The Acromioclavicular joint is classified as a diarthrodial joint. Its stability is maintained by articular capsule, acromioclavicular ligament, articular disc, coraco clavicularligament(trapezoid and conoid ligament) and attached muscles. 17 cases of acromioclavicular dislocation which had been seen at Seoul Red Cross Hospital during the period of January 1975 through December 1977 were studied. The following observations were made. 1. This injury is more prevalent in male (82%) with the peak incidence in the 3rd and 4 th decades (53%). 2. Conservative treatment was given in 11 cases by adhersive strapping around the elbow and lateral one third of the clavicle reinforced by Velpeau dressing for 3 weeks, then followed by active exercise. 3. Operative treatment consist of modified Phemister technique in 3 cases, Mumford technique in 2 cases, and Dewar and Barington's technique in 1 case. 4. Results were evaluated in 4 groups as excellent, good, fair, and poor according to Gerald weitzman's classification(1975). 5. Overall results of more than good (satisfactory) was obtained in 72.7% of the 11 cases with conservative treatment and in 50% of the 6 cases with operative treatment.
Acromioclavicular Joint ; Bandages ; Clavicle ; Clinical Study ; Dislocations ; Elbow ; Humans ; Incidence ; Joint Capsule ; Joints ; Ligaments, Articular ; Male ; Muscles ; Red Cross ; Seoul

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1--30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (+/-58.6) minutes; 2023(+/-50.7) minutes for the university hospitals and 164.2(+/-60.5) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the major reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430Won. Out of the total medical fee, 20,323Won(9.3%) was for the newborn nursery care. In case of C-section delivery six nights and seven days, who stayed otal medical fee was 732,578Won and out of the total fee 76,937Won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141Won for the tertiary care hospitals and 14,576Won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.
Education ; Fee Schedules ; Fees and Charges ; Fees, Medical* ; Hospitals, General ; Hospitals, University ; Humans ; Infant, Newborn* ; Insurance ; Investments ; Maintenance and Engineering, Hospital ; Nurseries* ; Nursing ; Nursing Care ; Nursing, Supervisory ; Pediatrics ; Salaries and Fringe Benefits ; Tertiary Healthcare

In accidents, the spines are generally subjected to one of five types of violence; pure flexion, flexion and rotation, extention, vertical compression, or direct shearing force by Holdsworth's report. Flexion and rotational violence, so-called, unstable rotational fracture-dislocation results in paraplegia commonly. The treatment of the fracture-dislocations of the thoracic and lumbar spine had varied widely during the past 100 years, including conservative and operative treatment, but there is no definitive study that convincingly show the superiority of either operative or nonoperative treatment till now. Ten cases of the unstable thoracolumbar vertebral fracture or fracture-dislocations during the past two years were reported in this paper. In unstable types on the thoracolumbar vertebral fracture or fracture-dislocations, direct blow was the most common cause of injury and the thoracolumbar junction extending from T10 to L1 was the most common location of injury in this report. Three among four paraplegic patients were received flexion and rotational violence and the remaining one, direct shearing force. All four paraplegic parients were operated. Among them two cases, the one who was performed open reduction and simple wire fixation and the other open reduction and Harrington instrumentation, recovered almost completely except mild motor weakness of lower extremities. All cases complained of remaining back pain more or less without relation to the method of treatment.
Back Pain ; Clinical Study ; Humans ; Lower Extremity ; Methods ; Paraplegia ; Spine ; Violence

Synovial Sarcoma is a very rare and highly malignant tumor. It is prevalent near the joints. Its peak incidence is from 3 rd to 6 th decade. It occurs almost at the upper and lower extremities and is also called as Sarcomesothelioma, Synovial Endothelioma, Malignant Synovioma and Synovioma. Three cases of Synovial Sarcoma which was treated at the department of Orthopedic Surgery, Seoul Red Cross Hosp. from 1968 to 1977 was reported.
Incidence ; Joints ; Lower Extremity ; Orthopedics ; Red Cross ; Sarcoma, Synovial ; Seoul

