No abstract available.

Femoral neck fracture has given marked attention to the orthopaedic surgeon due to complications, such as avascular necrosis of femoral head, non-union and degenerative arthritis, moveover common in older age group since early part of the 20th century. It is one of disabling and unsolved problems, so various techniques and implants were introduced and applied. Percutaneous Knowles pinning is one of simple, safe and reasonably effective method in treating femoral neck fracture, provided it is performed correctly. Nineteen cases of femoral neck fracture treated with precutaneous Knowles pinning at the Department of Orthopaedic Surgery, National Medical Center were analyzed and following result were obtained. l. Among the 19 cases, 13 cases were female and 6 cases were male, and high incidence was noted in older age group. 2. The amout of bleeding during operation was less than 100ml and the operative time was less than one and half hour under the local anesthesia in majority. 3. Good result was obtained in the group of operation less than 3 days after initial injury compared to more than 3 days group. 4. There was high complication rate in poor group than acceptable group according to Garden alignment index and we could predict the end result by aid of alignment index. 5. There was no cast immobilization in case of stable reduction, good fixation and good Rapport. 6. Bony union was established within 4.7 months in non-displaced fracture and 7.3 months in displaced fracture in average. 7. There were 1 case of avascular necrosis. 3 cases of non-union and 2 cases of degenerative osteoarthritis and poor results were correlated with Garden stage.
Agriculture ; Anesthesia, Local ; Female ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Hemorrhage ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Necrosis ; Operative Time ; Osteoarthritis

Accelerated atherosclerosis is not only a frequent complication but also the most common cause of death in patients with chronic renal failure (CRF). Although mechanisms are unclear, disorder of lipid metabolism may be a major factor. Since apolipo-protein (apo) E is known to play a major regulatory role in lipid metabolism, we evaluated apo E genotype in 72 male patients with CRF and compared with that in 194 rnale normal controls. In addition, we measured plasma lipid and apolipoprotein concentrations and evaluated them according to apo E genotype in patients and controls. Apo E genotype was determined with the INNO-LiPA Apo E kit (Innogenetics, Belgium), which is based on reverse hybridization. The results are as follows ; 1) The distribution of the three major apo E alleles in patients with CRF ( e 2: 6.2%, e 3: 80.6%, e 4: 13.2%) was not different from that in controls ( e 2: 4.1%, e 3: 87.6%, e 4: 8.3%). 2) In patients with CRF, total cholesterol, lowdensity lipoprotein (LDL) and high-density lipoprotein (HDL) levels were significantly lower and the triglyceride and lipoprotein (a) levels were significantly higher than those in controls. 3) In controls, E 4/3 group had significantly lower levels of HDL than E 3/3 and E 3/2 groups. In patients with CRF, E 4/3 group had significantly higher levels of total cholesterol and apo B lipoprotein than E3/2 group. In conclusion, although there was no significant difference in the apo E genotype frequencies between male patients with CRF and controls, apo E polymorphism may play an important role in the determination of individual differences in plasma lipids in male patients with CRF.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cause of Death ; Cholesterol ; Genotype ; Humans ; Individuality ; Kidney Failure, Chronic* ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Male* ; Plasma* ; Triglycerides

No abstract available.

No abstract available.
Fistula*

BACKGROUND: A medulloblastoma is a primitive neuroepithelial tumor of the cerebellum that occurs in children and metastasizes through the cerebrospinal fluid. It is highly malignant and invasive, and the 5-year survival rate is only 60%. Surgical resection techniques, radiation, and chemotherapy have improved the overall survival but the patients suffer life-long cognitive dysfunctions or endocrine abnormalities as the side effects of treatment. Therefore it is essential to identify prognostic markers to determine the appropriate treatment strategy in order to minimize the side effects. METHODS: This study evaluated the immunohistochemical differentiation and survival rate with synaptophysin, glial fibrillary acidic protein, epithelial membrane antigen, vimentin and primitive neuroepithelial marker nestin of 55 paraffin-embedded medulloblastomas, using a tissue microarray. The expression of survivin, the apoptotic inhibitor, and the survival rate with regard to the proliferation index of Ki-67 were also investigated. RESULTS: The group testing positive to vimentin, a mesenchymal differentiation marker, had a worse prognosis and there was a strong correlation between vimentin expression and nestin expression. Patients with a survivin expression rate >35% had a significantly poorer clinical course and there was a correlation between the survivin expression rate and Ki-67 expression rate. CONCLUSION: In conclusion, vimentin and survivin are negative prognostic markers in medulloblastomas.
Cerebellum ; Cerebrospinal Fluid ; Child ; Drug Therapy ; Glial Fibrillary Acidic Protein ; Humans ; Medulloblastoma* ; Mucin-1 ; Nestin ; Neuroectodermal Tumors, Primitive ; Prognosis ; Survival Rate ; Synaptophysin ; Vimentin*

Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis

No abstract available.
Hemangioma* ; Ligation*

No abstract available.
Carcinoma, Renal Cell* ; Genes, Tumor Suppressor*

PURPOSE: This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. METHODS: Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, Scheffe? test, Pearson correlation coefficients, and multiple stepwise regression. RESULTS: The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. CONCLUSION: Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.
Career Mobility* ; Hospitals, General ; Intention* ; Job Satisfaction* ; Surveys and Questionnaires ; Seoul