Dislocation of the clavicle at its sternal end is relatively rare, as compared with acromioclavicular dislocation. Among them, the posterior dislocation of the sternoclavicular joint was extremely rare. So, not more than fifty cases had been reported in the literature. Of these three main typesanterior, superior, and posterior-the anterior one is by far the most common. Most authors have stressed the difficulty in confirming the diagnosis with routine radiographs. We experienced a case of traumatic posterior dislocation of the sternoclavicular joint treated successfully by manipulative reduction. So, we report it with review of literature.
Clavicle ; Diagnosis ; Dislocations ; Sternoclavicular Joint

No abstract available.

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

PURPOSE: To evaluate the difference between the predicted postoperative refraction and the actual postoperative refraction after simultaneous vitrectomy and cataract surgery with sulcus fixation of an intraocular lens (IOL). METHODS: The records of patients with simultaneous vitrectomy and cataract surgery with sulcus IOL implantation (group 1) and with in-the-bag IOL implantation (group 2) were reviewed. We compared the spread between the predicted and actual refractive errors in the two groups. RESULTS: Group 1 consisted of 19 eyes in 19 patients and group 2 consisted of 23 eyes in 20 patients. The spread between the predicted and actual refraction (spread = actual-predicted) was -0.71 +/- 1.02 D in group 1 (p = 0.012) and -0.07 +/- 0.74 D in the group 2 (p = 0.86). The actual refractive errors in group 1 shifted toward myopia from the predicted in-the-bag refraction when compared with group 2. CONCLUSIONS: For the implantation of an IOL in the sulcus after simultaneous vitrectomy and cataract surgery, the IOL power should be approximately 1.0 D less than the power for in-the-bag fixation.
Cataract ; Humans ; Lenses, Intraocular* ; Myopia ; Refractive Errors* ; Vitrectomy

No abstract available.
Borrelia burgdorferi* ; Borrelia* ; Ixodes* ; Korea* ; Lyme Disease* ; Ticks*

BACKGROUND: The development of the medicine and the rise in the expectation of living has led the Korea into an aging society and the senior population in the Korea continues to grow. The objective of this study is to investigate the clinical features of geriatric ocular trauma in in a regional emergency medical center. METHODS: We retrospectively reviewed the medical records of 163 eyes of 146 patients older than 65 with ocular trauma who visited Emergency Room of Dongguk University Gyeongju Hospital from March 1, 2007 to February 29, 2012. RESULTS: In all patients, the incidence of the geriatric ocular trauma in patients over 65 was 7.3% (146 patients). And it was found to be 2.4 times more common in males (103 patients, 70.5%) than it was in females (43 patients, 29.5%). The mean age of patients was 70.7 years. Geriatric ocular trauma occurred mostly in the summer and the most common place of occurrence was the streets. Traffic accidents were the most common reason (35 patients, 24%) and the most common form of ocular trauma was the corneal erosion (42 patients, 21.1%). CONCLUSION: Through this study we found out the characteristics and the tendency of geriatric ocular trauma. And these results can be helpful in the prevention of geriatric ocular trauma and the improvement on treatment of geriatric ocular trauma.
Accidents, Traffic ; Aging ; Emergencies* ; Epidemiology ; Eye Injuries ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Retrospective Studies

Objectives: This study aimed to investigate the characteristics of early maladaptive schemas and their associations with clinical symptoms in patients with schizophrenia. Methods: Forty-eight patients with schizophrenia, 49 patients with major depressive disorder, and 50 healthy controls completed the Young Schema Questionnaire and symptom measures including the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Results: The schizophrenia group had significantly higher scores than the healthy controls and lower scores than the depression group in most schemas. Compared with healthy controls, the schizophrenia group exhibited higher scores in 10 schemas, i.e., mistrust, social isolation, failure, dependence, vulnerability to harm, enmeshment, insufficient self-control, subjugation, emotional inhibition, and negativity schemas (all p<0.001). Moreover, vulnerability to harm, enmeshment, subjugation, and negativity schemas were correlated with total scores of the BPRS-E (0.37≤r≤0.43, all p<0.05). Regarding the five BPRS domains, emotional deprivation schema showed significant relationships with negative (r=0.50, p=0.005) and disorganization (r=0.39, p=0.033) symptoms, while no schemas showed correlations with positive symptoms. Conclusion These results suggest that most schemas in patients with schizophrenia pertain to impaired autonomy and performance as well as disconnection and rejection domains and may improve our understanding and the treatment of schizophrenia from a perspective of schema therapy focused on these domains.

No abstract available.
Osteochondroma*

BACKGROUND: Several abnormalities of the autonomic regulation of the heart have been noted after acute myocardial infarction(AMI). Measurement of heart rate(HR) variability has been reported to provide indirect, noninvasive estimate of the cardiac efferent parasympathetic activity. The purposes of this study were to get the information on heart rate variability after AMI and to determine its relation to clinical and hemodynamic data. METHODS: We measured HR variability in 28 patients(23 men and 5 women : mean age, 56.6+/-10.4 years) 3-15days after AMI, in 25 patients with unstable angina and in 21 normal subjects by using triangular interpolation of the frequency distribution histogram om normalto-normal RR intervals from Holter tapes. RESULTS: HR variability was lower in AMI than unstable angina patients(357.9+/-118.6 versus 426.1+/-122.5 msec : p<0.05) and normal subjects(525.1+/-137.4 msec : p<0.025). There was no difference for infarct site, thrombolytic therapy, presence of Q-wave. HR variability was significantly related to mean 24-hour HR, left ventricular ejection fraction(all p<0.0001), left ventricular end diastolic diameter(p<0.05). HR varability was lower in patients belonging to Killip class 2-4 and who reqired the use of diuretics or digitalis(all p<0.05). CONCLUSION: After AMI, HR variabillity was reduced and significantly related to clinical and hemodynamic indexes of severity. Measurement of HR variability early after AMI may offer important clinical information for the early high stratification of patients.
Angina, Unstable ; Autonomic Nervous System ; Diuretics ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Infarction* ; Thrombolytic Therapy

Recent studies showed effective early recannalization of infarct-related artery achieved by intravanous urokinase, but dosage of urokinase is still arbitary. Thirty-five patients with acute trasmural myocardial infarction were treated with intraveous urokinase from April 1984 to October 1988. The incidence of coronary thrombolysis, left ventricula function and effect on fibrinolytic system were investigated. Inital 18 patients recieved 0.5 to 2.0 million unitis of urokinase and remaining 17 patients received 3 million units of urokinase intravenously for 1 hour. Thirteen of 17 patients(76.4%) with 3 million units but only four of 18 patients(22.2%) with 0.5 to 2.0 million units showed patent infarct-related coronary artery. Left ventricular function was significantly better in patients with patent infarct-related coronary artery, and the difference was marked in anterior myocardial infarction. There were three local bleeding at puncture site in 3 million units group, one of which required transfusion. Thus, intravenous infusion of 3 million units of urokinase provide rapid reperfusion of infarct-related coronary arterty and myocardial salvage is more lkiely to occur.
Arteries ; Coronary Vessels ; Hemorrhage ; Humans ; Incidence ; Infusions, Intravenous ; Myocardial Infarction* ; Punctures ; Reperfusion ; Urokinase-Type Plasminogen Activator* ; Ventricular Function, Left