It is generally accepted that trochanteric fractures are best treated by internal fixation as it provide satisfactory reduction and fixation of the fractures allowing early mobilization of the patient thus avoiding general and local complication following this sort of trauma. Fourty-seven cases of trochanteric fracture of the femur were treated at the Department of Orthopedic Surgery, Paik Hospital, Seoul, Inje Medical College from June 1974 to June 1982 and clinical analysis was made with particular emphasis on the comparision between compression hip screw fixation and Jewett nail technique. The result of the analysis are as follows: l. 63% of the male patient belongs to active age group in contrary to common belief in age incidence and the common causes of the injury was traffic accidents and fall from height. 2. By the Tronzo classification of the intertrochanteric fracture, the most common type is type III and type V was predomonant in the traffic accidents group and 87% of all cases belongs to unstable category. 3. Of the seventeen associated injuries, visceral injuries, fracture of the lower extremities, fractures of the upper extremities, fractures of the pelvis were observed in order of frequency. 4. More general complications were observed among the conservatively treated group and local complications occurred mainly in the group treated with Jewett naiL 5. The compression hip screw method seemed to be superior to Jewett nail owi#ng to shorter operation time, less blood loss and less complications. 6. Ender nail appears to be a promising method of treatment in the elderly patient because it had shorter operation time, negligible blood loss, minimal stress to the patient and early mobilization and weight bearing.
Accidents, Traffic ; Aged ; Classification ; Clinical Study ; Early Ambulation ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Lower Extremity ; Male ; Methods ; Orthopedics ; Pelvis ; Seoul ; Upper Extremity ; Weight-Bearing

BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

Pulmonary siderosis is one kind of pneumoconiosis caused by the long term inhalation of iron dust. Iron is deposited in the lungs, usually in the form of iron oxides. Iron oxides are relatively inert particles with a minimal fibrotic response. It occurs in a number of occupations including welding, steel rolling and grinding, casting, iron ore mining and oxyacetylene cutters. We have experienced the first case of pulmonary siderosis in Korea. A 42-year-old woman who had engaged in a metalware manufacturing factory as a manager for 7 years was admitted because of dyspnea on exertion. A pulmonary function test disclosed a mildly obstructive ventilatory defect. Open lung biosy revealed deposition of iron-laden macrophages in most alveolar spaces by which confirmed the diagnosis of pulmonary siderosis. We report a case of pulmonary siderosis with a review of the literature.
Adult ; Diagnosis ; Dust ; Dyspnea ; Female ; Humans ; Inhalation ; Iron ; Korea ; Lung ; Macrophages ; Mining ; Occupations ; Oxides ; Pneumoconiosis ; Respiratory Function Tests ; Siderosis* ; Steel ; Welding

Some researchers tried to use Tc-99m MIBI scintigraphy for evaluating breast cancer patients Early reports revealed that Tc-99m MIBI breast scintigraphy is useful in distinguishing malignancies from benign masses in patients who have difficulty in mammographic evaluation. Further studies suggested that the functional imaging with Tc-99m MIBI in breast cancer seems to be correlated with levels of P-glycoprotein (Pgp) expression and angiogenesis in cancer tissues. So we evaluated whether there is an actually significant relationship between the pattern of Tc-99m MIBI uptake in tumor tissue and tumoric factors including Pgp expression and angiogenesis. Thirty one untreated breast cancer patients (pathologically proved to invasive ductal carcinoma later) were prospectively studied by both Tc-99m MIBI scintigraphy and immunohistochemical analysis of angiogenesis and Pgp expression on sugically removed tumor tissues. Both lateral and anterior planar images were obtained at 10 minutes and 3 hours after intravenous injection of 740 MBq Tc-99m MIBI. Tumor-to-normal breast ratio(T/N) and washout index (WI, early T/N minus late T/N divided by early T/N) were calcuated. The results were follows; A significant correlation was found between T/N at early and late images(r=0.54, p=0.002 on early images, r=0.47, p=0.008 on late images). T/N of early images were not different among different groups of Pgp expression(p=0.3696), while those of late images were significantly different among groups(p=0.0276). Even more significant difference of WI among the groups were noted (p=0.0015). A significant negative correlation was noted between T/N of late images and Pgp expression (p=0.00276). A even stronger correlation was found between WI and Pgp expression (r=0.68, p=0.001). In conclusion, the tumoral uptake and washout of Tc-99m MIBI can be used as a simple functional test for angiogenesis and P-glycoprotein expression in untreated breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Humans ; Injections, Intravenous ; P-Glycoprotein ; Population Characteristics* ; Prospective Studies ; Radionuclide Imaging*

PURPOSE: Although percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL. MATERIALS AND METHODS: The medical records of 370 patients who underwent PCNL by a single surgeon from January 2005 to December 2010 were reviewed retrospectively. All patients were divided into two groups according to median blood loss (lesser bleeding group and higher bleeding group). Various clinical and perioperative factors including age, sex, stone size and position, degree of hydronephrosis, operative time, underlying disease, history of anticoagulant medication, presence of previous nephrostomy catheter, stone composition, and thickness of the renal cortex were assessed. For statistical assessment, univariate and multivariate logistic regression analyses were used. RESULTS: The mean patient age was 48.8 years (range, 22 to 75 years). Forty-three patients (11.6%) received a transfusion and 9 patients (2.4%) underwent angioembolization after surgery. The mean blood loss was 511.8+/-341.3 mL. Body mass index (BMI), stone size, stone position, operation time, and degree of preoperative hydronephrosis were predictive factors for severe bleeding during PCNL. CONCLUSIONS: On the basis of the results achieved by a single surgeon, staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with the risk of severe bleeding during PCNL.
Body Mass Index ; Catheters ; Hemorrhage ; Humans ; Hydronephrosis ; Incidence ; Kidney Calculi ; Logistic Models ; Medical Records ; Nephrostomy, Percutaneous ; Operative Time ; Retrospective Studies

An irreducible ankle dislocation is a rare injury. The cause is a dislocation of the distal fibula anteriorly or posteriorly or the insertion of soft tissue, such as the deltoid ligament or posteromedial tendon. The tibialis posterior tendon can be dislocated through distal tibiofibular diastasis and prevent reduction of the ankle joint. The authors experienced anterolateral ankle fracture dislocation with a diastasis of the distal tibiofibular joint, and reduction was impossible because of impingement of the tibialis posterior tendon dislocated anteriorly through the distal tibiofibular diastasis. This paper reports the treatment of this injury.

BACKGROUND: Stellate ganglion block is usually performed at the transverse process of C6, because the vertebral artery is located anterior to the transverse process of C7. The purpose of this study is to estimate the location of the transverse process of C6 using the cricoid cartilage in the performance of stellate ganglion block. METHODS: We reviewed cervical lateral neutral-flexion-extension views of 48 patients who visited our pain clinic between January and June of 2010. We drew a horizontal line at the surface of the cricoid cartilage in the neutral and extension views of cervical lateral x-rays. We then measured the change in the shortest distance from this horizontal line to the lowest point of the transverse process of C6 between the neutral and extension views. RESULTS: There was a statistically significant difference in the shortest distance from the horizontal line at the surface of the cricoid cartilage to the lowest point of transverse process of C6 between neutral position and neck extension position in both males and females, and between males and females in both neutral position and neck extension position. The cricoid cartilage level was 4.8 mm lower in males and 14.4 mm higher in females than the lowest point of transverse process of C6 in neck extension position. CONCLUSIONS: Practitioners should recognize that the cricoid cartilage has cephalad movement in neck extension. In this way, the cricoid cartilage can be still useful as a landmark for stellate ganglion block.
Cricoid Cartilage ; Female ; Humans ; Male ; Neck ; Pain Clinics ; Stellate Ganglion ; Vertebral Artery

The metastasis of renal cell carcinoma to the ureteral stump is very rare and only a Few cases were reported. In most cases ureteral metastasis appeared after nephrectomy. We are presenting a case of metastatic renal cell carcinoma to the ureteral stump after radical nephrectomy in a 14 years old male with brief review and literature.
Adenocarcinoma* ; Adolescent ; Carcinoma, Renal Cell ; Humans ; Male ; Neoplasm Metastasis* ; Nephrectomy ; Ureter*

Neurilemmoma is wel1 encapsulated tumor of Schwann cell origin. It is more often solid than cystic and. usually solitary and may be benign. The treatment is surgical excision. We report a 42-year-old man hospitalized with complaints of RUQ pain and palpable mass. There was no endocrinological abnormality. Ultrasonography, computerized tomography and angiography revealed right huge extrarenal mass without metastatic evidence. The patient underwent surgical excision.
Adult ; Angiography ; Humans ; Neurilemmoma* ; Ultrasonography

No abstract available.
Abducens Nerve Diseases* ; Abducens Nerve* ; Fistula*