• Title/Summary/Keyword: radiographic analysis

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Analysis of Radiological and Clinical Results in Treatment of Open Segmented Tibia Fractures: A Comparison between Intramedullary Nailing and Minimal Invasive Plate Osteosynthesis

  • Kim, Ji Wan;Song, Hyung Keun
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.76-81
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    • 2016
  • Purpose: The purpose of this study was to compare the data comprehensively including not only the clinical and radiographic outcomes but some parameters related to operation between the minimally invasive plate osteosynthesis (MIPO) technique and intramedullary nailing (IMN) for treatment of segmental tibia shaft fractures. Methods: We conducted a retrospective study of 31 patients (mean age, 49.3 years, range, 27-74 years), with a mean follow-up of 14.1 months (range, 12-19 months) with acute segmental tibial fractures (AO 42-C2) who underwent either surgical treatment of MIPO or IMN. In accordance with the Gustilo-Anderson classification, 11 were type I, 5 were type II, and 15 were type III. Initial compartment syndrome was confirmed in 2 cases. Results: There were no statistically significant differences in terms of the patient demographic data between the two groups. The time to definitive fixation was longer in the MIPO group (mean $13.7{\pm}10.9days$; range, 2-27) than in the intramedullary group (mean $5.4{\pm}9.6days$; range, 0-35) with statistically significant difference (p=0.002). Bony union was observed in most of cases but except 5 cases of nonunion were diagnosed (3 in the MIPO vs 2 in IMN, p=0.188). The average bone healing time was 27.1 weeks (10 to 56 weeks) in MIPO group and 23.2 weeks (13 to 66 weeks) in IMN group, respectively (p=0.056). Overall complications were 5 cases in MIPO group and 2 cases in the IMN group. Difference in LEFS was not statistically significant between both groups (p=0.824). Conclusion: This study showed that segmental tibia shaft fractures treated with both MIPO and intramadullary nailing was challenging with relatively high complication rate. A well planned sequential strategy with keeping the soft tissue and personality of fracture in mind is utmost significant as much as the choice of surgical modalities.

Benign Symmetrical Lipomatosis (Madelung's Disease) -A case report- (양성 대칭성 지방종증 -1예 보고-)

  • Han Jong-Hee;Kang Min-Woong;Yu Jae-Hyeon;Lim Seung-Pyung;Lee Young;Na Myung-Hoon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.419-422
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    • 2006
  • Benign symmetric lipomatosis (BSL), also called Madelung's disease, is a rare disease in middle-aged chronic alcohol user. The cause of BSL is unknown. A 63 year-old man with rapid growing lesions in both shoulders for 2 months visited our hospital. Except for cosmetic problem, no abnormal finding was found in blood cell analysis and chemistry; however, excessive fat deposition was found on radiographic findings. Lipoma was revealed in pathologic examination and BSL was diagnosed clinically. Patient is being followed up without any specific problem.

The Significance of Serum Carcinoembryonic Antigen in Lung Adenocarcinoma

  • Kim, Jae Jun;Hyun, Kwanyong;Park, Jae Kil;Moon, Seok Whan
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.335-344
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    • 2015
  • Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

Ultrasonic Inspection Technology of Defect Detection of Solid Propellant Rocket Motor (초음파를 이용한 고체 추진제 추진기관의 결함 검출 기법)

  • Na Sung-Youb
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2006.05a
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    • pp.239-245
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    • 2006
  • Ultrasonic inspection method is more profitable than X-ray radiographic inspection in cost and effect of defect detection such as dis-bond, damage, and it does'nt need special constructions and can be possible real time inspection with safety. This report explains the experiment and analysis of ultrasonic property of solid propellant and the inspection methods of propellant/liner dis-bond by inside or outside inspection, and of propellnat micro crack by damage. At result, ultrasonics has big attenuation$(6\sim8db/cm)$ in solid propellant, and it. can be possiblle to detect the defect of propellant/liner dis-bond by inside or outside inspection. And also it can be possible to detect the propellant micro crack caused by damage by using ultrasonic attenuation.

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Symptomatic Adjacent Segment Degeneration Following Posterior Lumbar Arthrodesis : Retrospective Analysis of 26 Patients Experienced in. 10-year of Periods

  • Shin, Myung-Hoon;Ryu, Kyeong-Sik;Kim, Il-Sup;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.184-190
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    • 2007
  • Objective : The authors retrospectively analyzed clinical and radiographic features of patients who developed symptomatic adjacent segment degeneration (ASD) that required re-operation. Methods : From 1995 to 2004, among 412 patients who underwent posterior lumbar fusion surgery, the authors experienced twenty-six patients who presented symptomatic ASD. Records of these patients were reviewed to collect clinical data at the first and second operations. Results : The patients were 9 males and 17 females whose mean age was $63.5{\pm}8.7$ years. Among 319 one segment and 102 multi-segment fusions, 16 and 10 patients presented ASD, respectively. Seventeen ASDs were noticed at the cephalad to fusion (65%), eight at the caudad (31%), and one at the cephalad and caudad, simultaneously (4%). All patients underwent decompression surgery. Nine patients underwent additional fusion surgeries to adjacent degenerated segments. In 17 patients who underwent only decompression surgery without fusion, the success rate was 82.4%. In fusion cases. the success rate was observed as 55.5%. There were no statistically significant factors to be related to development of ASD. However, in cases of multi-level fusion surgery, there was a tendency toward increasing ASD. Conclusion : Multi-segment fusion surgery could be associated with a development of ASD. In surgical treatment of symptomatic ASD, selective decompression without fusion may need to be considered as a primary procedure, which could reduce the potential risk of later occurrence of the other adjacent segment disease.

