Purpose: To evaluate the results of blade plate fixation and bone grafting for the treatment of failed intertrochanteric hip fractures. Materials and Methods: Eight patients were treated with 95° blade plate fixation and bone grafts were performed in 7 patients. The mean age of the patients was 73 years old and the mean follow-up period was 26 months (range, 6 to 65 months). Clinical and radiological results were evaluated based on pain, walking ability, union period, and maintenance of reduction. Results: 6 of 8 patients obtained a solid union after a median period of 20 weeks. The neck-shaft angle was changed from 118° to 133° postoperatively. One patient underwent revision of a bipolar hemiarthroplasty due to failed blade plate fixation and varus malunion occurred in one patient Conclusion: Blade plate fixation and bone grafting for failed internal fixation of intertrochanteric hip fractures can provide a solid union and a good clinical result.
Bone Transplantation ; Follow-Up Studies ; Hemiarthroplasty ; Hip Fractures* ; Hip* ; Humans ; Transplants ; Walking

Introduction: Several investigators demonstrated that routine nasogastric decompression after abdominal surgery was unnecessary and can be safely eliminated. Some authors suggested that early feeding could be tolerated by the majority of patients after elective colorectal surgery. PURPOSE: The aim of our study was to prospectively assess the safety and tolerability of early oral feeding after colorectal surgery. METHODS: This trial included 69 patients who underwent an colon or rectal operation between April 1997 and August 1998. Patients were randomized after the operative procedure into one of two groups. Group 1: early oral feeding-all patents received a clear liquid diet on the first postoperative day followed by a regular diet as tolerated. Group 2: delayed feeding-all patients were treated in the traditional way with feeding only after the resolution of their postoperative ileus. Both groups had intraoperative nasogastric tubes that were removed at the end of surgery. The patients were monitored for vomiting, nasogastric tube reinsertion, time of regular diet consumption, complication, and length of hospitalization. The nasogastric tube was reinserted if two or more episodes of vomiting of more than 100 ml occurred in the absence of bowel movement. RESULTS: Sixty-nine consecutive patients were studied, 34 patients in group 1 (12 males and 22 females, mean age 58.1+/-12.7), and 35 patients in group 2 (16 males and 19 females, mean age 58.5+/-12.7). Significant differences were not noted in age and type of procedures. No significant differences were seen in rates of vomiting and overall complications. However, early feeding group well tolerated a regular diet (postoperative period to take regular diet of group 1: 5.4+/-4.0 days, group 2 : 8.1+/-4.6 days, p=0.013), and were discharged from hospital significantly earlier than the delayed feeding group(group 1: 14.0+/-5.1 days, group 2: 19.1+/-8.6 days, p=0.004). CONCLUSION: Early feeding after colorectal surgery is successfully tolerated by the majority of patients and led to earlier hospital discharge.
Colon ; Colorectal Surgery* ; Decompression ; Diet ; Female ; Hospitalization ; Humans ; Ileus ; Male ; Prospective Studies ; Research Personnel ; Surgical Procedures, Operative ; Vomiting

BACKGROUND: Becker's mealanosis is not an uncommon entity, and many cases are probably not reported because the diagnosis is usually made clinically and the condition is benign with cosmetic significance only. the etiology remains obscure. OBJECTIVE: The purpose of this study is to establish the clinicopathologic characteristics of Becker's melanosis in Korean. METHODS: Thirty-six patients with Becker's melanosis were retrospectively studied. RESULTS: The clinical and histopathologic findings observed in our cases were similar to previous reports except for the following. Nine patients(25%) had abnormal findings in their hair follicles : dilatation of the infundibular portion filled with abnormal keratin, Pityrosporum orbiculare and bacteria(19.4%); formation of intrafollicular cyst(5.6%). Three patients(8.3%) had granulomatous infiltration. Twenty-two patients(61.1%) had increased smooth muscle bundles. CONCLUSION: The findings associated with dermal hair follicles may be related to the pathogenesis of Becker's melanosis.
Diagnosis ; Dilatation ; Hair Follicle ; Humans ; Malassezia ; Melanosis* ; Muscle, Smooth ; Retrospective Studies

Hypernephroma comprises about 85-90% of renal malignancy in adults. The natural course of hypernephroma isvery diverse and unpredictable from abrupt explosive growth with wide spread metastasis to asymptomatic slowgrowth for several years. Reports from aliens indicated that hypernephroma with histopathological papillary growthpattern has better prognosis and more frequently hypovascular on renal angiography and less echogenic onultrasonography than non-papillary hypernephroma. Reviewed here retrospectively all the patients who were admittedand diagnosed as hypernephroma histopathologically at the Severance Hospital from March, 1973 through September,1984, in respective of angiographic vascularity, ultrasonographic echogenicity, histopathologic cell type andgrowth pattern, and following results were obtained. 1. The incidence of calcification in hypernephroma was 7cases out of 53 cases(13%). The incidence of hypernephroma according to cell type was clear cell type 20 cases(56%), mixed cell type 11 cases (31%), granular cell type 4 cases (11%), sarcomatous cell type 1 case(2%). Theincidence of hypernephroma according to growth pattern was papillary growth pattern 14 cases(45%) andnon-papillary growth pattern 17 cases(55%). 2. Renal angiographically, hypervascular hypernephroma was 19cases(73%), hypovascular hypernephromas was 6 cases(23%), all of which showed abnormal marginal vessels. 3.Angiographically hypervascular hypernephroma had high incidence of predominantly high echogenicity andangiographically hypervascular hypernephroma had high incidence of predominantly low echogenicity. 4. Clear celltype hypernephroma had high incidence of predominantly low echogenicity on ultrasonography. 5. Predominantly lowechogneic hypernephroma had high incidence of papillary growth pattern and predominantly high echogenichypernephroma had high incidence of non-papillary growth pattern. In summary, clear cell type hypernephroma hadhigh incidence of hypovascularity angiographically and hypovascularity on angiography was correlated withpredominantly low echogenicity on ultrasonography, and predominantly low echognicity had high incidence ofpapillary hypernephroma which was reported to have more good prognosis than non-papillary hypernephroma. So, itcan be suggested that if a hypernephroma show hypovascularity on angiography or predominantly low echogenicity onultrasonography, it has a good prognosis than hypervascular or predominantly high echogenic hypernephroma.
Adult ; Angiography ; Carcinoma, Renal Cell ; Emigrants and Immigrants ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Ultrasonography

PURPOSE: To correlate histologic subtypes with MR signal intensity in meniagioma and to find etiologic factors responsible for the signal characteristics of T2WI. MATERIALS AND METHODS: We. reviewed MRIs and histopathologic studies in 35 cases of meningioma. MR signal intenisty was measured with respect to cerebral cortex(gray matter) as hypointense, isointense, or hyperintense. Pathologically, meningioma was classified into subtypes, acording to the new WHO classification of brain tumors. The degree of cellularity, collagen, and vascularity was graded from 1 to 3, and presence or absence of psammoma bodies, microcysts, micronecrosis and microhemorrhage was obeserved. Multiple linear regression analysis was done to find relationship between the pathologic findings and MR signal intensity of T2WI. RESULTS: Even in the same subtype, cellularity, collagen and vascularty of the tumor were different. T1WI was not useful in discriminating pathologic subtype because most tumors were isointense or hypointense to the cortex regardless of histologic type. Most tumors showed various signal intensity on T2WI, but T2WI were not useful, either. Exceptionally, all five cases of microcystic meningiomas were hyperintense on T2W1. In analysing the relationship between MR signal intensity and pathologic factor, increased collagen content produced decreased signal intensity(P<0.01) and the existence of microcyst resulted in high signal intensity(P<0.01). Cellularity, vascularity, microcalcification, micronecrosis and microhemorrhage had no relationship with signal intensity on T2WI. CONCLUSION: Except for the five microcystic meningiomas with hyperintenty on T2WI there was no relationship between MR signal intensity and subtype of meningiomas. Pathologic factors influencing T2 signal intensity were microcyst and collagen. Even in the same subtypes of meningiomas, the T2 signal intensity was different. This may be due to different ratio of microcyst and collagen.
Brain Neoplasms ; Classification ; Collagen ; Linear Models ; Magnetic Resonance Imaging* ; Meningioma*

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

We report the clinical evolution of two male patients with generalized granulama annulare(GGA) who were controlled with hydroxychloroquine. In the first case, a 3-year-old boy was treated with systemic steroid, and in the second case, a 68-year-old man was treated with prednisolone, niacin, and retinoic acid. But, remission and recurrence of the skin lesions were repeated. A good clinieal response was achieved in both cases after administration of hydroxychloroquine without side effects or any signs of recurrence. Hydroxychloroquine may be helpful to treat the GGA that have side effects to the systemic corticosteroid or resistence to other therapeutic modalities.
Aged ; Child, Preschool ; Granuloma Annulare* ; Granuloma* ; Humans ; Hydroxychloroquine* ; Male ; Niacin ; Prednisolone ; Recurrence ; Skin ; Tretinoin

OBJECTIVE: This study was performed to develop a program for predicting individual cancer risk and to validate its discrimination power between case and control groups. METHODS: The author used the five databases for searching journals about risk factors of six major cancers in Koreans: stomach, liver, colorectal, breast, uterine cervix and lung cancer. The risk models were selected from journals presenting a multivariate linear logistic regression analysis. The baseline hazards which had no risk factors were calculated, and a cancer risk assessment program was developed using relative risks based on risk factors' combination and baseline hazards. Case-control study was performed for five years to validate the program. RESULTS: The discrimination power between case and control was 0.827 in stomach cancer, 0.949 in liver cancer, 0.594 in colorectal cancer, 0.587 in breast cancer, 0.708 in uterine cervix cancer and 0.663 in lung cancer. The estimated cancer probabilities were higher in all case groups compared to the control groups. CONCLUSION: The developed program is considered to be a valid tool for estimating probabilities of cancer development in Koreans. It is expected to be useful for the assessment of individual cancer risks, the selection of screening tools and preventive options for risk reduction.
Breast ; Breast Neoplasms ; Case-Control Studies ; Cervix Uteri ; Colorectal Neoplasms ; Discrimination (Psychology) ; Female ; Liver ; Liver Neoplasms ; Logistic Models ; Lung Neoplasms ; Mass Screening ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Stomach ; Stomach Neoplasms

We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.
Adult ; Early Diagnosis ; Humans ; Male ; Megacolon ; Multiple Endocrine Neoplasia* ; Neuroma* ; Pheochromocytoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms