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

Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.
Meningioma ; Neurilemmoma* ; Neurofibroma, Plexiform ; Neurofibromatoses* ; Neurofibromatosis 1 ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Peripheral Nerves

BACKGROUND: In recent years, lymphocyte subset analysis in peripheral blood is widely performed using erythrocytes-lysed whole blood and two color immunofluorescence/flow cytometry method. Use of fresh blood drawn within 6 hours of staining is recommended, and some patients have to revisit the hospital for blood collection. We tested whether 24 hours-refrigerated/stored whose blood can be used for lymphocyte subset analysis. METHODS: Twenty consecutive blood samples from patients (including nine HIV positive patients) collected in EDTA-vacutainer were tested: 1) on the day of sampling using fresh blood kept at room temperature for up to 6 hours until staining (as recommended by the manufacturer) and 2) on the following day using the same tube of blood refrigerated for 24 hours after the first staining. Two colon immunofluorescenc staining was done using Simultest(TM) IMK-Lymphocyte kit (Beckon Dickinson, U.S.A.) and flow cytometric analysis was performed using FACScan and SimulSET(TM) software (Becton Dickinson, U.S.A.). Results of alive kinds of Lymphocyte subsets (CD3+, CDl9+, CD3+CD4+CD3+CD8+, CD3-CDl6+ and/or CD56+) on day 1 and day 2 were compared by pained-t test and Wilcoxon signed rank test. RESULTS: There was no significant change of values for all of the lymphocyte subsets except CD3+CD8+suppressor/cytotoxic (S/C) T cells. There was a slight but statistically significant change in S/C T cells (39.9%-->41.8%: 1.9%, p=0.008) after 24 hours of refrigeration, and this change was observed mainly in HIV-positive patient group. However, there was no significant change in the absolute count of helper/inducer T cells or CD4/CD8 ratio, and the change of S/C T cells in these patients was not considered to be of clinical significance. CONCLUSIONS: The difference in the values of lymphocyte subsets between fresh blood and 24 hours-refrigerated blood was negligible and it is concluded that 24 hours-stored blood samples can be used for lymphocyte subset analysis for clinical purposes.
Colon ; HIV ; Humans ; Lymphocyte Subsets* ; Lymphocytes* ; Refrigeration ; T-Lymphocytes

No abstract available.
Osteoporosis* ; Spondylolisthesis*

Statistical observation was made on 1,512 out-patients and 71 in-patients in the Department of Urology, Capital Military Hospital during the period from January 1, 1970 to December 31, 1970.
Hospitals, Military* ; Humans ; Military Personnel* ; Outpatients ; Urology*

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*

BACKGROUND/AIMS: This study was aimed to examine if FB1 induced-hepatotoxicity involves apoptosis, and cholesteryl hemisuccinate (CS) pre-treatment would selectively interfere with FB1 induced-apoptosis of hepatocytes. METHODS: Sprague-Dawley rats were intravenousely injected with FB1 (1.25 mg/kg/day) for two days, and were sacrificed at 3, 6, 12, 24 and 48 hours after injection. Another experiment group was composed of rats with pretreatment of CS (100 mg/kg/day, i.p.) before FB1 injection. RESULTS: This study demonstrated that administration of hepatotoxic dose of FB1 to Sprague-Dawley rats resulted in liver injury leading to cell death by apoptosis. FB1-induced apoptosis was preceded by early elevation in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and appearance of injured pre-apoptotic cells at 12 hours was followed by massive fragmentation and margination of heterochromatin at 24 hours. CS pre-treatment prior to FB1 injection ameliorated serum biochemistry and hepatic injury with apoptosis, demonstrated by histological, ultrastructural and TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling) methods. In addition, there was remarkable decrease in number of PCNA (proliferative cell nuclear antigen)-positive proliferating hepatocytes compared to that of FB1 treated group. CONCLUSION: This study suggests that apoptosis significantly contributes to FB1-induced hepatotoxicity in vivo, and pre-exposure of rat to CS prevents FB1-induced hepatic apoptosis and proliferation.
Alanine Transaminase ; Animals ; Apoptosis* ; Aspartate Aminotransferases ; Biochemistry ; Cell Death ; Cholesterol ; Hepatocytes* ; Heterochromatin ; In Situ Nick-End Labeling ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Epidural anesthesia is becoming an increasingly important aspect of anaesthetic practice because it has many advantages. To achieve the appropriate sedation, various methods have been described. The authors applied the ketamine for this purpose in subanesthetic dose and compared with the midazolam that has been most commonly used for intravenous sedation. METHODS: Fifty-seven adult patients undergoing lower abdominal and extremity surgery who were receiving epidural anesthesia were randomely enrolled into this clinical study. They were allocated to three groups to receive only normal saline (group C), midazolam 0.05 mg/kg (group M) and ketamine 0.5 mg/kg midazolam 0.05 mg/kg (group K) in normal saline 10ml, respectively. Hemodynamic and respiratory measurements were recorded at baseline, 1 minute, 3 minute, 5 minute, 10 minute, 20 minute and 30 minute after sedation. The degree of sedation was assessed by a blinded observer using sedation score. RESULTS: There were no significant differences for hemodynamic and respiratory parameters, but decrements of arterial pressure at 1 minute after sedation were most remarkable in the group M. Sedation was satisfactorily achieved by combination of ketamine and midazolam without significant emergence reaction. CONCLUSIONS: The combination of ketamine and midazolam was judged to be suitable alternative for sedation during epidural anesthesia.
Adult ; Anesthesia, Epidural* ; Arterial Pressure ; Extremities ; Hemodynamics ; Humans ; Ketamine* ; Midazolam*

OBJECTIVE: Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. METHODS: A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. RESULTS: The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p (pc) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, pc = 0.02, OR = 14.67] and non-familial MMD patients (vs. 14.8%, pc = 0.02, OR = 13.42; vs. 1.9%, pc = 0.02, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. CONCLUSION: Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.
Alleles ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Child ; Chimera ; Far East ; Genes, MHC Class II ; HLA-DQ Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Humans ; Incidence ; Moyamoya Disease ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic