The incidence of trochanteric fracture of the femur is increasing, which is likely to continue for many years because of an increase in traffic accidents and the population of elderly people. The primary goal in the treatment of an elderly patient with an intertrochanteric hip fracture is to return the patient to his prefracture activity without any complication, as soon as possible. Rapid mobilization with stable internal fixation helps to prevent skin ulceration, pneumonia, urinary stasis, thromboembolic disease and other complications of confinement to bed in the elderly. Stable internal fixation depends mainly upon the fracture type and operative techniques. A clinical study of operative techniques was done in twenty three patients with trochanteric fracture of the femur who had been admitted and treated surgically at the Orthopaedic Department of W.M.B.H. during of two years from Mar. 1982 to Feb. 1984. The following are brief descriptions of the operative techniques. l. An L-shape incision and refiection of the vastus lateralis muscle provided wide exposure and facilitated anatomical reduction under direct vision. 2. The nail insertion site was selected at a slightly eccentric position anterior to rather than exactly midway from the opposite lateral cortex of the lesser trochanter. Therefore the nail could be laid rigidly between the thick anteromedial cortex and the posteromedial calcar portion. 3. The best stable position among the fracture line, the neck shaft angle and the nail plate could be obtained by the yoking procedure. It also allowed for later proximal migration of the shaft fragment and fracture impaction without impingement on the base of the barrel.
Accidents, Traffic ; Aged ; Clinical Study ; Femur ; Hip ; Humans ; Incidence ; Neck ; Pneumonia ; Quadriceps Muscle ; Skin Ulcer

Epithelioid hemangioendothelioma of liver is a very rare tumor of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. We present a primary epithelioid hemangioendothelioma of liver in a 40-year-old male. This tumor was composed of an ill-defined yellowish white, 7 x 4cm sized, firm, solid mass and small satellite nodules in the right lobe of liver. Microscopically, two types of tumor cells-dendritic and epithelioid-were identified. The neoplastic cells infiltrated into sinusoids and intrahepatic veins. The background of tumor showed marked sclerotic change and focal proliferation of bile ductules. Confirmation of the endothelial origin of these cells was provided by positive immunoperoxidase staining for factor VIII-related antigen, and by electron mi-croscopic demonstration of Weibel-Palade body. This is the first case of epithelioid heman- gioendothelioma of liver documented in Korea. We report this case in view of its scarcity and distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma.

Synovial sarcoma is one of the most common malignant soft tissue tumors in paraarticular regions. However, it is very rare to occur without any apparent relationship to synovial or articular structures. We report a case of synovial sarcoma manifested as a subcutaneous nodule in the upper lip. A 12-year-old boy complained of a palpable tender mass in the upper lip for several months. Under the impression of a benign soft tissue neoplasm, surgical excision was done. The mass, 1.5 cm in maximum diameter, was easily separated from surrounding tissues. Microscopically, this tumor showed a characteristic biphasic pattern of synovial sarcoma. On immunohistochemical and ultrastructural studies, the tumor cells showed evidence of epithelial differentiation. There was no evidence of joint-related, primary lesions or metastatic foci. This report describes a case of synovial sarcoma arising in very unusual location and size for histologically typical synovial sarcoma.
Neoplasm Metastasis

No abstract available.
Cyclophosphamide* ; Humans* ; Stomach Neoplasms*

No abstract available.
Titanium*

No abstract available.
Nose* ; Rhinoplasty*

No abstract available.
Spinal Cord Injuries* ; Spinal Cord*

Intra-uterine fracture of normal bone is extremely rare. It was reported few cases in the other contries, but it was very rare in Korea. It is difficult to distinguish it from birth fracture and the other fractures or deformities seen at birth. The authors experienced a case of intra-uterine fracture of the femur in the middle third of the shaft, with abundant callus formation in infant without serious injury to the mother.
Bony Callus ; Congenital Abnormalities ; Femur ; Humans ; Infant ; Korea ; Mothers ; Parturition

To identify significant prognostic factors in patients undergoing simple hysterectomy in the presence of invasive cervical cancer, the records of 45 patients who had taken such a procedure between 1993 and 1997 were reviewed. Overall relapse-free survival and 5-year survival rates were 91.1 and 92.1%, respectively. Factors found to be significantly related to survival were the retrospectively determined stage(p=0.0000), the presence of residual disease(p=0.0001), and cell type(p=0.0000). By multivariate analysis, factor emerging as significantly detrimental to survival was the cell type. The presence of residual disease was a marginally significant factor(p=0.067). The expectations for survival of patients with residual tumor mass and/or with adenocarcinoma after simple hysterectomy appear to be markedly worse than those with others, so radical reoperation should be considered in those patients.
Adenocarcinoma ; Humans ; Hysterectomy* ; Multivariate Analysis ; Neoplasm, Residual ; Reoperation ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

Most of the macular hole retinai detachinents are limited to the perimacular area. Therefore, we must look for the peripheral retinal hole when the macular hole retinal detachment extends beyond equator. And the principle of operation should be on the peripheral retinal hole rather than macular hole. Authors studied the clinical feature of macular hole retinal detachment associated with the peripheral retinal hole. Among the 39 macular hole retinal detachment patients, peripheral hole was found in 12 patients (30.7%). Sex distribution was the same and mean age was 55.9 years old. Retinal detachment was not diagnosed for more than I month in 7 cases (58.4%). Nine cases (75.0%) were extensive retinal detachments extending beyond 3 quardrants. Nine cases (75.0%) had one peripheral hole and most of peripheral holes were found on the ternporal side. Associated diseases were cataract (5 cases, 38. 5%) and high myopia (5 cases, 38.5%). In 4 cases (33.3%) hole was found on the opposite side. Among the 12 macular hole retinal detachment patients, 11 operations were performed with the technique of gas injection and scleral buckling which lead to successful attachment in 5 cases (41.7%). Among the 7 cases in which reoperations were needed, 3 cases (42.9%) were recurred in 3 months. In 8 cases (66.7%) there were improvements of post-operative visual acuity.
Cataract ; Humans ; Myopia ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Scleral Buckling ; Sex Distribution ; Visual Acuity