The clinical picture of adult hemiplegia caused by cerebrovascular lesion shows many variation, depending on the degree and distribution of paresis and spasticity. One of the most common deformities resulting from a stroke is equino-varus of the involved foot. If the equino-varus is due to moderately excessive pattern response, or moderate spasticity in the calf muscles, it can be controlled by a short leg brace. When the deforming forces are severe, surgery is necessary to make it possible for the patient to walk safely. It is quite obvious that there is some incidence of hip fracture following sequence of unsafe hemiplegic gait, among post stroke patients as reported by Rancho-Los-Amigo Hospital. This study reviews a preliminary report of a case of surgical treatment of a patient with post stroke who had sustained a hip fracture due to falling because of unbalanced hemiplegic gait. In this case there was performed a low friction arthroplasty of the hip joint because of the original X-ray. The former treatment was ignored because it would inevitably have produced avascular necrosis of the femoral head. The spastic equino-varus deformity was well corrected by means of split anterior tibialis tendon transfer, which is the normal surgery for stroke.
Accidental Falls ; Adult ; Arthroplasty ; Braces ; Congenital Abnormalities ; Foot ; Friction ; Gait Disorders, Neurologic ; Head ; Hemiplegia ; Hip Joint ; Hip ; Humans ; Incidence ; Leg ; Muscle Spasticity ; Muscles ; Necrosis ; Paresis ; Stroke ; Tendon Transfer

This paper is intended to draw attention to the cases of non-union of reattached greater trochanter after LFTA for hip disorders with an our short experience of this subject. Previous information on this subject is scanty. Charnley mentioned on his paper of the long time result of LFTA of the hip for non-union of the great trochanter was reported in 4.2% of 379 hips followed for a minium of four years. Of these, a quarter went on to separation of the bony fragment. With his report, wire breakage occured in 28 cases in the presence of a united trochanter, a phenmenon which results from loops of the wire passing through soft tissues, out side the bone, and becoming fatigued by repeated bending movements. However, he pointed that the clinical result does not seems to be impaired althrough such patients occasionally complain of a feeling of insecurity when weight bearing. Among our series, two cases of non-union of the greater trochanter, after LFTA, is reported. Those of two patient were bilateral hip disorders who has indicated both hip total hip replacement. But we have done only one hip each because of inevitable patients physical conditions during the surgery. Presumably, the principal cause of non-union appeared to be excessive force on the operated one hip. The type of internal fixation for reattachment of the greater trochanter was investigated, six types which we used in this series, two separate knots for security of wire breakage after Bechtol resulted satisfactory union of the detached greater trochanter. A case of detached trochanter for revision which we used original Charnley technique with additional figure of eight wire fixation for re-enforcement. Eventually, we agree that advantage of bilateral total hip replacement at the same operative session.
Arthroplasty, Replacement, Hip ; Femur ; Friction ; Hip ; Humans ; Torque ; Weight-Bearing

No abstract available in English.
Arthroplasty ; Friction ; Hip ; Tuberculosis

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes

PURPOSE: To prepare the appropriate guideline in choosing the internal fixatives for the intertrochanteric fractures of the femur in the elderly. MATERIALS AND METHODS: We reviewed 95 cases of intertrochanteric fractures of the femur from January, 1999 to December, 2003. We fixed the fracture with Proximal Femoral Nail in 37 cases (PFN group), Dynamic Hip Screw in 56 (DHS group), Dynamic Condylar Screw in 2 cases (DHS group). We reviewed operation time, blood loss during operation, changes in neck-shaft angle and sliding of lag screw. RESULTS: There were no significant differences in the parameters between the 2 groups in stable fracture. In unstable fractures, operation time in PFN group and DHS group revealed 103.9 and 128.2 minutes respectively; mean amount of blood loss during operation revealed 523.2 and 573.1 ml respectively. Mean changes in the neck-shaft angle at final follow-up in PFN group and DHS group revealed 4.6 degrees and 4.1 degrees; sliding of lag screw averaged 3.4 and 6.5 mm respectively. Among the DHS group, cases of additional fixation with trochanteric supporting plate revealed 3.1 degrees of changes in neck-shaft angle and 4.2 mm of lag screw sliding. CONCLUSION: In cases of stable fractures, any fixative might suffice. In cases of unstable fractures, there were no significant differences in results of treatment between these two groups, however, PFN group revealed shoter operation time and less blood loss during operation. It seemed to be necessary to apply additional fixation with trochanteric supporting plate when using DHS in unstable cases.
Aged* ; Femur* ; Fixatives* ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans

OBJECTIVE: To compare the usefulness of prenatal screening tests for chromosomal abnormalities by analyzing the cytogenetic results of midtrimester amniocentesis METHODS: We reviewed a total of 1264 cases of midtrimester prenatal genetic amniocentesis performed from February 1997 to September 2003, of which accorded to indications of cytogenetic studies. Cytogenetic results were analyzed with the distribution of maternal age, indications of amniocentesis. RESULTS: The most common age of total subjects was in between 35-39 years (37.1%). The indications of amniocentesis were abnormal maternal serum marker (60.0%), advanced maternal age (34.8%), abnormal ultrasonographic findings (3.2%), in order. The overall incidence of chromosomal aberration was 3.9% (49/1264). No significant difference was found between the mean maternal age with and without abnormal fetal karyotype. According to indications, there was 12.5% (5/49) of chromosomal abnormalities in abnormal sonographic finding group, 5.2% (36/688) in abnormal maternal serum screening group and 2.4% (12/498) in advanced maternal age group. There was statistical significance (P=0.004) only in abnormal ultrasonographic finding group. CONCLUSION: Ultrasonography was become to be more important due to development of high resolution ultrasonography, skillful technique and awareness of sonographic markers. Ultrasonographic abnormality could be the most predictive marker for abnormal fetal karyotypes.
Amniocentesis* ; Biomarkers ; Chromosome Aberrations ; Cytogenetics ; Female ; Humans ; Incidence ; Karyotype ; Mass Screening ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Ultrasonography

This study was conducted to estimate the causing factors of industrial accident, and to prepare the fittable control program for accident through the evaluation of views of the patients who suffered from accidents. From January 5 to February 6 1993, questionnaire survey was executed on 166 persons who were injured and covered by the insurance under industrial accident compensation law at four university hospitals in Pusan. The results were as follows : 1. Most of subjects worked in the manufacturing (56.6%) and construction(29.5%), and in the small factory less than 49 workers(56.0%). They were thirties and forties(63.8%), less than 3 years tenure(53.6%), habitual drinker(69.2%). And, 72.3% worked for above 9 hours per day, 53.6% worked as near clerks, 89.2% thought that work is rather suitable to his own personality. 2. Self-recognition for the causing factor of industrial accident was the other's malfunction(19.3%), carelessness(15.1%), lack of education for safety(15.1%), and they thought the accident occurred by mainly some defect of establishment and working environment(34.9%), unskillfulness(22.9%), self-carelessness(22.3%). 3. The interests and recognition on safety was insufficient, 88.6% require job education, but 53% pointed out the necessity for strengthening of present status-rather incomplete with relying on self-education (40.9%), no previous participation in safety education (29.5%), etc. 4. For the kind of accident, fall-down(16.3%), crash(13.3%), falling(12.7%) was frequent, head(24.7%) and fracture(41.0%) was frequent for the part and type of injury, respectively. And, they had more injured by cooperative work (82.5%) than single work. As results, improvement of working environment and strengthening education program would be emphasized for the effective control of industrial accident. And, there should be prepared the specific prevention program for the small scale industries.
Accidents, Occupational* ; Busan ; Compensation and Redress ; Education ; Hospitals, University ; Humans ; Insurance ; Jurisprudence ; Questionnaires

No abstract available.
Carcinoma, Endometrioid* ; Uterus*

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome