Osteoporosis has been described as the most common disease in the old age group. As the bone mineral density decreases, the skeleton becomes more prone to fracture. Hip fractures occur late in life following substantial reduction in skeletal mass. So the incidence of hip fracture is increasing due to prolongation of average life span. The bone density of femoral neck, Ward triangle, and trochanteric region were measured by dual energy x-ray absorptiometry (DEXA) in 15 patients with femoral neck fractures and in 58 patients with intertrochanteric fractures to evaluate the relationship between bone mineral density (BMD) value and fracture type. The results were as follows 1. In femoral neck fracture group, the mean BMD value was 0.59+/-0.02 g/cm2 in femoral neck, 0.38+/-0.08 g/cm2 in Ward triangle and 0.48+/-0.09 g/cm2 in trochanteric region. In intertrochanteric fracture group, the mean BMD value was 0.57+/-0.09 g/cm2 in femoral neck, 0.39+/-0.10 g/cm2 in Ward triangle, and 0.47+/-0.13 g/cm2 in trochanteric region. 2. In femoral neck fracture group, the fracture threshold value was 0.75 g/cm 2 in femoral neck, 0.60 g/cm2 in Ward triangle and 0.67 g/cm2 in trochanteric region. In intertrochanteric fracture group, the fracture threshold value was 0.63 g/cm2 in femoral neck, 0.51 g/cm2 in Ward triangle, and 0.57 g/cm2 in trochanteric region. In conclusion, there was no statistical relationship in BMD value between neck fracture and intertrochanter fracture group, and no statistical relationship between BMD value and each fracture type in femoral neck and intertrochanter fracture. The type of hip fracture may be related to the degree of trauma rather than the value of the BMD.
Absorptiometry, Photon ; Bone Density* ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip* ; Humans ; Incidence ; Neck ; Osteoporosis ; Skeleton

PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.
Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Length of Stay ; Operative Time ; Wounds and Injuries

No abstract available.
Masticatory Muscles* ; Trismus*

Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

PURPOSE: Increasingly, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) has been performed. However, yet, there is no standard therapy after incomplete EMR or ESD. The aim of this study was to evaluate the necessity of further resection after an incomplete EMR or ESD. METHODS: We analyzed 24 patients who underwent curative gastrectomy due to an incomplete EMR or ESD between January 2000 and February 2007. A retrospective review was performed evaluating the clinicopathological characteristics, operating methods and presence of residual tumor. RESULTS: After the gastrectomy, the total positive residual tumor rate was 66.7% (16/24), with a rate of 73.5% (11/15) for mucosal cancer a rate of 50.0% (4/8) for submucosal cancer, and a rate of 100% (1/1) for cancer that invaded the muscularis propria. There were no positive lymph nodes. There was no recurrence in a mean 35.5 months (range, 4~90 months) of follow-up. CONCLUSION: Further resection is recommended for patients with a positive resection margin, because of the possibility of the presence of a residual tumor. Laparoscopic resection may be one of the most effective therapeutic options for these patients as a minimally invasive procedure by which curative resection can be expected.
Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm, Residual ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

Rectus sheath hematoma is an uncommon cause of acute abdomen, caused by a tear in deep epigastric vessels or its branches. It occurs spontaneously, after trauma or surgery. Rectus abdominus myonecrosis is a life threatening complication of rectus sheath hematoma. We report a case with fatal rectus sheath hematoma complicated by rectus abdominus myonecrosis caused by ischial fracture in a chronic active rheumatoid arthritis patient.
Abdomen, Acute ; Arthritis, Rheumatoid* ; Hematoma* ; Humans

A deep infection following a prosthetic joint replacement is a serious complication with an incidence ranging from 1 to 2% of patients undergoing total prosthetic surgery. The common invading organisms are staphylococci, streptococci and gram negative bacillus. A candida infection after a prosthetic joint replacement is very rare, and a diagnosis is difficult because of the indolent nature of the clinical symptoms and signs as well as its rarity. We report a case of candida infection after a TKA, which was treated successfully by a staged reimplantation.
Bacillus ; Candida albicans* ; Candida* ; Diagnosis ; Humans ; Incidence ; Joints ; Replantation

No abstract available.
Radiation Oncology*

Specific values for amplitude and implicit time may differ among laboratory due to normal variations in recording electrodes, equipment, and protocol. We presented the results of fulHield and focal macular electroretinography in normal subjects using MacADIOS 411 and Maculoscope. Full-field electroretinograms were obtained in 87 normal subjects (65 males, 22 females) and focal macular electroretinograms were recorded in 33 valunteers(18 males, 15 females) under controlled condition. Age-matched norms were given in table, and for the purpose of clinical application, range of values was given for each group.
Electrodes ; Electroretinography* ; Humans ; Male

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytoiogic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows ; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2, Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Child* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Humans ; Leukocytes, Mononuclear ; Mastitis ; Mothers* ; Neutrophils ; Salivary Glands