Injuries to the acromioclavicular joint are usually the result of force applied downward to the acromoion. Surgery treatment modalities for grade IU complete acromioclavicular dislocation are extremely varied and usually successful. 13 cases of complete acromioclavicular dislocation were operated by techniuqe of Kirschner wire with tension-band wiring at Wonju Christian Hospital from June 1984 to Oct. 1985. And they had been followed for average 17.8 months and following results were obtained. l. Of the 13 cases, male was 8 cases(61%) and female was 5 cases(39%) . 2. The most common cause of injury was traffic accident. Nexts were fall down, slip down and direct blow. 3. Results were evaluated by using Weaver and Dunn criteria, 12 cases(92.3%) were good and 1 case was fair but this technique involved a more extensive implant removal that required general anesthesia. Therefore, AO tension-band wiring is thought useful operative method in the treatment of acromioclavicular dislocation.
Accidents, Traffic ; Acromioclavicular Joint ; Anesthesia, General ; Dislocations ; Female ; Gangwon-do ; Humans ; Male ; Methods

Galeazzis frature has been described as a fracture of the radius complicated by a dislocation of the distal radioulnar joint. This fracture, with angulation of the distal radius and dislocation of the distal radioulnar joint, shows the tendency to redisplacement after reduction due to a variety of factors including the brachioradialis muscle, the pronator quadratus muscle and the thumb abductors and extensors. Because of these factors, this fracture may rarely be treated by manipulation and plaster immobilization alone. The treatment of choice for Galeazzis fracture is open reduction and internal fixation. The author reviewed the cases of 28 patients with Galeazzis fracture who had been treated at the Department of Orthopedic Surgery, Yonsei University Wonju College of Medicie from January 1978 to December 1986. This study emphasized the nature of the injury, the level of the radial fracture, treatment and results. The results were as follows ; 1. The subjects included 2 children and 26 adults. Males were affected more frequently than females, and the sex ratio was 6: 1 2. The causes of injury included car accidents in ten cases(36%), falls in eight cases(29%), injuries from machinery in five cases(18%), direct blows in four cases(14%) and explosion in one case(3%). 3. The fracture occured most often at the junction of the middle and distal thirds of the radial shaft in thirteen cases(47%), and less often in the middle third of the radial shat, eitht cases(29%). Infrequent sites of fracture included the junction of the proximal and middle thirds in four cases(14%), the distal third in two cases(7%) and the proximal third of the radius in one case(3%). 4. Twenty-two cases(78%) experienced fracture composed of only two fragmented, but six cases(22%) were multifragment fractures. The frature was oblique and in one case, spiral. In twenty-two cases, the fractures were closed and in six cases, open. Three cases of open fractures had grade III soft tissue injuries. 5. Roentgenograpghic diagnosis of the distal radioulnar joint disruption was possible in 82% of the cases. 6. Associated injuries were noted in 57% of the cases including six cases of head injuries, four cases of head injuries, two cases of injury to the lower extremities, two cases of spinal injury, one cases of a fractured humerus. 7. Conservative treatment was given in five cases and operative treatment twenty-two cases. Conservative treatment gave excellent results in one case, fair results in two cases, while operative treatment resulted in an excellent outcome in thirteen cases, a fair outcome in eight cases and poor in one case. 8. Six cases experienced complications including delayed union in two cases, subluxation of the distal radioulnar joint in two cases, ahgulation in one case and infection in one case.
Accidental Falls ; Adult ; Child ; Clinical Study ; Craniocerebral Trauma ; Diagnosis ; Dislocations ; Explosions ; Female ; Fractures, Open ; Gangwon-do ; Humans ; Humerus ; Immobilization ; Joints ; Lower Extremity ; Male ; Orthopedics ; Radius ; Sex Ratio ; Soft Tissue Injuries ; Spinal Injuries ; Thumb

This study was conducted to find out an appropriate means for preventing the juvenile delinquency (JD), which is supposed to be greatly realted to family environment. The data were collected through a questionnaire survey with a means of writing by themself, to 257 middle and high school students and 309 juvenile delinquents who were in confinement. The questionnaire was consisted of 27 items of juvenile delinquencies, 15 questions about personal environment in their period of childhood, 36 questions on their home atmosphere, 25 items with regard to their parental behavior to their children in the rearing of them. The extent of delinquency was calculated by summing the numbers of experienced delinquencies of the listed items. The study subjects were divided into two groups; student group (SG) and juvenile delinquent group (JDG) and the collected data were analyzed with the extent of delinquency in each group by SPSS/PC+statistical package. The extent of JD was increased as the study subjects grew older, defective families were more common, total family income was more poor, parents' educational level was lower, personal expenses were higher and the conflicts between parents were more high in JDG as compared with of SG. The differences were statistically significant. As long as the extent of delinquency is concerned, delimquent points of JDG were significantly higher as compared with that of SG in all items except one item, below the primary school item in fathers' educational level. (In order to prevent JD in our country, it is recommended that educational level and the living standared of the lower class people should be raised, the sound families which do have less conflictsshould be established as much as possible, the present educational system which is making much conflicts between parents and their offsprings should be changed so that their given temperament would be brought up to the highest level, defective families should be reduced as much as possible and adults should not do actions that are considered not to be done by youngsters and must set a good example.)
Adult ; Atmosphere ; Child ; Humans ; Juvenile Delinquency* ; Parents ; Surveys and Questionnaires ; Temperament ; Writing

