• Title/Summary/Keyword: Medulla

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Management Outcomes of Aneurysms of Vertebral Artery and its Branches (추골동맥 및 분지부 동맥류의 치료결과)

  • Ahn, Jae Sung;Kim, Joon Soo;Kim, Jeong Hoon;Kwon, Yang;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.33-40
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    • 2001
  • Objective : Aneurysms of vertebral artery and its branches make up approximately 3% of all intracranial aneurysms. As the aneurysm have an intimate relationship with lower cranial nerves and medulla, surgical management of the aneurysms are one of the challenging neurosurgical problems. The authors analyzed the management outcomes for aneurysms arising from vertebral artery and its branches. Methods : At the authors' institution between May 1989 and Jan. 2000, 42 patients were treated with transcranial and endovascular surgery for aneurysms of vertebral artery and its branches. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : Forty two patients were comprised of 28 female and 14 male patients aged from 26-80 year old(mean : 51.8). Of the 42 patients, 37 patients(88%) had subarachnoid hemorrhage. Of the 37 patients with subarachnoid hemorrahge, 35 patients(95%) were in good neurological status(Hunt Hess grade I-III), 2 patients(5%) in poor grade(H-H grade IV-V) before operation. Location of the aneurysm were 16 in vertebral artery, 12 in vertebro-PICA junction, and 14 in the peripheral PICA. Twenty nine patients were treated with transcranial surgery and 13 patients with endovascular surgery. The management outcome of the transcranial surgery was : Glasgow outcome scale(GOS) I and II ; 24, GOS III ; 2, GOS IV ; 1 and GOS V(death) ; 2. The causes of mortality related to transcranial surgery were rebleeding after failure in clipping in one and suspected brainstem infarct in one. Morbidity was attributed to vasospasm(3), lower CN palsy(7, including temporary dysfunction) and pseudomeningocele(1). The management outcome of the endovascular surgery was : Glasgow outcome scale(GOS) I-II ; 9, GOS III ; 1, GOS IV ; 1, and GOS V(death) ; 2. The causes of mortality related to endovascular surgery were sepsis from pneumonia(1) and vasospasm(1). There were one cerebellar infarct and one lateral medullary syndrome. Conclusion : Excellent and good surgical results can be expected in 80% of the patients with aneurysms of vertebral arery and its branches. The outcomes of endovascular surgery in treating vertebral artery aneurysm were satisfactory and endovascular surgery may offer a therapeutic alternative especially in vertebral dissecting aneurysm.

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Effect of Various Divalent Ions on the Calcium Current of Adrenal Medullary Chromaffin Cells in the Rat

  • Kim, Jun;Leem, Chae-Hun;Kim, Sang-Jeong
    • The Korean Journal of Physiology
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    • v.26 no.2
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    • pp.113-122
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    • 1992
  • It is well known that chromaffin cells of adrenal medulla secrete catecholamine in response to sympathetic nerve activation and the influx of $Ca^{2+}$ through the voltage dependent $Ca^{2+}$ channels (VDCC) in the cell membrane do a major role in this secretory process. In this study, we explored the effect of divalent cations on VDCC of rat chromaffin cells. Rat (Sprague-Dawley rat, 150-250 gm) chromaffin cells were isolated and cultured. Standard giga seal, whole cell recording techniques were employed to study $Ca^{2+}$ current with external and internal solutions that could effectively isolate VDCC currents $(NMG\;in\;external\;and\;TEA\;and\;Cs^{2+}\;in\;internal\;solution)$. The voltage dependence and the inactivation time course of VDCC in our cells were identical to those of bovine chromaffin cells. A persistent inward current was first activated by depolarizing step pulse from the holding potential (H.P.) of -80 mV to -40 mV, increased to maximum amplitude at around +10 mV, and became smaller with progressively higher depolarizing pulses to reverse at around +60 mV. The inactivation time constant $(\tau)$, fitted from the long duration test potential (2 sec) was $1295.2{\pm}126.8$ msec $(n=20,\;1\;day\;of\;culture,\;mean\;{\pm}S.E.M.)$ and the kinetic parameters were not altered along the culture duration. Nicardipine $(10\;{\mu}M)$ blocked the current almost completely. Among treated divalent cations such as $Cd^{2+},\;Co^{2+},\;Ni^{2+},\;Zn^{2+}\;and\;,Mn^{2+},\;Cd^{2+}$ was the most potent blocker on VDCC. When the depolarizing step pulse from -80 mV to 10 mV was applied, the equilibrium dissociation constant $(K_d)$ of $Cd^{2+}\;was\;39\;{\mu}M,\;K_d\;of\;Co^{2+}\;was\;100\;{\mu}M\;and\;K_d\;of\;Ni^{2+}];was];780{\mu}M.$ The principal findings of this study are as follows. First, the majority of $Ca^{2+}$ channels in rat chromaffin cells are well classified to L-type $Ca^{2+}$ channel in the view of kinetics and pharmacology. Second, all divalent cations tested could block the $Ca^{2+}$ current and the most potent blocker among the tested was $Cd^{2+}$.

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Effect of Gentamicin on Sodium Transport in Human Erythrocytes (Gentamicin이 적혈구막을 통한 $Na^+$ 이동에 미치는 영향)

  • Kim, Kyung-Hyo;Park, Kae-Sook;Kim, Hee-Jin;Shin, Ho-Im;An, Mi-Ra;Kang, Bok-Soon
    • The Korean Journal of Physiology
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    • v.23 no.1
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    • pp.23-34
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    • 1989
  • Gentamicin (GM) is a polybasic, aminoglycoside antibiotic used frequently for the treatment of serious gram-negative infections. The major limiting factors in the clinical use of GM as well as other aminoglycoside antibiotics are their nephrotoxicity and ototoxicity. The primary mechanism of cell injury in aminoglycoside toxicity appears to be the disruption of normal membrane function and the inhibition of $Na^{+}-K^{+}$ ATPase activity. There are both indirect and direct evidences which suggests that the effect of aminoglycoside antibiotics on $Na^{+}-K^{+}$ ATPase may explain, or contribute to, their toxicity. It has been shown that aminoglycoside reduce total ATPase activity (Kaku et al., 1973) and $Na^{+}-K^{+}$ ATPase activity (linuma et al., 1967) in the stria vascularis and spiral ligament of the guinea-pig cochlea. Lipsky and Lietman (1980) reported that aminoglycoside antibitoics inhibited the activity of $Na^{+}-K^{+}$ ATPase in microsomal fractions of the cortex and medulla of the guinea-pig kidney, isolated rat renal tubule and human erythrocyte ghosts. The present invstigation was undertaken to elucidate the mechanism of GM on human erythrocytes by examining its effect on $Na^{+}-K^{+}$ ATPase activity, actives sodium and potassium transport across red blood cell and $^{3}H-ouabain$ binding to red blood cell membranes. The results obtained are summarized as follows: 1) CM inhibited significantly both the activity of total ATPase and $Na^{+}-K^{+}$ ATPase at all concentrations tested. 2) GM inhibited active $^{22}Na$ efflux across red blood cell. When ouabain is present, the rate of $^{22}Na$ efflux was completely inhibited. When both GM and ouabain were added, the inhibitory effect of active $^{22}Na$ efflux was more pronounced. 3) Active $^{86}Rb$ influx was inhibited significantly by GM. In the presence of ouabain, the rate of $^{86}Rb$ influx is markedly inhibited. But $^{86}Rb$ influx is not appreciably altered by the presence of both GM and ouabain. 4) In the presence of GM, $^{3}H-ouabain$ binding to red blood cell membrane increased. From the above results, it may be concluded that the inhibition of active sodium and potassium transport across red blood cell by gentamicin appears to be due to the inhibition of $Na^{+}-K^{+}$ ATPase activity and an increase in ouabain binding to red blood cell membranes.

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Heterogeneity of Renin Released from Renal Cortical Slices (고혈압백서의 신장 Renin Heterogeneity에 관하여)

  • Jeon, Chang-Yeal;Choi, Byung-Soo;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.22 no.2
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    • pp.295-305
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    • 1988
  • It has been well known that the renal cortical blood flow rate was much higher than that of the medulla and the renal blood flow distribution was affected by hemorrhage, volume expansion or salt-loading. The existance of the heterogeneities of glomerular filtration rate and nephron has also been reported. In order to understand the regulations and physiological roles of the heterogeneities, studies on the intrarenal renin-angiotensin system have been focused. Although it is well known that the granularity of iuxtaglomerular cells and renal renin content are more marked in superficial than in the deep glomeruli, their physiological significance is not quite clear. This study was therefore undertaken to clarify changes in renin response and isoelectric ronin profile to TMB-8 in outer, mid and inner cotices of normotensive and hypertensive rats. The basal rate of renin release was highest in outer cortex of Sprague-Dawley rat (SDR), Wistar rat (WR) and spontaneously hypertensive rat (SHR). The basal renin release from outer and inner cortex of SHR was significantly lower than that from those of SDR. The reponse of renin release to TM8-8 was highest in mid cortex and the increase of renin release in response to TMB-8 from inner cortex of SDR was significantly higher than that in SHR. In dehydrated rats, the basal renin release from renal cortical slices of SDR was increased but that from WR and SHR was not. The response of renin release to TMB-8 from mid and inner cortex of dehydrated WR tended to increase. In dehyrated SHR, increase of renin release from inner cortex was significantly higher than that in euhydrated SHR. No significant differences in the isoelectric renin profile were found both in different cortical areas and strains. In dehydrated rats, the percentage of renin form 2 was decreased and those of renin form 5 and 6 were increased. These results suggest that the heterogeneity of renin release from cortical area of euhydrated and dehydrated rats in response to TMB-8 may be related to the changes of renal blood flow and/or calcium metabolism in cortical area. These data also suggest that the renin forms with different isoelectric points may have an physiological significance.

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Course and Distribution of Facial Nerve of the Korean Native Goat (한국재래산양 두부의 안면신경 분포에 관한 해부학적 연구)

  • Lee, Heung-shik;Lee, In-se;Kim, Dae-joong
    • Korean Journal of Veterinary Research
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    • v.26 no.1
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    • pp.1-9
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    • 1986
  • This study was carried out to investigate the branch and distribution of Nervus facialis of the Korean native goat. The observation was made by dissection of embalmed cadavers of ten Korean native goats. The results were as follows; 1. N. facialis arose from the ventrolateral surface of the medulla oblongata. 2. In the facial canal, N. facialis gave off N. petrosus major, N. stapedius and Chorda tympani. 1) N. petrosus major arose from Ganglion geniculi, passed through the pterygoid canal and terminated in Ganglion pterygopalatinum. 2) Chorda tympani joined N. lingualis at the lateral surface of the internal pterygoid muscle. 3. At the exit of the stylomastoid foramen, N. facialis gave off N. caudalis auricularis, Ramus auricularis internus, Ramus stylohyoideus and Ramus digastricus. 1) N. caudalis auricularis arose by two branches in 6 cases and by a single branch in 4 cases. N. caudalis auricularis gave off branches to the caudoauricuIar muscles and the internal surface of the conchal cavity. 2) Ramus auricularis internus arose by a single branch except in 2 cases in which it arose in common with N. caudalis auricularis. It penetrated the caudolateral surface of the tragus and distributed in the skin of the scapha. 3) Ramus stylohyoideus and Ramus digastricus arose separately from N. facialis. 4. In the deep surface of the parotid gland, N. facialis divided into N. auriculopalpebralis, Ramus buccalis dorsalis and Ramus buccalis ventralis. In 6 cases, N. facialis gave off Ramus buccalis ventralis and then divided into N. auriculopalpebralis and Ramus buccalis dorsalis. In 3 cases, N. facialis trifurcated into Ramus buccalis ventralis, Ramus buccalis dorsalis and N. auriculopalpebralis. In one case, N. facialis gave off N. auriculopalpebralis and then divided into Ramus buccalis dorsalis and Ramus buccalis ventralis. 1) Ramus buccalis ventralis ran along the ventral border of the masseter muscle and distributed to the buccinator and depressor labii inferioris muscles. Ramus buccalis ventralis communicated with a branch of Ramus buccalis dorsalis and N. buccalis. In 2 cases, it also communicated with N. mylohyoideus. 2) Ramus buccalis dorsalis communicated with Ramus transverses faciei, N. buccalis, N. infraorbitalis and a branch of Ramus buccalis ventralis. Ramus buccalis dorsalis distributed to the orbicularis oris, caninus, depressor labii inferioris, levator labii superioris, buccinator, malaris, nasolabialis and zygomaticus muscles. 3) N. auriculopalpebralis gave off Rami auriculares rostrales, which supplied the zygomaticoauricularis muscle, the frontoscutularis muscle and the skin of the base of the ear. N. auriculopalpebralis then continued as Ramus zygomaticus, which innervated the frontal muscle, the lateral surface of the base of the horn, the orbicularis oculi muscle and the adjacent skin of the orbit. N. auriculopalpebralis communicated with Nn. auriculares rostrales and Ramus zygomaticotemporalis. In 7 cases, it also communicated with N. infratrochlearis.

