The ankle joint plays important biomechanical role in erect position or ambulation. The ankle injury includes bony structures with articular surface, ligaments and soft tissue injury. So the goal of treatment is anatomical reduction of ankle mortise. Fifty two patients of ankle fractures which were admitted and treated in Seoul Adventist Hospital from January, 1980 to December, 1984, were analysed in the clinical and radiological aspect. The results obtained from this study were as follows; l. Of the 52 cases, male was 39 cases(75.0%) and female was 13 cases(25.0%). The average age of the patients was 33 years with range from 18 years to 75 years. 2. The most common cause of injury was traffic accidident. Nexts were fall down, sports injury, slip down and industrial injury in orders. 3. The most common type of the ankle fractures, according to the classification of Lauge-Hansen, was supination-external rotation type(40.4%). 4. 36 cases(69.2%) were treated with open reduction and internal fixation and 16 cases(30.8%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 5. Accurate reduction and rigid internal fixation of the lateral malleolus without shortening was important factor. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Ligaments ; Male ; Seoul ; Soft Tissue Injuries ; Walking

Attention is a phenomenon hard to define, but can be conceptualized as a mental function ranging from sustaining readiness to perceive stimuli to understanding the nature and value and selecting stimuli that are most relevant to the given situation. Manifestations of attention include vigilance, and focused, directed, selective, divided, and sustained attentions. While basic attentional tone is controlled by the interaction among reticular activating system, thalamus, and prefrontal cortex, direction and selection of attention is controlled by neural circuits of prefrontal, posterior parietal, and limbic cortex. It is expected that understanding of attention and its neural could provide answers to the relationship between pathophysiology and clinical symptoms of some major psychiatric disorders. More effort are required to develop tools to assess more detailed and various aspects of attention in Korea.
Attention ; Korea ; Prefrontal Cortex ; Rabeprazole ; Thalamus

Recently atypical antipsychotics have been used as first line agent in the treatment of schizophrenia, and also played a significant role in the treatment of many kinds of psychiatric disorders. The pharmacokinetic and pharmacodynamic properties of these newer antipsychotics are well know through preclinical and early clinical trials. However, it is important to note the limitations of the results due to its relatively short experience. Clozapine is eliminated principally by the hepatic P450 1A2 and 3A4 cytochrome enzymes. 1A2 inducers such as carbamazepine and smoking can reduce its half-life, while 1A2 inhibitors such as SSRIs especially fluvoxamine can increase its duration of action. Carbamazepine should be avoided in a patient on clozapine because of carbamazepine's potential effects on bone marrow. Benzodiazepines tend to increase the chances of sedation delirium and respiratory depression. Risperidone is metabolized to 9-hydroxyriperidone by the hepatic P450 2D6 cytochrome enzymes. Fluoxetine and paroxetine, 2D6 inhibitors interfere with metabolism, but 9-hydroxyrisperidone has similar biological activity as parental drug, so it has little affect on the outcome. Olanzapine shows minimal capacity to inhibit cytochrome P450 isoenzymes and shows minimal chance of drug interaction. It is eliminated principally by the hepatic P450 1A2 and 2D6 cytochrome enzymes.
Antipsychotic Agents* ; Benzodiazepines ; Bone Marrow ; Carbamazepine ; Clozapine ; Cytochrome P-450 Enzyme System ; Cytochromes ; Delirium ; Drug Interactions* ; Fluoxetine ; Fluvoxamine ; Half-Life ; Humans ; Isoenzymes ; Metabolism ; Parents ; Paroxetine ; Respiratory Insufficiency ; Risperidone ; Schizophrenia ; Smoke ; Smoking

The study was undertaken to assess the ventricular system of the brain in normal korean adults on the base ofCT. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed atSeoul National University Hospital, were evaluated. The known to be a reliable indicator of the ventricular size.This ratio was measured at the level of the lateral, third and fourth ventricles respelctively. The shape of thequardigeminal and suprasellar cistern was analyzed. The resuls are as follows; 1. The cerebroventricular ratios ofthe lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30±0.04 and 0.14±0.02,respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than theright. 2.There was correlation between the cerebroventricular ratio and age, i,e., with increase of age, the C-Vratio increased slightly. 3. The cerebroventricular ratio of the third ventricle was 0.03±0.01. 4. Thecerebroventricular ratio of the fourth ventricle in width and height was 0.14±0.02 and 0.10±0.03, respectively.The anteroposterior position index of the fourth ventricle was 0.42±0.04. 5. The quadrigeminal cistern showedU-shape in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in10.5%. 7. There was no significant difference between male and female according to the above results.
Adult ; Brain ; Female ; Fourth Ventricle ; Humans ; Lateral Ventricles ; Male ; Third Ventricle

A case of postradiation sarcoma, found in a 52-year-old woman, who underwent a total hystrectomy under the diagnosis of cervical cancer 12 years ago, followed by radiation therapy. The tumor invasion was extensive involving the left innominate bon and upper end of the left femur including the head and neck. Histopathological findings revealed sarcomatous change with atypical osteoid formation and stromal proliferation. The case has been followed for 2 years since February 1974 and survives today.
Diagnosis ; Female ; Femur ; Head ; Humans ; Middle Aged ; Neck ; Osteosarcoma ; Pelvic Bones ; Sarcoma ; Uterine Cervical Neoplasms

Ninety cases of meniscus injury were treated by arthroscopic meniscetomy between March, 1988 and March, 1992. Eighty four cases were treated by arthroscopic partial, 5 cases by subtotal, and 1 case by total meniscectomy. All cases were followed up for more than 1 year. The results were as follows. 1. The ratio of male to female was 57 to 31, and that of right to left was 52 to 38. 2. There were 41 cases of medial meniscus and 49 cases of lateral meniscus. Longitudinal tears were 35 cases (39%), oblique tears were 20 cases (22%), horizontal tears were 15 cases (17%), and radial tears were 9 cases (10%). There was no difference in the shape of tear between medial and lateral meniscus. 4. The most common associated injury was anterior cruciate ligament tear. 5. The Tapper and Hoover scale was used to record the clinical results, and satisfatory results (exellent and good)were in 86% of cases.
Anterior Cruciate Ligament ; Clinical Study ; Female ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

Williams syndrome is a progressive and multisystemic disorder. We experienced one case of Willams syndrome which was characterized by elfin facies, mental retardation, diffuse aortic hypoplasia, mitral regurgitation and chronic nonparoxysmal sinus tachycardia. The tachycardia has been managing with beta-blocker successfully. We presented a case of unusual form of Williams syndrome with a reivew of literatures.
Facies ; Intellectual Disability ; Mitral Valve Insufficiency ; Tachycardia ; Tachycardia, Sinus ; Williams Syndrome*

A case of melorheostosis, which affected upon left upper extremity as monomelic type, was experienced at the Department of Orthopedic Surgery of Seoul National University Hospital in May 1971. We report this case with reference because of the rarity of melorheostosis and an addition of the case, a case with the literal reference is persented.
Melorheostosis ; Orthopedics ; Seoul ; Upper Extremity

Central to the question of anesthetic risk is the definition of an anesthetic death. This has yet to be defined within any reasonable limits. A number of factual and philosophical considerations have complicated attempts to derive a precise definition. Anesthetic risk is largely confused with surgical risk, involving a second set of persons and procedures. Only events between induction of anesthesia and onset of operation clearly relate the risk of anesthesia to patient diseases and the causes of deaths during and after operation are usually speculative. Among those factors which relate to anesthetic risk; age, physical status, surgical area, anesthetic method, selection of anesthetic agent, inadequate preoperative preparation, improper decision and skill of anesthesiologist himself, and elective vs emergency operations are most important in minimizing the anesthetic risk. Furthermore, elective vs emergency operations relate more to anesthetic mortality than to other factors. Many emergency operations were practiced in our hospital, more than in other institutions. Thus, our anesthesiologists are faced with a higher incidence of anesthetic risks. Evaluated results were as follows; 1) The percentage of emergency operations was 57.4% of the total performed operations. 2) The mortality rate is significantly higher in emergency surgical procedures than in elective surgical procedures, 3) Frequent changing of the operation schedule may cause confusion in the anesthesiologist's decision on preparation and selection of the anesthetic agent and technique, and may also cause an increased workload.
Anesthesia ; Appointments and Schedules* ; Cause of Death ; Elective Surgical Procedures ; Emergencies ; Humans ; Incidence ; Methods ; Mortality

PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes