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*

No abstract available.
Carcinoma, Small Cell* ; Prognosis*

BACKGROUND: The aging of the patient population is one of rhe most important factirs influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. mong them, coronary heart disease is the most importane. METHOD: Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clonical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results : 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66vs 1.91,P=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. CONCLUSIONS: Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.
Aged ; Aging ; Arrhythmias, Cardiac ; Atrioventricular Block ; Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Disease ; Delivery of Health Care ; Diagnosis ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Pulmonary Edema ; Risk Factors ; Stroke ; Thrombolytic Therapy

No abstract available.

PURPOSE: The aim of the present study was to assess the clinicopatholgical significance of Bcl-2 oncoprotein expression in childhood non-Hodgkin's lymphoma (NHL). METHODS: We have assessed 16 cases of childhood NHL during last 6 years from 1990 to 1995. Bcl-2 oncoprotein expression has been semiquantitatively analyzed in paraffin sections from 16 cases of childhood NHL with 39 control cases of adult NHL. The expression of Bcl-2 oncoprotein was correlated with histologic grade, immunophenotype, proliferative activity as measured by immunostain of Ki-67 antigen, clinical stage, and survival rate (event free survival rate, EFS). RESULTS: 1) Bcl-2 oncoprotein expression significantly decreased according to increase of histological grade (P<0.05). 2) High Bcl-2 oncoprotein expression was more frequent in B-cell NHL than T-cell NHL (P<0.05). 3) Proliferative activity as measured by immunostain of Ki-67 antigen was negatively correlated with Bcl-2 oncoprotein expression (P<0.05). 4) Bcl-2 oncoprotein expression was not correlated with clinical stage (P>0.05). 5) EFS of patients was significantly correlated with Bcl-2 oncoprotein expression, that is, reduced EFS was demonstrated in the patients with low Bcl-2 oncoprotein expression (P<0.05). CONCLUSIONS: Thus Bcl-2 oncoprotein, as demonstrated immunohistochemically in routinely paraffin embedded tissue, can be restrictively used in prediction of prognosis and grade of childhood NHL, in aggrement with the role of Bcl-2 oncoprotein in blocking of apoptosis and indirect contribution to increase of cellular proliferative activity of NHL.
Adult ; Apoptosis ; B-Lymphocytes ; Child ; Humans ; Ki-67 Antigen ; Lymphoma, Non-Hodgkin* ; Paraffin ; Prognosis ; Survival Rate ; T-Lymphocytes