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

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

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

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

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Aged* ; Apgar Score ; Dementia ; Depression* ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires

The effects of Equiseti Herba Water-heating extract on the kidey & liver of rats were studied in 25 male Sprague-Dawley rats evenly divided into five groups, i.e., 5 rats each. The group I, which served as control and the group II, III, IV, were fed 300 mg/kg, 1000 mg/kg of Eqiseti Herba water-heating extract daily for one week, respectively. The group V was fed 1000 mg/kg of Equiseti Herba extract daily for two weeks. The effect of Equiseti Herba on the kidney and liver were determined by the measurements of the serum levels of BUN, creatinine, calcium, phosporus, sodium and potassium, total protein, albumin, transaminase (GOT & GPT) and cholesterol and 24hrs urine volume and GFR(ml/min), as well as by light microscopic and ultrastructural examinations of kidney and light microscopic examinations of liver in rats. The results were as follows; The groups II, III, IV were slightly higher than the control group on serum creatinine and potassium levels, but the group V was declined on serum creatinine and potassium levels, and 24hrs urine volume in spite of increased GFR. Histologically there was no remarkable changes in groups compared with the group I, except mild vacuolization of proximal convoluted tubule in group IV and V. These results suggested that equiseti Herba water-heating extract in rats induced reversible tubular changes on the kidney of rats. But the groups administrated by Equiseti Herba water-heating extract were not significantly higher than the control group on liver function test. Histologically there was no remarkable changes in groups II, III, IV & V compared with the group I.
Animals ; Calcium ; Cholesterol ; Creatinine ; Humans ; Kidney* ; Liver Function Tests ; Liver* ; Male ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium

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