A wide variety of malignancies, including carcinoma of the lung, breast, prostate thyroid and kidney, frequently metastasize to bone. Patient suffering pathological fracture secondary to these metastases are frequently referred to the orthopaedic surgeon for care and management. In such cases, operative intervention with rigid fixation and early ambulation offer much in terms of over-all patient management. One case of breast careinoma metastatic to right proximal femur, neck and femoral head of segmental resection and restoration by special segmental femoral prosthesis with Giliberty Bipolar Endoprosthesis was presented. This technique provides an effective means of restoring the structural integrity of proximal femur and of preserving physiologic function of the joint.
Breast Neoplasms ; Breast ; Early Ambulation ; Femur ; Fractures, Spontaneous ; Head ; Humans ; Joints ; Kidney ; Lung ; Neck ; Neoplasm Metastasis ; Prostate ; Prostheses and Implants ; Thyroid Gland

No abstract available.
Diagnosis ; Ductus Arteriosus, Patent ; Endarteritis ; Pulmonary Embolism

OBJECTIVE: Spinal instrumentation without fusion often fails due to biological failure of intervertebral joints (spontaneous fusion, degeneration, etc). The purpose of this study is to investigate the influence of fixation rigidity on viability of intervertebral joints. METHODS: Twenty pigs in growing period were subjected to posterior segmental fixation. Twelve were fixed with a rigid fixation system(RF) while eight were fixed with a flexible unconstrained implant(FF). At the time of the surgery, a scoliosis was created to monitor fixation adequacy. The pigs were subjected to periodic radiological examinations and 12pigs (six in RF, six in FF) were euthanized at 12-18months postoperatively for analysis. RESULTS: The initial scoliotic curve was reduced from 31+/-5degrees to 27+/-8degrees in RF group (p=0.37) and from 19+/-4degrees to 17+/-5degrees in FF group (p=0.21). Although severe disc degeneration and spontaneous fusion of facet joints were observed in RF group, disc heights of FF group were well maintained without major signs of degeneration. CONCLUSION: The viability of the intervertebral joints depends on motion spinal fixation. Systems allowing intervertebral micromotion may preserve the viability of intervertebral discs and the facet joint articular cartilages while maintaining a reasonably stable fixation.
Cartilage, Articular ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Joints* ; Scoliosis ; Swine ; Zygapophyseal Joint

No abstract available.
Brain* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis*

No abstract available.
Laminectomy ; Neoplasm Metastasis* ; Radiotherapy ; Spinal Cord Compression

Human ; Female ; Aged 80 and over ; quality of life ; adenocarcinoma ; neoplasms ; Colon

Background: Sudden unexplained nocturnal death syndrome (SUNDS) has been reported worldwide. SUNDS is endemic in Southeast Asia and is colloquially known as Bangungut in the Philippines, Lai Tai in Thailand, and Pokkuri in Japan. Although SUNDS in Thailand and Japan have been determined to be phenotypically, genetically and functionally identical to the Brugada syndrome, the relationship between Bangungut/ SUNDS in the Philippines and the Brugada syndrome has not been clarified. This paper explores the concordance between Bangungut/ SUNDS and the Brugada syndrome. Methods: We summarized autopsy studies on Bangungut retrieved from PubMed since 1917 and current epidemiological data on Philippine SUNDS to clarify its diagnostic features. We also reviewed current hypotheses of the pathophysiological mechanism of the Brugada syndrome to explore its applicability to Bangungut/SUNDS. Results: The use of the term Bangungut is confusing as it includes many diseases that may cause SUNDS. However, our review reveals a notable subset of Bangungut, identified as Bangungut/SUNDS with no gross cardiac pathology that conforms to the clinical picture of the folk-belief of Bangungut and of the Brugada syndrome, namely: predominance among male in the 20-40 age range; sudden death during sleep or at rest, usually following ingestion of a large meal at night; and victims were in apparent good health prior to their demise. Current pathophysiological mechanisms of Brugada syndrome seemed plausible explanations for a majority of this subset of Bangungut/SUNDS. Conclusion: Bangungut/SUNDS and the Brugada syndrome appear closely related. Pathophysiological mechanisms of the Brugada syndrome may explain the enigma of Bangungut/SUND. Whether Bangungut/SUNDS is phenotypically, genetically and functionally an allele of the Brugada syndrome remains inconclusive due to lack of research data. We therefore proposed a research agenda including genetic testing and pharmacological challenge of probands and their family members suspected of SUNDS to conclusively establish the relationship between these two syndromes.