No abstract available.
Chinchilla* ; Neurons*

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

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

In vitro culture of Toxoplasma gondii in HL-60 cells cnd cell-mediated immunity against Toxoplasma in dimethylsulfoxide(DMSO)-induced HL-60 cells, i.e., differentiation into granulocytes, were pursued. HL-60 cells were treated with various concentrations of DMSO, and 1.3%(v/v) for 3 day incubation was chosen as the optimal condition for differentiation into granulocytes. The degree of differentiation was assayed in physiological and functional aspects in addition to morphological point. When treated with 1.3% DMSO for 3 days, HL-60 cells did not synthesize DNA materials beyond background level, and showed active chemotactic response to chemotactic peptide, formyl-methionyl-leucyl-phenylalanine(FMLP). Morphologically promyelocytes of high nuclear/cytoplasmic(N/C) ratio changed to granulocytes of relatively low N/C ratio. The relationships between HL-60 cells or DMSO-induced HL-60 cells and Toxoplasma were examined after stain with Giemsa and fluorescent dye (acridine orange). HS-60 cells did not show any sign of toxoplasmacidal activity but showed intracellular proliferation of Toxoplasma to form rosette for 72 hr co-culture. In contrast, DMSO-induced HL-60 cells phagocytosed Toxoplasma within 1 hr, and performed a process of intracellular digestion of Toxoplasma thereafter. With the above results, it is suggested that phagosome-lysosome fusion is one of the critical events for the parasitism by Toxoplasma or for susceptibility of host cells. The in vitro culture system of this study has offered a defined condition to study the protozoan parasite-host cell interactions.
parasitology-protozoa ; Toxoplasma gondii ; HL-60 cells ; dimethylsulfoxide ; in vitro culture ; dimethylsulfoxide

The occurrence of a lipoma-like condition associated with trauma would tend to be regarded as a subset of or a separate entity from ordinary lipoma. We report herein a case of traumatic Lpoma occuring on the dorsum of the left hand. The patient was a 46-year-old male, who had struck his left hand against a window about two months previously and noted casually an asymptomatic, firm, dermal lesion at the site of injury. On gross examination, the enucleated nodule was a smooth-surfaced, yellow fatty mass measuring 0.3 × 0.5 × 0.3cm which looked like a kernel of corn. Microscopic examination revealed encapsulated mature fat consistent with lipoma.
Hand ; Humans ; Lipoma* ; Male ; Middle Aged ; Zea mays

STUDY OBJECTIVE: We evaluate the clinical characteristics and natural history of patients presenting with spontaneous pneumomediastinum (SPNM) . DESIGN: A retrospective case series was conducted to identify patients diagnosed with SPNM. ICD-7(J98.2) discharge codes were used for Jan. 1993 to Aug. 1996 at four institutions , and emergency department(ED) records and admission charts were reviewed. Clinical features, interventions, complications, setting, etiology, symptoms, and length of hospital stay were recorded. PARTICIPANTS: All ED patients more than 12 years old with a diagnosis of SPNM. RESULTS: Thirteen cases were identified. Age range was 14 to 58 years(mean 24 years). Presenting symptoms were chest pain in eight(62%), dyspnea in six(46%), both symptoms in three(23%), no complaints in three(23%). Seven(54%) patients complained only of throat discomfort. Seven(54%) had subcutaneous emphysema, and two(15.3%) had a small pneumothorax. Two(15.3%) were smokers. Three(23%) had normal esophagograms and another three had normal chest CT findings. Two cases(15.3%) were associated with inhalational drug use and three cases were due to exercise. Nine cases(69%) had a history of "Valsalva-type" maneuver. Two patients(15%) had a history of antituberculous treatment and one(7.7.%) had suffered from bronchial asthma. Mean hospital days were 7.3 days(range 3 to 14), none of all needed any intervention. Specifically, no patient developed a subsequent pneumothorax or airway compromise. Seven cases(54%) were received prophylactic antibiotics. CONCLUSION: Most simple SPNM cases are benign disease and most of them(78%) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use is not a main cause of SPNM yet, but increase in use of bronchoinhalers is a suspicous cause of SPNM.
Anti-Bacterial Agents ; Asthma ; Chest Pain ; Child ; Diagnosis ; Dyspnea ; Emergencies ; Humans ; Length of Stay ; Mediastinal Emphysema* ; Natural History* ; Pharynx ; Pneumothorax ; Retrospective Studies ; Subcutaneous Emphysema ; Tomography, X-Ray Computed

No abstract available.
Humans ; Interferon-alpha* ; Interferons* ; Melanoma* ; Ulcer*

BACKGROUND: The skin prick test and in vitro allergen-specific IgE assays are commonly used to diagnose atopic diseases. However, there is still a need for comparison of their diagnostic efficiency. Objective and METHOD: To evaluate their clinical efficiency, the results of UniCAP and multiple antigen simultaneous test (MAST) were compared with skin prick test results. After 51 allergic patients completed skin prick test (SPT), serum sample was collected and UniCAP and MAST were performed to determine specific IgE to house dust mite (Dermatophagoides pteronyssinus : Dp and D. farinae. Df). Result : When SPT was used as a reference standard, UniCAP depicted higher sensitivity of 88.8% to Dp IgE and 91.4% to Df - IgE, but lower specificity of 73.3% to Dp IgE and 75.0% to Df - IgE. However, MAST had lower sensitivity of 75.1% to Dp-IgE and 71.4% to Df - IgE, higher specificity of 93.3% to Dp-IgE and 93.7% to Df - IgE. The values of UniCAP and MAST were significantly correlated with the reactivity grade of skin prick test, respectively. Additionally, the response of SPT was not apparently associated with ECP levels. CONCLUSION: These study results may suggest that both UniCAP and MAST are generally feasible for measuring house dust mite - specific IgE and that they are both replicable.
Dust* ; Humans ; Immunoglobulin E* ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin*

Segmental wiring to treat the unstable fracture and fracture-dislocation of the thoraco-lumbar spine is more effective method than Harrington instrumentation as primary procedure which afforded immediate rigid internal fixation of the spine and permitted mobilization without external support and immediate rehabilitation. A clinical study was made of twenty seven patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Wonju Christian Hospital from Feb. 1979 to Apr. 1983. The following results were obtained: l. Of twenty seven patients, nine(33.3%) had a flexion rotation, eight(29.6%) had a shearing, eight (29. 6%) had a flexion compression and two(7.5%) had a vertical compression by Holdsworths mechanism of injury and by Pauls classification of fracture, thirteen(48. 1%) had a flexion distraction fracture, twelve(44. 4%) had a translation fracture and two(7. 5%,) had a unstable burst fracture. 2. Fifteen(55. 6%) had a complete neural deficit and five(18. 5%,) had an incomplete neural deficit. Six(22.2%) of the fifteen patients with complete neural deficit and one(3. 7%.) of the five patients with incomplete neural deficit showed slight neurological recovery, but eight(29.6%) gained complete recovery. 3. Correction of kyphotic deformity was average 12. 4 degree in Harrington instrumentation and average 18. 0 degree in segmental wiring, and during the follow-up periods, there was a final loss of 6. 3 degrees of kyphotic correction in Harrington instrumentation and 3. 0 degrees in segmental wiring. 4. In external support, fourteen(51.9%) had body jacket cast and four(14.8%) had back brace in Harrington instrumentation, but all patients except one brace had no external support in segmental wiring. 5. In complication, two hook dislocations and two pseudoarthroses were occurred in Harrington instrumentation, but any complication except only one cases of wound infection was not occurred in segmental wiring.
Braces ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Gangwon-do ; Humans ; Methods ; Pseudarthrosis ; Rehabilitation ; Spine ; Wound Infection

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy