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Ultrasonographic Diagnosis of the Patellar Clunk Syndrome after Posterior Stabilized Total Knee Arthroplasty - A Case Report - (후방 안정형 인공 관절 전치환술 후 슬개골 덜컹 증후군의 초음파적 진단 - 증례 보고 -)

  • Yoo, Jae Doo;Kim, Nam Ki;Chung, Jae Yoon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.39-44
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    • 2014
  • The patellar clunk syndrome is one of the patellofemoral complication, caused by formation of the fibrous nodule at the suprapatellar region after total knee arthroplasty. The symptom involves painful catching, crepitus and clunk during knee extension. It has been mainly but not exclusively associated with the posterior stabilized total knee system. The fibrous nodule is entrapped in the femoral intercondylar notch of the femoral component during flexion and as the knee is extended, it displaces back to the trochlear groove abruptly and the typical symptoms occur. The risk of developing this complication is primarily related to the design of the femoral component and higher incidence was noted with earlier designs of posterior stabilized knee prosthesis. Modifications have been made to the femoral component to optimize the kinematics of the patellofemoral joint and thereby reduced the incidence of patellar clunk syndrome but did not eliminate the problem completely. Clinical examination is the gold standard of diagnosis and imaging study has been used as a possible adjunct to diagnosis. Especially ultrasonography is an imaging modality, which can be easily performed to detect the fibrous nodule on the quadriceps tendon. We report a case of patellar clunk syndrome which was diagnosed with ultrasonography.

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Radiologic Evaluation for Differentiating Benign from Malignant Solitary Pulmonary Nodule (고립성 폐결절에서 양, 악성 감별을 위한 화상적 고찰)

  • 박재길;사영조;정정임
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.943-951
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    • 2003
  • We are now detecting an increasing number of solitary pulmonary nodules (SPNs) that are difficult to diagnosis. The purpose of this study was to evaluate the useful radiologic findings for differentiating benign from malignant pulmonary nodules. Material and Method: The high-resolution CT (HRCT) findings of SPNs smaller than 3 cm in largest diameter were evaluated in 134 patients with malignant and benign nodules in regard to internal structures, margin characteristics, and surrounding parenchymal responses. Result: The nodules with the area of ground-glass attenuation (GGA) greater then 50% were noted in adenocarcinoma, inflammatory lesions and some of metastatic tumors, and the lesions greater than 90% were noted only in adenocarcinoma. The area of GGA in non-adenocarcinoma, benign tumors and tuberculomas were less than 50%, and mainly less than 10%. The findings of air bronchogram, spiculation, lobulation, vascular involvement, and pleural indentation were some noted at every types of malignant tumors, but especially high over than 30% in adenocarcinomas. Conclusion: Most peripheral lung adenocarcinomas form a characteristic radiologic findings especially in HRCT. Evaluation of these findings would be helpful in differentiating between lung cancer, especially adenocarcinoma, and other lesions.

Diffuse Nodular Interstitial Infiltrations with Bilateral Hilar Lymphadenopathy (양측 폐문 림프절 종대를 동반한 간질성 결절성 폐침윤)

  • Yoon, Jae Ho;Yeo, Chang Dong;Shin, Eun Joong;Song, So Hyang;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.294-298
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    • 2006
  • Lymphocytic interstitial pneumonia(LIP) is an uncommon condition in which the alveolar septa and extra-alveolar interstitial space are markedly expanded by small lymphocytes, plasma cells and histiocytes. Chest radiographs generally show nonspecific patterns with the most common pattern showing bibasilar reticular or reticulonodular infiltrates. Hilar or mediastinal lymphadenopathy and pleural effusions are usually absent. We encountered a 42-year-old female patient who was admitted to hospital because of exertional dyspnea and palpitation. The chest X-ray showed an enlarged bilateral hilar shadow and diffusely increased bronchovascular markings in both lung fields. The chest CT showed diffuse nodular infiltrations with mild septal thickening and combined patchy ground glass opacity in both lungs, and conglomerated mediastinal and bilateral hilar lymphadenopathy. A diagnosis of LIP was made from the tissue pathology taken by a thoracoscopic lung biopsy. The patient showed clinical and radiographic improvement after 3 months of treatment with prednisolone. We report a case of LIP presenting as diffuse nodular interstitial infiltrations with multiple mediastinal and bilateral hilar lymphadenopathy.

