• Title/Summary/Keyword: 대퇴골 경부

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Treatment of Osteoid Osteoma (유골 골종의 치료)

  • Han, Chung-Soo;Cho, Chang-Hyun;Cho, Young-Lin;Cho, Nam-Su;Lim, Chan-Teak
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.22-29
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    • 2000
  • Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.

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A Comparative Study of Bone Mineral Density and Urinary Bone Metabolic Makers according to the Nutrients Intake Levels in Postmenopausal Women (일부 폐경 후 여성의 영양소 섭취수준에 따른 골밀도와 소변 중 골대사 지표 비교연구)

  • Kim, Mi-Hyun;Lee, Da-Hong
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.719-727
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    • 2007
  • To elucidate the relationship among the levels of nutrients intake, bone mineral density(BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline(DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine(L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were $0.86g/cm^2$(lumbar spine), $0.60g/cm^2$(femoral neck), $0.49g/cm^2$(trochanter), and $0.41g/cm^2$(ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes(DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI $\leq$ adequate < 125% DRIs, high $\geq$ 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups(p<0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups(p<0.05, p<0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake(p<0.05, p<0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age(p<0.05, p<0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.

A Study on the Causes of Injury Codes by Case-Based Injury Code of External Causes Frequency Analysis (사례 중심의 손상코드 별 손상외인코드 빈도수 분석에 따른 손상코드 발생 원인에 관한 연구)

  • Eun-Mee Choi;Hye-Eun Jin;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.1
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    • pp.50-59
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    • 2023
  • The purpose of this study was to analyze the patients hospitalized with damage by injury code based on data for two years in 2020 and 2021 of A institution located in Gangneung, Gangwon-do. Analyzed the injury codes with a large number of occurrences per year, and analyzed the injury codes of external causes accordingly. The cause of the injury code was analyzed by analyzing the frequency of the injury code of external causes. Injury code S0650 had the highest frequency of injury code of external causes W189 and X5999, which was judged to be the cause of traumatic subdural hemorrhage without open intracranial wounds when falling in an unspecified place or toilet. Injury code S72120 had the highest frequency of injury code of external causes W010 and W180, and it was judged to be the cause of obstructive femoral intertrochanteric fracture that occurs when falling in the residence. The injury code S32090 had a high frequency of X5999, and it was analyzed that it caused the obstructive fracture of the lumbar region due to an accident caused by exposure in an unspecified place, and the injury code S72.090 had a high frequency of W010 and W180. It was confirmed that the cause of the obstructive fracture of the femoral neck was mainly caused by slipping or slipping in the residence, and the injury code S0220 had a high frequency of the injury code of external causes Y049, and it was confirmed that the fibula was fractured mainly by the force or fist. As such, the cause of the injury code was analyzed by analyzing the frequency of the injury code for each injury code of external causes.

The Association between Bone Mineral Density, Bone Turnover Markers, and Nutrient Intake in Pre- and Postmenopausal Women (폐경 전.후 여성의 골밀도 및 골대사 지표에 영향을 미치는 요인)

  • Park, Ji-Youn;Choi, Mi-Youn;Lee, Seon-Heui;Choi, Yoon-Ho;Park, Yoo-Kyoung
    • Journal of Nutrition and Health
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    • v.44 no.1
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    • pp.29-40
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    • 2011
  • The purpose of this study was to examine the association among bone mineral density (BMD), biochemical bone markers, nutrients, and salt intake in premenopausal and postmenopausal women. We evaluated 431 subjects who visited a health promotion center of a university hospital between January 2008 and July 2009. We excluded those who were taking medications or who had an endocrine disorder affecting osteoporosis. The subjects were divided into premenopausal (n = 283) and postmenopausal (n = 143) women. We evaluated the correlation among BMD of the lumbar spine, femoral neck, and total femoral, as well as biochemical bone markers, hormone, serum profiles, general characteristics, nutrient intakes, and food intake frequencies. From a stepwise multiple regression analysis, lumbar spine BMD was positively correlated with weight (p < 0.001) and negatively correlated with osteocalcin (OC)(p < 0.001), Femoral neck BMD was positively correlated with weight (p < 0.001) and negatively correlated with C-telopeptide (CTx) and alkaline phosphatase (ALP)(p < 0.001, p < 0.05). In premenopausal women, femoral total BMD was positively correlated with BMI (p < 0.001) and negatively correlated with CTx (p < 0.001). In postmenopausal women, lumbar spine BMD was positively correlated with calcium intake (p < 0.01) and negatively correlated with sodium intake (p < 0.01). Femoral neck and femoral total BMD were both positively correlated with weight (p < 0.001), and femoral neck BMD was negatively correlated with age and ALP (p < 0.001, p < 0.05). Femoral total BMD was negatively correlated with age and OC (p < 0.001, p < 0.01). These results suggest that reducing sodium intake may play an important role delaying bone resorption and preventing a decrease in BMD.

