• Journal of Chest Surgery
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• 제56권3호
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• pp.220-223
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• 2023

Well-differentiated papillary mesothelial tumor (WDPMT) is an uncommon tumor, formerly named well-differentiated papillary mesothelioma in the 2015 World Health Organization classification. It has a characteristic papillary architecture, bland cytologic features, a tendency toward superficial spread without invasion, and a good prognosis due to its clinically indolent behavior with prolonged survival. Rare cases with superficial invasion are termed WDPMT with invasive foci. WDPMT occurs primarily in the peritoneum of reproductive-age women, but also rarely in the pleura. We report a case of a 60-year-old woman who developed WDPMT with minimal invasion in the pleura with atypical radiological features and a family history of mesothelioma and indirect asbestos exposure.

• 대한족부족관절학회지
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• 제13권2호
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• pp.129-132
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• 2009

Purpose: We evaluated the result of operative treatment of the hallux valgus in male patients. Materails and Methods: Total 11 cases (10 patients) of the hallux valgus deformity that treated with operation were evaluated. Following Mann's radiological classification system, there was 1 cases of mild, 8 cases of moderate, and 2 cases of severe. Preoperative, postoperative, postoperative 3 months and postoperative 6 months follow up standing radiographs were used as radiologic evaluation. And we evaluated radiological outcomes by hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA) and clinical outcomes by hallux-metatarsophalangeal scale of American Orthopaedic Foot and Ankle Society (AOFAS) score. Result: Radiologically, the mean preoperative HVA $37^{\circ}$ and IMA $13.7^{\circ}$ were improved postoperatively as HVA $11.9^{\circ}$ and IMA $4.7^{\circ}$, and the mean preoperative DMMA $29.4^{\circ}$ and PPAA $8.6$ were improved postoperatively DMMA $13.9^{\circ}$ and PPAA $7^{\circ}$. But, postoperative 6 months follow up HVA, IMA, DMMA and PPAA was increased at $14.2^{\circ}$, $6.3^{\circ}$, $16.1^{\circ}$ and $8.3^{\circ}$. Average AOFAS score were improved from 61.2 points to 75.2 points. Conclusion: In our study, operative treatment of hallux valgus in male patients with proximal metatarsal osteotomy and distal soft tissue procedure showed good results but it was necessary to pay attention to increase aspect of follow up radiologic measurements.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.155-161
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• 2006

Purpose: To compare the clinical and radiological results between the modified Weaver-Dunn method and modified Phemister method in the acute acromioclavicular joint dislocation. Materials and Methods: We reviewed 19 patients who were treated for the acute acromioclavicular joint dislocation from 2001 to 2002. 10 patients were operated with the modified Weaver-Dunn method (group A) and the others with modified Phemister method (group B). The classification of preoperative injury was analyzed by using the Rockwood system, the clinical assessment of preoperative and postoperative by the modified UCLA rating scale and the radiological assessment by simple x-ray. Results: With the modified UCLA rating scale, group A showed 5 cases(50%) of excellent and 5 cases(50%) of good, group B showed 4 cases(44.4%) of excellent and 5 cases(55.6%) of good. In the radiologic findings of the coracoclavicular distances, group A was 16.2 mm at preoperative, 8.8 mm at postoperative, 9.7 mm at last follow-up and group B was 12.9 mm, 6.7 mm and 7.9 mm respectively. Postoperatively there were no complications such as surgical wound infection and failure of Kirschner wires. Conclusion: Both the modified Weaver-Dunn and modified Phemister methods have shown satisfied clinical and radiologic results, and there was no difference in these result between two groups (p>0.05).

