• 제목/요약/키워드: Neck Bone

검색결과 620건 처리시간 0.029초

지방육종의 치료에서 술후 방사선 치료의 역할 (Role of Post-operative Irradiation in Treatment of Liposarcoma)

  • 강용구;박원종;송석환;김형민;이승구;우영균;김정만;문명상;인용
    • 대한골관절종양학회지
    • /
    • 제1권2호
    • /
    • pp.194-199
    • /
    • 1995
  • To evaluate the role of post-operative irradiation in reducing local recurrence after surgical treatment of liposarcoma, 19 patients who were treated between July 1988 and June 1994 at Department of Orthopedic Surgery, Catholic University were studied retrospectively. The average follow up was 31 months. 1. There were 14 males and 5 females and an average age was 51 years old. 2. Thirteen cases were in extremities and buttock, 3 in neck, 2 in retroperitoneum and 1 in back. 3. Histologic types were 16 cases of myxoid type and 3 cases of well differentiated type. 4. Ten cases were achieved with wide margin and 9 with inadequate(intralesional or marginal) margin. 5. There were no local recurrence in 10 cases with wide margin, whereas 6(67%) local recurrences in 9 cases with inadequate margin. 6. Among 6 cases of local recurrence, 5 cases had been treated with post-operative irradiation. In conclusion, post-operative irradiation for inadequate margin(intralesional or marginal margin) was not sufficient to reducing local recurrence.

  • PDF

제 1, 2 경추간 판하철사고정술 없는 후방 경관절 나사못 고정술 및 골유합술 (Posterior C1-2 Transarticular Screw Fixation without C1-2 Sublaminar Wiring in Atlantoaxial Instability)

  • 신용환;황정현;성주경;황성규;함인석;박연묵;김승래
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권11호
    • /
    • pp.1469-1475
    • /
    • 2000
  • Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

  • PDF

칼돌기 통증 - 2예 보고 - (Xiphodynia - 2 cases report -)

  • 이승진;김동현;이석열;이철세
    • Journal of Chest Surgery
    • /
    • 제42권2호
    • /
    • pp.272-274
    • /
    • 2009
  • 칼돌기 부위에 고통을 느끼는 칼돌기 통증은 흔하지 않은 근골격계 질환으로 전흉부와 상복부, 목, 양측 어깨, 등으로 통증이 방사될 수 있다. 진단에서 중요한 것은 이러한 통증이 칼돌기의 이상에 의해서 발생할 수 있다는 것을 임상적으로 알고 있어야 한다는 것이다. 2 증례의 칼돌기 통증 환자를 경험하였는데, 칼돌기 부위를 가볍게 누르면 전흉부와 상복부의 통증이 반복적으로 재생산될 때 진단하였다. 수년간 칼돌기 통증으로 고통 받아 왔던 첫번째 증례 환자에서는 칼돌기 제거수술을 하였고, 두번째 증례 환자에서는 국소마취제를 주사하여 치료하였다.

고용량 모르핀의 지속적 경막외주입에 의한 암성 통증 조절 -증례보고- (Epidural Analgesia Using High Dose Morphine in a Terminal Lung Cancer Patient -A case report-)

  • 이지연;신혜란;김태정;차영덕;송하나;양춘우
    • The Korean Journal of Pain
    • /
    • 제19권1호
    • /
    • pp.96-100
    • /
    • 2006
  • Pain control is very important in managing terminal cancer patients and there are several modalities to alleviate their pain. A high dosage of epidural morphine is effective to control terminal cancer pain. Furthermore, to decrease the amount of morphine, adding an alternative adjuvant like ketamine to the morphine regimen is considered helpful for controlling the pain of a terminal cancer patient. A 45 year old male patient with terminal lung cancer had neck pain that was caused by multiple bone metastases. Continuous epidural block was started with 2 mg/day of morphine and the dosage was gradually increased to 90 mg/day in 86 days. 30 mg/day of ketamine was then added to it. Overall, the morphine and ketamine dosages were increased to 564 mg/day and 140 mg/day, respectively, in 11 months until the patient expired. In this case, the high dosage of epidural morphine, 580 mg/day, was administered to control cancer pain without any severe adverse effects.

Growth, Feed Conversion Efficiency and Carcass Characteristics of Malpura and Malpura × Awassi Crossbred Lambs in a Hot Semi Arid Environment

  • Karim, S.A.;Santra, A.;Verma, D.L.
    • Asian-Australasian Journal of Animal Sciences
    • /
    • 제15권3호
    • /
    • pp.377-381
    • /
    • 2002
  • The growth rate, feed conversion efficiency and carcass characteristics of nine native Malpura (M) and eight Awassi ${\times}$ Malpura half bred (AM) male lambs were compared under intensive feeding on 60:40 concentrate and roughage based composite feed. Weaning body weight was similar in the two genetic groups while finishing body weight, total body weight gain and average daily gain during the experiment were higher (p<0.01) in AM than M lambs. The feed conversion efficiency was lower in M than AM lambs with 15.7 and 19.8 per cent feed conversion efficiency, respectively, in the two genetic groups. The dressing yield in terms of preslaughter weight or empty live weight was however similar in the two genetic groups. The loin eye area was also greater (p<0.01) in AM than M lambs. The cutability was similar for the two groups amounting to 33.2, 13.3, 13.2, 23.3 and 16.6% of half carcass, respectively, for leg, loin, rack, neck and shoulder and breast and foreshank. On an average the separable lean, fat and KOH bone content of the half carcass were 48.3, 16.8 and 23.3% for native M and 54.1, 15.0 and 19.0% for AM lambs, respectively. It is concluded that growth rate and feed conversion efficiency were better in Awassi ${\times}$ Malpura half bred than native Malpura lambs while dressing yield and cutability of standard cuts were similar in the two genetic groups.

A Morphologically Atypical Case of Atlantoaxial Rotatory Subluxation

  • Umebayashi, Daisuke;Hara, Masahito;Nishimura, Yusuke;Wakabayashi, Toshihiko
    • Journal of Korean Neurosurgical Society
    • /
    • 제55권5호
    • /
    • pp.284-288
    • /
    • 2014
  • A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.

Treatment and Outcomes of Ewing Sarcoma in Turkish Adults: A Single Centre Experience

  • Seker, Mehmet Metin;Kos, Tugba;Ozdemir, Nuriye;Seker, Ayse;Aksoy, Sercan;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권1호
    • /
    • pp.327-330
    • /
    • 2014
  • Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

공기 전도형 출력을 갖는 정원창 자극형 인공중이의 출력방식 제안 (A Proposal of Output Method of Round Window Stimulation Type Middle Ear Implants using Acoustic Transmission)

  • 성기웅;이규엽;김명남;조진호
    • 한국멀티미디어학회논문지
    • /
    • 제21권6호
    • /
    • pp.678-684
    • /
    • 2018
  • In order to broaden the indication of middle ear implant, research has been actively conducted on the reverse output method that stimulates the round window. However, it is very difficult to transmit the vibration output effectively because the indivisual anatomical difference of the round window niche is very large and also the visual field is not secured even by a skilled otolaryngologic surgeon. In this paper, we propose a new reverse stimulation method of middle ear implants that transmits energy to the inner ear by using air as a medium. This can compensate for the disadvantages of the conventional method of transmitting vibration energy and minimizes the energy transfer efficiency interference due to the combination of the excitation point and the output device. It was shown that forward and backward transfer characteristics were obtained by cadaveric experiments, and it was shown that it can overcome the acoustical impedance of high round window and transmit energy to inner ear. The receiver, which is the output device of the conventional hearing aids, can generate a constant volume velocity, so it can have a high output at a limited volume, such as a round window niche. So, suggested method can overcome the high acoustical impedance of the round window and deliver acoustic energy to the inner ear.

Management of Unilateral Facet Dislocation of the Cervical Spine

  • Baek, Geum-Seong;Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
    • /
    • 제41권5호
    • /
    • pp.295-300
    • /
    • 2007
  • Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

Effect of Histone Deacetylase Inhibitors on Differentiation of Human Bone Marrow-derived Stem Cells Into Neuron-like Cells

  • Jang, Sujeong;Park, Seokho;Cho, Hyong-Ho;Yang, Ung;Kang, Maru;Park, Jong-Seong;Park, Sah-Hoon;Jeong, Han-Seong
    • 통합자연과학논문집
    • /
    • 제12권4호
    • /
    • pp.133-141
    • /
    • 2019
  • Mesenchymal stem cells (MSCs) are known to differentiate into multiple lineages, making neurogenic differentiation an important target in the clinical field. In the present study, we induced the neurogenic differentiation of cells using histone deacetylase (HDAC) inhibitors and studied their mechanisms for further differentiation in vitro. We treated cells with the HDAC inhibitors, MS-275 and NaB; and found that the cells had neuron-like features such as distinct bipolar or multipolar morphologies with branched processes. The mRNA expressions encoding for NEFL, MAP2, TUJ1, OLIG2, and SYT was significantly increased following HDAC inhibitors treatment compared to without HDAC inhibitors; high protein levels of MAP2 and Tuj1 were detected by immunofluorescence staining. We examined the mechanisms of differentiation and found that the Wnt signaling pathway and downstream mitogen-activate protein kinase were involved in neurogenic differentiation of MSCs. Importantly, Wnt4, Wnt5a/b, and Wnt11 protein levels were highly increased after treatment with NaB; signals were activated through the regulation of Dvl2 and Dvl3. Interestingly, NaB treatment increased the levels of JNK and upregulated JNK phosphorylation. After MS-275 treatment, Wnt protein levels were decreased and GSK-3β was phosphorylated. In this cell, HDAC inhibitors controlled the non-canonical Wnt expression by activating JNK phosphorylation and the canonical Wnt signaling by targeting GSK-3β.