Traumatic dislocation of the hip presents serious problems that may lead to avascular necrosis, nerve palsy, post-traumatic arthritis even when reduction is promptly and adequately carried out. Among them avascular necrosis is the most important prognostic factor, so the early detection of this complication has critical significance for final result. Bone scan has been considered one of early diagnostic test, but recently MRI replaced its role for imaging in the detection of early AVN, treatment monitoring and prediction of prognosis. Authors prospectively studied the early finding of MRI to detect avascular necrosis of the femoral head and to predict prognosis in traumatic hip dislocation and fracture-dislocation. From December 1990 to November 1994, 12 case of dislocation and fracture-dislocation of the hip were studied . In follow up period ranging from 19 months to 65 months, 10 case had excellent or good result. All cases had abnormal MRI finding such as paraarticular edema, capsular bulging, joint effusion, femoral head fracture, but findings such as femoral head signal changes were dectected in only 3 cases. Among the 3 cases, 1 case had developed AVN and 2 cases were uneventful. Other complications were 3 cases of posttraumatic arthritis, 2 cases of incomplete sciatic nerve palsy, and 1 case of heterotrophic ossification. Although early MRI finding at posttrauma 2weeks gave less specific information, it could give good information for risk group and follow up control with more cases. Although it is expensive, MRI can be one of the most reliable reference in early diagnosis of AVN and prediction of prognosis in traumatic dislocation and fracture- dislocation of the hip with non-invasive method.
Arthritis ; Diagnostic Tests, Routine ; Dislocations ; Early Diagnosis ; Edema ; Follow-Up Studies ; Head* ; Hip Dislocation* ; Hip Joint ; Hip* ; Joints ; Magnetic Resonance Imaging* ; Necrosis ; Paralysis ; Prognosis ; Prospective Studies ; Sciatic Neuropathy

Seidel nail provides more advantages for treatment of humeral shaft fracture than other treatment modalities. It enables patients to get high bone union rate, makes surgical technigne less invasive, and allows early mobilization mobilization so that the patients is subjected to more comfortable treatment. But, Seidel nail is apt to injure the rotator cuff and has relatively weak holding power of distal fragment of fracture so that it may result in distraction and rotatory instability, and make nonunion and impaired shoulder function. Thus, in order to the functional and radiological results, complications and technical problems, we evaluated the efficacy of Seidel nail in treatment of 20 cases of hurneral shaft fractures from March l994 to March 1996, retrospectively. The results were as follows. 1. 18 cases(90%) achieved radiological union. 2. The time of union was 12.5 weeks in average. 3. 17 cases achieved satisfactory results according to Neers functional score. 4. The complications included proximal protrusion of nail from the entry site(10%), fracture of greater tuberosity of proximal humerus(5%), loosening of distal spreading screw(10%), and nonunion( l 0%). In conclusion, Seidel nailing is one of good treatment modalities for humeral shaft fracture, but skillful operative technique is needed to obtain the satisfactory functional result. And also, it is necessory to modify the distal locking system of Seidel nail to reinforce the rotational stahility of the fracture site.
Early Ambulation ; Humans ; Humerus ; Retrospective Studies ; Rotator Cuff ; Shoulder

Purpose: The survival of organisms critically depends on avoidance responses to lifethreatening stimuli. Information about dangerous situations needs to be remembered to produce defensive behavior. To investigate underlying brain regions to process information of danger, manganese-enhanced MRI (MEMRI) was used in olfactory fear-conditioned rats. Materials and Methods: Fear conditioning was conducted in male Sprague-Dawley rats. The animals received nasal injections of manganese chloride solution to monitor brain activation for olfactory information processing. Twenty-four hours after manganese injection, rats were exposed to electric foot shocks with odor cue for one hour. Control rats were exposed to the same odor cue without foot shocks. Fortyeight hours after the conditioning, rats were anesthetized and their brains were scanned with 9.4T MRI. Acquired images were processed and statistical analyses were performed using AFNI. Results: Manganese injection enhanced brain areas involved in olfactory information pathways in T1 weighted images. Rats that received foot shocks showed higher brain activation in the central nucleus of the amygdala, septum, primary motor cortex, and preoptic area. In contrast, control rats displayed greater signals in the orbital cortex and nucleus accumbens. Conclusion Nasal delivery of manganese solution enhanced olfactory signal pathways in rats. Odor cue paired with foot shocks activated amygdala, the central brain region in fear, and related brain circuits. Use of MEMRI in fear conditioning provides a reliable monitoring technique of brain activation for fear learning.

Medial meniscal root tears have been repaired using various methods. Arthroscopic all-inside repair using a suture anchor is one of the popular methods. However, insertion of the suture anchor into the proper position at the posterior root of the medial meniscus is technically difficult. Some methods have been reported to facilitate suture anchor insertion through a high posteromedial portal, a posterior trans-septal portal, or a medial quadriceptal portal. Nevertheless, many surgeons still have difficulty during anchor insertion. We introduce a technical tip for easy suture anchor insertion using a 25° curved guide and a soft suture anchor through a routine posteromedial portal.
Menisci, Tibial ; Surgeons ; Suture Anchors* ; Sutures* ; Tears

