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

The purpose of this study is to observe the choroidal vascular occlusion by photocoagulation under intravenous administration of fluorescein sodium. Argon laser photocoagulation(intensity: 50 mW, duration: 0.05 sec., spot size: 200 micrometer) was applied to the retina of the left eye(control group) and the same method was repeated to the right eye combined with intravenous infusion of 2 ml of fluorescein sodium in the pigmented rabbit(experimental group). The photocoagulated rabbit eyes were enucleated after 2 hrs, 1, 3 and 5 days and the retina and choroid were observed under electron microscopy. The result were as follows. 1. In the control group, loss of melanin pigments in the retinal pigment epithelium and destruction of outer segments of the photoreceptor were observed but endothelial cells of choriocapillaris and Bruch's membrane were intact. 2. In the experimental group, two hours after irradiation, endothelial cells of choriocapillaries were destroyed and capillary lumen was occupied with thrombus components, the retinal pigment epithelium and outer segment of the photoreceptor cells were also destroyed. One day after irradiation, occupied materials in lumen were absorbed but residual debris of thrombus was demonstrated. Three days after irradiation, newly formed endothelial cel1 processes were extended in the area of destroyed choriocapilJaries. Five days after irradiation, long processes of newly fonned endothelial cells extended in the area of choriocapillaries. The outer part of retina was repaired with newly formed pale pigment epithelium and proliferated Miil1er cells. 3. In conclusion, argon laser-provoked vascular change was more easily recognized by intraluminal fluorescein sodium which probably acted as an energy absorbent.
Administration, Intravenous ; Argon ; Bruch Membrane ; Capillaries ; Choroid* ; Endothelial Cells ; Epithelium ; Fluorescein* ; Infusions, Intravenous ; Light Coagulation ; Melanins ; Microscopy, Electron ; Photoreceptor Cells ; Retina ; Retinal Pigment Epithelium ; Thrombosis

The ultrastructural changes of the chorioretina following the intravitreal injection of ornithine in rabbit eyes at 1,2,4,8 week time intervals were investigated employing electron microscopy in this animal experiment. 1. 1 week after injection, swelling of the mitochondria in the cytoplasm of the pigment epithelium was seen. 2. 2 weeks after injection, phagosomes and phagolysosomes were present in the cytoplasm of the pigment epithelium and nerve elements in the inner nuclear layer disappeared and were replaced by Muller cell. 3. 4 weeks after injection, stroma of the choroid was atrophied and abundant melanocytes were aggregated, and papillary formed pigment epithelium with detachment of the retina was seen. 4. 8 weeks after injection, stromal atrophy and attenuated choriocapillaries of the choroid were present, and proliferation of the microvilli of the pigment epithelium after detachment of the retina was seen. 5. In summary intravitreal injection of ornithine in rabbits initially caused marked changes in the pigment epithelium with subsequent degeneration of the choroid and sensory retina.
Animal Experimentation ; Atrophy ; Choroid ; Cytoplasm ; Epithelium ; Intravitreal Injections ; Melanocytes ; Microscopy, Electron ; Microvilli ; Mitochondria ; Ornithine* ; Phagosomes ; Rabbits ; Retina

Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

Stress has been regrarded as one of the causes of central serous chorioretinopathy. We studied the effect of Hexamethonium (ganglionic blocking agent) on experimentaI serous chorioretinopathy following epinephrine injection in rabbits. In group 1, we injected the 0.1 % epinephrine into the rabbits through IV route for 10 days and in group 2, we addited Hexamethonium subcutaneously prior to injection of the epinephrine same term of gorup 1. We could find slight histological changes in gorup 2 as com paired with group 1, which produced serous chorioretinopathy, under the electronmicroscopic study so we would expect the preventive effect of Hexamethonium on the stress-induced serous chorioretinopathy.
Central Serous Chorioretinopathy ; Epinephrine ; Hexamethonium* ; Rabbits*

Stress has been regrarded as one of the causes of central serous chorioretinopathy. We studied the effect of Hexamethonium (ganglionic blocking agent) on experimentaI serous chorioretinopathy following epinephrine injection in rabbits. In group 1, we injected the 0.1 % epinephrine into the rabbits through IV route for 10 days and in group 2, we addited Hexamethonium subcutaneously prior to injection of the epinephrine same term of gorup 1. We could find slight histological changes in gorup 2 as com paired with group 1, which produced serous chorioretinopathy, under the electronmicroscopic study so we would expect the preventive effect of Hexamethonium on the stress-induced serous chorioretinopathy.
Central Serous Chorioretinopathy ; Epinephrine ; Hexamethonium* ; Rabbits*

Infection in primary total hip arthroplasty may cause catastrophic results and is the major reason for implant failure. The purpose of this study was to evaluate the utility of the hip joint fluid culture as a method of predicting the possibility of a hip joint infection by calculating the sensitivity, specificity and accuracy. We performed 628 primary total hip arthroplasty and aerobic and anaerobic bacterial cultures for hip joint fluid between January 1989 and June 1996. The hip joint fluid culture was routinely performed to evaluate the utility of the femoral head for bone banking. Thirty-two cases out of the 628 hips showed positive intraoperative culture and 596 cases showed negative intraoperative culture. The isolated organisms from 32 positive cultures were 11 for Staphylococcus aureus, eight for Staphylococcus coagulase negative, seven for Enterococcus, three for E.coli and one each for Enterobacter, Acinetobacter and Pseudomonas. Anaerobic culture was negative in all cases. In the positive intraoperative culture cases, none had delayed infection during the follow-up period. But in the negative intraoperative culture cases, one case had acute infection and two cases had delayed infection. In the case with acute infection, Staphylococcus aureus was isolated and on two cases with delayed infection, Enterococcus and Staphylococcus coagulase negative were isolated, respectively. All 32 positive culture cases were fa~lse positive and 595 negative culture cases were true negative and one negative culture case was fa~lse negative. The sensitivity of the hip joint culture was 0%, the specificity was 94.9% and the accuracy was 0%. The specificity of hip joint fluid culture in primary total hip arthroplasty was high, hut the sensitivity score was zero. Therefore, the hip joint fluid culture should not be used for a routine check of infection status in primary total hip arthroplasty. We recommend the hip joint fluid culture in revision arthroplasty or hips in which infection is clinically suspected.
Acinetobacter ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Banks ; Coagulase ; Enterobacter ; Enterococcus ; Follow-Up Studies ; Head ; Hip Joint* ; Hip* ; Pseudomonas ; Sensitivity and Specificity ; Staphylococcus ; Staphylococcus aureus

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis