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.

The currently proposed factors inducing prostatic hyperplasia are the combined effect of androgen and estrogen and the reawakening of the embryonic growth potential of mature prostatic stroma. This experiment was designed to find out any histological or structural differences occurring after compensating sex hormones on the mature prostate and the implanted fetal urogenital sinus (UGS) tissue which possesses a differentiating potential under the same condition. The ventral lobe of the rat prostate with implanted fetal UGS showed 4.4 fold increase in weight compared to the non-implanted contralateral ventral lobe. After the castration, both ventral lobes showed marked atrophy, and no further progress in differentiation occurred in the implanted UGS. Dihydrotestosterone (DHT) compensation after castration revealed a significant increase in weight in the mature prostate but the ventral lobe with the implanted UGS showed relatively low recovery rate in weight than in non-castrated control group. The compensation of estradiol after the castration showed little difference in mature prostate compared to castrated control group, but the UGS implanted ventral lobe revealed a relative stromal hyperplasia. Unlike the single-hormone compensation, the mature prostate displayed the characteristic hyperplasia of epithelium of each acinar lumen, but the UGS dearly showed the formation of new acini with nodular pattern when compensated with both DHT and estradiol. The level of DHT showed a significant correlation with the height of the prostatic acinar cell which differentiated from the UGS, and an inverse correlation with the stroma/epithelium ratio of implanted group. The serum concentration of estradiol showed a significant correlation with the relative volume of juxta-prostatic tissues, such as the coagulating gland and the adjacent stroma. From the above results, it might be assumed that the estrogen may have an important role in the embryonic stroma-mediated initiation of nodular hyperplastic changes of microacini under the influence of DHT and the determination of histologic pattern after initiation might be controlled by the prostatic DHT concentration.
Acinar Cells ; Adult* ; Animals ; Atrophy ; Castration ; Compensation and Redress ; Dihydrotestosterone ; Epithelium ; Estradiol ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Hyperplasia ; Mice* ; Prostate* ; Prostatic Hyperplasia ; Rats

Pneumocystis carinii is a pulmonary pathogen of immunocompromised humans or other mammals. Its infection results from activation of organisms involved in latent infection or from new infection through the air. Almost all children are known to be infected within 2 to 4 years of birth, though prenatal transplacental transmission has not yet been demonstrated. In this study we observed experimental P. carinii infection in neonatal rats, thus investigating the possibility of transplacental vertical transmission by Diff-Quik staining of the lung impression smears and in-situ hybridization for lung sections. The positive rate of P. carinii infection in immunosuppressed maternal rats was 100%, but that in normal maternal rats was 0%. Cystic forms of P. carinii were observed in three of six 1-week old neonatal rats born of heavily infected mothers, but none of them was positive by in-situ hybridization. Five weeks after birth, cystic forms were detected in four neonatal rats. In the lobes of the lungs, no predilection site of P. carinii was recognized. Counts of cystic forms on smears and the reactivity of in-situ hybridization in the lungs of neonatal rats were significantly lower than in maternal rats. The present findings suggest that P. carinii is rarely transmitted through the placenta and proliferates less successfully in the lungs of neonatal rats than in mothers.
Animal ; Animals, Newborn/microbiology* ; Disease Transmission, Vertical* ; Female ; Immunocompromised Host ; Lung/microbiology ; Male ; Opportunistic Infections/transmission* ; Opportunistic Infections/complications ; Pneumocystis carinii/isolation & purification ; Pneumonia, Pneumocystis carinii/transmission* ; Pneumonia, Pneumocystis carinii/complications ; Pregnancy ; Rats ; Rats, Wistar

Twenty-two cases of idiopathic myocardiopathy were observed during the period of 1962 to 1971 and follow up clinical study was made in 5 cases. The criteria of diagnosis was based mainly on exclusive diagnosis in etiology unknown marked cardiomegaly. 1) Male and female ratio of idiopathic myocardiopathy was 1.1:1 and age of onset were distributed from first decade to fifth decade with similar number of cases. 2) Cardinal symptoms were dyspnea, palpitation, chest pain and cough. Common physical findings were protodiastolic gallop (in 2 cases), moist rales (in 3 cases) and hepatomegaly(in 3 cases). 3) Laboratory findings were normal except elevated T.T.T. in one case. 4) Electrocardiogram were abnormal in all cases. There were 3 cases of left ventricular hypertrophy, 3 cases of non-specific ST-T changes and one case of first degree A-V block, intraventricular conduction defect, abnormal Q wave and low valtage, respectively. 5) After medical treatment, symptoms were improved in 4 cases but heart size was reduced in only one case and E.C.G. abnormalities were unchanged in all cases.
Age of Onset ; Cardiomegaly ; Cardiomyopathies* ; Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Male ; Respiratory Sounds

No abstract available.
Angioplasty* ; Thrombectomy* ; Thrombosis*