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

OBJECTIVE: The aim of this study was to determine the safe distance from anterior clinoid process (ACP) when the frontotemporal approach (FTA) was used for clipping of anterior communicating artery aneurysms (Acom ANs) and eventually to confirm whether the interhemispheric approach (IHA) was more effective in a certain Acom ANs. We defined the high positioned (HP) Acom AN as more than 18mm and the usual positioned (UP) Acom AN as less than 18 mm above the ACP on the lateral view of the conventional carotid artery angiogram. METHODS: Two hundred thirty four cases of Acom ANs were treated surgically either FTA or IHA by the same operator during last 14 years. The UP Acom ANs were 187 cases and the HP Acom ANs were 47 cases. We analysed the postoperative status of not only clinical conditions but also radiological findings in all cases retrospectively. RESULTS: FTA or IHA was chosen in 187 (182/5) cases of UP Acom ANs. But FTA or IHA was performed in 47 (21/26) cases of HP Acom ANs. The prognosis was better in UP Acom ANs than HP Acom ANs when FTA was chosen. But if the AN located more than 18 mm above the ACP, so called the HP Acom AN, IHA was made better prognosis than FTA. CONCLUSION: The safe distance from ACP to AN neck was lower than 18mm when FTA was chosen for the Acom ANs. IHA showed better results in the cases of AN neck higher than 18 mm from the ACP, ANs associated with a significant hematoma at the frontal lobe, moyamoya like diseases on the middle cerebral artery territory, another ANs at the distal anterior cerebral artery or aneurysmal projection of superoposterior type.
Aneurysm ; Anterior Cerebral Artery ; Carotid Arteries ; Frontal Lobe ; Hematoma ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck ; Prognosis ; Retrospective Studies

A 26-year-old male undergoing thoracotomy and bleeding control received a preoperative thoracic epidural for postoperative analgesia. On the fifth postoperative day, paralysis of both lower limbs occurred and urgent magnetic resonance imaging showed massive anterior epidural hematoma. During laminectomy and decompression, platelet dysfunction was diagnosed and preoperative non-steroidal anti-inflammatory drugs medications were supposed to the cause of platelet dysfunction. After infusion of ten units of platelet concentrate, coagulopathy was improved. We should be more careful to drugs with antiplatelet effect when using regional analgesia.
Adult ; Analgesia ; Analgesia, Epidural* ; Blood Platelets ; Decompression ; Hematoma* ; Hemorrhage ; Humans ; Ketorolac* ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Mefenamic Acid* ; Paralysis ; Thoracotomy

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*

PURPOSE: We analyzed the causative factors of femoral component radiologic abnormality after total knee arthroplasty (TKA) using a Legacy Posterior Stabilized (LPS)-Flex prosthesis. MATERIALS AND METHODS: 140 cases of TKA using LPS-Flex and 140 cases of Vanguard from Jan 2008 to June 2010 were analyzed and radiographic abnormalities around the femoral stems were compared. Secondly, TKA using LPS-Flex was divided into two groups according to the posterior femoral cutting technique, which were single cutting method and additional cutting method. Accuracy of the femoral posterior resection was compared. RESULTS: Radiographically, anterior radiolucent line was found in eight cases with LPS-Flex but no case with Vanguard. Posterior overhang more than 30% was found in ten cases in both groups. Posterior bone defect more than 50% was found in 23 and seven cases respectively. Anterior radiolucent line and posterior bone defect were observed significantly more in LPS-Flex. In the second study, we found femoral posterior bone defect in 20 cases with additional cutting method which was caused by flexion of the femoral box-cutting guide. CONCLUSION: Posterior bone defect from LPS-Flex was caused by inappropriate resection due to flexion of the box cutting guide. Single cutting method should be adopted for more accurate posterior femoral cutting.
Arthroplasty ; Knee ; Osteoarthritis ; Prostheses and Implants