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

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

PURPOSE: This study was undertaken to compare blood eosinophilic inflammatory markers between the acute period and clinical remission in children with upper respiratory infection (URI) -induced wheezing, and to assess the effects of atopy and age on these changes. METHODS: In 77 children with URI-induced wheezing, blood eosinophil count and serum eosinophil cationic protein (ECP) were measured during the acute wheezing phase and clinical remission period. The data were analyzed in the subgroups divided by atopy and age, respectively. RESULTS: Blood eosinophil count was significantly lower during acute period (181.6/microliter, 67.3-490.0) than that during clinical remission period (261.8/microliter, 120.7-567.7, P=0.001), and this significant eosinopenic response was found in non-atopic children (n=36) [92.2 (41.3-206.0) /microliter vs 204.5 (106.6-392.2) /microliter, P< 0.001], but not in atopic children (n=41). A significantly higher level of serum ECP was observed during acute period (15.1 microgram/L, 7.2-31.6) than during clinical remission (13.0 microgram/L, 6.6-25.7, P=0.05), and this difference was significant only in atopic children[24.2 (15.3-38.1) microgram/L vs 16.2 (8.3-31.6) microgram/L, P< 0.001]. A significant fall in blood eosinophil count during acute period was found only in children < or=4 years (n=37), while a significant rise in serum ECP was detected only in children > 4 years (n=40). However, these differences a due to dissimilar distribution of atopy in the two age groups. CONCLUSION: Our results showed different eosinophil responses to infection in non-atopic and atopic children with URI-induced wheezing. It appears that the blunted eosinopenic response in atopic children may be associated with the predominant Th2-like response to infection.
Child* ; Eosinophil Cationic Protein ; Eosinophils* ; Humans ; Respiratory Sounds*

Background: Recent studies have shown that oral administration of probiotics may improve the immune imbalance caused by dysbiosis of the gut microbiome in atopic dermatitis (AD). This study aimed to investigate the clinical and immunological effects of Lactobacillus pentosus in children with mild to moderate AD. Methods: Children aged 2–13 years with AD were randomized to receive either 1.0 × 1010 colony-forming units of L. pentosus or placebo, daily, for 12 weeks. The clinical severity of AD and transepidermal water loss were evaluated. Blood eosinophil counts, serum total immunoglobulin E (IgE), and cytokine levels were measured. The diversity and composition of the gut microbiota were also analyzed. Results: Eighty-two children were recruited, and 41 were assigned to the probiotics intervention group. The mean scoring of atopic dermatitis (SCORAD) indices at baseline were 30.4 and 34.3 for the probiotics and placebo groups, respectively. At week 12, the mean indices were 23.6 and 23.1 for the probiotics and placebo groups, respectively. Clinical severity decreased significantly over time in both groups, with no significant difference between the two groups. In both groups, there were no significant differences in cytokine levels, microbial diversity, or the relative abundance of the gut microbiota at week 12 compared with the corresponding baseline values. The mean subjective scores of SCORAD indices after intervention for the probiotics group were significantly lower than those for the placebo group in IgE sensitized AD (P = 0.019). Conclusion Our results show improved symptoms in the probiotics and placebo groups, and we could not find additional effects of L. pentosus in AD. However, the mean subjective scores of SCORAD indices for the probiotics group are significantly improved compared with those for the placebo group in allergen-sensitized AD.

OBJECTIVE: The purpose of this retrospective study was to report the outcome of the endovascular treatment of eight patients with eight saccular posterior inferior cerebellar artery (PICA) aneurysms. MATERIALS AND METHODS: Over the last seven years (1999-2006), eight consecutive patients with saccular PICA aneurysms were treated by endovascular methods. Five of the aneurysms were presented with subarachnoid hemorrhaging, whereas three were discovered incidentally. Four of the aneurysms (3 ruptured and 1 incidental) were treated by intrasaccular coiling, whereas the remaining four (1 ruptured and 3 incidental) were treated by vertebral artery (VA) occlusion. RESULTS: Of the four aneurysms treated by intrasaccular coiling, three were completely packed with coils and one was partially packed. In three of four patients who underwent vertebral artery occlusions, follow-up digital subtraction angiographies demonstrated thrombosed aneurysms and PICA. No procedure-related morbidity occurred and no re-bleed was encountered during a follow-up examination (mean; 31 months). CONCLUSION: As a result of this study, we found that the endovascular management of saccular PICA aneurysms should be considered as safe and effective.
Adult ; Aged ; Aneurysm, Ruptured/radiography/*therapy ; Cerebellum/blood supply/*radiography ; Cerebral Angiography ; Embolization, Therapeutic/*methods ; Female ; Humans ; Incidental Findings ; Intracranial Aneurysm/radiography/*therapy ; Male ; Middle Aged ; Retrospective Studies ; Subarachnoid Hemorrhage/radiography/*therapy ; Treatment Outcome

