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.

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

Total cholesterol and triglyceride were measured in sera of 40 cases of hypertension, 22 cases of myocardial infarction, 14 cases of cerebral thrombosis, 18 cases of subarachnoidal hemorrhage and 30 cases of normal control in Chungnam national University Hospital from October 1980 to September 1981, and the results are as follows; 1) The mean serum total cholesterol and triglyceride levels in normal control group are 153.57+/-40.60mg% and 150.82+/-51.76mg%. 2) The age incidence of these diseases were highest in 6th decade. 3) Serum cholesterol levels of myocardial infarction, hypertension, cerebral thrombosis and subarachinoidal hemorrhage group were higher than that of normal control group. 4) Serum triglyceride levels of acute myocardial infarction and hypertension were significantly higher than that of normal control group, but there is only slightly increases in cerebral thrombosis and subarachinoidal hemorrhage. 5) In general, serum lipid levels are higher in cardiovascular diseases(hypertension and myocardial infarction) than cerebrovascular diseases(cerebral thrombosis and subarachnoidal hemorrhage). 6) Serum Cholesterol and triglyceride levels decreased by administration of pancreatic mucopolysacharide for 1 or 2 months. In conclusion, it seems that high serum cholesterol and triglyceride level may play and important risk factor in development of hypertension and myocardial infarction.
Cholesterol ; Chungcheongnam-do ; Hemorrhage ; Hypertension ; Incidence ; Intracranial Thrombosis ; Myocardial Infarction ; Risk Factors ; Thrombosis ; Triglycerides

PURPOSE: To evaluate preoperative and intraoperative factors affecting the clinical results and determine the effectiveness of the internal limiting membrane in surgery for long standing idiopathic macular holes (stage 2, 3, 4). METHODS: The data were reviewed from a retrospective study on 95 consecutive eyes with idiopathic macular holes undergoing vitrectomy, fluid gas exchange. Forty six of the 95 eyes underwent internal limiting membrane removal surgery additionally. Postoperative follow up was for 2 years. Wilcoxon matched pairs test, Wilcoxon rank test and multiple regression analysis were performed by using SPSS program. RESULTS: The surgery was anatomically successful in 74 of the 95 eyes (77.8%) and 30 of the eyes (31.5%) showed functional success. Preoperative visual acuity and internal limiting membrane removal were important factors affecting postoperative visual outcome in 2 years follow up of the vitrectomy for idiopathic macular holes. Preoperative factors such as age, sex, duration of visual complaints, stage were not found any association with postoperative visual acuity. CONCLUSIONS: Preoperative visual acuity and internal limiting membrane removal were good prognostic factors in idiopathic macular hole surgery. Functional success group showed constant improvement of visual acuity in postoperative 2 years.
Follow-Up Studies ; Membranes ; Retinal Perforations* ; Retrospective Studies ; Visual Acuity ; Vitrectomy

No abstract available.
Pituitary Neoplasms*

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