No abstract available.
Acrocephalosyndactylia* ; Hypertelorism* ; Orbit*

OBJECTIVE: The goal of study is the evaluation of clinical and radiological outcome of thoracic pedicle screw fixation and fusion in unstable thoracic spine fractures. METHODS: The authors retrospectively studied 21 patients with unstable thoracic fractures received thoracic pedicle screw fixation and fusion from 1995 to 2001. We analyzed the pre- and postoperative neurological finding(Frankel functional classification), radiological finding(Sagittal index: SI, Percentage of anterior body compression:ABC), complications, and displacement of screws. RESULTS: All five Frankel E grades remained E grade, 7 of 10 incompletes improved, and 6 complete deficits remained complete. No patients sustained an increase in neurologic deficit. These 21 patients had a mean preoperative SI as 19.3 degrees, which was corrected to 14.4 degrees after operation. After 6 months follow-up, the SI was 14.2 degrees And those had an mean preoperative ABC as 53.8% which was corrected to 34% after operation. At 6 months. the mean ABC was 34.4%. A statistically significant difference existed between the preoperative, postoperative and follow-up SI and ABC. The complications were respiratory and urinary tract infection, decubitus et al., but the hardware failure was not occurred. The cortical violation of pedicle screw in 4 patients who had mid-upper thoracic fractures was 26.7%, but the displacement was less than 2 millimeter and any neurological, cardiovascular, or pulmonary injury were not revealed. The bone fusion and stabilization was successful in all patients. CONCLUSION: Pedicle screw fixation and fusion is an effective and safe method in unstable thoracic spine fractures, because of high fusion rate, good neurological and radiological outcome and low complication rate. Mild displacement of pedicle screw does not affect the clinical outcome. So, pedicle screw fixation can be an acceptable procedure in unstable mid-upper thoracic spine fracture or dislocations.
Dislocations ; Follow-Up Studies ; Humans ; Lung Injury ; Neurologic Manifestations ; Retrospective Studies ; Spine* ; Urinary Tract Infections

To evaluate the clinical and histopathological significance of the proliferative activity in neoplastic and non-neoplastic thyroid lesions, we analyzed the mitotic count and the proliferating cell nuclear antigen labeling index (PCNA-LI) by immunohistochemistry as the proliferation- related markers. In this study included were surgically removed normal thyroid tissue (27 cases), adenomatous goiter (15 cases), Hashimoto's thyroiditis (5 cases), follicular adenoma (13 cases), follicular carcinoma (7 cases), papillary carcinoma (44 cases), poorly differentiated carcinoma (2 cases) and undifferentiated carcinoma (3 cases). The median PCNA-LI was 0 in normal thyroid tissue, 0.5 in adenomatous goiter, 6.2 in Hashimoto's thyroiditis, 1.2 in follicular adenoma, 4.8 in follicular carcinoma, 8.5 in papillary carcinoma, 60.8 in poorly differentiated carcinoma, and 55.2 in undifferentiated carcinoma (p=0.0001). Although PCNA-LI was exceptionally high in Hashimoto's thyroiditis, it was suggested that PCNA-LI could be used as a marker differentiating benign lesions from malignant neoplasm. Also, it could differentiate follicular adenoma from follicular carcinoma. Except clinical stage (p=0.0397), PCNA-LI was not related with sex, size, histologic subtype, and lymph node metastasis in papillary carcinoma. The presence of mitosis differentiated the neoplastic thyroid lesions from the non-neoplastic lesions (p<0.05), however, it could not divide benign and malignant neoplasm. These results suggest that an evaluation of the proliferative activity can help to differentiate the thyroid lesions. In addition, there was no significant correlation between the value of PCNA-LI and the presence of mitosis. It can be recommended to evaluate both the mitotic count and the PCNA-LI for determining the proliferative activity of the thyroid lesions.
Adenoma ; Carcinoma ; Carcinoma, Papillary ; Goiter ; Immunohistochemistry ; Lymph Nodes ; Mitosis ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen* ; Thyroid Gland* ; Thyroiditis

OBJECTIVES: We retrospectively studied the efficacy of anterior cervical discectomy and interbody fusion without plate fixation in degenerative cervical disease. METHODS: Thirty two consecutive patients with degenerative cervical disease treated by decompression and interbody fusion(Smith-Robinson technique) without anterior cervical plating were studied for postoperative complication rate as well as the clinical and radiologic outcomes and were compared the result of ours with other reported series where the anterior cervical plating was used. RESULTS: All cases were reviewed after average period of 13 months for the purpose of this study. There were 4 postoperative complications related to grafting. A solid fusion was obtained in all cases with single-level fusion(n=21) and 81.8 % of the cases with a two-level fusion(n=11). The overall fusion rate was 93.8 % and fusion rate per level fused was 95.3%. The clinical outcome of the patients was comparable with that in the literature, with one patient having a poor result. Comparing the result of this study with others of the anterior cervical plating, clinical outcome and fusion rate were not superior in plate fixation group in single-level fusion, but increased fusion rate and decreased graft-related complication rate were noted in multilevel fusion with plate fixation. However, the clinical outcome was not superior to noninstrumented fusion group of this study. CONCLUSION: These results demonstrate that anterior cervical discectomy and interbody fusion(Smith-Robinson technique) without instrumentation is safe and reliable method of single-level fusion in degenerative cervical disease. Plate fixation system doesn't seem necessary in single level fusion in degenerative cervical disease.
Decompression ; Diskectomy* ; Humans ; Postoperative Complications ; Retrospective Studies ; Transplants

OBJECTIVE: In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. MATERIALS AND METHODS: Most common fracture level was C4-5, mean age 41, and male to female ratio 13: 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. RESULTS: Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than 5degrees, 2 cases(12%) 5-20degrees, and 1 case(6%) more than 20degrees. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. CONCLUSION: In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.
Dislocations ; Female ; Humans ; Male ; Motor Vehicles ; Retrospective Studies ; Spine* ; Transplants

No abstract available.
Transplants*

No abstract available.

Lymphomatous involvement of the heart, occurring at initial diagnosis and presentation, is extremely rare. We report here a case of 58 year old man who presented with generalized edema, pericardial effusion, and a large right atrial mass detected by transesophageal echocardiography. There is no other evidence of disseminated lymphoma in this patient. Tumor removal and pulmonary embolectomy was done. Pathologically, the mass was malignant lymphoma, diffuse large cell type. Unfortunately, we have no chance to perform the intensive chemotherapy. The patient discharged in moribund state.
Diagnosis ; Drug Therapy ; Echocardiography, Transesophageal ; Edema ; Embolectomy ; Heart ; Humans ; Lymphoma* ; Middle Aged ; Pericardial Effusion

Secondary amyloidosis occurs in patients with chronic inflammatory diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The major therapeutic approach to secondary amyloidosis involves controlling the underlying inflammatory disease. Tumor necrosis factor-alpha (TNF-alpha) inhibitors have revolutionized the treatment of rheumatic diseases; in many cases dramatic clinical improvement of secondary amyloidosis due to AS has been observed in response to treatment with these agents. However, the development of secondary amyloidosis associated with AS refractory to treatment with TNF-alpha inhibitors has been infrequently reported. Here, we described a case of a 37-year-old male patient with longstanding AS who was diagnosed with secondary amyloidosis due to high disease activity despite treatment with etanercept, adalimumab and infliximab.
Adult ; Amyloidosis* ; Arthritis, Rheumatoid ; Humans ; Male ; Rheumatic Diseases ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha* ; Adalimumab ; Infliximab ; Etanercept

No abstract available.
Catheters*