Release of reactive oxygen species (ROS) generated in the mitochondria to the cytosol is well controlled by various proteins in order to maintain and regulate redox homeostasis and cellular signaling pathways, however, the exact mechanisms by which the proteins located in the mitochondrial membrane control ROS release still remains to be identified. Although there are reports that several proteins play a role in mitochondrial ROS release to the cytosol, little is known about how it is released into the cytosol or its origin. Recently, several reports demonstrated that the ROS modulator 1 (Romo1) protein located on the mitochondrial membrane modulates ROS release into the cytosol and that these ROS are indispensible for survival in both normal cells and tumor cells. If these ROS are over-produced or dysregulated in pathological conditions, they may cause oxidative damages resulting in a variety of diseases. Therefore, understanding and identifying the mechanisms by which ROS are released to the cytosol may offer new strategies for pharmaceutical therapy of diseases related to oxidative stresses.
Cytosol ; Homeostasis ; Mitochondria ; Mitochondrial Membranes ; Oxidation-Reduction ; Oxidative Stress ; Proteins ; Reactive Oxygen Species

The purpose of this study is to investigate that the biological effect of mitomycin C(MMC) in cellular metabolic activity and morphological change on the ptreygium fibroblast in vitro by MMC concentration and duration of exposure used clinically. Human pterygial fibroblasts were exposed for threeminute and five-minute to MMC 0.002%, 0.004%, 0.01%, 0.02%, 0.04%, and DMEM(control). MTT based colorimetric assay was performed to assess the metabilic activity, inhibition of fibroblast proliferation on the MMC concentration and exposure time. The higher the concentration of MMC, and longer the duration of exposure time, the absorbance of spectrometer are decreased. The metabolic activity of fibroblasts were inhibited by 50% at least only over MMC 0.02% for five-minute expoure time. In histological findings, the higher the concentration and longer the duration of MMC exposure time, the enlargement of many mitochondira and rough endoplasmic reticulum without nuclear damage were more distinctly appeared. Especially, the ptergial fibroblast has more severe cytoplasmic damage at a five-minute exposure to MMC 0.02% than a three-minute exposure to MMC 0.04%. For inhibition of fibroblast proliferation, in case of using MMC should be at least over 0.02% concentration for five-minute exposure time. Arthors think that the experimental and clinical research on the duration of MMC exposure time as well as the concentration MMC, should be need to evaluate the effect on inhibition of cellular proliferation.
Cell Proliferation ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Fibroblasts* ; Humans ; Mitomycin*

PURPOSE: The aim of this study was to identify the relationship between awareness of nutrition labeling and menstrual cycle irregularity in women from a nationally representative sample of the Korean population. METHODS: A cross-sectional analysis was performed using hierarchical multivariable logistic regression analysis models. A total of 4,324 women aged 19~54 years from the 2010~2012 Korean National Health and Nutrition Examination Survey participated in the study. The participants were classified into three groups based on self-report responses to a questionnaire about their awareness of nutrition labels: Reading, Not-Reading, and Not-Knowing Groups. RESULTS: The Reading, Not-Reading, and Not-Knowing Groups comprised 46.4%, 44.9%, and 8.7% of the participants, respectively, and 53.6% of the participants had never used nutrition labels. In the Not-Knowing Group, irregular menstrual cycles for more than 3 months were significantly more common than women with irregular menstrual cycles for up to 3 months and women with regular menstrual cycles. Women in the Not-Knowing Group were more likely to exhibit menstrual cycle irregularity (adjusted odds ratio: 1.63, 95% confidence interval: 1.10~2.41) compared to women in the Reading Group after adjusting for age, body mass index, smoking status, alcohol intake, exercise regularity, stress, depression, suicidal ideation, metabolic syndrome, age at menarche, parity, and use of oral contraceptives. CONCLUSION: No awareness of nutrition labeling appears to be associated with a higher prevalence of menstrual cycle irregularity in a nationally representative group of Korean women.
Body Mass Index ; Contraceptives, Oral ; Cross-Sectional Studies ; Depression ; Female ; Food Labeling ; Health Literacy ; Humans ; Korea* ; Logistic Models ; Menarche ; Menstrual Cycle* ; Nutrition Surveys* ; Odds Ratio ; Parity ; Prevalence ; Smoke ; Smoking ; Suicidal Ideation

