There is still discussion concerning the methods for treating Tossy type 3 dislocations of the acromioclavicular joint. Since 1995, the authors have treated 10 patients of type 3 dislocations by arthroscope-assisted modified Weaver and Dunn operation with favorable results. The operation consisted of diagnostic shoulder arthroscopy, arthroscopic resection of acromial end of coracoacromial ligament with bone block, excision of distal end of clavicle, bone block transfer of coracoacromial ligament into the medullary canal of clavicle, and augmentation between coracoid process and resected distal end of clavicle with the Mersilene tape. The advantages of this arthroscope-assisted modified Weaver and Dunn operation are as follows: (1) Using the shoulder arthroscope, associated patholgy in the shoulder joint can be found and treated appropriately. (2) Arthroscopic resection of the acromial end of coracoacromial ligament can give the small incision and least damage to the deltoid muscle so that immediate post-operative range of motion exercise can be possible. (3) Bone block transfer of coracoacromial ligament and augmentation between coracoid process and resected clavicular end can prevent displacement of the resected clavicular end.
Acromioclavicular Joint ; Arthroscopes ; Arthroscopy ; Clavicle ; Deltoid Muscle ; Dislocations ; External Fixators* ; Hand* ; Humans ; Ligaments ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

Uterine papillary serous carcinoma is a morphologically distinct variant of endometrial carcinoma that is associated with an aggressive behavior with rapid progression and high recurrence, and poor response to salvage treatment. The most common type of malignancy developing in the uterus after radiation therapy is the malignant mixed mullerian tumor, however, the papillary serous carcinomas have rarely been reported.Here we report a case of uterine papillary serous carcinoma which had developed 7 years after radiation therapy for invasive cervical cancer.
Endometrial Neoplasms ; Female ; Recurrence ; Uterine Cervical Neoplasms ; Uterus

External fixation was improved in its devices and techniques as a specific method of fracture treatment. It was possible to immobilize the fractures firmly with the use of Vidal modified Hoffmann external fixation and could be used effectively in difficult fractures with severe soft tissue injury. From October 1981 to December 1983, 28 patients of tibial fracture who had been treated with Hoffman external fixation at Severence Hospital, Yonsei University College of Medicine were studied. The results are summerized as follows: 1. The age of patients varied from 14 to 66 years old, the majority (53.6%) being between 20 to 39 years old and males comprized 89.3%. 2. Traffic accidents and machinary injuries comprized 96.4%. 3. Average duration with Hoffmann frame was 16.6 weeks and average time of bone union was30.1 weeks. 4. Many complications were noticed but majority were related to personalities of the fractures, not due to Hoffmann external fixation itself. 5. Hoffmann device was relatively easy and quick to apply: sufficient stability was obtained: reasonable anatomic reduction of major fragments was possible: facilitated treatment and care of polytr- aumatized patients. 6. Secondary operations, e,g., bone grafting and even plastic surgery, had been possible without necessitating removal of the device. 7. It was useful in open fractures with severe soft tissue tissue injury and also in taking care of further necessary managements.
Accidents, Traffic ; Bone Transplantation ; Fractures, Open ; Humans ; Male ; Methods ; Soft Tissue Injuries ; Surgery, Plastic ; Tibia ; Tibial Fractures

We report a case of primary mucosa-associated lymphoid tissue (MALT) lymphoma in the esophagus that manifested as a large submucosal tumor (SMT). Primary esophageal lymphoma is very rare, occurring in less than 1% of all patients with gastrointestinal lymphoma. Only a few cases of MALT lymphoma in the esophagus have been reported in the English literature. A 53-year-old man was referred to Dongguk University Ilsan Hospital (Goyang, Korea) in July 2012 for further evaluation and treatment of an esophageal SMT. Endoscopy showed a cylindrically elongated submucosal mass with normal overlying mucosa in the mid esophagus, 25-30 cm from the incisor teeth. He underwent surgery to confirm the diagnosis. Pathologic findings showed diffuse small atypical lymphoid cells which were stained with Bcl-2, CD20, but not with CD3, CD5, CD23, Bcl-6, or cyclin D1. These cells showed a positive monoclonal band for immunoglobulin heavy chain gene rearrangement. Based on the pathological, immunohistochemical, and molecular biological features, the esophageal mass was diagnosed as extranodal marginal zone B-cell lymphoma of the MALT type.
Antigens, CD20/metabolism ; Bone Marrow/pathology ; Esophageal Neoplasms/*diagnosis/pathology/surgery ; Gastroscopy ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Mucous Membrane/pathology ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Tomography, X-Ray Computed

Malaria infection is not uncommon in Korea these days, but there was no report of malaria infection in the patients who had been transplanted his or her kidney. With the immunosuppression, the atypical findings are frequent and make prompt diagnosis difficult. We report a case of malaria which showed atypical clinical course but treated successfully with conventional anti-malarial drug therapy. A 37 year old male patient were transplanted his kidney in Sep. 1997. He was admitted because of fever, which lasted 40 - 50 min every afternoon for 27 days. Numerous trophozoites were found on his peripheral blood smear, which was diagnosed as vivax malaria. Chloroquine and primaquine were given, and fever subsided next day. The patients has been stayed afebrile thereafter. We reported a case of malaria in the renal transplanted patient with the review of literatures.
Adult ; Chloroquine ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Immunosuppression* ; Kidney Transplantation ; Kidney* ; Korea ; Malaria* ; Malaria, Vivax ; Male ; Plasmodium vivax ; Primaquine ; Trophozoites

The use of a high dose regimen of interferon (INF) has recently been demonstrated to benefit patients with malignant melanoma and the use of high dose INF for stage IIB and III melanoma was approved by Food and Drug Administration in 1995. The therapeutic benefits of INF are sometimes hampered by their severe and troublesome adverse effects including depression, mania, and cognitive impairment. The authors report a melanoma patient treated with adjuvant INF-alpha2b who developed a manic-depressive syndrome or mood instability with therapy and we reviewed literatures on mania and mixed affective syndrome associated with INF.
Bipolar Disorder ; Depression ; Humans ; Interferons ; Melanoma* ; United States Food and Drug Administration

PURPOSE: The aim of this study was to investigate the clinical characteristics and causative organisms of meningitis in the Daegu region and seek a useful tool for the early prediction of bacterial meningitis in children. METHODS: We retrospectively reviewed the medical records of 115 pediatric patients diagnosed with bacterial or aseptic meningitis at Yeungnam university hospital in Daegu from March 2012 to July 2013. We evaluated their clinical symptoms, laboratory findings, clinical courses, bacterial meningitis scores and complications. RESULTS: The subjects included 106 with aseptic meningitis and 9 with bacterial meningitis. At the time of visit, fever was the most frequent symptom, followed by headache, vomiting and neck stiffness. In cerebrospinal fluid (CSF) analysis, white blood cell (WBC) count were higher in the bacterial meningitis group (1423.8+/-1980.4 vs. 120.0+/-161.6 mg/dL). Mean CSF protein was 219.4+/-183.6 mg/dL in bacterial meningitis and 42.4+/-27.0 mg/dL in aseptic meningitis (P <0.001). Bacterial meningitis score (BMS) were higher in the group with bacterial meningitis. Abnormal radiological findings were found in 44% of the group with bacterial meningitis. CONCLUSION: Although the clinical features between the groups were similar, the CSF analysis revealed significant differences statistically. Furthermore, BMS could be helpful to predict bacterial meningitis in children. During the outbreak of aseptic meningitis, it might reduce unnecessary hospital admissions and antibiotic treatments.
Cerebrospinal Fluid ; Child ; Daegu ; Fever ; Headache ; Humans ; Leukocytes ; Medical Records ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Neck ; Retrospective Studies ; Vomiting

OBJECTIVES: The purpose of this study is to determine the amount of burden placed on the caregivers of patient diagnosed as dementia and depression. The study is intended 1) to compare depression and anxiety levels of caregivers with the degree of their burden and 2) to analyze and determine the clinical factors that contributed to such levels of depression and anxiety. METHODS: 93 individuals with dementia, suspected dementia, and depression were selected between February 2001 and April 2001. In order to determine the patients decreased cognitive function and psychopathology MMSE-K and NPI were used. In addition, the burden scale recently developed from Zarit, HARS, HDRS were used on 58 caregivers. RESULTS: The MMSE-K figure form in the demented group was significantly lower than that of the non-demented group, 15.65 and 25.55 respectively. As for the NPI figures, the demented group posted higher numbers compared to the non-demented group. Among the individuals in the demented group, apathy, aberrant motor behavior, and night-time behavior showed the highest figures. On the caregiver's burden point, the demented group showed higher scores compared to the non-demented group with 76.62 and 58.30 respectively. The caregiver's burden point compared to the HDRS and HARS figures provided an evidence that there is a signigicant relationship between the groups. CONCLUSIONS: The caregiver's burden point is found to be more affected by the demented patient's progressive phase of psychopathology than conditions due totheir decreased cognitive functions. There is a probability that an increase in the caregivers burden is likely to contribute to an increase in the caregiver's depression and anxiety.
Aged* ; Anxiety ; Apathy ; Caregivers ; Dementia ; Depression ; Humans ; Psychopathology*

OBJECTIVE: The differences of various neurocognitive functions, including attention, memory, motor function, and higher cognitive function were compared between PTSD patients and normal control subjects. Also, correlation with PTSD symptom severity and neurocognitive functions were evaluated between PTSD patients and normal control subjects. METHOD: We assessed the neurocognitive functions by computerized neurocognitive test(CNT) batteries. The visual continuous performance test(CPT) and digit span test, finger tapping test and Wisconsin card sorting test(WCST) were executed. The Impact of Event Scale-Revised(IES-R) was used in the evaluation of the severity of PTSD. RESULT: The PTSD patients showed significantly impaired neurocognitive performance in all of the items, compared with normal control subjects. The relation between impairment in neurocognitive functions and symptom severity showed significant correlations. CONCLUSION: These results imply that PTSD patients have impaired neurocognitive functions concerning with specific brain areas, especially the frontal area. For the thorough evaluation of further neurocognitive functions, more detailed evaluation items of neurocognitive functions and brain imaging studies are necessary in the future study.
Brain ; Fingers ; Humans ; Memory ; Neuroimaging ; Stress Disorders, Post-Traumatic* ; Wisconsin

The prevalence of Epstein-Barr virus(EBV) in the uterine cervix was investigated to define the possible etiologic role in cervical carcinogenesis. The viral genotyping and LMP-1 30bp deletion were also studied. The materials included 169 uterine cervical swabs(152 within normal limits, 12 atypical squamous cells of uncertain significance, 3 low grade intraepithelial lesions, and 2 high grade squamous intraepithelial lesion) and 104 uterine cervical tissues obtained from hysterectomy specimens(32 carcinoma in situ, 9 microinvasive squamous cell carcinomas, 37 invasive squamous cell carcinomas, 7 adenocarcinomas, 7 adenosquamous carcinomas, and 12 cervicitis). EBV detected by PCR for EBNA-1 was positive in 52(56.5%) of 92 invasive and noninvasive cervical carcinomas, and 80(48.8%) of 164 inflammatory or normal cervices. The viruses detected in carcinomas were all type A, and LMP-1 30bp deletion form was more frequent in premalignant and malignant cervical lesions than in nonneoplastic cervices. From the above results, it may be concluded that EBV is one of common viruses detected in uterine cervix of Korean women, and type A virus and LMP-1 30bp deletion form may have a role in cervical carcinogenesis.
Adenocarcinoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Genotype ; Herpesvirus 4, Human* ; Humans ; Hysterectomy ; Polymerase Chain Reaction ; Prevalence