Acetabular fracture is severe injury and is associated with other body injuries severely. It's complications are traumatic arthritis and avascular necrosis of femoral head which induce severe permanent disability and its treatment is equivocal. A clinical study was performed on 70 patients with 65 fresh fractures and 5 old fractures of the acetabulum, who were hospitalized and treated at Severance Hospital from January 1971 to December 1980 and following results were obtained. 1. The prevalent age distribution was between 20 and 50 years of age (75.7%), and the ratio between males and females was 2.2:1. The most common cause of injury was traffic accident (70.%). 2. 56 patients (80.0%) were associated injuries of other parts and the most common associated fracture was pelvic bone fracture and the most common associated soft tissue injury was urological injury. 3. A classification of acetabular fracture was induced from Judet and Letournel's anatomical classification; simple fracture was 45 cases (64.2%), associated fracture was 25 cases (35.8%) and most common hip dislocation was posterior dislocation (31.4%). 4. The methods of treatment were; closed management by using traction for 53 patients, surgical management by open reduction and internal fixation for 12 patients, and hip reconstructive surgery by total hip replacement(2 patients), cup arthroplasty (2 patients), acetabular roof formation by using iliac bone graft (1 patient). 5. The satisfactory result of conservative treatment was (57.8%), surgical treatment was (72.7%), hip reconstructive treatment was (80.0%). 6. The complications of the acetabular fracture were traumatic arthritis (36.1%), avascular necrosis (23.0%), myositis ossificans (6.6%), infection (3.3%). 7. Finally, the results of treatment depend largely on anatomical reduction, early joint motion.
Accidents, Traffic ; Acetabulum ; Age Distribution ; Arthritis ; Arthroplasty ; Classification ; Clinical Study ; Dislocations ; Female ; Head ; Hip ; Hip Dislocation ; Humans ; Joints ; Male ; Myositis Ossificans ; Necrosis ; Pelvic Bones ; Soft Tissue Injuries ; Traction ; Transplants

In order to evaluate causes and the effective treatment of postoperative bleeding after open heart surgery, we measured platelet count and plasma fibrinogen levels before, during a 30 and 60-minute, and after a 30, 60 and 90-minute extracorporeal circulation in 5 patients perfused by a bubble and membrane oxygenator, respectively. The results were as follows: 1) The platelet count was reduced significantly by 57.2+/-3.04% during a 30-minute extracorporeal circulation using the bubble oxygenator and by 43.8+/-0.84% using the membrane oxygenator, and these levels were maintained throughout the extracorporeal circulation. 2) The platelet count after a 90-minute extracorporeal circulation increased significantly compared with after a 30-minute extracorporeal circulation (p<0.05) and these effects were more prominent using the bubble oxygenator (p<0.025). 3) The plasma fibrinogen level was reduced by 28.6+/-7.50% during a 30-minute extracorporeal circulation using the bubble oxygenator and by 33.6+/-5.77% using the membrane oxygenator, and these levels were maintained throughout the extracorporeal circulation. 4) The plasma fibrinogen level after a 90-minute extracorporeal circulation increased significantly compared with after a 30-minute extracorporeal circulation (p<0.05).
Blood Platelets* ; Extracorporeal Circulation* ; Fibrinogen* ; Hemorrhage ; Humans ; Oxygen ; Oxygenators ; Oxygenators, Membrane ; Plasma* ; Platelet Count* ; Thoracic Surgery

