Analysis of Survival and Prognostic Factors in Patients of Pulmonary Metastasis from Osteosarcoma / 대한정형외과학회잡지

PURPOSE: We analyzed survival rates and the prognostic factors of pulmonary metastases from osteosarcoma. MATERIALS AND METHODS: Between 1989 and 2001, of 312 patients who were diagnosed and treated for osteosarcoma in our institute, 35 patients with pulmonary metastases were included in the present study. We examined the overall survival rates and analyzed prognostic factors, such as age, gender, chemotherapeutic response, number of the pulmonary lesions, and disease-free interval. RESULTS: Overall 3-year and 5-year survival rates were 62.3% and 39.3%. Patients treated with thoracotomy and chemotherapy seemed to survive longer than patients without thoracic surgery. In the thoracostomy group, the degree of tumor necrosis after neoadjuvant chemotherapy, the number of metastatic nodules, and the tumor free interval were meaningful factors of survival. CONCLUSIONS: In osteosarcoma with pulmonary metastasis, complete metastatectomy and intensive postoperative chemotherapy can improve survival in selected patients.

Differences of Meniscal Injuries by Age Groups

PURPOSE: We analyzed and classified the patterns of meniscal injuries by age groups and tried to find the statistical meanings. MATERIALS AND METHODS: We reviewed 217 cases with meniscal injuries of 340 patients who received knee arthroscopy from January 1996 to June 2000. We analyzed the statistical significances of them by age groups and classified injury patterns of site, shape and combined injuries. RESULTS: Medial meniscal injuries, especially in posterior horn, were more common, and degenerative tears have higher incidence in elderly groups. In younger groups, longitudinal and flap tears were more common. More prevalent associated injuries were ACL tears in younger groups and loose bodies in elderly groups. CONCLUSION: In knee arthroscopy, to find out the patterns of meniscal injuries by age groups is important to determine the method of treatment and prognosis.

Epidural Hemangioma: A Case Report / 대한척추외과학회지

STUDY DESIGN: A case report and review of the literature. OBJECTIVES: To discuss an epidural hemangioma and review the literature. MATERIAL AND METHOD: A 56-year-old woman had back pain and pain radiating to the left lower extremity that had gradually worse over 2 weeks. No definite history of trauma was disclosed. The straight leg raising test was positive at 60degree on the left side. Sensation to pinprick was diminished in the L5, S1 dermatome on her left leg. Examination of the left leg revealed weakness of the extensor hallucis longus(3/5 strength). Plain films of the lumbar spine showed degenerative scoliosis and degenerative L4-5 spondylolisthesis with no bone involvement. In retrospective study, T1-,T2-weighted image showed a hyperintense signal mass, unlike an usual MR imaging of epidural hemangioma. A preoperative diagnosis of spondylolisthesis with spinal stenosis was made. RESULTS: The mass compressing L5 root was excised through posterior approach and the fusion was performed from L4 to S1 with bone graft, instumentation. A purple encapsulated tumor, size 1.5x1x.8cm, was found. Histopathologic examination revealed a thin walled sinusoidal vascular space of varying sizes, lined with a single layer of endothelial cells, consistent with typical hemangioma. The patient had a complete neurologic recovery and is doing well 5 months after surgery. CONCLUSIONS: Although the diagnosis of epidural hemangioma was difficult, because of the rarity of that, we should pay attention to awareness of the possibility of such lesion, differential diagnosis in clinical manifestration, neuroradiologic study.