OBJECTIVES: This Study was designed to investigate the pattern of AUI(Alcohol Use Inventory) and MAST(Michigan Alcohol Screening Test) according to the awareness of drinking problem and receptiveness to treatment, and to know whether the type(type1 and type 2 according to Barbor's typology) has effects on the RECPAWAR(acknowledgement and awareness of use problem and receptive to treatment of these problem) score. METHODS: Subjects were 134 alcoholic patients from Alcoholic treatment ward. They were requested to fill up the questionnaires of Korean version of AUI and MAST(MAST for patient and MAST for caretaker). At first, based on the RECPAWAR, they divided into high RECPAWAR group(above 30 percentile) and low RECPAWAR group(below 30 percentile). According to typology, they divided into type 1 and type 2. The data was analyzed by T-test, Correlation, and Regression Analysis. RESULTS: 1) Significant negative correlation was observed between RECPAWAR score and MAST difference score(patient's MAST-caretaker's MAST). 2) High RECPAWAR group had significantly higher scores in the most scales than low RECP-AWAR group, except ENHANCED scale in AUI. 3) There was not significant difference on RECPAWAR score between type 1 and type 2. CONCLUSION: Except ENHANCED scale, the high RECPAWAR group had higher score in the second level scale. As compared with the low RECPAWAR group, the high RECPAWAR group responds more negative in drinking, and is more anxious about their drinking problems. So, they seem to have the objective view about their drinking problems. However the type was not related to receptive and awareness of drinking problem.
Alcoholics* ; Drinking* ; Humans ; Mass Screening* ; Michigan* ; Surveys and Questionnaires ; Self Report* ; Weights and Measures

OBJECTIVE: The purpose of this article is to report mixed germ cell tumor, which revealed changes compatible with early transformation of dysgerminoma to endodermal sinus tumor(EST) through histogenetic considerations and immunohistochemical stains. METHODS: Ovarian germ cell tumors were reviewed from files of Dept. Ob/Gyn. Seoul Paik Hospital fiom 1992.1 to 1996.12. Total of 5 cases include 4 pure dysgerminoma and 1 mixed germ cell tumars. All tissues were fixed in 10% neutral buffered formalin and embedded in paraffin and reviewed by two pathologists with immunohistochemical staining for cytokeratin, vimentin, AFP, PCNA, p53 & bc1-2. RESULTS: Grossly, the areas of transformation were located at the middle of the mixed tumor. The outer layer of the tumor mass was filled with typical pure dysgerminoma. They were characterised as the presence of microcysts and small glandular structures in hematoxylin-eosin(H-E) stains with positive stain for vimentin, except the tissue of the EST. The cells in the intermediate layer were characterised as the mixed form of dysgerminomatous and EST structures in H-E stains. AFP in the dysgerminomatous cells in intermediate layer and EST were stained, but not in outer layer. CONCLUSION: Dysgerminoma may possess the ability to transform to EST. There might be intermediate stage between dysgerminoma and EST, and Immunohistochemical staining for AFP, cytokeratin, vimentin, PCNA also can be used for prognosis of germ cell tumor.
Coloring Agents ; Dysgerminoma* ; Endoderm ; Endodermal Sinus Tumor* ; Formaldehyde ; Germ Cells ; Keratins ; Neoplasms, Germ Cell and Embryonal ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen ; Seoul ; Vimentin ; Yolk Sac*

Frature of the tibial shaft is the most common fracture of the long bone and the treatment has become one of the most controversial subjects in orthopedic surgery. 61 cases of tibial shaft fracture in adults were treated by closed Kuntscher I-M nailing at the department of Orthopedic Surgery, Dae-Jeon Eul-Ji Hospital during 5 years from January, 1983 to December, 1987. In this paper we are reporting our result of 52 selected cases which we could follow up more than 6 months. The results were as follows. 1. The mean duration of clinical bone union was 9.6 weeks and that of radiological bone union was 15.6 weeks. 2. 6 cases of complication were noted with a little impairment of function finally. The complication were ankle joint stiffness(2), superficial infection(1), irritation of protruded nail(2) and bursting fracture(1). 3. Closed Kuntscher and occasionally combined interlocking I-M nailing are relatively short operative procedure with rigid fixation, low complication, wide indication and early weight bearing. So we consider them to be good methods of treatment for tibial shaft fractures.
Adult ; Ankle Joint ; Follow-Up Studies ; Humans ; Orthopedics ; Surgical Procedures, Operative ; Weight-Bearing

161 patients with tibia fracture were treated by closed intramedullary nailing at the department of Orthopedic Surgery, Eul-Ji General hospital, Dae Jeon, during 5 years from January, 1988 to April, 1993. 134 of these patients were performed with Kiintscher IM nailing and 27 patients with Ender nailing. Rigid IM nailing is the method of choice in tibia shaft fracture with rigid fixation, low complication, wide indication and early weight bearing, but the treatment of segmental fracture of the tibia will have many difficulties because of severe displacement, severe comminution, massive soft tissue damage and lack of blood supply at fracture site. Either antegrade or retrograde Ender nailing was of value for the management of segmental fracture which was too proximally or too dixtally located to insert interlocking screws, open fracture and soft tissue injury around Kiintscher insertion site. The result as fllows; 1. 43 fractures were open and 118 were closed. 69 fractures involved the distal portion, 55 fractures the middle portion, 13 fractures the proximal portion of the tibia and 24 fractures were segmental. 2. Among the 161 eases, 114 cases were male and 47 cases were female, the most common ages were ranged from 21 year to 30 year, involving 44 cases. 3. The most common cause was traffic accident. 4. Average intervals from injury to operation were 6.34 days(closed fracture) and 9.84 days(open fracture). 5. The mean durations of the bone union were 18.90 weeks(closed fracture) and 16.46 weeks(open fracture). 6. Complication included 7 cases delayed union, 3 cases nonunion, 8 cases superficial infection, 4 cases joint stiffness, 3 cases nail migration, 2 cases angular deformity, 2 cases rotational deformity, 1 cases osteomyelitis.
Accidents, Traffic ; Congenital Abnormalities ; Daejeon ; Female ; Fracture Fixation, Intramedullary ; Fractures, Open ; Hospitals, General ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

One hundred and ninety-four consecutive patients with two hundred and one diaphyseal femur fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from Oct. 1990 to Feb. 1997 at Eulji Medical Center. Fifteen patients had associated ipsilateral knee ligament injuries. There were eleven(73.3%) males and four(26.7%) females with an average age of 35.7(17-68) years. Thirteen(86.7%) patients were injured by traffic accident. Ten patients were followed for average of 38 months(12-73 months). There were five(33.4%) partial and two(13.3%) complete tears of anterior cruciate ligaments, three(20.0%) partial and four(26.7%) complete tears of posterior cruciate ligaments, one(6.7%) partial and four(26.7%) complete tears of medial collateral ligaments, one(6.7%) complete and three(20.0%) partial tears of lateral collateral ligaments, five(33.3%) tears of medial menisci and four(26.7%) tears of lateral menisci. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Better range of knee motion and HSS knee score was obtained when both the femur and ligament injuries were surgically managed. The invention of the MRI and the development of arthroscopic techniques have made it easy to diagnose and take care for ligament injuries. Early diagnosis and proper treatment on ruptured ligaments and tom meniscus combined with diaphyseal femur fractures seem to be important for good prognosis.
Accidents, Traffic ; Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Female ; Femoral Fractures* ; Femur ; Humans ; Inventions ; Knee* ; Lateral Ligament, Ankle ; Ligaments* ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prognosis ; Retrospective Studies

Particulate wear debris(polyethylene, polymethylmethacrylate and metal particles, or combination of these) can initiate aseptic loosening. To eliminate polyethylene debris and reduce the total amount of wear, metal on metal bearings(Metasul) which were made of a wrought Co-28Cr-6Mo-0.2C alloy, were introduced. From May 1994 total hip replacements using a Metasul metal on metal articulation were performed by the authors. 34 patients with 40 hips with minimum follow-ups during 24 months were analysed in this study. The mean follow up period was 31 months(ranging from 24 to 47 months). We used Armor cups and standard cups as acetabular comporients and SL stems, CLS stems and cone stems as femoral components. Preoperative average Harris hip score of 48 points became postoperatively 93(from minimum 81 to maximum 100). And there were slight and occasional thigh pains in 2 cases(5%). There were no revisions for the early aseptic loosening of femoral stems or stem failures. Radiologic evaluation which revealed mild calcar atrophy was developed in 33 cases(82.5%), revealing cortical hypertrophy in 10 cases(25%). Osteolysis was not noted around the prosthetic stem nor around the cup. Radiolucent lines were found in 9 cases of femoral components(22.5%) and in 1 case of acetabular component(2.5%) and subsidence of more than 3mm in 1 case of femoral components(2.5%) were also found. There was 1 case of definitive loosening of acetabular component(2.5%). These also showed that endosteal bone formation adjacent to femoral prosthesis was developed in 22 cases(55%) but no distal pedestal and stem shift occurred. The short-term but satisfactory results of the contemporary metal on metal articulation investigated in this study were encouraging and warrant continued study.
Acetabulum ; Alloys ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Atrophy ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Osteolysis ; Polyethylene ; Polymethyl Methacrylate ; Prostheses and Implants ; Thigh

An intra-articular fracture of the distal tibia or a fracture of the tibial plafond is a relatively uncommon but the most difficult fracture to manage. There are many treatment options and many authors have reported good results after open reduction and rigid internal fixation to restore the length with articular surface and bone-graft followed by early motion and prolonged non-weight bearing. But in the fractures with severe comminution or with severe soft tissue injury, tries for internal fixation with plate and screws in the distal tibia will result in extensive soft tissue stripping of the wound with precarious blood supply, high rates of wound breakdown, superficial and deep infection, and osteomyelitis. The purpose of this study is to evaluate the results of treatment of severely open (open type III-A and more by Gustilo and Anderson) or comminuted plafond fractures (fracture type III and more by Ovadia and Beals) with an Ilizarov method with a minimum follow up of one year (average: 27.9 months) and we have reviewed 12 cases from December 1990 to October 1995. The results were as follows. 1. The average time of bone union were 17.5 weeks (range: 6-42weeks). 2. The radiological results of the treatment were excellent in 4 patients (33.3%), good in 4 patients (33.3%) and poor in 4 patients (33.3%) by radiological assessment of Crutchfield and the clinical results of the treatment were excellent in 4 patients (33.3%), good in 5 patients (41.7%) and poor in 3 patients (25.0%) by functional rating scaie of Crutchfield. 3. It seems that prognosis depends on severity of comminution at the time of injury. 4. The complications were bony collapse of the distal tibia in 2 patients, nonunion in 1 patient, degenerative arthritis of the ankle joint in 2 patients and chronic osteomyelitis in 2 patients. 5. Ilizarov technique is an useful method in the management of severely open or comminuted plafond fracture of the tibia and it would be preferable to apply buttress plate or bone graft after improvement of skin condition to prevent the late collapse.
Ankle Joint ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Intra-Articular Fractures ; Osteoarthritis ; Osteomyelitis ; Prognosis ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants ; Wounds and Injuries

The management of ipsilateral fractures of the femoral neck and shaft has proved to be a challenge to the orthopedist. Most major institutions have treatment protocols that emphasize early rigid stabilization of the femoral neck fracture to minimize the incidence of avascular necrosis of the femoral head and the shaft fractures were fixed prior to definitive neck stabilization. Whenever possible, patients should be followed for a minimum of three years to rule out aseptic necrosis of the femoral head. These dual fractures are usually encountered in the young, associated with high-velocity accidents and usually accompanied by multiple system trauma. At the department of orthopedic surgery, Eul Gi General Hospital, from June, 1986 to August, 1993, 21 cases of the concomitant ipsilateral femoral neck and shaft fractures had been treated. The mean follow-up was 2.8 years(ranging from 1.6 to 5.8 years). The diagnosis of femoral neck fracture was delayed in two patients. Seventeen of the 21 cases underwent surgery had a relatively satisfactory functional outcome without complication of femoral head. In two patient, a symptomatic varus nonunion and varus malunion developed. In two cases, osteonecrosis of femoral head developed and one case of these patients was treated with Meyer techniqe of muscle pedicle graft. Our series emphasize that the recommended treatment consists of a closed intramedullary fixation of the femoral shaft fracture followed by ASNI screw fixation of the femoral neck fracture, with good long term functional results and minimum complication. And approaches to the treatment of concomitant femoral neck and femoral shaft fractures should be selected according to the skill and experience of the surgeon and the availability of equipment.
Clinical Protocols ; Diagnosis ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hospitals, General ; Humans ; Incidence ; Neck ; Necrosis ; Orthopedics ; Osteonecrosis ; Transplants

Calcification of intervertebral discs of the cervical spine in a child is an uncommon disorder, and is often associated with clinical symptoms. The etiology is still unknown, but the natural history has been reported as having a self-limiting course with an excellent prognosis. Here we report two cases of symptomatic cervical disc calcification in a child and provide a literature review.
Child ; Humans ; Intervertebral Disc ; Natural History ; Prognosis ; Spine

Spontaneous brain stem hemorrhage usually results in higher mortality and morbidity with poorer prognosis than any other intracranial vascular lesions in spite of meticulous medical or surgical treatment. We have experienced 86 cases of spontaneous brain stem hemorrhage who were admitted to Wonju college of medicine from January 1983 to Octobr 1995. 33 cases were treated with operation and 53 cases with non-operative treatment. The results were as follows: 1) Clinical parameters in both operative and non-operative groups showed no significant differences. 2) Treatment results were better in the operative group. Operative treatment is recommended in cases of GCS score below 7, hematoma size larger than 10ml, young age, and normotensive patients. 3) Appropriate operative approaches should be considered according to the patient's status. Recently, we most frequently performed a stereotactic approach. 4) Better outcome was obtained when the patients were operated from 72 hours to one or two weeks following the h emorrhage. 5) Hypertension, old age, and GCS score above 7 showed no statistical differences in terms of outcome between the operative and non-operative groups.
Brain Stem* ; Brain* ; Gangwon-do ; Hematoma ; Hemorrhage* ; Humans ; Hypertension ; Mortality ; Prognosis