Joint deformity secondary to neoplastic involvement of the soft tissue has been well described and is easy to diagnose. Mesenchymema is a rare neoplasm which can arise at anyplace of the body and called as angiomyolipoma, lipomyohemangioma, fibromyxolipoma and etc. according to the composition of the various tissues. We experienoed a case of equinus deformity due to mesenchymoma of calf muscle. The patient was treated by excision and tendo calcaneus lengthening with satisfactory result.
Achilles Tendon ; Angiomyolipoma ; Congenital Abnormalities ; Equinus Deformity ; Humans ; Joints ; Mesenchymoma

Isoimmune hemolytic disease of the newborn due to anti-E is a disease characterized by the progressive neonatal hyperbilimbinemia and anemia which is caused by the IgG antibody transmitted from the mother to the ferns. Authors have experienced two cases of isoimmune hemolytic disease due to anti-E, who presented with jaundice on the first and the second day of life, respectively. The ABO and Rh blood types of their mother and father were B, CcDee and O, ccDEE, respectively. Both babies showed positive direct Coombs test and the mother showed strong positive indirect Coombs test. Antibody identification tests were made only in the first case and the mother, both of which revealed anti-E antibody. The first case was treated with phototherapy for 3 days and two blood transfusions. The second case was treated with phototherapy for 6 days and two exchange transfusions.
Anemia ; Blood Transfusion ; Coombs Test ; Fathers ; Ferns ; Humans ; Immunoglobulin G ; Infant, Newborn ; Jaundice ; Mothers ; Phototherapy ; Siblings*

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

BACKGROUND: Microlymphocytotoxicity test is most widely used for HLA Class l typing but almost all laboratories depend on imported HLA Class 1 typing trays. Matching criteria for the selection of HLA- matched platelets to treat platelet refractoriness is not as strict as for bone marrow transplantation. Therefore, with the acquisition of various antisera against high frequency HLA antigens, self-made HLA typing trays can be used for HLA typing of HLA-matched platelet donors. METHODS: 140 samples obtained during placental delivery were tested for the presence of HLA antibodies against a well-characterized panel of 90 cells. Specificity of HLA antisera were determined by evaluating the correlation coefficient r of the 2 x 2 table, x2 test. Antisera strength was evaluated by the strength index. RESULTS: HLA antibodies were detected in 25 samples by primary screening and 23 samples also showed a positive reaction in secondary screening(16%). Among 23 samples, 1 1 antisera were of reagent grade quality and 7 were monospecific antisera. DISCUSSION: Imported HLA typing trays can be replaced by harvesting HLA antisera against HLA antigens which are relatively common in Koreans through continuous HLA antibody screening using gushed out blood during placental delivery. (Korean J Blood Transfusion 10(1): 53-60, 1999)
Antibodies ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Histocompatibility Testing ; HLA Antigens ; Humans ; Immune Sera ; Mass Screening ; Sensitivity and Specificity ; Tissue Donors

The aim of this study was to investigate adult individuals' perceptions on the association between chronic diseases and oral health provide basic data required for motivating individuals to follow ideal oral health behaviors and boost their interests in oral disease prevention and treatment. Subjects in their 20s to 50s were selected through the convenience sampling method and eleven questions were set as factors and answered via self-administered questionnaires. To determine statistical significance, analysis of variance was used with the level of significance set at 0.05. The subjects' perception of the association between chronic diseases and oral health were analyzed with respect to their health behaviors. Individuals with relatively higher stress levels demonstrated higher levels of perception levels (p<0.05). Public education regarding the association between chronic diseases and oral health has not been ideally effective in South Korea. Thus, the general public's perceptions of the association between chronic diseases and oral health should be revised. In addition aspects regarding this matter should be enhanced within oral health education programs which often only focus on demonstrating the importance of oral health management so that individuals can get sufficient information on the association between chronic diseases and oral health.
Adult ; Chronic Disease* ; Education ; Health Behavior ; Humans ; Korea ; Methods ; Oral Health*