It has been emphasized that the treatment of choice for the trochantric fracture of the femur is open reduction and rigid internal fixation to reduce complications by early ambulation. The incidence of trochanteric fracture of the femur in the young age group has been considerably increased in recent years because of increased traffic and industrial accidents. The author treated 38 cases of trochanteric fracture of the femur in the year 1974 through 1979, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. In sex distribution, 24 out of 38 were males and 14 were females. 16 cases out of 24 male patients were in the age group 20-40 and 9 cases out of 14 female were over 60 years of age. Over all mortality was 7.9%. 2. The numbers of patients of type I and III were 11 cases in each type out of 38 trochanteric fracture. 3. 26 cases out of 38 cases were treated by open reduction and internal fixation and the others were by traction and cast. 4. The applied metal devices were 3 types: Smith-Peterson nail and Thornton or McLaughlin plate, compression hip screw, and multiple pinning. 5. Mean duration of bony union is shorter in the group of open reduction and internal fixation (13 weeks) than the group of traction and cast (15 weeks). The cause of difference is that the 6 out of 9 cases of type IV and V were included in conservative group. 6. The incidece of the complications such as coxa vara, slipping screw, long nail and traction palsy occurred higher in the group fixed with Smith-Peterson nail and plate than the group fixed with compression hip screw.
Accidents, Occupational ; Coxa Vara ; Early Ambulation ; Female ; Femur ; Hip ; Humans ; Incidence ; Male ; Mortality ; Paralysis ; Sex Distribution ; Traction

BACKGROUND: Eugenol is a major component of the essential oil isolated from Eugenia caryophyllata (Myrtaceae), and has been widely used as a traditional medicine. In this study, the effects of eugenol on the cytotoxicity, induction of apoptosis and putative pathways of its actions were investigated in human promyelocytic leukemia cells (HL-60). METHODS: After applying eugenol to cultured HL-60, the changes in the mitochondrial membrane potential of the cells were monitored after double staining with propidium iodide and rhodamine 123, with 2', 7'-dicholorofluorescin diacetate was used to measure of levels of reactive oxygen species (ROS) RESULTS: Eugenol was shown to be a potent inducer of apoptosis; transducing the apoptotic signal via ROS generation; thereby, inducing mitochondrial permeability transition (MPT) and cytochrome c release to the cytosol. The production of ROS, mitochondrial alteration and subsequent apoptotic cell death in eugenol-treated cells were blocked by the antioxidant, N-acetylcystein (NAC). CONCLUSION: Taken together, the present study has demonstrated that eugenol induces ROS-mediated mitochondrial permeability transition and resultant cytochrome c release.
Apoptosis* ; Cell Death ; Cytochromes c ; Cytosol ; Syzygium ; Eugenol* ; HL-60 Cells ; Humans* ; Leukemia* ; Medicine, Traditional ; Membrane Potential, Mitochondrial ; Oxygen* ; Permeability ; Propidium ; Reactive Oxygen Species ; Rhodamine 123

BACKGROUND: Hyperhomocysteinemia has been known to be associated with cerebrovascular disease. It is toxic to vascular endothelial cell and promotes arteriosclerotic detachment. There was no study of the homocysteine level in ischemic stroke patients in Korea except case report. Therefore we measured total plasma homocysteine level in ischemic stroke patients and evaluated association with other stroke risk factors. METHODS: We measured total plasma homocysteine level in 44 patients with ischemic stroke and 16 age-matched normal controls, and analyzed its relationship to other stroke risk factors. Total plasma homocysteine level was determined by using a radioenzymatic method. RESULTS: Total plasma homocysteine level was 12.12 5.11 micromol/L in patients and 9.40 1.93 micromol/L in controls. It was 13.03 5.78 micromol/L in lacunar infarction and 9.96 1.57 micromol/L in territory infarction. The total plasma homocysteine level of the patients with hypertension, DM, hyperlipidemia, heart disease, smoking, alcohol, previous stroke, carotid bruit was not different statistically from those without them. CONCLUSIONS: Total plasma homocysteine level was significantly higher in the ischemic stroke patients than that of controls. Lacunar infarction showed significantly higher level of total plasma homocysteine compared to territory infarction.
Cerebral Infarction* ; Endothelial Cells ; Heart Diseases ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Hypertension ; Infarction ; Korea ; Pilot Projects* ; Plasma* ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar

BACKGROUND: The aim of gender verification test is to maintain impartiality among female competitors by excluding males in women's sports competitions. Some microscopic methods such as X-chromatin test and Y-chromatin test had been used for this purpose. Because of their known shortcomings, the methods were replaced with the polymerase chain reaction(PCR)-based test. In this report we describe the assay used in the gender verification during the '99 Kangwon Asian Winter Games. METHODS: Buccal smear samples of 126 female competitors were obtained. These samples underwent digestion with proteinase K, and were followed by boiling treatment with Chelex resin. PCR was performed to detect the sex determining region of Y chromosome(SRY) in order to confirm the femininity, and beta globin region was coamplified for confirming that the DNA was extracted from buccal cells. An X-Y homologous region encoded amelogenin was also amplified so that the femininity could be reconfirmed. RESULTS: No SRY and Y-amelogenin like sequences were amplified in any of samples of 126 female competitors analysed. CONCLUSIONS: Established gender verification method based on PCR amplification of Y chromosomal DNA seems to be superior to others. Sampling is simple. The procedure of extracting DNA is simple, rapid, and does not require multiple tube transfers. False positivity and/or false negativity appear to be less. It appear that this method is useful and reliable for gender verification in international sports events.
Amelogenin ; Asian Continental Ancestry Group* ; beta-Globins ; Digestion ; DNA* ; Endopeptidase K ; Female ; Femininity ; Gangwon-do* ; Humans ; Male ; Polymerase Chain Reaction* ; Sports

BACKGROUND: To clarify the clinicoradiological correlation and prognosis of acute ischemic stroke involving para-median territory of pons. METHODS: We studied 37 patients with first-ever ischemic stroke involving paramedian terri-tory of pons and divided them based on the shape and level of lesion shown in their MRI. The clinical features, MRI findings, and prognosis were assessed. RESULTS: The paramedian infarctions extending to the basal surface were found in 28 patients (76%), and small infarctions separated from the basal surface were found in 9 patients (24%). In patients with infarction extending to the basal surface, 23 patients (82%) had progressive or fluctuating onset, whereas all patients with small infarction separated from the basal surface had non-progressive onset. In the group with upper pon-tine lesion (14 patients), dysarthria-clumsy hand syndrome was found in 4 patients, ataxic hemiparesis (AH) in 3, pure motor hemiparesis (PMH) in 2, and pure sensory stroke in 1. In the group with middle and lower pontine lesion (22 patients), PMH was found in 9, AH in 3, and sensory motor stroke in 2. The mean Modified Rankin Disability Scale scores on admission and after follow-up (mean 29 months) of the group with upper pontine lesion were 2.36 +/-0.50 and 1 . 0 0 +/-0.55, those with mid-lower pontine lesions, 3.48 +/-0.51 and 1.17 +/-0.49 (P<0.01 and P>0.05 respectively). CONCLUSIONS: Paramedian pontine infarction extending to the basal surface usually presents with progressive onset. Paramedian pontine infarction most often produces classic lacune syndrome of which PMH is the most common. In our study, patients with mid-lower paramedian pontine infarction had more severe initial neurological deficits than those with upper paramedian pontine infarction. However, a late outcome was found to be favorable in both groups.
Follow-Up Studies ; Hand ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paresis ; Pons ; Prognosis* ; Stroke

PURPOSE: Postoperative hypocalcemia is one of the most common complications in patients who undergo a bilateral thyroid resection and can prolong hospital stay. However, there is no reliable predictor of clinical hypocalcemia after a thyroidectomy. The aim of this study was to identify the clinical predictors of hypocalcemia after a thyroidectomy and to determine if the perioperative measurements of iPTH would be helpful in identifying patients at risk of post-thyroidectomy hypocalcemia. METHODS: 213 consecutive patients undergoing thyroidectomy between Nov 2004 and Feb 2005 were examined. The iPTH, serum calcium and ionized calcium levels were measured at 6 hours, 1 day and 2 weeks after surgery, respectively. All the patients were divided into the lower PTH group (<10 pg/ml) and normal PTH group according to the level of iPTH measured at 6 hours after surgery. RESULTS: The lower PTH group comprised 33% of all patients: 39% after the total thyroidectomy and 11% after a less than total thyroidectomy. The incidence of IV calcium replacement was 36% in the lower PTH group compared with 13% in the normal PTH group. Hypocalcemia and a lowered PTH level occurred more frequently in patients who underwent surgery for a malignant tumor than for a benign tumor. CONCLUSION: There was a correlation between the level of ionized calcium and the incidence of calcium replacement and with the 6 hr-later iPTH level. Therefore, a iPTH leve Calcium ; Humans ; Hypocalcemia* ; Incidence ; Length of Stay ; Parathyroid Hormone* ; Thyroid Gland ; Thyroidectomy