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

• 대한방사선기술학회지:방사선기술과학
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• 제32권2호
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• pp.147-151
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• 2009

ROC에 의한 의료영상을 평가하는 방법으로 지금까지는 5단계로 평가하는 평정확신도법이 일반적으로 사용되었다. 이 평정확신도법에서는 TPF나 FPF의 산출을 쉽게 구하는 것이 가능하나, 실험에 있어서 부드럽게 ROC곡선의 추정을 하기 위해서 관찰자에 대해 적당한 카테고리 배분이 요구되거나 또 짜여진 카테고리 배분을 위해 그 데이터가 무효해지는 경우가 많다. 이러한 문제를 해결하기 위해 또는 관찰실험 이외의 데이터에도 ROC해석의 응용이 가능해지도록 카테고리 분류가 되어 있지 않은 연속적으로 분포된 실험결과를 이용 ROC 해석을 행하는 방법인 연속확신도법이 보고 되었다. 하지만 국내에서는 의료영상의 평가에 연속확신도법을 적용한 예가 거의 없어서 흉부 디지털영상의 평가에 적용해 보았다. 그 결과 상용화된 프로그램에 의하여 부드러운 ROC곡선을 그릴 수 있었으며, 특성값을 쉽게 측정할 수 있어 디지털 의료영상의 평가에 적절히 사용될 수 있으리라 사료된다.

• 대한족부족관절학회지
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• 제24권1호
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• pp.25-30
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• 2020

Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권6호
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• pp.266-272
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• 2014

Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.560-566
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• 2017

Objectvie : The global sagittal postural patterns as characterized by Roussouly classification have been previously described in various ethnicities, there were no studies investigated in Koreans. To analyze the distribution of the global sagittal postural patterns in Korean adults using Roussouly classification, the author prospectively studied. Methods : 252 asymptomatic Korean adults was recruited. Data was obtained by reviewing the films for each subject. Spinopelvic parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. We compared the data across different ethnicities from our study and a previous study to further characterize Korean sagittal postures. Results : The subject included 151 males and 101 females, with mean age of $33.2{\pm}8.2years$. The average descriptive results were as below : thoracic kyphosis $28.6{\pm}7.7^{\circ}$, lumbar lordosis $48.3{\pm}10.2^{\circ}$, sacral slope $37.8{\pm}5.8^{\circ}$, pelvic incidence $45.1{\pm}7.5^{\circ}$, pelvic tilt $9.4{\pm}6.7^{\circ}$, spinosacral angle $130.1{\pm}5.4^{\circ}$, and sagittal vertical axis $16.25{\pm}22.5mm$. 125 subjects among 252 (49.6%) belonged to Roussouly type 3 (namely neutral). There were also 58 (23%), 33 (13.1%), and 36 (14.3) subjects in type 1, 2, and 4 (namely non-neutral), respectively. Conclusion : Enrolling 252 asymptomatic Korean adults, this prospective study found that 49.6% of asymptomatic Korean adults possessed a sagittal posture of Roussouly type 3. All radiologic parameters follows general concept of spinal sagittal balance pattern. Overall, this study might be a basis for further investigation of spinal sagittal balance.

• 한국방사선학회논문지
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• 제5권6호
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• pp.315-324
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• 2011

본 연구는 전 의경에 대한 체계적이고 효율적인 인적자원 관리를 위한 기초 자료로써의 성격을 갖는다. 우선 전 의경과 경찰관을 대상으로 방사선 검사 중 단순 X-선검사, CT 검사, MRI 검사를 시행한 환자를 대상으로 분석을 실시하였다. 질환별 분류에 있어서는 신체부위별로 일반 질환과 근 골격계 질환으로 분류하였다. 근 골격계 질환은 다시 검사 부위별로 세분화하여 분석하였다. 경찰관과 전 의경의 정량적 비교에 있어서는 단순 X-선검사, 전산화 단층 촬영술, 자기공명영상검사의 부위별 평균 인원을 비교하였다. 연구 결과 전 의경은 단순 X선 검사, CT 검사, MRI 검사 등 세 검사 모두 Lower extremity 검사가 다른 부위에 비해 가장 많이 차지하고 있으며 Lower extremity 검사 중에서 특히 Knee 검사 비율이 가장 많이 차지하고 있다.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.