Purpose: We evaluated the clinical results of operative treatment of the intraarticular calcaneal fracture according to fracture classification. Materials and Methods: There were 25 cases (24 patients) which had at least one year follow up, 17 men and 7 women who were treated from June 1997 to March 2003. We have analysed the Bohler's angle, cruciate angle, width and posttraumatic osteoarthritis in radiological evaluation, and evaluated clinical results according to the Creighton-Nebraska health foundation score. Results: Excellent results were noted in 7 cases, good results in 6 cases, fair results in 4 cases and poor results in 8 cases. Radiological changes showed as follows: Bohler angle $17^{\circ}$, Crucial angle $0.1^{\circ}$, Width 6mm. Conclusion: Type II showed satisfactory results and type IV showed unsatisfactory results in Sanders classification. Proper evaluation of the intraarticular calcaneal fracture by X-ray and CT scan is necessory to predict prognosis and decise method of operative treatment.
Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
Journal of Korean Neurosurgical Society
/
v.29
no.11
/
pp.1484-1490
/
2000
Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.
Purpose: This study was conducted to evaluate the correlations among pulmonary contusion severity, trauma score and cardiac troponin I (cTnI) level. Methods: We prospectively evaluated patients with multiple injuries who had been admitted to the emergency department (ED) from July 2007 to July 2008. We first measured the total creatinine kinase (CK), the MB fraction of CK (CK-MB), TnI, and myoglobin within 2 hours after the injury. We then checked the electrocardiogram, x-ray, and computed tomography (CT) results. Finally, we assessed the injuries as variables and then compared the results for patients with elevated TnI levels (group A) and patients whose TnI levels fell within the normal range (group B). Results: Eighty-six of the 92 patients admitted to the ED were enrolled. The pulmonary contusion score (PCS) was well correlated with $PaO_2/FiO_2$. TnI levels were correlated with PCS. When TnI levels were above 0.86 ng/ml, the mortality was estimated with 100% sensitivity and 86.1% specificity. Conclusion: Pulmonary contusion severity is correlated with TnI level. When the PCS is high and the cTnI level is elevated in multiple-injury patients, we recommend continuous cardiac monitoring and further evaluation
Lee Jae-Hoon;Chung Woung-Yoon;Kang Hae-Youn;Park Cheong-Soo
Korean Journal of Head & Neck Oncology
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v.16
no.2
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pp.201-205
/
2000
Objectives: Despite of high prevalence of tuberculosis in Korea, thyroid tuberculosis is very rare and only a few records are available. This study was carried out to evaluate the clinicopathologic characteristics of thyroid tuberculosis and to find out optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1986 to July. 2000, of 5,493 patients who were underwent thyroidectomy, only 8(0.14%) had discovered to have thyroid tuberculosis. The medical records of them were analyzed retrospectively. Results: There were one man and seven women with a mean age of 40.3 years. Only one had tuberculosis sequalae on chest X-ray and two had past history of tuberculous lymphadenitis. However, none of them had symptomatic pulmonary tuberculosis. Most frequent symptom was palpable neck mass. The preoperative U/S, CT and FNAB failed to diagnose thyroid tuberculosis. The pathologic reports were chronic granulomatous thyroiditis with caseous necrosis in all the cases and AFB stain was positve in 5 cases. All cases were successfully treated by surgical resection and anti-Tbc. medications. Conclusions: The incidence of thyroid tuberculosis was extremely low and most of them have been presented as a palpable neck mass especially in relatively young-aged female patients. Although any diagnosis for thyroid tuberculosis prior to microscopical study of tissue removed at operation was not yielded, the preoperative diagnostic workups will be available with experience. Surgical resection and anti- Tbc medication would be the choice in the management of thyroid tuberculosis.
Golestan province has a reputation for relatively high incidence rates of gastric cancer in Iran. Along with dietary, lifestyle and environmental influential factors, soil selenium and high levels of pesticide used may exert influence in this region. The present study was designed for modeling the influential predictors on incidence of gastric cancer in Golestan. All registered cases of gastric cancer from March 2009 to March 2010 (49 females and 107 males) were investigated. Data were gathered by both check list and researcher made questionnaire (demographic, clinical and lifestyle characteristics) and analysed using logistic regression. Mean (${\pm}SD$) age at diagnosis was $62.9{\pm}13.8$ years. CIR and ASR of gastric cancer showed 9.16 and 13.9 per 100,000 people, respectively. Based on univariate logistic regression, a history of smoking (OR= 2.076), unwashed hands after defecation (OR= 2.612), history of cancer in relatives (OR= 2.473), history of gastric cancer in first-degree relatives (OR= 2.278), numbers of gastric cancers in first-degree relatives (OR= 2.078), history of X-ray and dye exposure (OR= 2.395), history of CT scan encounter (OR= 2.915), improper food habits (OR= 3.320), specific eating behavior (OR= 0.740), consumption of probable high risk foods (OR= 2.942), charred flesh (OR= 1.945), and animal fat (OR= 2.716) were confirmed as a risk factors. Changes in lifestyle may be expected to increase gastric cancer incidence dramatically in the near future. Therefore, appropriate educational interventions should be designed and implemented by competent authorities.
The Al die casting process has been widely used in the manufacturing of automotive parts when the process requires near-net shape casting and a high productive rate. However, porosity arises in the casting process, and this hampers the wider use of this method for the creation of high-durability automotive components. The porosity can be controlled by the shot condition, but, it is critical to set the shot condition in the sleeve, and it remains difficult to optimize the shot condition to avoid air entrapment efficiently. In this study, the 4.5 mm, 2.0 mm plate die castings were fabricated under various shot conditions, such as plunger velocities of 0.7 m/s ~ 3.0 m/s and fast shot set points of the cavity of -25%, 0%, 25%, and 50%. The mold filling behavior of Al melts in the cavity was analyzed by a numerical method. Also, according to the shot conditions, the results of numerical analyses were compared to those of die-casting experiments. The porosity levels of the plate castings were analyzed by X-ray CT images and by density and microstructural analyses. The effects of the porosity on the mechanical properties were analyzed by tensile tests and hardness tests. The simulation results are in good general agreements with the die-casting experimental results. When plunger velocity and fast shot set point are 1.0 m/s and cavity 25% position, castings had optimum condition for good mechanical properties and a low level of porosity.
Park, Sang-Kyu;Bak, Koang-Hum;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
Journal of Korean Neurosurgical Society
/
v.40
no.2
/
pp.90-94
/
2006
Objective : Acute vertebral burst fractures warrant extensive fixation and fusion on the spine. Osteoplasty [vertebroplasty with high density resin without vertebral expansion] has been used to treat osteoporotic vertebral compression fractures. We report our experiences with osteoplasty in acute vertebral burst fractures. Methods : Twenty-eight cases of acute vertebral burst fracture were operated with osteoplasty. Eighteen patients had osteoporosis concurrently. Preoperative MRI was performed in all cases to find fracture level and to evaluate the severity of injury. Preoperative CT revealed burst fracture in the series. The patients with severe ligament injury or spinal canal compromise were excluded from indication. Osteoplasty was performed under local anesthesia and high density polymethylmethacrylate[PMMA] was injected carefully avoiding cement leakage into spinal canal. The procedure was performed unilaterally in 21 cases and bilaterally in 7 cases. The patients were allowed to ambulate right after surgery. Most patients discharged within 5 days and followed up at least 6 months. Results : There were 12 men and 16 women with average age of 45.3[28-82]. Five patients had 2 level fractures and 2 patients had 3 level fractures. The average injection volume was 5.6cc per level Average VAS [Visual Analogue Scale] improved 26mm after surgery. The immediate postoperative X-ray showed 2 cases of filler spillage into spinal canal and 4 cases of leakage into the retroperitoneal space. One patient with intraspinal leakage was underwent the laminectomy to remove the resin. Conclusion : Osteoplasty is a safe and new treatment option in the burst fractures. Osteoplasty with minimally invasive technique reduced the hospital stay and recovery time in vertebral fracture patients.
