PURPOSE: To evaluate the treatment results of geriatric intertrochanteric fractures by using Asian-Pacific Gamma nails. MATERIALS AND METHODS: From June 1994 to June 1997, 58 cases of the intertrochanteric fractures were treated with Asian-Pacific Gamma nail, particularly compression hip screw fixation complications such as communited fracture involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, and studied complications and intraoperative cautions. RESULTS: The average age was 74.4 years old, the mean duration of follow-up was 17 months, the mean duration of bone union was 14.2 weeks, the average neck-shaft angle was postop. 133+/-2.78 degree and last follow-up was 129.5+/-3.37 degree, and the average lag screw sliding was 4.7+/-3.16 mm. Intraoperative complications were difficulty in distal drilling (posterior drilling) in 4 cases, fracture displacement by nail insertion in 3 cases, and postoperative complications were coxa vara in 13 cases, superior cutting out of lag screw with nonunion in 1 case and superficial infection in 1 case. The entry portal must be formed by awling. The fracture displacement when inserting nail could be prevented by proper reaming after inserting the C-shaped guide pin, and posterior drilling could be avoided by confirming the locking between target device and nail. CONCLUSIONS: We conclude that the Asian-Pacific Gamma nail could appropriately treat the osteoporotic, communited intertrochanteric fracture in elderly patients and we obtained satisfactory results.
Aged ; Coxa Vara ; Femur* ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Intraoperative Complications ; Postoperative Complications

We studied the natural history of asymptomatic early avascular necrosis of the femoral head in forty-three patients(forty-three hips) who had been treated with arthroplasty due to progressed avascular necrosis of femoral head but had no symptoms in the other side. All initial lesions were classified with Ficat staging and International classification(ARCO). The duration until symptom onset and radiologic evidence of disease progression were evaluated. The average follow up period was over 37 months. Among forty-three hips, twenty-nine cases(67.4%) remained asymptomatic until last follow up but fourteen cases(32.6%) were symptomatic during the follow up, and twenty-six cases(60.5%) did not progress on the radiography but seventeen cases(39.5%) progressed to Ficat stage 3 or 4. Fifteen cases of IA, IIA, IB-cental and II B-central without lateral lesion did not occur symptom and didnt progress to Ficat stage 3 or 4 over a period of average 47 months(24-71 months). But fourteen cases of IB, IC, g B and II C progressed to Ficat stage 3 or 4 and they were all lateral lesion. These results suggest careful observation only can be done in the case of small involvement(less than 15%) and medial or central lesion relatively over a long period of time but for the large involvement(more than 30%) and especially lateral lesion, aggressive surgical treatment may be considered even though the early stage of disease for the prevention of progression. However it will need more period of time to accurately compare the results of various methods of treatment.
Arthroplasty ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Natural History* ; Necrosis* ; Radiography

The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache cases with more than moderately abnormal EEG visited the Neurology Clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study in only analysis of clinical treatment of 162 cases without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial improvement and partial progression. Case1. In 4 weeks of antiepileptic therapy (AR), spikes disappeared but in 2 months developed bursts. Case2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case3. In 1 week of AR, bursts disappeared but spikes developed. Case4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandma seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study with more patients is to be expected.
Adenosine Triphosphate ; Anticonvulsants ; Electroencephalography ; Epilepsy* ; Ergoloid Mesylates ; Headache ; Humans ; Neurology ; Phenytoin ; Seizures

No abstract available.
Humans ; Motor Vehicles*

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

Tegafur is a fluoropyrimidine structurally similar to 5-fluorouracil, used in the treatment of advanced gastrointestinal neoplasms. Mucocutaneous side reactions induced by this agent are rare and include photosensitivity of lichenoid and eczematous types, acral erythema, hyperpigmentation and palmoplantar keratoderma. However, to our knowledge, there has been no report of concurrent development of eruptions of two types in a patient. We describe a female patient with breast cancer, presented with combined features of acral erythema and hyperpigmentation due to oral tegafur.
Breast Neoplasms ; Erythema* ; Female ; Fluorouracil ; Gastrointestinal Neoplasms ; Humans ; Hyperpigmentation* ; Keratoderma, Palmoplantar ; Tegafur*

Acrokeratoelastoidosis of Costa is a rare palmoplantar keratoderma with autosomal dominant inheritance. It is clinically charaeterized by small, firm, yellowish, shiny, translucent papules occumng over the dorsal hands, the knuckles, and the lateral margine of the palms and soles. Histologically, the characteristic features are hyperkeratosis, aeanthosis, and most strikingly, fragmentation of coarse elastic fibers within the dermis. The lesions usually begin in early childhood and progress slowly. We herein report two familial cases of acrokeratoelastoidosis of Costa showing typical clinic1 and histopathological features.
Dermis ; Elastic Tissue ; Hand ; Keratoderma, Palmoplantar ; Wills*

Terbinafine is now widely used for the treatment of dermatophytic infections of the skin and nails. Cutaneous side effects of terbinafine are rare and mild. They includes erythema, pruritus, urticaria, desqumation, and macular exanthem. In addition, fixed drug eruption, erythema multiforme, Stevens-Johnson syndrome, and erythema annulare centrifugum-like psoriatic drug eruption were recently described in the literatures. Herein, we reported a case of acute generalized exanthematous pustulosis induced by terbinafine.
Acute Generalized Exanthematous Pustulosis* ; Drug Eruptions ; Erythema ; Erythema Multiforme ; Exanthema ; Pruritus ; Skin ; Stevens-Johnson Syndrome ; Urticaria

No abstract available.
Hematoma, Subdural, Spinal* ; Spinal Puncture*

No abstract available.
Cesarean Section* ; Endometritis* ; Female ; Pregnancy