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Osteosarcoma is the most common primary malignant tumor in the orthopaedic field. Recently, the management of osteosarcoma was evolved in many aspects and the improved results were reported in many articles. The purpose of this study is to evaluate the changes of clinical findings and management modalities in osteosarcoma since 1980. We reviewed 127 osteosarcomas managed from 1980 to 1992. The Enneking surgical stage was as follows; stage I 12 cases, stage II 98 cases and stage III 17 cases. They were subclassified into classic(97 cases), parosteal(12 cases), telangiectatic(5 cases), secondary(4 cases), periosteal(2 cases), gnathic(2 cases), high grade surface(1 cases) and undetermined(4 cases). The disease-free survival rate was evaluated for the patients of stage II classic osteosarcomas treated with amputation(27 cases) or limb-salvage operation(23 cases), and average follow up period of them was 49 months. In 27 cases of amputation adjuvant chemotherapy was administered in 23 cases. And in 23 patients treated with limb-salvage operation, neoadjuvant and adjuvant chemotherapy were done in 19 cases and only adjuvant chemotherapy in 2 cases. The clinical changes since 1980 were as follows: (1) The mean duration from symptom onset to diagnosis was decreased gradually from 6.5 months(1980) to 3.1 months(1992). (2) The proportion of curative surgery was increased from 40%(1980) to 87%(1992) in stage I and II. (3) The proportion of limb-salvage operation was rapidly increased upto 88% since 1985. The 5 year disease-free survival rate of stage II classic osteosarcoma was 36% with amputation and 67% with limb-salvage operation.
Amputation ; Chemotherapy, Adjuvant ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Osteosarcoma

Arbekacin is a broad-spectrum aminoglycoside used to treat methicillin-resistant Staphylococcus aureus (MRSA). Arbekacin has antibacterial activities against high-level gentamicin-resistant Enterococci, multidrug-resistant Pseudomonas aeruginosa, and Acinetobacter baumannii et al. Here, we reviewed in vitro data on arbekacin in Staphylococci and Gram-negative microorganisms. We also reviewed clinical studies for clinical efficacy and microbiologic efficacy data in patients with identified MRSA and suspected MRSA infections. The overall clinical efficacy ranged from 66.7% to 89.7%. The microbiologic efficacy rate ranged from 46.2% to 83%. In comparative studies between arbekacin and glycopeptides, arbekacin was similar to other glycopeptides with respect to clinical and microbiological efficacy rates. Combination trials with other antibiotics suggest that arbekacin will be a promising strategy to control Enterococcus spp. multi-drug resistant P. aeruginosa. The major adverse reaction was nephrotoxicity/hepatotoxicity, but patients recovered from most adverse reactions without any severe complications. Based on these results, arbekacin could be a good alternative to vancomycin/teicoplanin in MRSA treatment. Finally, therapeutic drug monitoring is recommended to maximize clinical efficacy and decrease nephrotoxicity.
Acinetobacter baumannii ; Anti-Bacterial Agents ; Drug Monitoring ; Enterococcus ; Glycopeptides ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa

1.Clinical Observation of Acute Lymphocytic Leukemia with Mediastinal Mass.

2.Osteosarcoma-Thirteen-Year Experience

3.Scrotal Epididymal Anatomy In Hydrocele And Hernia.

4.Progressive Cribriform and Zosteriform Hyperpigmentation.

5.Speckled Lentiginous Nevus.

6.Clinical Study of Wilms' Tumor .

7.Clinical Usefulness of Arbekacin.

8.Correction of severe foot deformity using ilizarov external fixator.

9.A Clinical Observation on the Incidence of Childhood Leukemia.

10.A Case of Trensient Myeloproliferative Disorder with Down Syndrome.

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