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*

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

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*

No abstract available.
Umbilical Cord*

Hyperemesis gravidarum is characterized by severe nausea, vomiting followed by weight loss, dehydration, electrolyte imbalance and acid-base derangements. Its treatment was composed of adequate fluid therapy, electrolyte replacement and nutrient supply. In severe case, it also leads to a variety of neurological symptoms including confusion, gait disturbance and nystagmus, possibly due to thiamine deficiency and may result in so called Wernicke's disease. We have experienced a case of Wernicke's encephalopathy associated with severe hyperemesis gravidarum and this case is presented with a brief review of literature.
Dehydration ; Female ; Fluid Therapy ; Gait ; Hyperemesis Gravidarum* ; Nausea ; Pregnancy ; Thiamine Deficiency ; Vomiting ; Weight Loss ; Wernicke Encephalopathy*

PURPOSE: Ethanol is the most common toxic substance encountered clinically and is becoming increasingly important in forensic medicine. Generally, pre-treatment with an alcohol disinfectant such as isopropyl alcohol for blood sampling could influence evaluations and affect legal evidence. This study was performed to determine whether isopropyl alcohol affects the serum ethanol level. METHODS: Volunteers were prohibited from drinking alcohol and taking medication for 48 hours prior to participating. Pregnant volunteers and volunteers with abnormal liver enzymes or abnormal kidney function were excluded. Enrolled subjects had their blood collected from each arm to measure the alcohol concentration, one side was disinfected with povidone iodine and the other with isopropyl alcohol. After waiting one hour, they ingested 20g of alcohol and waited. After one hour, the serum ethanol levels were measured using the same method as the first sampling. RESULTS: Ten volunteers enrolled for this study. Without the alcohol intake, all serum ethanol levels were in the nondetectable range(<3 mg/dL) for both samples with either isopropyl alcohol or povidone iodine. After drinking alcohol, the serum ethanol level varied among individuals; the mean value of the serum ethanol levels in the alcohol preparation group was 21.08+/-4.85 mg/dL, which was significantly greater than that of the povidone iodine preparation group (19.71+/-5.47 mg/dL) (p=0.006). However, the Bland-Altman analysis showed that the precision of both groups was 1.230 mg/dL, which was less than the measurement error of the equipment (3.48 mg/dL). Therefore, there was no significant difference between the two groups with regard to the measurement error. CONCLUSION: Before alcohol intake, there was no influence on the blood alcohol concentration from the alcohol disinfection, and the result was reliable. After alcohol intake, the possible influence of pre-treatment alcohol on the serum ethanol level was less than the measurement error of the equipment used.
2-Propanol ; Alcohol Drinking ; Arm ; Disinfection ; Drinking ; Ethanol ; Forensic Medicine ; Kidney ; Liver ; Povidone-Iodine

Residual renal function rapidly declines after the initiation of hemodialysis and its mechanisms are supposed to be associated with frequent hypotensive episodes during hemodialysis and subsequent ischemic injury to remnant nephron, but blood-membrane interaction might play an important role because of its ability to activate complement system and other various humoral and cellular mechanisms. Blood monocytes are activated by complements, bacterial contaminants and activated monocytes are known to secrete multiple proinflammatory cytokines such as TNF-alpha, IL-1 beta. The expression of TNF-alpha and IL-1 beta in mRNA and protein level were examined by RT-PCR and ELISA respectively in patients with ESRD after the initiation of hemodialysis. Author also investigated the mRNA expression of Fas in human proximal tubular cell culture in the presence of TNF-alpha and PBMC culture supernatant before and after the initiation of hemodialysis. Compared to PBMC separated before the initiation of HD, the amount of cytokine mRNA from PBMC separated after the initiation of HD showed increased tendency from 0.97+/-0.2 to 1.12+/-0.28 for TNF-alpha(p=0.29), from 1.03+/-0.18 to 1.10+/-027 for IL-1 beta (p=0.54). TNF-alpha and IL-l beta protein level in PBMC culture supernatant also showed increased tendency from 2.25+/-0.5 to 4.254+/-3.77 for TNF-alpha (p=0.10), from 3.5+/-2.08 to 4.0+/-4.3 for IL-1 beta(p=0,25). TNF-alpha increased Fas mRNA expression dose-dependently compared to control but it was not statistically significant(p=0,37, 0.22). Compared to the the level of Fas expression in HPTC cultured in the presence of pre HD PBMC supernatant, the level of Fas expression increased significantly in the presence of post HD PBMC supernatant (0.64+/- 057 vs 1.05+/- 0.12, p=0.01). As a conclusion, cytokine gene expression and secretion can increase as a result of blood-membrane interaction and these might have some influence on the loss of residual renal function in CRF patients maintained on hemodialysis.
Cell Culture Techniques* ; Complement System Proteins ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Humans* ; Interleukin-1 ; Interleukin-1beta ; Kidney Failure, Chronic* ; Monocytes ; Nephrons ; Renal Dialysis* ; RNA, Messenger ; Tumor Necrosis Factor-alpha

No abstract available.