https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/268 2025-12-30T13:30:13Z 2025-12-30T13:30:13Z Kim, Yongsung Park, Jong Woong Cho, Hwan Seong Jang, Woo Young Han, Ilkyu Kim, Han-Soo https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64373 2025-05-01T06:30:07Z 2023-11-01T00:00:00Z

Title: Does the Clinical Presentation of Secondary Osteosarcoma in Patients Who Survive Retinoblastoma Differ From That of Conventional Osteosarcoma and How Do We Detect Them? Authors: Kim, Yongsung; Park, Jong Woong; Cho, Hwan Seong; Jang, Woo Young; Han, Ilkyu; Kim, Han-Soo Abstract: Background Osteosarcoma is the most common secondary malignancy among survivors of retinoblastoma. Most previous reports on secondary malignancy of retinoblastoma included all types of secondary malignancies without a focus on osteosarcoma, owing to its rarity. In addition, there are few studies suggesting tools for regular surveillance for early detection.Questions/purposes(1) What are the radiologic and clinical characteristics of secondary osteosarcoma after retinoblastoma? (2) What is the clinical survivorship? (3) Is a radionuclide bone scan a reasonable imaging modality for early detection in patients with retinoblastoma?Methods Between February 2000 and December 2019, we treated 540 patients for retinoblastoma. Twelve patients (six male, six female) subsequently developed an osteosarcoma in the extremities; two of these patients had two sites of osteosarcoma (10 femurs, four tibiae). A Technetium-99m bone scan image was examined annually in all patients for regular surveillance after the treatment of retinoblastoma as per our hospital's policy. All patients were treated with the same strategy as that used for primary conventional osteosarcoma, namely neoadjuvant chemotherapy, wide excision, and adjuvant chemotherapy. The median follow-up period was 12 years (range 8 to 21 years). The median age at the time of diagnosis of osteosarcoma was 9 years (range 5 to 15 years), and the median interval from retinoblastoma diagnosis to osteosarcoma diagnosis was 8 years (range 5 to 15 years). Radiologic characteristics were assessed with plain radiographs and MRI, while clinical characteristics were assessed through a retrospective review of medical records. For clinical survivorship, we evaluated overall survival, local recurrence-free survival, and metastasis-free survival. We reviewed the results of bone scans and clinical symptoms at the time of diagnosis for osteosarcoma after retinoblastoma.Results In nine of 14 patients, the tumor had a diaphyseal center, and five of the tumors were located at the metaphysis. The femur was the most common site (n = 10), followed by the tibia (n = 4). The median tumor size was 9 cm (range 5 to 13 cm). There was no local recurrence after surgical resection of the osteosarcoma, and the 5-year overall survival rate after the diagnosis of osteosarcoma was 86% (95% CI 68% to 100%). In all 14 tumors, the Technetium bone scan showed increased uptake in the lesions. Ten of 14 tumors were examined in clinic because of patient complaints of pain in the affected limb. Four patients showed no clinical symptoms detected by abnormal uptake on bone scan.Conclusion For unclear reasons, secondary osteosarcomas in patients who were alive after the treatment of retinoblastoma had a slight predilection for the diaphysis of the long bone compared with patients with spontaneous osteosarcoma in other reports. The clinical survivorship of osteosarcoma as a secondary malignancy after retinoblastoma may not be inferior to that of conventional osteosarcoma. Close follow-up with at least yearly clinical assessment and bone scans or other imaging modalities appears to be helpful in detecting secondary osteosarcoma after the treatment of patients with retinoblastoma. Larger multi-institutional studies will be needed to substantiate these observations.Level of Evidence Level IV, therapeutic study. Conclusion For unclear reasons, secondary osteosarcomas in patients who were alive after the treatment of retinoblastoma had a slight predilection for the diaphysis of the long bone compared with patients with spontaneous osteosarcoma in other reports. The clinical survivorship of osteosarcoma as a secondary malignancy after retinoblastoma may not be inferior to that of conventional osteosarcoma. Close follow-up with at least yearly clinical assessment and bone scans or other imaging modalities appears to be helpful in detecting secondary osteosarcoma after the treatment of patients with retinoblastoma. Larger multi-institutional studies will be needed to substantiate these observations.Level of Evidence Level IV, therapeutic study.

2023-11-01T00:00:00Z Choi, Yoon Hyo Kwon, Tae Hun Choi, Ji Hye Jeong, Naun Koo, Seungbum Lee, Kyoung Min https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64133 2024-07-11T09:34:39Z 2023-10-01T00:00:00Z

Title: Radiographic Measurements Associated With Ankle Power Generation During Gait in Patients With Cerebral Palsy Authors: Choi, Yoon Hyo; Kwon, Tae Hun; Choi, Ji Hye; Jeong, Naun; Koo, Seungbum; Lee, Kyoung Min Abstract: Background: Pes planovalgus (PV) deformity accounts for lever arm dysfunction and compromises gait in patients with cerebral palsy (CP). However, the association between ankle power generation and radiographic indices is not yet understood. We aimed to investigate the association between ankle power and radiographic indices during gait in patients with CP concomitant with PV deformity. Methods: Patients older than 14 years with ambulatory CP and PV deformity were included. All the patients underwent 3-dimensional gait analysis and weight-bearing foot radiography. Gait data were collected, including foot progression angle, tibial rotation, hip rotation, and ankle power generation. Radiographic measurements included anteroposterior (AP) talo-first metatarsal angle, lateral talo-first metatarsal angle, and hindfoot angle. A linear mixed-effects model was performed to identify significant radiographic indices associated with ankle power generation. Results: Thirty-one limbs from 15 patients with spastic diplegia and 6 with spastic hemiplegia were included. Statistical analysis demonstrated that ankle power generation was significantly correlated with the CP type (P=0.0068) and AP talo-1st metatarsal angle (P=0.0230). Conclusion: Ankle power generation was significantly associated with the AP talo-first metatarsal angle. Surgeons might need to pay attention to correcting forefoot abduction to restore ankle power when planning surgeries for pes PV deformities in patients with CP. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

2023-10-01T00:00:00Z Song, Mi Hyun Yang, Jae Hyuk Chang, Dong-Gune Nam, Yunjin Suh, Seung Woo https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64236 2023-12-27T01:00:25Z 2023-09-01T00:00:00Z

Title: Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass Authors: Song, Mi Hyun; Yang, Jae Hyuk; Chang, Dong-Gune; Nam, Yunjin; Suh, Seung Woo Abstract: Objective: Osteotomies are required for the mobilization of spinal segments in patients with revisional scoliosis surgery with a fusion mass; however, only a few techniques have shown efficacy and safety, and their mid-and long-term outcomes remain unelucidated. This study aimed to analyze long-term outcomes of the posterior multilevel crack osteotomy (PMCO) technique for revisional surgery for scoliosis with a fusion mass.Methods: Data from 18 patients who underwent revisional scoliosis surgery using PMCO between 2009 and 2015 and had more than 5-year follow-up were retrospectively reviewed. The Cobb angle and coronal and sagittal balance parameters were examined preoperatively, postoperatively, and during the final follow-up. Perioperative parameters and complications were also assessed.Results: Preoperative and postoperative Cobb angles were 60.5(degrees) and 29.9(degrees), respectively (p < 0.001); this improvement was maintained until the final follow-up (33.4(degrees), p = 0.058). The difference in preoperative and postoperative coronal balance was statistically significant (15.9 mm and 9.2 mm, respectively; p < 0.001); this was maintained until the final follow-up (p = 0.071). There was no change in sagittal balance parameters over the 3 measurement periods. Only 1 patient showed PMCO-related motor weakness, but he spontaneously re-covered 3 months after postsurgery. Pseudarthrosis was not observed during the follow-up period.Conclusion: Incomplete osteotomy using PMCO provided satisfactory deformity correc-tion without severe complications during revisional surgery for scoliosis with a fusion mass. It may be a less invasive procedure that maintains cortical continuity, preserves soft tissues, and provides sufficient mobility for the correction of spinal segments.

2023-09-01T00:00:00Z Park, Sung Cheol Kim, Hyoung-Bok Chung, Hoon-Jae Yang, Jae Hyuk Kang, Min-Seok https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64243 2023-12-19T04:31:03Z 2023-09-01T00:00:00Z

Title: Mid-Thoracic Vertebral Compression Fracture after Mini-Trampoline Exercise: A Case Series of Seven Patients Authors: Park, Sung Cheol; Kim, Hyoung-Bok; Chung, Hoon-Jae; Yang, Jae Hyuk; Kang, Min-Seok Abstract: Background and Objectives: Home-based training exercise gained popularity during the coronavirus disease 2019 pandemic era. Mini-trampoline exercise (MTE) is a home-based exercise that utilizes rebound force generated from the trampoline net and the motion of the joints of the lower extremities. It is known to be beneficial for improving postural balance, stability, muscle strength and coordination, bone strength, and overall health. However, we encountered several patients with mid-thoracic vertebral compression fractures (VCFs) following regular MTE, which was never reported previously, despite having no history of definite trauma. This study aims to report mid-thoracic VCFs after regular MTE and arouse public attention regarding this spinal injury and the necessity of appropriate prior instructions about the correct posture. Patients and Methods: All consecutive patients diagnosed with acute VCFs following regular MTE were included. We collected data on patient demographics, history of MTE, characteristics of symptoms, and radiological findings such as the location of fractures and anterior vertebral body compression percentage. Results: Seven patients (one man and six women) and ten fractures (T5 = 1, T6 = 3, T7 = 2, and T8 = 4) were identified. Symptoms started 2.57 +/- 1.13 weeks after the beginning of regular MTE. All patients reported that they were never properly instructed on the correct posture. They also stated that they were exercising with a hunchback posture and insufficient joint motion of the lower extremities while holding the safety bar with both hands, which resulted in increased peak vertical force along the gravity z-axis in the mid-thoracic area and consequent mid-thoracic VCFs. Conclusions: Mid-thoracic VCFs can occur following regular MTE even without high-energy trauma in case of improper posture during exercise. Therefore, public attention on mid-thoracic VCFs following MTE and the appropriate prior instructions are imperative.

2023-09-01T00:00:00Z