Acetabular fractures assume great clinical importance because acetabular is weight bearing joint in the lower extremity. The undisplaced fractures of the acetabulum gave satisfactory results with closed method, but the treatment of displaced fractures have been controversial. A clinical analysis was performed on the 72 patients with displaced acetabular fractures, who had been treated at Soonchunhyang University Hospital from January 1980 to December 1989. The results obtained were as follows. 1. The prevalent age ranged from 21 to 50 years, which comprised 86.1% of all, and the ratio between male and female was 3:l. 2. The most common cause of injury was traffic accident, which comprised 76.4%. 3. According to Letournel's classification, simple fracture was 38 cases (52.8%), associated fracture was 34 cases (47.2%) and hip dislocation was associated in 28 cases (38.9%) and most common was posterior (20.8%). 4. Closed treatment was done in 47 cases and open treatment in 25 cases. 5. Results of open treatment group were better than closed treatment group in both clinical and roentgenographic study. 6. The complication were occured in 14 (29.8%) out of 47 cases of closed treatment group, and 10 (40.0%) out of 25 cases of open treatment group. 7. Not only choice of treatment but also determination of surgical approach require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radilogic analysis.
Accidents, Traffic ; Acetabulum ; Classification ; Female ; Hip Dislocation ; Humans ; Joints ; Lower Extremity ; Male ; Methods ; Weight-Bearing

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Intraoperative collection of bile and a bile culture are of use in predicting bacterial infection in the biliary system. The aim of this study was to identify chronological changes in the bacteriology of the bile in the age and sex distributions for biliary tract disease of the patients. METHODS: We retrospectively reviewed the clinical records of 722 patients who had been operated on for biliary tract disease at the Department of Surgery Ewha Womans University Hospital, from Jan. 1979 to July 1998 and on whom intraoperative bile culture had been performed. We divided the 722 patients into two group based on the time of their treatment, period A being 1979-1988 and period B being 1989-1998. The statistical analysis was done by using the Mantel-Haenszel Chi-Square test. RESULTS: The overall bile culture positive rate was 56% (404 cases), and the male-to-female ratio was 1:1.64. There was no significant statistical difference in the sex ratio between the two periods (period A: 1:1.78, period B: 1:1.55) (p>0.05). Overall, the most commonly isolated organism in the bile was Escherichia coli (137 cases, 30%). Comparing the two periods, we found that the Enterococcus species was an organism found increasingly in biliary tract infections (period A: 0%; period B: 17%) whereas infection by Escherichia coli was significantly decreased in the latter period (period A: 43%; period B: 28%) (p<0.05). The sixth decade (29.1%) was the most prevalent age overall. The age distribution for period A showed no statistical difference between the 5th (21.58%) and the 7th decades (21.94%), but there was significant difference between the 7th (29.95%) and the 5th decades (16.89%) in the age distribution for period B (p<0.05). CONCLUSIONS: According to the above results, we concluded that there were significant chronological changes in the bacteriology of the bile & in the age distributions between the two periods, but no such difference was observed between the sex distribution.
Age Distribution ; Bacterial Infections ; Bacteriology* ; Bile* ; Biliary Tract ; Biliary Tract Diseases ; Enterococcus ; Escherichia coli ; Female ; Humans ; Retrospective Studies ; Sex Distribution ; Sex Ratio

The authors experienced three cases of cholangiocarcinoma associated with profuse mucin production. We intended to review and summarize the clinical features of these patients to emphasize the clinical importance of mucin-producing cholangiocarcinoma. All patients were female. Symptoms were mainly right upper quadrant pain and jaundice. Diagnosis was made by characteristic endoscopic retrograde cholangiographic findings and computed tomography. Bile ducts were dilatated and obstructive jaundice had developed as a result of the accumulation of mucin realeased by the tumor. Treatments were hepatic lobectomies for two intrahepatic cholangiocarcinoma patients and extrahepatic bile duct resection and hepaticojejunostomy for one patient. There was no postoperative complication. Pathologies were well differentiated papillary adenocarcinoma in two cases. Two patients are still living without recurrence for over three and four years respectively. One patient who had T4 lesion died of recurrence 38 months after operation. Conclusively, aggressive surgical treatment may be justified in the treatment of mucin hypersecreting cholangiocarcinoma even in advanced stage in view of the favorable outcome after radical operation. Further study is needed to clarify its biological behavior.
Adenocarcinoma, Papillary ; Bile Ducts ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma* ; Diagnosis ; Female ; Humans ; Jaundice ; Jaundice, Obstructive* ; Mucins ; Pathology ; Postoperative Complications ; Recurrence

Trichorrhexis nodosa(TN) denotes small node-like swelling with a loss of cuticle of the hair shaft through which the hair readily fractures. The basic cause of TN is mechanical or chemical trauma, and a contributing factor is an inherent weakness of the hair shaft. We report a case of localized TN in a 37-year-old male. He had an ovoid hair patch with multiple small white-gray dotted and stubby hairs localized to the right occipital scalp. TN is known to be the commonest of all hair shaft anomalies (Price, 1975). However TN is rarely reported, and there have been only four reports in Korean dermatological literature, to our knowledge, which might be due to underdiagnosis of this disorder. We postulated that diagnostic difficulty lies in the discrepancy between terminology and gross morphological findings.
Adult ; Fibrinogen ; Hair ; Humans ; Male ; Scalp

OBJECTIVES: This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. METHODS: Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. RESULTS: The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age (55.8%) were significant explanation variables for health related quality of life. CONCLUSIONS: The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Humans ; Personality Assessment ; Prevalence ; Quality of Life

Accurate measurement of cortisol is critical in adrenal insufficiency as it reduces the risk associated with misdiagnosis and supports the optimization of stress dose. Comprehensive assays have been developed to determine the levels of bioactive free cortisol and their clinical and analytical efficacies have been extensively discussed because the level of total cortisol is affected by changes in the structure or circulating levels of corticoid-binding globulin and albumin, which are the main reservoirs of cortisol in the human body. Antibody-based immunoassays are routinely used in clinical laboratories; however, the lack of molecular specificity in cortisol assessment limits their applicability to characterize adrenocortical function. Improved specificity and sensitivity can be achieved by mass spectrometry coupled with chromatographic separation methods, which is a cutting-edge technology to measure individual as well as a panel of steroids in a single analytical run. The purpose of this review is to introduce recent advances in free cortisol measurement from the perspectives of clinical specimens and issues associated with prospective analytical technologies.

The adrenal gland plays a pivotal role in an organism’s health span by controlling the endocrine system. Decades of research on the adrenal gland have provided multiscale insights into the development and maintenance of this essential organ. A particularly interesting finding is that founder stem/progenitor cells participate in adrenocortical development and enable the adult adrenal cortex to regenerate itself in response to hormonal stress and injury. Since major advances have been made in understanding the dynamics of the developmental process and the remarkable regenerative capacity of the adrenal gland, understanding the mechanisms underlying adrenal development, maintenance, and regeneration will be of interest to basic and clinical researchers. Here, we introduce the developmental processes of the adrenal gland and discuss current knowledge regarding stem/progenitor cells that regulate adrenal cortex remodeling and regeneration. This review will provide insights into the fascinating ongoing research on the development and regeneration of the adrenal cortex.

OBJECTIVE: The purpose of this study was to evaluate of course of delivery & perinatal outcomes for postterm pregnancy compared with fullterm pregnancy. METHODS: This study included 360 cases of postterm pregnancy out of 16,992 cases delivered at Department of Obstetrics and Gynecology from January 1, 1993 to December 31, 1997. 16,143 cases of full term deliveries of 38 to 42 gestational weeks conducted in same period were used as the control group. Postterm pregnancy was defined as a pregnancy that it exceeds 295 days calculated from first day of the last menstrual period. RESULTS: The incidence of postterm pregnancy was 2.13% with the highest incidence occurring in the 26 ~30 years age group. This study group was significantly different from the control group in the incidence of fetal distress (10.28% vs. 2.20%), large fetus (10.83% vs. 6.95%), perinatal death (1.67% vs. 0.27%). CONCLUSIONS: Adverse perinatal outcomes were increased markedly as the gestational weeks to be prolonged. Therefore, careful prenatal care, accurate determination of delivery date is very important.
Fetal Distress ; Fetus ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy* ; Prenatal Care

BACKGROUND: The development of cholangitis requires two conditions: first, the patient must have infected bile, and second, there must be an increase in bile duct pressure. Clinical symptoms of this disease (e.g., fever and chills, jaundice, abdiminal pain) are correlated with bactbilia, increased biliary pressure. METHODS: This study was planned to investigate two important factors in patients with cholangitis who have clinical manifestation like high fever, chills, and right upper guadrant (RUQ) pain at records of 50 patients who had been admitted to the Department of Surgery at DongDaeMoon Ewha Womans University Hospital between September 1994 and December 1997 and have been operated with the diagnosis of hepatobiliary disease were reviewed. The cases had been who had using abdominal computed tomography, ultrasonography, or endoscopic retrograde cholangiopancreatography. Under general anesthesia, the diameter of the Common bile duct (CBD) and intrabiliary ductal pressure were measured. the direct bilirubin, Alkaline phosphatase (ALP), body temperature and the peripheral white blood cell count were also measured. We analyzed the correlation of the measured parameters. RESULTS: Fortyfive of the 50 patients had biliary tract stones, and 5 had a cancer located in the periampullary area. Their average age was 54. There were no statistical significance among the location of the biliary duct stone, the causative organism, and the intrabiliary ductal pressure. The measured CBD diameter was 17.2+/-3.7 mm. The measured intraductal pressure was 18.5+/-6.5 cmH2O. There were no statistical correlation between the CBD diameter and the intraductal pressure. The direct bilirubin was 1.86+/-1.96 mm, higher than the normal value, and a statistically significant correlation with the CBD diameter. The serum ALP was 338 IU/L, and it was higher than normal value. Though the ALP had no statistically significant correlation with the CBD diameter, it had a significant correlation with the CBD pressure. The peripheral WBC count was 11,000+/-4433/mm3, higher than the normal value, but it had no statistical corrlation with the CBD diameter and the intraductal pressure. The CBD pressure of the patients who had elevated body temperature above 37.5oC was higher than the CBD pressure of the patients whose body temperarure was below 37.5degrees C. CONCLUSION: This study suggests that an elevated intrabiliary ductal pressure plays an important role in aggravated symptoms of cholangitis. The serum ALP represents the elevated biliary ductal pressure of the acute phases, while an increased biliary duct diameter and direct bilirubin represent the chronic phase, also, the change of WBC count does not correlate with the intrabiliary ductal pressure and the CBD diameter, and the patients with elevated body temperatures have increased biliary ductal pressure.
Alkaline Phosphatase ; Anesthesia, General ; Bile Ducts* ; Bile* ; Biliary Tract ; Bilirubin ; Body Temperature ; Chills ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Common Bile Duct ; Diagnosis ; Female ; Fever ; Humans ; Jaundice ; Leukocyte Count ; Reference Values ; Ultrasonography