Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

The purpose of this study was to investigate the effects of nutrition education on nutrition knowledge, dietary attitude and dietary intake of Chinese college students in Korea. The subjects were 64 Chinese college students in Korea (educated group, 32 students vs. non-educated group, 32 students). Educated group was lessoned as group and/or individual. Nutrition education program consisted of four lessons (40min / lesson), '6 major nutrients & function (group lesson)', '6 food group and sources (group lesson)', 'personalized daily needed energy and food exchange units using Food Exchange System (individual lesson)', and 'smart choice of snacks and eating-out foods (group lesson)'. We examined the differences between educated group and non-educated group in nutrition knowledge, dietary attitudes and nutrients intake. After education, there were positive improvements on nutrition knowledge: 'function and foods of 6 nutrients', on dietary attitudes: 'type of breakfast' in educated group. In the evaluation of nutrient intakes according to Dietary Reference Intakes for Korean (KDRI), there were positive improvements on intake levels of riboflavin, fiber, vitamin B6, vitamin C, folate, Ca and K in the educated group. In the index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased in the educated group. In conclusion, it is possible to improve nutrition knowledge, dietary attitude and dietary intake of Chinese college students in Korea through the nutrition education focused on personalized daily needed energy and food exchange units.
Ascorbic Acid ; Asian Continental Ancestry Group* ; Education* ; Folic Acid ; Humans ; Korea* ; Riboflavin ; Snacks ; Vitamin B 6

We report a case of histopathologically confirmed hepatic angiosarcoma. A 29-year old patient was admitted with fever and palpable tender mass in the right upper abdomen. On ultrasonography, a large, well circumscribed mixed echoic mass was seen in the right lobe of the liver. On CT scan, irregular enhancement was seen mainly in the peripheral portion of the mass ; the central portion was not enhanced. The mass showed low signal intensity on T1W1, and high signal intensity on T2WI. Peripheral nodular enhancement was noted on Gd-enhanced MR images; In the peripheral portion of the mass,
Abdomen ; Adult ; Angiography ; Fever ; Hemangiosarcoma* ; Hepatic Artery ; Humans ; Liver* ; Radionuclide Imaging ; Sarcoma ; Tomography, X-Ray Computed ; Ultrasonography

Generally, early exercise after coronary stenting is considered safe, but isolated cases of acute stent thrombosis have been associated with the performance of a treadmill exercise test after percutaneous coronary intervention (PCI). The treadmill exercise test is often used to noninvasively assess the functional result of PCI. In this report, we describe a case of terrible stent thrombosis related to an exercise test performed 3 days after stenting, and the patient died as the result of an intractable thrombus.
Exercise Test ; Humans ; Percutaneous Coronary Intervention ; Stents ; Thrombosis

The intrapelvic migration of cervicocephalic lag screws is a rare complication after intertrochanteric fracture synthesis with an intramedullary nail. Only 15 cases of intrapelvic penetration by three different instrument systems have been described in the literature. However, to our knowledge, there is no report of intrapelvic migration of the lag screw with wedge wing designed to increase fixation power using the Dyna locking trochanteric (DLT) nail. We present a case of intrapelvic migration of the lag screw with wedge wing from DLT nail. The patient described herein underwent a two-staged operation of implant removal without intrapelvic approach followed by bipolar hemiarthroplasty. With intrapelvic migration conditions, although it is not uncommon to require an additional intrapelvic approach, this modification can lead to lethal consequences. For this reason, it is recommended to coordinate with the vascular surgery department due to the close proximity of the major vessels.
Femur ; Hemiarthroplasty ; Humans

PURPOSE: We wanted to analyze the clinical outcomes of prospectively randomized surgeries between internal fixation and hemiarthroplasty for treating unstable intertrochanteric hip fracture in elderly patients. MATERIALS AND METHODS: From January, 2004 to December, 2007, 62 cases of unstable intertrochanteric fracture that underwent internal fixation or hemiarthroplasty were analyzed retrospectively for the clinical outcomes with using the SF-36. Thirty cases were treated with internal fixation and 32 cases were treated with hemiarthroplasty. The clinical outcomes, as assessed by using the SF-36, were statistically analyzed with using SPSS for Windows. RESULTS: Hemiarthroplasty show a better result than internal fixation for pain, limping and the support scales in the 70~79 years old group, and the limping scale was also better in the over 80 years old group (P<0.05). There were no differences between the two groups according to age. Four cases of internal fixation failed due to loss of fixation (3)and nonunion (1), and 4 cases of hemiarthroplasty failed due to infection (2) and revision for dislocation (2). CONCLUSION: Primary hemiarthroplasty should be more beneficial than osteosynthesis, such as performing internal fixation, for treating unstable intertrochanteric fracture in elderly patients because of the reduced pain and early ambulation that are due to the early stabilization.
Aged ; Dislocations ; Early Ambulation ; Hemiarthroplasty ; Hip ; Humans ; Retrospective Studies ; Weights and Measures

PURPOSE: To evaluate the CT grading of complications developing after endoscopic sphincterotomy (EST), and their clinical course. MATERIALS AND METHODS: We retrospectively evaluated CT in 19 patients in whom pancreatitis or duodenal perforation developed after EST in 594 patients. The CT grading of pancreatitis was classified as mild, moderate or severe, according to the extent of peripancreatic infiltration; duodenal perforation was classified as mild, moderate or severe grade, according to the extent of fluid collection. We attempted to correlate CT grade with the average duration of hospitalization after EST, treatment method and mortality. RESULTS: Post-EST complications detected on CT were pancreatitis (ten patients, 1.7%) and duodenal perforation (nine patients, 1.5%). In those with pancreatitis, hospitalization after EST lasted an average of nine days in mild cases (n=2), 21 days in moderate (n=1) and 41 days in severe (n=7). Nine of ten patients with pancreatitis were treated conservatively, while the other, whose grade was severe, underwent percutaneous drainage. Eight of these ten recovered; the two who died were severe grade patients, one having been treated conservatively and the other by percutaneous drainage. In patients with duodenal perforation, hospitalization after EST lasted an average of 13 days in mild cases (n=2), 16 days in moderate (n=2) and 37 days in severe (n=5). Four of nine patients with duodenal perforation were treated conservatively, while the other five (severe, four; moderate, one) underwent percutaneous drainage. One patient, graded as severe, expired, but the remaining eight rocovered. Percutaneous drainage was performed mostly in severe grade cases, and among patients thus graded, only three (3/594; 0.5%) died. CONCLUSION: CT is considered useful for predicting the clinical course and prognosis of complications occurring after EST.
Drainage ; Hospitalization ; Humans ; Mortality ; Pancreatitis ; Prognosis ; Retrospective Studies ; Sphincterotomy, Endoscopic*

In unstable pelvic ring injury, if there is damage to both the anterior and posterior, both anterior and posterior fixation will be needed in order to stabilze the pelvic ring. A female patient complained of dyspareunia due to malunion and additional bone bridge at the inferior ramus of the pelvis. She should have undergone both anterior and posterior fixation, but had undergone anterior fixation only. We report on a patient who was treated successfully with resection of additional bone bridge, scar tissue and adhesive band around the vagina.
Adhesives ; Cicatrix ; Dyspareunia* ; Female ; Humans ; Pelvis* ; Vagina

To control such a hemorrhage, a displaced pelvic ring must be rapidly reduced and stabilized with a pelvic binder, an external fixator, or a pelvic clamp. Among them, pelvic clamps can be life-saving but pin malposition may cause vascular complications. We present a case of superior gluteal artery pseudoaneurysm caused by AO pelvic C-clamp pin malposition.
Aneurysm, False* ; Arteries* ; External Fixators ; Hemorrhage ; Pelvis