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

Traumatic dislocation of peroneal tendons is caused by sudden dorsiflexion of the foot accompanied by a powerful contraction of peroneal muscles. This tears the peroneal retinaculum and allows the tendons to dislocate anteriorly. This injury is not uncommon, but clinically it has been given little attention. Authors experienced a case of traumatic dislocation of peroneal tendons which was treated surgically with good result.
Dislocations ; Foot ; Muscles ; Tears ; Tendons

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

The authors studied paranoid ideation and obsession, using Derogatis' SCL-90, in the subjects of 2,564 male and 1,252 female college freshmen of Yeungnam University. The authors collected the reports of Self-Rating Paranoid ideation and Obsession Scale during the periods from January to February, 1987, and applied ANOVA and t-test on paranoid ideation and obsession scores in order to compare them between various psychosocial factors, and sexes. The results are as follows: 1. There was not significant difference in the mean averages of total paranoid ideation scores between male and female students: male students scored 4.16±3.09, female students scored 4.16±2.91. 2. High scored items were delusion and suspiciousness. 3. Fifty-nine male students (2.3%) showed high paranoid ideation scores of 12 or higher, while twenty-six female students (2.1%) showed the same scores. 4. There was strong tendency toward higher paranoid ideation scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present or future in both group (respectively P<0.001). The male students who believed protestantism showed higher level of paranoid ideation scores (P<0.01). The male students who attended the department of fine art showed higher level of paranoid ideation scores (P<0.05). 5. There was significant difference in the mean averages of total obsession scores between male and female students (P<0.05): male students scored 10.40±5.43, female students scored 10.75±5.02 6. High scored items were perfectionism, indecisiveness, inattention & obsessive thoughts. 7. Thirty-eight male students (1.6%) showed high obsession scores of 25 or higher, while fifteen female students (1.2%) showed the same scores. 8. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present, or future in both group (respectively P<0.001). The female students who attended the department of home economic & whose educational fees were paid by her brothers & sister, showed higher level of obsession scores (respectively P<0.01).
Atmosphere ; Delusions ; Fees and Charges ; Female ; Humans ; Male ; Obsessive Behavior* ; Parents ; Protestantism ; Psychology ; Recognition (Psychology) ; Siblings

The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

Functional voiding disorder is characterized by symptoms referable to the genitourinary organs without organic obstruction or neurovesical dysfunction. In an attempt to understand possible mechanisms of symptoms of functional voiding disorder in young male adult, we retrospectively reviewed the urodynamic findings of 51 men with functional voiding disorder between the ages of 19 and 51 (mean 40.7 years). Presenting symptoms are divided into three groups: 1) Sx. of irritation(irritation group) in 17 patients; 2) Sx. of bladder outlet obstruction(BOO group) in 25 patients; 3) Sx. of bladder outlet obstruction with episodes of overdistention (overdistention group) in 9 patients. On filling cystometry, time of first filling sense and urge sense was delayed significantly in overdistention group and involuntary contraction was found in 5 patients with BOO(20%), in 3 patients with irritation(18%), and in 1 patients with episodes of overdistention. In overdistention group, maximal voiding detrusor pressure was significantly lower and amount of postvoiding residual urine was significantly larger than other two group on pressure/flow study. Total voiding time and time to maximal uroflow rate were delayed significantly in BOO and overdistention group. Pseudo detrusor-sphincter-dyssynergia was found in 3 patients among 25 patients with BOO. Therefore, we were able to find correlations between specific symptomatic group and urodynamic parameters by this result. Results of urodynamic assessment were divided into 5 categories: Impaired detrusor contractility(IDC), detrusor instability(DI), obstruction, sensory urge syndrome, and equivocal studies. DI was found in 20% of patients with irritation or BOO. IDC was found in 80% of patients with episodes of overdistention and in 24% of patients with BOO. Thorough care is necessary in determining the treatment modality, and in follow up evaluation for patients showing IDC, DI or obstruction on urodynamic study. Conclusively, urodynamic study is thought to afford the opportunity in identifying these specific voiding disorder.
Adult ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urodynamics* ; Young Adult*

No abstract available.
Anetoderma* ; Granuloma Annulare* ; Granuloma*

Thirty-nine patients with pityrosporum folliculitis were investigated clinically and histopathologically. On clinical observation there were numerous, chronic, moderately itchy (64.1%), dome-shaped papules (89.7%) and pustules (66.7%). The most frequent sites of the lesions were the upper portion of the chest (76.9%) and back (56.4%). In biopsy specimens, abundant round and budding yeast cells were seen in a dilated hair follicle. The reptured follicle was observed in 19 specimen (48.7%). The accumulation on inflammatory cells were observed in or around the upper part of the follicle in all specimens. The effect of antimycotic treatment was excellent. After 4 weeks of treatment, 36 patients (92%) were cured and 3 (8%) had improved significantly. KOH/Parker Ink direct smear was done in 20 patients. Blue-colored round and budding yeast cells were observed under a light mcroscope in all patients. We suggest that pityrosporum folliculitis is a common disease of young and middle-aged Koreans.
Biopsy ; Folliculitis* ; Hair Follicle ; Humans ; Ink ; Malassezia* ; Saccharomycetales ; Thorax ; Yeasts

No abstract available.
Patella*

Electrical burn is thought to be similar to crushing injury in that it usually involves skin, muscle and neurovascular structure simultaneously. Especially in extremity, there are many occasions that amputations are inevitable. Since the demarcation between viable and non-viable tissue tends to be obscure, electrical burn greatly differs from other types of injury in detailed methods of treatment, such as the level, the timing and the technique of amputation. During the past 10 years from January, 1978 to December, 1987, authors experienced 285 amputations in 181 cases of electrical burn at Orthopedic Department of Hanil Hospital. The clinical data of our experience were reviewed and analysed. The results were as follows ;l. Amputation rate in electrical burn was 22.4%. 2. Out of total 285 amputations, the number of upper extremity was 187 (65.6%) and it was 1.9 times more than that of lower extremity. Right forearm was 1.8 times more than left forearm. 3. Multiple limbs amputation were performed in 83 cases (45.9%). 4. Among 285 stumps, more than one operation were done in 74 stumps because of infection (50%), necrosis of stump end (35.1%), bony overgrowth at stump end (8.1%) and neuroma(6.8%).
Amputation ; Amputees ; Burns ; Extremities ; Forearm ; Humans ; Lower Extremity ; Necrosis ; Orthopedics ; Skin ; Upper Extremity