There are many procedures for treatment of injuries of acromioclavicular separation, but still controversies concerning the best management of these injuries. From March 1981 to August 1984 at Masan Korea Hospital, twelve cases were treated by technique of modified Phemister method, two cases by Dewar and Barrington method, two cases by Stewart method, one case by Neviaser method, three cases by skillful neglect method and two cases by shoulder harness immobilization. The following results were obtained. 1. These injuries were more prevalent in male and more in right side. 2. The most common cause of injuries was traffic accident and followed by falling from the height. 3. Three cases were grade 2 and nineteen cases grade 3 by Allman's classification. 4. We treated these injuries by operative method in seventeen cases and non-operative method in five cases. 5. There were good functional results of treatment in operative method. 6. There were two cases of superficial wound infection, two cases of migration of K-wire and one case of recurrence of deformity in operative method, and two cases of shoulder stiffness and 2 cases of recurrence of deformity in non-operative method.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Classification ; Congenital Abnormalities ; Humans ; Immobilization ; Korea ; Male ; Methods ; Recurrence ; Shoulder ; Wound Infection

No abstract available.
Upper Extremity Deep Vein Thrombosis

No abstract available.
Wilms Tumor*

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

PURPOSE: All procedures for the removal of retained intrahepatic stones were performed on inpatient basis. We evaluated the advantage of the procedures performed on inpatient basis compared with outpatient basis in terms of the success rate, causes of failure and the complication. MATERIALS AND METHODS: Percutaneous removal of retained intrahepatic stones was performed in 58 patients through a T-tube tract on inpatient basis from April 1990 to December 4992. Stones were exclusively intrahepatic in 28 patients, whereas 30 patients had combined stones in common bile duct. Preshaped catheters, baskets, and balloon catheters were used to remove the stones and dilate the strictures of the ducts. Extracorporeal shock wave lithotripsy and choledochoscopy with electrohydraulic lithotripsy were used to crush the impacted stones. RESULTS: The stones were completely removed in 34 (58.6%) of 58 patients and most of the stones were removed in 17 patients (29.3%). The overall success rate was 87.9%. The complications (cholangitis in 13% and pancreatitis in 0.8% per session) were found and successfully managed by appropriate care. CONCLUSION: Better success rate could be achieved by more aggressive appraoch on inpatient basis when compared with previous reports on outpatient basis. We suggest that the procedures should be performed on inpatient basis especially in a case with severe strictures or impacted stones.
Catheters ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Inpatients ; Lithotripsy ; Outpatients ; Pancreatitis ; Shock

PURPOSE: LASEK is a newly developed refractive surgery technique that can make up for the complications from PRK and LASIK. The most unique procedures in LASEK is covering of the cornea with epithelial flap after keratectomy. We examined the effect of corneal epithelial flap on the wound healing of canine cornea. METHODS: Operation was performed in eyes from 12 dogs, and the 12 eyes were recovered with epithelial flap and the remaining 12 eyes were recovered without epithelial flap. Wound healing process was compared using fluorescein staining, light and transmission electron microscopic examination. RESULTS: Fluorescein stained area of the cornea was reduced with time in both groups, and from 9 hours after the operation, it was significantly reduced in the group with epithelial flap compared with those of the group without epithelial flap (p< 0.05). On light microscopic examination of the group with epithelial flap, and normal epithelial structure was found at 24 and 48 hours, respectively. However, in the group without epithelial flap, no complete reepithelialization had occurred on center at 48 hours after the operation. On transmission electron microscopic examination, eyes of the group with epithelial flap showed hemidesmosomes in the area where epithelial flap was closely contacted with the stroma at 24 hours, and they were completely developed at 48 hours. On the other hand, in the group without epithelial flap, hemidesmosomes developed only in the proximal portion but not at the leading edge even at 48 hours. CONCLUSIONS: These results suggest that corneal epithelial flap accelerate the wound healing process of the cornea and the wound healing process depend on the vitality of the epithelial flap.
Animals ; Cornea ; Dogs ; Fluorescein ; Hand ; Hemidesmosomes ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Refractive Surgical Procedures ; Wound Healing* ; Wounds and Injuries*

To evaluate criterial for detecting corpus callosum (CC) abnormality, measurements of CC were done in 100 Korean adults on midline sagittal T1 weighted images using the spin echo technique with a 2.0 Tesla MR unit. The mean (±SD) anteroposterior diameter of CC, and the mean (±SD) thicknesses of genu, body, transition, and splenium were 71.1±5.0, 11.2±1.6, 5.7±1.0, 3.6±10, and 11.6±1.6mm, respectively. The outlines of CC were traced directly from the scans, and the maximal anteroposterior length of the CC was divided into quartiles. Area measurements of the anterior quartile, body, splenium, and whole CC were made with a digitizer pad and computer, and the mean (±SD) areas of these were 211±36, 194±36, 205±34, and 610±90mm, respectively. The following ratios were calculated; Maximum anteroposterior diameter of CC/length of brain, area of anterior quartile/area of whole CC, area of body/area of whole CC, and area of splenium/area of whole CC. There was a statistically significant increased of maximum anteroposterior diameter of CC/length of brain by age, and a statistically significant decrease of the area of the body by age. However, there were no statistically significant differences of all measurements between males and females.
Adult* ; Brain ; Corpus Callosum* ; Female ; Humans ; Male

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns and clinical responses in inpatients and/or outpatients with obsessive compulsive disorder (OCD) at a university hospital. METHODS: A total of 71 OCD patients were included and followed during the first 4 months, first year and second year from 1998. The patterns of medication use and clinical responses according to the Yale-Brown obsessive-compulsive scale (Y-BOCS) were analyzed descriptively in this period. RESULTS: During the first 4 months, 26.7% of the patients underwent monotherapy in which most of the drugs were serotonin reuptake inhibitors (SRIs). Therapy with two or more drugs was administered in 66.6% of the patients and combination drugs with SRIs were atypical antipsychotics and clonazepam. The clinical response rate using Y-BOCS was 24.0% compared with baseline score. During the first year, the frequency of the monotherapy decreased to 6.5%, while that of therapy with two or more drugs increased to 80.6% (two and three drug frequencies were 35.3%, and 32.3%, respectively). The clinical response rate was 26.4% during this period. During the second year, the frequency of the monotherapy was 25% and that of multidrug therapy was 70.8% (two and three drug frequencies were 20.8%, and 45.8%, respectively). The clinical response rate was 39.3% compared with baseline score. CONCLUSIONS: In this study, the frequency of the combination therapy was relatively high compared with SRI monotherapy during the first 4 months and it increased further during the first year. The combination therapy was maintained without change of SRI dosage during the second year. Most of the drugs used in the combination therapy were atypical antipsychotics and clonazepam.
Antipsychotic Agents ; Clonazepam ; Drug Therapy* ; Humans ; Inpatients ; Obsessive-Compulsive Disorder* ; Outpatients ; Serotonin Uptake Inhibitors

PURPOSE: To determine how clinical and angiographic factors relate to the amount of subarachnoid blooddetected by computerized tomography in patients with a ruptured aneurysm. MATERIALS AND METHODS: Between January1996 and December 1997, 22 patients with a posterior communicating artery aneurysm were retrospectively evaluated. RESULTS: Oval(three of four cases), funnel(both cases), and daughter-sac (four of five cases) types of aneurysmalsac were found among the 13 patients with a large amount of subarachnoid blood ; eight of these had a past historyof hypertension or diabetes. Seven of eleven cases of cylindrical-type aneurysmal sac were found among the 9patients with a small amount of sularachnoid blood ; eight of these had no past history of hypertension ordiabetes. The average S/N ratio (ratio of maximum sac length to neck diameter) of patients with a small amount ofblood was higher than that of patients with a large amount of blood(2.72 vs 2.07). CONCLUSION: Although manyfactors influence the amount of subarachnoid blood in an aneurysmal rupture, we found that a large amount of bloodwas frequently present in the oval, funnel and daughter sac types of aneurysm, when S/N ratio was low, and when anunderlying disease such as hypertension or diabetes was present. Conversely, a small amount of blood was presentin the cylindrical type, when S/N ratio was high, and where there was no of underlying disease.
Aneurysm ; Aneurysm, Ruptured ; Humans ; Hypertension ; Intracranial Aneurysm* ; Neck ; Nuclear Family ; Retrospective Studies ; Rupture

OBJECTIVE: This retrospective study of 101 patients with symptomatic lumbar disc herniation (LDH) treated via percutaneous endoscopic surgery using the extreme lateral transforaminal approach (ELTFA) was performed to assess the clinical results and to determine the relationship between the location of the herniated disc fragment and surgical success. METHODS: The operated levels were distributed as one case of L2-3, ten cases of L3-4, 83 cases of L4-5 and seven cases of L5-6. The clinical outcomes were assessed using visual analogue pain (VAS), Oswestry disability index (ODI) and MacNab's criteria. All assessments were performed one day prior to the operation, as well as three days and one month after the operation. RESULTS: Mean preoperative back VAS (4.33+/-1.48) and leg VAS (6.29+/-2.72) were significantly decreased three days (1.43+/-1.48, 2.03+/-1.98, respectively) and one month (1.23+/-1.25, 1.89+/-1.72, respectively) postoperatively. Mean preoperative ODI score was improved from 45.86+/-20.44% to 18.92+/-12.98% after three days and to 16.34+/-9.86% one month after operation. Twenty-three patients showed a vertical migration of the herniated disc of greater than 4 mm. There was no statistically significant difference between the extents of improvement in VAS or ODI score or between the degrees of vertical migration. According to MacNab's criteria assessment, the overall surgical success rate, as measured by surgeries classified as "excellent" and "good," was 89.8%. Surgical complications included seven patients with transient leg paresthesia, one patient with transient motor weakness and one patient with postoperative discitis. CONCLUSION: This study demonstrates that percutaneous endoscopic surgery using ELTFA is an effective surgical endoscopic approach for selected LDH patients. This procedure is safe and could expand indications to vertically migrated discs.
Discitis ; Diskectomy ; Humans ; Intervertebral Disc Displacement ; Leg ; Paresthesia ; Retrospective Studies