A wide variety of cancers metastasize to the ovaries. In a majority of instances the primary site is the gastrointestinal tract, breast, or other gynecologic organs. The best known tumor of this type is signet-ring cell adenocarcinoma. The gallbladder and bile duct are rare sources of these metastases. The authors have had an experience of a case that was presented of Krukenberg tumor metastatic from the gallbladder and report the case with brief review of literature.
Adenocarcinoma ; Bile Ducts ; Breast ; Female ; Gallbladder* ; Gastrointestinal Tract ; Krukenberg Tumor* ; Neoplasm Metastasis* ; Ovary

With an aging population, osteoporotic vertebral collapse is an increasingly common condition. This compression fractures has been considered a benign entity, quite responsive to conservative treatment. In a rare patients, however, a major neurologic complication and painful kyphosis despite conservative treatment can develop. Therefore, the purpose of this present study is to analyze the surgical results of 14 patients with severe back pain, an increasing kyphosis and neurologic deficits caused hy osteoporotic vertebral collapse following minor trauma, who were treated surgically. Presenting signs and symptoms included severe back pain with progression of kyphosis in 6 patients and increasing neural deficit in 8 patients. Of 14 patients, eight patients had an intravertebral cleft sign (vacuum sign). Indications for surgery included increasing kyphotic deformity, intractable pain, or increasing neurologic deficit. There was no correlation between intravertebral cleft sign and neurologic deficit. However, patients who had intravertebral cleft sign had not well respond to conservative treatment. As treatments, combined anterior and posterior fusion in 8, anterior fusion in 4, posterior instrumentation, and wide decompressive laminectomry in one patient, respectively, were carried out. The final correction of the deformity averaged 0.3 degrees. Therefore. correction of kyphosis was not favorably maintained because of variable surgical methods, and sinking of graft bone or instrumentation into the osteoporotic vertebral bodies. However, pain was reduced significantly in all patients. In addition neurological symptoms improved in 7 patients. One patient underwent reoperation with nnterior inierbody tusion together with anterior instrument because of an increasing kyphosis, neurologic. iymptoms and scvcre hack pain following wide decompressive laminectomy. There was no complication relatecl to instruments. The authors strongly helieved that surgical intervention has highly satisfactory results in patients who have intravertehral cleft sign with persistent back pain despite conservative treatment, and proressive or persistent neurologic deficits following osteoporotic vertebral collapse.
Aging ; Back Pain ; Congenital Abnormalities ; Fractures, Compression ; Humans ; Kyphosis ; Laminectomy ; Neurologic Manifestations ; Osteoporosis ; Pain, Intractable ; Reoperation ; Transplants

Posterior transarticular screw fixation is known to be one of the best surgical method for the atlanto-axial instability. Between April 1995 and February 1997, this technique was used in the treatment of 21 patients(10 men, 11 women) suffering from this condition. The average age at the time of operation was 39 years(range, 17 to 63). and mean follow-up period was 14(mean 3 to 25) months. The indication for fusion were nine cases, type II-A odontoid process fracture; three cases, type II-P odontoid process fracture; three cases, os odontoideum; three cases transverse ligament laxity due to rheumatoid disease; and three cases, transverse ligament injury without bone fracture. Eleven operations involved cases were operated with posterior C1, 2 transarticular screw fixation using a 3.5 mm cortical screw augmented th interlaminar iliac graft and sublaminar wire fixation. The other ten patients underwent the same surgery without sublaminar wire fixation. In two cases d screw were misplaced; one was placed lateromedially and the other caused widening of the joint capsule space, but there were corrected by reoperation. Patients were ambulated with Philadelphia neck collar on the first post-operation day. At the end of three months follow-up, bone union was seen in all cases, and the following conclusions may be drawn: 1) Immediately after surgery, ambulation is possible; 2) The rate of occurrence of bone union is high; 3) A halo vest is not needed; 4) Sublaminar wiring is also unnecessary.
Follow-Up Studies ; Fractures, Bone ; Humans ; Joint Capsule ; Ligaments ; Male ; Neck ; Odontoid Process ; Reoperation ; Transplants ; Walking

The human intestinal microbiota is a community of 10(13)-10(14) microorganisms that harbor in the intestine and normally participate in a symbiotic relationship with human. Technical and conceptual advances have enabled rapid progress in characterizing the taxonomic composition, metabolic capacity and immunomodulatory activity of the human intestinal microbiota. Their collective genome, defined as microbiome, is estimated to contain > or =150 times as many genes as 2.85 billion base pair human genome. The intestinal microbiota and its microbiome form a diverse and complex ecological community that profoundly impact intestinal homeostasis and disease states. It is becoming increasingly evident that the large and complex bacterial population of the large intestine plays an important role in colorectal carcinogenesis. Numerous studies show that gut immunity and inflammation have impact on the development of colorectal cancer. Additionally, bacteria have been linked to colorectal cancer by the production of toxic and genotoxic bacterial metabolite. In this review, we discuss the multifactorial role of intestinal microbiota in colorectal cancer and role for probiotics in the prevention of colorectal cancer.
Animals ; Bacteroides/metabolism ; Colorectal Neoplasms/immunology/*microbiology ; Fatty Acids, Nonesterified/metabolism ; Humans ; Hydrogen Sulfide/metabolism ; Intestinal Mucosa/immunology/microbiology ; Metagenome ; *Probiotics ; Reactive Oxygen Species/metabolism ; Toxins, Biological/metabolism

Corneal endothelial degeneration has been reported in diseases associated with CAG repeat expansion including spinocerebellar ataxia type 1 (SCA1) and dentatorubropallidoluysian atrophy (DRPLA). We report a 35-year-old man who has cerebellar ataxia, myoclonic seizure, dystonia, chorea, mental retardation, and visual disturbance. Detailed ophthalmologic examination showed marked reduction of the corneal endothelial cell density. Genetic analysis revealed the presence of a pathological CAG expansion within the DRPLA gene. We suggest that corneal endothelial degeneration might be one of the signs differentiating DRPLA from other hereditary ataxias.
Adult ; Atrophy* ; Cerebellar Ataxia ; Chorea ; Dystonia ; Endothelial Cells ; Humans ; Intellectual Disability ; Seizures ; Spinocerebellar Ataxias ; Spinocerebellar Degenerations

Corneal endothelial degeneration has been reported in diseases associated with CAG repeat expansion including spinocerebellar ataxia type 1 (SCA1) and dentatorubropallidoluysian atrophy (DRPLA). We report a 35-year-old man who has cerebellar ataxia, myoclonic seizure, dystonia, chorea, mental retardation, and visual disturbance. Detailed ophthalmologic examination showed marked reduction of the corneal endothelial cell density. Genetic analysis revealed the presence of a pathological CAG expansion within the DRPLA gene. We suggest that corneal endothelial degeneration might be one of the signs differentiating DRPLA from other hereditary ataxias.
Adult ; Atrophy* ; Cerebellar Ataxia ; Chorea ; Dystonia ; Endothelial Cells ; Humans ; Intellectual Disability ; Seizures ; Spinocerebellar Ataxias ; Spinocerebellar Degenerations

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disease, which causes chronic progressive inflammation and thickening of the basal dura mater and produces multiple cranial neuropathies, headache, ataxia, and seizure. A 40 year-old man presented with a continuous, diffuse, dull headache with left periorbital pain, exophthalmos, ptosis and loss of visual perception. Brain MRI revealed thickened, highly enhanced pachymeninges in all supratentorial areas in association with the left cavernous sinus. A subsequent meningeal biopsy showed non-specific chronic inflammations of the pachymeninges. The patient dramatically responded to steroid therapy. To our knowledge, this is an extremely rare case of IHCP associated with Tolosa-Hunt syndrome. (J Korean Neurol Assoc 19(1):56~59, 2001
Adult ; Ataxia ; Biopsy ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Dura Mater ; Exophthalmos ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Rare Diseases ; Seizures ; Tolosa-Hunt Syndrome* ; Visual Perception

Paraneoplastic sensory neuronopathy may present with autonomic dysfunction resulting either from autonomic neuropathy, or invasion/compression by tumor. We present a 61-year-old female presented with frequent syncope, anhidrosis, and sensory change. Investigations disclosed sensory-autonomic polyneuropathy with positive anti-Hu antibody. The chest computed tomography showed a left mediastinal mass with invasion to the brachiocephalic vein, and a small cell lung cancer was confirmed. She was treated with radiation therapy showing limited improvement. The possible causes of autonomic dysfunction in our patient were discussed.
Autonomic Nervous System ; Brachiocephalic Veins ; Carcinoma, Small Cell ; Female ; Humans ; Hypohidrosis ; Middle Aged ; Paraneoplastic Polyneuropathy ; Polyneuropathies ; Small Cell Lung Carcinoma ; Syncope ; Thorax

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated polyneuropathy with a relaps-ing or progressive course. Although the occurrence of CIDP is very rare in childhood compared to the occurrence in adulthood, it does occur in children. In childhood CIDP, the main clinical features are somewhat different from that of adults, which includes a more precipitous onset of symptoms, a high frequency of gait abnormalities, and significant neurological dysfunction. Also, the response to immune-modulating therapy is more reliable and rapid in children than in adults. The recognition of childhood CIDP is important as it may mimic hereditary neuropathies which usually pre-sent with progressive gait disturbance associated with pes cavus deformity. A careful history, clinical examination, and electrophysiological study is crucial for the accurate diagnosis of this treatable disease. Here, we report a case of CIDP in a 13-year-old Korean girl whose initial clinical presentation strongly suggested hereditary motor-sensory neuropathy.
Adolescent* ; Adult ; Child ; Congenital Abnormalities* ; Diagnosis ; Female* ; Foot Deformities* ; Gait ; Humans ; Polyneuropathies* ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

OBJECTIVE: The purpose of the present study was to compare inter-fragmentary compression pressures after fixation of a simulated type II odontoid fracture with the headless compression Herbert screw and a half threaded cannulated lag screw. METHODS: We compared inter-fragmentary compression pressures between 40- and 45-mm long 4.5-mm Herbert screws (n=8 and n=9, respectively) and 40- and 45-mm long 4.0-mm cannulated lag screws (n=7 and n=10, respectively) after insertion into rigid polyurethane foam test blocks (Sawbones, Vashon, WA, USA). A washer load cell was placed between the two segments of test blocks to measure the compression force. Because the total length of each foam block was 42 mm, the 40-mm screws were embedded in the cancellous foam, while the 45-mm screws penetrated the denser cortical foam at the bottom. This enabled us to compare inter-fragmentary compression pressures as they are affected by the penetration of the apical dens tip by the screws. RESULTS: The mean compression pressures of the 40- and 45-mm long cannulated lag screws were 50.48±1.20 N and 53.88±1.02 N, respectively, which was not statistically significant (p=0.0551). The mean compression pressures of the 40-mm long Herbert screw was 52.82±2.17 N, and was not statistically significant compared with the 40-mm long cannulated lag screw (p=0.3679). However, 45-mm Herbert screw had significantly higher mean compression pressure (60.68±2.03 N) than both the 45-mm cannulated lag screw and the 40-mm Herbert screw (p=0.0049 and p=0.0246, respectively). CONCLUSION: Our results showed that inter-fragmentary compression pressures of the Herbert screw were significantly increased when the screw tip penetrated the opposite dens cortical foam. This can support the generally recommended surgical technique that, in order to facilitate maximal reduction of the fracture gap using anterior odontoid screws, it is essential to penetrate the apical dens tip with the screw.
Polyurethanes