• Title/Summary/Keyword: proximal methods

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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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Early Therapeutic Effects of Cyberknife Radiosurgery on Trigeminal Neuralgia (삼차신경통에 대한 사이버나이프 방사선수술의 조기 치료 효과)

  • Mun Seong-Kwon;Choi Ihl-Bohng;Kang Young-Nam;Jang Ji-Sun;Kang Ki-Mun;Choi Byung-Ock
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.88-95
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    • 2006
  • Purpose: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). Materials and Methods: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of $60{\sim}64 Gy$ were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). Results: Follow-up period was $3{\sim}15$ months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. Conclusion: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.

A Study on the Enamel Surface Texture and Caries Susceptibility in Interdentally Stripped Teeth (치간삭제 후의 법랑질 표면조도와 치아우식 감수성에 관한 연구)

  • Kim, Kyong-Nim;Yoon, Young-Ju;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.567-578
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    • 2001
  • To investigate the difference of Texture exhibited on interproximal enamel surface with each different stripping method and the susceptibility of proximal enamel to demineralization after stripping and the application of a topical fluoride go] and sealant, one hundred human premolars, which were Previously extracted for orthodontic reasons were evaluated by means of Scanning electron microscopy and laser fluorescence. The results were as follows : 1. No matter what the initial stripping instrument was the furrows that resulted from all the stripping methods were not completely removed by careful polishing. 2. Among the enamel surfaces that were treated with three different initial abrasive instruments, followed by the same polishing method (Sof-$Lex^{(r)}$ disks), the enamel surfaces that were treated with 700 crosscut carbide bur showed the smoothest surfaces. 3. The stripped teeth, no matter what the initial stripping instrument was, were less resistant to initial demineralization than untreated teeth. But no difference in caries susceptibility according to differently stripped methods was found (p<(0.001). 4. Teeth treated with APF-gel or sealant were mote resistant to demineralization than those treated without other treatment after stripping (p<0.001). 5. Comparing groups treated with APF-gel to groups treated with sealant, the former was more resistant to demineralization than the tatter (p<0.05). In conclusion, enamel surfaces that were stripped jnterproximally were less resistant to demineralization even though various attempts were made to produce smooth, self-cleaning enamel surfaces. Therefore, additional treatment-sealant or calcifying/ fluoridating solution To the stripped enamel surfaces is recommended.

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Reconstruction with Extracorporeally Radiated Autogenous Bone Graft After Wide Resection of Bone Tumors (골종양 절제후 방사선 조사한 자가골을 이용한 재건술)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Kim, Sug-Jun;Lee, Soo-Yong;Yang, Hyun-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.32-38
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    • 1997
  • PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

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Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb (오픈소스 기반 수술항법장치의 하지 골절수술 응용검토)

  • Joung, Sanghyun;Park, Jaeyeong;Park, Chul-Woo;Oh, Chang-Wug;Park, Il Hyung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.5
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    • pp.497-503
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    • 2014
  • Minimally invasive intramedullary nail insertion or plate osteosynthesis has shown good results for the treatment of long bone fractures. However, directly seeing the fracture site is impossible; surgeons can only confirm bone fragments through a fluoroscopic imaging system. The narrow field of view of the equipment causes malalignment of the fracture reduction, and radiation exposure to medical staff is inevitable. This paper suggests two methods to solve these problems: surgical navigation using 3D models reconstructed from computed tomography (CT) images to show the real positions of bone fragments and estimating the rotational angle of proximal bone fragments from 2D fluoroscopic images. The suggested methods were implemented using open-source code or software and evaluated using a model bone. The registration error was about 2 mm with surgical navigation, and the rotation estimation software could discern differences of $2.5^{\circ}$ within a range of $15^{\circ}$ through a comparison with the image of a normal bone.

Relationships Between Rounded Shoulder Posture and Biceps Brachii Muscle Length, Elbow Joint Angle, Pectoralis Muscle Length, Humeral Head Anterior Translation, and Glenohumeral Range of Motion

  • Choi, Sil-ah;Cynn, Heon-seock;Lee, Ji-hyun;Kim, Da-eun;Shin, A-reum
    • Physical Therapy Korea
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    • v.24 no.2
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    • pp.48-57
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    • 2017
  • Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

A Report on "Debates on the Strategy for Treating Gastric Cancer" at the Congress of the KoreanGastric Cancer Association

  • Kim, Sung-Geun;Park, Cho-Hyun;Kim, Kyung-Mi;Kim, Jae-Gue;Kim, Hyung-Ho;Park, Wong-Sang;Park, Jong-Jae;Lee, Mun-Su;Jung, Hyun-Chul;Jung, Hun-Yong;Han, Sang-Wook;Hyung, Woo-Jin;The Academic Committee of The Korean Gastric Cancer Association, The Academic Committee of The Korean Gastric Cancer Association;Ryu, Sung-Yeop;Kim, Wook;Yook, Jung-Hwan;Jeung, Hei-Cheul;Jung, In-Ho;Park, Do-Joong;Oh, Sang-Hun;Ryu, Keun-Won;Chin, Hyung-Min;Lee, Sang-Ho;Kim, Min-Chan
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.141-148
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    • 2010
  • We have always attempted to create a standard treatment protocol for patients with gastric cancer. However, many debates still exist regarding gastric cancer treatment. For the past 2 years, at the Annual Congress of the Korean Gastric Cancer Association, we have presented a grand symposium on the "Debates on the strategy for treating gastric cancer". In 2008, four major topics were discussed and voted on after discussion. The four major topics were proximal location treatment for early gastric cancer, management choices for pyloric obstruction with advanced gastric cancer, management of liver metastasis, and reconstruction methods after a distal gastrectomy. The opinions of the audience for six minor topics were expressed by an electronic voting system. In 2009, the four main topics were treatment for submucosal tumor sized around 2 cm, laparoscopic gastrectomy in T2N1 gastric cancer, choices for managing gastric lymphoma, and application of a pylorus preserving procedure for early gastric cancer at the antrum. The opinions of the audience for these six minor topics were expressed by an electronic voting system, as was conducted in 2008. It was good opportunity to identify a point of contact about the debates on managing gastric cancer. The results of these debates and studies will identify the best methods to treat patients with gastric cancer.

Reliability Analysis of Finger Joint Range of Motion Measurements in Wearable Soft Sensor Gloves (웨어러블 소프트 센서 장갑의 손가락 관절 관절가동범위 측정에 대한 신뢰도 분석)

  • Eun-Kyung Kim;Jin-Hong Kim;Yu-Ri Kim;Ye-Ji Hong;Gang-Pyo Lee;Eun-Hye Jeon;Joon-bum Bae;Su-in Kim;Sang-Yi Lee
    • PNF and Movement
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    • v.21 no.2
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    • pp.171-183
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    • 2023
  • Purpose: The purpose of this study was to compare universal goniometry (UG), which is commonly used in clinical practice to measure the range of motion (ROM) of finger joints with a wearable soft sensor glove, and to analyze the reliability to determine its usefulness. Methods: Ten healthy adults (6 males, 4 females) participated in this study. The metacarpophalangeal joint (MCP), interphalangeal joint (IP), and proximal interphalangeal joint (PIP) of both hands were measured using UG and Mollisen HAND soft sensor gloves during active flexion, according to the American Society for Hand Therapists' measurement criteria. Measurements were taken in triplicate and averaged. The mean and standard deviation of the two methods were calculated, and the 95% limits of agreement (LOA) of the measurements were calculated using the intraclass correlation coefficient (ICC) and Bland-Altman plot to examine the reliability and discrepancies between the measurements. Results: The results of the mean values of the flexion angles for the active range of motion (AROM) of the finger joints showed large angular differences in the finger joints, except for the MCP of the thumb. In the inter-rater reliability analysis according to the measurement method, the ICC (2, 1) value showed a low level close to 0, and the mean difference by the Bland-Altman plot showed a value greater than 0, showing a pattern of discrepancy. The 95% LOA had a wide range of differences. Conclusion: This study is a preliminary study investigating the usefulness of the soft sensor glove, and the reliability analysis showed a low level of reliability and inconsistency. However, if future studies can overcome the limitations of this study and the technical problems of the soft sensor glove in the development stage, it is suggested that the measurement instrument can show more accurate measurement and higher reliability when measuring ROM with UG.

Comparative study between proportional method and directional method in locating acupoints at forearm (전완부(前腕部) 경혈(經穴) 취혈(取穴)에서 골도분촌법(骨度分寸法)과 일부법(一夫法)의 비교(比較) 연구(硏究))

  • Park, Hi-Joon;Chae, Youn-Byoung;Cha, Wung-Seok;Park, Jong-Bae;Lee, Hye-Jung;Lee, Hyang-Sook;Yin, Chang-Sik;Koh, Hyung-Kyun;Kim, Su-Young;Choe, Il-Hwan;Kim, Kang-Sik;Moon, Jung-Bae;Bae, Ki-Tae;Rheu, Kyoung-Hwan;Yook, Keun-Yung;Jeong, Byeong-Ju;Sohn, In-Chul;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.21 no.4
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    • pp.31-41
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    • 2004
  • Background : The cun measurement system, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height. Conclusion : These findings suggest that the directional method is less likely dependable in locating acupoints than the proportional method because the influencing factors are different.

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Percutaneous Autologous Marrow and Heterograft Bone Grafting in a Treatment for Simple Bone Cyst (경피적 자가 골수 및 이종골 이식을 이용한 고립성 골낭종의 치료)

  • Lee, Keun-Bae;Rowe, Sung-Man;Yoon, Taek-Rim;Son, Il-Jin;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.24-30
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    • 2003
  • Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

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