Bone Cement Augmentation of Pedicular Screwing in Severe Osteoporotic Spondylolisthetic Patients

  • Kim, Hyeun-Sung;Park, In-Ho;Ryu, Jae-Kwang;Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.1
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    • pp.6-10
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    • 2007
  • Objective : The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. Methods : Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. Results : Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was $11.0^{\circ},\;20.1^{\circ}$ and $18.3^{\circ}$, respectively, with mean sagittal angle correction gain $7.3^{\circ}$. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. Conclusion : Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.

Anterior Cervical Interbody Fusion with the Carbon Composite Osta-Pek Frame Cage in Degenerative Cervical Diseases

  • Han, Kwang-Wook;Kim, Joon-Soo;Kim, Kyu-Hong;Cho, Yong-Woon;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.422-426
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    • 2005
  • Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.

Radiation for persistent or recurrent epithelial ovarian cancer: a need for reassessment

  • Choi, Noorie;Chang, Ji Hyun;Kim, Suzy;Kim, Hak Jae
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.144-152
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    • 2017
  • Purpose: The role of radiotherapy (RT) was largely deserted after the introduction of platinum-based chemotherapy, but still survival rates are disappointingly low. This study focuses on assessing the clinical efficacy of RT in relation to chemotherapy resistance. Materials and Methods: From October 2002 to January 2015, 44 patients were diagnosed with epithelial ovarian cancer (EOC) and treated with palliative RT for persistent or recurrent EOC. All patients received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy. The biologically effective dose (BED) was calculated with ${\alpha}/{\beta}$ set at 10. Ninety-four sites were treated with RT with a median BED of 50.7 Gy (range 28.0 to 79.2 Gy). The primary end-point was the in-field local control (LC) interval, defined as the time interval from the date RT was completed to the date any progressive or newly recurring disease within the RT field was detected on radiographic imaging. Results: The median follow-up duration was 52.3 months (range 7.7 to 179.0 months). The 1-year and 2-year in-field LC rates were 66.0% and 55.0%, respectively. Comparisons of percent change of in-field tumor response showed similar distribution of responses among chemoresistant and chemosensitive tumors. On multivariate analysis of predictive factors for in-field LC analyzed by sites treated, $BED{\geq}50Gy$ (hazard ratio, 0.4; confidence interval, 0.2-0.9; p = 0.025) showed better outcomes. Conclusion: Regardless of resistance to platinum-based chemotherapy, RT can be a feasible treatment modality for patients with persistent of recurrent EOC. The specific role of RT using updated approaches needs to be reassessed.

Analysis of Keratocystic Odontogenic Tumor (각화낭성 치성종양에 관한 분석)

  • Lim, Hyoung-Sup;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Moon, Kyung-Nam;Yoon, Jeong-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.332-336
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    • 2010
  • We reviewed 30 cases of keratocystic odontogenic tumor (KCOT) managed during the 8-year period between 2001 and 2008. This case report described the clinical, radiographic and histopathologic features of these KCOT. Of the 30 patients in whom KCOTs were diagnosed, 18 (60%) of the patients were male and 12 (40%) were female. The mean age of these patients was 34.2 years, with peak incidence occurring in the third decade of life. The lesions were mostly located in the mandible (74.2%) and in the maxilla (25.8%). There was a marked predilection to occur in the posterior mandible. Radiographically, 19 (63%) out of the 30 cases were unilocular type with a well demarcated border, while 11 cases (37%) were multilocularin appearance. Histopathologically, 73% of the cysts were lined with parakeratinized stratified squamous epithelium, while only 3% of the cysts were lined with mixed parakeratinized of orthokeratinized epithelium. 22 cases (73%) contained keratin in the lumen. A satellite cyst was observed in 14 cases (47%). All cysts were treated by enucleation. The recurrence rate was shown as 10% for 3 patients with a follow up period and recurred lesions were treated by re-enucleation.

Effect of slow forced eruption on the vertical levels of the interproximal bone and papilla and the width of the alveolar ridge

  • Kwon, Eun-Young;Lee, Ju-Youn;Choi, Jeomil
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.379-385
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    • 2016
  • Objective: Forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. The aim of this study was to examine the changes in the alveolar ridge width and the vertical levels of the interproximal bone and papilla following forced eruption. Methods: Patients whose hopeless maxillary anterior teeth were expected to undergo severe bone resorption and soft tissue recession upon extraction were recruited. In addition, patients whose maxillary anterior teeth required forced eruption for restoration due to tooth fracture or dental caries were included. Before and after forced eruption, the interproximal bone height was measured by radiographic analysis, and changes in the alveolar ridge width and the interproximal papilla height were measured with an acrylic stent. Results: This prospective study demonstrated that the levels of the interproximal alveolar bone and papilla were significantly increased by 1.36 mm and 1.09 mm, respectively, in the vertical direction. However, the alveolar ridge width was significantly reduced by an average of 0.67 mm in the buccolingual direction. The changes in the level of the interproximal alveolar bone and papilla were positively correlated. Conclusions: Although the levels of the interproximal bone and papilla were significantly increased, the alveolar ridge width was significantly decreased following forced eruption. There was a modest positive and significant correlation between the changes in the height of the interproximal alveolar bone and the papilla. Based on our findings, modification of vertical forced eruption should be considered when augmentation of the alveolar ridge width is required.