We analysed the factors causing adverse drug reactions reported by a spontaneous reporting system in patients receiving fentanyl PCA monotherapy and those receiving fentanyl TTS in combination with fentanyl PCA. Results: Based on the spontaneous adverse drug reaction reporting, the risk ratio for the incidence rate of adverse drug reaction in the fentanyl TTS combination therapy group was 3.04 (95 % CI: 2.4-4.00, P < 0.0001), which was approximately 3-fold higher than that reported for fentanyl PCA monotherapy. Only 60 % of the adverse drug reactions were reported. Conclusion: It is inappropriate to add fentanyl TTS to fentanyl PCA to manage post-operative acute pain. There is a need to improve adverse drug reaction reporting. We expect that regular analysis of adverse drug reactions reported at regional pharmacovigilance centre would aid in appropriate drug utilization by patients.

Association of Common Vitamin D Receptor Gene Variations with Fracture Risk and Bone Mineral Density in Postmenopausal Korean Population

  • Hwang, Joo-Yeon;Lee, Seung Hun;Kim, Ghi-Su;Koh, Jung-Min;Go, Min-Jin;Kim, Tae-Ho;Hong, Jung-Min;Park, Eui-Kyun;Kim, Shin-Yoon;Lee, Jong-Young
    • Genomics & Informatics
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    • 제7권1호
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    • pp.13-19
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    • 2009
  • Osteoporosis is characterized by impaired osteogenesis. BMD is a major determinant of bone strength. The role of the VDR gene in predisposition to primary osteoporosis has been recognized. However, population-based case-control studies have been reported controversial results for known candidate genes in an ethnically distinct group. To determine the genetic effects of VDR variants on osteoporosis and BMD, we directly sequenced the VDR gene in 24 unrelated Korean individuals and identified eighteen sequence variants. We investigated the potential involvement of eight SNPs in osteoporosis in postmenopausal women (n = 729). Two SNPs (LD) in intron 2, -5294G>C (rs2238135) and -4817G>A (rs17882443) showed the evidence of association with enhanced BMD of the femoral neck ($p_{additive}$=0.031 for rs2238135; $p_{additive}$=0.017 and $p_{dominant}$= 0.019 for 17882443). Moreover, VDR -4817G>A was significantly associated with protective effect on all fracture risk ($p_{recessive}$=0.035, OR=0.2, 95% CI=$0.05{\sim}0.89$), and tended to be higher BMD values at various proximal femur sites. Therefore, we suggest that the -4817G>A may be useful genetic marker for vitamin D-related metabolism and may have an important role in the increased BMD of the proximal femur in postmenopausal Korean women.

Should We Recommend Ultrasonography for an Incidental Thyroid Nodule on Additional Cervicothoracic Sagittal T2-Weighted Image of Lumbar Spine MRI?

  • Cho, Hee Woo;Park, Jin-Oh;Lee, Young Han;Chung, Soo Yoon;Suh, Jin-Suck
    • Investigative Magnetic Resonance Imaging
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    • 제19권4호
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    • pp.224-230
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    • 2015
  • Purpose: To determine whether we should recommend ultrasonography (US) for an incidental thyroid nodule identified by additional cervicothoracic sagittal T2-weighted image (C-T sag T2WI) of lumbar spine magnetic resonance imaging (MRI). Materials and Methods: A retrospective study of 61 patients who underwent both lumbar spine MRI and thyroid US between December 2011 and April 2015 was conducted. For all US-found thyroid nodules > 1 cm, investigators evaluated whether there was any correlation between thyroid nodule detectability by C-T sag T2WI and US features such as echogenicity, composition, or suspicion of malignancy. Results: Solid hypoechoic (2/4; 50%) or mixed echoic nodules (4/8; 50%) appeared to be found relatively more easily by C-T sag T2WI than more benign-looking solid isoechoic (1/4; 25%) or spongiform nodules (0/6; 0%). Among six nodules with ultrasonographic suspicion for malignancy, only one nodule was detected by C-T sag T2WI. Conclusion: If an incidental thyroid nodule is seen by C-T sag T2WI, it would be better to recommend thyroid US for identifying malignancy.

