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*

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*

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

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

Objective: : Although Republic of Korea is an advanced country in medical technology with a successful treatment rate for serious diseases, such as cancer, and has improved technology for highly difficult surgery, many excellent medical doctors and physicians are struggling due to the recent unreasonable medical environment. Specialization in brain tumor surgery also faces challenges in Republic of Korea, including low financial incentives, legal threats, and limited career prospects. In response, the Korean Brain Tumor Society (KBTS) formed the Future Strategy Committee to assess these obstacles and propose solutions. Methods: : A survey was conducted among the KBTS members to understand their perceptions and concerns across different career stages. Results: : The findings revealed a decline in interest among chief residents in brain tumor surgery, owing to limited job opportunities and income prospects. Neurosurgical fellows expressed neutral satisfaction but highlighted challenges, such as low patient numbers and income. Faculty members with varying levels of experience echoed similar concerns, emphasizing the need for improved financial incentives and job stability. Despite these challenges, the respondents expressed dedication to the field and suggested strategies for improvement. Conclusion : The KBTS outlines a vision that focuses on practical excellence, comprehensive research, professional education, responsibilities, and member satisfaction. Addressing these challenges requires collaborative efforts among healthcare institutions, professional societies, and policymakers to support brain tumor specialists and enhance patient care.

Objective: : Although Republic of Korea is an advanced country in medical technology with a successful treatment rate for serious diseases, such as cancer, and has improved technology for highly difficult surgery, many excellent medical doctors and physicians are struggling due to the recent unreasonable medical environment. Specialization in brain tumor surgery also faces challenges in Republic of Korea, including low financial incentives, legal threats, and limited career prospects. In response, the Korean Brain Tumor Society (KBTS) formed the Future Strategy Committee to assess these obstacles and propose solutions. Methods: : A survey was conducted among the KBTS members to understand their perceptions and concerns across different career stages. Results: : The findings revealed a decline in interest among chief residents in brain tumor surgery, owing to limited job opportunities and income prospects. Neurosurgical fellows expressed neutral satisfaction but highlighted challenges, such as low patient numbers and income. Faculty members with varying levels of experience echoed similar concerns, emphasizing the need for improved financial incentives and job stability. Despite these challenges, the respondents expressed dedication to the field and suggested strategies for improvement. Conclusion : The KBTS outlines a vision that focuses on practical excellence, comprehensive research, professional education, responsibilities, and member satisfaction. Addressing these challenges requires collaborative efforts among healthcare institutions, professional societies, and policymakers to support brain tumor specialists and enhance patient care.

Objective: : Although Republic of Korea is an advanced country in medical technology with a successful treatment rate for serious diseases, such as cancer, and has improved technology for highly difficult surgery, many excellent medical doctors and physicians are struggling due to the recent unreasonable medical environment. Specialization in brain tumor surgery also faces challenges in Republic of Korea, including low financial incentives, legal threats, and limited career prospects. In response, the Korean Brain Tumor Society (KBTS) formed the Future Strategy Committee to assess these obstacles and propose solutions. Methods: : A survey was conducted among the KBTS members to understand their perceptions and concerns across different career stages. Results: : The findings revealed a decline in interest among chief residents in brain tumor surgery, owing to limited job opportunities and income prospects. Neurosurgical fellows expressed neutral satisfaction but highlighted challenges, such as low patient numbers and income. Faculty members with varying levels of experience echoed similar concerns, emphasizing the need for improved financial incentives and job stability. Despite these challenges, the respondents expressed dedication to the field and suggested strategies for improvement. Conclusion : The KBTS outlines a vision that focuses on practical excellence, comprehensive research, professional education, responsibilities, and member satisfaction. Addressing these challenges requires collaborative efforts among healthcare institutions, professional societies, and policymakers to support brain tumor specialists and enhance patient care.

Objective: : Although Republic of Korea is an advanced country in medical technology with a successful treatment rate for serious diseases, such as cancer, and has improved technology for highly difficult surgery, many excellent medical doctors and physicians are struggling due to the recent unreasonable medical environment. Specialization in brain tumor surgery also faces challenges in Republic of Korea, including low financial incentives, legal threats, and limited career prospects. In response, the Korean Brain Tumor Society (KBTS) formed the Future Strategy Committee to assess these obstacles and propose solutions. Methods: : A survey was conducted among the KBTS members to understand their perceptions and concerns across different career stages. Results: : The findings revealed a decline in interest among chief residents in brain tumor surgery, owing to limited job opportunities and income prospects. Neurosurgical fellows expressed neutral satisfaction but highlighted challenges, such as low patient numbers and income. Faculty members with varying levels of experience echoed similar concerns, emphasizing the need for improved financial incentives and job stability. Despite these challenges, the respondents expressed dedication to the field and suggested strategies for improvement. Conclusion : The KBTS outlines a vision that focuses on practical excellence, comprehensive research, professional education, responsibilities, and member satisfaction. Addressing these challenges requires collaborative efforts among healthcare institutions, professional societies, and policymakers to support brain tumor specialists and enhance patient care.