Fractures of the phalanges of the hand are very common. Many are minor and likely to have a good result. However many other phalangeal fractures cause significant and prolonged disability. Non-union of the tubular bones of the hand are uncommon occurrence, but are often associated with functional deficits. The authors have reviewed 7 cases of non-union of the phalanges which were treated in the department of orthopaedic surgery, National Medical Center from 1978 to 1985. The results were summarized as follows: 1. The non-union of phalangeal bone was defined by clinical symptoms and signs and roentgenological examination. 2. The incidence of non-union of phalangeal bone fractures was 0.9% (7/771 cases.) 3. of 7 patients, there were 6 in male and 1 in female. 4. Non-union occurred more commonly in the second decade and the group between 10 and 30 years of age. 5. Seven cases, all were the right handed, but injury was developed in the left hands except two cases. 6. The causes of non-union were thought as open wound (7 cases), type of fracture (simple or comminution:3 cases), inadequate immobilization (4 cases) and overtraction (1 case). 7. of 7 cases, 4 cases were treated with bone peg graft and K-wire fixation and 2 cases with excision of distal fragment. 8. The clinical union was 9 weeks in average.
Clinical Study ; Female ; Fractures, Bone ; Hand ; Humans ; Immobilization ; Incidence ; Male ; Transplants ; Wounds and Injuries

In spite of recent development in fixation technique we still have lots of complication including avascular necrosis of femoral head. For many years, orthopaedic surgeon have been searching for a simple, safe, accurate and reliable clinical test to asses the vascular status of the femoral head. In early detection of viability of the femoral head, nothing is more certain than bone scan at the moment. Bone scan can detect or predict the viability of the femoral head. Subramanian and McAfee introduced 99mTc-Sn-polyphosphate as a bone seeking agents. We applied serial bone scan in 19 cases of femur neck fractures from 1982 to 1985 at the department of orthopaedic surgery, National Medical Center. The results were as follows; 1. The uptake ratio of displaced and undisplaced group based on preoperative radiography was 1.ZO, 1.46, 1.52, 1.55, and 0.63, 1.23, 1.81, 1.58 in average in postoperative bone scan interval 1–2 wks, 3 months, 6 months, 12 months. The bone scan uptake ratio was lower in the former than the latter, but after 3 months, there was no remarkable difference between them. 2. At the time of 1 to 2 weeks, 3 months, 6 months and 12 months, uneventful group was 0.74, 1.27, 1.72, 1.62 and avascular necrosis group 0.13, 0.18, 0.30, 0.67 in the uptake ratio. In 2 cases of avascular necrosis, the uptake ratio was markedly decreased. 3. There was no difference between the group operated within 48 hour after injury and the group delayed later.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Necrosis ; Radiography

During 1 year and 9 month period, from September, 1980 to June, 1983, retrospective study was performed on 35 patients with Mitral Valve Prolapse at Kyung Hee University Medical Center. And the following results were obtained; 1) The mitral valve prolapse syndrome presents with various cardiovascular symptoms including dyspnea(63%), palpitation(49%), chest pain(34%), syncope and dizziness(11%). 2) Of 35 patients with MVP, 17 cases were isolated MVP, 13 cases were associated with cardiovascular disorders and 5 cases were associated with non-cardiovascular disorders. 3) Electrocardiographic abnormalities were found in 20 patients with MVP. The most common abnormality was ST-T change and atrial fibrillation, VPB, RBBB, first degree A-V block and W-P-W syndrome were also noted. 4) QTc interval prolongation was more common in serverely symptomatic patients with MVP. 5) 18 cases in 35 patients showed systolic click or murmur on phonocardiography. 6) Of 35 patients with MVP, 19 patients demonstrated prolapse of the anterior leaflet, 11 patients demonstrated prolapse of posterior leaflet and 5 patients demonstrated prolapse of the both leaflets. 7) There were severe derangement on echocardiography in severely symptomatic patients were MVP.
Academic Medical Centers ; Atrial Fibrillation ; Echocardiography ; Electrocardiography ; Humans ; Mitral Valve Prolapse* ; Mitral Valve* ; Phonocardiography ; Prolapse ; Retrospective Studies ; Syncope ; Thorax

Pheochromocytoma is a hazardous and dramatic cause of hypertension. This potentially lethal neoplasm originates in most cases in the adrenal medulla and less frequently in the cells of the extraadrenal paraganglion system which are disseminated along the paravertebral axis from the pelvis to the base of the skull. The organ of Zuckerkandl is paraganglia lying the abdominal aorta with highest incidence in the region of the inferior mesenteric artery and usually degenerate shortly after birth. In the literature, and additional one case of pheochromocytoma arising from the organ of Zuckerkandl associated with intracerebral hemorrhage which was treated recently in the Kyung Hee University Hospital is presented in this report.
Adrenal Medulla ; Aorta, Abdominal ; Axis, Cervical Vertebra ; Cerebral Hemorrhage* ; Deception ; Hypertension ; Incidence ; Mesenteric Artery, Inferior ; Para-Aortic Bodies* ; Parturition ; Pelvis ; Pheochromocytoma* ; Skull

No abstract available.
Animals ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Cochlear Nucleus* ; Rats*

OBJECTIVE: To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. MATERIALS AND METHODS: Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. RESULTS: The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL +/- 6.8 before stent insertion, decreased to 4.58 mg/dL +/- 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 +/- 99 days, and the median patient survival was 179 +/- 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). CONCLUSION: Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.
Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/complications/secondary/*surgery ; Bile Ducts, Extrahepatic/*surgery ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Jaundice, Obstructive/diagnosis/etiology/*surgery ; Male ; Middle Aged ; Prosthesis Design ; Retrospective Studies ; *Stents ; Stomach Neoplasms/*complications/secondary/surgery ; Treatment Outcome

PURPOSE: We investigated the impact on prostate-specific antigen (PSA) and prostate volume (PV) of statin medication for 1 year in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We retrospectively investigated 791 patients in whom BPH was diagnosed. For analysis, the patients were divided into four groups according to their medications: group A, alpha-blocker; group B, alpha-blocker+statin; group C, alpha-blocker+dutasteride; group D, alpha-blockers+statin+dutasteride. To investigate changes in serum PSA, PV, and total cholesterol, we analyzed the data at the time of initial treatment and after 1 year of medication. RESULTS: After 1 year, group A showed a 1.3% increase in PSA and a 1.0% increase in PV. Group B showed a 4.3% decrease in PSA and a 1.8% decrease in PV. The difference in PV reduction between groups A and B was statistically significant (p<0.001). Group C showed a 49.1% reduction in PSA and a 22.9% reduction in PV. Group D showed a 51.6% reduction in PSA and a 24.5% reduction in PV. The difference in PV reduction between groups C and D was not statistically significant (p=0.762). By use of a multivariate logistic regression model, we found that the probability of PV reduction after 1 year was more than 14.8 times in statin users than in statin nonusers (95% confidence interval, 5.8% to 37.6%; p<0.001). CONCLUSIONS: Statin administration reduced PSA and PV in BPH patients. This finding may imply the improvement of lower urinary tract symptoms and prevention of cardiovascular disease and chemoprevention of prostate cancer with statin treatment.
Azasteroids ; Cardiovascular Diseases ; Chemoprevention ; Cholesterol ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Logistic Models ; Lower Urinary Tract Symptoms ; Morinda ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Retrospective Studies ; Dutasteride

The incidence of horseshoe kidney is about 1 in 400 cases. The presence of Wilms' tumor with a horseshoe kidney is unusual, and the occurrence of Wilms' tumor in a horseshoe kidney is estimated at 0.4 to 0.9% of all Wilms' tumors. We report the case of a 5-year-old boy who presented with a stage IV Wilms' tumor in a horseshoe kidney. The patient was treated with preoperative chemotherapy followed by surgical resection and adjuvant chemotherapy. This case illustrates the role of preoperative chemotherapy for preserving renal function and aims to highlight the multimodality treatment of Wilms' tumor.
Chemotherapy, Adjuvant ; Humans ; Incidence ; Kidney ; Neoadjuvant Therapy ; Preschool Child ; Wilms Tumor

Glutathione S-transferase (GST) plays a key role in the detoxification of xenobiotic atherogen generated by smoking. To analyze the effect of GSTM1/T1 gene polymorphisms on the development of smoking-related coronary artery disease (CAD), 775 Korean patients who underwent coronary angiography were enrolled. The subjects were classified by luminal diameter stenosis into group A (>50%), B (20-50%), or C (<20%). GSTM1 and GSTT1 gene polymorphisms were analyzed using multiplex polymerase chain reaction (PCR) for GSTM1/T1 genes and CYP1A1 gene for internal control. Of 775 subjects, 403 patients belonged to group A. They had higher risk factors for CAD than group B (N=260) and group C (N=112). The genotype frequencies of null GSTM1 and GSTT1 showed no significant differences among 3 groups. Considering the effect of GSTM1 gene polymorphisms on the smoking-related CAD, smokers with GSTM1 null genotype had more increased risk for CAD than non-smoker with GSTM1 positive genotype (odds ratios [OR], 2.07, confidence interval [CI], 1.06-4.07). Also the effect of GSTT1 gene polymorphism on smoking-related CAD showed the same tendency as GSTM1 gene (OR, 2.00, CI, 1.05-3.84). This effect of GSTM1/T1 null genotype on smoking-related CAD was augmented when both gene polymorphisms were considered simultaneously (OR, 2.76, CI, 1.17-6.52). We concluded that GSTM1/T1 null genotype contributed to the pathogenesis of smoking-related CAD to some degree.
Aged ; Coronary Angiography ; Coronary Artery Disease/epidemiology/*genetics/radiography ; Female ; Genetic Predisposition to Disease/epidemiology ; Genotype ; Glutathione Transferase/*genetics ; Humans ; Male ; Middle Aged ; *Polymorphism, Genetic ; Risk Factors ; Severity of Illness Index ; Smoking/epidemiology/*genetics

PURPOSE: Animal tumor models are important for the evaluation of novel therapeutic modalities. Since the initial report of an orthotopic bladder tumor model, several modifications have been proposed to improve the tumor take rate. Here we compared the HCl-pretreated and electrocauterization-pretreated orthotopic murine bladder tumor models. MATERIALS AND METHODS: MBT-2 murine bladder cancer cells were transurethrally implanted in the bladder of syngeneic C3H/He mice. The mice were divided into three groups according to pretreatment methods (electrocautery, HCl, and control group) and were subjected to pretreatment before instillation of MBT-2 tumor cells into the bladder. Mice were sacrificed on day 21, and bladders were harvested, weighed, and examined histopathologically. RESULTS: The tumor take rate of the control, electrocautery, and HCl groups was 0%, 54%, and 100%, respectively. The tumor take rate of the HCl group was significantly higher than that of the control group (p<0.01) and the electrocautery group (p=0.01). Pathologic reports revealed that all established bladder tumors were high-grade papillary urothelial carcinomas. CONCLUSIONS: The HCl pretreatment model was a preferable murine bladder tumor model for evaluating further therapeutic interventions.
Administration, Intravesical ; Animals ; Electrocoagulation ; Mice ; Models, Animal ; Urinary Bladder ; Urinary Bladder Neoplasms