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

A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

No abstract available.
DNA* ; Ploidies* ; Stomach Neoplasms* ; Stomach*

Myositis Ossificans Traumatica, ossifying hematoma and calcifying hematoma have been used interchangeably to dcscribe the process of calcification and ossification occuring within muscle tissue in response to trauma. Authors analysed 27 cases of traumatic myositis ossificans of the Quadriceps who were diagnosed and treated at the department of orthopaedic surgery, National Police Hospital from January 1978 to June 1984. The results are as follows: 1. In sex distribution, in all cases 27 were males, in age distribution they were between 19 and 25 years old. 2. The causes of trauma consisted of 11 in kicking and treading, 6 in falling and slipping, 6 in football, 4 in demonstration injury. 3. The duration from injury to initial visit was variable. The average duration was 2 weeks. 4. Quadriceps contusions in all cases were grouped according to severity of trauma as mild, moderate and severe. Among 27 cases, 4 cases were mild, 11 cases were moderate, 12 cases were grouped as severe. According to the severity of trauma, duration of treatment and restoration of affected knee joint motion were more prolonged. 5. Among 27 cases, 6 cases sustained reinjury. 6. Total 27 cases, average duration of treatment was 4.6 weeks. 7. In those patients presenting after 2 weeks from injury, the duration of treatment was 3.8 weeks, and in those patients presenting within 2 weeks it was 5.4 weeks. Thc moderate cases were required 3.8 weeks of the duration of treatment, severe cases were required 6.5 weeks. Reinjury cases, 6 cases required more prolonged treatment, 6.8 weeks. These results suggest that early treatment, low violence of trauma and prevention of reinjury were the factor of minimizing the impairment of knee joint motion and shortening the duration of treatment. 8. The earlist X-ray change was found of the 14th day from injury. (average the 27th day from injury). 9. Within 6 months, all cases regained full range of motion of knee joint. 10. With only conservative treatment applied on all cases, we get the satisfactory result.
Accidental Falls ; Age Distribution ; Clinical Study ; Contusions ; Dronabinol ; Football ; Hematoma ; Humans ; Knee Joint ; Male ; Myositis Ossificans ; Myositis ; Police ; Quadriceps Muscle ; Range of Motion, Articular ; Sex Distribution ; Violence

No abstract available.
Paraplegia* ; Pseudarthrosis* ; Spondylitis, Ankylosing*

A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author’s knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.

No abstract available.

Fibrous histiocytoma are complex group of tumors that feature cells resembling fibroblasts and histiocytes.In a case of fibrous histiocytoma involving the cornea and corneolimbus, we evaluated the finding of H-E, Masson-trichrome, reticulin, CD68, alpha-1-antitrypsin antibody and smooth muscle actin antibody stain after the localized excision in 26 years old male patient. In H-E stain, tumor cell included many multinucleated giant cells having abundant eosinophilic and foamy cytoplasm infiltreated by numerous lymphocyte, CD68 & alpha-1-antit-rypsin antibody staining resulted in diffuusely positive finding. Therefore examination. Good result was noted after complete excision at 6 month follow-up.
Actins ; Adult ; Cornea* ; Cytoplasm ; Eosinophils ; Fibroblasts ; Follow-Up Studies ; Giant Cells ; Histiocytoma, Benign Fibrous* ; Humans ; Lymphocytes ; Male ; Muscle, Smooth ; Reticulin

Inadequate effectiveness of anticancer drug in treating renal cell carcinoma has been attributed to the overexpression of multidrug resistance gene (MDR1) and its product, membrane-bound P-glycoprotein. P-glycoprotein is known to actively pump out intracellular drug, which results in low intracellular anticancer drug concentration. Progesterone, which has been used in patients with advanced renal cell carcinoma is found to cause a three to four-fold increase in vinblastine accumulation in the P-glycoprotein-expressing murine macrophage-like cell line.We have studied to evaluate the MDR modulating action of medroxyprogesterone acetate (MPA) in renal cell carcinoma cell lines also with tamoxifen and verapamil. A-498 of a high mdrl expressed cell line and Caki-2 of a low mdrl expressed cell line were each placed in 96 multiwell plates. Vinblastine, in concentration from 0.01 ug/ml to 10 ug/ml was added to each well and verapamil, from 0.1 uM to 10 uM, MPA, from 2.5 uM to 25 uM, or tamoxifen, from 0.1 uM to 10 uM was also added. The in vitro chemosensitivity of two renal cell carcinoma cell lines (Caki-2 and A498) to vinblastine was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazol bromide(MTF) colorimetric assay. Growth of Caki-2 cells is inhibited by low doses of vinblastine(IC50: 0.27 ug/ml), but A-498 cells are highly resistant to the drug, with ICs0 value of 0.47 ug/ml. The chemosensitivity of the A-498 cells is increased in response to 5 uM MPA, 1 uM verapamil and 2 uM tamoxifen, which are known to partially reverse the MDR phenotype in other resistant tumors. The effective concentration of MPA for MDR reversal is in clinically achievable concentration but one of verapamil is not. The chemosensitivity of Caki-2 cells does not change according to MDR modulating agents. .MPA is an effective MDR modulating agents to enhance the cytotoxicity of vinblastine in renal cell carcinoma cell line showing P-glycoprotein expression. It suggests that combination therapy of MPA and vinblastine is better than monotherapy with MPA or vinblastine alone.
Carcinoma, Renal Cell* ; Cell Line* ; Drug Resistance, Multiple ; Genes, MDR ; Humans ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; P-Glycoprotein ; Phenotype ; Progesterone ; Tamoxifen ; Verapamil ; Vinblastine*

Inadequate effectiveness of anticancer drug in treating renal cell carcinoma has been attributed to the overexpression of multidrug resistance gene (MDR1) and its product, membrane-bound P-glycoprotein. P-glycoprotein is known to actively pump out intracellular drug, which results in low intracellular anticancer drug concentration. Progesterone, which has been used in patients with advanced renal cell carcinoma is found to cause a three to four-fold increase in vinblastine accumulation in the P-glycoprotein-expressing murine macrophage-like cell line.We have studied to evaluate the MDR modulating action of medroxyprogesterone acetate (MPA) in renal cell carcinoma cell lines also with tamoxifen and verapamil. A-498 of a high mdrl expressed cell line and Caki-2 of a low mdrl expressed cell line were each placed in 96 multiwell plates. Vinblastine, in concentration from 0.01 ug/ml to 10 ug/ml was added to each well and verapamil, from 0.1 uM to 10 uM, MPA, from 2.5 uM to 25 uM, or tamoxifen, from 0.1 uM to 10 uM was also added. The in vitro chemosensitivity of two renal cell carcinoma cell lines (Caki-2 and A498) to vinblastine was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazol bromide(MTF) colorimetric assay. Growth of Caki-2 cells is inhibited by low doses of vinblastine(IC50: 0.27 ug/ml), but A-498 cells are highly resistant to the drug, with ICs0 value of 0.47 ug/ml. The chemosensitivity of the A-498 cells is increased in response to 5 uM MPA, 1 uM verapamil and 2 uM tamoxifen, which are known to partially reverse the MDR phenotype in other resistant tumors. The effective concentration of MPA for MDR reversal is in clinically achievable concentration but one of verapamil is not. The chemosensitivity of Caki-2 cells does not change according to MDR modulating agents. .MPA is an effective MDR modulating agents to enhance the cytotoxicity of vinblastine in renal cell carcinoma cell line showing P-glycoprotein expression. It suggests that combination therapy of MPA and vinblastine is better than monotherapy with MPA or vinblastine alone.
Carcinoma, Renal Cell* ; Cell Line* ; Drug Resistance, Multiple ; Genes, MDR ; Humans ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; P-Glycoprotein ; Phenotype ; Progesterone ; Tamoxifen ; Verapamil ; Vinblastine*