A clinical analysis was done on forty-five patients with fracture of the femoral neck, who have been admitted and treated at our orthopedic department during the period of 6 years, from January 1975 to December 1980. The following results were obtained: Age over 60 comprised 60% of the patients. Male to female ratio revealed no significant difference, being 21 to 24. However, with advancing age, female was affected more frequently than male. The major cause of injuries were “fall or slip down” occuring in 33 patients (73.3%) and “hit by car” in 12 patients (26.7%). Of the 39 patients in whom Garden's calssification of fracture could be applied. Stage II was the most common type occuring in 29 patients (75%), followed by Stage N in 6(15.4%), and Stage 5 in 4 (10%). Of the total 45 cases, forty patients were reduced and fixed with multiple Knowles pins and two patients with Jewett nail. Three patients with neglected treatment of the fracture for over 1 to 4 months were treated with primary replacement arthroplasty of the femur in two and total hip replacement in one. Fractures were united within 3 months in 10 patients (23%), 4 to 6 months in 19 patients (45.2%), and non-union in 2 patients. Relationship between accuracy of reduction using Gardens alignment index and develepment of avascular necrosis was evaluated. Of the 27 patients with reduction in the range of 155 180 in both frontal and lateral views, 3 patients were developed avascular necrosis, and of the 9 patients with reduction of less than 155 in frontal view or greater than 180 in lateral view, 4 patients were developed avascular necrosis.
Agriculture ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Humans ; Male ; Necrosis ; Orthopedics

No abstract available.

No abstract available.
Ephedrine* ; Rabbits*

Ipsilateral fractures of the femoral neck and shaft represent many difficulties in diagnosis and treatment. The femoral neck fracture of this injury is commonly missed on initial evaluation. The overlooked femoral neck fracture may lead to higher risk of complications such as avascular necrosis of the femoral head, nonunion and coax vara. The authors reviewed nine cases of ipsilateral femoral neck and shaft fracture treated in our clinic from September 1989 to May 1995, and average follow-up period was 33 months(range, 12 to 101 months). The results obtained were as follows : 1. The most common cause of injury was traffic accident, and three femoral neck fractures were missed initially. 2. The most common site of femoral neck fractures was basicervical in 7 cases, and that of shaft fracture was middle 1/3 shaft in 5 cases. 3. The most common associated injury was ipsilateral knee injury(6 cases). 4. Five cases were treated with femoral reconstruction nail, two with multiple neck-pinning and retrograde interlocking IM nail, one with multiple screws for neck fracture and long dynamic compression plate for shaft fracture, and the other, multiple neck-pinning and antegrade interlocking IM nail. 5. The complications were a refracture of the shaft after removal of interlocking nail and a delayed union of shaft fracture which had been treated by reconstruction nailing. Coxa vara, delayed union and metal loosening were found in femoral neck fracture site, but all that were clinically acceptable. In conclusion, the fracture of femoral neck should be kept in mind not to be lost in case of high velocity-femoral shaft fracture, and if found, it should be treated with anatomical and rigid internal fixation in femoral neck fracture having first priority. Recently reconstruction nail for the treatment of these fractures was widely used, but that is technically difficult and might destroy the neck fracture during shaft fracture fixation. We recommend retrograde interlocking nail followed by multiple neckpinning might be safe and stable fixation for the ipsilateral neck and shaft fracture.
Accidents, Traffic ; Coxa Vara ; Diagnosis ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Fracture Fixation ; Head ; Knee ; Neck ; Necrosis

The extensive traumatic wound has posed a serious problem to the surgeon. Various drugs and dressing methods have been used for this kind of wound but there has been no ideal method. The pigskin xenograft was used initially for the treatment of burn wound. The salutary effect of porcine xenograft are the stimulation of growth of healthy granulation tissue, as well as epithelial borders, inhibition of bacterial growth and pain relief. We have performed porcine xenograft in 20 cases having extensive traumatic wound with skin defect from January 1981 to February 1982. The results obtained are as follows: 1. Protect large open wound until autograft are available. 2. Alleviate pain in the wound. 3. Promote granulation tissue growth which is needed for early autograft. 4. Protect the exposed wound areas (bone and tendon) from infection. 5. The healing time of the wound depended upon the severity and the state of underlying tissue in the wound rather than wound size.
Autografts ; Bandages ; Burns ; Granulation Tissue ; Heterografts ; Methods ; Skin ; Wounds and Injuries

