Fractures of the shaft of the humerus due to muscle violence esp. from throwing hand grenades are uncommon. Even so there are reports from many authors documenting such fractures from throwing a javerin, baseball, hand grenade and arm wrestling. Fractures of this type are usually spiral in nature; located between the middle and distal third of the humerus. We have treated four such cases during activities in which hand grenades were thrown. These fractures were sustained by military recruits in the Department of Orthopaedic Surgery, Capital Armed Forces General Hospital from Jan. 1980 Dec. 1980.
Arm ; Baseball ; Hand ; Hospitals, General ; Humans ; Humerus ; Military Personnel ; Violence ; Wrestling

This is a first report on an interview study of fertility and attitude toward family planning among a systematic random sample of about 1,000 couples in Korean rural area. More specifically, the authors analyzed the replies to the five important questions in fertility control; (1) the level of fertility, (2) the ideal family size, (3) the family planning limitation factors, (4) the prevalence of conception control and (5) the attitude towards the use of contraceptives. It was found that the level of reproductive performance has remained high with the total fertility rate of 7 or more, while their ideal family size revealed at the interview was 3 to 5. Such an excess fertility has not been well controlled by delaying of the age of marriage and/or by spacing birth, but the most prominent factors in limiting the family size has been the high mortality of children especially in infancy. As the infant mortality rate is declining, the family limitation is now practiced by the increasing rate of induced abortion. The practice of modern contraceptive method was low in prevalence, and if they were in use a high proportion were known to have begun the practice only after having their desired number of children(3 to 5). Family planning information was widespread and general1y accepted by the informed population. Also the majority of the respondents desired to learn (60%) and to practice (55%) the family planning. However, they were unable to practice it mainly due to the lack of detailed knowledge and instructions. This points out the need for proper education for developing the active family planning program in Korean rural area.
Adolescent ; Adult ; Child ; *Family Planning Services ; *Fertility ; Human ; Korea ; Middle Aged ; Vital Statistics

OBJECTIVE: Primary intraventricular hemorrhage(PIVH) is uncommon and accounts for only 3.1 % of all non-traumatic intracerebral hemorrhage. The aim of this study is to analyze clinical characteristics, image features, etiology and prognostic factors of outcome in patients with PIVH. METHODS: We identified 25 patients with PIVH during 9-year period between 1994 and 2002 at our institute. The clinical data, complimentary examination, outcome and computed tomographic blood amounts were reviewed. RESULTS: Major symptoms included sudden decreased level of consciousness, headache, nausea/vomiting and neck stiffness. Cerebral angiography was performed in 12 patients(48%) and revealed vascular malformation in 6 patients(24%). The positive result of angiography was more common in young patients and among vascular malformation the incidence of Moyamoya disease was relatively high(4 patients). Other causative factors were coagulation disorder, arterial hypertension, tumor bleeding. Outcome were death in 9 patients(36%): 7 patients(28%) died by direct consequence of bleeding and 2 patients died after other adverse events(sepsis, hepatic failure) but prognosis of survivor was good. Factors correlating with the outcome were the presence of coagulopathy, initial Glasgow Coma Scale(GCS), obstruction of 4th ventricle and ventricular blood amount including hemorrhagic dilatation of temporal horn of lateral ventricle, 3rd and 4th ventricle. CONCLUSION: The poor prognosis factors of PIVH are the presence of coagulopathy, low initial GCS, obstruction of 4th ventricle and large ventricular blood amount. Additionally patients whose initial clinical condition is not serious need an appropriate work up including cerebral angiography, because cause of bleeding is vascular malformation especially in young patients.
Angiography ; Animals ; Cerebral Angiography ; Cerebral Hemorrhage ; Coma ; Consciousness ; Dilatation ; Headache ; Hemorrhage* ; Horns ; Humans ; Hypertension ; Incidence ; Lateral Ventricles ; Moyamoya Disease ; Neck ; Prognosis ; Survivors ; Vascular Malformations

This investigation was evaluated for in vitro antibacterial activity against 169 Helicobacter pylori strains isolated from patients with gastric cancer in Pusan, Korea. The minimum inhibitory concentration (MIC) of 6 antibiotics was determined by broth microdilution method. The isolation rate of H. pylori was 39.3% in the patients with gastric cancer, and which was not observed any differences between male and female or age group. The MIC50amoxacillin, clarithromycin, and amoxacillin plus clarithromycin against H. pylori isolates was 4.0, 2.0, 0.5, 0.5, 0.5, 1.0, and 1.0 microgram/ml, respectively. The MIC50 of the metronidazole, erythromycin, ciprofloxacin, tetracycline, amoxacillin, clarithromycin, and amoxacillin plus clarithromycin against H. pylori isolates was 32.0, 16.0, 1.0, 1.0, 4.0, 16.0, and 8.0 microgram/ml, respectively. The prevalence of one kind of antibiotic resistant strains of H. pylori was 31.9% for metronidazole, 31.9% for erythromycin, 23.1% for clarithromycin, 11.2% for amoxacillin, 6.5% for ciprofloxacin, and 9.5% for amoxacillin and for clarithromycin. The prevalence of two kinds of antibiotic resistant strains of H. pylori was 8.3% for amoxacillin and clarithromycin, 4.1% for metronidazole and erythromycin, 1.3% for metronidazole and ciprofloxacin, 1.3% for erythromycin and ciprofloxacin. The prevalence of three kinds of antibiotic resistant strains of H. pylori was 5.9% for metronidazole, amoxaciltin, and ciprofloxacin, 2.4% for metronidazole, erythromycin, and ciprofloxacin. The prevalence of four kinds of antibiotic resistant strains of H. pylori was 1.3% for metronidazole, erythromycin, tetracycline, and ciprofloxacin.
Anti-Bacterial Agents ; Busan ; Ciprofloxacin ; Clarithromycin ; Erythromycin ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Male ; Metronidazole ; Microbial Sensitivity Tests ; Prevalence ; Stomach Neoplasms* ; Tetracycline

A volvulus of the colon is a twisting of a redundant segment of the colon at its narrow mesentery. A sigmoid volvulus is the most common type. This disorder may spontaneously reduce and recur as a chronic problem. However, it more frequently becomes acute as a result of an obstruction, which can lead to strangulation and gangrene with a high mortality if not treated promptly. Colonoscopic reduction and decompression is the preferred initial treatment for patients with a sigmoid volvulus who show no signs of bowel strangulation, which may be the cause of the high mortality associated with emergency surgery. We experienced 2 cases of a sigmoid volvulus in a 44-year-old female and a 51-year-old male. The sigmoid volvulus was diagnosed by simple abdominal film and treated successfully by an emergency colonoscopic reduction. We report our experience on the use of colonoscopy to treat sigmoid volvulus with a reviews of the relevant literlature.
Female ; Humans ; Mortality

We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Biopsy ; Diagnosis ; Endoscopy ; Fibrosis ; Granuloma ; Humans ; Inflammation ; Male ; Melena* ; Middle Aged ; Mycobacterium tuberculosis ; Stomach Ulcer ; Tuberculosis*

PURPOSE: The purpose of this study is to describe the CT and MR findings of inverted papilloma and to determine the specific differential finding between inverted papilloma with and without coexisting malignancy. MATERIALS AND METHODS: Twenty-two histopathologically proven inverted papillomas were included in this study; in six patients there was coexisting malignancy. Twenty-two CT images and eight MR images were retrospectively reviewed. RESULTS: On CT images, the inverted papillomas were seen as unilateral sinonasal masses with bone remodeling (n=15) rather than bone destruction (n=1) and showed iso- or slightly high attenvation. Three of the six malignant cases showed aggressive bone destruction and widespread extension into the orbit, intracranial and buccal spaces, and pterygopalatine fossa. On MR images, the inverted papillomas (n=3) were iso- (n=2) or slightly high (n=1) in signal intensity in relation to muscle on T1 weighted images, and high (n=3) on T2 weigihted images. Gadolinium enhanced images showed heterogenous moderate enhancement. In the cases of coexisting malignancy (n=5), the masses were iso- (n=5) on T1 weighted images, high (n=5) on T2 weighted images and also showed heterogenous moderate enhancement. CONCLUSION: Inverted papilloma should be considered in the differential diagnosis of a bulky unilateral nasal mass extending into the adjacent paranasal sinuses, especially in an elderly patient with chronic nasal obstruction. Although there were no specific differential findings in signal intensiy and enhancement pattern on CT and MR images between benign and malignant inverted papilloma, aggressive bone destruction and widespread extension beyond the sinonasal cavity are findings which are highly suggestive of coexisting malignancy.
Aged ; Bone Remodeling ; Diagnosis, Differential ; Gadolinium ; Humans ; Nasal Obstruction ; Orbit ; Papilloma ; Papilloma, Inverted* ; Paranasal Sinuses ; Pterygopalatine Fossa ; Retrospective Studies

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
Adult ; Bile Duct Neoplasms/*diagnosis/etiology/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/etiology/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/complications/*diagnosis ; Female ; Humans ; Positron-Emission Tomography and Computed Tomography ; Tomography, X-Ray Computed

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma