A 43 years old woman had suffered from a lower back pain for 2 months. She experienced pain aggravation after spinal manipulative therapy that was practiced by non-licentiate. Physical examination showed tenderness on L1 and L2 spinous processes. Radionuclide bone scan with 99mTc-MDP showed increased radioactivity of L1, L2 vertebral bodies. The MRI finding showed low signal intensity of L1 and L2 vertebral bodies in T1-weighted image and high signal intensity in T2-weighted image. Needle biopsy finding showed fibrosis and inflammatory cell invasion of bone marrow. We concluded that she had tuberculous spondylitis and non-detection or negligent treatment of a preexisting disease contributed to aggravation of her symptoms. We report one case of tuberculous spondylitis aggravated by spinal manipulative therapy with review of literatures.
Adult ; Biopsy, Needle ; Bone Marrow ; Female ; Fibrosis ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Musculoskeletal Manipulations* ; Physical Examination ; Preexisting Condition Coverage ; Radioactivity ; Spondylitis* ; Technetium Tc 99m Medronate

Purpose: This study aimed to analyze the profiles and mechanisms of injuries using online injury surveillance system (OISS) with match video files at 2017 World Taekowndo Championship (WTC) athletes. Methods: This study design was a prospective epidemiological study with video analysis. All injuries were recorded during the 2017 WTC using the OISS developed by the International Olympic Committee. A total of 971 athletes who participated in the 2017 WTC were enrolled. Each injury was recorded retrospectively by three cameras surrounding each court. Injury profiles and mechanisms were calculated as; percent injury rate, injury rate/100 athlete-exposures, injury location, type, and mechanism via the injury surveillance system and video analysis form. Results: There were 74 injuries, which corresponded to an overall incidence of 13.5 injuries (95% confidence interval, 11.2–15.8) per 100 athletes. The face (27.0%), hand/finger (23.0%), knee (14.9%), and ankle (10.8%) were most frequently injured parts. Contusions (37.8%), fracture and ligament sprains (20.3%) were the most frequently injury types. The main mechanism for contact injury is while attacking with the roundhouse kick (66.2%), or not used block (81.1%). There were also noncontact injuries (24.3%). Conclusion The incidence of injuries to the face, hand/fingers, knee, and ankle was relatively high. To prevent contact injuries, protective headgear and better shin guards and hand protectors need to be developed. As for the noncontact injuries, we recommend hamstring strengthening exercises, and neuromuscular training to strengthen the tendons and ligaments protecting the ankle and knee joints.

Resection of hepatic tumors located near the confluence of hepatic vein or invading retrohepatic vena cava has become technically feasible and relatively safe with the introduction of veno-venous bypass. Hepatic vascular exclusion(HVE) with the aid of veno-venous bypass using centrifugal pump enables safe resection and reconstruction of vena cava without hemodynamic instability, compared to conventional HVE. The authors report a case of a successful en bloc resection of right lobe and caudate process of liver, right adrenal, right kidney, and retrohepatic vena cava, in order to extirpate huge retroperitoneal tumor, with the aid of veno-venous bypass using centrifugal pump. Pathologic diagnosis revealed B cell type non Hodgkin's lymphoma arising from adrenal gland. After resection, caval defect was reconstructed with Dacron graft. Patency of reconstructed cava could be observed at five months postoperatively.
Adrenal Glands ; Diagnosis ; Hemodynamics ; Hepatic Veins ; Kidney* ; Liver* ; Lymphoma, Non-Hodgkin ; Polyethylene Terephthalates ; Transplants

Osteochondromas are benign bone tumors typically found in the metaphyseal region of long bones. These tumors are often asymptomatic and detected incidentally. However, their occurrence in atypical sites such as the talus can pose significant diagnostic and treatment challenges. This report describes a rare case of osteochondroma of the medial tubercle of the talus, which is an unprecedented location based on a review of relevant literature. A 28-year-old male presented with worsening medial ankle pain and limping. Imaging revealed a lesion consistent with osteochondroma contributing to medial ankle impingement syndrome. Uniquely, this case also featured a coinciding gout attack in the ankle joint. Surgical removal of the lesion resulted in significant symptom relief and functional improvement. This case underscores the need to consider rare diagnoses, such as talar osteochondroma, when presented with persistent medial ankle pain and highlights the potential presence of concurrent conditions, such as gout.

BACKGROUND/AIMS: In patients with advanced biliary malignancies, a chance of curability is obtained by only performing extended liver resection with concomitant pancreatoduodenectomy. This hepatopancreatoduodenectomy(HPD) is known to carry high risk of hepatic failure. We evaluated the effect of pancreatoduodenectomy on liver regeneration and the risk of hepatic failure in patients having undergone HPD to prevent complications associated with liver function. METHODS: Sixteen cases of HPD with extended liver resection were reviewed in the aspects of liver regeneration and hepatic failure. Twenty cases of extended right hepatectomy were selected as a control group(ERL group) for comparison of liver regeneration. Liver volumes were measured by computed tomogram volumetry. RESULTS: Resection rates of the liver and the pancreas in the HPD group were more than 51% and about 40%, respectively. Right portal vein embolization was performed in 66% of cases and all cases with obstructive jaundice underwent percutaneous biliary drainage. Rate of liver regeneration at postoperative 1 month in HPD group was 162%, and that of the ERL group was 169%, resulting in no statistical difference. There was no occurrence of hepatic failure in the HPD group. CONCLUSIONS: Forty percent resection of pancreatic parenchyme following concomitant pancreatoduodenectomy may not compromise liver regeneration after extended liver resection. Complete external drainage of obstructive jaundice and preoperative portal vein embolization are recommended as preoperative procedures for patients undergoing extended liver resection with pancreatoduodenectomy.
Drainage ; Hepatectomy ; Humans ; Jaundice, Obstructive ; Liver Failure ; Liver Regeneration* ; Liver* ; Pancreas ; Pancreaticoduodenectomy* ; Portal Vein ; Preoperative Care