Since Whitehead had described a circular hemorrhoidectomy in 1882, many surgeons adopted it for decades for patients with protruding anal deformity. After a few decades of performing Whitehead operation, devastating complications such as anal stricture, fecal incontinence, and wet anus with mucosal eversion had been reported on the literatures and then it was buried as an abandoned procedure by surgeons for a long period. Recently, a few prominent anal surgeons reported that they could avoid such devastating complications by introducing diverse modifications of the original Whitehead's operation. The authors analyzed 22 patients who had undergone original Whitehead circular hemorrhoidectomy with the technique of preserving most of the perianal skin and W-shaped circular incision during the period from 1991 to 1996, with special regard to the com plications such as anal stricture and anal mucosal eversion which have been debated on so far and reviewed the articles about these issues. In immediate postoperative period, suture failure and resultant non-surgery requiring, mild anal stricture were documented in 3 of the 22 cases(13.6%). On long-term follow-up with the mean period of 44 months (18~79 months) in 14 cases, except those 8 cases that were lost, with phone-call questionaire, 13 patients(93%) had quite normal anal functions. The authors would like to suggest that the original Whitehead's circular hemorrhoidec tomy is a valuable surgical technique to manage the protruding anal deformity if surgeons can avoid well known complications such as anal stricture and anal mucosal eversion by choosing a correct location of initial W-shaped incision to preserve as much perianal skin as possible.
Anal Canal ; Congenital Abnormalities ; Constriction, Pathologic ; Fecal Incontinence ; Follow-Up Studies ; Hemorrhoidectomy* ; Humans ; Postoperative Period ; Skin* ; Sutures

Trochanteric fractures are seen in elderly patients and have high mortality and morbidity. Strong internal fixation and early ambulation is the best way to treat fractures. For this purpose, recently, compression sliding screw plate became popular. The surgical procedure of open reduction and internal fixation were carried on 36 intertrochanteric fractures at Depertment of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1972 to Dec. 1977 and the following results were obtained. 1. Of 36 cases of intertrochanteric fracture, 20 cases were in man, with the peak age at the 5th decade, and 16 cases in woman mostly over the 7th decade. 2. Most common causes were fall or traffic accidents in man and fall in woman. 3. Interval from injury to operation was less than 1 week usually. 4. Unstable fractures were 86% and of these, Tronzo Type III was the most common. 5. The trend of use of internal fixation device was from S-P plate and screw, and Jewett nail to sliding compression plate and screw. 6. Reduction of medial displacement with Dimon-Hughston method was used commonly in Jewett nailing and anatomical reduction in sliding compression plate and screw. 7. Post operative cast immobilization were applied in a few cases of under 50 years old, Other-wise early ambulation were carried out. 8. Post operative complications were encountered in 8 cases (22%), but none were fatal.
Accidents, Traffic ; Aged ; Early Ambulation ; Female ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Methods ; Mortality ; Orthopedics ; Seoul

The treatment of open tibia fracture is challenging to Orthopedic Surgeon with its high infection rate and other complications. We had wound culture of open tibia fracture at emergency room in all cases, and treated using various External Fixators. The author analized the 134 cases of the open tibia fractures from March 1979 to February 1987. The average follow-up was one year. The results were as follws : 1. Type I open fracture was 23 cases, Type II 58 cases, Type IIIA 33, Type IIIB and Type IIIC was 10 cases each. The most frequent type of fracture was Type II, 58 cases by Gustilo classification. 2. The union time of Type I fracture was 6.5 months in average, and that of Type II and Type III was 9.5 months, 11.2 months. 3. Of those 52 cases whose initial culture was positive, 12 cases developed infection. The low infection rate would probably be due to combined administration of cephalosporin and firm application of external fixator to severe open tibia fractures.
Classification ; Clinical Study ; Emergency Service, Hospital ; External Fixators ; Follow-Up Studies ; Fractures, Open ; Orthopedics ; Tibia ; Wounds and Injuries

No abstract available.
Incontinentia Pigmenti*

No abstract available.
Carcinoid Tumor*

No abstract available.
Constriction, Pathologic*

No abstract available.
Progeria*

No abstract available.
Child* ; Humans ; Rhabdomyosarcoma*

Calbindin-D28k, a vitamin D-dependent calcium binding protein, plays a cardinal role in transport of calcium in kidney. Previous studies have demonstrated calbindin-D28k immunoreactivity in the distal nephron of mammalian kidney. However, it is well known that in most species including rat and human, there is a gradual transition from the distal convoluted tubule to the cortical collecting duct, and that the connecting segment do no tclearly demarcated, because of intermingling of distal convoluted tubule cells, connecting tubule cells, principal cells and at least two configurations of intercalated cells. In this study, to identify the cell types of calbindin-D28k-positive cells in distal nephron of rat kidney, we used double immunostaining with an antibody against calbindin-D28k and antibodies against thiazide sensitive Na+/Cl- cotransporter for distal convoluted tubule or H+-ATPase for intercalated cells. In the distal convoluted tubule, most of the distal convoluted tuble cells were calbindin-D28k-positive, whereas the intercalated cells were calbindin-D28k-negative. In the connecting tubule, 68% of the cells were calbindin-D28k-positive, and about 97% of the positive cells were connecting tubule cells and only 3% of them were intercalated cells. In the cortical collecting duct, and outer medullary collecting duct of outer stripe and inner stripe, only 8.6%, 11.8% and 4.4% of cells were weak positive for calbindin-D28k respectively. These weak positive cells in the collecting duct are mainly identified as intercalated cells. These findings indicate that calbindin-D28k is involved in not only transcellular transport of calcium but also processes regulating intracellular calcium in rat kidney.
Animals ; Antibodies ; Calbindin 1 ; Calcium* ; Carrier Proteins* ; Humans ; Immunohistochemistry ; Kidney* ; Nephrons* ; Rats* ; Transcytosis ; Vitamins

Psoriatic arthritis is an uncommon disease in the community and probably occurs in no more than 5 percent of the general psoriatic population. The authors experienced a patient who had the findings of mutilating type of psoriatic arthritis with severe joint deformities. A 30 year-old man was admitted to our hospital due to multiple joint pain and deformities with wheel chair bound state. We report a case of mutilating type in the psoriatic arthritis with brief review of literatures.
Adult ; Arthralgia ; Arthritis, Psoriatic* ; Congenital Abnormalities ; Humans ; Joints ; Wheelchairs