The Role of Adjunctive Therapy of Optic Pathway Glioma in Children

OBJECTIVE: This study is performed in order to compare the outcomes of surgical management and to define the role of adjunctive therapy in the management of optic pathway glioma in children. METHODS: Sixteen children with optic pathway glioma had been managed in various treatment methods during the last 8 years. The patients aged from 5 months to 14 years. The patients presented with progressive visual loss, increased ICP symptoms, endocrine dysfunction, seizure, and motor weakness. Optic pathway glioma associated with neurofibromatosis was excluded. Tumor involved chiasmatico-hypothalamus(12 patients), optic chiasm(3), and optic nerve(1). The extent of surgical resection were radical(3 patients), subtotal(12), and partial(1). RESULTS: Three patients treated with radical resection showed no evidence of tumor recurrence. Among 12 patients treated with subtotal resection and without adjunctive therapy, 6 patients(50%) developed recurrence in the postoperative period of average 20.5 months. Those patients with recurrence were managed by reoperation(3 patients), irradiation therapy(2), and chemotherapy(1). However three patients with residual tumors after subtotal(2), or partial(1) resection were treated with adjunctive chemotherapy in the postoperative period showed no evidence of recurrence. CONCLUSION: Although radical resection of optic pathway glioma might offer long-term control of tumor, adjunctive chemotherapy could be effective to prevent tumor recurrence in children with subtotally or partially resected optic pathway glioma. More experience is necessary to determine the optimal method of treatment of optic pathway gliomas in children.

Multiple Spinal Metastases of Hemangiopericytoma: Case Report

The authors report a case of multiple spinal metastasis from a meningeal hemangiopericytoma. A 35-year-old man who had undergone radical resection of temporal hemangiopericytoma presented with a two-month history of worsening low back pain and severe radiating pain on the left leg. Radiologic examination demonstrated a tumor involving body, pedicle and facet joint on the left side of L4 compressing dural sac with large paraspinal extension. Also there was a small tumor on left side pedicle and posterior body of T10. Satisfactory results were obtained after gross total resection of tumors on both regions with posterior lumbar instrumented fusion. Unlike a well differentiated tumor on temporal lesion, the metastatic spinal lesions were anaplastic histologically. Multiple spinal metastasis should be considered after surgical treatment of cranial hemangiopericytoma.

Tibia Fractures Treated With The External Fixator / 대한정형외과학회잡지

The use of external fixator is popular in the treatment of open tibial fracture, severe comminuted fracture and segmental fracture, which minimizes further soft tissue injury and provides rigie fixation. The purpose of this study was to determine the complications and effectiveness of external fixation for treating the fractures of tibia. 33 patients with tibial fracture had been treated with external fixator from April 1993 to April 1994 at the orthopaedic department of Kang Dong Catholic General Hospital. We analysed 23 cases(21 patients) which could be followed up more than 12 months. The results were as follows; 1. Average duration with external fixator was 15.1 weeks. 2. Average time of bone union was 22.9 weeks. 3. 6 cases of pin tract infection were developed and they were treated with curettage and drainage, local antibiotics therapy, pin translation, or removal of external fixator. 4. The delayed union were developed in 5 cases, angulation deformity in 1 case, chronic osteomyelitis in 2 cases and soft tissue defect in 1 case. 5. Secondary operations caused by delayed union, valgus deformity, skin defect and bone exposure, were performed in 6 cases. 6. The use of external fixator provided good result in open fracture, intraarticular comminuted fracture, segmental fracture, and multiple injury, but chronic osteomyelitis and articular stiffness were developed in some cases.