The principle in the treatment of an elderly patient with an intertrochanteric fracture has swung from traction to internal fixation due to complication such as pneumonia, skin ulcer, and throm-boembolic disease, etc. Since the introduction of the Smith-Peterson nail, numerous internal fixation devices such as I-beam nail, Thornton plate, Jewett nail and Holt nail have been developed by gadgeteers and instrument companies. Recently Compression Hip Screw is popular because of rigid internal fixation. The operative management of intertrochanteric fractures of the hip using Compression Hip Screwplate was performed in thirty-three patients who were followed more than 5 months after operation at Department of Orthopedic Surgery, Kyung Hee University Hospital, from Feb. 1974 to 1978. The results were as follows. 1. Of 33 cases of intertrochanteric fractures, 3 cases were stable fracture and 30 cases were unstable fracture. The commonest type was Tronzo type III with 42 percentage. 2. Dimon-Hughston reduction in 13 cases with unstable fracture and anatomical reduction in 20 cases with stable and unstable fracture were achieved. 3. The average time to fracture union was 12 weeks, minimum in 8 weeks (maximum 20 weeks). The average union time in age group over 50 years was 14 weeks and 11 weeks in age group under 50 years. 4. The average union time was 13 weeks in medial displased group and 10 weeks in anatomical reduction group. 5. Complication after internal fixation were 4 cases e.g., two cases of varus deformity, one case of genitourinary tract infection and one transient peroneal nerve palsy. 6. Compression Hip Screw is a good internal fixation device to treat intertrochanteric fracture.
Aged ; Congenital Abnormalities ; Hip Fractures ; Hip ; Humans ; Internal Fixators ; Orthopedics ; Paralysis ; Peroneal Nerve ; Pneumonia ; Skin Ulcer ; Traction

Maple syrup urine disease (MSUD) is an autosomal recessive disorder. Impaired activity of the branched-chain 2-oxo acid dehydrogenase complex causes accumulation of branched-chain L-amino and 2-oxo acid that can exert neurotoxic effects. MSUD presents heterogeneous clinical and molecular phenotypes. Severity of the disease, ranging from classical to mild variant types, is commonly classified on the basis of indirect parameters, e.g. onset, leucine tolerance and/or residual enzyme activity in cell. Since early 1990's, tandem mass spectrometry has been applied to newborn screening, because it is amenable to population-wide testing for a large number of disorders of fatty acid, organic acid, and amino acid metabolism. And so, we report a case of MSUD in 15 days old boy detected by newborn screening using tandem mass spectrometry.
3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide) ; Acer* ; Humans ; Infant, Newborn* ; Leucine ; Male ; Maple Syrup Urine Disease* ; Mass Screening* ; Metabolism ; Phenotype ; Tandem Mass Spectrometry*

Localized scleroderma(LS) is sclerosis of the skin characterized by one or multiple circumscribed ivory-white, indurated, sometimes confluent plaques. It has been reported that LS might result from the unbalance between synthesis and degradation of collagen in the dermis. Recently, treatment of LS with long wave UVA1, which can induce mRNA of matrix metalloproteinase-1 from dermal fibroblast and can cause apoptosis of infiltrating T lymphocytes, showed promising results. In this case, a 14-year-old girl had a 6 month history of linear, brown colored, indurated plaque on her left thigh compatible with LS histopathologically. UVA1(2.4-10.8J/cm2) was irradiated to the skin lesion at each visit, a total of 68 times for 18 months with the cumulative dose of 533J/cm2 UVA1. Her fibrotic skin lesion was resolved during treatment, but became hardened with cessation of phototherapy. She remains disease free for 11 months. We report a case of LS with improvement with low-dose UVA1 phototherapy.
Adolescent ; Apoptosis ; Collagen ; Dermis ; Female ; Fibroblasts ; Humans ; Matrix Metalloproteinase 1 ; Phototherapy* ; RNA, Messenger ; Scleroderma, Localized* ; Sclerosis ; Skin ; T-Lymphocytes ; Thigh

Pilomatricoma is a tumor with differentiation toward hair cortex cells. There have been a few cases of multiple familial pilomatricomas in association with myotonic muscular dystrophy. We report two members of the family(brother and sister) with association of multiple pilomatricomas and myotonic muscular dystrophy. Multiple familial pilomatricomas may be a cutaneous manifestation of the myotonic syndrome.
Hair ; Humans ; Muscular Dystrophies* ; Pilomatrixoma* ; Siblings*

