Diastasis of the ankle joints was associated with not only ankle fracture but also with ligamentous rupture. Since keeping anatomical reduction and giving secure stability to the injured ankle is the gole of the treatment for a good outcome, diastasis should not be overlooked from the first time. To obtain this goal, thorough understanding of diastasis and clear-cut diagnostic guide is important. Seventy one patients of ankle diastasis treated at Presbyterian Medical Center from Jan. 1979 to Dec. 1985 were analyzed in clinical and radiological aspect. The results obtained from this study were as followings. l. Among the 71 diastasis patients, male was predominantly 90%. The average age was 32 years old of age. 2. The main cause of diastasis was traffic accident (42 cases) and the other causes were falling from a height, sport injury in order of frequency. 3. In classification of the Lauge-Hansen, the most common mechanism that causes ankle diastasis was supination-external rotation (47.8%). 4. On the degree of the diastasis, complete type was 32.4%, and incomplete type was 67.6%. 5. 67.8% of the ankle injury patients developed ankle diastasis. 6. The average transfixation time was 11 weeks. 7. By the Meyers assessment, clinically 81.6%, radiologically 87. 3% good result can be obtained. 8. Good result could be achieved by early accurate diagnosis and proper operative intervention.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Classification ; Diagnosis ; Humans ; Ligaments ; Male ; Protestantism ; Rupture ; Sports

This study was aimed at primarily to develop a tool to evaluate sexuality education and secondarily to test effectiveness through application of developed evaluation tools in elementary school. The results from this study were summarized below: 1. On the basis of targeting the lower grades (1st- 3th year) and the higher grades (4th-6th year) elementary school students' sexuality education guidebooks published by Korea Ministry of Education & Human Resources Development, 71 preliminary items targeting the lower grades, 90 preliminary items targeting the higher grades were developed. 2. Through the validity test about the contents of the preliminary items three times, the items were regulated to 65 items targeting the lower grads and 57 items targeting the higher grades. And then, the preliminary items were re-regulated to 40 items separately. Then, pre-test which targeting each 30 students was enforced. 3.Finally, the evaluation tools for sexuality education that consisted of 40 items targeting the lower grades and the higher grades were developed. 4.Reliability test of the developed tools, sexuality education evaluation tools showed alpha coefficient of internal consistency were 0.8355 (for the use of the lower grades) and 0.8881 (for the use of the higher grades). 5.To apply the developed sexuality education evaluation tools, 10-times sexuality education were carried out class unit and pre-post test were done using same questionnaire, which contains developed tool, there were significant difference in low grade (t=16.548, p=0.000), high grade (t=14.773, p=0.000). The results of this study suggest that the evaluation tool for sexuality education in elementary school may be a useful tool with a high degree of reliability and validity. In this sense, the evaluation tool for sexuality education developed by this study can be effectively utilized in Korea elementary schools.
Education* ; Evaluation Studies as Topic ; Humans ; Korea ; Reproducibility of Results ; Sexuality* ; Staff Development ; Child Health ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: There is conflicting evidence for whether or not the incidence of stroke is influenced by the daily temperature. The association between daily temperature and incidence of stroke is largely unknown in Korea. This study attempted to evaluate whether the maximum or minimum daily temperature is associated with increased numbers of strokes and stroke subtypes among Seoul residents. METHODS: We obtained the maximum and minimum daily temperatures in Seoul from the Korean Meteorological Administration between January 2005 and December 2014. Consecutive patients with acute stroke were registered who visited the emergency room or outpatient clinic in Soonchunhyang University Hospital, Seoul. The residential addresses of cases were restricted to within a 2-kilometer radius of this hospital. The stroke events were prospectively recorded with onset time, and were classified by subtypes. The categories of daily temperature were divided by 10℃ from the mean temperature. The mean daily number of strokes was calculated during the study period. One-way analysis of variance and Duncan's post-hoc test were applied to compare the number of strokes among the temperature groups. RESULTS: In total, 2,313 acute strokes were identified during the period: 1,643 ischemic strokes and 670 hemorrhagic strokes. The number of cases was significantly higher when the maximum daily temperature was >32℃ or ≤3℃ (p=0.048) or the minimum daily temperature was ≤-11.0℃ (p=0.020). The lowest maximum daily temperature was associated with increased instances of intracerebral hemorrhage (p=0.029) and small-vessel occlusion (p=0.013), while the highest maximum daily temperature was associated with an increased instance of large-artery atherosclerosis (p=0.045). CONCLUSIONS: The daily temperature had measurable and different associations with the number of strokes and strokes subtypes in Seoul, Korea.
Ambulatory Care Facilities ; Atherosclerosis ; Cerebral Hemorrhage ; Emergency Service, Hospital ; Humans ; Incidence ; Korea ; Prospective Studies ; Radius ; Seoul* ; Stroke*

Intracranial aneurysmal rupture causes subarachnoid hemorrhage which usually leads to fatality or severe disability. Treatment of unruptured intracranial aneurysms (UIAs) can substantially reduce the risk of rupture and prevent the grave consequences, but the risk of prophylactic treatment cannot be ignored. UIAs have diverse characteristics and management strategy needs to be tailored according to their location, size and clinical status. In the absence of level I evidence, the treatment guidance often relied on expert's opinions and experience. Knowledge of the natural course and management risks of individual aneurysms can help to guide treatment decision, but the natural history is still controversial and risks are not clearly defined. The Korean Society of Cerebrovascular Surgeons (KSCVS) decided to issue a Korean version of UIA management guideline as a framework for the treatment decision and as a basis for future studies, following 'Guideline Development Manual' of the Clinical Research Center for Stroke (CRCS). The organized committee systematically reviewed relevant literature and major guidelines published between January 2000 and July 2010 and took a developmental strategy of adaptation rather than de novo methods. On the basis of interpretation of the published evidences, recommendations were synthesized, and the level of evidence and the grade of recommendation were determined using the methods adapted from those of the US Agency for Healthcare Policy and Research and CRCS. The current guideline focuses on three domains of natural history, diagnosis and treatment of UIAs. The hierarchy of evidence and the recommendation grading indicate the current level by the literature and do not indicate the necessity or the prohibition of a certain clinical practice. Accordingly, this guideline cannot provide the answer for every clinical situation and should not take precedence over the clinical judgment of responsible physicians for individual patients. The final judgment regarding the care of a particular patient must be made by the physician and patient in light of circumstances specific to that patient. This is the first version of the UIA management guideline in Korea and new evidences will be timely and continuously updated in the future guidelines.
Aneurysm ; Calcium Hydroxide ; Delivery of Health Care ; Humans ; Intracranial Aneurysm ; Judgment ; Korea ; Light ; Natural History ; Risk Management ; Rupture ; Stroke ; Subarachnoid Hemorrhage ; Zinc Oxide

Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.
Aneurysm ; Brain Ischemia ; Cerebrovascular Disorders ; Diagnosis ; Disease Management ; Hydrocephalus ; Intracranial Aneurysm ; Mortality ; Neurology ; Quality Control ; Rehabilitation ; Risk Factors ; Search Engine ; Subarachnoid Hemorrhage ; Surgeons