• 제목/요약/키워드: Cervical approach

검색결과 231건 처리시간 0.022초

Surgical Management of Cervical Spinal Epidural Abscess Caused by Brucella Melitensis : Report of Two Cases and Review of the Literature

  • Ekici, Mehmet Ali;Ozbek, Zuhtu;Gokoglu, Abdulkerim;Menku, Ahmet
    • Journal of Korean Neurosurgical Society
    • /
    • 제51권6호
    • /
    • pp.383-387
    • /
    • 2012
  • Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

Role of CXCR7 and Effects on CXCL12 in SiHa Cells and Upregulation in Cervical Squamous Cell Carcinomas in Uighur Women

  • Kurban, Shajidai;Tursun, Mikrban;Kurban, Gulinar;Hasim, Ayshamgul
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권21호
    • /
    • pp.9211-9216
    • /
    • 2014
  • CXCR7 is involved in tumor development and metastasis in multiple malignancies. However, the function and molecular mechanisms of action of CXCR7 in human cervical cancer are still unclear. In the present study a loss of-function approach was used to observe the effects of recombinant CXCR7 specific small interfering RNA pBSilence1.1 plasmids on biological behavior including proliferative activity and invasive potential, as indicated by MTT assays with the cervical cancer SiHa cell line in vitro. Reverse transcription polymerase chain reaction and Western blotting revealed that CXCR7 was downregulated in transfected compared with control cells, associated with inhibited cell growth, invasiveness and migration. The expression of CXCR7 and CXCL12 was also determined immunohistochemically in 152 paraffin-embedded, cervical squamous cell carcinoma (CSCC) and cervical intraepithelial neoplasia (CIN), or normal cervical epithelial to assess clinico-pathological pattern and CXCR7 status with respect to cell differentiation and lymph node metastasis in Uighur patients with CSCC. CXCR7 and CXCL12 expression was higher in cervical cancer than CIN and normal cervical mucosa, especially in those with higher stage and lymph node metastasis. CXCL12 appeared to be positively regulated by CXCR7 at the post-transcriptional level in CSCC. We propose that aberrant expression of CXCR7 plays a role in carcinogenesis, differentiation and metastasis of CSCC, implying its use as a potential target for clinical biomarkers in differentiation and lymph node metastasis.

경추 물림 금속판을 이용한 경추 전방추체간 유합술 (Anterior Cervical interbody Fusion with Cervical Spine Locking Plate)

  • 박주태;안길영;이영태;안면환
    • Journal of Yeungnam Medical Science
    • /
    • 제14권1호
    • /
    • pp.209-219
    • /
    • 1997
  • 포항 성모병원 정형외과에서 실시한 경추 전방유합술 및 A-O금속판 고정술을 병행하여 치료하고 13개월이상(평균 20개월) 추시가 가능하였던 경추 추간판 탈출증 환자 11례 및 외상환자 3례를 대상으로 관찰하여 다음과 같은 결과를 얻었다. 1. 경추 추간판 탈출 환자 11례 중 상지 방사통을 호소한 경우가 8례이었으며 감각 둔화 및 근력약화를 호소한 환자가 3례이었다. 2. 외상의 기전으로는 굴곡 회전손상 3례이었다. 3. 고정범위는 1개 분절고정이 12례, 두개 분절고정이 2례이었으며 술후 분절수에 관계없이 필라델피아 보조기를 이용해 조기 보행을(평균 2일) 시작하였으며 이러한 조기 보행으로 인한 불편함의 호소는 없었다. 4. 골유합은 이종골을 사용한 1례에서의 불유합을 보였으나, 동종골을 사용한 13례에서는 전례 모두 유합(평균 12주)을 보임으로 이종골 보다는 동종골의 이식에서 높은 유합율을 보였다. 5. 추간판 탈출환자 전례에서 증상의 호전이 있었으며 불완전 마비가 있었던 외상환자 3례에서도 술후 추시 기간 중 Frankel분류상 B에서 C등급으로 호전되었다. 6. 술후 합병증은 금속판 파열 1례 및 일시적인 사성 2례를 제외한 환부 혈종이나 나사못 파열 등의 다른 합병증은 관찰되지 않았다. 이상의 결과를 종합해 보면 전방 도달법에 의한 전방유합술 및 물림나사와 금속판을 이용해 시술한 경추 추간판 탈출증 및 외상 환자에 있어서 수술적 치료가 안전하고 압박된 신경에 대한 감압, 충분한 안정성 확보로 인한 외고정 기간의 단축 및 신속한 골유합을 기대할 수 있는 방법이며 기존의 금속판과 달리 후방 피질골을 관통하지 않기 때문에 척수의 손상을 피할수 있으며 수술중 방사선 피폭량도 줄일수 있어 권장할 만한 방법으로 사료된다.

  • PDF

경추부에 발생한 간엽성 연골육종 - 증 례 보 고 - (Mesenchymal Chondrosarcoma of the Cervical Spine - Case Report -)

  • 권오현;김정득;박상준;김의중;윤성문
    • Journal of Korean Neurosurgical Society
    • /
    • 제30권11호
    • /
    • pp.1336-1339
    • /
    • 2001
  • Mesenchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristic of a malignant nature. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 23-year-old woman which had invaded the cervical spine. The patient presented with severe both shoulder pain, left upper extremity weakness(Grade IV) and paresthesia at admission. Radiologic studies of the cervial spine showed an aggressive osteolysis of C4 vertebral body, pedicle and lamina with compression of the spinal cord posteriorly on C3, C4, C5 levels. The tumor was totally removed by a combined anterior and posterior approach. The removed vertebral body was replaced with autogenous bone and stabilized by Codman locking plate symtem. The pathological examination showed characteristic of mesenchymal chondrosarcoma.previous symptoms well improved postoperatively. The authors present a case of mesenchymal chondrosarcoma with review of literature.

  • PDF

치경부 병소를 포함한 치은 퇴축 치료에 있어 결체 조직 이식과 수복 치료를 이용한 임상증례 (CTG and restoration in treatment of gingival recession associated with a cervical lesion: report of three cases)

  • 김은숙;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
    • /
    • 제39권4호
    • /
    • pp.437-441
    • /
    • 2009
  • Purpose: The purpose of this report is to show three cases treated by an intergrated periodontal and restorative dentistry approach. Methods: Three patients with Miller Class Ⅰgingiva recessions associated with cervical lesions were enrolled for treatment. Two patients received a connective tissue graft and resin modified glass ionomer, and one patient was treated with a connective tissue graft, resin restoration. Keratinized gingiva and relative gingival recession were measured. Results: The mean reduction of relative gingival recession was 3.7 mm, and the mean keratinized gingiva increase was 2.5 mm. The percentage of root coverage was 80% in average. No signs of gingival inflammation or bleeding on probing were seen. The patients were satisfied with the final esthetics and had no more dentin hypersensitivity. Conclusions: This report indicates that teeth with Miller ClassⅠ gingival recession associated with cervical lesions can be successfully treated by a connective tissue graft combined with restorative dentistry. However, longitudinal randomized controlled clinical trials must be performed to support this approach.

총상으로 인한 경추부 및 척수손상: 증례 보고 (A Gunshot Wounds to the Cervical Spine and the Cervical Spinal Cord: A Case Report)

  • 팽성화
    • Journal of Trauma and Injury
    • /
    • 제25권2호
    • /
    • pp.57-62
    • /
    • 2012
  • Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

Challenges of Providing Cervical Cancer Prevention Programs In Iran: A Qualitative Study

  • Bayrami, Roghieh;Taghipour, Ali;Ebrahimipour, Hossein
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권23호
    • /
    • pp.10071-10077
    • /
    • 2015
  • Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

Comparison between Anterior Cervical Decompression with Fusion and Posterior Cervical Fusion with Wide Facetectomy for Treatment of Severe Bony Foraminal Stenosis

