Closed intramedullary nailing for trochanteric fractures of femur has many advantages such as minimal operative trauma, low incidence of infection, good stability of fracture, low incidence of delayed or nounion and early ambulation. Complications have been frequently experienced especially in elderly, osteoporotic patients, but these could be avoided by meticulous surgical procedure. The authors hsve treated 99 cases of intertrochanteric fracture and 23 cases of subtrochanteric fracture from March 1982 to December 1987 with this method and the results are summerized as follows : 1. The aversge age was 61.4 yrs. 2. In classification of intertrochanteric fracture, stable fractures(Kyle type I & II) were 53 cases(43.3%) and unstable fractures(Kyle type III & IV) were 46 cases(37.6%). And in subtrochanteric fracture, stable transverse fractures were 12 cases(9.8%) and unstable long oblique or spiral fractures were 11 cases(9.0%). 3. Intraoperative complications were experienced in 23 cases(18.8%). The entry hole breakage was most common and occurred in 16 cases. 4. Of the 94 patients with more than 6 months follow-up, 21 patients(22.3%) showed more than one complication, e.g, knee joint pain in 15 cases, external rotation deformity in 8 and nail migration in 11 including 3 cases of fixation loss and one case of nonunion with nail breakage, etc. 5. Complications occurred more frequently in unstable fractures(31.8%) and in old ages (29.1%) than in stable fractures and in young ages respectively. And it was felt that complications could be minimized by packing of the medullary canal with nails. 6. It is thought that flexible intramedullary nailing is a good method for trochanteric fractures of femur not only in elderly debilitated patients but also in young patients. However, experience and caution are required to prevent complications.
Aged ; Classification ; Congenital Abnormalities ; Early Ambulation ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Intraoperative Complications ; Knee Joint ; Methods

Hypochondroplasia is a form of short
Achondroplasia ; Christianity ; Dwarfism ; Extremities ; Hand

Fracture healing is the ongoing process but it is often delayed in elderly patients. Because the fractures in elderly patients with osteoporosis are severely comminuted and their quality of bone is poor, the associated delay of fracture healing is likely to lead to surgical failure. Recently, as a way to promote healing fractures, intermittent systemic parathyroid hormone treatment has been actively researched. Although the effect of parathyroid hormone, which is demonstrated by animal experiments, is well known, there are not many clinical applications. The authors report 2 cases which had the time-shortened callus formation by intermittent parathyroid hormone (teriparatide) administration after surgical treatment, maximum preservation of periosteum as possible, in elderly patients who have supracondylar fracture on distal femur.
Aged ; Animal Experimentation ; Bony Callus ; Femoral Fractures ; Femur ; Fracture Healing ; Humans ; Osteoporosis ; Parathyroid Hormone ; Periosteum

Serial neurosonographic examinations are routinely performed at frequent intervals during nursery course of all preterm infants of very low-birth-weight who are admitted to the intensive care nursery of Presbyterian Medical Center from November 1, 1990 to July 30, 1992. After discharge, the following survivors who had received periodic, serial scanning by meas of cranial ultrasonography were longitudinally observed in an interdisciplinary neurodevelopmental follow-up program to a mean corrected age of 13 months. Neurodevelopmental outcome was assessed by means of Vojta's postural reaction and other neurological examinations. The results are as follows: 1) The incidence of PV-IVH in the study was 79%. 2) According to Papile's grading system of PV-IVH, gradel was 20%, gradell was 46%, gradelll was 19%, and grade IV was 13%. 3) The risk factors associated with PV-IVH were birth weight, gestational age, apgar score, ventilator care, RDS, and sepsis. 4) The mortality of PV-IVH was 20% for gradel, 19% for gradell, 44% for gradelll, and 67% for grade lV. 5) According to relationship between PV-IVH and neurodevelopmental outcome, in two of the four subjects with grade lll PV-IVH, moderate/severe CCD was developed. 6) According to relationship between PVE with cysts and nuerodevelopmental outcome, moderate/severe PVE with periventricular cysts larger than 3mm in diameter was associated with development of severe CCD.
Apgar Score ; Birth Weight ; Follow-Up Studies ; Gestational Age ; Hemorrhage* ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Critical Care ; Mortality ; Neurologic Examination ; Nurseries ; Protestantism ; Risk Factors ; Sepsis ; Survivors ; Ultrasonography ; Ventilators, Mechanical

No abstract available.
Mandibular Condyle

PURPOSE: This study quantitatively evaluated the apoptosis in human peripheral blood lymphocytes using flow cytometry, and investigated the possibility of using this method, with a small amount of blood, and the time and dose dependence of radiation-induced apoptosis. MATERIALS AND METHODS: Peripheral blood lymphocytes were isolated from the heparinized venous blood of 11 healthy volunteers, 8 men and 3 women, with each 10 ml of blood being divided into 15 samples. The blood lymphocytes were irradiated using a linear accelerator at a dose rate of 2.4 Gy/min, to deliver doses of 0.5, 1, 2 and 5 Gy. The control samples, and irradiated cells, were maintained in culture medium for 24, 48 and 72 hours following the irradiation. The number of apoptotic cells after the in vitro X-irradiation was measured by flow cytometry after incubation periods of 24, 48 and 72 hours. We also observed the apoptotic cells using a DNA fragmentation assay and electron microscopy. RESULTS: The rate of spontaneous apoptosis increased in relation to the time interval following irradiation (1.761+/-0.161, 3.563+/-0.564, 11.098+/-2.849, at 24, 48, and 72 hours). The apoptotic cells also increased in the samples irradiated with 0.5, 1, 2 and 5 Gy, in a radiation dose and time interval after irradiation manner, with the apoptosis being too great at 72 hours after irradiation. The dose-response curves were characterized by an initial steep increase in the number of apoptotic cells for irradiation doses below 2 Gy, with a flattening of the curves as the dose approached towards 5 Gy. CONCLUSION: The flow cytometric assay technique yielded adequate data, and required less than 1 mL of blood. The time and dose dependence of the radiation-induced apoptosis, was also shown. It is suggested that the adequate time interval required for the evaluation of apoptosis would be 24 to 48 hours after blood sampling.
Apoptosis* ; DNA Fragmentation ; Female ; Flow Cytometry ; Healthy Volunteers ; Heparin ; Humans ; Lymphocytes* ; Male ; Microscopy, Electron ; Particle Accelerators

We compared the serotypes of Streptococcus pneumoniae between the pre-pneumococcal conjugate vaccine (PCV)13 era and post-PCV13 era among homogenous inhabitants of an isolated South Korean island. A total of 325 S. pneumoniae strains were isolated. In the pre-PCV13 era, 19A/F, 15A/F, 19B, and 23A serotypes were identified. In the post-PCV13 era, 15 serotypes were identified. The 19F and 23A serotypes showed the highest prevalence in the pre- and post-PCV13 era, respectively. After PCV13 introduction, the PCV 13 serotype coverage rate was decreased (80.0% and 30.5% in the pre- and post-PCV13 eras, respectively), while the proportion of non-PCV 13 serotypes increased.

PURPOSE: Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients. MATERIALS AND METHODS: The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed. RESULTS: We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients. CONCLUSION: Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.
Asian Continental Ancestry Group ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sample Size ; Survival Rate ; Venous Thromboembolism*

Meningioma is a common brain tumor and the associated calcification is frequently found in imaging study. However, calcification of entire tumor bulk in meningioma is very rare finding. We present the clinical and radiological summery of our case which showed totally calcified meningioma and discuss the pathogenesis and clinical significance of such a tumoral calcification.
Brain Neoplasms ; Meningioma*

PURPOSE: To evaluate the role of curative radiotherapy alone in the treatment of uterine cervical carcinomas, by a retrospective analysis with respects to survival and pelvic control, and to find any risk factors of failure MATERIALS AND METHODS: Between Jan. 1990 and Dec. 1995, a total of 187 patients, diagnosed with uterine cervical carcinomas in FIGO stages greater than IA, were treated by curative radiotherapy alone with no chemotherapy. The ages of the patients ranged from 26 to 80 years, with a median of 60 years. The number of patients diagnosed with squamous cell carcinomas were 183 (97.9%). The number of patients with FIGO stage IB1, IB2, IIA, IIB, IIIA, IIIB and IVA were 61 (32.6%), 7 (3.7%), 43 (23.0%), 62 (33.3%), 3 (1.6%), 7 (3.7%) and 4 (2.1%), respectively. External radiotherapy was performed with 6 MV or 10 MV X-rays, with a dose range of 19.8 Gy~ 50.4 Gy (median; 30.6), to whole pelvis. Intracavitary radiation (ICR) was then performed using a high-dose rate remote controlled afterloader with radioisotopes of Co-60 and Cs-137. The fraction size of the ICR was 5 Gy twice a week, and was delivered up to total doses of 10 Gy~ 55 Gy (median; 40). After the ICR, additional pelvic external radiotherapy with midline shielding width of 4 cm was performed with the dose range of 0~30.6 Gy (median; 19.8), and the resultant total doses of A points ranged between 49.8 Gy and 86.0 Gy (median; 70.6). RESULTS: The five-year overall survival rates of FIGO IB1, IB2, IIA, IIB, III and IVA were 88.3%, 83.3%, 86.1%, 65.2%, 60.0% and 50.0%, respectively (p=0.005). The pelvic control rates of each stage were 90.1%, 85.7%, 86.1%, 69.4%, 68.6% and 50.0%, respectively (p=0.03). From the multivariate analysis, the radiation response and tumor diameter were found to be significant factors affecting the overall survival. The significant factors influencing pelvic control were the radiation response and pre-treatment hemoglobin level. CONCLUSION: The radiation response and tumor diameter were significant factors affecting survival, so patients with tumor diameters greater than 4 cm should be considered for a combined modality, such as concurrent chemoradiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Drug Therapy ; Humans ; Multivariate Analysis ; Pelvis ; Radioisotopes ; Radiotherapy* ; Retrospective Studies ; Risk Factors ; Survival Rate