• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.14-19
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• 2012

Purpose: We analyzed the oncologic outcome of the malignant transformed benign giant cell tumor of bone. Materials and Methods: Between January 2000 and February 2012, 5 cases were referred with suspicious malignant transformation of benign giant cell tumor. No patients underwent radiation therapy. Results: After referral, all patients received the wide excision of the tumor and its' pathologic diagnosis were osteosarcoma. As classified by the location of tumor lesion, 3 cases were located in the distal femur, 1 case was in the distal radius and 1 case was in the proximal femur. The average latent period between diagnosis of benign giant cell tumor and diagnosis of secondary malignant giant cell tumor was 49.2 months. (range, 24-126 months) The mean follow-up period was 21.6 months. There were subsequent local recurrence in 2 cases and 3 patients developed distant metastasis. All patients with lung metastasis were dead. Conclusion: Malignant transformation of benign giant cell tumor of bone can be occurred within 5 years. Therefore, when benign giant cell tumor suspicious malignant transformation, it is necessary to do more aggressive treatment.

• Journal of radiological science and technology
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• v.35 no.1
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• pp.1-7
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• 2012

Dual Energy X-ray Absorptiometry(DEXA) is commonly used to diagnose Osteoporosis. The errors of DEXA bone density operation are caused by operator, bone mineral density meter, blood testing, patient. We focus on operator error then study about how much influence operator's region of intest(ROI) in bone testing result. During from March to July in 2011. 50 patients ware selected respectively from 30, 40, 50, 60, and 70 age groups who came to Korea University Medical Center(KUMC) for their Osteoporosis treatment. A-test was performed with usually ROI and B-test was performed with most widely ROI. Then, We compare A-test and B-test for find maximum difference of T-score error which occurred operator ROI controlling. Standard deviation of T-score of B-test showed 0.1 higher then A-test in femur neck. Standard deviation of B-test showed 0.2 higher then A-test in Ward's area which in Greater trocanter and Inter trocanter. Standard deviation of B-test showed 0,1 lower then A-test in L-1. Bone density testing about Two hundred patients results are as follow. When operator ROI was changed wider than normal ROI, bone density of femur was measured more higher but bone density of L-spine was measured more lower then normal bone density. That means, sometime DEXA bone density testing result is dependent by operator ROI controlling. This is relevant with the patient's medicine and health insurance, thus, tester always keep the size of ROI for to prevent any problem in the patient.

• 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.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.491-497
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• 2021

Purpose: To investigate the prevalence of osteoporosis or osteopenia via dual-energy X-ray absorptiometry bone mineral density (DEXA BMD) in adult males who showed radiolucent lumbar vertebra on the plain radiographs. Materials and Methods: The DEXA BMD values of 98 adult males, who showed radiolucent vertebrae on plain X-rays, were compared with those of the control group (n=168) and osteoporosis-related fracture group (n=113) by statistical analysis. The World Health Organization (WHO) method (lower value between the mean lumbar and femur neck) and the Hansen's method (lowest lumbar vertebra) were used to determine osteoporosis. Results: The mean and standard deviation of the BMD value of each group was -1.4 (±1.2) in the suspicious group, -0.8 (±1.1) in the control group, and -2.4 (±1.0) in the fracture group, respectively; the difference was statistically significant. Using the WHO method, the prevalence ratio of osteoporosis was 17.3% in the suspicious group, 8.3% in the control group, and 45.1% in the fracture group, respectively. Osteopenia was observed in 40.8% of the suspicious group. Hansen's method (lowest lumbar vertebra) revealed the prevalence of osteoporosis in 30.6% of the suspicious group, 17.9% of the control group, and 62.0% of the fracture group. Conclusion: Approximately 17.3% of the suspicious group was diagnosed with osteoporosis, and 40.8% were osteopenic by a confirmative BMD study (WHO criteria) among the adult males showing apparent radiolucency on plain X-rays. The control group also showed an 8% prevalence of osteoporosis. These results suggest that males also are vulnerable to osteoporosis. Therefore, a BMD study should also be used for males, especially for the people showing lumbar vertebrae with radiolucent features.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.788-790
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• 2005

Chondromyxoid fbroma (CMF) is a rare, benign tumor of the bone that represents fewer than $2\%$ of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.25-31
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• 2008

Purpose : This study was conducted to understand for the diagnostic discordance of bone mineral density(BMD) in DEXA(Dual Energy X-ray Absorptiometry). And the diagnostic difference between lumbar spine and femur neck, forearm was evaluated using T-score. Materials and Methods : We studied 220 females measured BMD on lumbar spine, and femur neck, forearm including ward's triangle and ultra digital(UD). We were distinguished T-score into normal, osteopenia, osteoporosis(WHO classification) and evaluated discordance rate according to age and degree of bone loss. Correlation analysis and chi-square test between L-spine, L-4, femur neck, Ward, Forearm, UD were carried out. Results : In the lumbar spine, the number of normal were in 57(25.9%), osteopenia in 86(39.1%), osteoporosis in 77(35.0%). In the L-4 and ward's triangle, the number of osteoporosis were in 78(35.5%), in 126(57.3%). There was significant correlation between lumbar, femur neck and forearm BMD in all cases. The discordance of BMD between lumbar and femur were 57%, lumbar and forearm 43%, forearm and femur 51%. The discordance rates of normal, osteopenic, osteoporotic groups were 39%, 64%, 43%, respectively, showing the highest discordance rate in osteopenia patients. In normal group of lumbar spine, the discordance rate was 25%, 23%, 11%, 65%, 86% in 30', 40', 50', 60', 70', respectively. In osteopenia, osteoporosis group of lumbar spine, the discordance rate was 62%, 55%, 36%, 20%, 9% in 30', 40', 50', 60', 70', respectively. Conclusion : It was different of the results of BMD with lumbar, femur and forearm site. The discordance rate was decreased with age in osteopenia, osteoporosis lumbar spine. In osteopenia group, the discordance rate was the highest. So, it is necessary that the BMD of lumbar, femur neck and forearm should be checked.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.1-6
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• 2000

Purpose : The purpose of this study was to compare the results of ACL reconstruction using bone-patellar tendon-bone to hamstring. Materials and Methods : Thirty-two ACL reconstructions with autogenous BPTB and eighteen reconstructions with hamstring were compared in terms of functional outcome, stability and tunnel expansion. Results : The functional score of BPTB group was higher than hamstring group in OAK(Orthopadishe Arbeitsguppe Knie) and IKDC(International Knee Documentation Committee) system. In BPTB group, OAK scores were 71.6$({\pm}10.0)$ preoperatively and 88.5$({\pm}7.9)$ finally. In hamstring group, OAK scores were 73.9$({\pm}11.5)$ and 82.5$({\pm}12.9)$ respectively. There was no difference in stability checked by either $KT-1000^{TM}$ or stress view. Anterior tibial translation measured by $KT-1000^{TM}$ were 2.4$({\pm}1.8)$mm in BPTB and 2.3$({\pm}2.4)$mm in hamstring group. Anterior tibial translation in stress view were 2.8$({\pm}3.4)$mm in BPTB and 2.8$({\pm}2.5)$mm in hamstring group. There was no difference in tibial tunnel expansion but femoral tunnel was more enlarged in hamstring group than BPTB (P=0.03). Conclusion : As there was no difference in stability between two groups, it seems prudent to select either graft defend on such factors as anterior knee pain, skeletal maturity and cosmetic concern. Tunnel expansion seems not to affect stability, but further study is needed to confirm that decrease of which might improve stability.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.1
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• pp.20-26
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• 2002

Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.8-13
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• 2009

Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.