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

There is a great variety of abdominal calcifictions of varying etiology. Among them, calcification in gastriccarcinoma is rare. To the best of our knowledge, there has been no previous report of calcifying mucinousadenocarcinoma of the stomach in Korea. In the present communication, we report two cases of this rare tumor. Thefirst case was 27 years old female who had anorexia and palpable mass in the epigastrium. By palpation, a firmnon-tender large mass ws felt in the epigastrium. A plain abdominal film showed numerous pnuctate calcificationsin the left upper quadrant. Film from an upper G-I series demonstrated findings of advanced gastric carcinoma withmultiple punctate calcifications involving the antrum and body. Gastroscopic biopsy proved the lesion to bemucinous adenocarcioma(signet ring cell type). The second case was 38 years old female who compained of nausea,vomiting and weight loss. On physical examination, she appeared normal. Routine laboratory tests were withinnormal limits. A plain abdominal film revealed stippled calcifications in the left upper quadrant medial to thesplenic shadow. The film from an upper G-I series showed a mass in the fundus and upper body of stomach withmultiple stippled calcifications along the lesser curvature. Subtotal gastrectomy was perfomred and the pathologicfindings was calcifying mucinous adenocarcinoma(signet ring cell type).
Adenocarcinoma, Mucinous ; Anorexia ; Biopsy ; Female ; Gastrectomy ; Humans ; Korea ; Mucins ; Palpation ; Physical Examination ; Stomach ; Weight Loss

No abstract available.
Arthritis, Juvenile*

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

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

We described here a patient who presented with symptoms of heart failure who was found to have severe bilateral impairment of atrioventricular inflow. Primary cardiac lymphoma (PCL) with extensive involvement of the two atria, pericardium and myocardium is an extremely rare tumor in immunocompetent patients. We report here a case of PCL in an immunocompetent patient with involvement of both atria and the atrial septum. The tumor had a butterfly shape. We could not do surgical excision because of the massive pericardiac invasion. The diagnosis was B-cell lymphoma and this was confirmed by the pericardiac biopsy.
Atrial Septum ; Biopsy ; Butterflies ; Heart Atria ; Heart Failure ; Heart Neoplasms ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Myocardium ; Pericardium

BACKGROUND: This is the first annual data on the surveillance of intensive care unit (ICU) module by the Korean Nosocomial Infections Surveillance System (KONIS) from July 2007 through June 2008. METHODS: The KONIS performed a prospective surveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 96 ICUs in 56 hospitals. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,637 NIs were found during the study period; 1,391 UTIs (1,365 cases were urinary catheter-associated), 667 BSIs (563 were central line-associated), and 579 PNEUs (357 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.43 cases per 1,000 device-days (95% confidence interval, 4.20-4.67) and urinary catheter utilization ratio was 0.84 (0.839-0.841). The rate of central line-associated BSIs was 2.83 (2.61-3.07) and the utilization ratio was 0.54 (0.538-0.542). The rate of ventilator-associated PNEUs was 2.49 (2.25-2.76) and the utilization ratio was 0.39 (0.388-0.392). Although the ventilator utilization ratios were lower in the hospitals with less than 900 beds than in the hospitals with more than 900 beds, the rates of ventilator-associated PNEUs were higher in the smaller hospitals than in the larger ones. CONCLUSION: This result suggests that ongoing targeted surveillance and implementation of proven infection control strategies are needed.
Cross Infection ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

BACKGROUND: Emergence and spread of antimicrobial resistant bacteria make it difficult to treat infections. A rapid increase in antimicrobial-resistant bacteria has become a serious problem in many countries including Korea, and it is important to perform a nationwide study of antimicrobial resistance to obtain some basic data that will help solve these problems. The aim of this study was to determine the nationwide prevalence of resistance among frequently isolated bacterial pathogens in 2005 and 2006 in Korea. METHODS: We collected routine susceptibility data for medically important bacterial pathogens from 12 university and general hospital laboratories in Korea from April to September in 2005 and from January to June in 2006. Collected data was analyzed by patient group. RESULTS: The proportions of methicillin-resistant Staphylococcus aureus (MRSA) were 65% in 2005 and 72% in 2006, respectively. The resistance rates of Enterococcus faecium to vancomycin were 29% in 2005 and 24% in 2006. The non-susceptible rates of Streptococcus pneumoniae to penicillin were 68% in 2005 and 74% in 2006. The resistant rates of Escherichia coli and Klebsiella pneumoniae to the 3rd generation cephalosporin were 10~12% and 25~39%, respectively, in 2005 and 11~15% and 30~34% in 2006. In Citrobacter freundii, Enterobacter cloacae and Serratia marcescens, the resistance rates to 3rd generation cephalosporin were 23~31%, 32~34%, and 17~27%, respectively, in 2005 and 21~37%, 37~43%, and 13~31% in 2006. The resistance rates to imipenem and meropenem were 21% and 18%, respectively, in Pseudomonas aeruginosa and 18% and 25% in Acinetobacter baumannii in 2005; 29% and 20% in P. aeruginosa and 18% and 23% in A. baumannii in 2006. Cotrimoxazole and levofloxacin resistance rates of Stenotrophomonas maltophilia were 5% and 13%, respectively, in 2005 and 3% and 7% in 2006. There were no isolates resistant to 3rd generation cephalosporin and fluoroquinolone among non-typhoidal Salmonella in 2005. CONCLUSION: Antimicrobial resistance of medically important bacteria is still a serious problem in Korea. To manage the problem, a continuous nationwide surveillance and diversified investigation and effort have become more important.
Acinetobacter baumannii ; Bacteria* ; Citrobacter freundii ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Hospitals, General ; Humans ; Imipenem ; Klebsiella pneumoniae ; Korea* ; Levofloxacin ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Prevalence ; Pseudomonas aeruginosa ; Salmonella ; Serratia marcescens ; Stenotrophomonas maltophilia ; Streptococcus pneumoniae ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
Acute Disease ; Aged ; Drug Therapy, Combination ; Female ; Hemorrhage ; Heparin/*therapeutic use ; Heparin, Low-Molecular-Weight/*therapeutic use ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/epidemiology/mortality/*therapy ; Myocardial Revascularization ; Odds Ratio ; Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors/metabolism ; Prognosis ; Registries