뼈주위 지방종의 자기공명영상 소견: 증례 보고 (MR Imaging Findings of Parosteal Lipoma: Case Report)

  • 배형주;홍석주;김예림;강은영;김학준;류영준;정원용
    • Investigative Magnetic Resonance Imaging
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    • 제14권2호
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    • pp.134-138
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    • 2010
  • 뼈주위 지방종은 골막과 밀접한 관련성을 지니며 발생하는 드문 양성지방종으로 조직소견은 전형적인 연부조직 지방종과 같은 성숙지방세포로 구성된다. 영상에서 특징적으로 뼈와 인접한 지방성의 덩어리로 나타나며 인접한 골피질에 다양한 반응성 변화를 일으킨다. 자기공명영상에서는 뼈주위에 위치한 양성지방종, 이와 연결된 뼈의 돌기 또는 반응성 골피질 변화, 또한 신경 압박에 의한 이차적 근육 퇴행 등의 소견을 관찰할 수 있다. 이 보고에서는 중족골에 연해 발생한 뼈주위 지방종의 증례를 자기공명영상 소견을 중심으로 기술하고자 한다.

Methods to determine the volume of infrapatellar fat pad as an indicator of anterior cruciate ligament tear

  • Cheruvu, B.;Tsatalis, J.;Laughlin, R.;Goswami, T.
    • Biomaterials and Biomechanics in Bioengineering
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    • 제3권1호
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    • pp.27-35
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    • 2016
  • Anterior knee pain is a major problem among adolescents and young adults especially those who participates in sports. The most common pathogenesis of anterior knee pain can arise from compression and shear forces in the patellofemoral joint. It is also caused by impingement of infrapatellar fat pad. Fat pad impingement can occur when the fat pad becomes swollen and inflamed due to a direct blow or chronic irritation. As a result, the bottom tip (or inferior pole) of the patella can pinch the fat pad. One of the many causes of swollen fat pad can be secondary to anterior cruciate ligament (ACL) injury. The aim of this study was to compare the infrapatellar fat pad volume in patients with acute ACL injury and a group of age-, gender-, and activity- matched controls with intact ligament. Axial magnetic resonance (MR) images have been performed on 32 patients with torn ACL and 40 control patients. The volume of the fat pad was measured digitally from MR image by using a 3d Reconstruction software, ellipsoidal approximation, and a MATLAB code. The results were compared between patients with torn ACL and control group. Patients with a torn ACL had a significantly larger fat pad than the controls (P=0.01). There was no significant difference between the methods used to measure the infrapatellar fat pad volume (P=0.83-0.87). Thus, lesions of the infrapatellar fat pad is often associated with ACL injury.

Chondrogenic Differentiation of Bone Marrow Stromal Cells in Transforming Growth $Factor-{\beta}_{1}$ Loaded Alginate Bead

  • Park, Ki-Suk;Jin Chae-Moon;Kim, Soon-Hee;Rhee John M.;Khang Gil-Son;Han, Chang-Whan;Yang, Yoon-Sun;Kim, Moon-Suk;Lee, Hai-Bang
    • Macromolecular Research
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    • 제13권4호
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    • pp.285-292
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    • 2005
  • We developed alginate beads loaded with transforming growth $factor-{\beta}_{1}(TGF-{\beta}_{1})$ to examine the possible application of the scaffold and cytokine carrier in tissue engineering. In this study, bone marrow stromal cells (BMSCs) and $TGF{\beta}_{1}$ were uniformly encapsulated in the alginate beads and then cultured in vitro. The cell morphology and shape of the alginate beads were observed using inverted microscope, scanning electron microscope (SEM), histological staining and RT-PCR to confirm chondrogenic differentiation. The amount of the $TGF{\beta}_{1}$ released from the $TGF-{\beta}_{1}$ loaded alginate beads was analyzed for 28 days in vitro in a phosphate buffered saline (pH 7.4) at $37^{\circ}C$. We observed the release profile of $TGF-{\beta}_{1}$ from $TGF-{\beta}_{1}$ loaded alginate beads with a sustained release pattern for 35 days. Microscopic observation showed the open cell pore structure and abundant cells with a round morphology in the alginate beads. In addition, histology and RT-PCR results revealed the evidence of chondrogenic differentiation in the beads. In conclusion, these results confirmed that $TGF-{\beta}_{1}$ loaded alginate beads provide excellent conditions for chondrogenic differentiation.

한국 직업 발레 무용수 통증의 임상적 특징 및 통증클리닉에 대한 인식 (The Clinical Characteristics of Pain and the Usefulness of Pain Clinics from the Perspective of Professional Ballet Dancers in Korea)

  • 김창재
    • The Korean Journal of Pain
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    • 제21권2호
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    • pp.131-135
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    • 2008
  • Background: There has recently been a rapid increase in the number of pain clinics and significant advancement in the treatment of pain in Korea. Therefore, this study was conducted to identify possible problems associated with pain clinics and to use this information to help design future pain clinics. This assessment was conducted from the perspective of professional ballet dancers, who are at high risk for pain like other athletes. Methods: One-hundred professional ballet dancers responded to questionnaires designed to ascertain their preference for different types of clinics, the extent of the pain they experience, and their overall opinion of pain clinics. Results: All of the respondents complained of pain in one or more sites and reported that they had visited some type of clinic for treatment at least once. Overall, the respondents preferred using the following methods to treat pain: orthopedic surgery (76 dancers), oriental medicine (49 dancers), and therapy at pain clinic (48 dancers). Fifty-three percent of the 48 dancers who had received treatment at pain clinics were satisfied with their treatment. Forty-four percent of the 52 dancers who had not been treated at a pain clinic had no knowledge of the existence of such facilities. Conclusions: This survey revealed that, although professional ballet dancers have a high prevalence of pain, many have no knowledge of pain clinics. Therefore, efforts should be made by pain clinics to make information regarding their facilities widely available to professional ballet dancers so they can serve the widest range of clientele.

Spinal Metabotropic Glutamate Receptors (mGluRs) are Involved in the Melittin-induced Nociception in Rats

  • Cho, Chul-Hyun;Shin, Hong-Kee
    • The Korean Journal of Physiology and Pharmacology
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    • 제12권5호
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    • pp.237-243
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    • 2008
  • Intraplantar injection of melittin has been known to induce sustained decrease of mechanical threshold and increase of spontaneous flinchings. The present study was undertaken to investigate how the melittin-induced nociceptive responses were modulated by changes of metabotropic glutamate receptor (mGluR) activity. Changes in paw withdrawal threshold (PWT), number of flinchings and paw thickness were measured at a given time point after injection of melittin ($10{\mu}g$/paw) into the mid-plantar area of rat hindpaw. To observe the effects of mGluRs on the melittin-induced nociceptions, group I mGluR (AIDA, $100{\mu}g$ and $200{\mu}g$), $mGluR_1$ (LY367385, $50{\mu}g$ and $100{\mu}g$) and $mGluR_5$ (MPEP, $200{\mu}g$ and $300{\mu}g$) antagonists, group II (APDC, $100{\mu}g$ and $200{\mu}g$) and III (L-SOP, $100{\mu}g$ and $200{\mu}g$) agonists were intrathecally administered 20 min before melittin injection. Intraplantar injection of melittin induced a sustained decrease of mechanical threshold, spontaneous flinchings and edema. The effects of melittin to reduce mechanical threshold and to induce spontaneous flinchings were significantly suppressed following intrathecal pre-administration of group I mGluR, $mGluR_1$ and $mGluR_5$ antagonists, group II and III mGluR agonists. Group I mGluR antagonists and group II and III mGluR agonists had no significant effect on melittin-induced edema. These experimental findings indicate that multiple spinal mGluRs are involved in the modulation of melittin-induced nociceptive responses.

경추부 초음파 유도하 중재술 (Ultrasound-guided Intervention in Cervical Spine)

  • 문상호
    • 대한정형외과 초음파학회지
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    • 제7권1호
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    • pp.49-66
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    • 2014
  • 지금까지 경추부 중재술은 방사선 투시하에 하는 것이 표준화된 방법이었다. 그러나 방사선을 피폭해야 하는 문제가 있으며, 실시간으로 조영제를 이용하여 투시하거나 컴퓨터단층촬영 유도하 시술로써 안전하게 시행하려는 노력에도 불구하고, 특히 경추간공 차단술에서, 예기치 않은 주사제의 동맥내 주입이 발생하여 심각한 합병증인 척수 손상, 소뇌 및 뇌간 경색 등의 증례들이 방사선 투시하 시술에서 보고되는 것이 사실이다. 최근에는 그 대안으로서 경추부 초음파 유도하 중재술이 시행되고 있는데, 초음파는 주요 신경 및 혈관 구조물들의 위치를 관찰하면서 목표 부위 주위로 주사제가 퍼져나가는 양상을 파악할 수 있다는 장점이 있기 때문이다. 또한 초음파는 방사선이 없고 간편하며 주사하는 동안 실시간으로 계속 영상을 제공함으로써 시술의 정확도를 높일 수 있는 술기이다. 결국 초음파 유도하 시술은 주요 신경과 혈관의 위치를 확인하면서 그에 대한 손상 혹은 주사를 피할 수 있기 때문에 이러한 구조물들의 손상 위험이 높은 경추부에서 안전하게 시행할 수 있다는 중요한 장점이 있는 술기이다. 그리하여 저자는 실시간 초음파 유도하라는 술기가 경추부 중재술에서 얼마나 유용한가에 대해 분석하여 기술하였다.

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