PURPOSE: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. MATERIALS AND METHODS: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. RESULTS: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. CONCLUSION: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.
Disease-Free Survival ; Extremities ; Humans ; Osteosarcoma ; Prognosis ; Radius ; Survival Rate

It is generally considered that enteral feeding is superior to parenteral nutritional support. Thus enteral meal should be given whenever patients have proper gastrointestinal function to take enteral feeding. Because the morbidity and mortality for surgical jejunostomy have been reported as high as 50% and 10% respectively, direct percutaneous endoscopic jejunostomy has been developed to reduce the morbidity and mortality. A 55-year-old male patient, who was suffering from dysphagia and oropharyngeal aspiration, was transferred to the division of gastroenterology to be done permanent enteral feeding. His stomach was resected (subtotal gastrectomy with billroth II anastomosis) due to peptic ulcer hemorrhage 10 years before. We performed direct percutaneous endoscopic jejunostomy without any complication. Herein, we report a successful case.
Deglutition Disorders ; Enteral Nutrition ; Gastrectomy* ; Gastroenterology ; Gastroenterostomy ; Humans ; Jejunostomy* ; Male ; Meals ; Middle Aged ; Mortality ; Nutritional Support ; Peptic Ulcer Hemorrhage ; Stomach

PURPOSE: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. MATERIALS AND METHODS: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. RESULTS: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. CONCLUSION: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.
Chondrosarcoma ; Disease-Free Survival ; Enchondromatosis ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteochondroma ; Osteochondromatosis ; Prognosis ; Recurrence ; Retrospective Studies

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

OBJECTIVES: The causes of benign esophageal stricture were postoperative, corrosive, peptic and after esophageal sclerotheraphy, etc. The patients mainly suffered from dysphagia and insufficient nutrition. Recently, balloon and bougie dilatation were introduced to these patients. This study was performed to evaluate the effectiveness and safety of both procedures in different types of strictures METHODS: 32 patients who presented dysphagia enrolled from March 1996 to August 1997 who visited Pusan National University Hospital. Balloon dilatation was performed on 22 patients and bougie on 10 patients. RESULTS: 1) The causes of stricture were postoperative (18 cases), corrosive (10 cases), hypertensive LES (2 cases), peptic (1 case) and web (1 case). 2) Overall cure rate was 59% in bougie dilatation and 40% in balloon dilatation 3) The cure rate of postopertive stricture was 59% which is significantly higher than that of corrosive stricture (27%), and cure rate of hypertensive LES, peptic stricture and web was 100%. 4) The cure rate of corrosive stricture was significantly higher on bougie dilatation than balloon dilatation. 5) The cure rate of postoperative stricture was similiar between balloon and bougie dilatation 6) The length of stricture was inversly affected on cure rate of both dilatation procedures. 7) Overall complication was 5.6% and similiar between balloon and bougie dilatation. CONCLUSIONS: These results suggested that bougie dilatation was recommended on corrosive stricture and balloon dilatation on postopertive stricture
Busan ; Constriction, Pathologic ; Deglutition Disorders ; Dilatation* ; Esophageal Stenosis* ; Humans

PURPOSE: Electrophysiologically assess conduction pathways of the pyramidal and extrapyramidal systems in rats and predict the pathways involved in spinal cord injuries. METHOD: The motor area of the cerebral cortex, medullary reticular nucleus, lateral vestibular nucleus, and red nucleus of adult Sprague-Dawley rats were stimulated with microelectrodes. Laminectomies were performed at the C6, T10 and L2 cord level. Field potentials evoked by stimulation of the cerebral cortex and the three motor nuclei were recorded with a glass microelectrode of 1.5~2.5 Mohm filled with 0.2M NaCl. To construct a cross-sectional map of field potentials, recording was made in 7 tracks equally spaced across the spinal cord. In each track, field potentials were recorded at seven equally spaced points from the ventral to dorsal cord. RESULT: Stimulation of the cerebral motor cortex evoked 5 wanes, such as P1, P2, P3, P4, P5. P1 was monitored mainly in the bilateral dorsal half of the spinal cord and other wades mainly in the ventral half of the spinal cord. With lateral vestibular nucleus stimulation, 1 or 2 short duration biphasic waves followed by a longer duration positive wave were monitored mainly in the ipsilateral ventrolateral funiculus of the cord. Field potentials produced by stimulating the medullary reticular nucleus were shown mainly in the ventromedial funiculus, and their latencies were longer than those from the vestibular nucleus stimulation. Field potentials generated by the stimulation of the red nucleus were monitored mainly in the dorsolateral funiculus. CONCLUSION: motor evoked potential is clinically useful to evaluate the descending pathways of the spinal cord.
Adult ; Animals ; Cerebral Cortex ; Evoked Potentials, Motor* ; Glass ; Humans ; Laminectomy ; Microelectrodes ; Motor Cortex ; Rats* ; Rats, Sprague-Dawley ; Red Nucleus ; Spinal Cord ; Spinal Cord Injuries ; Vestibular Nucleus, Lateral

Kainate is known as a neurotoxin acting on the glutamate receptors in the central nervous system (CNS). Glutamate acts an excitatory neurotransmitter at physiological concentration but has a neurotoxic effect in excess amount. BDNF (brain-derived neurotrophic factor) has been reported to have a protective effect against the cellular toxicity and to plays an important role in neuronal survival and differentiation in peripheral nervous system. However, the functional mechanism of BDNF in CNS is unclear. This study was performed to examine the protective effect of BDNF in kainate-induced neurotoxicity and to observe the relation between BDNF mRNA expression and increasing pathways of intracellular Ca2+ concentration. Cultured hippocampal neurons were prepared from 17-18 day embryonic rats and used at the 7th day after neuronal culture. The amounts of BDNF mRNA were measured by reverse transcription polymerase chain reaction after the treatment of several glutamate receptor agonists: glutamate, kainate, -amino-3-hydroxyl-4-isoxazolepropionic acid, N-methyl-D-aspartate. Kainate showed the most prominent effect in an increase of BDNF mRNA expression among the glutamate receptor agonists. The maximal increase of BDNF mRNA expression was obtained in 50 M kainate at 3 hr after the treatment. Adding BDNF to kainate containing cultured hippocampal neurons diminished the increasing level of lactic dehydrogenase according to the single treatment of kainate. In the experiment to evaluate the Ca2+ influx pathways related in BDNF mRNA expression, nifedipine (10 M), a voltage-dependent Ca2+ channel blocker, decreased the both kainate (50 M) and KCl (50 mM) induced BDNF mRNA expressions by 18.4% and 35.0%, respectively. Ryanodine (10 M), a blocker of intracellular release from Ca2+ storage, however, did not show any effect in the both kainate- and KCl-treated neurons.These results suggest that BDNF has a protecting effect against the kainate-induced neurotoxicity in cultured rat hippocampal neurons, and its expression is more related with the Ca2+ influx through the voltage-dependent Ca2+ channels than the release from intracellular Ca2+ storage.
Animals ; Brain-Derived Neurotrophic Factor* ; Calcium* ; Central Nervous System ; Glutamic Acid ; Kainic Acid ; N-Methylaspartate ; Neurons ; Neurotransmitter Agents ; Nifedipine ; Oxidoreductases ; Peripheral Nervous System ; Polymerase Chain Reaction ; Rats ; Receptors, Glutamate ; Reverse Transcription ; RNA, Messenger* ; Ryanodine

BACKGROUND/AIMS: It has been recently reported that celiac ganglia can be identified by linear-array endoscopic ultrasonography (EUS). Still, there has been no report on the detection rate of celiac ganglia with radial scanning EUS. The aim of this study was to evaluate the detection rate of celiac ganglia by radial scanning echoendoscopy during a routine examination. METHODS: We prospectively enrolled 57 consecutive patients (23 men, 34 women; mean age 54 years, range 21-78 years) who were referred for EUS examination from September 2006 to December 2006. EUS was performed using a radial scanning echoendoscope. The size, location and EUS appearance of the celiac ganglia were recorded for each patient. RESULTS: Celiac ganglia were identified in 51 out of 57 patients (89.4%). They were identified at the left side of the celiac trunk and aorta and between the celiac artery and the left adrenal gland. They appeared as hypoechoic, oblong or lobulated structures, often with an irregular edge, and they often contained a hyperechoic focus or strand. The mean size was 18 mm by 4 mm. Structures corresponding to the visualized celiac ganglia were retrospectively identified on CT scans in 33 among the 37 patients (89.2%). CONCLUSIONS: The results of this study showed that celiac ganglia could be identified, with radial scanning EUS, in the majority of subjects.
Adult ; Aged ; Endosonography/*methods ; Female ; Ganglia, Sympathetic/radiography/*ultrasonography ; Humans ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Tomography, X-Ray Computed

In the rat lumbar spinal cord, the pathways and distribution of corticospinal tract (CST) axons were investigated using retrograde transport of Fast Blue(FB) and Fluoro-Gold(FG). The purpose of this study was, therefore, to fond the extent of CST projections in the lateral funiculus in the rat. Total of twelve female rats were used in this study. The laminectomy was performed at the 78 cord level to expose the spinal cord. Using a radiofrequency lesioning device, the CST, including the dorsal columns, were lesioned bilaterally. Three to seven days after lesioning, two laminectomies were performed at C6-8 and L3-5 to expose the spinal cord for dye injections. Retrograde tracing of fast blue(FB) and fluoro-gold(FG) were used to quantitate the number of cerebral cortex neurons projecting to the lumbar cord through tracts other than the CST in the dorsal column. New findings of the this study are : (1) a small number of CST axons projected to lumbosacral spinal cord bilaterally in the dorsolateral funiculi. (2) some axons projecting to the lumbar cord through the dorsolateral funiculi are collateral of neuron that project to the cervical spinal cord. Our results suggest that there are a larger number of CSTs than previously thought projecting to the lumbar spinal cord through the lateral funiculi. These residual tracts may play a role in the functional recovery of the affected limbs.
Animals ; Axons ; Cerebral Cortex ; Extremities ; Female ; Humans ; Laminectomy ; Neurons ; Pyramidal Tracts* ; Rats* ; Spinal Cord*

Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder of lymph node and extranodal site. Bone involvement is very rare. We report a case of extranodal RDD of the tibia in 32-year old male. The patient presented with pain with no evidence of lymphadenopathy. Clinico-radiologic diagnosis was metastatic carcinoma or Langerhans cell histiocytosis, but, histopathologic examination confirmed the diagnosis with RDD. We performed curettage on the osteolytic lesion of tibia. In South Korea, there was no report about RDD of the extremity and we want to report this case with review of the literature.
Curettage ; Diagnosis ; Extremities ; Histiocytosis, Langerhans-Cell ; Histiocytosis, Sinus* ; Humans ; Korea ; Lymph Nodes ; Lymphatic Diseases ; Male ; Tibia*