Purpose: To report the surgical skills needed, and the clinical results of, minimally invasive hip surgery with dynamic hip screws and the comparison with the classical technique in stable pertrochanteric fractures of the femur. Materials and Methods: Thirty-two patients with pertrochanteric fractures of the femur who were treated with dynamic compression hip screws between April 1999 and March 2004, and were evaluated retrospectively, and were followed up for more than 12 months. 16 cases were treated with a classical dynamic hip screw technique and 16 cases with a minimally invasive technique in random order. The mean age was 73.2 years, and there were 11 males and 21 females. The operative times, total hemovac bleeding loss, functional scores, and average hemoglobin decrease ratios were evaluated. The clinical assessments were performed with the Harris Hip Score (HSS) and bony union was evaluated with serial follow-up plain radiographs. Results: The average operative time was 63.9 minutes with the classical technique and 42.5 minutes with the minimally invasive technique. The total average hemovac blood loss was 640 cc with the classical technique and 143 cc with the minimally invasive technique. Clinically, the HHS was an average of 85.9 and 89.2 in groups 1 and 2, respectively, by the last follow-up and there were no statistically significant differences between the two groups (P <0.05) The hemoglobin decrease ratio was the same in both groups and there was no nonunion. Conclusion: Minimally invasive dynamic hip screw insertion was useful in stable pertrochanteric fractures, because it decreased blood loss and operative times; and there were no changes in fracture healing and functional outcomes.
Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hemorrhage ; Hip* ; Humans ; Male ; Operative Time ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

PURPOSE: Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit MATERIALS AND METHODS: To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings. RESULTS: Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI. CONCLUSION: MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.
Brain ; Cauda Equina ; Conus Snail ; Diagnosis ; Follow-Up Studies ; Foot ; Gait ; Humans ; Hydrocephalus ; Lipoma ; Magnetic Resonance Imaging ; Meningomyelocele ; Neural Tube Defects* ; Neurologic Manifestations ; Retrospective Studies ; Skin ; Spinal Cord ; Spine

We analyzed the occurrence of enteric viruses and bacteria at 22 places of drinkable groundwater (civil defense emergency water-supply facility), 8 places of the groundwater used for drinking water in group food services, and 10 places of spring-water. When the 40 concentrated samples were analyzed using nested RT-PCR and real-time RT PCR methods, norovirus and other enteric viruses were not detected in all samples tested. The detection percentages for total coliforms, Escherichia coli, Yersinia enterocolitica of fecal indicator were 57.5%, 22.5% and 7.5%, respectively. Colipages were not detected. These results suggest that high levels of fecal indicator bacteria in groundwater and spring-water are not directly related to occurrence of enteric viruses.
Bacteria ; Drinking Water ; Emergencies ; Escherichia coli ; Food Services ; Groundwater ; Norovirus ; Polymerase Chain Reaction ; Yersinia enterocolitica

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Peptic Ulcer* ; Prevalence* ; Stomach Neoplasms*

Two patients with an unusual multisystemic syndrome characterized by polyneuropathy, organomegaly(especiallyhepatosplenomegaly), endocrine dysfunction, M-protein, and skin abnormalites(POEMS syndrome) are discussed.Characteristic radiographic features include hepatosplenomegaly, lymph node enlargement, sclerotic bony lesions,and a peculiar variety of bony proliferation.
Humans ; Lymph Nodes ; POEMS Syndrome* ; Polyneuropathies ; Skin

Heteratopic or ectopic pancreas is found in 0.5% to 13% autopsy series and also found one in approximately every 500 operations in abdominal surgery. The mast common sites are stomach (esp, greater curvature of the antrum), duodenum and proximal jejunum. Many ar most of these lesions do not cause clinical symptoms and the symptoms with heterotopie pancreas are nonspecific. When it produces complication(hemorrhage, pancreatitis, pyloric or CBD obstruction, pseudocyst, cancer etc.), the symytoms depend on the site of lesion, the size of mass, and the primary pathologic processes occurring within the heterotopic pancreatic tissue. Gaetrofiberoscopy revealed a small round, submucosal projection with a central niche or umblication, but this characteristic umbilication is not always present. The lesions are frequently confused with polyp, leiomyoma, intramural neoplasm, gastric ulcer and early gastric cancer, The tumors are predominantly intramural masses; 75 percent are submuicosal and the others are either intrsmuscular or subserosal. We have recently experienced a case of heterotopic pancreas on the antrum of greater curvature of stomach in 54-year-old man, who visited our hospital for melena. Gastrofiberoscopy revealed a 2 x 2 cm sized submucosal mass without bleeding focus and local excision was performed. Histologic finding showed a pancreatic acini within the gastric poper muscle layer.
Autopsy ; Duodenum ; Hemorrhage ; Humans ; Jejunum ; Leiomyoma ; Melena ; Middle Aged ; Pancreas* ; Pancreatitis ; Pathologic Processes ; Polyps ; Stomach ; Stomach Neoplasms ; Ulcer