Vertebral ankylosing hyperostosis is a systemic rheumatological abnormality of unknown etiology whose hallmark is luxurious flowing ossification of the anterior longitudinal ligament. It has been regarded as asymptomatic ankylosis requiring no medical or surgical treatment. However, dyspnea, dysphagia, spinal cord compression, and peripheral nerve entrapment have all been documented in association with this disorder. On the other hand, reports on spinal stenosis at lumbar level are extremely rare. We present a case of spinal stenosis assosiated with vertebral ankylosing hyperostosis.
Ankylosis ; Deglutition Disorders ; Dyspnea ; Hand ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Longitudinal Ligaments ; Peripheral Nerves ; Spinal Cord Compression ; Spinal Stenosis*

OBJECTIVE: Bilateral cavernous sinus dural arteriovenous fistula (CSdAVF) is very rare, even in Asian countries. The research intended to present clinical and radiologic outcomes of treating such fistulas through endovascular embolization. MATERIALS AND METHODS: Data was obtained from 220 consecutive patients, with CSdAVF, who were treated from January 2004 to December 2015. Bilateral CSdAVF was identified in 17 patients (7.7%). The clinical and radiologic outcomes of the fistulas were assessed with an emphasis on the technical aspects of treatment. RESULTS: At the time of treatment, 7 and 10 patients presented with bilateral and unilateral symptoms, respectively. In the former cases, 4 patients had progressed from unilateral to bilateral symptoms. Bilateral fistulas were treated with a single-stage transvenous embolization (TVE) in 15 patients, via bilateral inferior petrosal sinuses (IPS) (n = 9) and unilateral IPS (n = 6). In the other 2 patients with one-sided dominance of shunting, only dominant fistula was treated. Two untreated lesions were found on follow-up to have spontaneously resolved after treatment of the dominant contralateral fistula. Of the 34 CSdAVF lesions, complete occlusion was achieved in 32 lesions after TVE. Seven patients (41.2%) developed worsening of cranial nerve palsy after TVE. During the follow-up period, 4 patients obtained complete recovery, whereas the other 3 remained with deficits. CONCLUSION: With adjustments of endovascular procedures to accommodate distinct anatomical configurations, endovascular treatment for bilateral CSdAVF can achieve excellent angiographic occlusion results. However, aggravation of symptoms after TVE may occur frequently in bilateral CSdAVF. In the patients with one-sided dominance of shunt, treatment of only dominant fistula might be an alternative option.
Arteriovenous Fistula ; Asian Continental Ancestry Group ; Cavernous Sinus* ; Central Nervous System Vascular Malformations* ; Cranial Nerve Diseases ; Endovascular Procedures ; Fistula ; Follow-Up Studies* ; Humans

Rhabdomyolysis is the consequence of extensive muscle injury with the release of muscle cell constituents into plasma. It can arise from trauma and also from a variety of nontraumatic causes. Trauma, drugs, toxins and infection are the major causes of rhabdomyolysis, but it is rarely associated with metabolic disorders such as severe electrolyte disturbance, diabetic ketoacidosis, hyperosmolar nonketotic coma, hypothyroidism and thyrotoxicosis. There have been several reported cases of metabolic rhabdomyolysis, but panhypopituitarism as a cause has never been identified. We experienced a case of acute rhabdomyolysis associated with panhypopituitarism. Thus, So we report this case with the review of related literature. Metabolic disorder is a rare cause of rhabdomyolysis, but it should always be considered in a patient having and unexplained increased of the creatine kinase concentration
Coma ; Creatine Kinase ; Diabetic Ketoacidosis ; Humans ; Hypothyroidism ; Muscle Cells ; Plasma ; Rhabdomyolysis* ; Thyrotoxicosis

