We studied retrospectively 1,112 mild head injury patients visited during a 2-year period to Dankuk University Medical Center to determine the clinical value of routine computerized tomography(CT) of the head and the indication of early discharge in patients with mild head injury(Glasgow coma scale score>or=13) at emergency room. Routine urgent cranial CT scans were obtained on all patients. Variables reviewed were mental status, symptom & sign of head trauma(brief loss of consciousness(LOC), amnesia, nausea and vomiting, headache). skull fracture on skull radiology, intracranial lesions, and operation. Patients with 13-14 Glasgow coma scale(GCS) or skull fracture have a significantly higher incidence of intracranial lesions and operation. Thus we suggest classifing patients with a GCS of 13-14 or skull fracture into "moderate" rather than "mild" in severity and recommend performing CT in all those patients. The patients with normal mental status(GCS score of 15) and no skull fracture have a rate of abnormal CT finding of 8.5% in the subgroup with history of LOC/amnesia and symptoms of head injury, but no patient in the subgroup without LOC/amnesia and symptoms of head injury. There was a few occurrence of delayed intracranial hematoma in normal mental status, but no patient required surgical intervention. We conclude that routine CT of the head in patients with GCS score of 13-14, skull fracture, and history of LOC/amnesia or symptoms of head injury in clear mental status is indicated. If the results of CT scan are normal, these patients may be safely discharged. But if there is no history of LOC/amnesia or symtoms of head injury in normal mental status, an immediate CT scan is not indicated and these patients may also be safely discharged.
Academic Medical Centers ; Amnesia ; Coma ; Craniocerebral Trauma* ; Emergencies* ; Emergency Service, Hospital* ; Head* ; Hematoma ; Humans ; Incidence ; Nausea ; Retrospective Studies ; Skull ; Skull Fractures ; Tomography, X-Ray Computed* ; Vomiting

BACKGROUND: Tsutsugamushi disease, Leptospirosis, and Hemorrhagic fever with renal syndrome(HFRS) are an acute febrile illness of autumn-winter type which are characterized by fever, headache, myalgia in acute stage. We reported the clinical and laboratory characteristics of 49 cases under investigation far febrile illness in rural communities of Korea in order to differentiate the diagnosis among Tsutsugamushi disease, Leptospirosis, and HFRS. METHODS: This study was done retrospectively by investigation of patient's age, occupation, symptom, laboratory findings and chest X-ray findings of Tsutsugamushi disease, Leptospirosis, and HFRS. All patients was seen in our hospital between September and November in 1997 and 1998 consecutive year. RESULTS: The most characteristic symptoms and signs of Tsutsugamushi disease were eschar(90.1%), and skin rash(70%). The epidemiological and laboratory characteristics of Tsutsugamushi disease were age 40 or more, farmer(90.1%), s-GOT(serum glutamic oxaloacetic transaminase) and s-GPT(serum glutamic pyruvic transaminase) elevation. The most characteristic symptoms and signs of Leptospirosis were sputum and cough(75%). The epidemiological and laboratory characteristics of Leptospirosis were all farmers(100%), hyperbilirubinemia(1.67 mg/dl). The most characteristic symptoms and signs of HFRS were gastrointestinal disturbance(100%), flank pain(66.7%). The epidemiological and laboratory characteristics of HFRS were leukocytosis, thrombocytopenia, azotemia, proteinuria (91.6%), and hematuria (83.3%). CONCLUSION: As the clinical feature, presence of eschar and skin rash were suggestive of Tsutsugamushi disease. As the clinical feature, presence of cough and sputum and laboratory finding such as elevation of bilirubin level were suggestive of Leptospirosis. As the clinical feature, presence of gastrointestinal disturbance, flank pain and laboratory finding of thrombocytopenia, and renal dysfunction were suggestive of HFRS.
Azotemia ; Bilirubin ; Cough ; Diagnosis ; Exanthema ; Fever ; Flank Pain ; Headache ; Hematuria ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospirosis ; Leukocytosis ; Myalgia ; Occupations ; Proteinuria ; Retrospective Studies ; Rural Population* ; Scrub Typhus ; Skin ; Sputum ; Thorax ; Thrombocytopenia

This study is concerned with the classifcation of Korean adult mandibular condyles on the basis of the shape of their anteroposterior view. The results were as follows ; 1. Morphological variations are classified into 4 groups. The percentage of each group has been : flat, 7.7% ; convex, 47.2% ; angled, 14.8% ; round, 30.3%. 2. The location of the highest point were as follows : in the lateral third, 15.5% ; middle third, 80.3% ; medial third, 4.2%. 3. The maximum transverse diameter and greatest height were 20.3±2.4mm and 6.5±1.5mm, respectively.
Adult* ; Classification* ; Humans ; Mandibular Condyle*

In order to develop a method for the detection of minimal residual leukemic disease (MRD) in T cell acute lymphocytic leukemia (T cell ALL), T cell leukemia cell line was used to detect clonal TCR p chain mRNA and to synthesize CDR3 specific oligonucleotide probe. For the Jurkat cell line clonal TCR p chain cDNA was amplified by using RT-PCR with oligonucleotide primer, Vp universal primer. As the result of RT-PCR an approximate 300 bp fragment of the TCR chain was obtained, and the partial identification of the TCR p chain gene and the amino acid sequence of the fragment were done by gene cloning and sequencing. The gene sequence of TCR p obtained was identified as Vp8-Jp1.2-Cp2. Diversity gene segment could not be found. Within the p chain, the CDR3 region was identified as 12 amino acids (SFSTCSANYGYT). It is kown that TCR is expressed in about 40% of the all T cell ALL. However it is not kown what percentage of the TCR p chain mRNA expression translates into the actual TCR molecule. It is not certain how many patients with MRD can be detected by this method used in this study, but this technique might be useful to detect MRD in at least 40% of the patients with T-cell ALL.
Amino Acid Sequence ; Amino Acids ; Cell Line* ; Clone Cells ; Cloning, Organism ; DNA, Complementary ; Humans ; Jurkat Cells ; Leukemia, T-Cell* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Receptors, Antigen, T-Cell* ; RNA, Messenger ; T-Lymphocytes

In the antero-posterior and lateral viewe of the lumbar X-ray film of 258 normal Korean adults(120 males, 138 females), the following measurement was made ; the measurement of the interpeduncular distance, anteroposterior diaameter, width of the lumbar vertebral body and height, and thickness of the pedicle. The mean value of interpeduncular distances and anteroposterior diameter of each lumbar vertebral level was measured in relation to the variables of sex and age. The value of interpeduncular distance at each level was related to the pedicle index and width of the vertebral bodies. Statistical analysis was made. The percentage of type A was 74.42%, type B 21.32%, type C 4.26%, but type D was not observed. The mean value of the interpeduncular distances of each level of the lumbar vertebra was measured. In male, Ll was 23.57mm, L2 24.29mm, L3 25.36mm, L4 27.09mm, and L5 was 29.77mm. In female, Ll was 22.24mm, L2 23.03mm, L3 24.11mm, L4 25.70mm, and L5 28.29mm. The difference between male and female was significant (P<0.05). The difference between each age group was not signifcant (F>3.58). There was no significant relationship between the interpeduncular distance, anteroposterior diameter, pedicle indices and the width of the body at all levels.
Adult* ; Female ; Humans ; Male ; Spinal Canal* ; Spine ; X-Ray Film

To investigate the genetic factors in Koreans with leprosy, 157 unrelated leprosy patients have been typed for HLA antigens, and compared with 162 healthy controls. The patient group consisted of 124 with lepromatous leprosy and 33 with tuberculoid leprosy. HLA-A11 was found to be increased in lepromatous leprosy (p=0.0005). HLA-Aw33 was found to be increased in both lepromatous leprosy (p = 0.0002) and tuberculoid leprosy (p = 0.005). HLA-Cw5 was found to be decreased in lepromatous leprosy (p = 0.009). Frequencied of HLA-B antigens did not differ significantly between the leprosy patients and the healthy controls.
HLA Antigens/analysis* ; Human ; Korea ; Leprosy/genetics ; Leprosy/immunology* ; Phenotype

The polymorphic variants of HLA-linked genetic markers GLO, Bf, C2 and C4 were determined in Koreans. The GLO2 allele was found at a similar frequency as compared with other orientals and at higher frequency than in Caucasians. The gene frequencies of BfS and BfF showed different figures from those in other orientals and were similar to Caucasians. The C2C allele was the highest variant as in other populations. The rare variant C2A was not observed in this study. The common variants of C4A alleles are C4A*3 and C4A*4. Among the C4B variants, C4B*1, C4B*2 and C4B* QO are common in that order. Several undefined electrophoretic variants C4A and C4B were observed in this study. These findings suggest that the frequencies of various HLA-linked genetic markers can be used in anthropological studies.
Caucasoid Race ; Comparative Study ; Genetic Markers* ; HLA Antigens/genetics* ; Human ; Korea ; Mongoloid Race* ; Polymorphism (Genetics)

The electrical burns constitute a unique type of thermal injury and usually consist of a limited area of cutaneous burn, but associated with deep muscle damage of variable extent. The deep tissue destruction resulting from such injury leads to high incidence of amputation. So electrical burns are different from other types of injuries requiring individualized and varied methods of treatment, such as early fasciotomy, repeated debridement, wound coverage and technique of amputation. During 5 years from Jan. 1988 to Dec. 1992, we experienced 310 cases of electrical burn. We analyzed these cases on the aspects of functional result and necessity of amputation according to the treatment variability. The result showed the extent of burn in amputation group was 11.6%, salvage group 13.1%, with no difference of extent between 2 groups(p>0.05, by qui square test). When the fasciotomy was done earlier than 12 hours after injury showed 39.1% of more than good functional result, when later than 12 hours 7.7% of more than good, that is, earlier fasciotomy resulted in better function(p < 0.05, qui square test). The amputation rate was 23.9% during the last 5 years which was a marked improvment when compared to the previous ten years(32.4%). From these results we concluded that in order to reduce the rate of amputation and to improve the function of patients, early fasciotomy, early repeated debridement and wound coverage is necessary.
Amputation ; Burns ; Debridement ; Humans ; Incidence ; Wounds and Injuries

No abstract available.
Patella*

PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament ; Collateral Ligaments ; Diagnosis ; Humans ; Joints ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies