BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons

Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism (usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.
Abdomen ; Actinomyces ; Actinomycosis* ; Chest Pain ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophagectomy ; Female ; Humans ; Lung ; Middle Aged ; Stents*

A clinical study was performed on 940 cases of essential hypertension observed at Dept. of Internal Medicine of Seoul National University Hospital during a period of last seven years from 1971 to 1977. The followings were the results: 1. The incidence of hypertensive patients was 13.8% among all medical in-patients and 68.2% among all cardiac in-patients. 2. The highest occurence was observed in sixth decade and accounted for 34.2% of all cases and least occurence was in second decade of life which accounted for 0.6% of all cases. No difference was found in age distribution between both sexes. The male to female ratio was 1.2:1. 3. The mean value of blood pressure was 178.1+/-21.8/107.4+/-12.3 mmHg and tended to increase with age at least over the decades from second to seventh and there was tendency to decrease after the eighth decade. No paticular difference in blood pressure levels was found in both sexes. 4. The most outstanding symptom was headache which was found in 51.5% of all cases. Dizziness, dyspnea and palpitation were the next orders in frequency. There was a general trend of the the subjective symptoms which were more pronounced in younger than older patients. 5. Hypertensive retinopathy was found in 83.3% of all cases. Hypertensive retinopathy of K-W grade II was found in 36.1% of all cases and was the most frequent finding among the Keith-Wagener grades. Malignant hypertension of K-W grade IV was found in 4.2% of all cases and the largest numbers were between the fourth and fifth decade of life. 6. The abnormal retinal finding was found to be rather proportional to the blood pressure levels. 7. Albuminuria was detected in 56.2% of all cases and it was more frequent in male than in female patients. 8. The appearance of albuminuria seemed to have a close correlation with hypertensive retinal change and blood pressure levels. 9. Electrocardiographic abnormalities were associated in 71.9% of all cases. The most frequent association among electrocardiographic abnormalities was left ventricular hypertrophy which accounted for 45.2% of all cases. There was the reverse correlation between the normal electrocardiogram and degree of blood pressures. The finding of left ventricular hypertrophy and degree of blood pressures were closely correlated. 10. Cerebrovascular accident, renal failure, congestive heart failure and atrial fibrillation were four major complications. It was recorded in 26.5%, 10.4%, 5.4% and 2.0% of all cases respectively. The complications were common in men than in women. 11. Renal failure, congestive heart failure and myocardial infarction were closely corelated with hypertensive retinopathy.
Age Distribution ; Albuminuria ; Atrial Fibrillation ; Blood Pressure ; Dizziness ; Dyspnea ; Electrocardiography ; Female ; Headache ; Heart Failure ; Humans ; Hypertension* ; Hypertension, Malignant ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Incidence ; Internal Medicine ; Male ; Myocardial Infarction ; Renal Insufficiency ; Retinaldehyde ; Seoul ; Stroke

Before impression making in the fixed restorations or other prosthesis, hemostatic solutions are used for hemostasis and moisture control. Hemostatic solutions effectively control bleeding but their major ingredients, acid removes smear layers which are formed in the tooth preparation, exposes the dentinal tubular orifices which are occluded by smear layers, makes dentinal tubular fluid displace more easily to the various external stimulus, and according to the hydrodynamic theory, consequently causes dentin hypersensitivity. To know the effect of hemostatic solutions on dentin permeability, coronal dentin discs, 1 mm in thickness, were prepared from extracted third molars free from decay and wear, and a spilt chamber device was used. Hydraulic conductance values and SEMs, which were measured before and after treatment with Astringedentr , Altract and Epri-dent , were compared and analyzed. The following conclusion were drawn : 1. Hydraulic conductance values which wee measured after the treatment of hemostatic solutions were increased in all groups(p<0.05). 2. %change values of hydraulic conductance were compared but no significant difference was found among the three hemostatic solutions(p<0.05). 3. on SEM observations of all groups, after treatment smear layers were removed and dentinal tubular orifices were partially exposed. on the basis of these conclusions, the reckless use of hemostatic solutions should be restricted, and when in use, various methods should be considered to protect dentin.
Dentin Permeability* ; Dentin Sensitivity ; Dentin* ; Hemorrhage ; Hemostasis ; Hydrodynamics ; Molar, Third ; Prostheses and Implants ; Tooth Preparation

The authors developed a computer program for use in report printing as well as data storage and retrieval for the gastrointestinal endoscopy service. This program used IBM PC XT and was written in dBASE III plus language. We applied the automatic SNOMED coding method, which is one of the most efficient and accurate method of computerization of medical data. The working sheet which contained the results of previous endoscopic studies could be printed during registration. The dBASE word processor enabled issuing of the formal report of endoscopic result, and the data storage was carried out during the typewriting of the report. Two kinds of data files were stored in the hard disk; the temporary file contained full informations and the permanent file contained patients identification data and SNOMED code. Searching of a specific case was performed by chart number, patients name, date of study, or SNOMED code within a second. All the cases were arranged by SNOMED codes of procedure, topography and morphology codes. Every new data was copied to the diskette automatically. with which data could be restored in case of hard disk failure. The main advantages of this program in comparison to the large main frame computer system are low price, flexibility and easy accessibility. Based on our experience (including surgical pathology department, radiology, clinical pathology), we assume that this program may fit every endoscopy room where there are less than 20,000 cases per year.
Information Storage and Retrieval ; Clinical Coding* ; Computer Systems ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Information Storage and Retrieval* ; Pathology, Surgical ; Pliability ; Systematized Nomenclature of Medicine

No abstract available.
Granuloma, Pyogenic* ; Port-Wine Stain*

A study of the volume and linear measurements of the breast to determine new nipple positions for 142 subjects was undertaken. Volume determination was done by using the Grossman-Roudner device. The size and shape of the female breast may differ significantly, and such size and linear measurements have to be measured accurately prior to breast aesthetic surgery. Statistical analysis of these results are closely related to physical constitution(height, weight, chest circumference). There have been increasing changes in linear measurement and decreasing changes in breast volume during the last 10 years, The results were as follows: 1) the mean distance from the midclavicular point to the nipple was 19.5cm, the distance from the sternal notch to the nipple was 19.4cm, the distance between nipples was 18.6cm, and the areolar diameter was 3.3cm, 2) the regression equation for the midclavicular point to the nipple was 7.236+ 0.00077x height(cm)+ 0.233 x weight(kg), for the sternal notch to the nipple was 8.845-0.0039 x height(cm)+ 0.214x weight(kg), for the distance between nipples was 11.192 - 0.0033xheight(cm)+ 0.151x weight(kg), and for the areolar diameter was 4.031+0.02xheight(cm)-0.048 x weight(kg),3) the mean value of breast volume of the left side was 209.6cc, and that of the right side was 211.8cc, 4) the regression equation for the mean breast volume was -137.673 + 6.668 x weight(kg), which was equal to -528.414 + 9.115x chest circumference under the axilla(cm) and -468.420 + 8.298 x chest circumference across the nipple (cm). In conclusion, these data could be useful for numerous aspects of breast surgery, including augmentation mammoplasty, mastopexy, reduction mammoplasty, and correction of asymmetrical breasts as the standard for Korean females, if we know the body constituents (weight, chest circumference) before surgery.
Breast* ; Female* ; Humans ; Mammaplasty ; Nipples ; Thorax

OBJECTIVE: The effects on spermatogenesis by expression of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were investigated. MATERIALS AND METHODS: Testicular specimens were obtained from 40 infertile males due to primary testicular failure and from 10 fertile males with other urologic problems. The specimens of infertile males were devided into 4 groups according to histologic findings; Sertoli cell only syndrome (A), maturation arrest (B), hypospermatogenesis (C) and sloughing and disorganization (D). VEGF and ET-1 expression were detected with immunohistochemical stain. RESULTS: VEGF expression on Leydig cell was detected in all cases. But, VEGF expression rates on germ cell were significantly higher in infertile group B, C, D compared to that of the control group (p<0.05). ET-1 expression rates on Leydig cell was significantly lower in all infertile group compared to that of the control group (p<0.05). But, ET-1 expression rates on Sertoli cell was significantly higher in all infertile group compared to that of the control group (p>0.05). In germ cell of infertile group, LH, FSH and prolactin were significantly decreased, and estradiol is increased in positive stain group on ET-1 immunohistochemical stain (p<0.05). VEGF and ET-1 expression were not correlated mean seminiferous tubule diameter (p>0.05). CONCLUSIONS: Abnormal spermatogenesis would be reflected in VEGF expression in germ cell.
Endothelin-1* ; Estradiol ; Germ Cells ; Humans ; Male ; Oligospermia ; Prolactin ; Seminiferous Tubules ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Testis* ; Vascular Endothelial Growth Factor A

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants

The current study evaluated DSM-IV psychiatric diagnoses and investigated the psychological characteristics of sexual offenders by using the Hypersexual Behavior Inventory(HBI), Sexual Addiction Screening Test (SAST), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Fifty male sexual offenders and 36 male healthy controls completed the psychiatric diagnosis and 30 of the 50 male sexual offenders completed the psychological tests listed above. Thirty-two of the 50 sexual offenders were patients with paraphilias, these sexual offenders had been admitted by the Ministry of Justice to the Institute for Forensic Psychiatry in Gongjui-si due to sexual violence. Participants displayed high lifetime rates of psychiatric disorders: 32 (64%) had paraphilias, 16 (32%) had depressive disorders, 10 (20%) had anxiety disorders, 9 (18%) had impulse control disorders, 6 (12%) had schizophrenia, 2 (4%) had bipolar disorders, and 16 (32%) had personality disorders or some other Axis II disorder. Scores for the sexual offenders were significantly higher both on the HBI and the SAST than the comparison group. Scores for the sexual offenders were also higher for the BDI and the BAI as compared to the control group, but this difference was not statistically significant. Results indicate that sexual offenders may have sexual addictions and be hypersexual. In addition to depressive and anxious psychopathologies, they also seem to have sexual psychopathologies. These results suggested that the psychopathology of sexual offenders may be different than that of a control group.
Anxiety ; Anxiety Disorders ; Axis, Cervical Vertebra ; Bipolar Disorder ; Criminals ; Depression ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Forensic Psychiatry ; Humans ; Disruptive, Impulse Control, and Conduct Disorders ; Male ; Mass Screening ; Mental Disorders ; Paraphilic Disorders ; Personality Disorders ; Psychological Tests ; Psychopathology ; Schizophrenia ; Sex Offenses ; Social Justice