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

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

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

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*

Eccrine angiomatous hamartoma, eccrine-pilar angiomatous hamartoma and sudoriparous angioma represent the same disease entity, a hamartoma showing hyperplasia of the eccrine sweat apparatus and of vascular elements in the same lesion histologically. We present a case of eccrine angiomatous hamartoma on the medial side of the right thigh in a 3-year-old male patient and review 16 cases reported in Korea.
Child, Preschool ; Hamartoma* ; Hemangioma ; Humans ; Hyperplasia ; Korea ; Male ; Sweat ; Thigh

PURPOSE: To evaluate the ultrasonomammographic findings of breast fibroadenoma. METHODS AND MATERIALS:We evaluated the ultrasonographic findings of histopathologically proved 135 fibroadenomas in 103 patients from January 1986 to September 1990, retrospectively. The ultrasonographic examinations were performed with a hand held linear array 5MHz transducer(Acuson 128(USA). Aloka 650, 280(Japan)). A sonopad was also used during the examinations. RESULTS: The common ultrasonographic findings of fibroadenomas usually showed smooth contour in 120 lesions(88.9% ), oval or round shape in 114 lesions(84.4%), uniform homogeneous echogenecity in 106 lesions(78.5% ), intermediate hypoechoic internal echo pattern in 105 lesions(77.8%), thin boundary echo in 117 lesions(86.7%), lateral shadowings in 97 lesions(72%), and posterior acoustic enhancement in 56 lesions(41%). The longitudinal/transverse ratio of fibroadenoma was revealed between 0.2 and 1.14 (mean 0.58) and usually under 1.0 (68.9%). CONCLUSION: Finally, most of fibroadenomas are easily diagnosed by ultrasonography but if differential diagnosis from malignant breast mass is difficult due to atypical appearance, other combined modalities such as filmmammography, fine needle aspiration biopsy and MRI are necessary.
Acoustics ; Biopsy ; Biopsy, Fine-Needle ; Breast* ; Diagnosis, Differential ; Fibroadenoma* ; Hand ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography

PURPOSE: To evaluate the characteristic CT findings of neuroblastoma, we studied neurobalstomas. METHODS AND MATERIALS: We analysed CT findings of available 25 cases among pathologically proved 51 neurobalstomas from Jan. 1983 to Sept. 1990. RESULTS: The most frequent site of origin is adrenl gland (40%) and the second is retroperitoneum (32%) and the third ismediastinum (16%). Characteristic CT findings are as follows:Calcifications within the tumor is detected in 86% of abdominal neuroblastomas and 50% of mediastinal origin. Hemorrhagic and necrotic changes within the tumor is noted at 86% in the tumor of abdominal origin and 25% in mediastinal neuroblastomas. Contrast enhanced study showed frequently septated enhanced appearance with/without solid contrast enhancement. Encasements of major great vessels such as aorta and IVC with/without displacement by metastatic lymphnodes or tumor are frequently seen in 90% of abdominal neuroblastomas. Multiple lymphadenopathy are detected in 95% of abdominal neurobalstomas and 25% of mediastinal neuroblastomas. The most common organ of contiguous direct invasion is kidney in 6 cases and the next one is liver but intraspinal canal invasion is also noted in 2 cases. CONCLUSION: We concluded that diagnosis of neuroblastoma would be easily obtained in masses of pediatric group from recognition of above characteristic findings.
Aorta ; Diagnosis ; Kidney ; Liver ; Lymphatic Diseases ; Neuroblastoma*

BACKGROUND AND OBJECTIVE: AT-1 cells have been derived from the left atrial tissue in which the ANF promoter targeted SV40 large T antigen expression. When cultured, clusters of spontaneously contracting cells were observed after 4-5 days and contiguous sheets of synchronously beating cardiomyocytes were formed after 10 days. In this study, expression of several cell cycle regulatory genes were monitored through Northern blot analyses in AT-1 cells during beating and after formation of beating sheets (BS). MATERIALS AND METHOD: AT-1 RNAs were obtained in 3 days after plating, during beating and after formation of BS, and used for Northern blot analyses. RESULTS: alpha-Cardiac myosin heavy chain expression was prominent in beating cells, as would be expected for this contractile protein isoform but ANF was decreased after beating. Gax was not expressed in cultured AT-1 cells but in AT-1 tumor and murine heart. p53 and p21 were decreased after beating which indicate transcription level of p53 and p21 correlated well in AT-1 cells. In contrast, pRB and p107 were increased after beating but p68 (2.4 kb) which arose by alternative splicing of p107 and lacks the pocket domain B was decreased in beating cells. pTCS2, murine tuberous sclerosis gene, represented similar levels during beating but a little was decreased after formation of BS. mRAD50, the murine homologue of yeast DNA recombinational repair gene RAD50, was increased in beating cells, a similar pattern to p107 and pRB. But the p50 arose by alternative splicing of mRAD50 and has 3' half of mRAD50 had unexpectedly appeared and maintained after beating. CONCLUSION: The expression of cell cycle regulatory genes after beating and formation of BS in AT-1 cells showed gene-specific pattern and the p50 which has homology to the mRAD50 may participate in differentiation of cardiomyocytes.
Alternative Splicing ; Antigens, Viral, Tumor ; Atrial Natriuretic Factor ; Blotting, Northern ; Cell Cycle* ; Genes, Regulator* ; Heart ; Myocytes, Cardiac* ; Myosin Heavy Chains ; Recombinational DNA Repair ; RNA ; Tuberous Sclerosis ; Yeasts

The folling results were obtained through the clinical review and Virology Laboratory of 100 cases of meningitis seen at ward of the pediatric department of Has Sung Hospital during the period from May to June, 1993. 1) Early childhood period was the most frequent age group and male was predominant in aseptic meningitis. 2) The common chief complaints were fever, vomiting, headache in order. 3) On physical examination meningeal irritation signs were not prominent. 4) On admission, leukocytosis (WBC count>10.000/mm(3)) on peripheral blood was showed in 36%. 5) The findings of cerebrospinal fluid showed that cells (Mean WBC count 671.8/mm(3)) were increased in all cases, and protein and sugar were mostly within normal limit. 6) Echovirus 9 was thought to be main causative agent according to the cerebrospinal fluid culture and antibody test. 7) On follow up study 2 months after discharge, 14 cases showed minimal abnormalities of EEG but no abnormal finding in BERA.
Cerebrospinal Fluid ; Echovirus 9 ; Electroencephalography ; Fever ; Follow-Up Studies ; Headache ; Humans ; Leukocytosis ; Male ; Meningitis ; Meningitis, Aseptic* ; Physical Examination ; Virology ; Vomiting