The relative rarity and anatomical position of presacral tumors may lead to difficulty in diagnosis and surgical treatment. The clinical features and surgical approach of 4such tumors(teratocarcinoma 1, endodermal sinus tumor 1, chordoma 1, neurilemmoma 1) have therefore reviewed. Low back pain or sacral pain was present in 3patients although all tumors were palpable on rectal examination. Surgical resection was carried out using the posterior transverse approach in Kraske's prone position. Complete surgical excision was performed in 3cases(chordoma, teratocarcinoma, neurilemmoma) and incomplete excision in 1 case(endodermal sinus tumor). A review of literature concerning these tumors and the surgical approach are presented.
Chordoma ; Diagnosis ; Endodermal Sinus Tumor ; Low Back Pain ; Neurilemmoma ; Prone Position ; Teratocarcinoma

The Supracondylar fracture of the humerus is the most common elbow fracture in children. In general, accurate anatomic reductio, the least regional trauma as possible and the maintenance of the reduction are necessary to obtain excellent results. Lateral and posterior approach is commonly used method for the treatment of supracondylar fracture of the humerus in children. But lateral and posterior approach has some troubles in reduction of fracture and Kirschner wire fixation. From March 1988 to February 1993, seventeen supracondylar fractures of the humerus were treated by means of medial approach and followed from 8 monts to 13 months with an average 10 months. There were some advantages in medial approach. Reduction was easy and ulnar nerve was not damaged by medial approach at insertion of Kirschner wire and no more another incision. The results obtained are as follows. Postoperative vascular impairment or Volkmann's ischemia was not complicated and neurologic deficits accompanied with injury were all recovered completely. According to Mitchell and Adams' criteria, all had satisfactory results.
Child ; Elbow ; Humans ; Humerus ; Ischemia ; Methods ; Neurologic Manifestations ; Ulnar Nerve

Ischemic preconditioning (IP), a brief period of flow interruption prior to a prolonged ischemic period, increases tolerance to ischemia and improves function during reperfusion in the heart. The aim of the present study is to determine whether IP attenuates and protects against ischemia-reperfusion injury in the skeletal muscle of rabbits. Normal sham control (NC) group was the leg muscles which had no procedures taken after anesthesia. Ischemic control (ICH) group was the leg muscles with ischemia taken for 180 min. followed by reperfusion for 60 min, after anesthesia. Ischemic preconditioning 1 (IP 1) group, IP 2 group and IP 3 group were the leg muscles taken 1, 2 and 3 cycles of ischemia for 10 min. and reperfusion for 10 min. respectively, prior to same procedures as ICH group. The ischemic injury of skeletal muscles was assessed using transmission electron microscope and biospectrophotometric method. The triphenyltetrazolium chloride (TTC) reduction activity was measured, and concentrations of the ATP and its metabolites were also measured. The ICH group showed severe to irreversible changes of the myocytes homogenousely in contrast to the IP 1 group in which irreversible change was only focal and not homogenous. The TTC reduction assay significantly demonstrated that the IP 1 and IP 2 group showed higher reduction activity than the ICH group (p<0.05). The ATP content of muscles was maintained higher in the IP 1 group than in the ICH group (P<0.05). The protective effect of ischemic preconditioning can be induced in the rabbit skeletal muscles, and its effect is associated with lower energy metabolism during sustained ischemia.
Adenosine Triphosphate ; Anesthesia ; Energy Metabolism ; Heart ; Ischemia ; Ischemic Preconditioning* ; Leg ; Muscle Cells ; Muscle, Skeletal* ; Muscles ; Rabbits ; Reperfusion ; Reperfusion Injury