The incidence of trochanteric fracture of the femur is increasing, which is likely to continue for many years because of an increase in traffic accidents and the population of elderly people. The primary goal in the treatment of an elderly patient with an intertrochanteric hip fracture is to return the patient to his prefracture activity without any complication, as soon as possible. Rapid mobilization with stable internal fixation helps to prevent skin ulceration, pneumonia, urinary stasis, thromboembolic disease and other complications of confinement to bed in the elderly. Stable internal fixation depends mainly upon the fracture type and operative techniques. A clinical study of operative techniques was done in twenty three patients with trochanteric fracture of the femur who had been admitted and treated surgically at the Orthopaedic Department of W.M.B.H. during of two years from Mar. 1982 to Feb. 1984. The following are brief descriptions of the operative techniques. l. An L-shape incision and refiection of the vastus lateralis muscle provided wide exposure and facilitated anatomical reduction under direct vision. 2. The nail insertion site was selected at a slightly eccentric position anterior to rather than exactly midway from the opposite lateral cortex of the lesser trochanter. Therefore the nail could be laid rigidly between the thick anteromedial cortex and the posteromedial calcar portion. 3. The best stable position among the fracture line, the neck shaft angle and the nail plate could be obtained by the yoking procedure. It also allowed for later proximal migration of the shaft fragment and fracture impaction without impingement on the base of the barrel.
Accidents, Traffic ; Aged ; Clinical Study ; Femur ; Hip ; Humans ; Incidence ; Neck ; Pneumonia ; Quadriceps Muscle ; Skin Ulcer

The purpose of this study was to elucidate the prevalence rate of tbe concomitant; atopic diseases in the patients with allergic rhinitis and, concurrently, the incidence of the atopic diseases in the families of the patients. A total of 40 patients who were referred to the department of dermatology, Kang Nam St. Marys Hospital, for the confirmative examinations of allergic srhiniti were taken for this study. The results were as follows, 1. The prevalence rate of concomitant atopic dermatitis in the sample patients was 22.5% and that of concomitant bronchial asthma was 12. 5% The prevalence rate of concomitancy with both diseases was 2.5% and that of concomitancy with atopic dermatitis and/or bronchial asthma was 37.5%. 2. The frequency of the associated manifestations, in descending order, was allergic conjunctivitis (30%), urticaria or angioedema (25%), insect sting (22.5%), oral symptoms (5%), migrane or headache (5%), immediate drug reactions (2.5%) and gastrointestinal symptoms (2.5%).
Angioedema ; Asthma ; Conjunctivitis, Allergic ; Dermatitis, Atopic ; Dermatology ; Headache ; Humans ; Incidence ; Insect Bites and Stings ; Prevalence ; Rhinitis* ; Urticaria

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

Primary progressive aphasia(PPA) can be classified into nonfluent and fluent types. The fluent PPA usually manifests as Wernicke's or transcortical sensory aphasia. We report a 61-year-old right-handed woman who presented with a fluent PPA. An aphasia test revealed fluent speech and intact comprehension but decreased repetition and naming, consistent with conduction aphasia. Other cognitive functions and activities of daily living were preserved. Brain MRI and SPECT respectively showed a focal atrophy and a hypoperfusion in the left temporal lobe.
Activities of Daily Living ; Aphasia, Conduction* ; Aphasia, Primary Progressive* ; Aphasia, Wernicke ; Atrophy ; Brain ; Comprehension ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neuropsychological Tests ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

BCG osteomyelitis occurs in the infants and children as complication of BCG vaccination and its occurrence is very rare. It involves the metaphysis of the long bone and its development is chiefly hematogenous spread and direct inoculation. Radiologic feature shows well demarcated, eccentrically located destruction in the metaphysis of the long bone and soft tissue swelling about the lesion but periosteal reaction was absent initially. We experienced a case of BCG osteomyelitis which occurs in the left proximal humerus in 3 month after BCG vaccination.
Child ; Humans ; Humerus ; Infant ; Mycobacterium bovis ; Osteomyelitis ; Vaccination

Supracondylar fracture of the humerus is the most common fracture of the elbow in children For period of 4 years from Jan. 1980 to Dec. 1983, 54 children with dispaced supracondylar fracture of the humerus were classified by direction of displacement of distal fragment and treated by immediate closed reduction after lateral skeletal traction. 32 cases of these were followed up for more than 6 months. The results were obtained as follows.: 1) The most common incidence (79.6%) was 5 to 12 years of age and male and female ratio was 2.4 : l. The left humerus was involved in 35 cases (64.8%). 2) Of all fracture, extension type was 96.3% and flexion type 3.7%. 3) Under the exact anteroposteier and lateral views, fractures were classified by displaced direction of distal fragment. Immediate closed reduction was done by using thick and strong periosteal hinge after lateral skeletal traction. The more accurate anatomical reduction was obtained by maintenance of reduction state and further correction during lateral skeletal traction, and complications such as VIC, loss of reduction were lessened probably. 4) For follow up study of 32 cases, final result were analized according to Mitchells classification. Excellent results were obtained 23 cases (71.9%) Good results were 8 cases (25.0%) Unsatisfactory result was 1 case (3.1 %) 5) In 2 cases of treatment failure, the brachialis muscle was buttonholed by metaphyseal spike of the proximal fragment. 6) During lateral skeletal traction, superficial infection was developed through pin tract in 4 cases. These were treated by the administration of antibiotics and there were no complication such as osteomyelitis.
Anti-Bacterial Agents ; Child ; Classification ; Elbow ; Female ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Male ; Osteomyelitis ; Traction ; Treatment Failure

The calcar femorale is a specific anatomic entity which is often confused with the medial trabecular system or posteromedial cortex of the neck of the femur. The clinical significance of its architecture is evident when one considers the great number of operative procerdures performed in the upper end of the femur. This study deals with 45 cases of the Korean Dry femur(male: 27, female: 12, useless: 6) and two pairs of the femur from the cadavers. The authors observed the three dimensional structure of the calcar femorale and studied the relation between anteversion and calcar femorale. The results obtained were as follows: 1. The calcar femorale was a vertical plate of the thickened bone that lay deep to the lesser trochanter. The length in the vertical axis of the calcar femorale was 44.82±3.59mm. The calcar femorale was thickest medially where it joins the medial trabecular system of the femoral neck (maximal thickness: 2.65±0.65, width: 8.90±1.82mm). 2. The calcar femorale lay in one plane, which inclined 30.02±7.80 degree to the discondylar axis of the femur. By using this inclination of the calcar plane, it could be best visualized with about 60° external rotation of femur in a simple X-ray. 3. The angle between the calcar plane and the diacondylar axis was proportionate to the anteversion of the femoral neck. Correlation coefficient(r=0.80) was calculated. The regression line of y (anteversion) on x(calcar angle) was y=0.75X−8.53(slope). With this proportion, the angle of the femoral anteversion could be determined. 4. Microscopic features of the calcar femorale was revealed in the scanning electron microscopic studies. The medial side of the calcar was a cortical extension and it became thinner posterolaterally and than it was composed of fused or thickened trabeculae.
Cadaver ; Female ; Femur Neck ; Femur ; Humans ; Neck

Sequestration of disc herniation is important cause of failure of chemonucleolysis. It is important to recongnize this particular variety of disc herniation before considering enzymatic discetomy. Disc herniation were classified into three-anatomical categories. type I: Subligamentous Herniation type II: Extra-ligamentous Herniation type III: Free-extraligamentous Herniation, Sequestratid disc. one-hundred and eight-six cases of herniatid intervertebral disc were evaluated in Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University and in Department of Orthopedic Surgery, Inchon Christian Hospital from March 1982 to March 1988. The results of study are as follows; l. Among 186 patients, type III sequestrated disc patients were 32 cases(17.2%). 2. The ratio between male and female was about 2:l. 3. The duration of symptoms in type II,III were longer than type I. 4. On examination, the physical changes were more common in type III than in other types. Positive well leg rasing test was prominant finding especially in type III. 5. The myelographic findings, in type III, were irregularity of dural sac at the level of vertebra body both on obligue and lateral view. 6. The C-T findings, in type III, were irregular protruded disc, or caudal or cephalsd migrated disc materials.
Clinical Study ; Female ; Gangwon-do ; Humans ; Incheon ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Leg ; Male ; Orthopedics ; Spine

BACKGROUND: The purpose of this research was to compare one hospital family practise residents' diagnostic and therapeutic behavior with a Dupont et al described Guidelines on acute infectious diarrhea in adults and HARRISON'S PRINCIPLES OF INTERNAL MEDICINE 15th edition's algorithm for the management of acute diarrheal patients. METHODS: From March 1, 2003 to April 30, 2003, we reviewed 82 acute diarrheal patients (3.19% of the total patients) who had visited one hospital's emergency room which was located in Jeonju district. Doctor's diagnostic and therapeutic approaches were reviewed on the basis of history and physical exam. Then we compared with the standard algorithm referred above. RESULTS: Inpatients were 36.6% (30 patients) among the total of 82 and 63.4% (52 patients) returned home after symptomatic treatment. Among the 52 return home patients, doctors did not entirely conduct stool exam. Among the 30 hospitalized patients, doctors conducted stool exam in 25% among 4 of 16 high fever patients, in 25% among 2 of 8 moderately dehydrated who had diarrhea more than 10 times per day, and in 60% among 6 of 10 patients whose symptom duration was more than 48 hours. Doctors did not use antibiotics in 76.9% (40 patients) of 52 return home patients. Quinolone and Augmentin tablets were administered to each 6 patients of 12 return home patients. Among the 30 inpatients, Augmentin injection were given to 80% (24 patients) and second-generation cephalosporin with aminoglycoside combination injection to 13.3% (4 patients) and quinolone injection to 6.7% (2 patients). CONCLUSION: Compared with standard algorithm, doctors neglected testing stool examination that may be the most important way to diagnose the specific etiology of acute diarrhea. If we actively utilize the stool exam, it may help in providing the correct diagnosis and suitable treatment.
Adult ; Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Diagnosis ; Diarrhea ; Emergency Service, Hospital ; Fever ; Humans ; Inpatients ; Internal Medicine ; Jeollabuk-do ; Tablets

No abstract available.
Hysterectomy* ; Sexual Behavior*