The incidence of trochanteric fracture of the femur is increasing, which is likely to continue for many years because of an increase in traffic accidents and the population of elderly people. The primary goal in the treatment of an elderly patient with an intertrochanteric hip fracture is to return the patient to his prefracture activity without any complication, as soon as possible. Rapid mobilization with stable internal fixation helps to prevent skin ulceration, pneumonia, urinary stasis, thromboembolic disease and other complications of confinement to bed in the elderly. Stable internal fixation depends mainly upon the fracture type and operative techniques. A clinical study of operative techniques was done in twenty three patients with trochanteric fracture of the femur who had been admitted and treated surgically at the Orthopaedic Department of W.M.B.H. during of two years from Mar. 1982 to Feb. 1984. The following are brief descriptions of the operative techniques. l. An L-shape incision and refiection of the vastus lateralis muscle provided wide exposure and facilitated anatomical reduction under direct vision. 2. The nail insertion site was selected at a slightly eccentric position anterior to rather than exactly midway from the opposite lateral cortex of the lesser trochanter. Therefore the nail could be laid rigidly between the thick anteromedial cortex and the posteromedial calcar portion. 3. The best stable position among the fracture line, the neck shaft angle and the nail plate could be obtained by the yoking procedure. It also allowed for later proximal migration of the shaft fragment and fracture impaction without impingement on the base of the barrel.
Accidents, Traffic ; Aged ; Clinical Study ; Femur ; Hip ; Humans ; Incidence ; Neck ; Pneumonia ; Quadriceps Muscle ; Skin Ulcer

Primary Cutaneous Neuroendocrine Carcinoma(CNEC : or Merkel Cell Tumor) usually occurs as a solitary tumor in middle aged to elderly individuals. This tumor may occur on any layer of the skin but the most frequent location is in the dermis. Electron microscopic studies reveal that the tumor cell contains round, dense core granules similar to epidermal Merkel cell and other cells of the neural crest derived APUD system. We describe the clinical, histological, electron microscopic, immunohistochemical observation of a case of primary CNEC in a 66-year-old female and discuss the theories regarding the histogenesis of this unusual tumor.
Aged ; Carcinoma, Neuroendocrine* ; Dermis ; Female ; Humans ; Middle Aged ; Neural Crest ; Skin

A total of 39 malignant melanoma cases diagnosed at Chonnam National University Hospital for past 10 years from 1980 to April, 1990 were included for the clinicopathologic study. Among the 29 primary cutaneous melanomas, 18 cases(62.1 % ) occurred on the hands and the feet, especially on the heel. The average age of the patients was 54.3 years at the time of diagnosis and the male to female ratio was 1 to 1,4. Acral lentiginous melanoma was the most common (62.1% ) histopathologic type and the invasion level c)f 22 cases(78.4% ) was over 1.50mm by Rreslows thickness.
Diagnosis ; Female ; Foot ; Hand ; Heel ; Humans ; Jeollanam-do ; Male ; Melanoma

We experienced a 40-year-old female patient who had vegetating plaques, erosions and a few vesicles on the external genitalia and the oral mucasa, assoeiated with pulmonary tuberculosis. On the skin biopsy specimen of the vegetating plaque, it showed acanthoais, papillomatosis, downward proliferation of the epidermis and eosinophilic microabacess in the epidermis. Direct immunofluorescence of the perilesional skin revealed deposition of IgG, Cq, Cs and C on the intercellular substance of the epidermis. Indirect immunofluorescence disclosed IgCi auto antibody(1: 320) positive to the inter ellular substance of the normal human back skin. The skin lesion had impraved with dapsone therapy.
Adult ; Biopsy ; Dapsone ; Eosinophils ; Epidermis ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Genitalia ; Humans ; Immunoglobulin G ; Papilloma ; Pemphigus* ; Skin ; Tuberculosis, Pulmonary

We performed an immunohistochemical study, using bioti-navidin system to clarify the pattern of carcinoembryonic antigen(CEA)immunoreactivity in various tumors of the skin, according to its histogenetic origin. Positive reaction was observed in syringorna, eccrine spiradenoma, eccrine angiomatous hamartoma, eccrine carcinoma, syringocystadenoma papilliferum, metastatic breast carcinoma and mammary Pagets disease. But in epithelial tumors, metastatic skin cancer from maxillary sinus, tumors derived from pilar and sebaceous gland structure, mesenchymal tumors and neuroectodermal tumors, CEA was not observed. These results suggest that immunohistochemical study for CEA could be used as an adjunct for the differential diagnosis of sweat gland tumors from others, especially pilar structure and sebaceous-gland-derived tumors, for the detection of the histogenesis of metastatic tumors, and for the diagnosis of Pagets clisease.
Breast Neoplasms ; Carcinoembryonic Antigen* ; Diagnosis ; Diagnosis, Differential ; Hamartoma ; Maxillary Sinus ; Neuroectodermal Tumors ; Paget's Disease, Mammary ; Sebaceous Glands ; Skin Neoplasms ; Skin* ; Sweat Glands

OBJECTIVE: We investigated the expression of TSP-1 and -2 in eutopic endometrium of advanced endometriosis and control patients. METHODS: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29-44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression from eutopic endometrium for TSP-1 and -2 were analyzed by RT-QC PCR. RESULTS: The mRNAs of TSP-1 and -2 were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. There were no significant differences in expression of TSP-1 and TSP-2 in eutopic endometrium between controls and endometriosis patients. CONCLUSION: Our results indicated that TSP-1 and -2 had no crucial role compared to other molecules in the regulation of angiogenesis. These findings also suggest that dysregulation of other angiogenic regulators would be concerned in pathophysiologic role in endometriosis development.
Endometriosis* ; Endometrium ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Menstrual Cycle ; Polymerase Chain Reaction ; RNA, Messenger* ; Thrombospondin 1 ; Thrombospondins

No abstract available.
Fruit* ; Pregnancy*

OBJECTIVE: We investigated the expression of uPA and uPAR in eutopic endometrium of advanced stage endometriosis and control patients. METHODS: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29~44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression of uPA and uPAR from eutopic endometrium were analyzed by RT-QC PCR. RESULTS: The mRNAs of uPA and uPAR were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. Uterine endometrium from women with endometriosis expresses significantly (p<0.05) higher levels of u-PA mRNA than endometrium from normal women without endometriosis in the proliferative phase. There were no significant differences in expression of uPAR in eutopic endometrium between controls and endometriosis patients. CONCLUSION: These results suggest that eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater u-PA mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one etiology for the invasive properties of the endometrium resulting in the development of endometriosis.
Endometriosis* ; Endometrium* ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Menstrual Cycle ; Polymerase Chain Reaction ; Proteolysis ; RNA, Messenger* ; Urokinase-Type Plasminogen Activator

No abstract available.

OBJECTIVE: In this study, we examined the reliability and validity of the Korean version of the Prodromal Questionnaire-Brief (PQ-B), a self-report screening instrument for clinical high risk for psychosis (CHR). METHODS: A total of 3,400 middle, high school and college students participated, and 261 subjects with a PQ-B total score ≥3 completed both the PQ-B and the Structured Interview for Prodromal Syndromes (SIPS). Receiver operating characteristic (ROC) curves were used to examine the psychometric properties of the PQ-B. RESULTS: A cut-off of 7 for the PQ-B total score and a cut-off of 22 for the PQ-B distress score showed the best balance of sensitivity (72.2%, 77.8%) and specificity (71.4%, 75.0%). CONCLUSION The Korean version of the PQ-B showed good reliability and validity for predicting prodromal risk symptoms in the community population.