No abstract available.
Adenocarcinoma* ; Carcinoma, Squamous Cell*

PURPOSE: As neoplasia is the result of unbalanced cell growth and cell death, alternations in the growth control pathway including the immunity within the individual host-tumor relationship has been attributed to the development of breast cancer. Interferon(IFN)-gamma based immunity was recently reported to have an antitumor effect and some new methods to assess the state of interferon-gamma based immunity have been introduced. Interferon regulatory factor(IRF)-1 and interferon regulatory factor(IRF)-2 are transcriptional factors that mediate the effects of Interferon-gamma. It was suggested that the loss of IRF-1 expression is associated with the loss of tumor suppression and the development of IRF-2 expression is associated with oncogenic activation. Thus, we studied the significances of the IRF-1 and IRF-2 expressions as they are related with some clinicopathological parameters to determine the biological behavior of breast cancer including the menopausal status, tumor size, lymph node status, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the expression of p53 protein. METHODS: Formalin-fixed paraffin embedded specimens from 82 patients with invasive ductal carcinoma were used to evaluate the expression of IRF-1 and IRF-2 by performing immunohistochemical staining with using an avidin-biotin-peroxidase complex technique. RESULTS: The expression of IRF-1 was observed in 80.5 % of the study group. However, the expression of IRF-1 did not show any correlation with menopausal status, tumor size, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the p53 expression. Only lymph node metastasis showed a decreasing tendency of IRF-1 expression, but this was without statistical significance (p=0.075). The expression of IRF-2 was observed in 58.5% of the study group and it did not show any significant relationship with any of the above mentioned clinicopathological parameters. CONCLUSION: This study suggests that the expression of IRF-1 and IRF-2 does not affect the previously established parameters for determining such biological behaviors of breast cancer as the tumor size, lymph node metastasis, the histologic grade, the expression of steroid receptors, the expression of c-erb B2 and the expression of p53. In spite of these results, We'd like to recommend that another study be done to evaluate the role of IRF-1 and IRF-2 for the proper selection of the patients who are suitable for immunotherapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Death ; Humans ; Immunotherapy ; Interferon Regulatory Factors* ; Interferon-gamma ; Interferons* ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Receptors, Steroid

PURPOSE: Plasma cholinesterase is a sensitive measure determining the severity of organophosphate intoxication. The author evaluated the usefulness of the plasma cholinesterase level as a prognostic indicator of the severity of organophosphate intoxication. METHODS: From June 1999 to May 2001, 55 patients presented with organophosphate insecticide intoxication to the Emergency Medical Center of the Chonnam National University Hospital, and these were enrolled in this study. The plasma cholinesterase activities of these 55 patients were determined at the time of presentation. The relationships between the plasma cholinesterase level and the clinical variables of organophosphate toxicity, quantity of ingested poison, elapsed time to gastric lavage, and the APACHE score at the time of hospitalization were analyzed. RESULTS: The plasma cholinesterase activity significantly decreased in association with the degree of toxicity of the poison (p<0.001), elapsed time to gastric lavage (p<0.001), and the quantity of organophosphate ingested (p=0.013). In the 55 patients, lower plasma values of cholinesterase were observed in patients with longer durations of mechanical ventilation (r=-0.717, p<0.001) and in patients who developed pneumonia during treatment (r=-0.538, p<0.001). Also, decreased cholinesterase activity correlated with a higher APACHE score (r=-0.672, p<0.001). CONCLUSION: These results suggest that immediate determination of the plasma cholinesterase level at the time of hospitalization may be useful as a prognostic indicator in patients with organophosphate intoxication.
APACHE ; Cholinesterases* ; Eating* ; Emergencies ; Gastric Lavage ; Hospitalization* ; Humans ; Jeollanam-do ; Plasma* ; Pneumonia ; Respiration, Artificial

The mainstay of treatment in primary breast cancer is still a radical mastectomy. In the case of advanced breast cancer, preoperative chemotherapy is an alternative treatment method to induce surgical therapy. Although the number of elderly patients with breast cancer is increasing, the knowledge about the possible differences in the biology and clinical outcomes of breast cancer according to age is limited. In addition, elderly patients have difficulties with surgical treatment because of the higher rate of coincident systemic illness, high anesthetic risk and high rate of operation refusals for an operation than those in young patients. As it was well known that elderly patients have better prognoses than younger patients and more estrogen and progesterone receptors in tumor tissue, it was expected that oral chemoendocrine and radiation therapy could be an alternative in elderly patients who refuse surgery. Good results were experienced in our three elderly breast cancer patients when applying these non-surgical treatments.
Aged* ; Biology ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Estrogens ; Female ; Humans ; Mastectomy, Radical ; Prognosis ; Receptors, Progesterone

