Percutaneous vertebroplasty at C7 for the treatment of painful metastases: A case report / 대한마취과학회지

The cervical spine is a less common site for metastatic disease than is the thoracolumbar spine. Percutaneous vertebroplasty (PVP) in the cervical spine can be performed using an anteromedial or lateral approach. A 51-year-old woman with breast cancer had been experiencing severe weight-bearing neck pain for 2 months, even after undergoing radiation therapy. Imaging studies revealed an osteolytic compression fracture in the C7 vertebra. For performing PVP at C7 using the anteromedial approach, a needle was inserted from the left side of the patient's neck. The needle was advanced to the anterior 1/3 anterior 1/3 or 1/2 of the vertebral body by hammering, and approximately 2 ml of cement was injected. Immediately after the operation, the patient could move her neck without pain. In conclusion, PVP using an anterolateral approach may be an option for treating metastatic osteolytic vertebral lesions in the cervical spine for alleviating intractable axial neck pain.

Amatoxins Poisonings in Korea / 대한간학회지

BACKGROUND/AIMS: From the review of Korean literature most fatal mushroom poisonings have been due to amatoxins with high mortality. So far there have never been investigations on the amatoxins poisonings such as annual incidence, mortality, common causal species, and endemic areas. This study was carried out to develop some basic statistics as part of studies for an effective management of amatoxins intoxications. METHOD: For the year 1999 authors collected cases of mushroom poisonings which had been mainly gathered from hospitals nation-wide. All of the cases with suggestive amatoxins poisonings were screened by symptomatology and laboratory findings. The causal species of mushrooms were identified grossly and microscopically. RESULTS: A total of 54 victims with mushroom poisonings were evaluated. The causal mushroom toxins were diagnosed or strongly suggested as amatoxins in 43 of 54 victims. Eleven of 54 victims did not conform to the category of amatoxins intoxication due to absent or minimal elevation of aminotransferase. Mean age of the victims was 44.3 23.3 (range: 7-78) with male predominance (1.2 : 1). The causal species were confirmed, or strongly suggested, as Amanita virosa in 25 victims, Amanita subjunquillea in 14, and unknown species in 4. Thirty-five out of a total of 43 were regarded as moderate to severe intoxication (AST or ALT >1,000 IU/L) with 20% mortality. Most fatal victims showed marked thrombocytopenia (40,000 19,000/mm3) compared to non-fatal victims (109,066 42,245/mm3). A total of 88.4% of victims was developed in the Kangwon and Kyungpuk provinces. Both are west of the Taebaek Mountains (38/43). CONCLUSIONS: Although the common causal species for amatoxins poisonings in Korea are different from European countries and North America, the mortality is similar to that of those areas. In order to further reduce the mortality, bedside diagnostic methods using biological fluids and more effective therapy for liver failure should be established.

The effect of tensile force on dna and protein synthesis in bone cells / 대한치과교정학회지

The present study was undertaken to determine the effect of tensile force on DNA and protein biosynthesis in bone cells, and to identify the cell type(s) which primarily respond to external physical force among the heterogenous bone cell populations. As a prerequisite for this study, two bone cell populations which retain fibroblastic and osteoblastic feature were isolated from fetal rat calvaria with sequential enzyme digestion scheme. Tensile force was delivered to each bone cell population by two acrylic resin plates connected with a orthodontic expansion screw during culture period. Rate of DNA and protein synthesis in each bone cell population were assessed by the incorporated radioactivity of [3H]-thymidine into DNA and [3H]-proline into fraction of collagenase-digestible protein and noncollagenous protein, respectively. DNA synthesis of osteoblast-like calvarial cell populations was increased significantly by the application of tensile force for 24 hours. In contrast, no alteration in DNA synthesis of fibroblast-like populations could be observed in response to applied force. Tensile force induced the change in protein synthesis of bone cell populations with the same pattern. Total protein and collagen synthesis were increased within 24 hours in osteoblast-like populations, but not in fibroblast-like populations by tensile force application. These findings indicate that physical force can affect cellullar activity of the particular cell population, not all cell populations residing in bone and osteoblasts respond more sensitively than fibroblasts. So osteoblasts can modulate the behavior of other bone cells including osteoclasts by producing several local regulating factors of bone metabolism. In this context, preferential responsiveness of osteoblasts to applied tensile force observed in this study suggests that osteoblasts may play an important role in regulation of physical force-induced remodeling process.