Metastatic tumors of the cervical spine represent an omnious complication of systemic cancer. Neoplastic disease of the cervical spine is a rare disorder. Because of the potential morbidity and mortality associated with cervical tumors, their significance to both patients and surgeon is much greater than the incidence. The potential for devasating morbidity associated with unstable symptomatic cervical spine stresses the importance of early recognition and vigorous treatment of this disorder. Our approach to the problem is based on an experience which includes surgical treatment in a series of eight consecutive patients with symptomatic spinal metastases during three years from September 1993 to August 1996. The primary foci were lung in 4 cases, breast in 2, prostate in 2, and unknown in 1. The surgery performed with anterior approach in 3 cases, posterior in 4 cases, combined in 1. The immediate postoperative result was excellent without any surgical complications. The author thinks that unstable cervical metastatic tumors may be required a vigorous treatment because of its devasating nature.
Breast ; Humans ; Incidence ; Lung ; Mortality ; Neoplasm Metastasis ; Prostate ; Spine*

OBJECTIVE: It is not unusual to decompress two consecutive disc levels in treating patients with multiple radiculopathy or uncertain level diagnosis. However, the controversy over whether to use corpectomy or bisegmental diskectomy for anterior cervical fusion is still largely unsettled. The aim of this study is to define the properties of these two surgical options. PATIENTS AND METHODS: We performed a retrospective review of radiological data and clinical records only in patients whom the follow up period is longer than 12 months. Functional outcome, fusion rate, complication rate, and duration of anesthesia were analyzed in both groups. RESULTS: In total of 61 cases, corpectomy was performed in 34 and the bisegmental diskectomy in 27 patients. Mean follow-up periods were over 24 months in both groups. Anesthesia time was shorter in corpectomy patients(280 minutes vs. 300 minutes in segmental diskectomy). However, the bisegmental diskectomy group was better in achieving good clinical outcome(92.6% vs. 82%). Overall fusion rate in bisegmental diskectomy was 100%. Hardware failure rate was lower in bisegmental diskectomy group(11% vs. 18%). Revision was needed in 6% of corpectomy group. CONCLUSIONS: In conclusion, although the anesthesia time is slightly longer in bisegmental fusion, we believe the method of bisegmental diskectomy is better in accomplishing higher fusion rate and lower complication rate.
Anesthesia ; Diagnosis ; Diskectomy* ; Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

No abstract available.

No abstract available.
Reference Values*

PURPOSE: This study was done to identify levels of physical fitness in student nurses and to ascertain the relationship among the different aspects of physical fitness of strength, power, muscle endurance, agility, balance and flexibility. METHOD: The participants were 266 students selected from one college of nursing. From May 1 to July 31 in 2003, physical constitution, muscle strength (grip strength, back strength), power (standing long jump), muscle endurance (sit-ups), agility (whole body reaction time-light, sound), balance (close-eyes foot-balance), and flexibility (sitting trunk flexion) were measured. RESULT: The mean(standard deviation) for grip strength was 22.59(3.93) kg., for back strength, 48.52(12.85) kg., for standing long jump, 135.29(20.54) m., for sit-up's, 23.66(9.35) per minute, whole body reaction time (light), 0.43(0.11) sec, whole body reaction time (sound), 0.50(0.16) sec, close-eyes foot-balance, 33.35(38.67) sec, and sitting trunk flexion 34.72(9.37) cm. CONCLUSION: This study showed that the physical fitness of student nurses is very low compared to the results in a report from the Korea Sports Science Institute. It is necessary to include exercise programs for student nurses in order to improve their physical fitness.
Constitution and Bylaws ; Hand Strength ; Humans ; Korea ; Muscle Strength ; Nursing ; Physical Fitness* ; Pliability ; Reaction Time ; Sports ; Students, Nursing

Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure. Acute pyelonephritis without urinary tract obstruction, previous renal diseases or septic shock is a rare cause of acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function could be slow and incomplete. We experienced a 45 year-old woman with diabetes who developed bilateral acute pyelonephritis followed by acute renal failure. The renal biopsy revealed diffuse edematous and focal fibrotic inters- titium with infiltration of lymphocytes compatible with interstitial nephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at about 10-month follow-up, suggesting permanent renal damage. Therefore, we report this case with brief review of related literature.
Acute Kidney Injury* ; Adult ; Biopsy ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Middle Aged ; Nephritis, Interstitial ; Pyelonephritis* ; Shock, Septic ; Urinary Tract ; Urinary Tract Infections

Anterior cervical fusion without internal fixation destabilizes an already unstable spine and can result in tenuous bone graft stability and potential for incorporation. Anterior fusion of cervical spine with screw-plates is gaining in popularity in the management of anterior cervical spine instability. Eighty six cases that underwent anterior fusion with or without internal fixation and autogenous iliac bone graft were compared and analyzed. The pathologies included 40 cases of cervical disc disease, 43 of cervical spondylosis and 3 of ossification of posterior longitudinal ligament. Changes in the alignment of the total cervical spine and of the fused segment were evaluated in both groups. Dislodgement of the grafted bone, which was observed in 2 of 11 cases in the nonplate group, was not seen in the plate group. Hardware failure was developed in 3 of 24 cases in the bicortical group, but not in 51 cases in the unicortical group. Alignment of the cervical spine was corrected and relatively well manintained in the plate group compared with the nonplate group. We concluded that a unicortical screw fixation was superior than a bicortical screw and a fusion without plating system could not keep a cervical lordotic curve in the treatment of the degenerative cervical disease.
Ossification of Posterior Longitudinal Ligament ; Pathology ; Spine* ; Spondylosis ; Transplants

To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles), but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the 14 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.
Adenocarcinoma ; Cisplatin ; Disease Progression ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Gastrectomy ; Hepatomegaly ; Humans ; Ifosfamide ; Liver ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Mastectomy, Segmental ; Mesna ; Neoplasm Metastasis ; Prognosis ; Stomach* ; Tomography, X-Ray Computed

Matrix producing carcinoma of the breast is a variant of heterologous metaplastic carcinoma which is defined as "overt carcinoma with direct transition to a cartilagenous and/or osseous stromal matrix without an intervening spindle cell zone or osteoclastic cells". This tumor is very rare, occuring in less than 0.2% of total breast carcinoma, but the prognosis is better than other metaplastic carcinoma. We experienced a case of fine needle aspiration(FNA) cytologic finding of matrix producing carcinoma of the breast. A 75-year old woman, who presented a right huge breast mass(9x8cm) during 10months, was examined. Mammography reveals right lateral mass with even density without calcification. Breast ultrasonography shows multifocal hypoechogenic cystic change in the huge mass, suggesting resolving hematoma or carcinoma or sarcoma with necrosis. On cytologic finding of FNA, myxoid matrix was the dominant feature and the rest of the material was composed of scanty isolated atypical cells with large irregular nuclei. The histologic finding was moderately differentiated adenocarcinoma with abundant cartilagenous matrix and focal squamous metaplasia.
Adenocarcinoma ; Aged ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Female ; Hematoma ; Humans ; Mammography ; Metaplasia ; Necrosis ; Needles ; Osteoclasts ; Prognosis ; Sarcoma ; Ultrasonography, Mammary