  • Lee, Subum;Cho, Dae-Chul;Chon, Haemin;Roh, Sung Woo;Choi, Il;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
    • /
    • 제64권4호
    • /
    • pp.552-561
    • /
    • 2021
  • Objective : To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) with wide facetectomy in the treatment of parallel-shaped bony foraminal stenosis (FS). Methods : Thirty-six patients underwent surgery due to one-or-two levels of parallel-shaped cervical FS. ACDF was performed in 16 patients, and PCF using CPS was performed in 20 patients. All patients were followed up at 1, 3, 6, and 12 months postoperatively. Standardized outcome measures such as Numeric rating scale (NRS) score for arm/neck pain and Neck disability index (NDI) were evaluated. Cervical radiographs were used to compare the C2-7 Cobb's angle, segmental angle, and fusion rates. Results : There was an improvement in NRS scores after both approaches for radicular arm pain (mean change -6.78 vs. -8.14, p=0.012), neck pain (mean change -1.67 vs. -4.36, p=0.038), and NDI score (-19.69 vs. -18.15, p=0.794). The segmental angle improvement was greater in the ACDF group than in the posterior group (9.4°±2.7° vs. 3.3°±5.1°, p=0.004). However, there was no significant difference in C2-7 Cobb angle between groups (16.2°±7.9° vs. 14.8°±8.5°, p=0.142). As a complication, dysphagia was observed in one case of the ACDF group. Conclusion : In the treatment of parallel-shaped bony FS up to two surgical levels, segmental angle improvement was more favorable in patients who underwent ACDF. However, PCF with wide facetectomy using CPS should be considered as an alternative treatment option in cases where the anterior approach is burdensome.

Inhibition of Wnt/β-catenin signaling by monensin in cervical cancer

  • Bingbing Fu;Lixia Fang;Ranran Wang;Xueling Zhang
    • The Korean Journal of Physiology and Pharmacology
    • /
    • 제28권1호
    • /
    • pp.21-30
    • /
    • 2024
  • The challenging clinical outcomes associated with advanced cervical cancer underscore the need for a novel therapeutic approach. Monensin, a polyether antibiotic, has recently emerged as a promising candidate with anti-cancer properties. In line with these ongoing efforts, our study presents compelling evidence of monensin's potent efficacy in cervical cancer. Monensin exerts a pronounced inhibitory impact on proliferation and anchorage-independent growth. Additionally, monensin significantly inhibited cervical cancer growth in vivo without causing any discernible toxicity in mice. Mechanism studies show that monensin's anti-cervical cancer activity can be attributed to its capacity to inhibit the Wnt/β-catenin pathway, rather than inducing oxidative stress. Monensin effectively reduces both the levels and activity of β-catenin, and we identify Akt, rather than CK1, as the key player involved in monensin-mediated Wnt/β-catenin inhibition. Rescue studies using Wnt activator and β-catenin-overexpressing cells confirmed that β-catenin inhibition is the mechanism of monensin's action. As expected, cervical cancer cells exhibiting heightened Wnt/β-catenin activity display increased sensitivity to monensin treatment. In conclusion, our findings provide pre-clinical evidence that supports further exploration of monensin's potential for repurposing in cervical cancer therapy, particularly for patients exhibiting aberrant Wnt/β-catenin activation.

하인두 후벽암으로 오인된 경추 내고정 금속판 삽입 후 발생한 육아종 1예 (Granuloma Resulting from the Cervical Metallic Plate, Masquerading as Posterior Pharyngeal Wall Cancer)

  • 김승우;김영배;사대진
    • 대한두경부종양학회지
    • /
    • 제27권2호
    • /
    • pp.218-221
    • /
    • 2011
  • The anterior approach to the cervical spine surgery is associated with possible complications such as dysphagia, hoarseness and granuloma formation etc. Because of orthopedic metallic plates, the increasing or focal uptake pattern may be demonstrated in $^{18}F$-FDG PET/CT scan. A 67-year-old-man came to our department, complained of dysphagia during the 4 months. He underwent cervical spine surgery three years ago. The CT and MRI findings mimicked typical posterior pharyngeal wall cancer with cervical metastasis. Furthermore, the SUV in $^{18}F$-FDG PET/CT was 10.3. But he was finally diagnosed as a granuloma resulting from the metallic cervical implants. The clinical correlation and medical history should be taken into account to avoid false-positive findings in PET/CT and to avoid many erroneous diagnostic pathways.