This study consisted of 66 peritrochanteric fractures which were treated by the modified Gamma nail (Asian Pacific nail) from August 1993 to October 1995. Sixty-one intertrochanteric fractures and five subtrochanteric fractures were treated in our institution. Average length of follow-up was 15.0 months. Four patients died during follow-up. The results were as follows; Lag screws were ideally introduced in 55 (83%) cases. The mean length in lag screw sliding was 4.3 mm in stable trochanteric fractures and 5.7 mm in unstable ones. Fifty-one out of 62 patients (82%) were returned to their previous ambulatory status. Intraoperative complications were as follows; distal crack (3 cases); rotation of femoral head (2 cases); entry point crack (I case); medialization of proximal fragment (7 cases); and missing of the interlocking screw (1 case). All of these complications did not affect the outcome. All medial cortical gaps were closed after sliding of lag screws. Three distal cracks did not propagate to the shaft. Postoperative complications were a case of superior cut-out, and two second fractures after falls. Callus formed more early in the stable trochanteric fractures (5+/-2.1 weeks) than unstable fractures (7.3+/-2.1 weeks). It was statistically significant. Union time between stable and unstable trochanteric fractures was not statistically significant. In conclusion, the Asian Pacific (AP) nail could appropriately fix the osteoporotic peritrochanteric fractures in elderly patient. It could offer early rehabilitation to these patients and decrease the mortality and morbidity.
Aged ; Asian Continental Ancestry Group ; Bony Callus ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Head ; Hip Fractures ; Humans ; Intraoperative Complications ; Mortality ; Postoperative Complications ; Rehabilitation

No abstract available.
Respiratory Syncytial Virus Infections* ; Respiratory Syncytial Viruses*

No abstract available.
Kidney* ; Neuroectodermal Tumors, Primitive*

No abstract available.
Sensation* ; Zygote Intrafallopian Transfer*

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*

Progressive zosteriform macular pigmented lesion(PZMPL) is a chronic pigmentary dermatosis similar to progressive cribriform and zosteriform hyperpigmentation(PCZH). This dermatosis described by Simoes in 1980 is characterized by a uniformly tanned macular pigmented lesion in a zosteriform distribution preceded by multiple pruritic macular pigmentation in a part of the dermatome for a period. PZMPL is not a fully understood disease entity but it is thought to be a variant of PCZH. It is differentiated from PCZH by accompanying pruritus as a prodromal symptom, a characteristic clinical course, and histological findings such as pigmentary incontinence. We report herein a case of PZMPL in a 17 year-old girl with the pigmentary skin lesion extending from the left forearm to the left chest along the Blaschkos line. The histological findings revealed increased melanin pigments in the basal layer and focal pigmentary incontinence in the upper dermis. To our knowledge, this case is the first report of PZMPL in korea thought to be the same case reported by Simoes.
Adolescent ; Dermis ; Female ; Forearm ; Humans ; Korea ; Melanins ; Pigmentation ; Prodromal Symptoms ; Pruritus ; Skin ; Skin Diseases ; Thorax ; Triacetoneamine-N-Oxyl

No abstract available.
Lichen Planus*

Mullerian adenosarcoma is a tumor composed of a mixture of glandular and stromal elements in which the glandular component appear to be neoplastic but, histologically, benign with the stromal component showing varying degrees of malingancy. We report a case of ovarian m llerian adenosarcoma with sex cord stroma differentiation in the stromal components. A 57 year-old female who presented with palpable mass in the right lower abdomen had undergone through salingo-oophorectomy. Grossly, the ovary was multicystic, and partly showed a solid appearance with multiple polypoid projections into the dilated cystic spaces. On microscopic examination, the tumor consisted of benign to borderline epithelial glands that were lined by variety of mullerian epithelia and sarcomatous component with sex cord-stromal elements, which include sertoliform tubules, Leydig cell like clusters, and granulosa cells.
Female ; Humans

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Pregnancy ; Female ; Humans

No abstract available.
Aorta, Thoracic* ; Truncus Arteriosus*