The purpose of this article is to describe an alternative approach to the nasal septum and the advantages offered by the decortication septorhinoplasty in correcting difficult nasal deformities. Using the Decortication septorhinoplasty approach, the entire cartilagenous septum can be exposed so that each specific deformity can be visualized and corrected appropriately. Retracting the lateral crura laterally, a midline plane is dissected, and the anterior septal angle and dorsal margin of the septal cartilage is identified. The elevation of the mucoperichondrium is started at the area of the anterior septal angle. After anterior approach, scissors are inserted between the septal cartilage and the upper lateral cartilage and their junction is sharply divided. Elevation of the rest of the mucoperichondrium is completed as a skeletonized single unit. Sculpting the entire cartilagenous and/or bony vault, as well as correcting difficult septal malalignments, can be carried out under better direct vision with great precision, accuracy, and predictability. From January 2000 till March 2001 the decortication approach is used for correcting difficult nasal deformity in 24 patients. Of these, 5 are secondary cleft lip nose, 10 are deviated nose, 5 are traumatic saddle nose, and 4 are hump nose. The mean follow up period is 12 months, ranging from 5 to 20 months. The patients are overall satisfied with the aesthetic and functional results. The disadvantage and complication of the Decortication septorhinoplasty is the same as compared to the conventional open rhinoplasty. The decortication approach is most suited for correction of deformities at the dorsal aspect of the nasal septum that causes a twisted nose deformity, of deformities at the anterior septal angle causing an asymmetric tip, and of deformities along the caudal aspect of the quadrangular cartilage producing columellar distortion, and of relational deformities between anterior nasal spine and septum. The decortication technique has provided a effective avenue for the correction of severe nasal deformities.
Cartilage ; Cleft Lip ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Nasal Septum ; Nose ; Rhinoplasty ; Skeleton ; Spine

Clinical studies were made on 37 cases with thalamic hemorrhage diagnosed by computed tomographic scan and only localized on the thalamic area, were admitted to the Keimyung University Dongsan hospital from January 1981, to December 1985. The age and sex distribution, symptoms and neurologic signs on admission, relationship between the hospital course and many factors affecting the prognosis such as age, side of lesion, level of consciousness, volume of the hematoma, degree of hydrocephalus and ventricular hemorrhage were analysed. The results were summarized as follows; 1. The most prevalent age group was above 51 years of age with 41-50 years, 21-30 years and 31-40 years of age in the order of frequency. Male to female ratio was 15:22. 2. The clinical symptoms on admission in the order of frequency were the impairment of consciousness, headache, nausea and vomiting, speech disturbance and hemiparesis, dizziness and voiding difficulties. The neurologic signs on admission showed hemiparesis, hyperreflexia, and positive Babinski sign, impaired consciousness, hemisensory deficit, central facial nerve palsies, dysarthria, sluggish and unreactive light reflex, small pupil and absent gag reflex, impaired vertical gaze, papilledema, aphasia and abducens nerve palsies in that order. 3. The hospital course had no significant relationship with the age of the patients and the side of hematoma but there was a significant relationship between the alert-drowsy group and the stuporcoma group (P<0.01). 4. The hospital course had no significant relationship with the degree of volume of hematoma and hydrocephalus. The hospital course had a significant relationship with ventricular hemorrhage (P<0.05) but the hospital course of the improved group had no significant tendency to the rate of improvement.
Abducens Nerve Diseases ; Aphasia ; Consciousness ; Dizziness ; Dysarthria ; Facial Nerve ; Female ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Papilledema ; Paralysis ; Paresis ; Prognosis* ; Reflex ; Reflex, Abnormal ; Reflex, Babinski ; Sex Distribution ; Vomiting