The coracoclavicular joint is a rare genetical anatomic variants. The joint occurs at the junction of a bony projection extending inferiorly form the outer third of the clavicle at the site of the conoid tubercle and a bony projection extending superiorly form the coracoid process of the scapula. In our study we reviewed the radiological incidence of the coracoclavicular joint in Korean adults. The materials consist of 4,625 routine chest films, 9,250 sides. Sex distribution were 3,000 males and 1,625 females. The authors observed coracoclavicular joint on 17 persons (0.37%) and 25 sides (0.26%) and among them, 8 persons (47%) were bilateral and in 9 (53%) it was unilateral. The joint when unilateral occures frequently on left side, and there was no significant sex difference. There were statistically significant differences in the incidence of coracoclavicular joints among Korean, Japanese and Chinese.
Adult ; Asian Continental Ancestry Group ; Clavicle ; Female ; Humans ; Incidence ; Joints ; Male ; Scapula ; Sex Characteristics ; Sex Distribution ; Thorax

BACKGROUND: Non ulcer dyspepsia(NUD) is a commonly encountered disease at the primary practice. The relations of functional gastrointestinal disorder and Irritable bowel syndrome with depression or stress were suggested by previous studies. But the contributions of the anxiety, depression and stress as a whole to the NUD were not assessed. In this study, we wanted to show the associations of the anxiety, depression and stress levels with NUD. METHODS: This study was performed by case and control method from Aug. 1 to Sep. 7 at the outpatient department of Family Medicine and at the Health Management and Service department in Pusan Paik Hospital. The both groups were matched by sex and age. The case was defined who has three or more symptoms among nine upper gastrointestinal symtoms like dyspepsia, epigastric pain and anorexia etc. frequently or alwalys and who has no ulcer at the gastrofibroscope. The anxiety, depression, stress levels were measured by questionnaire which was validated by previous studies. The questionnaire was composed of Trait-STAI, Jung's Self Depression Scale(SDS), Modified BEPSI, and Grobal Assessment of Recent Stress(GARS) Scale. RESULTS: The total subjects were 136 persons(NUD group : 86 persons/control group : 86 persons). There were. significant differances in regularity of diet(P<0.001), levels of education(P=0.009), and history of medications(P<0.001) between two groups. The two group had higher scores than the control group in the depression score, anxiety score and modified BEPSI score(P<0.001). All items in GARS showed higher scores in NUD group than in control group(P<0.001). CONCLUSIONS: NUD group had higher degree of anxiety and depression than the control group. It seems that the NUD may have streeful status. When we encounter the NUD in outpatiet department, we had better consider the underlying psychogenic or stressful conditions.
Anorexia ; Anxiety* ; Busan ; Depression* ; Dyspepsia* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Ulcer* ; Surveys and Questionnaires

Visualization of falx cerebri on non-enhanced CT of children with severe head injuries (the falx sign) has been regarded as an evidence of subarachnoid hemorrhage. On the contrary, other authors have reported reverse results. To evaluate clinical significance of the falx sign, authors studied frequency of visualization and CT number of falx cerebri and dural sinuses in 65 children with head injury and 65 children without head injury examined by cranial CT at the Dep. of Radiology, St. Paul's Hospital, Catholic Medical College from March to Sept. 1981. All patients with head trauma were studied within 1 week of the traumatic event. Visualization of falx cerebri was observed at slice in the region of lateral ventricle and slice near to vertex respectively. On the slice in the region of lateral ventricle, falx cerebri was identified in 82% of all of the children examined, of which 92%showed partial visualization of falx cerebri and remaining 8% totally. On the slice near to vertex, falx cerebri was identified in 92% of all the children examined, of which 38% showed partial visualization of falx cerebri and remaining 62% totally. In head trauma group, frequency of visualization of falx cerebri was 78% on the slice in the region of lateral ventricle and 89% on the slice near to vertex; in non-traumatic group, frequency of visualization of falx cerebri was 86% and 94% respectively. The highest numerical value of the falx densities averaged 47 Hounflieds (range, 32-63) in non-traumataic group, averaged 49 Housfields (range, 32-69) in head trauma group. All or a portion of the superior sagittal sinus was visualized in 59% of all of the cases studied, 50% in head trauma group, and 69% in nontraumatic group. The straight sinus was identified in 45% of all of the cases studied, 39% in head trauma group, and 51% in non-traumatic group. In conclusion, there was no distinction between head trauma and non-traumatic group in visualization of falx cerebri and dural sinuses, and we could frequently identify the falx density in normal. Also we could find that frequency for visualization of falx cerebri and drual sinuses increased as the age increased.
Child ; Craniocerebral Trauma ; Humans ; Lateral Ventricles ; Spinal Cord ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus

We experienced 2 cases of cerebral arteriovenous malformation(AVM) with tital extirpation recently. One patient, 23 year old man had chief complaints of sudden headache and loss of consciousness of 3 days duration. On admission, the patient was in a drowsy mental state and had mild papilledema on both sides. Other neurological and physical examinations were normal. Right carotid angiogram revealed AVM which is fed from the right middle cerebral artery and is drained into the right transverse sinus. We found intracerebral hematoma(100 cc) on operative field. The other patient, 30 year old man had chief complaints of Jackson's type seizure several times on the left hand during a five month duration and also had a severe headache intermittently for three months. Left carotid angiogram revealed AVM which is fed from the left anterior cerebral artery and left middle meningeal artery, and is drained into the superior sagittal sinus. We did not find intracerebral hematoma but found an old hemorrhage pouch. The 2 cases of AVM lesions were not found on the postoperative carotid angiogram.
Adult ; Anterior Cerebral Artery ; Hand ; Headache ; Hematoma ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Meningeal Arteries ; Middle Cerebral Artery ; Papilledema ; Physical Examination ; Seizures ; Superior Sagittal Sinus ; Unconsciousness ; Young Adult

Chemical rhizotomy with the intrathecal alcohol injection was firstly attempted by Dogliotti in 1931, and with phenol in 1955 by Maher. The intrathecal neurolytic injection was a very simple, effective and nonsurgical procedure without any great danger. Good indications for the procedure are the bilateral pelvic and lower limb pain syndrome, well circumscribed pain in limited area and in poor general condition. We have reported two cases of intractable pain of limited area, successfully relieved by chemical rhizotomy, and discussed the importance of the procedure and presented the review of literatures.
Lower Extremity ; Pain, Intractable* ; Phenol ; Rhizotomy

Thymic size can be affected by both exogenous and endogenous glucocorticoids. Development of the respiratory distress syndrom (RDS) is influenced by adernal cortical function. thus, thymic size in RDS is considered to been larged due to decreased adrenal cortical function. To find whether the presence of RDS correlates with thethymus, the size and shape of the thymus were evaluated in the radiographs of premature infants with RDS, without RDS(control prematurity) and normal infants. The subjects were consisted of chest films of Korean premature infants, 120 with RDS, 60 without RDS, and 60 of normal infants taken at the Departement of Radiology, Our Lady of Mercy Hospital during the period of 62 months since January 1978. Relative size of the thymus was determined bycardiothymic/thoracic ratio(CT/T ratio). Grading and locaiton of the thymic prominence as well as incidence of the shape were examined. And all the relations among the radiographs of RDS, control prematurity and normal infants were analyzed. The results were as follows; 1. The CT/T ratio of premature infants with RDS was significantly greater than that of control prematurity and normal infants (P<0.01). 2. The incidence of bilateral thymicprominence was more frequent in premature infants with RDS than in control prematurity and normal infants(P<0.05).3. The frequency of thymic prominence was greater in the right than left side in all the three groups (P<0.05). 4.As in the shape of the thymus, a rounded type was most frequent, and a triangular type was least frequent in allthe three groups. 5. Incedence of RDS was very low(9.8%) when the CT/T ratio is below 0.3 and it was very high(90.9%) when the CT/T ratio is above 0.49.
Glucocorticoids ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Thorax ; Thymus Gland

Fracture of odontoid process is relatively common, but fracture of axis body without fracture of odontoid precess is known to be exceptionally. Recently, we have experienced a case of axis body fracture complicating typical Brown-Sequard syndrome below the level of C4, and we present the case with the review of literature.
Axis, Cervical Vertebra* ; Brown-Sequard Syndrome* ; Odontoid Process

