The incidence of intertrochanteric fracture of femur in young adult is relatively high in our home than other countries. But recently the incidence in elderly patient is progressively increased due to prolongation of average life span and increased activity. Various devices has been developed and the result of treatment has been improved, but the morbidity after fracture in elderly patient remains high because of poor general condition and osteoporosis. We tried to assess the availability of SHCP(sliding hip compression plate) in the intertrochanteric fracture of the osteoporotic bone by the review of the 27 cases below Singh index III that we experienced from September, 1989 to June, 1993 at the Department of Orthopedic Surgery of Chonbuk National University Hospital. The results were as follows: 1. Mean age was 68 years. Type III in Tronzo classification was most common(51.9%). Singh index II was 17 cases(63%) and grade III was 10 cases(37%). 2. In 23 cases(88.8%), anatomical reduction was performed. The bony union was gained at average 15.8 weeks. The serious complications were 1 penetration and 1 osteoarthritis of hip. 3. Satisfactory results were obtained in 88% of patients by the functional class of Clawson DK.
Aged ; Classification ; Femur ; Hip ; Humans ; Incidence ; Jeollabuk-do ; Orthopedics ; Osteoarthritis, Hip ; Osteoporosis ; Young Adult

Sacral pressure sores have been treated by a variety of surgical methods. complete treatment needs wide excision and coverage with healthy tissue which has constant and sufficient blood supply. Use of gluteus maximus muscle flap with or without overlying skin is a revolutionary method because of the reliability of blood supply. However, it is technically a little bit complicated, and future reconstruction for recurrent decubitus is especially limited in paraplegic patients. The development of gluteal perforator-based flap with para-sacral perforator introduce a new treatment modality for the sacral pressure sores. Total 10 cases of sacral pressure sores were treated with gluteal perforator-based flap. There were minimal postoperative complications except wound dehiscence in one case. This flap has a many advantage of no transection or sacrifice of the gluteus maximus muscle, elevation time for the flap is short, reliable blood flow of the perforator, large rotation arc and no post-operative hindrance to walking in patients who are not paraplegic. The disadvantages of this perforator-based flaps are the anatomical variation in the location of perforators and the need for technically careful dissection.
Humans ; Postoperative Complications ; Pressure Ulcer* ; Skin ; Walking ; Wounds and Injuries

Angioleiomyoma (vascular leiomyoma) of the uterine cervix is an extremely rare type of benign tumor composed of smooth muscle cells and thick-walled blood vessels. Only a few cases of cervical angioleiomyoma have been reported. Here, we present imaging, including ultrasonography, contrast-enhanced CT, MRI, and histopathological findings of a 38-year-old female with an angioleiomyoma of the uterine cervix.

Pulmonary aspergillosis is classified as a saprophytic, allergic, and invasive disease. Chronic necrotizing pulmonary aspergillosis is categorized as an invasive pulmonary aspergillosis. Most invasive pulmonary aspergillosis have acute and toxic clinical features but chronic necrotizing pulmonary aspergillosis is characterized by a sub-acute infection, most commonly seen in patients with altered local defense system from preexisting pulmonary disease of in mild immunocompromised patients. Pulmonary artery aneurysm due to this infection is termed as a mycotic aneurysm, etiology of which are tuberculosis, syphilis, bacteria and fungus. We report a case chronic necrotizing pulmonary aspergillosis complicating pulmonary aneurysm is a 62 year-old man who was presented with cough, sputum, and fever. Chest radiographs showed a rapid, progressive cavitary lesion and pulmonary artery aneurysm. Angioinvastion of aspergillus was revealed by pathology after operative removal of left upper lobe containing the pulmonary artery aneurysm. He was treated with itraconazole.
Aneurysm* ; Aneurysm, Infected ; Aspergillus ; Bacteria ; Cough ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis* ; Itraconazole ; Lung Diseases ; Pathology ; Pulmonary Artery* ; Pulmonary Aspergillosis ; Radiography, Thoracic ; Sputum ; Syphilis ; Tuberculosis

The clinical value of the pre-(165 pts) and post-operative(149 pts) serum levels of carcinoembryogenic antigen(CEA) in 190 patients(pts) with colorectal cancer was investigated, who had a curative surgery and an abnormally elevated levels of CEA (> or=5 ng/ml) at Department of General Surgery, Chonbuk National University Hospital during 1989 to 1996. The results are as follows: 1) The preoperative positive rates of CEA level were 49(29.7%) of 165 patients, so preoperative CEA level measurement was no usefulness for screening test of colorectal cancer. The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D were 0, 28.6, 32.8 and 42.9% respectively, There was significant association between increased proportion of patients with preopertive serum CEA(> OR = 5 ng/ml) and the progressive stages of colorectal cancers(P<0.05). 2) There was no significant association between the frequency of abnormal CEA level and histologic differentiation of tumor. 3) The recurrence rate was 16.4% and 30.6% in patients with preoperative CEA < 5 ng/ml and > OR =5 ng/ml, respectively(p<0.05). 4) In patients with recurrence, the lymph node positive group(70.6%) was larger than the negative(29.4%)(p<0.05), and preoperative positive rate of CEA value was 44%. 5) The recurrence rate in Dukes stages A, Bl, B2, Cl, C2, and D were 0, 8.7, 12.7, 16.7, 32.3, and 90.0% respectively(p<0.01). 6) There was no significant association between the frequency of abnormal CEA level and location of tumor. 7) The recurrence rate was 12.3% and 65.7% in patients with postoperative CEA < 5 ng/ml and > OR = 5 ng/ml, respectively(p<0.01). 8) In patients with metastasis, postoperative positive rate of CEA level was 63%(p< 0.01).
Colorectal Neoplasms ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Recurrence

PURPOSE: We compared the clinical and urodynamic findings of patients suffering with lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia(BPH) and who underwent transurethral resection of the prostate, and we tried to determine the effect of urodynamical obstruction and the bladder function on the result of this operation. MATERIALS AND METHODS: 101 patients with LUTS/BPH were categorized in four groups based on the findings of the preoperative urodynamic study: 15(14.8%) patients without bladder outlet obstruction[(BOO(-)], 50 (49.5%), patients with BOO[(BOO(+)], 12 patients(11.8%) with BOO and with detrusor underactivity(BOO+DU), and 24 patients(23.7%) with BOO and with detrusor overactivity(BOO+DO). The outcomes and satisfaction were analyzed by the changes of the International Prostate Symptom Score(IPSS) and the quality of life(QoL) index before and after transurethral resection of the prostate(TURP), respectively. RESULTS: The Qmax was significantly high and residual urine was significantly low in group BOO(-). The PdetQmax was significantly high in group BOO(+) and also in the BOO+DO group. In group BOO(-), the decrease of the total IPSS was smaller than that noted in the other groups. There were significant decreases of the IPSS after TURP in groups BOO (+), BOO+DU and BOO+DO each voiding and storage subscore were decreased,but in group BOO+DO, the improvement was not as much as that in the other groups. The QoL was improved significantly in group BOO compared to the other groups. CONCLUSIONS: Performing urodynamics preoperatively helps to predict the degree of symptom relief, and a higherbaseline BOO positively predicts the postoperative improvement of the IPSS and the QoL. The outcome of the BOO+DU group was satisfactory, but storage symptoms still existed for the BOO+DO group.
Humans ; Prostate* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Urinary Tract* ; Urodynamics*

This study was conducted to investigate the association of the occurrence of pediatric disease with environmental, seasonal and atmospheric factors. The data were collected at 5 pediatric clinics in Seoul and the Department of Pediatrics of Yongin Severance Hospital from May 1986 to April 1987. The results were as follows: 1. Vacation periods had a great influence upon the occurrence of pediatric diseases. 2. The majority of pediatric diseases occurred mainly in spring and autumn, not in summer and winter. 3. The higher the average relative humidity was, the less diseases occurred; and the higher the maximum change of daily temperature, the more diseases occurred. 4. In summer, the pattern of diseases varied along with the environmental factors(eg., toilet).
Gyeonggi-do ; Humidity ; Pediatrics ; Seasons* ; Seoul

Langerhans cell granulomatosis(LCG), previously termed 'Histiocytosis-X', is one of the rare disease. LCG is characterized by proliferation of Langerhans cells in a unifocal or multifocal pattern. And LCG may be manifested in a variety of way, ranging from a spontaneously regressing solitary lesion to a multisystem life-threatening disorder. This disease usually involves the bone, lung, skin and lymph node. The most common endocrinologic abnormalities in LCG are diabetes insipidus and growth hormone deficiency. LCG involving the thyroid gland is extremely rare and only a small numbers of cases have been reported worldwide. A 41-year-old diabetic female visited the hospital due to the neck swelling for 3 months and she also complained of polyuria, polydipsia and easy fatigue. LCG involving multiple organs included thyroid gland was diagnosed by high-resolution CT of lung, by characteristic histological findings of the thyroid lesion and by the immunohistochemical staining for S-100 protein and OKT 6(CD la). She is followed at OPD without any medication.
Adult ; Diabetes Insipidus ; Fatigue ; Female ; Growth Hormone ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Lung ; Lymph Nodes ; Neck ; Polydipsia ; Polyuria ; Rare Diseases ; S100 Proteins ; Skin ; Thyroid Gland*

PURPOSE: Pancreaticoduodenectomy for mass-like lesions that are suspicious of malignancy sometimes reveals only nonneoplastic disease, especially in those cases where adequate tissues for biopsy are unavailable. In this study, we evaluated the outcomes and quality of life (QOL) after pancreaticoduodenectomy for treating nonneoplastic disease. METHODS: The clinical data of 28 patients who underwent pancreaticoduodenectomy for nonneoplatic disease and trauma from Jan. 1992 to Feb. 2006 were reviewed retrospectively. The QOL was evaluated using the FACT-Hep questionnaire. The patients who underwent laparoscopic cholecystectomy for benign gallbladder disease were utilized as the control group. RESULTS: 13.8% (28/203) of all the pancreaticoduodenectomized patients had nonneoplatic disease and trauma. Male patients were predominant (25/28) and all the trauma patients were male. The mean age was 48 (23~72) years old. The indications for surgery included lesions suspicious for malignancy (16 cases), pancreaticoduodenal artery aneurysm (1 case), and pancreatoduodenal injury (11 cases). The histologic findings of the nonneoplastic lesions revealed benign inflammation of the bile duct (6 cases), chronic pancreatitis (8 cases), pancreatic pseudocyst (1 case), and fibrosis of the Ampulla of Vater (1 case). No surgical mortality occurred. However, the trauma patients group had higher morbidity (72.7% Vs 23.5%, respectively, P=0.01) and a longer hospital stay (68.0 days Vs 32.6 days, respectively, P=0.02) after surgery compared to the nonneoplastic disease patient group. The QOL of the patient who underwent pancreaticoduodenectomy for nonneoplatic disease was not different from that of the control group. CONCLUSION: Since pancreaticoduodenectomy for nonneoplastic disease was safe and the QOL of the patients was acceptable, it should be performed more often when malignancies can not be excluded from the differential diagnosis.
Ampulla of Vater ; Aneurysm ; Arteries ; Bile Ducts ; Biopsy ; Cholecystectomy, Laparoscopic ; Diagnosis, Differential ; Fibrosis ; Gallbladder Diseases ; Humans ; Inflammation ; Length of Stay ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreaticoduodenectomy* ; Pancreatitis, Chronic ; Quality of Life* ; Surveys and Questionnaires ; Retrospective Studies

OBJECTIVES: Aminoglycosides are commonly used antibiotic agents, and they are known to generate free oxygen radicals within the inner ear and to cause vestibulo-cochlear toxicity and permanent damage to the sensory hair cells and neurons. Melatonin, a pineal secretory product, has the properties of being a powerful direct and indirect antioxidant. The aim of the present study was to prove the antioxidant effect of melatonin against gentamicin-induced ototoxicty. METHODS: The utricular maculae of Sprague-Dawley rats were prepared from postnatal day 2-4, and these maculae were were divided into 6 groups as follows: 1) control, 2) melatonin only, 3) gentamicin only, and 4), 5), and 6) gentamicin plus melatonin (10, 50, and 100 micrometer, respectively). To count the number of hair cells, 5 utricles from each group were stained with phalloidin-FITC on the 1st, 4th, and 7th days after drug administration. Reactive oxygen species (ROS) was assessed by using the fluorescent probe hydrofluorescent diacetate acetyl ester. The caspase-3 activity was also examined with using the fluorescent caspase-3 substrate and performing Western blotting. RESULTS: The result of this study showed that gentamicin induced the loss of utricular hair cells, and this loss of hair cells was significantly attenuated by co-administration of melatonin. Melatonin reduced ROS production and caspase-3 activation in the gentamicin treated utricular hair cells. CONCLUSION: Our findings conclusively reveal that melatonin has protective effects against gentamicin-induced hair cell loss in the utricles of rat by inhibiting both ROS production and caspase-3 activity.
Aminoglycosides ; Animals ; Antioxidants ; Blotting, Western ; Caspase 3 ; Ear, Inner ; Gentamicins ; Hair ; Hair Cells, Vestibular ; Melatonin ; Neurons ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Saccule and Utricle