Pituitary tumor can be accompanied with various pituitary hormone abnormalities. Pituitary tumors can be divided into functioning or nonfunctioning tumors. A functioning pituitary tumor, via the oversecretion of pituitary hormones, causes diverse clinical features. A nonfunctioning pituitary tumor can be accompanied with pituitary dysfunction and this may be due to compression or destruction of normal pituitary tissue, suppression of the pituitary portal system or direct damage to the hypothalamus. Corticotropin-releasing hormone (CRH) deficiency, which is caused by defects in the synthesis or release of CRH, is a cause of secondary adrenocortical insufficiency. The clinical presentations are hypoglycemia, weight loss, anemia, weakness, nausea, vomiting and hyponatremia. Acquired CRH deficiency has also been suggested to occur based on a lack of adrenocorticotropic hormone (ACTH) response to insulin-induced hypoglycemia, but there is a normal ACTH response to exogenous CRH. We experienced a case of a woman with pituitary macroadenoma accompanied with CRH deficiency. We report here on this case with the review of the literature.
Adrenocorticotropic Hormone ; Anemia ; Corticotropin-Releasing Hormone ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypothalamus ; Nausea ; Pituitary Hormones ; Pituitary Neoplasms ; Portal System ; Vomiting ; Weight Loss

Central pontine myelinolysis (CPM)is a demyelinating disorder that affects pons and is characterized by disturbance of consciousness, quadriparesis, and mutism and has been considered to have poor prognosis. It commonly occurs in patients with rapidly corrected hyponatremia. However, hypoglycemia induced CPM has been rarely reported. Diagnosis is confirmed by MR imaging. Here we report a case of CPM after severe hypoglycemia without any electrolyte disturbance in a patients with diabetic nephropathy.
Consciousness ; Demyelinating Diseases ; Diabetic Nephropathies* ; Diagnosis ; Humans ; Hypoglycemia* ; Hyponatremia ; Magnetic Resonance Imaging ; Mutism ; Myelinolysis, Central Pontine* ; Pons ; Prognosis ; Quadriplegia

Fibromuscular dysplasia (FMD) is an uncommon hyperplastic disorder affecting medium-sized arteries. It can lead to renovascular hypertension, sometimes associated with dissection. But it rarely causes renal infarction. We here report a case of recurrent renal infarction due to FMD. A previously healthy 29- year-old man presented with acute onset of right flank pain. He had been treated for the same symptom 8 years ago. Abdominal CT scan showed renal infarction at upper pole of right kidney. Renal arteriography demonstrated string of bead, consistent with FMD. It showed also old renal infarction at lower pole of right kidney. To our knowledge, recurrent renal infarction due to FMD has not been previously reported.
Angiography ; Arteries ; Fibromuscular Dysplasia ; Flank Pain ; Hypertension, Renovascular ; Infarction* ; Kidney ; Tomography, X-Ray Computed

Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. However, the exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the last two decades has resulted in more patients with SVC syndrome. Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following the reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. We describe a patient who developed SVC syndrome after internal jugular vein catheterization. The patient had been swollen the left arm intermittently due to left central vein stenosis for 1 year and experienced balloon angioplasty and stent insertion for three times. We diagnosed the SVC syndrome through the both subclavian venography, which revealed complete obstruction of the left brachiocephalic vein with extensive collateral circulation and mild stenosis of the distal right internal jugular vein. Resolution of the clinical SVC sydrome occurred after catheter removal.
Angioplasty, Balloon ; Arm ; Brachiocephalic Veins ; Catheterization* ; Catheters* ; Central Venous Catheters ; Collateral Circulation ; Constriction, Pathologic ; Humans ; Incidence ; Jugular Veins* ; Phlebography ; Renal Dialysis* ; Stents ; Subclavian Vein ; Superior Vena Cava Syndrome* ; Veins ; Vena Cava, Superior*