There are many procedures for treatment of injuries of acromioclavicular separation but there are still con- roversies concerning the best management of these injuries. With this in mind, we treated surgically 22 cases of acromioclavicular separation of which 3 cases were old type 2 and 19 cases were type 3 in the department of orthopaedic surgery, Eul Ji General Hospital from March 1977 to darch 1982. The results were as follows: l. Of 22 cases, 21 cases (95.5%) were male with peak incidence in the 3rd and 5th decades (90.9%). 2. The most common causes of the injuries were traffic accidents (63.6%) and followed by falling from height (22.7%). 3. The diagnosis in type 2 and type 3 injuries is based on the clavicular displacement and instability at the acromioclavicular joint. 4. Operative treatment consists of Weaver and Dunn method (54.5%), modified Phemister method (18.2%), Neviaser method (13.0%), Stewart method (9.1%) and modified Henry method (4.5%). 5. The operative procedure in old type 2 and typc 3 injuries is good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Diagnosis ; Hospitals, General ; Humans ; Incidence ; Male ; Methods ; Surgical Procedures, Operative

To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.
Electroencephalography ; Epilepsies, Partial* ; Humans ; Neurology ; Risk Factors ; Seizures ; Status Epilepticus

BACKGROUND AND PURPOSE: Periodic limb movements (PLM) during sleep (PLMS) are associated with cortical and cardiovascular activation. Changes in cerebral hemodynamics caused by cortical activity can be measured using near-infrared spectroscopy (NIRS). We investigated oscillatory components of cerebral hemodynamics during PLM and different sleep stages in restless legs syndrome (RLS) patients with PLMS. METHODS: Four female RLS patients with PLMS, and four age- and sex-matched normal controls were included. PLM and sleep stages were scored using polysomnography, while the spontaneous cerebral hemodynamics was measured by NIRS. The phase and amplitude of the cerebral oxyhemoglobin concentration [HbO] and the deoxyhemoglobin concentration [Hb] low-frequency oscillations (LFOs) were evaluated during each sleep stage [waking, light sleep (LS; stages N1 and N2), slow-wave sleep (stage N3), and rapid eye movement (REM) sleep]. In RLS patients with PLMS, the cerebral hemodynamics during LS was divided into LS with and without PLM. RESULTS: The cerebral hemodynamics activity varied among the different sleep stages. There were changes in phase differences between [HbO] and [Hb] LFOs during the different sleep stages in the normal controls but not in the RLS patients with PLMS. The [HbO] and [Hb] LFO amplitudes were higher in the patient group than in controls during both LS with PLM and REM sleep. CONCLUSIONS: The present study has demonstrated the presence of cerebral hemodynamics disturbances in RLS patients with PLMS, which may contribute to an increased risk of cerebrovascular events.
Extremities* ; Female ; Hemodynamics* ; Humans ; Oxyhemoglobins ; Polysomnography ; Restless Legs Syndrome* ; Sleep Stages ; Sleep, REM ; Spectroscopy, Near-Infrared*

Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO (who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows: 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLE lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLE lesion.
Cerebrovascular Disorders* ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Mesencephalon ; Nystagmus, Pathologic ; Ocular Motility Disorders* ; Pons

Isolated aneurysm of the common iliac artery that is secondary to medial degeneration (MD) is a very rare clinical entity. MD is an important histological abnormality that is commonly seen in the annuloaortic ectasia with Marfan syndrome. This abnormality is also observed in congenital aortic disease, atherosclerosis, and aging. This aortic disease develops as the consequences of disruption of the medial elastic layers in association with loss of vascular smooth muscle cells and the accumulation of proteoglycans. An iliac aneurysm greater than 3 cm in diameter should be treated. The treatment options include open surgical replacement with prosthetic graft or endovascular stent grafting. We experienced one case of the isolated common iliac artery aneurysm in a 60 year-old female patient. Her chief complaint was a pulsatile painful mass in the left lower quadrant of the abdomen that she had suffered with for 5 days. She was treated by performing aorto-left external iliac artery bypass with a Dacron graft (10 mm in diameter). The result was excellent. We report here on a case of a isolated common iliac artery aneurysm that was caused by MD, and we include a review of the relevant literature.
Abdomen ; Aging ; Aneurysm* ; Aortic Diseases ; Atherosclerosis ; Blood Vessel Prosthesis ; Dilatation, Pathologic ; Female ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Marfan Syndrome ; Middle Aged ; Muscle, Smooth, Vascular ; Polyethylene Terephthalates ; Proteoglycans ; Transplants

Arthroscopic treatment of shoulder instability involves two techniques mainly, transglenoid suture technique and anterior anchoring system. However, anterior anchoring system has some disadvantages such as limited indication, high cost, technical difficulty and incapability to suture or reconstruct for all types of Bankart lesion. Disadvantages of transglenoid suture techniques are indirect suture tie, bump effect and possibility of the suprascapular nerve injury. The authors use modified transglenoid suture technique (Rhees method) for shoulder instability involving Bankart lesion, type II SLAP lesion and capsular laxity. The purpose of this study is to accurately describe the relationship between the major neurovascular structures and the pinning sites used in transglenoid suture technique (Rhees method). Placement of two or three arthroscopic Beath pinning sites was simulated in four fresh cadaveric shoulder specimens by placing Steinman pins into the glenoid rim under open field. The specimens were then dissected and the relationship of the pinning sites to the suprascapular nerve and suprascapular artery were recorded. In Bankart lesion repair, safe zone of pinning sites were 2 and 5 oclock in two portals in right shoulder, safe zone of pinning sites were 7 and 10 oclock in two portals in left shoulder. Safe direction of pinning was as possible as inferomedial side in scapula. In type II SLAP repair, safe zone of pinning sites were 2 oclock and just above 2 oclock of glenoid in right shoulder and 10 oclock and just above 10 oclock of glenoid in left shoulder. Safe direction of pinning was pararell to glenoid cavity and slightly superior in horizontal plane. From this study, these sites and directions appeared to be safe. Proper pinning depends on careful attention to the topographical anatomy about the shoulder.
Arteries ; Cadaver* ; Glenoid Cavity ; Scapula ; Shoulder ; Suture Techniques* ; Sutures*

OBJECTIVES: To investigate brain oscillatory characteristics according to brightness and color temperature of light emitting diode (LED) light in young and elderly subjects. METHODS: We analyzed 22 young (age, 29.0±5.2 years) and 23 elderly (age, 64.8±4.5 years) healthy subjects. A LED light source was used with a combination of two color temperature (6,500 K vs. 3,000 K) and two brightness (700 lx vs. 300 lx) conditions. Participants were exposed to each light condition in relaxed wakefulness. Then, we analyzed power spectral density and functional connectivity from eye-open electroencephalography. RESULTS: A main effect of brightness on delta (p=0.044) and theta (p=0.038) power was significant in the elderly subjects. Bright light enhanced delta and theta power in the frontal region. By contrast, power spectral density of young subjects was affected by color temperature; high color temperature significantly increased beta-band power of the central region (p=0.034). Regarding functional connectivity, a significant effect of color temperature was observed in delta (p=0.006) and beta (p=0.046) frequencies. High color temperature light enhanced beta connectivity of young subjects (p=0.007), while not affecting that of elderly subjects (p=0.979). CONCLUSIONS: The present study demonstrated that spectral power and functional connectivity as well as subjective feelings are affected by the brightness and color temperature of LED light. These results might help us to understand the neurophysiological effects of light and identify the optimal indoor lighting conditions for an individual's environment.
Aged ; Brain ; Electroencephalography ; Healthy Volunteers ; Humans ; Wakefulness

Clinical Protocols ; Facial Nerve ; Humans ; Male ; Mandibular Condyle ; Mouth ; Paralysis ; Treatment Outcome

A 59-year old female was admitted to Yongdong Severance Hospital due to diarrhea and lower abdominal pain lasting for 2 months. She had a previous history of admission for stomach cancer on September 1995. At that time, she underwent total gastrectomy and gastroduodenostomy. The pathology of the specimen revealed a signet ring cell carcinoma of stomach. On admission, computerized tomography revealed rectal wall thickness and no evidence of lymph node enlargement in abdomen and pelvic cavity. Barium enema study showed stricture of rectum. After sigmoidoscopic biopsy, she was diagnosed as a rectal metastasis resulted in rectal stricture and underwent sigmoid loop colostomy. Hence we present a case of gastric cancer with rectal metastasis resulted in rectal stricture.
Abdomen ; Abdominal Pain ; Barium ; Biopsy ; Carcinoma, Signet Ring Cell ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic* ; Diarrhea ; Enema ; Female ; Gastrectomy ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Pathology ; Rectum ; Stomach ; Stomach Neoplasms*

Ovarian cancer is one of the main gynecologic malignancies including cervix cancer and endometrial cancer. Epithelial ovarian cancer generally presents with already advanced disease at the time of diagnosis and is known to have a poor prognosis. But ovarian cancer (stage I) defined as confined to the ovary is usually considered to have a good prognosis, illustrated by 5-year survival rates greater than 70-80%. Also, recurrences tend to be late and are common in the abdominopelvic cavity. Metastases to the skeleton structures are rare. We report a case of early ovarian cancer patient with recurrence as bone metastasis with review of literature.
Diagnosis ; Endometrial Neoplasms ; Female ; Humans ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Ovary ; Prognosis ; Recurrence ; Skeleton ; Survival Rate ; Uterine Cervical Neoplasms