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

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

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

OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

PURPOSE: The purpose of this study was to analyze factors affecting work engagement and burnout among clinical nurses according to resilience. METHODS: The study design was a descriptive survey and questionnaires were collected from 182 clinical nurses who worked in hospitals in "J" province. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheffe test, Pearson correlation, and hierarchical multiple regressions. RESULTS: The mean score of resilience, work engagement, burnout were 3.47+/-0.38, 4.29+/-0.98, 2.25+/-0.82 respectively. Resilience had 26.3% of the influence on work engagement and 50.5% of the influence on burnout. Sub-variables of causal analysis and empathy of resilience were statistically useful as factors influencing burnout. CONCLUSION: Resilience has been identified as a factor affecting work engagement and burnout. Therefore, nursing departments and nurse managers should strive to develop programs for the promotion of resilience.
Empathy ; Humans ; Nurse Administrators ; Surveys and Questionnaires

Hamartoma of the breast is a rare benign lesion presenting as palpable mass. They are, however, sometimes misdiagnosed by pathologist due to their resemblance to other benign or physiologic conditions of the breast. We report two cases of hamartomas of the breast. The clinical diagnosis was fibroadenoma in both cases. One patient was a 49-year-old woman presented with palpable mass for the duration of 5 months. Mammography showed a well demarcated round mass with homogeneous density which is slightly greater than the surrounding glandular tissue. Grossly it was a 3.5 3.0 2.0 cm sized round firm mass covered by thin fibrous tissue. Microscopically it was a well defined mass composed of variable amount of breast lobules, dilated ducts and adipose tissue surrounded by dense hyalinized connective tissue. The adipose tissue accounted for 30% of the entire lesion. Cellular atypism was not found. The other patient was a 18-year-old woman presented with palpable mass of the duration of 3 years, which was increased in size recently. Mammography demonstratesd a well delimited lobulated mass with lucent halo. Ultrasonography showed a well encapsulated low echoic mass admixed with high echoic areas. Grossly, it was a 4.0 4.0 2.0 cm sized well demarcated oval-shaped firm mass with translucent thin fibrous capsule.. Microscopic findings were similar to the former. The amount of adipose tissue was 20%.
Adipose Tissue ; Adolescent ; Breast* ; Connective Tissue ; Diagnosis ; Female ; Fibroadenoma ; Hamartoma* ; Humans ; Hyalin ; Mammography ; Middle Aged ; Ultrasonography

The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

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