This paper is intended to draw attention to the cases of non-union of reattached greater trochanter after LFTA for hip disorders with an our short experience of this subject. Previous information on this subject is scanty. Charnley mentioned on his paper of the long time result of LFTA of the hip for non-union of the great trochanter was reported in 4.2% of 379 hips followed for a minium of four years. Of these, a quarter went on to separation of the bony fragment. With his report, wire breakage occured in 28 cases in the presence of a united trochanter, a phenmenon which results from loops of the wire passing through soft tissues, out side the bone, and becoming fatigued by repeated bending movements. However, he pointed that the clinical result does not seems to be impaired althrough such patients occasionally complain of a feeling of insecurity when weight bearing. Among our series, two cases of non-union of the greater trochanter, after LFTA, is reported. Those of two patient were bilateral hip disorders who has indicated both hip total hip replacement. But we have done only one hip each because of inevitable patients physical conditions during the surgery. Presumably, the principal cause of non-union appeared to be excessive force on the operated one hip. The type of internal fixation for reattachment of the greater trochanter was investigated, six types which we used in this series, two separate knots for security of wire breakage after Bechtol resulted satisfactory union of the detached greater trochanter. A case of detached trochanter for revision which we used original Charnley technique with additional figure of eight wire fixation for re-enforcement. Eventually, we agree that advantage of bilateral total hip replacement at the same operative session.
Arthroplasty, Replacement, Hip ; Femur ; Friction ; Hip ; Humans ; Torque ; Weight-Bearing

No abstract available in English.
Arthroplasty ; Friction ; Hip ; Tuberculosis

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes

Bladder urothelial carcinoma typically occurs in individuals in their sixties or seventies: it rarely occurs in persons <20 years old. Moreover, in young patients, bladder urothelial carcinoma lesions are reported to be solitary and nonmuscle invasive, with low malignant potential. However, 13% of lesions in this age group are reported to be noninvasive high-grade papillary urothelial carcinoma but these are extremely rare in children <15 years. There is no specific consensus regarding treatment of bladder urothelial carcinoma in children and adolescent. In particular, method has been suggested for follow-up of high-grade bladder urothelial carcinoma. Therefore we report our experience of one case the, discuss surveillance methods, and provide a brief review of the literature.
Adolescent ; Child* ; Consensus ; Follow-Up Studies ; Humans ; Methods ; Pediatrics ; Urinary Bladder*

PURPOSE: Using transmission electron microscopy (TEM), we studied the ultrastructures of rapidly proliferating preretinal membranes of young patients with very extensive ischemic proliferative diabetic retinopathy and diabetes with uncontrollable blood sugar level. METHODS: Nine cases of preretinal membranes were obtained from six eyes of five patients with rapidly progressed proliferative diabetic retinopathy (mean age, 35 years) during vitrectomy. We obtained each preretinal membrane bimanually as one single sheet membrane using intraocular scissors and forceps. Each tissue was fixed in 3% glutaraldehyde in the operating room. All specimens were prepared and studied using TEM. RESULTS: The preretinal membranes were composed of blood vessels and some interstitial cells. The blood vessels within the preretinal membranes varied in developmental stages, from the immature stage to the mature stage. The blood vessels were highly active, in that primitive cells showed a large nucleus and prominent chromatin clumping with abundant cytoplasm. Highly active fibroblast-like cells were also noted. CONCLUSIONS: We observed highly active angiogenesis in preretinal membranes, which rapidly proliferated in cases of severe retinal ischemia in young diabetes patients. This is the first report of such a finding, which may help to explain the poor prognosis of this disease modality.
Blood Glucose ; Blood Vessels ; Chromatin ; Cytoplasm ; Diabetic Retinopathy ; Eye ; Glutaral ; Humans ; Ischemia ; Membranes ; Microscopy, Electron, Transmission ; Operating Rooms ; Prognosis ; Retinaldehyde ; Surgical Instruments ; Vitrectomy

BACKGROUND: Neuromuscular blocking drugs are designed to specifically block nicotinic cholinergic receptors at the neuromuscular junction, but many bind to muscarinic cholinergic receptors on ganglia, nerve endings, and smooth muscles, thereby altering parasymphathetically mediated airway caliber and heart rate. METHODS: We studied the effects of mivacurium on the tension of tracheal smooth muscle by using an isolated rat tracheal preparation. We studied the cumulative effect of acetylcholine after pretreating the tracheal smooth muscle with mivacurium at different concentrations, as well as the effect of L-NAME and propranolol on the tension of tracheal smooth muscle after pretreating with mivacurium. RESULTS: Mivacurium shifted the acetylcholine dose-response curve to the right. L-NAME and propranolol had no effect on the tension of tracheal smooth muscle after pretreating with mivacurium. CONCLUSIONS: We have found that mivacurium relaxes isolated rat tracheal smooth muscle and this effect has no relationship to beta-receptors or nitric oxide.
Acetylcholine ; Animals ; Ganglia ; Heart Rate ; Muscle, Smooth ; Nerve Endings ; Neuromuscular Blockade ; Neuromuscular Junction ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Propranolol ; Rats* ; Receptors, Cholinergic

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*

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography

PURPOSE: The purpose of this study was to compare differences in the time when bowel sounds were heard and gas was passed in women who had an abdominal hysterectomy and were treated for 5 minutes (experimental group A) or 10 minutes (experimental group B) with San-Yin-Jiao (SP-6) acupressure. METHOD: The design of this study was a nonequivalent control group non-synchronized post test only design. The participants included 142 women, 39 in experimental group A, 30 in experimental group B, and 73 in the control group. Data was collected using a structured questionnaire which included items on general characteristics and a self report of time when gas was passed. Differences for the three groups as to time when bowel sounds were heard and gas was passed were analyzed using ANOVA. RESULT: The time when bowel sounds were heard was statistically significantly shorter in both experimental groups compared to the control group(F=10.29, p=.000). The time when gas was passed was statistically significantly shorter in experimental group B(10 min) compared to the control group(F=4.68, p=.011). CONCLUSION: It could be concluded that SP-6 acupressure of 10 minutes was effective in shortening the time until bowel sounds were heard and gas was passed for women who had had an abdominal hysterectomy. Replication of the study with a larger number of participants is necessary in order to be able to generalize the results.
*Acupressure ; Adult ; *Auscultation ; Female ; *Flatulence ; *Gastrointestinal Motility ; Humans ; *Hysterectomy ; Middle Aged ; Postoperative Complications/*therapy

PURPOSE: We studied the degree of changes in antibiotic sensitivity toward causative organisms, prevalence and clinical manifestations of extended-spectrum beta-lactamase(ESBL)- producers of urinary tract infection(UTI) for a period of three years. This serves to provide useful information in selecting adequate drugs for the treatment of UTI. METHODS: We recruited 137 patients who grew more than 105 CFU/mL in their urine culture among 250 patients who visited and were admitted to Handong University's Sunlin Hospital for UTI treatment from January 2003 to December 2005. We retrospectively analyzed the data from the medical records. RESULTS: The common pathogenic organisms were Escherichia coli(65.0%), Klepsiella pneumoniae(14.0%), Enterococcus faecalis(5.8%) and Proteus vulgaris(2.9%) in consecutive order. The prevalence of ESBL-producers among isolated E. coli and K. pneumoniae was 4.5%(4 cases) and 14.3%(2 cases), respectively. The antibiotic sensitivity rates of E. coli were relatively high to amikacin(100%), imipenem(100%), ceftriaxone(95.5%) and tobramycin(91.4%) while relatively low to TMP/SMZ(55.4%), ampicillin/sulbactam(29.4%) and ampicillin (24.2%). CONCLUSION: The use of ampicillin, ampicillin/sulbactam and TMP/SMZ, which have been the first choices in the treatment of UTI, should be reconsidered due to the low sensitivity rates towards these antibiotics. Due to the high incidence and antibiotic tolerance of ESBL that might have risen from the development of new antibiotics and increased antibiotic use, it is necessary to consider changing the standard antibiotics that have been used in the treatment of UTI.
Ampicillin ; Anti-Bacterial Agents ; Child* ; Enterococcus ; Escherichia ; Humans ; Incidence ; Medical Records ; Pneumonia ; Prevalence ; Proteus ; Retrospective Studies ; Urinary Tract