Due to the instability of intertrochanteric fractures in elderly patients, various methods of reduction and fixation were introduced to obtain stable reduction and solid union, But there have been many controversies regarding advantages between anatomical reduction group and non-anatomical reduction group. The authors analyzed the 68 unstable intertrochanteric fractures out of total 94 cases of intertrochanteric fractures treated from Jan. 1988 to Jan. 1994 with mean follow-up 17 months and evaluated the radiologic and clinical results between those two groups. The results were obtained as follows: 1. The most common cause was low energy injury and according to the Tronzo classification, the type III was most common in 54 cases (79.4%). 2. The average union time was 14.0wks (84%), the union rate was low in the medialized reduction group(A-P) and anterior displaced reduction group(A-P), anterior displaced and anatomical reduction groups(Lateral). 3. The compression length more than 10mm of lag screw was deep in medialized reduction group(A-P), another displaced and anatomical reduction groups(Lateral). 4. The average length of lag screw sliding was 9.2mm and depth sliding of 6.8mm (74%) was occurred within immediate postoperative 1 month.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans

PURPOSE: Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking. MATERIALS AND METHODS: We observed 95 patients (mean age, 75+/-2.8 years) with trochanteric fractures who were treated with a CMN, and evaluated the relationship between FNS and patient factors including age, gender, fracture type (AO/OTA), bone mineral density, medullary canal diameter, canal occupancy ratio (COR=nail size/canal diameter), and tip-apex distance using initial, immediate postoperative, and follow-up radiography. RESULTS: Univariate regression analyses revealed that the degree of FNS was significantly correlated with fracture type (A1 versus A3, p<0.001), medullary canal diameter (p<0.001), and COR (p<0.001). Multiple regression analyses revealed that FNS was strongly correlated with fracture type (p<0.001) and COR (p<0.001). CONCLUSION: Presence of a CMN in the medullary canal could not effectively prevent FNS in patients with low COR and in A3 type fracture.
Aged ; *Bone Nails ; Female ; Femur Neck/*radiography ; Hip Fractures/radiography/*surgery ; Humans ; Male ; Orthopedic Procedures/*methods ; Regression Analysis

No abstract available.
Tibia*

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

No abstract available.

The incidence of skull tuberculosis is very rare, with only a few cases reported as a result of a simple radiography and computed tomographic findings. In this study, we report the magnetic resonance image (MRI) findings of a case of skull tuberculosis, which was confirmed histologically.
Frontal Bone ; Incidence ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Skull ; Tuberculosis ; Tuberculosis, Osteoarticular

PURPOSE: Atopic dermatitis is often accompanied by food allergies which occur through skin barrier defects. Especially Staphylococcus aureus colonization can exacerbate skin barrier defects that cause sensitization and increase specific IgE (sIgE) to food. We investigated the association between skin colonization and food sIgE changes in children with atopic dermatitis. METHODS: Atopic dermatitis was diagnosed by a pediatric allergist in patients between 3 months and 3 years of age. Total IgE and sIgE to egg white, cow's milk, wheat, and peanuts were taken. Eosinophil count and eosinophil cationic protein were also taken. Comparisons were done between the groups with and without S. aureus colonization. RESULTS: It was found that 50.3% of the 294 enrolled patients had S. aureus colonization on lesional skin. Statistically significant sensitization to wheat and peanut were increased with S. aureus colonization. Statistically significant increases in sIgE (above cutoff level) were also found in egg white, milk, wheat and peanut. Higher S. aureus colony counts also increased sIgE of all foods. Methicillin-resistant S. aureus showed no statistical difference compared to methicillin-susceptible S. aureus in severity and sIgE levels. CONCLUSION: S. aureus colonization increases the risk of food sensitization in children with atopic dermatitis.
Arachis ; Child* ; Colon* ; Dermatitis, Atopic* ; Egg White ; Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Methicillin Resistance ; Milk ; Skin ; Staphylococcus aureus* ; Staphylococcus* ; Triticum

PURPOSE: Although surgical resection offers patients with HCC the chance of a cure, the post-resection tumor recurrence rate is high, with reported cumulative 5-year tumor recurrence rates ranging from 40 to 70%. The objective of this study was to investigate risk factors for intrahepatic recurrence after resection of hepatocellular carcinoma, especially in patients with hepatitis B virus infection. METHODS: Between January 1999 and December 2003, 59 patients in our Hospital with hepatitis B virus infection underwent liver resection for hepatocellular carcinoma. Clinical, biological, and histopathological characteristics of these patients were collected and tested for their prognostic significance using a Chi-square test and a Student's t-test. Time to recurrence and survival rate were analyzed by the Kaplan-Meier method. RESULTS: Of the 59 patients who underwent liver resection, 24 (41%) experienced intrahepatic recurrence. The 1-, 3-, and 5-year overall survival rates of total enrolled patients were 83%, 63%, and 42%, respectively. The 1-, 3-, and 5-year overall survival rates after recurrence were 87%, 52%, and 20%, respectively. The risk factors for early recurrence were elevated serum aspartate aminotransferase (AST) level (p=0.044) and larger tumor size (p=0.049). For late recurrence, greater tumor size (p=0.039) was the only risk factor. CONCLUSION: Tumor size and serum aspartate aminotransferase are risk factors of intrahepatic recurrence after resection of HCC in patients with chronic hepatitis B virus infection. This finding indicates that patients who have these risk factors should be under more careful supervision and have more aggressive follow-up.
Aspartate Aminotransferases ; Carcinoma, Hepatocellular ; Follow-Up Studies ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver ; Organization and Administration ; Recurrence ; Risk Factors ; Survival Rate ; Viruses

PURPOSE: Synthetic absorbable monofilaments offer excellent glide characteristics and cause minimal tissue trauma as a result of their smooth monofilament structure and gradual absorption within the healing tissues. For these reasons, these suture materials are commonly used in various surgical fields such as gastroenterology, urology, gynecology, and plastic surgery. The aim of this study was to evaluate the safety and usefulness of a new synthetic absorbable monofilament, Glycoside-epsilon-caprolactone-trimethylene carbonate interpolymer (GCT), in gastrointestinal anastomosis and closure. MATERIALS AND METHODS: We evaluated 55 gastrointestinal anastomoses and closures using GCT (MONOSYNR, B. Braun, Germany) in 47 patients who underwent gastric surgery between December 2001 and May 2002 at Seoul National University Hospital. Patient's characteristics, operative procedure, surgeon's opinion of handling properties of GCT, and suture-related complications were analyzed. RESULTS: There were 34 males and 13 females (M:F= 2.6:1) with an average age of 54.2 years old. Forty-five cases of gastrointestinal anastomosis (20 gastrojejunostomies and 25 jejunojejunostomies) and 10 cases of intestinal closure (7 gastrostomy closures and 3 duodenal stump closures) were performed in 41 cases of stomach cancer, three of peptic ulcer disease, two of GIST, and one MALToma. The handling properties of GCT according to the criteria of knot breaking load, knot security, and placing property were always scored with 7 to 9 points (10=excellent, 1=very poor). Two cases of postoperative complications (3.6%) were noted. One was a leak of the gastrojejunostomy site which was successfully managed conservatively, and the other was a stricture of the gastrojejunostomy site which was managed by reoperation (side-to-side jejunojejunostomy). CONCLUSION: GCT seems to be an applicable suture material for various gastrointestinal anastomoses and closures.
Absorption ; Carbon* ; Constriction, Pathologic ; Female ; Gastric Bypass ; Gastroenterology ; Gastrostomy ; Gynecology ; Humans ; Male ; Peptic Ulcer ; Postoperative Complications ; Reoperation ; Seoul ; Stomach Neoplasms ; Surgery, Plastic ; Surgical Procedures, Operative ; Sutures ; Urology

BACKGROUND: AG60 is a complex of acriflavine and guanosine. Our previous study revealed that AG60 had not only in vitro antitumor activities in several human cancer cell lines, but also strong antitumor effects in animal experiments using p388 or S180 cells-implanted mice. METHODS: Antitumor effects of AG60 were compared with those of Adriamycin, acriflavine, guanosine or control group. Body weight, tumor weight change, and survival time were measured in Ehrlich carcinoma cells implanted ICR mice. RESULTS: Body weights in AG60, acriflavine, or Adriamycin treated groups were significantly lower than those in control group during 30 day observation period(p<0.05). The percent tumor growth inhibition of AG60, Adriamycin, acriflavine, or guanosine two weeks after last treatment was respectively 86% (T/C%=14), 83% (T/C%=17), 68%(T/C%=32), 41% (T/C%=59). According to above data, tumor growth inhibition in AG60 treated group was significantly stronger than that in control, acriflavine or guanosine treated group(p<0.01), but there was no significant difference between AG60 and Adriamycin treated group. Mean survival time in control, AG60, Adriamycin, acriflavine, or guanosine treated group was respectively 33+/-3.9 days, 68+/-4.2 days, 54+/-5.8 days, 36+/-3.8 days, 50+/-8.1 days. CONCLUSIONS: The anti-tumor effect of AG60 against Ehrlich tumor was significantly stronger than that of control, acriflavine or guanosine, and comparable with Adriamycin. Mean survival time in AG60 treated group was significantly longer than that in control, acrifavine, guanosine or Adriamysin treated group.
Acriflavine ; Animal Experimentation ; Animals ; Body Weight ; Cell Line ; Doxorubicin ; Guanosine ; Humans ; Mice ; Mice, Inbred ICR ; Survival Rate ; Tumor Burden