Hajdu-Cheney syndrome (HCS) is a rare skeletal dysplasia that is characterized by acroosteolysis of the distal phalanges, distinctive craniofacial and skull changes, dental abnormalities and generalized osteoporosis. The clinical and radiologic characteristics are variable and these characteristics progress with age. This syndrome shows autosomal dominant inheritance with sporadic cases. The genetic defects or molecular pathogenesis of HCS are still unknown. We experienced a case of Hajdu-Cheney syndrome in a 20-year-old man who had generalized osteoporosis with multiple non-traumatic spine compression fractures. He had acroosteolysis of the hands and feet, wormian bones in the skull, facial dysmorphism (mid-facial flattening, micrognathia and bushy eyebrows), a high arched palate, malocclusion and short dental alveolar processes. HCS was diagnosed based on the clinical and radiologic evidence. For the differential diagnosis, we excluded the other possible causes of the acroosteolysis and wormian bones, including hyperparathyroidism, osteogenesis imperfecta, hypophosphatemia and mandibuloacral dysplasia. The specific treatment of HCS is unknown, but case reports with bisphosphonate treatment have been reported.
Acro-Osteolysis ; Alveolar Process ; Diagnosis, Differential ; Foot ; Fractures, Compression ; Hajdu-Cheney Syndrome ; Hand ; Humans ; Hyperparathyroidism ; Hypophosphatemia ; Malocclusion ; Osteogenesis Imperfecta ; Osteoporosis ; Palate ; Skull ; Spine ; Wills ; Young Adult

Angioleiomyoma is a benign tumour arising from the vascular smooth muscle of blood vessel walls. It usually occurs in the lower extremities of females as a slow-growing, firm and occasionally painful mass. Only 8.5~10% of angioleiomyoma have been reported to occur on the head and neck area. Furthermore, to the best of our knowledge only 9 cases of angioleiomyoma have been reported to occur on the ear. Herein, we report a case of angioleioyoma in a 66 year-old woman who presented with a 4 year history of a painless, nontender nodule on the anti-helix of the ear, an unusual site of occurrence.
Aged ; Angiomyoma* ; Blood Vessels ; Ear* ; Female ; Head ; Humans ; Lower Extremity ; Muscle, Smooth, Vascular ; Neck

OBJECTIVE: Removal of the anterior clinoid process (ACP) is an essential process in the surgery of giant or complex aneurysms located near the proximal internal carotid artery or the distal basilar artery. An extradural clinoidectomy must be performed within the limits of the meningeal layers surrounding the ACP to prevent morbid complications. To identify the safest method of extradural exposure of the ACP, anatomical studies were done on cadaver heads. METHODS: Anatomical dissections for extradural exposure of the ACP were performed on both sides of seven cadavers. Before dividing the frontotemporal dural fold (FTDF), we measured its length from the superomedial apex attached to the periorbita to the posterolateral apex which connects to the anterosuperior end of the cavernous sinus. RESULTS: The average length of the FTDF on cadaver dissections was 7 mm on the right side and 7.14 mm on the left side. Cranial nerves were usually exposed when cutting FTDF more than 7 mm of the FTDF. CONCLUSION: The most delicate area in an extradural anterior clinoidectomy is the junction of the FTDF and the anterior triangular apex of the cavernous sinus. The FTDF must be cut from the anterior side of the triangle at the periorbital side rather than from the dural side. The length of the FTDF incision must not exceed 7 mm to avoid cranial nerve injury.
Aneurysm ; Basilar Artery ; Cadaver ; Carotid Artery, Internal ; Cavernous Sinus ; Caves ; Cranial Nerve Injuries ; Cranial Nerves

As a rule, spiradenoma occurs as a solitary intradermal nodule measuring 1 to 2cm in diameter. Occasionally, there are several nodules, and rarely, there are numerous small nodules in a zosteriform pattern or large nodules, up to 5 cm, in a linear arrangement. A 51-year-old man presented with a 4-year history of multiple, small, tender nodules which showed a linear distribution along the right subclavian area. The diagnosis of spiradenoma was made by clinical and histopathological findings and all the subcutaneous nodules were completely excised by a surgical method. We, herein, report a rare case of multiple linear spiradenoma.
Diagnosis ; Humans ; Middle Aged