Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(<40% versus >40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.
Amputation ; Chondrosarcoma ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Prostheses and Implants ; Prosthesis Failure ; Retrospective Studies ; Sarcoma

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

PURPOSE: A distal pancreatectomy was often simultaneously performed with splenectomy and total gastrectomy in the treatment of gastric carcinoma for complete removal of lymph nodes around the splenic artery. However, pancreatic juice leakage, subphrenic abscess, and postoperative diabetes were common complications in patients treated by pancreas resection. We performed a retrospective analysis to evaluate the role of distal pancreatectomy on the prognosis of gastric cancer patients. MATERIALS AND METHODS: The effect of distal pancreatectomy on survival was studied by examination of the records of 120 patients who underwent splenectomy and total gastrectomy for gastric carcinoma with serosal invasion. Of these, 75 underwent pancreas preserving splenectomy and 45 underwent pancreaticosplenectomy. Prognostic factors and postoperative complications were evaluated according to the operation types. RESULTS: The addition of distal pancreatectomy to splenectomy with total gastrectomy for patients with gastric cancer was not associated with severe complications. And patients underwent pancreaticosplenectomy showed similar survival as those underwent pancreas preserving splenectomy. CONCLUSION: Distal pancreatectomy for the gastric cancer patients with suspected metastatic lymph nodes around the splenic artery could be recommended for the purpose of radical lymph node dissection.
Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Pancreas ; Pancreatectomy* ; Pancreatic Juice ; Postoperative Complications ; Prognosis* ; Retrospective Studies ; Splenectomy ; Splenic Artery ; Stomach Neoplasms* ; Subphrenic Abscess

PURPOSE: The increased expression of cyclooxygenase (COX)-2 has been implicated in the development and progression of human cancer. This study investigated the COX-2 expression in colorectal cancer, and its relationships with tumor angiogenesis and the clinicopathological factors. MATERIALS AND METHODS: The expression of the COX-2 protein and microvessel density were evaluated, using immunohistochemical methods, in 21 normal colonic mucosa and 190 human colorectal carcinomas. Correlations between COX-2 expression and microvessel density, as well as various clinicopathological factors, were studied in colorectal carcinomas. RESULTS: The COX-2 protein expression in epithelial cells was increased in 169 of the 190 adenocarcinoma cases (88.9%), but in only 1 of the 21 (4.8%) normal mucosa cases. The COX-2 expression was significantly increased in the differentiated compared with the undifferentiated colorectal carcinomas (p<0.05), and significantly correlated with the depth of invasion and microvessel density (p<0.05). Rectal cancers had more COX-2 positive cases than the colon cancers (p<0.05). However, there were no significant differences in the tumor size and the presence of lymphatic or vascular invasion. CONCLUSION: The overexpression of cyclooxygenase-2 in colorectal carcinomas seems to play a role in the invasion and angiogenesis of the tumors, so may be a useful marker of the prognosis. The prominent expression was also demonstrated in differentiated colorectal cancers.
Adenocarcinoma ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Cyclooxygenase 2* ; Epithelial Cells ; Humans ; Microvessels* ; Mucous Membrane ; Prognosis ; Prostaglandin-Endoperoxide Synthases ; Rectal Neoplasms

PURPOSE: The exact role of postoperative radiotherapy following curative surgery of rectal carcinoma has been debated. In this retrospective study, we examined the effect of radiotherapy on the survival and recurrence rate of rectal cancer patients who underwent total mesorectal excision (TME). METHODS: Since June of 1994, we have recommended postoperative chemoradiation (6 cycles of 5-FU with folinic acid plus 5040 cGy external irradiation) for stage II and III rectal cancer patients. Among 134 stage II and III rectal cancer patients who underwent TME, 100 patients received postoperative chemoradiation (group A) and 34 patients decided not to receive radiation therapy (group B). For these two groups, survival and recurrence rates were compared. Follow-up times were 6 to 60 months (mean 24.7). There was no difference between two groups with regard to sex, stage of the disease, mean tumor location from dentate line, status of lateral margins, type of operation and mean follow-up duration. However, mean age was higher in group B (65.6 vs 53.9, P<0.05). RESULTS: The overall recurrence rate showed no difference between two groups (28.0% in group A vs 21.0% in group B, P>0.05). Local recurrence rate was also similar (11.0% vs 3.0%). There was no significant difference in duration between surgery and initial recurrence (14.0 months vs 11.0 months, P=0.18). The 5-year-disease-free survival rate was 57.0% in group A and 63.0% in group B (P=0.33). CONCLUSION: In this study, we found no beneficial effect of postoperative radiation therapy following TME for the rectal cancer.
Fluorouracil ; Follow-Up Studies ; Humans ; Leucovorin ; Radiotherapy* ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies ; Survival Rate

Traumatic diaphragmatic hernia may show a delayed presentation and it rarely simulates pleural effusion. We report here on two asymptomatic cases that were diagnosed by performing chest CT.
Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Omentum ; Pleural Effusion* ; Tomography, X-Ray Computed

The brachial plexus palsy is a rare complication of a clavicle fracture, occurring in 0.5% to 9.0% of cases. This condition is caused by excessive callus formation, which can be recovered by a spur resection and surgical fixation. In contrast, only seven cases have been reported after surgical reduction and fixation. A case of progressive brachial plexus palsy was observed after fixation of the displaced nonunion of a clavicle fracture. The symptom were improved after removing the implant.
Bony Callus ; Brachial Plexus Neuropathies ; Brachial Plexus ; Clavicle ; Paralysis ; Thoracic Outlet Syndrome

PURPOSE: The purpose of this study is to identify bilateral differences of physeal closure of the lateral compartment of the elbow in osteochondritis dissecans (OCD) and related factors with premature physeal closure. METHODS: Initial radiographs of the bilateral elbows in 40 baseball players with OCD (group I) were reviewed for the status of physeal closure of the lateral compartment; capitellum, radial head, lateral epicondyle. Forty baseball players with medial epicondylar apophysitis (group II) were enrolled as a control. Relative status of physeal closure of dominant elbow was defined as early, same, and delayed. Bilateral differences of the status of physeal closure were analyzed between groups, and according to the radiographic stages, extent of the lesions and demographic factors in group I. RESULTS: Significant early physeal closures of dominant elbows were identified in group I in capitellum (group I, 55%; group II, 3%), radial head (group I, 53%; group II, 3%), and lateral epicondyle (group I 37%; group II, 5%). In group I, advanced stage and extended lesion showed early lateral compartment physeal closure especially in capitellum and radial head, and players with longer career length and limitation of motion showed early closure. CONCLUSION: Over the half of the adolescent baseball players with OCD demonstrated early radiocapitellar physeal closures of dominant elbow in initial presentation. Because premature physeal closure contributes to the development of arthritis without appropriate radiocapitellar remodeling, early detection of OCD is essential for prevention of arthritis and successful conservative management.
Adolescent* ; Arthritis ; Baseball* ; Demography ; Elbow* ; Head ; Humans ; Osteochondritis Dissecans* ; Osteochondritis*

No abstract available.
Animals ; Gonadotropin-Releasing Hormone* ; Rats* ; RNA, Messenger* ; Testis*

No abstract available.
Animals ; Axis, Cervical Vertebra* ; Herpesvirus 1, Suid* ; Pseudorabies* ; Rats* ; Uterus*