MR imaging of the brain in 34 patients were reviewed to characterize the MR findings of brain damage due to perinatal hypoxic insult All the patients had a history of perinatal hypoxia and showed abnormal brain MR findings. Out of 34, eight infants were born premature and twenty-six were born at term or post-term. MR findings were analysed for the extent and location of abnormalities of the white matter, cortical abnormality. Corpus callosum atrophy, and abnormal progression of myelination. The major abnormalities were abnormal signal lesions or atrophy of the cerebral white matter and gyral atrophy of the cerebral cortex. The distribution of white matter lesions well correlated with maturity of the brain at the time of hypoxic insult. Periventricular and deep white matter lesions predominated in the premature-born patients. Corpus callosum atrophy was frequently seen. Reflecting the location of white matter injury. Delay in myelination was present in 55%. MR is a very useful diagnostic imaging modality and guide for the prediction of prognosis by accurate depiction of the location and extent of brain damage due to perinatal hypoxic insult.
Anoxia* ; Atrophy ; Brain* ; Cerebral Cortex ; Corpus Callosum ; Diagnostic Imaging ; Humans ; Infant ; Magnetic Resonance Imaging ; Myelin Sheath ; Prognosis ; White Matter

High output heart failure due to congenital arteriovenous fistula is a rare disease and is difficult to treat. A 27 year old man, suffering from dyspnea, palpitation, lower extremity edema, and abdominal distension admitted May, 1987. At admission there were continuous thrill and bruit at left supraclavicular and infraclavicular area. The heart sound was irregular and rapid, and grade IV/VI pansystolic murmur was audible at the apex. Chest PA showed marked cardiomegaly with pleural effusion and notching at superior aspect of left 2nd rib. Selective left subclavian artery angiogram showed extensive congenital arteriovenous fistula at the area of left subclavian artery and its branches. After setrial feeding artery embolization and palliative operation, the fistula size decreased much with clinical improvement.
Adult ; Arteries ; Arteriovenous Fistula* ; Cardiomegaly ; Dyspnea ; Edema ; Fistula ; Heart Failure ; Heart Sounds ; Humans ; Lower Extremity ; Pleural Effusion ; Rare Diseases ; Ribs* ; Subclavian Artery* ; Thorax

A clinical observation was made on 38 patients with the suspicion of prostatic cancer in the department of urology, St. Mary's Hospital during the period from January, 1969 to December, 1978. The results are as follows. 1. The most prevalent age was from 60 to 69 (44.7%) 2. Among 38 cases of the transrectal needle biopsy, the adequate tissues for the histologic diagnosis were obtained in 34 cases. 3. Of 34 cases whose tissue were obtained adequately by the needle biopsy, 22 cases were diagnosed the malignancy of prostate. 4. Among 38 cases of the transrectal needle biopsy, the fever were developed in 4 cases and the rectal bleeding in one case.
Biopsy, Needle* ; Diagnosis ; Fever ; Hemorrhage ; Humans ; Needles* ; Prostate ; Prostatic Neoplasms ; Urology

Authors performed angio-CT(portal &/or arterial CT) in 35 patients with various hepatic masses. We obtained portal CT in 32 and arterial CT in 13 patients. The contrast material was injected into superior mesenteric artery for portal CT and into hepatic artery for arterial CT after transfemoral cathetrization of these arteries. We concluded that portal CT was superior to other imaging modalities highly sensitive in detecting hepatic masses, especially, early hepatocellular carcinomas, daughter nodules, and subclinical metastatic hepatic malignancy, With this method, detection rate of early hepatocelluar carcinomas improved 62% in number of patients and 90% in number of masses. Detection rate of subclinical hepatic metastases improve 60% each in number of patients and in number of masses. It was also useful for the detection of portal vein invasion. Arterial CT was useful in differential of masses and in defining the characteristics of entire or part of the masses because this method revealed hemodynamic patterns more definitely.
Arteries ; Carcinoma, Hepatocellular ; Hemodynamics ; Hepatic Artery ; Humans ; Mesenteric Artery, Superior ; Methods ; Neoplasm Metastasis ; Nuclear Family ; Portal Vein

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.
Apnea ; Asthma ; Bronchiolitis ; Cough ; Dermatitis, Atopic ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hypersensitivity ; Infant* ; Lung Diseases ; Pneumonia ; Prevalence* ; Reference Values ; Respiratory Sounds*

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed