Trochanteric fractures frequently occur in elderly patients and are associated with other fractures due to increase in severity of accidents. Because of complications in elderly patients, trochanteric fractures are treated with open reduction and internal fixation with increasing frequency. The authors treated 41 cases of trochanteric fractures of the femur in the year 1977 through 1980 at the Department of Orthopedic Surgery, Jeonbug National University. The resuts were as follows: 1. Of 41 cases, 35 cases were males and 6 cases females. In males most occurred at 60's and in females at 70's. 2. The most common cause of the fracture was slipping or fall down. 3. In Tronzo classification, the type I was most commmon. 4. 5 cases were treated conservatively and 36 cases with open reduction and internal fixation. 5. The mean duration of bony union was 16.4 weeks and no differences were noticed in the cases treated with open reduction and internal fixation. 6. Satisfactory results were obtained in 91.7% of operative treatment and in 80% of non-operative treatment. 7. From these results, it was concluded that operative treatment of trochanteric fracture had more advantages of improvement of function and less complication than those of non-operative treatment.
Aged ; Classification ; Clinical Study ; Female ; Femur ; Hip Fractures ; Humans ; Jeollabuk-do ; Male ; Orthopedics

The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
Amyloid ; Blister ; Dermis ; Epidermis ; Follow-Up Studies ; Free Tissue Flaps ; Friction ; Glycosaminoglycans ; Heel ; Myocutaneous Flap ; Superficial Back Muscles ; Weight-Bearing

Tubular apocrine adenoma and papillary eccrine adenoma are rare sweat gland neoplasms that appear as a small solitary lesion on the scalp or extremities, respectively. Although these lesions are thought to be distinct entities, there are enough similarities between them to group them under the term tubulopapillary hidradenoma or papillary tubular adenoma. We describe a case showing many tubular structures with papillary projection, syringocystadenoma-like structures, and eccrine hirocystoma-like structures in the axillary area. The term of papillary tubular adenoma or tubulopapillary hidradenoma may be prefered in this case.
Acrospiroma ; Adenoma* ; Extremities ; Scalp ; Sweat Gland Neoplasms

PURPOSE: We evaluated the medium- to long-term outcomes of cortical strut allografts used to treat periprosthetic bone defects to better understand the correlation between radiological and clinical outcomes. MATERIALS AND METHODS: We retrospectively reviewed outcomes from 19 patients undergoing cortical strut allografts to treat periproshtetic bone defects from 2001 to 2015. The mean age at index operation was 59.4 years and the average follow-up period was 8.6 years. Surgeries were performed because of aseptic loosening (n=9), periprosthetic fractures (n=5), and infections (n=5). Each case was characterized and described in detail including the length of allograft and the union period; possible correlations between allograft length and detailed classification and union period was analyzed. Clinical evaluations included the Harris hip score and Kaplan-Meier survivorship. RESULTS: In revision total hip arthroplasty (THA), the average length of allografts used in patients experiencing fractures was significantly longer than those with aseptic loosening or infection. Of the 19 cases, incorporation was observed in 18 cases (94.7%). The average time to incorporation was 21.2 months and the time to incorporation was not significantly different among the two groups (fracture vs. aseptic loosening or infection). No positive correlation was identified between the length of allograft and incorporation period or in the time to cortical strut allograft incorporation among Paprosky or Vancouver subgroups. CONCLUSION: Results of cortical strut allografts show excellent incorporation rates based on medium- to long-term follow-up. Cortical strut allografts may be considered useful for the treatment of femoral bone defects experienced during revision THA and following periprosthetic fracture.
Allografts ; Arthroplasty, Replacement, Hip ; Classification ; Follow-Up Studies ; Hip ; Humans ; Periprosthetic Fractures ; Retrospective Studies ; Survival Rate

Hip dislocation represents 2 to 5% of all joint dislocation whereas bilateral hip dislocation occurring as a result of trauma is rarely reported, accounting for 0.025 to 0.050% of hip dislocation cases. It is known that the simultaneous occurrence of traumatic dislocation with one anterior and the other posterior is even rarer. The case described showed a bilateral hip dislocation which occurred anteriorly at the right hip and posteriorly at the left with both femoral heads fractured as a result of a traffic accident. The right hip of the patient was dislocated in the anteroinferior direction of the right acetabulum, and the left hip in the posterosuperior direction of the left acetabulum. Both hip fractures were accompanied by fragments above the fovea centralis. The patient was treated by immediate reduction followed by skin traction. Partial weight bearing was performed after 6 weeks of bed rest and full weight bearing began on the 10th week. No complications such as avascular femoral head necrosis or traumatic arthritis occured.
Accidents, Traffic ; Acetabulum ; Arthritis ; Bed Rest ; Dislocations* ; Fovea Centralis ; Head* ; Hip ; Hip Dislocation ; Hip Fractures ; Humans ; Joints ; Necrosis ; Skin ; Traction ; Weight-Bearing

Behavior-modification approaches are among the most widely used methods for losing weight. The most important concern in these approaches is that the client is helped to achieve long-term weight loss. The purpose of this study was to determine the effectiveness of nutritional counseling for weight reduction in office workers. Sixteen overweight office workers (BMI=25.8+/-.5 age=34.1+/-.0) were selected from Poscohuls. Prior to nutritional counseling, their dietary intakes were assessed using the 24-hour recall method, and survey questionnaires for lifestyle and dietary habits were collected. Nutrient intakes were calculated using the Food Processor II program modified for Korean foods. Nutritional counseling sessions were conducted every 2-3 weeks for 5 months. Various techniques tailored to the individual participants were used to facilitate weight loss. After 5 to 6 counseling sessions, questionnaires for lifestyle and dietary habits were re-evaluated. Daily energy intake showed great individual differences. The energy intake of every client decreased by about 15% (p=0.08). Fat consumption was lowered by 39.3%, but consumption of carbohydrate and protein was not changed. The common dietary and lifestyles problems were overeating, binges, dinning out, snacking, and drinking alcohol. Before counseling began, clients ate out an average of 2.8 times per week, and they ate high-fat foods such as belly pork. After counseling, they consumed low-fat dishes such as fish and lean meat in fewer dinning-out sessions. Also, the number of binges decreased slightly, and clients consumed smaller meals. Similar changes occurred with respect to the consumption of alcohol. During the counseling sessions, 25 percent of clients lost weight by approximately 2kg, while 75 percent maintained their weight. In conclusion, multiple nutritional counseling sessions are an effective and efficient approach to change eating pattern to keep losing weight. Furthermore, through multiple nutritional counseling sessions, clients can gain good dietary habits and learn to control their weight through behavior modification. However, clients need to have patience and trust to lose weight since it takes longer periods to show losing weight multiple nutritional counseling sessions.
Behavior Therapy* ; Counseling* ; Drinking ; Eating ; Energy Intake ; Food Habits ; Hyperphagia ; Individuality ; Life Style ; Meals ; Meat ; Overweight ; Surveys and Questionnaires ; Snacks ; Weight Loss

Glomerulosclerosis represents a pathological hallmark of progressive glomerular injury. Mesangial cell proliferation and accumulation of extracellular matrix (ECM) proteins in the mesangial area frequently precede the formation of glomerulosclerosis. To understand the role of platelet-derived growth factor (PDGF) and ECM in the development of glomerulosclerosis, we examined the expression of type IV collagen, laminin, fibronectin, and PDGF in 45 renal biopsies diagnosed with IgA nephropathy (IgAN) using a standard peroxidase antiperoxidase (PAP) technique. Normal control specimens were obtained from four nephrectomy specimens diagnosed with renal cell carcinoma. As compared with normal controls, type IV collagen increased in 68%, fibronectin in 73%, laminin in 51%, and PDGF in 36% of patients with IgA nephropathy. The staining intensity of PDGF, type IV collagen, and fibronectin increased significantly in cases with moderate to severe mesangial cell proliferation than cases without. In the areas of glomerulosclerosis, the staining intensity of type IV collagen, laminin, and PDGF decreased, whereas that of fibronectin increased. These results suggest that mesangial cell proliferation in relation to increased PDGF expression in IgAN could stimulate the expression of type IV collagen, laminin and fibronectin leading to mesangial expansion. They also suggest that ECM decreased in advanced glomerulosclerosis. Deposition of fibronectin, which originates mainly from the blood stream, increases during the course of progressive glomerulosclerosis, whereas other ECM components decrease in advanced glomeruloslresosis.
Biopsy ; Carcinoma, Renal Cell ; Collagen Type IV ; Extracellular Matrix* ; Fibronectins ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Laminin ; Mesangial Cells ; Nephrectomy ; Peroxidase ; Platelet-Derived Growth Factor* ; Rivers

Bacille Calmette-Guerin (BCG) lymphadenitis is the most common complication of BCG vaccination. It commonly occurs in infants aged <6 months involving ipsilateral axillary lymph nodes. We described BCG lymphadenitis in a 22-month-old boy presenting swelling of left supraclavicular lymph node that was confirmed by real-time polymerase chain reaction (PCR) and the multiplex PCR targeting the region of difference (RD).
Humans ; Infant ; Lymph Nodes ; Lymphadenitis* ; Male ; Multiplex Polymerase Chain Reaction ; Mycobacterium bovis* ; Real-Time Polymerase Chain Reaction ; Vaccination*

BACKGROUND: Cyclosporine, an immune suppressive agent has been reported to potentiate the neuromuscular blockade induced by vecuronium and atracurium. And the potentiation degree was more prominent in the vecuronium. Rocuronium and mivacurium have been introduced into clinical practice recently and there is no report whether the cyclosporine potentiates the neuromuscular blocking effects of these agents. We, therefore studied the effect of Sandimun (cyclosporine in cremophor-ethanol) on the neuromuscular blockade action of rocuronium and mivacurium in rabbits. METHOD: The effect of Sandimun on the rocuronium and mivacurium were investigated in anesthetized 30 rabbits. The rabbits were divided into five groups; rocuronium group (rocuronium bromide 1 mg/kg iv), rocuronium - Sandimun group (rocuronium bromide 0.1 mg/kg iv after Sandimun 5 mg/kg iv), mivacurium group (mivacurium chloride 0.064 mg/kg iv), mivacurium - Sandimun group (mivacurium chloride 0.064 mg/kg iv after Sandimun 5 mg/kg iv) and Sandimun group (Sandimun 5 mg/kg iv). Neuromuscular block was assessed by measuring the response of anterior tibial muscle to 0.1Hz single twitch stimulation of the common peroneal nerve. Onset time, duration of muscle relaxation and recovery index were compared among the groups. RESULTS: There were no significant differences in onset time and recovery indices among the groups. Significant difference was found in duration between the rocuronium group and the rocuronium-Sandimun group (p<0.05). CONCLUSION: Sandimun potentiates the rocuronium - induced neuromuscular blockade but not the neuromuscular blocking action of mivacurium.
Atracurium ; Cyclosporine* ; Muscle Relaxation ; Muscle, Skeletal ; Neuromuscular Blockade* ; Peroneal Nerve ; Rabbits ; Vecuronium Bromide

PURPOSE: This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. METHODS: A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. RESULTS: Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. CONCLUSION: The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.
Adult ; *Breast Feeding ; Counseling ; Emigrants and Immigrants/*psychology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Interviews as Topic ; Marriage ; Mothers/psychology ; Pregnancy ; *Program Evaluation ; Social Support ; Young Adult