Chondroblastoma is a rare primary bone tumor and that of sacrum was reported only 4 cases in the literatures. We report the case of 16 year old female with chondroblastoma of sacrum. The lesion was treated by partial excision of sacrum and coccyx as a block at 2nd sacral segment level. The excised tumor was round lobulated mass with diameter of 6 cm, and was consisited by yellowish cartilagenous tissue with scattered focus of calcification. Histological structure showed the proliferation of chondroblasts in chondroid ground substance with scattered multinucleasted giant cells. The ground substance showed the areas of calcification. During 22 months of follow up period, neither evidence of local recurrence nor metastasis could be boserved.
Chondroblastoma ; Chondrocytes ; Coccyx ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Neoplasm Metastasis ; Recurrence ; Sacrum

For the evaluation of the clinical and radiologicaI result in the surgical reduction and internal stabilization of the fracture-dislocations in the thoracic and lumbar area, the authors analysed the 39 patients who were treated with Harrington instrumentation supplemented by segmental sublaminar wiring and were follow up 24 months in average. l. Indications for the operation were: compression type with more than 50% of body wedging, bursting type with less than 30% of canal involvement without cord injury, fracture-dislocation type with instability and any type with complete cord injury. 2. Amount of fusion were 6 segments in 25 cases, 7 segments in 11 cases, 5, 8 and 10 segments in 1 case each. 3. Among 31 cases whose lumbar segment were involved in fusion, numbers of movable lumbar motion segments were three or less in 26 and two or less in 8. 4. Angular deformity were changed from 27 preoperatively to 8 postoperatively and to 12 at the end of follow up. Wedging amount of anterior vertebral height were 53% preoperatively, 23% postoperatively and 27% at the end of follow up. 5. External support were applied for 4 months in 35 cases; Taylor brace in 22, TLSO in 10 and body cast in 3. Ambulation was started within a week according to the general status. 6. Solid bony union were observed in 38 cases within 4 months period. Dislodgement of instrumentation and deep infection in one each patient were observed as operative complications. 7. Among 21 cases with cord injury symptoms, 18 cases with complete type showed no neurological recovery, but 3 cases with incomplete type showed complete recovery. It is concluded that the Harrington instrumentation with sublaminar wiring is an effective method of reduction and stabilization for the fracture and dislocations of the thoracic and lumbar spine. On the other hand, the operation is an extensive procedure with significant involvement of lumbar motion segments.
Braces ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Spine ; Walking

Although anterior fusion has several advantages in the management of fracture-dislocations of cervical spine than posterior methods, it has not been used in common. Because, it does not give sufficient stability to prevent the dislodgment of the graft and angular deformity and it requires prolonged rigid external immobilization. In order to promote the stability and to reduce the external support, authors have fixed with plate and screws in anterior spine fusion for various type of fracture-dislocations of cervical spine, and report the results of 29 consecutive cases. Minimum follow-up period was 6 months (Av. 12mos.). Two level fixation after anterior decompression by corpectomy was done in 7 cases. Ambulation was started from the day after operation with aid of orthosis, regardless of the neurological status. Bone union was observed in all, but one expired case, within 2–3 months. There was no failure in fixation and no worsening in neurology. Improvement of neurological status were observed in 17 patient during and follow up periods of treatment, among 23 patient with neurological symptoms on arrival. The observed complications of hoarseness(2 csses), dysphagia(2 cases) and Horner's syndrome(1 case) were improved later, but the patient with pneumonia was expired one month after operation. It is concluded that the procedure is a safe and better alternative for the fracture-dislocations including flexion injury between C2-T1, because it provides good stability, rapid union, short external support and possibility of neural decomprssion.
Congenital Abnormalities ; Decompression ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Neurology ; Orthotic Devices ; Pneumonia ; Spine ; Transplants ; Walking

It is well known that many cases of renal cell carcinoma accompanies gross or microscopic hematuria. It implies that much of renal cell carcinoma may also have pelvic or medullary invasion. But unlike other well known prognostic factors such as renal vessel or regional invasion, the prognostic significance of pelvic or medullary invasion in renal cell carcinoma has not been known well. We reviewed retrospectively 73 patients treated with radical nephrectomy in whom 18 patients has pathologically confirmed pelvic or medullary invasion. The mean follow-up duration was about 23 months. The average size of tumor in non-pelvic invasive group (NPIG) was 6.6 cm and in pelvic invasive group (PIG) it was 5.4 cm. In NPIG, 91% (67 patients) of tumor was Grade II and III and in PIG 100% of tumor was Grade II and III. 89% of NPIG tumor was stage pT3aN0M0 or below. And 88% of PIG was pT3aN0M0 or below. At 12 NPIG patients (16%) tumor has recurred and its mean duration was about 6.6 months. In PIG, 5 patients had recurrent tumor (27%) and its duration was about 7.6 months. Nine patients (12.3%) died due to renal cell carcinoma in NPIG. In PIG 3 patients (16%) died of renal cell carcinoma. The study revealed that there is no significant difference between pelvic or medullary invasive and non-pelvic invasive renal cell carcinoma in tumor grade and stage. But in pelvic invasive renal cell carcinoma, relatively more tumor recurrence had occurred (p>0.05) and also relatively more patients died due to tumor. We think that for more proper clarification of prognostic significance of pelvic or medullary invasion in renal cell carcinoma, more long term follow-up and stage by stage study will be needed.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Hematuria ; Humans ; Nephrectomy ; Recurrence ; Retrospective Studies

PURPOSE: Gleason score is well known prognostic factor of prostatic cancer, Especially Gleason score above 8 measns poor prognosis. But in intermediate range(Gleason scorn 5-7), it does not provide useful information about the prognosis. Therefore, in the range of intermediate Gleason score, additional information such as PSA changes in pre and post treatment period may be helpful for predicting prognosis. In this study, we retrospectively evaluated relationship between prognosis and PSA change of pre and post hormonal treatment period in different Gleason score group(intermediate Gleason score group: 5-7/high Gleason score group: 8-10). MATERIALS AND METHODS: Total 42 patients who were diagnosed as stage D1, D2 prostatic cancer with Gleason score 5-10 were studied. All patients were treated by hormonal treatment(Orchiectomy or gonadotropin releasing hormone agonist) between May 1992 and May 1996 in Korea university. Mean follow-up duration was 18.9 months. And mean age of patients was 67.0+/-7.5 years. Patients were classified into two groups. One group was consisted of 28 patients whose Gleason score was 5-7 And in the other group, 14 patients with Gleason score above 8 were included. In each group, pre- treatment PSA, post-treatment nadir PSA, time for post-treatment PSA fall to nadir and time for PSA reelevation were analysed. Also In each group, expired and survived patients were analysed. All data was statistically processed by Exact Fisher's test and Mann-Whitney Rank Sum score. RESULTS: Mean Gleason score of total 42 patients was 7.1 +/-7.5. Mean pre-treatment PSA value of 42 patients was 146.9+/-222.6ng/ml and mean nadir PSA value after treatment was 8.2+/- 15.9ng/ml. The mean time for nadir PSA fall after treatment was 6.2+/-4.4 months and mean time for PSA reelevation was 13.3+/-9.9 months. 14 patients had Gleason score 8 or more and the other 28 patients had Gleason score 5-7. There was significant difference in mortality between patients with intermediate Gleason score(4/28 patients) and high Gleason score(7/14 patients, p=0.024). In patients with high Gleason score(8-10), there were no significant difference of pre-treatment PSA, post-treatment nadir PSA , duration for post-treatment PSA fall to nadir and time for PSA reelevation between survived and expired patients(p> 0.05). But in case with intermediate Gleason score range(5-7), expired patients had significantly higher post-treatment nadir PSA value than survived patients(19.8+/- 0.4ng/ml vs 7.3+/-4.2ng/ml respectively, p=9.036). But in both Gleason scone group, there was no mortality difference between patients with nadir PSA above 4ng/ml and below 4ng/ml. CONCLUSIONS: With these result, we concluded that patients with high Gleason score (especially 8 or more) had poor prognosis. And in patients with high Gleason score PSA change in pre and post-treatment period have no additional prognostic importance on Gleason score. But in patients with intermediate Gleason score(5-7), higher post treatment nadir PSA means poor prognosis. But conventionally used criteria of post-treatment PSA level below normal range(<4ng/ml) cannot discriminate between good and poor prognostic group in both high and intermediate Gleason score patients. So we think that in cases of patients with intermediate Gleason score(5-7), a physician must try to check up post-treatment PSA change(especially post-treatment nadir PSA) thronghly for early detection of tumor recurrence or progression.
Adenocarcinoma* ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Korea ; Mortality ; Neoplasm Grading* ; Prognosis ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies*

No abstract available.
Humans ; Venous Thrombosis*

Scrotal leiomyosarcoma arising from dartos layer not involving the testis, epididymis or spermatic cord is very rare tumor. We report a case of scrotal leiomyosarcoma in 29 year old man who present with right scrotal painless growing mass. The lesion had been for 3 months but there was no related symptom such as pain or tenderness. The excised lesion was 3 x 3cm sized ovoid mass with smooth surface and it had no relationship with the testis, epididymis and spermatic cord. Its pathologic finding was compatible with leiomyosarcoma. So additional radical orchiectomy was done.
Adult ; Epididymis ; Humans ; Leiomyosarcoma* ; Male ; Orchiectomy ; Scrotum* ; Spermatic Cord ; Testis

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

BACKGROUND: Prostaglandin system is known to participate in manifestation of the renin-angiotensin system. However, role of prostaglandins on the renin-angiotensin system in development of hypertension is not well established. This study was to examine whether the role of prostaglandins is altered in experimental hypertension. METHODS: Two-kidney, one-clip(2KIC) renal hypertension was made by clipping the left renal artery with a silver clip(internal gap of 0.2mm) and deoxycorticosterone acetate (DOCA)-salt hypertension by subcutaneous implantation of DOCA(200mg/kg) strip plus saline(1%) drinking. They were used 3 weeks later. Age-matched normal rats served as a control. Femoral artery was cannulated and arterial blood pressure and heart rate were monitored continuously. RESULTS: 1) In normotensive rats, saralasin infusion(20 microg/kg/min, IV) caused a decrease in mean arterial pressure without significant alterations in heart rate. Indomethacin-pretreatment(10mg/kg, IP) abolished the depressor response to saralasin. 2) The depressor response to saralasin was more marked in renal hypertensive rats than in normotensive rats. The magnitude of maximum decrease in blood pressure, however, was comparable between the hypertensive and normotensive rats. Indomethacin-pretreatment did not affect the depressor response to saralasin in renal hypertensive rats. 3) In DOCA-salt hypertensive rats, saralasin infusion rather caused an increase in mean arterial pressure without significant alterations in heart rate. The pressor response to saralasin was not affected by indomethacin-pretreatment. CONCLUSION: These results indicate that prostaglandin system may modify renin-angiotensin system in normotensive rats. It is suggested that mechanisms other than prostaglandin system participate in the full-blown manifestation of renin-angiotensin system in 2KIC renal hypertensive rats.
Animals ; Arterial Pressure ; Blood Pressure ; Desoxycorticosterone ; Drinking ; Femoral Artery ; Heart Rate ; Hypertension ; Hypertension, Renal ; Prostaglandins I ; Prostaglandins* ; Rats* ; Renal Artery ; Renin-Angiotensin System* ; Saralasin ; Silver

Intracranial fibro-osseous lesion, also reported as calcifying pseudoneoplasm of the neural axis, is an uncommon lesion of the central nervous system. Since the discovery of this entity by Rhodes and Davis in 1978, there have been a total of 21 cases reported in the literature. We encountered one such case in a 28 year old male, who presented with left hemiparesis for 1 year. By the MR images, a 1.5 cm sized round mass was found at right parietal lobe near motor cortex. The mass lesion enhanced well, homogenously and revealed clear, slightly irregular margin. Excisional biopsy of the mass was performed. Microscopically the lesion was composed of calcified fibrous tissue with an amorphous gray-blue, coarsely fibrillar to chondromyxoid nodular areas. Sparse spindle cells, immunohistochemically negative for GFAP, vimentin and S-100, were scattered within the amorphous material. Palisading spindle or polygonal cells were present at the more cellular periphery of the lesion, which were vimentin positive but S-100 negative. There was no evidence of the pilocytic astrocytes, Rosenthal fibers, or GFAP positive hypertrophic astrocytes. Intracranial fibro-osseous lesions are apparently slow-growing with generally excellent prognosis after wide excision. The etiology remains unclear, but most investigators favor a reactive rather than neoplastic process.
Adult ; Astrocytes ; Axis, Cervical Vertebra ; Biopsy ; Central Nervous System ; Humans ; Male ; Motor Cortex ; Paresis ; Parietal Lobe ; Prognosis ; Research Personnel ; Vimentin