The authors reviewed 73 cases of ligament injuries in 70 patients from October, 1972 to June, 1978 who were admitted and treated in the Orthopedic Department at Kyung Hee University Hospital. Of 70 patients, the sex distribution was 59 patients (84%) in male and 11 patients (16%) in female. The high incidence was in age group from 21 to 40 years, that was 46 patients (55%). Traffic accident was most common cause of ligament injuries that was 61 patients (87%). Methods of treatment were direct repair, reconstruction and conservative treatment. Degree of angle and distance were measured with stress radiogram. Degree of angle and distance were also compared with normal and abnormal knee joints. Eleven cases were treated conservatively, and 62 cases, operatively, of whlch direct repair performed in 56 cases and reconstructive surgery, in 6 casea, The summary were as follows: 1. The result was better in the group with conservative treatment, as compared with operative treatment. And conservative treatment was applied only in single ligament injuries. 2. In normal knee joint, degree of angle was distributed evenly in the range of 0° to 10°, and distance was in the range of 0 to 10 mm. 3. In stress radiograrn, the significance of ligament injuries was present in more than 10° and 10 mm. 4. The measurement of distance seemed to be more meaningful than degree of angle. 5. It is helpful to measure the degree of angle and distance in diagnosis of ligament injuries, though not absolute.
Accidents, Traffic ; Clinical Study ; Diagnosis ; Female ; Humans ; Incidence ; Knee Joint ; Knee ; Ligaments ; Male ; Orthopedics ; Sex Distribution

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

Relapsing polychondritis (RP) is a rare multisystem autoimmune disease of unknown origin characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues. We present a patient diagnosed with meningoencephalitis associated with RP whose initial symptoms included chronic headache with memory disturbance and disorientation. After treatment of meningoencephalitis, the patient had frequent bilateral auricular swelling, polyarthralgia, and sensory neural hearing loss. Although RP is an extremely rare disease, it should be considered as a possible cause of chronic meningoencephalitis.
Arthralgia ; Autoimmune Diseases ; Headache Disorders ; Hearing Loss ; Humans ; Inflammation ; Memory ; Meningoencephalitis* ; Polychondritis, Relapsing* ; Rare Diseases

We describe here a case of intraductal tubular carcinoma of the main pancreatic duct. Gadolinium-enhanced pancreas magnetic resonance (MR) imaging showed an enhancing mass that was confined in the dilated main pancreatic duct of the pancreatic body, along with dilatation of the upstream main pancreatic duct and chronic pancreatitis that was due to obstruction. MR cholangiopancreatography and an endoscopic retrograde pancreatogram showed a filling defect that was due to an intraductal mass of the pancreatic body, along with dilatation of the upstream main pancreatic duct and no dilatation of the downstream main pancreatic duct. The pathological findings demonstrated an intraductal nodular appearance without papillary projection or mucin hypersecretion.
Adenocarcinoma/*diagnosis/pathology ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

Orthostatic headache after suboccipital craniectomy has been rarely reported. A 32-year-old man underwent emergent suboccipital craniectomy due to acute bilateral cerebellar infarctions with massive brain edema. Although his neurological deterioration halted after the craniectomy, he still suffered from a severe disabling orthostatic headache. We performed two epidural blood patches at the levels of the lumbar and thoracic spine. He improved considerably a few days after the repetitive epidural blood patches. Epidural blood patches may be a useful treatment modality for post-craniectomy postural headaches.
Adult ; Blood Patch, Epidural* ; Brain Edema ; Headache* ; Humans ; Infarction ; Spine

The authors report jerky seesaw nystagmus, extorsional downbeating in the right eye and intorsional upbeating in the left eye, in a patient with right internuclear ophthalmoplegia (INO). This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on damage to the pathways from contralateral vertical canals, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

PURPOSE: The purpose of this study was to determine whether in vitro plain radiography and ultrasonography(US) could predict the outcome of gallstone dissolution with methyl tert-butyl ether(MTBE). METHODS AND MATERIALS: The plain radiography and ultrasonography of 75 gallstones removed at surgery from 75 patients were obtained. The plaih radiographic findings were grouped by their calcification pattern as group l:lucent, group 2:central, group 3:diffuse and group 4: laminated. The ultrasonographic findings were grouped by their echo pattern as group 1 :arc shaped, clearly defined surface echo followed by distinct acoustic shadow, group 2:strong surface echo with gradually attenuating, meniscus shaped inner echo, group 3:strong surface echo with fill-in pattern of internal echo, group 4:strong surface echo with irregular inner echo and group 5:entirely discerning circumsference, homogeneous internal echotexture. After imaging, the gallstones underwent MTBE dissolution for 6 hours. The residual weight of each stone was measured every 2 hours. The correlation between imaging findings and dissolution rate was retrospectively analysed. RESULTS: The radiolucent and central calcification stones were dissolved rapidly as compared with the diffuse and laminated calcification stones(p<.05). There was no statistically significant difference among the groups based on ultrasonographic findings alone. However, after exclusion of the certain calcification groups that were resistent to dissolution-diffuse or laminated calcification stones-all US groups except one that shows wholly circumscribed margin and homogeneous fill-in pattern of internal echo dissolved well to average 20% or less of the original weight(p<.05). CONCLUSION: MTBE dissolution can be tried in stones that meet both ultrasonographic (not a stone with homogeneous fill-in pattern of internal echo) and plain radiographic (radiolucent or cental calcification stone) criteria.
Acoustics ; Ether* ; Gallstones* ; Humans ; Radiography* ; Retrospective Studies ; Ultrasonography*

PURPOSE: We studied the changes in the antibiotic sensitivity to the causative organisms of urinary tract infection, between 1979 and 2001, in order to provide useful information on the choice of adequate drugs in the treatment of urinary tract infection (UTI). MATERIALS AND METHODS: We retrospectively analysed 1,370 uropathogens, and their antimicrobial sensitivities, in 647 patients admitted to, or visiting our hospital, between January 1979 and December 2001, that had more than 105cfu/ml in urine culture. RESULTS: The incidence of UTI increased with age, and was highest in the 6th decades (21.0%). Mixed infections increased from 6.1%, in 1979, to 18.4%, by 2001. The common pathogens were E. coli (37.8%), enterococcus (15.0%), Pseudomonas (10.1%) and Klebsiella (9.1%). E. coli was the most important uropathogen during the stated time period. However, the incidence of Gram positive organisms increased from 14.2%, in 1979, to 26.0%, by 2001. In the Gram negative stained uropathogens, the antibiotic sensitivity was changed: ampicillin (11.8 to 14.6%), cephalothin (40.6 to 46.3%) and amikacin (80.5 to 74.8%). For E. coli, trimethoprim/Sulfamethoxazole (TMP/SMX) and ampicillin showed decreased sensitivities of 37.3 and 18.5%, respectively. However, sulbactam/cefoperazone, cefepime and imipenem showed high sensitivities of 96.1, 97.5 and 100%, respectively. CONCLUSIONS: Prior to receiving the bacteriological report, the use of TMP/SMX and ampicillin, as the first choices of treatment for UTI, should be reconsidered. Our results implied that amikacin, which showed the best effects, and was cheaper than fluoroquinolones, can be used as an alternative to these drugs as a primary empirical antibiotic for UTI.
Amikacin ; Ampicillin ; Cephalothin ; Coinfection ; Enterococcus ; Fluoroquinolones ; Humans ; Imipenem ; Incidence ; Klebsiella ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

A man and a woman were found dead in their parked car. The car was placed in a deep embankment. The windows were rolled up. Since it was cold winter the engine and heater was running while soil surrounded the rear of the automobile. The cause of death was 87%, 85% carbon-monoxide blood saturation respectively. The source of the CO was a defective exhaust system, The tail pipe outlet was blocked by the soil, and fumes could not escape adequately. Carbon monoxide fumes might entered the vehicle through the rusted floorboards, air conditioning, and through the dash board. It is important to know that unintened carbon monoxide deaths from motor vehicle exhaust can occur outdoors in older vehicles with defective exhaust system. We suggest the public need to be aware of the potential for this life threatening hazard to occur so that there can be proper prevention of fatalities.
Air Conditioning ; Automobiles ; Carbon Monoxide ; Cause of Death ; Female ; Humans ; Motor Vehicles ; Running ; Soil ; United Nations

No abstract available.
Hemianopsia* ; Isoniazid ; Tuberculosis