Trochanteric fractures are seen in elderly patients and have high mortality and morbidity. Strong internal fixation and early ambulation is the best way to treat fractures. For this purpose, recently, compression sliding screw plate became popular. The surgical procedure of open reduction and internal fixation were carried on 36 intertrochanteric fractures at Depertment of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1972 to Dec. 1977 and the following results were obtained. 1. Of 36 cases of intertrochanteric fracture, 20 cases were in man, with the peak age at the 5th decade, and 16 cases in woman mostly over the 7th decade. 2. Most common causes were fall or traffic accidents in man and fall in woman. 3. Interval from injury to operation was less than 1 week usually. 4. Unstable fractures were 86% and of these, Tronzo Type III was the most common. 5. The trend of use of internal fixation device was from S-P plate and screw, and Jewett nail to sliding compression plate and screw. 6. Reduction of medial displacement with Dimon-Hughston method was used commonly in Jewett nailing and anatomical reduction in sliding compression plate and screw. 7. Post operative cast immobilization were applied in a few cases of under 50 years old, Other-wise early ambulation were carried out. 8. Post operative complications were encountered in 8 cases (22%), but none were fatal.
Accidents, Traffic ; Aged ; Early Ambulation ; Female ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Methods ; Mortality ; Orthopedics ; Seoul

Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

No abstract available.
Lymphangioleiomyomatosis* ; Tuberous Sclerosis*

Santonin-kainic acid complex was evaluated as a chemotherapeutic of the mass treatment of the Ascaris lumbricoides infection in Korea. The results could be summarized as follows: The negative conversion rate was 82.9% in average in 4 treated groups. Some variations of negative conversion rate among the treated groups were noticed. The egg reduciton rate was 97.7% in average and the results were rather uniform among the three evaluated groups. By the analysis of egg reduction, it seems that the lightly infected cases whose E.P.G. were under 5,000 were resistant to treatment with the less reduced egg output. After the treatment with this complex, the number of egg discharged cases were reduced to 1.84% and the average number of discharge eggs per incompletely treated or untreated cases were reduced to 12.5% compared with the level of before-treatment egg output. The successive observations of the pattern of worm expulsion after drug intake was made. The worms were mostly expelled in the stool within 3 days, and 58.9% of total expelled worms were collected within 24-hour stool. The minimum length of the immature worms expelled was 7.6cm. Among the 659 Ascaris collected in the first-day stool from 91 rural people, 8.5% were in the range of 7.6-12.2 cm-long, immature worms. The sex ratio, male: female= 0.69: 1.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; chemotherapy ; Santonin ; kainic acid

On histological examination, an epidermolytic hyperkeratosis was observed adjacent to follicular papules on the back of a 53-year-old man. It has been reported that incidental epidermolytic hyperkeratosis occur either within various lesion (epidermal neoplasm, melanocytic neoplasm, scars, and inflammatory conditions) or in the normal skin adjacent to the lesion. This patient participated in the Vietnam War for 2 years, and had had contact with defoliants. He was treated for multiple peripheral neuropathies and cerebral infarcts. In keratinocytes, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD; Agent Orange) contained in defoliating agents is associated with altered patterns of keratinocyte differentiation. So, as a cause of incidental epidermolytic hyperkeratosis, defoliant contact could be suspected.
Cicatrix ; Humans ; Hyperkeratosis, Epidermolytic* ; Keratinocytes ; Middle Aged ; Peripheral Nervous System Diseases ; Skin* ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*

Teramethylammonium(TMA) in one of the synthetic compounds of nicotine that act at ganglionic site. The major action of TMA consists of initial stimulation followed by a more persistent depression of all autonomic ganglia by binding to a cholinergic receptor. It is well believed that the level of membrane potential in arterial smooth muscle is an important regulator of tension development. Depolarization and hyperpolarization by only few millivolts results in significant changes in tension. In general, the agents of vascular smooth muscle induce vascular relaxaion. The present study was undertaken to elucidate the effect of TMA on vascular contractility in the isolated rabbit thoracic aorta with or without endothelial cell, and mechanisms involved in the change of vascular contractility by TMA. The results obtained are summarized as follows ; 1) In the presence of endothelial cell, TMA induced a relaxtion of the aorta precontracted with norepinephrine but induced a contraction in the aorta without endothelial cells, indicating that in the rabbit aorta, relaxations produced by TMA were the endothelium-dependent. 2) The addition of inhibitor such as methylene blue, hemoglobin, hydroquinone and p-bromophenacyl bromide during the TMA-induced relaxation reversed the contractile tension to a level similar to or higher than that before the addition of TMA in rabbit thoracic aorta.This relaxation effect of TMA suggest that the TMA-inducdd relaxation in rabbit aorta is due to the release of endotheline derived relaxing factor(EDRF). 3) Relaxation induced by TMA was antagonized by atropine and thus the TMA does seem to act on the muscarinic receptors. 4) TMA reduced the norepinephrine-induced Ca++ influx into rabbit smooth muscle membrane. From the above results, it may be concluded that TMA-induced vacular relaxation in rabbit aorta is due to the release of EDRF. Mechanism involved in the relaxation induced by TMA may be the stimulation of soluble guanylate cyclase and increased tissue cGMP concentrations.
Aorta ; Aorta, Thoracic* ; Atropine ; Depression ; Endothelial Cells ; Endothelins ; Endothelium ; Endothelium-Dependent Relaxing Factors* ; Ganglia, Autonomic ; Ganglion Cysts ; Guanylate Cyclase ; Membrane Potentials ; Membranes ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nicotine ; Norepinephrine ; Receptors, Muscarinic ; Relaxation

No abstract available.
Heart Septal Defects, Atrial* ; Hemodynamics*

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

Cerebrotendinous xanthomatosis is a rare, inherited lipid-storage disease clinically characterized by tendon xanthoma, progressive neurologic dysfunction(cerebellar ataxia, spinal cord involvement, mental retardation), premature atherosclerosis and cataracts. Substantial elevation of serum cholestanol and urinary bile alcohols with low to normal plasma cholesterol concentrations establishes the diagnosis. Up to now, there have not been any reported case of cerebrotendinous xanthomatosis in Korea. So, we report herein a 36-year-old Korean woman with the clinical features of cerebrotendinous xanthomatosis.
Adult ; Ataxia ; Atherosclerosis ; Cataract ; Cholestanol ; Cholestanols ; Cholesterol ; Diagnosis ; Female ; Humans ; Korea ; Plasma ; Spinal Cord ; Tendons ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis