Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

No abstract available.
Sterilization, Tubal*

No abstract available.
Carcinoma, Renal Cell* ; Genes, Tumor Suppressor*

We experinced a case of 4p+ syndrome in male infant. He had multiple anomalies such as flat occiput, hypertelorism, low set malformed ear, lower anterior hair line, depressed nose, broad nasal bridge, bilateral complete cleft lip and palate, short neck, unusual position of fingers, ventricular septal defect and umblical hernia. He menifested growth and developmental retardation. Karyotype with banding revealed an extra short arm of chromosome 4. The mother's karyotype was normal. His father and father's sister had a translocation between the short arm of chromosome 4 and the short arm of chromosome 9; their karyotypes were 46, XY, t(4;9) and 46, XX, t(4;9), respectively. In this case, trisomy 4p was the result of parental balanced translocatiom. As this is the first case in Korea, it is worthwhile to report with reviewing literature.
Arm ; Chromosomes, Human, Pair 4 ; Chromosomes, Human, Pair 9 ; Cleft Lip ; Ear ; Fathers ; Fingers ; Growth and Development ; Hair ; Heart Septal Defects, Ventricular ; Hernia ; Humans ; Hypertelorism ; Infant ; Karyotype ; Korea ; Male ; Neck ; Nose ; Palate ; Parents ; Siblings ; Trisomy

Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

Clinical and pathological studies were carried out on 78 patients of ovarian cancer from January 1985 to March 1991. The results are as follows : l. Among 78 patients of ovarian cancer, the age group from 51 to 60 years old was most common which was 18 cases(23.1%). 2. When classified according to the cell type, epithelial cell origin cancers were 59 cases (75.6%), ovarian cancers from germ cell origin 9 cases(11.5%), sex cord stromal cancers 3 cases(3.8%), and metastatic cancers 7 cases(8.9%) respectively. 3. When classified according to the FIGO staging, stage I were 34 cases(43.5%), stage II 8 cases(10.3%), stage III 23 cases(29.5%) and stage IV 13 cases(16,7%), respectively. 4. Preoperative mean CA 125 value of stage I ovarian cancer was 130.2+/-57.3U/ml, stage II 74.2+/-144.4U/ml, stage III 376.9+/-296.8U/ml and stage IV 433.9+/-148.2U/ml respectively. and Also preoperative mean CEA value of stage I ovarian cancer was 3.4+/-3.2ng/ ml, stage II 6.9+/-4.3ng/ml, stage III 4.7+/-4.4ng/ml and stage IV 4.6+/-6.3ng/ml respectively. 5. When classified according to the physical examination, the most common finding was palpable mass which were 38 cases(43.7%), the second, abdominal pain 30 cases(38.4%) and the third, abdominal distension 21 cases(26.9%) 6. When classified according to the operation, ipsilateral oophorectomy was 15 cases(25.5%), ipsilateral oophorectomy and contralateral ovary wedge resection 6 cases(10.2%), total abdominal hysterectomy 17 cases(28.8%), total abdominal hysterctomy and omentectomy 14 cases(23.7%), total abdominal hysterectomy and omentectomy and debulking tumor resetion 4 cases(6.7%) and biopsy only 3 cases(5.1%) respetctively. 7. When calssifide according to the postoterative endometrial finding, atrophic pattern was 28 cases(65.7%), proliferative pattern 10 cases(28.6%) and secretory pattern 2 cases(5.7%) respectively.
Abdominal Pain ; Biopsy ; Epithelial Cells ; Female ; Germ Cells ; Humans ; Hysterectomy ; Middle Aged ; Ovarian Neoplasms* ; Ovariectomy ; Ovary ; Physical Examination ; Statistics as Topic*

Authors experienced a case of A3B in a 46-year-old patient with liver cirrhosis and two cases of A3 in her children by family study. A3 subgroups were confirmed by delayed and weak positive with anti-A and anti-A,B, negative in anti-A1 lectin, adsorption-elution test, and family study. We report a family case of A3B and A3 with brief review of literatures.
Child ; Humans ; Liver Cirrhosis ; Middle Aged

Malignant transformation of mature cystic teratoma of the ovary can develop with an incidence of 1-2%. Squamous cell carcinoma is the most common malignant tumor arising in benign cystic teratoma. The authors have recently experienced a case of combined microcystic adnexal carcinoma and squamous cell carcinoma arising in a benign cystic teratoma of the ovary in a 72-year-old Korean woman. The right ovarian cystic mass had been ruptured and firmly adhered with salpinx and omental fat tissue on operation. Thickened cystic wall with yellowish white solid infiltrative lesion was noted grossly, and two different malignant tumors of microcystic adnexal carcinoma exhibiting both eccrine and hair follicular differentiation and squamous cell carcinoma were observed microscopically. PAS and CEA positivities suggested eccrine differentiation in areas of microcystic adnexal carcinoma.
Aged ; Carcinoma, Skin Appendage/*pathology ; Carcinoma, Squamous Cell/*pathology ; Case Report ; Female ; Human ; Neoplasms, Multiple Primary/*pathology ; Ovarian Neoplasms/*pathology ; Skin Diseases/*pathology ; Skin Neoplasms/*pathology ; Teratoma/*pathology

BACKGROUND AND PURPOSE: There have been a few national population-based epidemiological studies of myasthenia gravis (MG) with wide variation of incidence and prevalence rates worldwide. Herein we report the first nationwide population-based epidemiological study of MG in Korea. METHODS: We attempted to estimate the incidence and prevalence rates of MG using the Korean National Health Insurance claims database for 2010 to 2013. Cases with MG were defined as those having claim records with a principal diagnosis of MG and the prescription of acetylcholinesterase inhibitors or immunosuppressive agents including corticosteroids and azathioprine within 2 years after the diagnosis. The year 2010 was set as a washout period, such that patients were defined as incident cases if their first records of MG were observed in 2011. RESULTS: In 2011 there were 1,236 incident cases, and the standardized incidence rate was 2.44 per 100,000 person-years. The standardized prevalence rates were 9.67 and 10.66 per 100,000 persons in 2010 and 2011, respectively. The incidence and prevalence rates peaked in the elderly population aged 60 to 69 years for both sexes. CONCLUSIONS: This is one of the largest national population-based epidemiological studies of MG, and it has confirmed the high incidence and prevalence rates of MG in the elderly population of South Korea.
Adrenal Cortex Hormones ; Aged ; Azathioprine ; Cholinesterase Inhibitors ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Humans ; Immunosuppressive Agents ; Incidence* ; Korea* ; Myasthenia Gravis* ; National Health Programs* ; Prescriptions ; Prevalence*