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Effects of the Thyroid Function on the Adrenal Gland, Hypophysis and Gonads in the Guinea Pigs. 1 Effects of the Thyroid Function on the Adrenal Gland in the Guinea Pigs (Guinea pig의 갑상선기능(甲狀腺機能)이 부신(副腎), 뇌하수체(腦下垂體) 및 생식선(生殖腺)에 미치는 영향(影響) I. Guinea pig의 갑상선(甲狀腺)이 부신(副腎)에 미치는 영향(影響))

  • Lee, Kang Wook;Lee, Kyu Sung;Cheong, Young Chai
    • Korean Journal of Veterinary Research
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    • v.8 no.2
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    • pp.110-116
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    • 1968
  • The mature guinea pigs were grouped as indicated in the table 1. Radio-active iodine(I-131)in dose of 4.5mci, was administered to the experimental groups. The animals were killed for examination in 1, 7, 14, 28, 42, and 55 days after the administration the radio-active iodine. The thyroid and adrenal glands were observed histologically. The results obtained were as follows; 1. One day after the administration, thyroid epithelial cells were abnormally enlarged. After seven days, specimens taken from the middle of the thyroid showed that the follicles and epithelial cells were changing to fibrous tissue, however, some follicles still remained in the verge of the thyroid. Follicles were not observed after fourteen days. After twenty-eight days, the follicles had all changed to fibrous tissue, and had lost their function. 2. The size of the zonas gromerulosa of adrenal cortex epually, in both male and female, showed slight fluctuation in size with no tendency to be changed. 3. Among the zones of the adrenal glands, zona fasciculata showed marked changes. Zona fasciculata was atrophied in Process of time. In females, it was atrophied significantly(P<0.05) after fourteen days, and highly significant (P<0.01) in twenty-eight and fifty-six days after the administration of radioactive iodine. In males, it also decreased significantly(P<0.05) in seventy-eight days and highly significant(P<0.01) in forty-two and fifty-six days after the administration. 4. The size of the Zona reticularis of adrenal cortex in the females increased significantly (P<0.05) in twenty-eight days after the administration. In males, it showed slight fluctuation until twenty-eight days, but it increased significantly(P<0.05) in forty-two and fifty-six days after the administration. 5. The size of the adrenal medulla increased significantly(P<0.05) in twenty-eight and forty-two days in females. It was increased significantly(P<0.05) in fourth-two days and high significantly(P<0.01) in fifty-six days after the administration.

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Gamma Knife Radiosurgery for Brainstem Metastasis

  • Yoo, Tae-Won;Park, Eun-Suk;Kwon, Do-Hoon;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.299-303
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    • 2011
  • Objective : Brainstem metastases are rarely operable and generally unresponsive to conventional radiation therapy or chemotherapy. Recently, Gamma Knife Radiosurgery (GKRS) was used as feasible treatment option for brainstem metastasis. The present study evaluated our experience of brainstem metastasis which was treated with GKRS. Methods : Between November 1992 and June 2010, 32 patients (23 men and 9 women, mean age 56.1 years, range 39-73) were treated with GKRS for brainstem metastases. There were metastatic lesions in pons in 23, the midbrain in 6, and the medulla oblongata in 3 patients, respectively. The primary tumor site was lung in 21, breast in 3, kidney in 2 and other locations in 6 patients. The mean tumor volume was $1,517mm^3$ (range, 9-6,000), and the mean marginal dose was 15.9 Gy (range, 6-23). Magnetic Resonance Imaging (MRI) was obtained every 2-3 months following GKRS. Follow-up MRI was possible in 24 patients at a mean follow-up duration of 12.0 months (range, 1-45). Kaplan-Meier survival analysis was used to evaluate the prognostic factors. Results : Follow-up MRI showed tumor disappearance in 6, tumor shrinkage in 14, no change in tumor size in 1, and tumor growth in 3 patients, which translated into a local tumor control rate of 87.5% (21 of 24 tumors). The mean progression free survival was 12.2 months (range, 2-45) after GKRS. Nine patients were alive at the completion of the study, and the overall mean survival time after GKRS was 7.7 months (range, 1-22). One patient with metastatic melanoma experienced intratumoral hemorrhage during the follow-up period. Survival was found to be associated with score of more than 70 on Karnofsky performance status and low recursive partitioning analysis class (class 1 or 2), in terms of favorable prognostic factors. Conclusion : GKRS was found to be safe and effective for management of brainstem metastasis. The integral clinical status of patient seems to be important in determining the overall survival time.

Mitogenic and Cytotoxic Effect of pure Fumonisin B$_1$, a carcinogen, in Sprague-Dawley Rats. (Fumonisin B$_1$의 SD흰쥐에 대한 세포분열과 세포독성작용)

  • Lim, Chae Woong;Has;Rim, Byung Moo
    • Environmental Mutagens and Carcinogens
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    • v.16 no.1
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    • pp.1-5
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    • 1996
  • Fumonisin B$_1$ is hepatotoxic in all species, but liver carcinogenic and nephrotoxic in rat. Our objective was to investigate the effects of multiple iv dose of FB$_1$. Male Sprague-Dawley rats were injected intravenously (iv) with FB$_1$ at 1 mg/kg singly (T1), or daily for 2 (T2) or 3 (T3). T1 rats did not show any cytotoxicity in both liver and kidney. However, the most dramatic change occurred in this group was mitotic figures in liver, which increased 5.5-fold to that of control. Hepatotoxic effects were shown in T3, based on histopathology and serum chemistry. A few scattered single cell deaths occurred primarily in the centrilobular area of the liver in T2. Similar but more lesions in liver and a small number of degenerating cells with hypereosinophilic cytoplasm in outer stripe of medulla of kideny were found in T3 rats. Serum chemical profiles included liver enzymes increased, in which cholesterol was very sensitive. This study suggests that multiple exposure of low dose FB$_1$ cause cytotoxic in the liver earlier time point than kideny. FB$_1$$ also stimulates mitosis in liver that may be associated with carcinogenesis.

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Studies on the Relationship of the Central Neural Pathways to the Urinary Bladder and Wijung($BL_{40}$) (방광(膀胱)과 위중(委中)의 중추신경로와의 연계성에 관한 연구)

  • Lee, Chang-Hyun;Kim, Ho;Lee, Kwang-Gyu;Jeong, Han-Sol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.805-817
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    • 2009
  • This study was to investigate central localization of neurons projecting to the urinary bladder and urinary bladder-related acupoints(Wijung, $BL_{40}$) and neurons of immunoreactive to hormones and hormone receptors regulating urinary bladder function by using peudorabies virus(PRV). In this experiment, Bartha's strain of pseudorabies virus was used in rats to trace central localization of urinary bladder-related neurons and urinary bladder-related acupoints($BL_{40}$) which can regulate urinary system. PRV was injected into the urinary bladder and acupoints($BL_{40}$) related urinary system. After six days survival of rats, mainly common labeled neurons projecting to the urinary bladder and urinary bladder-related acupoints were identified in spinal cord, medulla, pons and diencephalon by PRV immunohistochemical staining method. First-order PRV labeled neurons projecting to urinary bladder and urinary bladder-related acupoints were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled preganglionic neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in the lateral horn area(sacral parasympathetic nucleus and intermediolateral nucleus), lamina V-X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting to urinary bladder and Wijung($BL_{40}$) was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus of tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, Barrington's nucleus and periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the paraventricular nucleus and a few ones were in the lateral hypothalamic nucleus, posterior hypothalamic nucleus, ventromedial hypothalamic nucleus, arcuate nucleus, median eminence, perifornical nucleus, periventricular nucleus and suprachiasmatic nucleus. In cerebral cortex, PRV labeled neurons were marked mostly in the frontal cortex, 1,2 area, hind limb area, agranular insular cortex. Immunoreactive neurons to Corticotropin releasiing factor(CRF), Corticotropin releasiing factor-receptor(CRF-R), c-fos and serotonin were a part of labeled areas among the virus-labeled neurons of urinary bladder and Wijung($BL_{40}$). The commonly labeled areas were nucleus tractus solitarius, area postrema, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), locus coeruleus, A5 cell group, Barrington,s nucleus, arcuate nucleus, paraventricular nucleus, frontal cortex 1, 2 area, hind limb, and perirhinal(agranular insular) cortex. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of urinary bladder-relate organs and it was revealed by tracing PRV labeled neurons projecting urinary bladder and urinary bladder-related acupoints. These commonly labeled areas often overlap with the neurons connected with hormones and hormone receptors related to urination.

Reconstruction with Extracorporeally Radiated Autogenous Bone Graft After Wide Resection of Bone Tumors (골종양 절제후 방사선 조사한 자가골을 이용한 재건술)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Kim, Sug-Jun;Lee, Soo-Yong;Yang, Hyun-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.32-38
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    • 1997
  • PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

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