The intramedullary nailing is the effective device now available for patient with appropriate fracture of the femoral shaft in adulthood. But problems with shortening and rotation of the femur persist, especially in comminuted fracture of the femoral shaft. So, the fixation with proximal and distal screw was performed. The Brooker-Wills nail achieves distal fixation easily with a transverse fixator deployed through slot in the nail. 24 patients with 25 femoral shaft fractures who treated at Dept. of Orthopaedic Surgery, Ewha Womans University Hospital from April, 1987 to April, 1988 were clinically analysed and the results were as follow. l. Among 25 cases, 22 cases were male and 3 cases were female. Average ages were 35.3 years and 3rd decade was more prominent. 2. 25 cases were classified according to the Winquist-Hansen classification. The Grade II was most common in 20 cases(80%). 3. 18 cases were treated by closed method and 7 cases were treated by open method. The closed method was required for 1.8 hours and open method was required for 2.2 hours. 4. The average time of union of Grade II was most shortened(11 weeks) and Grade IV was most delayed(16 weeks). 5. The complications were non-union in 1 case, mild angulation in 3 cases and limitation of motion of knee joint in 2 cases. So the accurate anatomical reduction and nailing to just above the epiphyseal scar in the metaphysis will be decreased of any complications.
Cicatrix ; Classification ; Female ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Knee Joint ; Male ; Methods

PURPOSE: Leptin is a hormone, encoded by ob gene in adipocytes and regulates food intake and energy expenditure. The serum concentration of leptin is known to be proportional to the amount of body fat but the regulation of leptin for growth and development in childhood is not clear. The purpose of this study is to evaluate the correlation of serum leptin levels to gender, pubertal development and sex steroid in children. METHODS: Serum leptin levels were measured by RIA in 145 Korean children of both sexes, age 8-16yr, and were compared according to body mass index, gender and pubertal stage. The correlations of leptin with testosterone and estradiol were also analized. RESULTS: A positive relationship was observed for leptin levels with body mass index(in male:r=0.63, P<0.001, in female:r=0.80, P<0.001). The mean leptin level of girls was higher than that of boys(7.50+/-.83ng/mL vs 4.11+/-.72ng/mL, P<0.05) in lean children but there was no significant difference in obese group. An analysis according to the pubertal development showed an increase of leptin level in girls while leptin decreased in boys at overt puberty. Serum leptin levels of boys in puberty correlated inversely with testosterone(r=-0.52, P<0.001) but leptin of girls did not have significant correlation with estradiol. CONCLUSION: Serum leptin level increases in girls and decreases in boys as the pubertal development proceeds. The relationships between leptin level and pubertal developement show gender difference and it might be explained in part by suppressive effects of androgen in male.
Adipocytes ; Adipose Tissue ; Adolescent ; Body Mass Index ; Child* ; Eating ; Energy Metabolism ; Estradiol ; Female ; Growth and Development ; Humans ; Leptin* ; Male ; Puberty ; Testosterone

Orbital meningioma is relatively rare. A case of intraorbital meningioma arising from optic nerve sheath is presented, which extended intracranially through the optic canal. Transfrontal intradural and extradural approach under the operating microscope is the best successful exposure for the orbital meningioma when there is suspected intracranial extension of the tumor.
Meningioma* ; Optic Nerve ; Orbit*

PURPOSE: Patients with canalicular or common canalicular obstruction have been treated by carrying out conjuctivodacryocystorhinostomy mainly through skin or the nasal cavity, but all sorts of defects attendant on an operation have been indicated. At this, the authors inquired into a result of a surgery and their satisfaction in a different viewpoint for silicone intubation. METHODS: We inquired into a result of a surgery and their satisfaction in a different viewpoint for 68 patients' 72 eyes who can be observed over 3 months among patients diagnosed as canalicular or common canalicular obstruction and operated on with silicone intubation as subject. RESULTS: After surgery, silicone tube was removed at average postoperative 5.8 months and we observed them for average 10.5 months. The result of operations showed that successful cases are 72.2% (52 eyes) and failing cases are 28.8% (20 eyes). CONCLUSION: For the cases with canalicular obstruction, especially common canalicular obstruction for short period, primary silicone intubation would be one of the ideal lacrimal surgery that should be explained the possible secondary conjuctivodacryocystorhinostomy later.
Adult* ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasal Cavity ; Silicones* ; Skin

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Umbilicus*

The medulloblastoma is a tumor of the cerebellum, particulary common in children. Most of them in childhood are situated in the midline vermis, but in adults are in the lateral lobes. The authors reported two cases of medulloblastoma which developed in the midline vermis although the patients were adult, and reviewed with concerned articles.
Adult* ; Cerebellum ; Child ; Humans ; Medulloblastoma*

Chronic sclerosing dacryoadenitis is a rare and under-recognized chronic inflammatory disease of the lacrimal gland. We describe 2 patients with a localized type of chronic sclerosing dacryoadenitis. Both patients presented with a slowly growing painless mass of the eyelid mimicking a tumorous lesion. The morphologic findings of the masses excised under the clinical diagnosis of lymphoma closely recapitulate those of chronic sclerosing sialadenitis (Kuttner tumor). Immunohistochemical staining demonstrated an increased population of IgG4-positive plasma cells confirming that this disease also belongs to the spectrum of a recently described IgG4-related sclerosing disease.

No abstract available.
Hemangiosarcoma

The authors present 2 cases of malignant pituitary adenoma. One case has remote metastases to the right frontal lobe, and the other case has invasion into the adjacent temporal lobe and malignant features histologically. Malignant pituitary adenoma constitute less than 1% of the large reported series of pituitary adenoma, which defined as (1) it burst its capsule to invade the adjacent nervous structures or bone, (2) it shows malignant features histologically, such as frequent mitoses, anaplasia with hyperchromatic pleomorphic cells, loss of alveolar arrangement, and (3) presence of distant metastases.
Anaplasia ; Frontal Lobe ; Mitosis ; Neoplasm Metastasis ; Pituitary Neoplasms* ; Temporal Lobe

Multiple-system atrophy (MSA) is an adult-onset, sporadic, progressive neurodegenerative disease. Clinically, the cardinal features include autonomic failure, parkinsonism, cerebellar ataxia, and pyramidal signs in any combination, of which autonomic failure is an integral component in the diagnosis. Pathologically, MSA is characterized by alpha-synuclein-positive glial cytoplasmic inclusions and neuronal loss, predominantly in the basal ganglia, brainstem, cerebellum, and intermediolateral cell columns of the spinal cord. We report the first case of MSA confirmed by autopsy in Korea.
Atrophy ; Autopsy ; Basal Ganglia ; Brain Stem ; Cerebellar Ataxia ; Cerebellum ; Inclusion Bodies ; Korea ; Multiple System Atrophy ; Neurodegenerative Diseases ; Neurons ; Parkinsonian Disorders ; Spinal Cord