The fracture of the upper end of the femur is unique in orthopedics because it is endemic to an elderly population with special problem. In trochanteric fractures open reduction and internal fixation, with a hip nail used to maintain reduction, have become the standard treatment protocol for the elderly. Unlike fractures of the femoral neck, nonunion and avascular necrosis is rare but more frequently complicated by fatal sequele, such as pneumonia, thromboembolic disease, and decubitus ulceration. In order to achieve early ambulation of a patient with a trochanteric hip fracture, two conditions must be met: The implant used for fixation must be strong enough to withstand loadings exerted upon it during fracture healing, and the fracture itself must be rendered stable in a suitably reduced position. The treatment of the fracture of the femoral neck has a long and frustrating history. As recently as 20 years ago McCarroll remarked that this fracture must be considered “unsolved” until the incidence of aseptic necrosis and nonunion could be diminished or abolished. But now with adequate reduction, impaction, accurate internal fixation with newer devices, and carefully supervised postoperative care the fracture of the femoral neck can be expected to heal at least 90 per cent of the patients. A lower incidence of recognizable aseptic necrosis has been reported under these circumstances. X-ray films of 94 cases of hip nailing for hip fractures were collected in the Department of Orthopedic Surgery of Seoul National University Hospital. Twenty seven cases considered to be failed in hip nailing were analysed radiologically, and following results were obtained. 1. The incidence of failed hip nailing was most frequent in the fifties with average age of 54. 6 years, which seemed somewhat younger than that of the hip fracture. There was no sexual difference. 2. Hip nailings were failed in 23 cases of the femoral neck fractures and in 4 cases of the trochanteric fractures, which revealed respectively 52.3% and 8.2% of failure. Among these the technical failure was 22.7% in femoral neck fractures and 6.1% in trochanteric fractures. 3. Among the various fixation devices, Smith-Petersen nail or hip screws which has no side plate to fix the shaft rigidly showed high failure rates. 4. In all cases the etiology of the failed hip nailing was functional, such as failure of reduction, failure of fixation, penetration of the head, avaseular necrosis, infection, and inadequate postoperative management. 5. Most cases of femoral neck fractures which was not achieved near anatomical reduction was failed in fixation. 6. Too long or short nails showed high failure rates. In view point of this, hip nail should fix the lateral cortex, calcar femorale and center of subchondral bone, even in the trochanteric fracture. So devices such as heavy compression sliding nail or multiple pinning were more desirable to achieve complete fixation. 7. When, in the fresh fractures of the femur neck cannot be reduced to an anatomical or slightly overcorrected position, endoprosthesis should be considered seriously. When the joint is abnormal, the total hip arthroplasty can reduce morbidity and mortality, and also shorten the hospitalization.
Aged ; Arthroplasty, Replacement, Hip ; Clinical Protocols ; Early Ambulation ; Femoral Neck Fractures ; Femur ; Femur Neck ; Fracture Healing ; Head ; Hip Fractures ; Hip ; Hospitalization ; Humans ; Incidence ; Joints ; Mortality ; Necrosis ; Orthopedics ; Pneumonia ; Postoperative Care ; Pressure Ulcer ; Seoul ; X-Ray Film

It is widely blieved that the new bone formation is provoked by fine electrical stress to bone. There have been maay experimental studies that showed much efforts to define these small amounts of electricity, and these fine electricities are being used in the orthopedic field for the treatment of various fractures, nonunions and pseudsrthrosia The auther has checked the electrical potentials changing in the course of fractvre hesling in rabbits femur. Comparing these data with that of the normal control group, the following results were obtained. 1. In the normal rabbit's femur the electrical potentisl was 13.6mV less on the concave side than on the convex side. This finding can be explained by the existence of stress generated potential or piexoelectricity. 2. Electrcal potentials on the fractured femoral sites were lowered significantly from that of the control group. So auther could confirm the existence of bioelectrical generated by increased electrical activity of the living bone. 3. The electrical potential of the fractured femoral site has been decreased 50% and 20% as low as that of the normal site at 8 weeks respectively. It is expected that these lowered electrical potentials may become dose to the normal values when the changed metabolic process due to the fractured bone is no longer functioning and it is believed to take human 2 years to get the normal value.
Electricity ; Femur ; Fracture Healing ; Humans ; Metabolism ; Orthopedics ; Osteogenesis ; Rabbits ; Reference Values

A Clinical study was done on 90 cases of acute myocardial infarction admitted to Busan Wallace Memorial Baptist Hospital from January, 1977 to Febuary, 1983. The following results have been obtained. 1) The ratio of male to female was 2.2:1. The most age group were 5th decades(35.6%) and over 5th decades(5th decades and 6th decades) were two-thirds of all age group. And annual incidency were increasing tendencies, in 1980-1982 than 1977-1979. 2) Between the preceding diseases and the risk factors, the most common cause was the smoking (60%). And other associated diseases and factors were hypertension(54.4%), hypercholesterolemia (43.8%), hyperlipidemia(51.4%) and angina pectoris (34.4%). 3) The most common inducing factor was physical exertion(33.3%). And others were emotional stress(23.3%), alcohol drinking(10%), rest and sleeping(5.6%). 4) The major symptoms of acute myocardial infarction were precordial or epigastric pain(96.7%), dyspnea(53.3%), radiating chest pain (51.7%) and painless infarction(3.3%). 5) On laboratory data, there were leukocytosis in 50.5% increased SGOT in 68.6%, increased serum LDH in 75.9% and cardiomegaly in chest x-ray film were 82 percents. 6) The ratio between the anterior and inferior infarction on EKG was 1.9:1. 7) When admission, normal sinus rhythms on EKG were 59 percents. And the common associated electrocardiographic abnormalities were ventricular premature beat (23.6%), atrial fibrillation(15.7%), first degree A-V block (15.7%), left ventricular hypertrophy(15.7%). The most common abnormality was ventricular premature beat(23.6%). 8) The mortality rate of acute myocardial infarction was 10 percents. The causes of death were heart failure(33.3%), ventricular arrhythmia(33.3%), sudden death (22.2%) and cardiogenic shock(11.1%).
Angina Pectoris ; Aspartate Aminotransferases ; Busan ; Cardiac Complexes, Premature ; Cardiomegaly ; Cause of Death ; Chest Pain ; Death, Sudden ; Electrocardiography ; Female ; Heart ; Humans ; Hypercholesterolemia ; Infarction ; Leukocytosis ; Male ; Mortality ; Myocardial Infarction* ; Protestantism ; Risk Factors ; Smoke ; Smoking ; Thorax ; X-Ray Film

Adrenalectomy was performed in 13 cases of adrenal tumor admitted to the department of urology during the period from 1977 to 1988. The patients comprised 7 patients with Cushing's syndrome. 1 patient with primary aldosteronism and 5 patients with pheochromocytoma. All surgical approaches were provided transperitoneally including subcostal incision in 9 cases, midline abdominal incision in 3 cases and thoracoabdominal incision in 1 case. 2 cases of pheochromocytoma and 1 case of Cushirig's syndrome, of which masses weighed over 700g and had severe adhesion to the kidney, underwent either additional nephrectomy or partial nephrectomy along with adrenalectomy. Postoperative hospital stay ranged between 7 and 17 days. Hormonal assay done on 1 day to 1 week postoperatively revealed normal or subnormal value.
Adrenalectomy* ; Cushing Syndrome ; Humans ; Hyperaldosteronism ; Kidney ; Length of Stay ; Nephrectomy ; Pheochromocytoma ; Urology

No abstract available.
Colitis, Ulcerative* ; Ulcer*

No abstract available.
Brain* ; Neoplasm Metastasis*

It is generally accepted that ectopic bone should be removed after full maturation. Removal of immature ectopic bone was attempted combined with immidiate postoperative irradiation to suppress its recurrence. The authors report two cases immature heterotropic bone resection around elbow joint followed by 2000 Rad midplane irradiation given in ten fractions over fourteen days. The results obtained are as follows: 1. There was no evidence of recurrence after removal of immature ectopic bone. 2. Improved range of joint motion was observed during 3 months and 6 months posteroperatively.
Elbow Joint ; Joints ; Osteogenesis ; Recurrence

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

No abstract available.
Lupus Erythematosus, Systemic*

Sebaceous carcinoma is a particularly common malignant tumor of the eyelid. Therefore, this lesion is important to ophthalmologist. Recently, there appears to have been an increased incidence or recognition of sebaceous carcinomas of the eyelid, which had been previously believed to be very rare. Frequently mistaken for a recurrent chalazion, invasion by sebaceous carcinoma is frequently enhanced by repeat curettage and forms of therapy that obscure the true diagnosis. This tumor is difficult to completely resect due to intraepithelial widespread, so its prognosis is poor. The authors experienced two cases of sebaceous carcinoma of the eyelid. One was a 57 year old female patient who was treated with surgical resection and the other was a 71 year old male with cervical lymph node metastasis. He was treated with surgical resection, but he rejected radiotherapy.
Aged ; Chalazion ; Curettage ; Diagnosis ; Eyelids* ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Radiotherapy