60 cases of fractures of the femoral shaft were treated at the department of orthpaedic surgry, Pusan National Uriversity Hospital from Junuary, 1967 to August, 1970 The results were as follows; 1) The age group between 20 and 40 years occupied 51.6% in this series, and preponderance of male to female (3:1) was noted. 2) There were 39 cases (65%) being traffic accident, 20 being industrial injury and 1 case (1.7%) being other cause. 3) 30 cases involved the middle one third, 20 cases the lower one third and 10 cases the upper one third of femur shaft. 25 cases (41.6%) were on the left side and 32 cases (53.3%) were on the right side. 4) there were 35 cases of transverse, 25 cases of oblique and 10 cases (16.6%) of communited fractures, and 50 cases (83.3%) of closed fractures. 5) By using the adequate size intra-medullary nail, the complications, which could be resulted by the using the inadequate intra-medullary nail, could be prevented. 6) By using of the heavy intra-medullary nail, the rotation of the nail, could be prevented and so, the knee joint stiffness could be prevented so as to encourage early excercise. 7) By using the heavy intra-medullary nail, the duration of hospitalization could be shortened and the financial burden could be decreased.
Accidents, Traffic ; Adult ; Busan ; Female ; Femur ; Fractures, Closed ; Hospitalization ; Humans ; Knee Joint ; Male

BACKGROUND: If the corrections of the cryptorchid testes are delayed, it may lead the patients to suffer loss of testes or fertility. So we purposed to analyze the present status of correction and the causes of delay and tried to emphasize the needs to educate and inform the ideal age for correction. METHODS: Total 363 cryptorchid patients who visited our hospital in 10 years from January 1987 to December 1996 were divided into 3 groups according to their ages at visit as under 2, 3 to 5 and over 6 years groups. We analyzed the operative findings of the 3 groups, compared the ratio of the over 6 group during the half ten years till 1991 to the same ratio after 1992 and also analyzed the causes of delay in 81 patients for whom the causes of delay could be identified in over 6 years group. RESULTS: The age distributions showed 88 patients(24.2%) of under 2 years group, 118 patients(32.5%) of 3 to 5 years group and 157 patients(43.3%) of over 6 years group. When we compare the former 5 years till 1991 to the latter 5 years after 1992, the number of the patients who underwent orchiopexy under the age of 2 were increased from 34 (19.1%) to 54(29.2%) and those over the age of 6 were decreased from 88(49.4%) to 69 (37.3%) but still in higher proportion. The intraoperative findings showed that the rate of atropic or smaller testes than normal size in over 6 years group(128 testes, 73.1%) were higher than those of under 2 years(10 testes, 9.8%) and 3 to 5 years group(28 testes, 20.2 %). The most common causes of delay in over 6 years group was recommendation by relatives or neighbors(36 patients, 48.1%) and the remainders were advices of doctors other than urologists(27 patients, 33.3%), poor economic status(8 patients, 9.9%) and unawareness of the anomaly(7 patients, 8.6%). CONCLUSIONS: To prevent the loss of testicular function or testis itself in patient with cryptorchidism, the early correction should be performed because the recommended age for the correction tends to be decreased. The public information for the recommended age should be provided and also educational programs for the primary physicians are supposed to be performed.
Age Distribution ; Cryptorchidism ; Fertility ; Humans ; Male ; Orchiopexy ; Testis

BACKGROUND/AIMS: Although the only therapy of proven benefit for chronic hepatitis C is interferon alpha, the rate of sustained response after treatment with interferon is less than 25%. A 6-month course of combination therapy with interferon and ribavirin was associated with higher rate of long-term response than either interferon or ribavirin alone. Pilot studies suggested that combination of interferon and ursodeoxy-cholic acid (UDCA) resulted in higher biochemical response than interferon alone. We investigated the rates of end of treatment response(ETR) and sustained response(SR) of combination therapy of interferon e2a, ribavirin and UDCA and compared it with interferon a 2a alone. METHODS: Ninty-five naive patients with chronic hepatitis C who have been positive for anti-HCV by 3rd generation EIA and HCV RNA by RT-PCR and had elevated level of ALT over 6 months were included. They were assigned to three groups. Thirty seven patients in group 1 were treated with interferon a 2a (3MU thrice weekly) in combination with ribavirin (600mg/day) and UDCA (600mg/day) for 6 months. Twenty nine patients in group 2 were treated with the same dose of interferon a 2a alone for 6 months. Changes of ALT and HCV RNA were observed over 12 months (average 3029 mos) after the end of treatment in both groups. Twenty nine patients in group 3 were observed over 12 months without antiviral treatment. HCV genotypes were tested by Innop-Lipa in 24 patients in group 1. RESULTS: In group 1, not only ETR (68%) but also 12 month SR rate (54%) was significantly higher than group 2(31%, 21% respectively). There was no difference in relapse rate between two groups. The level of ALT became normalized and HCV RNA negative within 1 month after treatment in most responders in group l. Genotype 1b was associated with lower ETR and SR than non-lb, although not significant stastistically. CONCLUSION: Both the ETR and 12 month SR rate were significantly higher after combination treatment of interferon a 2a, ribavirin and UDCA than interferon e 2a alone in chronic hepatitis C. It is suggested that this combination is preferable to interferon alone in the treatment of naive patients with chronic hepatitis C.
Genotype ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Recurrence ; Ribavirin* ; RNA

PURPOSE: To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. MATERIAL AND METHODS: 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. RESULTS: The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of delamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the roedial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). CONCLUSION: Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may helpful in avoiding various ocular complication during ethmoid surgery.
Adipose Tissue ; Anatomic Variation* ; Depression* ; Humans ; Incidence ; Retrospective Studies ; Sinusitis

No abstract available.
Anxiety* ; Depression* ; Headache*

This study was conducted to assess the prognostic value of tumor angiogenesis and Cathepsin-D in breast carcinoma, by correlating them with other clinicopathologic prognostic factors. In order to estimate microvessels within the tumor, an immunohistochemical method using monoclonal antibodies for factor VIII-related antigens (DAKO-vWf, F8/86) was used, and they were counted (perx200 field) in the most active areas of neovascularization. For the expression of Cathepsin-D, an immunohistochemical method using monoclonal antibodies (Novocastra, NCL-CDm) was performed. The microvessel count ranged from 8 to 346 per x200 field and the mean (+/-SD) was 72.46+/-54.96. The microvessel count was correlated with the estrogen receptor status, and it was also correlated with the tumor size when it was graded into four groups (1-33, 34-67, 68-100, >100), but was not correlated with other clinicopathologic parameters. Cathepsin-D was expressed in 40% (46/115) of the cases, but it was statistically correlated with the tumor size only. In conclusion, the expression of Cathepsin D and the degree of angiogenesis in breast cancer showed a correlation with the tumor size only. Therefore, they do not appear to be good prognostic parameters, according to the present study.
Antibodies, Monoclonal ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cathepsin D ; Estrogens ; Microvessels ; Prognosis ; von Willebrand Factor

PURPOSE: Knee IVIR images were repeatedly obtained after intravenous administration of gadopentetate dimeglumine to evaluate the arthrographic effect and to determine the optimal scan timing and technique. MATERIALS AND METHODS: Sagittal Tl-weighted (650/15) sequences were repeated before and after intravenous gadolinium enhancement in 26 patients who were divided into exercise (14/26) and nonexercise (12/26) groups. Fourteen patients in exercise group were allowed to move the affected knee joint actively for 10 minutes immediately after the first post-enhancement scan and before repeating scans. The signal intensities in central and peripheral portions of the joint were measured and compared between these two groups. RESULTS: In all cases, enhancement of joint fluid began at peripheral portion and progressed toward central portion. The diffusion rate in exercise group was far faster than that in nonexercise group and homogeneous arthrographic image was revealed within 10 minutes after completion of joint movement. The arthrographic effect continued and the rate of signal decrease was quite slow. CONCLUSION: MR arthrographic image of knee joint can be obtained within 10 minutes after completion of a few minute exercise following intravenous injection of gadopentetate dimeglumine. Intravenous MR arthrography is expected to become an useful method as a convenient alternative to direct MR arthrography.
Administration, Intravenous ; Arthrography* ; Diffusion ; Gadolinium ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Joints ; Knee Joint ; Knee*

No abstract available.
Fever*

Congenital mesoblastic nephroma(CMN) is an important differential diagnosis of a renal mass occurring in the newborn or in early childhood. It was first described by Bolande as a separate disease entity distinct form Wilms' tumor. In 1974, Beckwith has predicted that this tumor has a pathologic spectrum with classic congenital mesoblastic nephroma at one extreme, unequivocally mallignant spindle cell sarcomas at the other, and intermediate "gray zone" lesions of indeterminate biologic significanse. In 1986, Joshi has described "atypical mesoblastic nephroma" as a potentially aggressive variant of CMN, which shows atypical gross and microscopic features such as hemorrhage, necrosis, high cellularity, and mitotic index. We report of a case of atypical mesoblastic nephroma presenting in a 38 days-old male infant. Grossly, the tumor involved the upper and midportion of the left kidney. On section, the cut surface was fleshy, grayish-white, and homogeneous. Microscopically, the tumorshowed high degree of cellularity and arrangement of fusiform cells in sheets and vague interlacing bundles. The individual tumor cells showed fusiform to oval nuclei, indistinct scanty pale-eosinophilic cytoplasm and many mitotic figures.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans ; Diagnosis, Differential

PURPOSE: To evaluate the clinical outcome of frontalis sling operation using preserved fascia lata with modified direct tarsal fixation in congenital ptosis patients. METHODS: Forty-seven congenital ptosis patients (60 eyes) who underwent a frontalis sling operation using preserved fascia lata with modified direct tarsal fixation method between March 2001 and December 2008 with a mean follow-up time of 52 months (range, 26 to 122 months) were included in this study. The medical records were reviewed retrospectively. RESULTS: A retrospective chart review was conducted in patients who were diagnosed with congenital ptosis and underwent frontalis suspension surgery using preserved fascia lata with modified direct tarsal fixation from 2001 through 2008 at Dong-A University Hospital. The patients were 34 males and 14 females. The age of the patients ranged from 1 to 18 years with an average age of 4.51 years. At a mean follow-up of 60 months, good final results were achieved in 46 eyes (76.6%), fair in 8 eyes (13.3%), and poor in 6 eyes (10%). The poor results consisted of undercorrection of 1 eye and recurrence in 5 eyes. The accumulative survival rate was 87.2%, with all recurrences occurring within 12 months postoperatively. CONCLUSIONS: Frontalis sling operation by preserved fascia lata with modified direct tarsal fixation appears to be an effective treatment for severe congenital ptosis, showing good long term results.
Adolescent ; Blepharoplasty/*methods ; Blepharoptosis/congenital/*surgery ; Child ; Child, Preschool ; Fascia Lata/*transplantation ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Infant ; Male ; Recurrence ; Retrospective Studies ; *Suture Techniques ; Transplantation, Autologous