BACKGROUND: The trefoil factor 1 protein (pS2/TFF1) is a candidate tumor-suppressor protein, and it is a pleiotropic factor involved in the organization and homeostasis of the gastrointestinal tract and various inflammatory or neoplastic diseases. The purpose of this study was to assess the expression of pS2/TFF1 and its clinicopathologic relationship, including the p53 and Ki-67 labeling index, in colorectal carcinogenesis. METHODS: The expression of pS2/TFF1 protein was evaluated immunohistochemically in 45 samples of normal colonic mucosa, 43 samples of adenoma and 186 samples of colorectal carcinoma. RESULTS: pS2/TFF1 protein was expressed weakly in 37.8% of normal colonic mucosa samples, and it had a weak to strong expression in 48.8% of adenomas and 28% of colorectal adenocarcinomas. pS2/TFF1 expression in carcinoma was slightly increased in the poorly differentiated group compared with the well to moderately differentiated group (p=0.059). Interestingly, mucinous carcinoma (4/4) and signet ring cell carcinoma (2/3) showed significant increase of pS2/TFF1 expression. pS2/TFF1 expression was inversely correlated with the p53 protein expression and the Ki-67 labelling index (p<0.05). There was no significant correlation with the tumor size, metastasis or pathologic staging. CONCLUSIONS: Overexpression of pS2/TFF1 expression in colorectal adenocarcinoma was inversely correlated with the Ki-67 labelling index and the p53 expression in cancer. These results suggest that pS2/TFF1 protein may contribute as tumor suppressor factor in colorectal adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Adenoma* ; Carcinogenesis ; Carcinoma, Signet Ring Cell ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Gastrointestinal Tract ; Homeostasis ; Immunohistochemistry ; Lotus ; Mucous Membrane* ; Neoplasm Metastasis

Fifteen patients with primitive neuroectodermal tumors were reviewed. Because of ongoing nosological difficulty, we include in this series only those tumors which are located in the cerebral hemisphere, and are composed of predominantly undifferentiated neuroepithelial tumor with or without glial or neuronal differentiation. The 20 months cumulative survival rate by Kaplan-Meir method was 40% and only two patients had a long term survival more than 5 years in this series. The prognosis of the patients with cerebral PNETs remains poor despite of treatment including surgical resection. Radiation therapy and/or chemotherapy. The histological features and the extent of surgical resection did not influence the patient's survival. But visible total resection afforded better control of local disease of the primary site.
Cerebrum ; Drug Therapy ; Humans ; Neoplasms, Neuroepithelial ; Neuroectodermal Tumors, Primitive* ; Neurons ; Prognosis ; Survival Rate

BACKGROUND: Chronic low back pain(CLBP) is one of the most common afflictions of humans. Between 70% and 80% of the population experience back pain some time during their lives. Especially, back pain is the most common cause of limited activity in individual under age 45. METHODS: The prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) were presented to subjects who visited our hospital for occupational routine check. The questionnaire was composed of duration and severity of back pain. The subject were divided into two groups, respectively with chronic low back pain history and without history. The differences of psychogenic symptoms between both groups were analysed. RESULTS: In general characteristics, there was no significant difference between both groups. There were significant differences in somatization, anxiety, depression, anger-hostilily, phobic anxiety, neurasthenic, hypochondriacal, interpersonal sensitivity and general dimensions between both groups(P<0.05). There was no significant difference in obsessive-compulsive dimension between both groups. CONCLUSIONS: These results showed the presence of various psychogenic symptoms in chronic low back pain patients. Such psychosocial variables will need to receive additional careful attention in primary care setting.
Anxiety ; Back Pain ; Depression ; Humans ; Low Back Pain* ; Primary Health Care ; Surveys and Questionnaires

Lymphangiomas are rare congenital benign tumors arising from the lymphatic system, and are mostly encountered in the neck and axillary regions of pediatric patients (95%). Lymphangioma of the pancreas is extremely rare accounting for less than 1% of these tumors. We report here on a case of pancreatic cystic lymphangioma. A 54-year-old woman presented with intermittent postprandial abdominal discomfort and radiating back pain. Abdominal computed tomography scan revealed 8 x 6.5 cm hypodense cystic mass arising from the tail of the pancreas without septa or solid component. The initial impression was a pancreatic pseudocyst. The patient underwent distal pancreatectomy with splenectomy. The histopathologic and immunohistochemical study helped make the diagnosis of a pancreatic cystic lymphangioma. Herein, we report a case of pancreatic cystic lymphangioma mimicking pancreatic pseudocyst and review the relevant medical literature.
Accounting ; Back Pain ; Female ; Humans ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Middle Aged ; Neck ; Pancreas ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Splenectomy