Reflections on the Significance of Post Offices as Indicators of the Evolution of the Red River Valley Settlement Systems in Louisiana (우편.체신업무체계에 근거한 루이지애나주 레드강유역의 취락발달 분석)

  • 홍금수
    • Journal of the Korean Geographical Society
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    • v.35 no.5
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    • pp.681-700
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    • 2000
  • 본 연구는 남북전쟁 이전 미국 루이지애나주 레드강 유역의 취락발달과정을 다루었다. 당시 프런티어에 들어선 우체국은 초기 기능지역의 결절점을 형성하였는데, 본 연구는 우체국의 업무기록에 수록된 통계자료를 바탕으로 우체국취락의 발달과정을 계층구조의 변화에 중점을 두고 접근하였다. 연구는 취락계층이 정보유통량에 비례한다는 가설을 전제로 수행하였다. 자료를 분석한 결과 크게 두 가지 사실을 확인하였는데, 초장기 취락발달이 배후지역으로의 확장을 특징으로 한 반면, 시대를 내려오면서 취락내부에 계층적 분화가 심화되고 있음을 알 수 있었다. 구조 변화의 주원인은 무엇보다 세계체제내에서 유럽과 미국 북동부 섬유산업의 원료로 이용되는 면화경제의 발달이었다.

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Focal Nodular Hyperplasia: Pitfalls in Hepatic Scintigram (간 국한성 결절상 증식증의 신티그램 감별 진단)

  • Chung, Soo-Kyo;Son, Hyung-Sun;Lee, Myung-Hee;Lee, Sung-Yong;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.2
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    • pp.91-92
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    • 1985
  • Hepatic Focal Nodular Hyperplasia(FNH)는 아주 드문 간 양성 질환으로 우연히 발견되는 수가 않다. FNH의 신티그램 소견은 다양하다. 즉 56%에서는 신티그램상 이상소견이 발견되지 않으며 17%에서는 냉소로 나타나고 나머지 7%에서는 열소로 나타난다. 저자들은 상복부 동통을 호소하는 25세된 여자 환자에서 간 신티그램상 이상소견을 발견할 수 없었던 FNH 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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Extragonadal Intraabdominal Mixed Germ Cell Tumor with Liver Metastasis: Successful Treatment and Long-term Follow-up (간 전이를 동반한 복강 내 성선 외 혼합 생식세포종양: 성공적인 치료 및 장기간 추적관찰)

  • Park, Jinyoung
    • Advances in pediatric surgery
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    • v.19 no.1
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    • pp.25-31
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    • 2013
  • 성선 외 생식세포종양은 비교적 드물어 모든 생식세포종양의 5% 미만을 차지한다. 주로 천미부생식세포종양이 골반부나 후복막으로 확장된 경우가 대부분이며, 후복막이나 복강 내에 발생하는 생식세포종양은 매우 드물다. 저자는 복부 종괴를 주소로 내원한 18개월 된 여아에서 간 전이를 동반한 복강 내 혼합 생식세포종양을 치료하였다. 복부 초음파 및 전산화 단층촬영에서 복부 좌상사분역에 석회화, 고형 및 지방 성분을 포함하고 있는 낭성 종괴와 간에 1cm 크기의 결절이 관찰되었다. 종괴는 개복 후 제거되었으며, 병리조직학적으로 대부분의 내배엽동 종양과 적은 성숙 기형종으로 구성된 혼합 생식세포종양으로 진단되었으며, 간의 전이병변도 동일하게 진단되었다. 수술 후 항암화학요법을 시행하였으며, 환자는 현재 수술 후 10년이 경과하였으나 재발의 소견은 없다.

A Case Report of Nodules on Lower Extremities with Pain (통증이 동반된 하지부 결절 환자 치험 1례)

  • Keum, Na-rae;Lee, Yong-Jae;Park, Seong-Sik;Bae, Hyo-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.3
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    • pp.267-275
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    • 2016
  • Objectives The purpose of this study was to report a case of nodules on lower extremities with pain which was treated by herbal medicine treatment and acupuncture.Methods One male patient who had nodules on lower extremities with pain was treated by Yangdokbaekho-tang and Hyungbangsabak-san, and acupuncture according to the result of Sasang constitutional diagnosis.Results and Conclusions The patient's pain and accompanied symptoms were improved after using Yangdokbaekho-tang and Hyungbangsabak-san. The Numeric Rating Scale(NRS) which was used to evaluate pain intensity was decreased from 9 to 2 without using Western medications.

Cellular Immune Response of the Grasshopper, Euprepocnemis shirakii Bolivar Following Injection of Bacillus subtilis (세균(Bacillus subtilis)에 대한 등검은메뚜기(Euprepocnemis shirakii Bolivar)의 세포성 면역반응)

  • 장병수;문명진한성식여성문
    • The Korean Journal of Zoology
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    • v.35 no.3
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    • pp.383-394
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    • 1992
  • 비병원성 세균인 고acirlus subtilis(ATCC6633)를 등검은메뚜기(Euprepocnemis shr'rakii Bolivar)의 성충 복강에 주입한 후, 혈구의 반응양상을 투과전자현미경으로 관찰하였다. 세균에 대한 혈구의 면역반응은 plasmatocyte와 granulocyte에 의한 식 세포작용(phagocytosis)의 형태로 이루어졌으며, 결절형꽁(nodule formation)은 일어나지 않았다. 식 세포작용의 초기 반응은 혈구의 세포질 돌기가 돌출되 면서 이물질을 둘러싼 후, 원형질막과의 융합에 의해 식포가 형성되었고, 식포의 주변부에서는 일차 리소조옴의 집적이 관찰되었으며, 이런 과정은 세균 주입후, 10분 이내에 완료되었다. 일차 리소조옴은 세균 주입 후 1시간 이내에 식포의 한계막과 융합하여 이차 리소조옴을 형성하였으며, 소화된 이물질은 9시간 이내에 exocytosis에 의해 배출 되었다.

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DENS INVAGINATUS AND TALON CUSP CO-OCCURING: REPORT OF THREE CASES (치내치를 동반한 탈론 교두: 증례보고)

  • Im, Sung-Ok;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.488-496
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    • 2010
  • Dens evaginatus is a tooth with cylindrical enamel projection which forms a nodule on occlusal surface. It could be explained as outward overgrowth of inner enamel epithelium or localized hyperplasia of pulpal mesenchymal tissue during tooth development. A problem is that it is likely to be worn out or fractured by mastication ensuing pulpal inflammation. It is occasionally found on the lingual surface of upper anterior teeth as well, called talon cusp. Dens invaginatus is a tooth with deep lingual pit made by invagination of lingual enamel epithelium during tooth development while it is considered normal in terms of size and shape. Radiographically, a part of cervical enamel shows inward growth forming cavity and it is reasonable to say that the base is possibly open to pulpal cavity since they are very close. Talon cusp and dens invaginatus are relatively common abnormality of shape. However it becomes the opposite if the two exist in the same tooth. Once the talon cusp is broken by occlusal force or fissure between cusps is decayed, the complicated structure of canals makes the pulpal treatment difficult. Preventive treatments such as occlusal equilibrium and sealant, and regular oral examination should be preceded and thorough understanding of canal shape, using radiography, is required when pulpal treatment is necessary. This report is about a 9- year-old boy(lower left central incisor), a 8-year-old girl(upper right central incisor), and a 7-year-old boy(upper right central incisor), who have dens invaginatus and talon cusp in the same teeth. The first and the second patients are under pulpal treatments, and the last one is being observed showing no pathologic impressions.

Pulmonary Mineralization Secondary to Iatrogenic Hyperadrenocorticism in a Dog (개에서 발생한 의인성 부신피질기능항진증과 속발성 폐 석회화 진단 1례)

  • Park, Noh-Won;Chung, Wook-Hun;Han, Jae-Ik;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.233-236
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    • 2014
  • An 11-year-old, intact male Shih Tzu presented with obesity, thin hair coat, and abdominal distention. The patient had previously received corticosteroid therapy for dermatitis. Thoracic radiographs showed incidental findings of a generally diffuse bronchointerstitial pattern and markedly radiolucent pleural lines between the middle and caudal lung lobes, but clinical signs related to the thoracic radiographic findings were absent. Echogenicity of the hepatic parenchyma was increased and bilateral adrenal glands were not enlarged on ultrasonography. On computed tomography, the central regions of the lung lobes showed ground-glass attenuation, the peripheral regions of the lung lobes were relatively hypoattenuated compared with the central regions, and hyperattenuated nodules were distributed throughout the pulmonary parenchyma. Iatrogenic hyperadrenocorticism and secondary pulmonary mineralization was diagnosed on the basis of diagnostic imaging and adrenocorticotropic hormone stimulation test.