No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

Peritrochanteric fractures are common in the elderly, and the mortaliy and morbidity rates after conservative treatment of the fractures are usually high. In these fractures the internal fixation now allows the patient more rapid functional gain. It has been known that for stabilization of fracture the sliding hip screw is superior to other fixation devices. To investigate the biomechanical difference between two different materials of dynamic hip screw, eight intertrochateric and eight subtrochanteric femur fractures were artificially induced in human cadavers. Two femurs were used as the control. In eight cadaver intertrochanteric fractures (Group I), four of them were treated with stainless steel compression hip screw and four were treated with titanium compression hip screw. Eight cadaver subtrochanteric fractures (Group II) were divided by two groups as equal number. One group was treated with stainless steel compression hip screw and the other was treated with titanium compression hip screw with plate. Each femur was secured in a fixation device of the Instron and loaded in a vertical compression. Collapse or fixation failure during vertical compression were observed and recorded continuously in slow speed with deformation rate of 3mm/min. Biomechanical analysis of maximal loading force in the control and experimental two groups were performed. The results were as follows; 1. The mean maximal loading force was 625 kp in control group. 2. The mean maximal loading force in each 4 intertrochanteric fractures fixed with stainless steel DHS (dynamic hip screw) and plate was 92.59 kp, and with titanium DHS and plate was 71.57 kp. There was no statistical significance between stainless steel DHS and plate fixation and titanium DHS and plate fixation. (p>0.05) 3. The mean maximal loading force in each 4 subtrochanteric fractures fixed with stainless DHS and plate was 140.12 kp, and with titanium DHS with plate was 169.4 kp. There was no statistical significance between stainless steel DHS and plate fixation and titanium DHS and plate fixation. (p>0.05) 4. The breakage of metal implant was not occurred at the maximal loading force 600 kp in both group. There was no difference of fixability and stability according to the metal quality, as the results of the experiment of compression loading force to the stainless steel DHS and titanium DHS fixation on intertrochanteric and subtrochanteric fractures in cadaverous femurs.
Aged ; Cadaver ; Femur* ; Hip Fractures ; Hip* ; Humans ; Internal Fixators ; Stainless Steel* ; Titanium*

Duodenal web is a very rare congenital anomaly which usually causes clinical features of intestinal obstruction from early infancy. It shows characteristic findings in the radiologic contrast study or endoscopy. But in the cases with large openings, preoperative diagnosis of web is difficult and often is overlooked until adolescence or adulthood because of delayed onset of symptoms. Duodenal web is usually single near the ampulla of Vater and may be multiple. Only a few cases of double duodenal webs have been reported in the literature. We experienced a case of double duodenal web in a 15 year-old girl who complained of peptic ulcer-associated symptoms including epigastric pain and bloody stool. She had suffered from longstanding abdominal symptoms, malnutrition and iron-deficiency anemia. We propose that duodenal web should be kept in mind for patients with a history of chronic gastrointestinal obstructive symptoms and atypical peptic ulcer.
Adolescent ; Ampulla of Vater ; Anemia, Iron-Deficiency ; Diagnosis ; Endoscopy ; Female ; Humans ; Intestinal Obstruction ; Malnutrition ; Peptic Ulcer*

The anorectal anomaly is not rarely seen in the neonatal period. But, If it is not accompanied with a fairly large fistula, it presents an urgent problem, so should be managed with perianal anoplasty or colostomy. Neonatal peritonitis is very grave and is caused by various conditions listed in Table 1. In Korea, no case of neonatal peritonitis caused by anorectal has yet been reported in the literature. With brief review of the literature, we present a case of neonatal peritonitis which appeared 36 hours after birth by perforation of the colon due to anorectal stenosis.
Colon ; Colostomy ; Constriction, Pathologic* ; Fistula ; Korea ; Parturition ; Peritonitis*

Congenital factor Vll deficiency is a rare bleeding disorder with an estimated incidence of 1 in 500,000. It is inherited as an autosomal recessive pattern with variable expression and high penetrance. In severely affected patients, repeated hemarthroses, chronic crippling hemarthropathy, and dangerous hematomas can occur. Other types of hemorrhage include epistaxis, menorrhagia, hematuria, gastrointestinal and gingival bleeding. Fetal cerebral hemorrhage has been reported, although less frequently than in severe hemophilia A or B. It is characterized by normal partial thromboplastin time and prolonged prothrombin time. Definitive diagnosis rests on a specific assay for factor Vll clotting activity. Replacement therapy is necessary to control the hemorrhage. Conventional prophylaxis and therapy in this disorder have consisted of fresh frozen plasma (FFP) or prothrombin complex concentrate. We experienced a case of intraventricular hemorrhage and hydrocephalus in a 4-year-old girl who had been diagnosed with congenital factor Vll deficiency during her neonatal period. She presented with episodes of frontal headache, frequent vomiting and malnutrition. We report this case with a brief review and related literatures.
Cerebral Hemorrhage ; Child, Preschool ; Diagnosis ; Epistaxis ; Factor VII Deficiency* ; Factor VII* ; Female ; Headache ; Hemarthrosis ; Hematoma ; Hematuria ; Hemophilia A ; Hemorrhage* ; Humans ; Hydrocephalus* ; Incidence ; Malnutrition ; Menorrhagia ; Partial Thromboplastin Time ; Penetrance ; Plasma ; Prothrombin ; Prothrombin Time ; Vomiting

No abstract available.
Umbilical Cord*

Terminal cancer pain is always a challenge to pain doctors.If the focus of the cancer pain is located in the restricted area, it is easy to control the pain. However, if the focus of cancer pain is widespread, it is very difficult to control the pain and it makes pain doctors embarrassed.Nowadays, the ultrasound-guided nerve block become a popular method. It is easy to find the nerve and helps to insert the catheter around the nerve for the continuous nerve block. We encountered a patient who was 59 years old with a stomach cancer and vertebral metastasis. He complained about the pain in his abdomen, back and left thigh. His abdominal and back pain vanished with the use of continuous lumbar epidural injection. However, the patient still complained about the pain and numbness on the left thigh, because of this, he couldn't get any sleep.We tried a continuous femoral nerve block under the ultrasound guidance, after that his pain was gone.The ultrasound-guided nerve block will be very helpful to control the pain.
Abdomen ; Back Pain ; Catheters ; Femoral Nerve ; Humans ; Hypesthesia ; Injections, Epidural ; Neoplasm Metastasis ; Nerve Block ; Stomach Neoplasms ; Thigh

Rathke's Cleft Cyst (RCC), which is located at the intrasellar region, is considered to be the distended remnants of Rathke's pouch, an invagination of the stomodeum. Lined with columnar or cuboidal epithelium of ectodermal origin, RCC usually contains mucoid material and it is found in 13-22% of normal pituitary glands. The cyst rarely leads to the development of symptoms but, when it does, the most common presenting symptoms are headache, visual impairment, hypopituitarism and hypothalamic dysfunction. However, in some cases it presents symptoms of diabetes insipidus, decreased libido and impotence. Recently we experienced a case of RCC inflammation presenting with diabetes insipidus and treated with transsphenoidal surgery. To our knowledge, this is the first report of RCC presenting with symptoms of diabetes insipidus in Korea.
Aged ; Case Report ; Central Nervous System Cysts/complications/*diagnosis/surgery ; Diabetes Insipidus/diagnosis/*etiology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Human ; Pituitary Neoplasms/complications/*diagnosis/surgery

BACKGROUNG AND OBJECTIVES: To evaluate the clinical and prognostic significance of precordial ST segment depression in precordial leads on admission electrocardiogram (ECG) in acute inferior myocardial infarction treated with intravenous thrombolytic therapy. We analysed about clinical and angiographic characters. MATERIALS AND METHOD: ECG findings in 50 patients with acute inferior myocardial infarction were retrospectively studied with results of coronary angiography and clinical informations. We classified all patients in two group according to the admissional ECG. Twenty nine patients (Group A) had no or <1.0 mm ST depression in precordial lead and Twenty one patients (Group B) had > or =1.0 mm ST depression in two or more precordial (V1-V6) leads were included in this group. RESULTS: In precordial ST segment depression in acute inferior myocardial infarction patients had higher plasma peak mean CK levels (1945+/-1419 vs 3547+/-2728 IU/L, p=0.027) and lower LV ejection fraction (62+/-10% vs 53+/-11%, p=0.008) and lower left ventricle global chordal shortening (0.89+/-0.71 vs -1.39+/-0.94, p=0.046) and inferior wall chordal shortening (-1.68+/-1.11 vs -2.43+/-0.74, p=0.014) and higher Killip class (1.3+/-0.8 vs 2.4+/-1.4, p=0.002) than without precordial ST segment depression patients. CONCLUSION: In conclusion acute inferior myocardial infarction with precordial ST depression patients had more extensive myocardial damage with global and inferior left ventricle severe wall motion dysfunction. Therefore, this suggests a worse prognosis in acute inferior myocardial infarction with precordial ST depression than without precordial ST depression patients. We need more aggressive diagnosis and treatment in this patients to prevent extending myocardial damage.
Coronary Angiography ; Depression* ; Diagnosis ; Electrocardiography ; Heart Ventricles ; Humans ; Inferior Wall Myocardial Infarction* ; Plasma ; Prognosis ; Retrospective Studies ; Thrombolytic Therapy

Crossed aphasia refers to disturbances of language following a purely right-hemisphere lesion in right-handed individuals. In right-handed individuals, aphasia is almost invariably related to a left cerebral lesion and crossed aphasia occurs in only 1 percent who developed a sudden left hemiparesis with global aphasia. He has neither family history of left-handedness or ambidexterity. Brain MRI showed an acute large infarct of the middle cerebral artery territory on the right side and brain SPECT disclosed extensive areas of hypoperfusion in the right hemisphere and no abnormal finding in the left hemisphere. The sensory component of language function was almost improved, but the motor component has been changed. Further studies of crossed aphasia may supply more data on the functional organization of the brain for speech and language.
Aphasia* ; Brain ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Paresis ; Tomography, Emission-Computed, Single-Photon