Acromioclavicular joint injuries are frequently seen with the recent increase of traffic and industrial accidents. The treatment of complete separation of the acromioclavicular joint has been, and is still, a subject of controversy. In view of a recent trend, anatomical reduction of acromioclavicular joint, and rigid internal fixation method is preferable, especially in type 3 injury. We operated on 16 cases of complete acromioclavicular separation by the technique of coracoclavicular wiring from March 1983 to Feb. 1987. The following results were obtained. 1. The functional results were excellent; 12 cases(75%), good; 3 cases(19a%), and fair ; 1 cases(6%). 2. The complications include wire reakage ; 1 case(6%), bony erosion ; 3 cases(19%) and subluxation, 1 case(6%). 3. The advantages of coracoclavicular wiring. 1) Avoids violation of acromioclavicular joint but does not restrict rotation of the clavicle. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy under local anesthesia. 5) This method corresponds to the coracoclavicular ligment biomechanically. Therefore, coracoclavicular wiring is thought to be a good operative method in the treatment of complete acromioclavicular separation.
Accidents, Occupational ; Acromioclavicular Joint ; Anesthesia, Local ; Clavicle ; Immobilization ; Methods

No abstract available.
Humans ; Lung Neoplasms* ; Lung*

PURPOSE: To evaluate the incidence, risk factors and prognosis of delirium in elderly patients with intertrochanteric fractures of femur. MATERIALS AND METHODS: 162 patients who underwent operation for intertrochanteric fracture of femur from July 2005 to January 2007 were reviewed retrospectively. Delirium was diagnosed by using Confusion Assessment Method (CAM). Medical records were reviewed for the information of the patients, Gross motor function classification of Palisano et al. was used for the evaluation of ambulatory status. Univariate analysis and multivariate analysis were done to find out the risk factors. RESULTS: 2 cases out of 162 (1.2%) met the criteria of delirium at admission, and 39 cases (24.1%) after surgery. Univariate analysis and multivariate analysis identified age, hematocrit, dementia, the duration of opiate use, and pulmonary complication as risk factors. Hospital stay was longer and postoperative ambulatory status was worse in the patients with delirium. CONCLUSION: Delirium is a frequent complication of intertrochanteric fractures of old age and associated with worse results. Cognitive function as well as physical status should be evaluated before and after surgery. Delirium needs more active prevention and treatment for better results.
Aged ; Delirium ; Dementia ; Femur ; Hematocrit ; Hip Fractures ; Humans ; Incidence ; Length of Stay ; Medical Records ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors

OBJECTIVES: The purpose of this study was to compare psychological test profiles of psychiatric outpatients with high and low depression/suicide ideation and to identify predictor variables for depression/suicide ideation. METHODS: Component scores of the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were compared using t-tests. Discriminant analysis was conducted for predictor variables of depression/suicide ideation. RESULTS: Regarding PAI profiles, somatic complaints (SOM), anxiety (ANX), anxiety-related disorder (ARD), depression (DEP), paranoia (PAR), borderline features (BOR), antisocial features (ANT), mania (MAN) drug problems (DRG) scores were significantly elevated in high depression and high suicide ideation groups. Concerning MMPI-2 profiles, the scores of hypochondriasis (Hs), depression (D), hysteria (Hy), psychopathic deviate (Pd), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si) were significantly elevated in these same groups. The PAI and MMPI-2 profile shapes were remarkably similar between high depression and high suicide ideation groups. Therefore, in terms of psychological profile, depression and suicidal ideation seemed to reflect the same construct. However, in discriminant analysis, significant predictors for depression were found to be Pt and D Sc from MMPI-2, while those for suicide ideation were found to be Pa and Sc, suggest subtle differences. CONCLUSION: The superficial characteristics of depression and suicide ideation groups reflected by the psychological test profiles seemed similar, but the determining factors may differ. Thus, the psychological interventions for these two groups may have to follow different routes considering these subtle differences.
Anxiety ; Bipolar Disorder ; Depression ; Discriminant Analysis ; Humans ; Hypochondriasis ; Hysteria ; Introversion (Psychology) ; Minnesota ; Outpatients ; Paranoid Disorders ; Personality Assessment ; Psychological Tests ; Schizophrenia ; Suicidal Ideation ; Suicide

PURPOSE: To describe plain radiographic and thin-section CT findings of hematogenous candida pneumonia in major burn patients. MATERIAL AND METHOD: We reviewed nine cases of hematogenous candida pneumonia in major burn patients who had positive blood culture for candida and findings of pneumonia on plain chest radiograph. On five of nine cases, thin-section CT was done. We evaluated retrospectively nine cases for onset, the pattern, distribution, and size of lesions on plain chest radiograph and thin-section CT. RESULTS: On plain chest radiograph, randomly distributed 2-10mm nodules were seen in six cases(66%) and randomly distributed 10-15mm consolidations in remaining three cases{33% ). Lesion occured in 11th to 75th post-burn day{average, 34th post-burn day). Other findings were cardiomegaly in three cases, atelectasis in three cases, and pulmonary edema in one case. Thin-section CT showed variable shaped subpleural nodules in all five cases. The size of nodules were 1-5mm in two cases(40%) and 5-10mm(60% ) in three cases. Feeding vessel signs were seen in two cases. Other findings were atelectasis in three cases, cardiomegaly in three cases, ground-glass opacity and interlobular septal thickenings by pulmonary edema in two cases. CONCLUSION: Plain chest radiographic findings of hematogenous candida pneumonia in major burn patients are randomly distributed nodules or consolidations of variable size. Thin-section CT findings are variable shaped subpleural nodules less than 1 cm.
Burns* ; Candida* ; Cardiomegaly ; Humans ; Pneumonia* ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic* ; Retrospective Studies ; Thorax*

BACKGROUND AND OBJECTIVES: Although a prominent large V wave in left atrial pressure tracing (PVLAP) has been reported to be associated with significant mitral regurgitation (MR) or decreased left atrial compliance (LAC), it is sometimes observed in patients with tight mitral stenosis (MS). The purpose of this study was to determine the prevalence and the hemodynamic significance of PVLAP in tight MS. MATERIALS AND METHODS: Catheterization data before percutaneous mitral balloon valvuloplasty (PMV) were analyzed in 84 consecutive patients and PVLAP was defined as V wave 10 mm Hg higher than mean left atrial pressure (MLAP). RESULTS: PVLAP was observed in 45% (38/84) and factors associated with PVLAP were younger age (p=0.02), higher MLAP (p<0.01), higher mitral gradient (p=0.04), smaller valve area (p=0.01) and low echo score (p=0.02): among them MLAP was the only independent factor in multivariate analysis. The presence of PVLAP had no effect on the result of PMV and successful PMV abolished PVLAP. CONCLUSION: PVLAP was observed not infrequently in these selected patients with MS referred for PMV. The presence of PVLAP was not associated with MR and had good correlation with MLAP, which suggest that PVLAP be determined by decreased LAC.
Atrial Pressure ; Balloon Valvuloplasty ; Catheterization ; Catheters ; Compliance ; Hemodynamics ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Multivariate Analysis ; Prevalence

No abstract available.
Carcinoma, Hepatocellular*

No abstract available.
Kidney Failure, Chronic* ; Renal Dialysis*

BACKGROUND: Paroxysmal supraventricular tachycardia(PSVT) is frequently associated with ST segment depression or T-wave inversion. However, the mechanism of ST-T changes in the context of various mechanisms of PSVT is not clear. The purpose of this study was to evaluate the prevalence of ST depression or T-wave inversion during PSVT and determine whether these changes are related to the mechanism of PSVT or the rate of the tachycardia. METHODS: Twelve-lead electrocardiograms were recorded during sinus rhythm and during PSVT in 163 patients who underwent an electrophysiologic study for ablation. Tachycardia cycle length, presence of ST depression or T-wave inversion during PSVT and the mechanism of tachycardia were evaluated. Significant ST depression was defined as at least 1mm horizontal or downsloping depression, measured 80ms after the J point and T-wave inversion as inversion of T-wave which was positive in the same lead during sinus rhythm. RESULTS: 1) The mechanism of PSVT analysed for ST segment depression was atrioventricular nodal reentry tachycardia in 60 cases and atrioventricular reentry tachycardia in 111 cases. The mean tachycardia cycle length was 373.8+/-68.0 msec. 2) ST depression and T-wave inversion was observed during PSVT in 56%(96/171) and 45%(77/171) of cases, respectively. 3) Tachycardia cycle length, degree of ST depression and number of leads with ST depression are not different according to the mechanism of PSVT. 4) ST depression and tachycardia cycle length had significant correlation, especially in atrioventricular reentry tachycardia. 5) Leads with T-wave inversion during tachycardia was observed more frequently in atrioventricular reentry tachycardia than atrioventricular nodal reentry tachycardia(p<0.05), but no difference between manifest and concealed bypass tract. CONCLUSIONS: ST segment depression is rate-related phenomenon and not different according to the mechanism of PSVT. Leads with T-wave inversion during tachycardia was observed more frequently in atrioventricular reentry tachycardia.
Depression* ; Electrocardiography ; Humans ; Prevalence ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Supraventricular

Among 51 intractanial AVM patients, 30 patients(58.8%) with AVM supplied mainly with PCA were studied for the relationship with feeding vessels, location and the size of AVM in connection with hemorrhage and also results in 20 surgical patients were analyzed. On cerebral angiogram, 56.7% accounted for AVM supplied only by PCA, 16.7% together with MCA and 26.6% with MCA and ACA. By location, 36.7% were for subcortical AVM and 63.3% were for deeply located paraventricular. 53.3% were large AVM and of them, 6.5% bleeded 30.0% accounted for small AVM, of which 88.9% bleeded. The total bleeding rate was high at 73.3%. Complete removal by surgery was available for 90.0%, and post operative improvement was at 75.0% with a mortality rate of 10.0%. 50.0% showed disappearance of seizure following total removal and 33.3% improved. 5.0%, however, had seizure for the first time following the surgery.
Hemorrhage ; Humans ; Mortality ; Passive Cutaneous Anaphylaxis* ; Posterior Cerebral Artery ; Seizures