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

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

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

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

No Abstract Available.

[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

PURPOSE: Extrapleural fat hypertrophy is thought to be associated with findings of chronic pleural or pulmonary parenchymal diseases, and more favours clinical course of benign disease rather than malignant disease which is rapidly progressive. Recently, however, we observed frequent extrapleural fat hypertrophy in CT scens of lung cencer patients, especially those with complicated ones. We studied the frequency of extrapleural fat hypertrophy and the relationship between the extrapleural fat hypertrophy and the complications of lung cancer. MATERIALS AND METHODS: We retrospectively analized the CT findings in 95 patients with primary lung cancer. 85 patients were confirmed pathologically and 10 patients were confirmed by clinical and radiological follow-up studies. RESULTS: Among the 95 patients, 79 patients were associated with more than one complications(Lung collapse, pneumonia, pulmonary tuberculosis., pleural reaction, pleural metastasis, empyema, chest wall invasion). Extrapleural fat hypertrophy was observed in 43(54%) patients with complication, and 2(13% ) patients without complication. The frequency of the extrapleural fat hypertrophy was 40%(14/35) in patients with only parenchymal complicated patients, 33%(2/6) in patients with only pleural complication, and 71%(27/38) in patients with both parenchymal and pleural complications. CONCLUSION: Extrapleural fat hypertrophy was more frequently observed in complicated lung cancer patients rather than non-complicated, and higher frequency of the extrapleural fat hypertrophy was noted in those with more than two complications. It was concluded that extrapleural fat hypertrophy in lung cancer patients was non-specific finding caused by associated complication. Its mechanism is thought to be chronic pleural irritation and negative thoracic pressure.
Empyema ; Follow-Up Studies ; Humans ; Hypertrophy* ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Pneumonia ; Retrospective Studies ; Thoracic Wall ; Tuberculosis, Pulmonary

PURPOSE: To describe a patient who developed left subconjunctival air and pneumocephalus without definite finding of skull fracture after facial trauma. METHODS: A 16-year-old man developed headache, upper eyelid swelling and decreased visual acuity after facial trauma. Ophthalmic examinations revealed left subconjunctival hemorrhage, air and corneal abrasion. Computed tomography and simple X-ray showed huge orbital emphsema. It extends into the left posterior sclera, around the optic nerve and optic canal. Diagnosis of pneumocephalus of basal cistern with no bony fracture of face, orbits and skull was made. RESULTS: In clinical practice, physician should be kept in mind that the possibility of pneumocephalus resulted from orbital or subconjunctival emphysema through optic nerve sheath in case of no definite evidence of basal skull fractures.
Adolescent ; Diagnosis ; Emphysema ; Eyelids ; Headache ; Hemorrhage ; Humans ; Optic Nerve ; Orbit ; Pneumocephalus* ; Sclera ; Skull ; Skull Fractures ; Visual Acuity

Recent molecular studies indicate two different genetic pathways leading to the development of glioblastoma; final progression of astrocytoma and de novo formation. To define the mutual relationships of cytogenetic changes in the pathogenesis of glioblastoma, molecular histopathologic alterations of p53 and epidermal growth factor receptor (EGFR) were evaluated by single stranded conformational polymorphion, reverse transcriptase-polymerase chain reaction and immunohistochemical stains in 15 primary and 21 secondary glioblastomas. Mutations in p53 gene and positive immunoreactivity to p53 protein (DO1) were more prevalent in secondary glioblastomas than in primary glioblastomas. A correlation between p53 mutations and p53 immunopositivities in glioblastomas was observed in 83.3% of the cases. All cases with positive p53 immunoreactivities showed p53 mutations; however, 13.9% of glioblastomas with p53 immuno-positivities lacked the relevant mutations. EGFR amplifications were detected in 73.3% of primary glioblastomas and 9.5% of secondary glioblastomas (p<0.001). The concurrence of p53 mutation and EGFR amplification was revealed in only 2 out of 15 primary glioblastomas and none among the secondary glioblastomas. Immunoreactivities for EGFR were noted in 66.7% of primary glioblastomas and in 9.5% of secondary glioblastomas (p<0.001). A correlation between EGFR amplification and EGFR immunopositivity in glioblastomas was observed in 91.7% of the cases. These data indicate that EGFR amplification and p53 mutations are two independent genetic events in the development of glioblastomas.
Adolescence ; Adult ; Brain Neoplasms/*genetics/metabolism ; Female ; *Genes, p53 ; Glioblastoma/*genetics/metabolism ; Human ; Immunohistochemistry ; Loss of Heterozygosity ; Male ; Middle Age ; *Mutation ; Protein p53/analysis ; Receptor, Epidermal Growth Factor/analysis/*genetics ; Reverse Transcriptase Polymerase Chain Reaction

Aconite is a common remedy of herb doctors and is widely used in the Far East. Clinical aspects of the visual disturbance produced by this drug have been described, but little is known about its pathology. Tinctura aconiti (0.6 mg of total alkaloid/kg 2x) was administered intraperitoneally in rabbits to evaluate its toxic effects on the visual system. The alteration in the visual evoked potential following aconite injection consisted of a delay in the onset and peak latency. Histopathologically, there were damages to the myelin sheath of the visual pathway, spinal cord and peripheral nerves. These findings suggest that aconite may cause primarily myelo-optic neuropathy.
Aconitum/administration & dosage/*toxicity ; Animals ; Evoked Potentials, Visual/*drug effects ; Injections, Intraperitoneal ; Myelin Sheath/*drug effects/ultrastructure ; Optic Nerve/*drug effects/ultrastructure ; Optic Nerve Diseases/*chemically induced/pathology ; Rabbits ; Spinal Cord/*drug effects/ultrastructure