ABSTRACT
Purpose@#Tibialis anterior tendon rupture is uncommon and usually caused by laceration. Rupture with an open window is often considered simple laceration, and thus diagnosis is often overlooked or delayed. The purpose of this study was to analyze the clinical features of tibialis anterior tendon rupture. @*Materials and Methods@#Twenty-two patients treated for tibialis anterior tendon rupture from March 2015 to December 2019 were examined. Age, sex, rupture etiology, rupture location, and diagnostic and treatment delays were investigated. @*Results@#Mean patient age was 45.7 years, and there were 14 males and 8 females. In 18 cases, rupture was caused by laceration and in 4 by spontaneous rupture. Of the 18 cases caused by laceration, 8 were lawnmower related, 8 were glass injuries, and 2 were caused by crush or degloving injuries, respectively. Three of the 4 spontaneous rupture cases and 4 of the 18 caused by laceration were overlooked. @*Conclusion@#Tibialis anterior tendon rupture is rare and is easily overlooked. Close physical examination is essential to arrive at a correct initial diagnosis in patients with acute or chronic rupture, and greater care is needed in cases of glass injury.
ABSTRACT
Primary neuroendocrine carcinomas of the breast are a rare, distinct category of breast carcinomas that require immunohistochemical staining for diagnosis. Currently, there is not enough evidence on the clinical pattern, prognosis, and proper management of the disease. Only few case series have described the imaging findings of neuroendocrine carcinomas of the breast. We herein present a case of a primary neuroendocrine carcinoma of the breast (small cell) presenting as a locally aggressive tumor with metastatic disease, and describe the radiologic findings.
ABSTRACT
Progressive transformation of germinal centers (PTGC) is a rarely diagnosed, benign disease of the lymph nodes that commonly manifests as chronic lymphadenopathy. PTGC may be characterized by single or multiple non-tender lymph nodes, and it commonly involves the cervical, axillary, and inguinal areas. Although PTGC is identified with concurrent lymphoma in some patients, it is not considered as a premalignant entity. Histopathologic diagnosis of PTGC is rarely made, and imaging findings have been reported in very few studies. We present a case of PTGC that occurred at the contralateral axillary lymph nodes and mimicked metastatic lymphadenopathy after breast cancer surgery. We also discuss its imaging findings.
ABSTRACT
The role of neuroimaging in patients with acute ischemic stroke has been gradually increasing. The ultimate goal of stroke imaging is to make a streamlined imaging workflow for safe and efficient treatment based on optimized patient selection. In the era of multimodal comprehensive imaging in strokes, imaging based on computed tomography (CT) has been preferred for use in acute ischemic stroke, because, despite the unique strengths of magnetic resonance imaging (MRI), MRI has a longer scan duration than does CT-based imaging. However, recent improvements, such as multicoil technology and novel MRI acceleration techniques, including parallel imaging, simultaneous multi-section imaging, and compressed sensing, highlight the potential of comprehensive MR-based imaging for strokes. In this review, we discuss the role of stroke imaging in acute ischemic stroke management, as well as the strengths and limitations of MR-based imaging. Given these concepts, we review the current MR acceleration techniques that could be applied to stroke imaging and provide an overview of the previous research on each essential sequence: diffusionweighted imaging, gradient-echo, fluid-attenuated inversion recovery, contrastenhanced MR angiography, and MR perfusion imaging.
ABSTRACT
Primary neuroendocrine carcinomas of the breast are a rare, distinct category of breast carcinomas that require immunohistochemical staining for diagnosis. Currently, there is not enough evidence on the clinical pattern, prognosis, and proper management of the disease. Only few case series have described the imaging findings of neuroendocrine carcinomas of the breast. We herein present a case of a primary neuroendocrine carcinoma of the breast (small cell) presenting as a locally aggressive tumor with metastatic disease, and describe the radiologic findings.
ABSTRACT
Progressive transformation of germinal centers (PTGC) is a rarely diagnosed, benign disease of the lymph nodes that commonly manifests as chronic lymphadenopathy. PTGC may be characterized by single or multiple non-tender lymph nodes, and it commonly involves the cervical, axillary, and inguinal areas. Although PTGC is identified with concurrent lymphoma in some patients, it is not considered as a premalignant entity. Histopathologic diagnosis of PTGC is rarely made, and imaging findings have been reported in very few studies. We present a case of PTGC that occurred at the contralateral axillary lymph nodes and mimicked metastatic lymphadenopathy after breast cancer surgery. We also discuss its imaging findings.
ABSTRACT
The role of neuroimaging in patients with acute ischemic stroke has been gradually increasing. The ultimate goal of stroke imaging is to make a streamlined imaging workflow for safe and efficient treatment based on optimized patient selection. In the era of multimodal comprehensive imaging in strokes, imaging based on computed tomography (CT) has been preferred for use in acute ischemic stroke, because, despite the unique strengths of magnetic resonance imaging (MRI), MRI has a longer scan duration than does CT-based imaging. However, recent improvements, such as multicoil technology and novel MRI acceleration techniques, including parallel imaging, simultaneous multi-section imaging, and compressed sensing, highlight the potential of comprehensive MR-based imaging for strokes. In this review, we discuss the role of stroke imaging in acute ischemic stroke management, as well as the strengths and limitations of MR-based imaging. Given these concepts, we review the current MR acceleration techniques that could be applied to stroke imaging and provide an overview of the previous research on each essential sequence: diffusionweighted imaging, gradient-echo, fluid-attenuated inversion recovery, contrastenhanced MR angiography, and MR perfusion imaging.
ABSTRACT
Intramammary Paget’s disease is an uncommon disease in which 90% of the cases are accompanied by invasive or noninvasive ductal carcinoma. It comprises approximately 0.7%-4.3% of all breast cancers. Typically, extramammary Paget’s disease is accompanied by dermal invasion; however, in intramammary Paget’s disease, dermal invasion through the basement membrane of the skin is very rare. Intramammary Paget’s disease with dermal invasion has been reported infrequently worldwide, and its management and prognosis remain unknown. We report a case of intramammary Paget’s disease with dermal invasion in a 64-year-old woman, accompanied by review of the literature.
ABSTRACT
Intramammary Paget’s disease is an uncommon disease in which 90% of the cases are accompanied by invasive or noninvasive ductal carcinoma. It comprises approximately 0.7%-4.3% of all breast cancers. Typically, extramammary Paget’s disease is accompanied by dermal invasion; however, in intramammary Paget’s disease, dermal invasion through the basement membrane of the skin is very rare. Intramammary Paget’s disease with dermal invasion has been reported infrequently worldwide, and its management and prognosis remain unknown. We report a case of intramammary Paget’s disease with dermal invasion in a 64-year-old woman, accompanied by review of the literature.
ABSTRACT
PURPOSE: The purpose of this study was to evaluate the effect of the zirconia surface architecturing technique (ZSAT) on the bond strength between veneering porcelain and zirconia ceramic. MATERIALS AND METHODS: 20 sintered zirconia ceramic specimens were used to determine the optimal surface treatment time, and were randomly divided into 4 groups based on treatment times of 0, 1, 2, and 3 hours. After etching with a special solution, the surface was observed under scanning electron microscope, and then the porcelain was veneered for scratch testing. Sixty 3 mol% yttria-stabilized tetragonal zirconia polycrystal ceramic blocks were used for tensile strength testing; 30 of these blocks were surface treated and the rest were not. Statistical analysis was performed using ANOVA, the Tukey post-hoc test, and independent t-test, and the level of significance was set at α=.05. RESULTS: The surface treatment of the zirconia using ZSAT increased the surface roughness, and tensile strength test results showed that the ZSAT group significantly increased the bond strength between zirconia and veneering porcelain compared to the untreated group (36 MPa vs. 30 MPa). Optimal etching time was determined to be 2 hours based on the scratch test results. CONCLUSION: ZSAT increases the surface roughness of zirconia, and this might contribute to the increased interfacial bond strength between zirconia and veneering porcelain.
Subject(s)
Ceramics , Dental Porcelain , Tensile StrengthABSTRACT
PURPOSE: This study compared in vivo kinematic differences between Caucasian and South Korean patients after a posterior-substituting total knee arthroplasty (PS-TKA). MATERIALS AND METHODS: In vivo motions of 9 Caucasian and 13 South Korean knees with a PS-TKA during weight bearing single leg lunge were determined using a dual fluoroscopic imaging technique. Normalized tibiofemoral condylar motions and articular contact locations were analyzed. RESULTS: Femoral condylar motions of the two groups showed a similar trend in anteroposterior translation, but the South Korean patients were more anteriorly positioned than the Caucasian patients at low flexion and maximal flexion angles in both medial and lateral compartments (p<0.05). Mediolateral femoral condyle translations were similar between the two groups. For tibiofemoral articular contact kinematics, the South Korean patients had significantly more anterior contact locations at the medial compartment at low flexion angles, and more lateral contact locations at the lateral compartment at 0° and 90° flexion compared to the Caucasian patients (p<0.05). The South Korean patients had significantly larger distances between the medial and lateral contact locations at 60° and 90° flexion compared to the Caucasian patients (p<0.05). CONCLUSIONS: The study revealed that while the Caucasian and South Korean knees had similar femoral condylar motions, after PS-TKA the South Korean patients showed different articular contact point kinematics compared to the Caucasian patients.
Subject(s)
Humans , Arthroplasty , Arthroplasty, Replacement, Knee , Asian People , Biomechanical Phenomena , Knee , Leg , Lung , Translations , Weight-BearingABSTRACT
PURPOSE: We aim to introduce the predictive value of a quantitatively described formula model in a multicenter prospective analysis using the EuroQol-5 dimensions (EQ-5D) health scale to anticipate postoperative improvement in patients with degenerative lumbar spine disease (DLSD). MATERIALS AND METHODS: Quality of life was evaluated in 376 patients from 17 tertiary hospitals before and after spinal decompression and fusion surgery. The five items of the EQ-5D, mobility (M), self-care (S), usual activities (A), pain/discomfort (P), and anxiety/depression (D), were checked as level 1, 2, or 3, with 3 being the worst. A minimal significant change in the calculated EQ-5D (cEQ-5D) was set as 0.05. Logistic regression analysis was performed to predict the highest successful outcome (cEQ-5D improvement after operation >0.05) with the given sets of 5 items of the EQ-5D. RESULTS: In the cEQ-5D analysis, among patients with a formula score of S+A+2×P+D≤8, 18/68 (27%) showed significant improvement in the cEQ-5D at 1 year postoperatively (p<0.05). However, in patients with a formula score of ≥9, 265/308 (86%) demonstrated significant improvements in the cEQ-5D at 1 year postoperatively (p<0.05). CONCLUSION: We suggest that S+A+2×P+D≥9 in the EQ-5D can quantitatively describe the better surgical outcome predictors for DLSD. With a definite DLSD lesion confirmed by an imaging study, patients who meet the formula scores of 9 or over and have refractory symptoms to non-operative treatment could be better surgical candidates resulting in satisfactory surgical outcomes of over 86%, than those who scored 8 or lower.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Decompression, Surgical/adverse effects , Health , Lumbar Vertebrae/surgery , Postoperative Complications/etiology , Postoperative Period , Prognosis , Prospective Studies , Quality of Life , Self Care , Spinal Diseases/diagnosis , Surveys and Questionnaires , Treatment OutcomeABSTRACT
PURPOSE: The purpose of this study was to report clinical results of open excision of extra-articular ganglion cysts around the knee joint combined with arthroscopic management of intra-articular pathologies if present. MATERIALS AND METHODS: Of the total 107 cases of cystic lesions around the knee, 23 cases of extra-articular ganglion cysts were reviewed between January 2006 and July 2011. There were 13 males and 10 females with a mean age of 48 years (range, 30 to 73 years). The mean follow-up duration was 40 months (range, 30 to 60 months). Preoperative magnetic resonance imaging (MRI) scan was done in all cases. Open surgical excision of the cyst was performed after arthroscopic management of intra-articular pathologies in all but 1 case. At the last follow-up, Lysholm and International Knee Documentation Committee (IKDC) scores were evaluated and MRI was conducted to detect recurrence. RESULTS: The mean Lysholm and IKDC scores showed significant improvement (p=0.005 and 0.013, respectively).The location of the cysts was anterior in 9, lateral in 7, medial in 6, and posterosuperior in 1. Intra-articular pathologies were found in 16/23 cases (69.6%). In 10/23 cases (43%), the cyst was connected to the knee joint. Three months postoperative MRI did not show any recurrence of ganglion cysts except for 1 case. CONCLUSIONS: In the treatment of extra-articular ganglion cysts, MRI can be useful for detecting intra-articular lesions and connecting orifices, and arthroscopic management of intra-articular pathologies with open excision of the cyst should be considered as a viable treatment option.
Subject(s)
Female , Humans , Male , Follow-Up Studies , Ganglion Cysts , Knee Joint , Knee , Magnetic Resonance Imaging , Pathology , RecurrenceABSTRACT
Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.
Subject(s)
Humans , Follow-Up Studies , Magnetic Resonance Imaging , Pathology , Range of Motion, Articular , Shoulder Joint , Shoulder Pain , Tears , TendonsABSTRACT
PURPOSE: The purpose of this study was to analyze complications after reverse total shoulder arthroplasty and report the clinical outcomes with review of previously reported studies. MATERIALS AND METHODS: Complications after reverse total shoulder arthroplasty were analyzed for 98 patients who underwent reverse total shoulder arthroplasty and were followed-up for at least 6 months. Of 98 patients, 22 were men and 76 were women. The mean age was 75.0+/-6.5 years (range, 59-92 years) with a mean follow-up period of 22+/-19 months (range, 6-74 months). The types and time of occurrence of complications, methods of treatment, and clinical outcomes at the final follow-up were analyzed. RESULTS: Complications occurred in 18 of 98 patients (18.4%). Seven of them received operative treatment and 11 were treated conservatively. Two cases had postoperative dislocations and were addressed with open reduction. In 2 cases, periprosthetic fractures occurred and were treated with open reduction and plate fixation. Two acromial stress fractures and 8 cases of heterotopic ossification were managed conservatively. Infection and humeral component loosening occurred in one case, respectively, and were treated with revision arthroplasty. Glenoid component loosening occurred in 2 cases, one of which was treated with revision arthroplasty and the other was managed conservatively. At the final follow-up, clinical outcomes showed a statistically significant improvement. Compared to groups with no complications, there were no significant differences in final clinical outcomes. Scapular notching occurred in 43.9% (43/98 cases). No statistically significant differences of clinical outcomes were observed between the scapular notching group and the no notching group (p>0.05). CONCLUSION: In our study, 18% of complications occurred after reverse total shoulder arthroplasty and final clinical outcomes of these complications showed significant improvement. Scapular notching developed in 44% and did not provide a significant clinical effect at short term follow-up.
Subject(s)
Female , Humans , Male , Arthroplasty , Joint Dislocations , Follow-Up Studies , Fractures, Stress , Ossification, Heterotopic , Periprosthetic Fractures , ShoulderABSTRACT
Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.
Subject(s)
Humans , Follow-Up Studies , Magnetic Resonance Imaging , Pathology , Range of Motion, Articular , Shoulder Joint , Shoulder Pain , Tears , TendonsABSTRACT
Fracture of the proximal humerus metaphysis with coexistent dislocation of the shoulder in children is a rare injury. The injury often occurs as a consequence of high velocity trauma. Most fractures of the proximal humerus commonly associated with the epiphysis in children can be treated with closed reduction. We presented a case of 5-year-old girl who sustained this type of fracture- dislocation of the shoulder. Open reduction and internal fixation with multiple smooth K-wires was performed. At two years follow-up, the patient was pain free and regained full range of motion.