Focal adhesion kinase (FAK) is a tyrosine kinase that is found in cellular structures called focal adhesions. FAK appears to be a key element in signal transduction pathways involved in cell adhesion and locomotion. FAK is overexpressed in various tumors, including tumors derived from regions of the head and neck, colon, breast, prostate, and liver. In this study, we investigated immunohistochemically whether FAK expression was increased in thyroid cancers. FAK staining was not seen in any of the 20 normal thyroid tissues or the 6 nodular hyperplasia specimens. In contrast, FAK staining was observed in all of 17 papillary carcinomas, 9 follicular carcinomas, 8 medullary carcinomas, and 2 anaplastic carcinomas. Nine of 17 follicular adenomas showed FAK immunoreactivity. FAK was not expressed in normal tissue and nodular hyperplasia, but was expressed in some of the follicular adenoma, and all of the follicular, papillary, medullary and anaplastic thyroid carcinoma. This result indicates that the up-regulation of FAK may play a role in the development of thyroid carcinogenesis.
Adenoma/*metabolism/pathology ; Adult ; Aged ; Carcinoma, Papillary/*metabolism/pathology ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Protein-Tyrosine Kinase/*metabolism ; Research Support, Non-U.S. Gov't ; Thyroid Neoplasms/*metabolism/pathology ; Tumor Markers, Biological/*metabolism

Hyperthyroidism may be associated or present with a variety of neuromuscular disorders, including thyrotoxic myopathy, exophthalmic ophthalmoplegia, periodic paralysis and myasthenia gravis. In contrast to muscle, peripheral nerve involvement in hyperthyroidism is exceedingly rare, and has received little attention. Paraplegia-like weakness during severe hyperthyroidism was first described by Charcot in 1889, and called Basedow's paraplegia' by Joffory in 1894. However, there has been no reported case in Korea. A 38-year-old woman was admitted for evaluation of progressive weakness and a gait disturbance. Her endocrinological results were compatible with hyperthyroidism. The polyneuropathy was also confirmed with sequential electrophysiological studies of the nerves and muscles. Drug therapy for hyperthyroidism resulted in resolution of the clinical neurological symptoms and progressive improvement of electrophysiological findings. Hyperthyroidisms are common medical disorders, which are often accompanied by diverse types of neurological and neuromuscular dysfunctions. All of these neurological manifestations are important, as they can serve as important clues to the diagnosis of a thyroid disorder. Furthermore, they are often related to the patient's presenting complaint. Therefore, the physician must be alert to the diverse manifestations of thyroid dysfunction, as they can lead to the diagnosis of potentially serious but treatable disorders. Herein is reported a case of myopathy and neuropathy associated with hyperthyroidism (Basedow's paraplegia), with a review of the literature
Adult ; Diagnosis ; Drug Therapy ; Female ; Gait ; Humans ; Hyperthyroidism ; Korea ; Muscles ; Muscular Diseases ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia ; Paralysis ; Paraplegia* ; Peripheral Nerves ; Polyneuropathies ; Thyroid Gland

Hyperthyroidism may be associated or present with a variety of neuromuscular disorders, including thyrotoxic myopathy, exophthalmic ophthalmoplegia, periodic paralysis and myasthenia gravis. In contrast to muscle, peripheral nerve involvement in hyperthyroidism is exceedingly rare, and has received little attention. Paraplegia-like weakness during severe hyperthyroidism was first described by Charcot in 1889, and called Basedow's paraplegia' by Joffory in 1894. However, there has been no reported case in Korea. A 38-year-old woman was admitted for evaluation of progressive weakness and a gait disturbance. Her endocrinological results were compatible with hyperthyroidism. The polyneuropathy was also confirmed with sequential electrophysiological studies of the nerves and muscles. Drug therapy for hyperthyroidism resulted in resolution of the clinical neurological symptoms and progressive improvement of electrophysiological findings. Hyperthyroidisms are common medical disorders, which are often accompanied by diverse types of neurological and neuromuscular dysfunctions. All of these neurological manifestations are important, as they can serve as important clues to the diagnosis of a thyroid disorder. Furthermore, they are often related to the patient's presenting complaint. Therefore, the physician must be alert to the diverse manifestations of thyroid dysfunction, as they can lead to the diagnosis of potentially serious but treatable disorders. Herein is reported a case of myopathy and neuropathy associated with hyperthyroidism (Basedow's paraplegia), with a review of the literature
Adult ; Diagnosis ; Drug Therapy ; Female ; Gait ; Humans ; Hyperthyroidism ; Korea ; Muscles ; Muscular Diseases ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia ; Paralysis ; Paraplegia* ; Peripheral Nerves ; Polyneuropathies ; Thyroid Gland