Endometriosis of the rectum is unusual condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. Symptoms related bowel involvement may vary from none to complete intestinal obstruction. Because the mucosa is involved infrequently there is rarely rectal bleeding. X-ray and sigmoidoscopic studies are usually negative. It was not reported that colonic endometriosis was confirmed by endoscopic biopsy. Recently we experienced a case of rectal endometriosis which presented itself as a cyclic rectal bleeding with abdominal pain and diagnosed by colonoscopic biopsy.
Abdominal Pain ; Appendix ; Biopsy* ; Cecum ; Colon ; Colonoscopy ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Ileum ; Incidence ; Intestinal Obstruction ; Mucous Membrane ; Rectum ; Uterus

PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30). The medical history and clinical findings including preoperative and postoperative blood examinations, radiological examinations and ambulatory status (measured using the Koval score). The rate of complications and morbidities were also investigated and compared. RESULTS: Preoperative hemoglobin/hematocrit was lower but a significant increase in partial thromboplastin time was observed in the hemodialysis group. The amount of bleeding/transfusions were higher and operative time was longer in the hemodialysis group. Upon radiologic examination, there was no significant difference in rate of unstable fracture and nonunion between the two groups. However the postoperative Koval score was significantly worse and the odds ratio of inability to walk after surgery was 13.5 times higher in the hemodialysis group. CONCLUSION: There was no significant difference in radiological results, but the risk of inability to walk after surgery was 13.5 times higher in the hemodialysis group. Hemodialysis patients have more morbidities and are hemodynamically unstable therefore require special attention. Accurate reduction and firm fixation is required and attentive postoperative rehabilitation is needed.
Femoral Neck Fractures ; Femur ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Kidney ; Necrosis ; Odds Ratio ; Operative Time ; Partial Thromboplastin Time ; Rehabilitation ; Renal Dialysis*

Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3~0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy.
Colon* ; Colonoscopy* ; Diagnosis ; Emergencies ; Gastrointestinal Contents ; Incidence ; Mortality ; Treatment Failure

OBJECTIVES: The purpose of this study was to estimate the normal blood lead (PbB) levels in a group of Korean subjects and to evaluate the association between PbB levels and habitual tobacco and alcohol use. METHODS: We recruited 532 adults (320 males and 212 females) with no history of occupational exposure to lead, as study subjects. RESULTS: PbB levels ranged between 0.43 microgram/dl and 9.45 microgram/dl. The adjusted geometric mean PbB in men was 3.19 microgram/dl, which was significantly higher than that seen in women: 2.66 microgram/dl (P=0.017). Geometric mean PbBs were not significantly different between urban and rural patients. The adjusted geometric mean PbB in smokers was 3.31 microgram/dl, which was significantly higher than that seen in nonsmokers: 2.64 microgram/dl (P=0.035). The adjusted geometric mean PbB in drinkers was 3.10 microgram/dl, which was significantly higher than that seen in non-drinkers: 2.75 microgram/dl (P=0.049). CONCLUSIONS: The PbB levels of some Korean adults seem to be comparable to those seen in foreign countries. Our results suggest that tobacco and alcohol cessation will be helpful in decreasing the harmful effect of lead.
Adult ; Drinking ; Humans ; Male ; Occupational Exposure ; Smoking ; Tobacco

OBJECTIVES: The purpose of this study was to investigate the stress coping strategies and psychological characteristics, such as combined psychopathology and tendency of symptom interpretation, in patients with somatization disorder. METHODS: Thirty patients meeting the criteria of DSM-IV somatization disorder were compared with thirty controls. We evaluated the subjects using Symptom Checklist-90-Revised (SCL-90-R), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and The Ways of Stress Coping Questionnaire (SCQ). Independent t-test and Pearson correlation analysis were used. RESULTS: From the results of SCL-90-R subscales, the scores of somatization, obsession-compulsion, depression, anxiety, and psychoticism were significantly higher in patients with somatization disorder than normal controls. Somatization disorder patients had greater amplification of physical sensation in SSAS and significantly higher score in physical interpretation of SIQ compared with psychological or environmental interpretation. In the SCQ of somatization disorder patients, we observed generally lower levels of total coping scores than the control group and significant positive correlation between passive coping style of SCQ and psychological interpretation of SIQ. CONCLUSION: These results show that patients with somatization disorder have various psychopathology, greater amplification of physical sensation, physical interpretation tendency of symptoms, and insufficient copying strategy.
Anxiety ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychopathology ; Surveys and Questionnaires ; Sensation ; Somatoform Disorders*

Peptic ulcer which extend beyond the serosa of the bowel wall may not perforate freely into the peritoneal cavity but instead penetrate adjacent structures (confined perforation). It has been reported that the frequency of penetration of peptic ulcer has been estimated around 20 percent in patients undergoing laparotomy for peptic ulcers. A 46-year- old male was admitted with chief complaint of hematemesis. Endoscopic examination revealed submucosal tumor like lesion with central ulcer and active bleeding which was located at the upper body, posterior wall of the stomach. Angiography demonstrated hypervascular tumor like lesion supplied by left gastric artery and short gastric branches of splenic artery. Postoperative biopsies showed inflammatory cell infiltration at the typical ulcer base and no evidence of malignancy. There was loss of acinus structure and fibrous adhesion with omentum at the pancreas. We report a case of gastric ulcer penetrating into pancreas, spleen with hypervascular nature with brief review of literatures.
Angiography ; Arteries ; Biopsy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Omentum ; Pancreas ; Peptic Ulcer ; Peritoneal Cavity ; Serous Membrane ; Spleen ; Splenic Artery ; Stomach ; Stomach Ulcer* ; Ulcer