Subject(s)
Child, Preschool , Female , Humans , Fracture Fixation, Internal , Shoulder Dislocation , Therapeutics , Shoulder Fractures , General SurgeryABSTRACT
BACKGROUND: We report intra- and postoperative complications of unicompartmental knee arthroplasty (UKA). METHODS: This study was conducted on 246 cases of UKA which were performed for degenerative osteoarthritis confined to the medial compartment, from May 2002 to May 2010, for which follow-up periods longer than one year were available. Complications were divided into intra- and postoperative complications. Pre- and postoperative clinical scores, the range of motion, and radiologic findings were analyzed. RESULTS: Complications developed in a total of 24 cases (9.8%, 24/246). Among them, 6 cases had intraoperative complications while 18 had postoperative complications. Among the 6 intraoperative complications, one fracture of the medial tibial condyle, two fractures of the intercondylar eminence, one rupture of the medial collateral ligament, one widening of the peg hole leading to femoral component malposition and late failure, and one total knee arthroplasty (TKA) conversion of a large bony defect of tibial avascular necrosis were observed. Among the 18 postoperative complications, four cases of aseptic loosening of the femoral component, one soft tissue impingement due to malalignment, nine cases of polyethylene bearing dislocation, one case of suprapatellar bursitis, one periprosthetic fracture, one TKA conversion due to medial component overhanging, and one TKA conversion due to pain of unexplained cause were observed. CONCLUSIONS: The mid-term clinical outcomes of UKA were excellent in our study. However, the incidence of complications was very high (9.8%). To prevent intra- and postoperative complications, proper selection of the patients and accurate surgical techniques are required.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee/adverse effects , Intraoperative Complications , Osteoarthritis, Knee/diagnostic imaging , Postoperative Complications , Retrospective StudiesABSTRACT
The crescent fracture consists of a posterior iliac wing fracture with extension into the sacroiliac joint and a dislocation of the sacroiliac joint. This fracture represents a subset of lateral compression injury. The strong posterior ligaments of sacroiliac joint remain intact and a fracture fragment (crescent shape) involving the posterior superior iliac spines remains firmly attached to the sacrum. We report a patient with atypical pelvic crescent fracture that is mainly influenced by vertical shear injury and is characterized by posterior fracture-dislocations of the sacroiliac joint. In this case report, we review the literature on classification and treatment of atypical type of crescent fracture.
Subject(s)
Humans , Classification , Joint Dislocations , Ligaments , Pelvic Bones , Sacroiliac Joint , Sacrum , SpineABSTRACT
BACKGROUNDS/AIMS: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an uncommon subtype of primary liver cancer that has rarely been reported in detail. This study was performed in order to evaluate the clinicopathological characteristics and prognostic factors of cHCC-CC in single center. METHODS: The clinicopathological features of patients diagnosed and operated with cHCC-CC at Chonbuk National Hospital between July 1998 and July 2007 were retrospectively studied by comparing them with patients with only hepatocellular carcinoma (HCC) who had undergone a hepatic resection during the same period. RESULTS: Ten out of 152 patients who had undergone a hepatic resection were diagnosed with cHCC-CC and thus included in this study (M : F=8 : 2, median age: 52+/-11.1 years). According to the parameters of the 7th American Joint Committee on Cancer T staging, there were 76 (50.0%), 44 (28.9%), 9 (5.9%), 18 (11.8%) and 5 (3.3%) patients with T stages 1, 2, 3a, 3b and 4, respectively. The overall survival period was longer in the HCC only group (68+/-40.4 months) than in the combined cHCC-CC group (23+/-40.1 months) (p<0.0001). The 5-year survival rate was 10% in the cHCC-CC group and 60% in the HCC group (p<0.0001). The disease free survival for patients with cHCC-HCC and HCC were 16+/-37.4 and 51+/-44.3 months, respectively (p<0.0001). Univariate analysis revealed that age, gender, transarterial chemoembolization (TACE), and T stage were statistically significant in terms of patient's overall survival. However, there were no significant clinicopathological factors identified by the multivariate analysis. CONCLUSIONS: Even after the hepatic resection in the HCC, the prognosis is poorer if the patient has cholangiocellular components compared to the usual HCC.