BACKGROUND: Smoking is a high risk factor for various chronic diseases. Therefore, physicians are expected to play a critical role in patients smoking cessation. There have been a number of studies which show that cessation recommendation by physicians is effective for patients to stop smoking. The purpose of this study is to assess physicians smoking status and its effect on physicians attitude for their advice to patients to quit smoking. METHODS: During August and September in 1995, self-report questionnaire was distributed to doctors in Jin-Gu, Pusan. It consisted of inquiries on their demographic features, their smoking status, whether physicians ask patients their smoking status or not, whether physicians advise patients to quit smoking or not, and whether physicians confirm patients smoking cessation. Among 203 responses returned, 193 cases was analyzed. RESULTS: Among the total 193 persons, 60 persons are smoking now(31.4%, Men 34.5%, women 0%), and 88 persons(67.2%) are ex-smoker. 84.1% of smokers have tried to quit smoking, and stress was the most common reason for failure. Smoking rate and experience rate were higher in men than in women(P<0.001), but there were no significant differences in smoking rate and experience rate according to ages, religions, specialties, hospital types, and positions. Among responders 144 cases(75.0%) asked smoking status of patients. 21.4% of them asked smoking status of all patients who may smoke, and 25.0% of them hardly ask smoking status of patients. For question about patients' smoking status, the younger physicians were more active in asking smoking status of patients(p=0.038), and the physicians in hospital did much more than physicians in university hospital and private clinics(p=0.015). Among responders, 161 persons(84.7%) advised patients to quit smoking, and 19.5% of them advised to quit smoking for all patients who smoked. However, 15.3% of them hardly gave patients such suggestion. It was found that there was no significant relationship between physicians smoking status and attitudes toward giving patients suggestion to quit smoking. CONCLUSIONS: This study revealed that there was no significant relationship between physicians smoking status and their attitudes toward giving patients suggestion to quit smoking, and physicians smoking status did not have any effect on smoking cessation advice. However, this study does not exclude the possibility that the results might be reversed, if the census would be extended to broader area. Physicians should take an active role against smoking.
Busan ; Censuses ; Chronic Disease ; Female ; Humans ; Male ; Risk Factors ; Smoke* ; Smoking Cessation* ; Smoking* ; Surveys and Questionnaires

The clinical value of lumbar epidural venography(L.E.V.) has been stressed in diagnosing lumbar disc since Batson's desciption of vertebral venous system in 1940. We have tried this procedure by the selective catheterization of ascending lumbar and, or internal iliac vein to 16 patients with disc symptoms. In 6 patients with abnormal myelography, 4 revealed abnormal L.E.V. and in 2, the above procedure was failed. In 6 patients with disc-like symptoms but normal myelography, 2 were abnormal L.E.V., 2 normal and 2 failed. 3 with disc-like symptoms but equivocal myelography, abnormal L.E.V. was definitely shown in 2 patients and failed. Operation was done in 7 patients(6, abnormal myelography and one, only abnormal L.E.V.).
Catheterization ; Catheters ; Humans ; Iliac Vein ; Myelography ; Phlebography*

Benign pulmonary tumors are rare entities, and among them bronchial lipomas are the most uncommon. Up to date, about 80 cases have been reported in the English literature. But, the bronchial lipoma with extrabronchial growth causing middle lobe syndrome and pneumonia is extremely rare. Bronchial lipomas, mainly arising from normal fatty tissue of the proximal portion of the lobar or segmental bronchi, are histologically benign. But if diagnosis and treatments are delayed, they can produce extensive pulmonary parenchymal damage and irreversible brochiectasis distally. So whenever possible, the treatment of choice is resection by means of bronchoscopy via early diagnosis. But if endoscopic removal is not possible because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy or if the nature of the tumor is unclear, surgery is necessary, with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma. We present a case of bronchial lipoma with extrabronchial growth, with a review of the literature and report of an unusual case.
Adipose Tissue ; Bronchi ; Bronchoscopy ; Diagnosis ; Early Diagnosis ; Lipoma* ; Middle Lobe Syndrome* ; Pneumonectomy ; Pneumonia*