Osteoporosis in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서의 골다공증에 관한 연구)

  • Kim, Seong-Ja;Lee, Young-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.90-96
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    • 1999
  • Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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Slipped Capital Femoral Epiphysis(SCFE) (대퇴골두 골단분리증의 치험례)

  • Dan, Jin-Myoung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.245-261
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    • 1997
  • Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

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The Bone Mineral Density Impact Factors of Adult Women before the Menopause - based on the National Health and Nutrition Examination Survey - (폐경 전 성인여성의 골밀도 영향 요인 - 국민건강영양조사 자료를 이용하여 -)

  • Kim, Kyung-Hee;Lee, Jung-Hee;Yeo, Jin-Dong
    • Journal of the Korean Society of Radiology
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    • v.9 no.3
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    • pp.147-168
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    • 2015
  • In this research, we have analyzed the impact factors on the bone mineral density thru the examination of bone density difference in the entire femur, femoral neck and lumbar of adult women before the menopause in accordance with the general features, lifestyle, eating habits, health and body composition. The survey was conducted among adult women before the menopause and older than 30 years based on the data of the National Health and Nutrition Examination Survey carried out in the 4th term (2008-2009) and 5th term (2010-2011) and we would like to provide the research results for the establishment of recommendations or guidelines for the treatment of adult women before the menopause with regard to the impact factors on the bone mineral density and for the development of health education materials for the accurate measurement of bone mineral density of young women in order to prevent the postmenopausal osteoporosis. With respect to the general features of adult women before the menopause, the bone mineral density was higher in the entire femur at age 40-44, femoral neck at 35-39, in high-school education level, in the earlier menarche group, without smoking experiences, with regular walking time and exercise frequency and with the habits of eating no hamburger or pizza. With regard to the body composition, the bone mineral density was higher in obesity and lower in underweight cases, higher among people with abdominal obesity and weight control experiences. In terms of total body fat ratio, total amount of fat and muscle, the bone mineral density got gradually increased from the 1st quarter (Q1) to the 4th quarter(Q4). The obesity, disease, total amount of fat and muscle were shown to be significantly related with the bone mineral density in this research and it is required for young women to keep the adequate weight and the normal BMI in order to increase the bone mineral density. For the prevention of osteoporosis, it is advised to keep the right habits including regular exercise and no smoking discipline from the growing period and achieve the maximum bone mass thru the control of proper weight from a young age.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

The Relationship Between Bone Mineral Density and Adipose Tissue of Postmenopausal Women (폐경 후 여성의 골밀도 수치와 지방조직과의 연관성)

  • Kim, Sun-Hwa;Kim, Jung-Hoon;Im, In-Chul
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.219-228
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    • 2017
  • Postmenopausal women are at increased risk for osteoporosis and obesity due to changes in hormones. The relationship between osteoporosis and body weight is known, and its relation with body fat mass is discussed. The purpose of this study was to evaluate the bone mineral density(BMD) changes of epicardial adipose tissue(EAT) and abdominal subcutaneous fat. The subjects of this study were 160 postmenopausal women who underwent BMD and echocardiography. The thickness of the epicardial adipose tissue was measured in three sections and the BMD were meassured according to the diagnostic criteria. The results of this study that age increase the risk of osteoporosis increases, and as the weight and BMI decrease, the risk of osteoporosis increases(p<0.05). The relationship between changes in bone mineral density and adipose tissue in postmenopausal women, increased epicardial adipose tissue was negatively correlated with the bone mineral density(p<0.05). conversely, increased abdominal subcutaneous fat thickness was positively correlated with bone mineral density(p<0.05). In other words, the effect of bone mineral density on the location of adipose tissue was different. If Echocardiography is used to periodically examine changes in the thickness of the epicardial adipose tissue, it may be prevented before proceeding to osteoporosis.