PURPOSE: Multiple Endocrine Neoplasia Type 2A (MEN 2A) is an autosomal dominant disease characterized by development of the medullary thyroid cancer, adrenal pheochromocytoma and parathyroid hyperplasia. Gennline mutations of RET gene, which cause a susceptibility to MEN 2A syndrome, have been reported in MEN 2A families. The identification of germline mutation in family members with hereditary tumor syndrome makes the presymptomatic diagnosis possible. However, there are only a few reports on the germline mutation of RET gene in Korean patients with MEN 2A. This study was performed to investigate the germline mutation of RET gene in a Korean MEN 2A family. MATERIALS AND METHODS: Blood samples were taken from family members of a MEN 2A family. Mutational status was investigated using single strand conformation polymorphism (SSCP) method, and following direct sequencing. Basal level of calcitonin was measured, and calcium provocation test was done when the result of basal level of calcitonin was equivocal. RESULTS: A missense type germline mutation of RET gene was identified at codon 634 (TGC->TGG) in eight patients from the family. All patients with the germline mutation of RET gene showed elevation of calcitonin level either in basal test or in calcitonin provocation test. CONCLUSION: We identified a germline mutation of RET gene in a family with MEN 2A, and it would make the accurate presymptomatic diagnosis possible.
Calcitonin ; Calcium ; Codon ; Diagnosis ; Germ-Line Mutation ; Humans ; Hyperplasia ; Multiple Endocrine Neoplasia Type 2a* ; Multiple Endocrine Neoplasia* ; Pheochromocytoma ; Thyroid Neoplasms

Sedation plays a crucial role in successful pediatric imaging, and chloral hydrate is commonly used for this purpose. However, the challenges associated with chloral hydrate administration, such as its unpleasant taste and potential induction of vomiting, remain a concern. Sweet oral solutions have emerged as potential solutions for reducing distress and providing analgesia. This study compared the efficacy of dextrose combined with chloral hydrate with that of conventional sedation methods. This prospective, double-blind, randomized controlled clinical study enrolled 160 pediatric outpatients scheduled for echocardiography. Chloral hydrate syrup (100 mg/mL) was supplemented with a dextrose solution (dextrose group) or distilled water (control group) in a 1:10 volume ratio. The sedation achievement time, Skeie scale score, revised Face, Legs, Activity, Cry, and Consolability (FLACC) score, and side effects (nausea, vomiting, hypoxia, and respiratory depression) were assessed. No significant difference in average time to achieve sedation was observed between the dextrose and control groups (24.4±17.8 vs. 24.7±17.1 min, p=0.92). Both groups demonstrated similar levels of sedation according to the Skeie scale and mean revised FLACC score. Although the occurrence rates of nausea and vomiting had no significant differences, the dextrose group had no cases of vomiting in children aged >24 months compared to the control group, which had three cases (30%). In conclusion, the addition of dextrose to chloral hydrate did not significantly affect sedation time, anxiety, pain reduction, or occurrence of gastrointestinal complications during sedation.

No abstract available.
Breast Neoplasms* ; Breast*

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

We report two cases of Wernicke encephalopathy presenting with convulsive seizures. The first patient had been supplied with total parenteral nutrition due to acute pancreatitis and presented with partial seizure evolving to generalized seizure. The second patient had been malnourished due to alcoholism and recent dyspepsia after a gastrectomy, who presented with generalized seizure. Brain MRI revealed high-signal lesions in the focal cerebral cortex on T2-weighted, FLAIR, and diffusion-weighted images. After a thiamine injection, the patients recovered and abnormalities on the MRIs disappeared.
Alcoholism ; Brain ; Cerebral Cortex ; Dyspepsia ; Gastrectomy ; Humans ; Magnetic Resonance Imaging ; Pancreatitis ; Parenteral Nutrition, Total ; Seizures* ; Thiamine ; Wernicke Encephalopathy*