Objective : Bilateral C1-2 transarticular screw fixation (TAF) with interspinous wiring has been the best treatment for atlantoaxial instability (AAI). However, several factors may disturb satisfactory placement of bilateral screws. This study evaluates the usefulness of unilateral TAF when bilateral TAF is not available. Methods : Between January 2003 and December 2007, TAF was performed in 54 patients with AAI. Preoperative studies including cervical x-ray, three dimensional computed tomogram, CT angiogram, and magnetic resonance image were checked. The atlanto-dental interval (ADI) was measured in preoperative period, immediate postoperatively, and postoperative 1, 3 and 6 months. Results : Unilateral TAF was performed in 27 patients (50%). The causes of unilateral TAF were anomalous course of vertebral artery in 20 patients (74%), severe degenerative arthritis in 3 (11%), fracture of C1 in 2, hemangioblastoma in one, and screw malposition in one. The mean ADI in unilateral group was measured as 2.63 mm in immediate postoperatively, 2.61 mm in 1 month, 2.64 mm in 3 months and 2.61 mm in 6 months postoperatively. The mean ADI of bilateral group was also measured as following; 2.76 mm in immediate postoperative, 2.71 mm in 1 month, 2.73 mm in 3 months, 2.73 mm in 6 months postoperatively. Comparison of ADI measurement showed no significant difference in both groups, and moreover fusion rate was 100% in bilateral and 96.3% in unilateral group (p=0.317). Conclusion : Even though bilateral TAF is best option for AAI in biomechanical perspectives, unilateral screw fixation also can be a useful alternative in otherwise dangerous or infeasible cases through bilateral screw placement.
The pulmonary giant cell carcinoma is classified as a variant of a large cell carcinoma and is diagnosed by the minimum component of 10% huge, pleomorphic and multinucleated giant tumor cell and emperipolesis of the neutrophils into the tumor cells. This tumor is characterized by local recurrences and early metastasis with extremely short patient survival. However, there are some reports that state that the survival time was extended by the operative resection and postoperative adjuvant chemotherapy and radiotherapy. A 46-year old male was admitted with complaint of hemoptysis for 2 months. Through chest X-ray and chest CT, a 5cm sized mass was found in the apical segment of the right upper lobe. During the preoperative evaluation, stenotic lesion in the left anterior descending coronary artery was found and treated by percutaneous transarterial coronary angioplasty. Four weeks later, right upper lobectomy was performed and the mass was proven to be a giant cell carcinoma. The patient received adjuvant chemotherapy and radiotherapy.
Purpose: The aims of this study were to measure the distance of the intraosseous vascular anastomosis in the anterolateral wall of the maxillary sinus from different reference points, and to correlate the location of the intraosseous vascular anastomosis with the tooth position and the residual bone height of the maxilla. Methods: Computed tomography (CT) images were taken from 283 patients undergoing dental implants placement in the posterior maxilla. Three horizontal lines were drawn at the ridge crest, maxillary sinus floor, and the position of the anastomosis. A vertical second line at the center of each tooth was drawn perpendicular to the horizontal lines. The distance from the ridge crest to the maxillary sinus floor and the distance from the maxillary sinus floor to the bony canal were measured from the intersections of the horizontal and vertical lines. The residual alveolar bone height was used to categorize three groups: group 1,<4 mm; group 2, between 4 and 8 mm; and group 3, >8 mm. Results: The residual bone height values of different tooth positions were significantly different (P=0.0002). The distance from the maxillary sinus floor to the intraosseous vascular anastomosis was significantly different between groups 1 and 3 (P=0.0039). At the molar sites, a moderate negative correlation was found between the residual bone height and the distance from the maxillary sinus floor to the intraosseous anastomosis. The distances of the alveolar ridge crest and the maxillary sinus from the intraosseous vascular anastomosis were not significantly different between sexes. Conclusions: Within the limitations of this study, sites with a higher residual bone height in the molar regions were at a relatively high risk of artery damage during window osteotomy preparation; therefore, we recommend taking more precautions when using a lateral approach for sinus elevation.
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