PURPOSE: To evaluate the effectiveness of Proximal Femoral Nail Anti-rotation (PFNA) for the treatment of unstable intertrochanteric fracture comparing with Compression Hip Screw (CHS) with Trochanteric Stabilizing Plate (TSP). MATERIALS AND METHODS: With clinical study, 43 patients who were treated surgically for unstable intertrochanteric fractures were retrospectively evaluated. One group was treated with CHS and TSP (Group 1, 22 cases) and the other was treated with PFNA (Group 2, 21 cases). By postoperative radiograph and last follow up radiograph we measured Tip-apex distance, Cleveland index, Lag screw slippage, Neck-shaft angle change and Union time. And By retrospective medical record review, the clinical results were evaluated with the operation time, intraoperative estimated blood loss, amount of drainage, amount of transfusion, walking ability change and complication. RESULTS: There was a lower operation time, intraoperative estimated blood loss, amount of drainage, amount of transfusion, lag screw slippage and neck shaft angle change in the Group 2 than in the Group 1 (p<0.05). CONCLUSION: PFNA showed better results than CHS with TSP in operation time, estimated blood loss, amount of drainage and transfusion, lag screw slippage and neck-shaft angle change.
Drainage ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Medical Records ; Nails ; Neck ; Retrospective Studies ; Walking

Objectives: Terminally ill cancer patients in hospice palliative care unit are reluctant to undergo repetitive invasive procedures due to coagulopathies and poor performance or condition, while catheter management such as regular irrigation during hospitalization is easy. The purpose of this study was to investigate the safety and efficacy of indwelling intraperitoneal (IP) catheter in hospitalized terminally ill cancer patients with recurrent ascites. Methods: A retrospective review was conducted in patients who underwent IP catheter at the hospice palliative care unit of Pusan National University Yangsan Hospital between August 2016 and June 2018. All catheters were inserted by interventional radiologists with radiological guidance. The primary end-points were functional IP catheter maintenance rate, which is catheter maintained with patency for drainage until the intended time. Results: A total of 25 terminally ill cancer patients underwent IP catheters placements during the study period. All catheters were successfully inserted without major complications, but one patient had trivial bleeding and one other patient had temporary pain. The median time from admission to catheter insertion was 5 days (range, 1 to 49 days). Twenty-one catheters were maintained with function until the intended time, three cases were maintained without function, and the last one was removed early due to obstruction and pain. Finally, the functional IP maintenance rate was 84% (21/25) and the median functional catheter life span was 15 days (95% confidence interval, 10.8 to 17.2). Conclusion Our study showed relatively favorable results for IP catheter maintenance and safety in hospitalized terminally ill cancer patients with malignant ascites.

Tuberous Sclerosis is an autosomal-dominant neurocutaneous disorder with a clinical triad of seizures, mental retardation and adenoma sebaceum, and the incidence is approximately one in 15,000 to 30,000 live births. The condition can be suspected if multiple cardiac rhabdomyomas are seen on fetal ultrasound. Tuberous sclerosis was subsequently confirmed by the brain ultrasound and MRI which revealed multiple nodules in the subcortical, subependymal or periventricular areas. We experienced two cases of antenatal tuberous sclerosis was diagnosed by ultrasound. One case was diagnosed with tuberous sclerosis at birth, the other case was confirmed with tuberous sclerosis during follow up brain ultrasound. We report these cases with brief review of related literatures.
Brain ; Follow-Up Studies ; Incidence ; Intellectual Disability ; Live Birth ; Neurocutaneous Syndromes ; Parturition ; Prenatal Diagnosis ; Rhabdomyoma ; Seizures ; Tuberous Sclerosis

PURPOSE: Congenital chylothorax is an accumulation of lymphatic fluid within the pleural space. It is a common cause of unidentified hydrops fetalis. We examined the perinatal history, clinical manifestation, diagnosis, treatment, and outcome in 6 newborns diagnosed to have congenital chylothorax with hydrops fetalis. We also studied the effect of octreotide therapy for congenital chylothorax in relation to conservative treatment. METHODS: We retrospectively reviewed the medical records of 6 patients diagnosed to have congenital chylothorax with hydrops fetalis among 27,907 newborns who were born at the Cheil General Hospital and Womens Healthcare Center between January 2004 and July 2007 . The diagnosis of chylothorax is based on the analysis of pleural fluid before and after milk feeding. RESULTS: Incidence of congenital chylothorax in this study was 0.021%. All 6 cases were noted in over the 92% lymphocyte in pleural analysis. Transudate was changed into chyle with increasing triglyceride levels above 200 mg/dL after milk feeding. Three of 6 infants improved with conservative treatment, including thoracostomy and assisted ventilation. The others had persistent symptoms despite conservative treatment and responded to octreotide therapy. A complication, specifically vomiting was noted in 1 case during octreotide therapy. CONCLUSION: In this study, octreotide therapy resulted in a safe and excellent outcome. Therefore, octreotide therapy is considered in severe refractory congenital chylothorax in conservative treatment. Further studies are required to determine appropriate guidelines for octreotide therapy.
Chyle ; Chylothorax ; Delivery of Health Care ; Exudates and Transudates ; Female ; Hospitals, General ; Humans ; Hydrops Fetalis ; Incidence ; Infant ; Infant, Newborn ; Lymphocytes ; Medical Records ; Milk ; Octreotide ; Retrospective Studies ; Thoracostomy ; Ventilation ; Vomiting