The acromioclavicular and coracoclavicular ligament are usually injured by traffic accident or during sports. So, various methods of treatment has been introduced. Fourty four cases of acromioclaviclar and coracoclavicular ligament injuries were admitted and treated at Koryo General Hospital from March 1985 to February 1989. 26 cases were treated by operative method, 18 cases by conservative method in Grade 1, 2 and 3 injuries. The following results were obtained. 1. These injuries were more prevalent in male and more in left side. 2. The most common cause of injuries was traffic accident. 3. Among 44 cases, 13 cases were Grade 1, 9 cases Grade 2 and 22 cases Grade 3 by Allman's classification. 4. 18 cases were treated conservatively and 26 cases operatively. Conservatively treated 18 cases include 15 cases by Kenny-Howard sling and 3 cases by skillful neglect. And operatively treated 25 cases include 12 cases by modified Phemister method(46.2%), 2 cases by modified Bosworth method(7.7%), 2 cases by acromioclavicular plate method(7.7%), 2 cases by Stewart method(7.7%) and one case by Mumford method(3.8%). 5. There were good functional results with the K-wire fixation method after the acurate diagnosis by operative method in the Grade 2 injury. And in the Grade 3 injury we could get the functional results with the modified Phemister method.
Accidents, Traffic ; Classification ; Diagnosis ; Hospitals, General ; Humans ; Ligaments ; Male ; Methods ; Sports

No abstract available.
Neural Plate* ; Neuroectodermal Tumors*

BACKGROUND: All allografted heart valves procured from brain dead multiorgan donors should be considered contaminated. If propriety procurement, disinfection and storage of allografted heart valves are done, it allows significantly better host tissue ingrowth into the implanted leaflets and maintains the viability of the allograft valve over a prolonged period after transplantation. Therefore, it is necessary that any potential contaminants should be eliminated by using adequate antibiotic disinfecting solutions for minimum loss of tissue viability. The author performed this study to evaluate the microorganisms isolated from allografted heart valves and the effectiveness of CLPV (Cefoxitin, Lincomycin, Polymyxin B, Vancomycin) antibiotic solutions for sterilization. METHODS: The samples were procured from 10 pigs. A total of 130 cultures were done from 40 samples of touch swab, 10 samples of saline transport solution and each of 40 samples of nutrient media with antibiotics preserved for 24 hours and 14 days at 4degreesC. Among the total 130 samples, 50 were sampled before antibiotics treatment and another 80 were sampled after antibiotics treatment. Aerobic, anaerobic, mycobacterial and fungal cultures were done using all specimens. RESULTS: A total of 209 microorganisms were isolated from 23 out of 50 samples before antibiotics treatment. Among the 209 microorganisms, aerobes were found in 135 (65%), anaerobes in 57 (27%) and fungi in 17 (8%), respectively. Aerobic isolates were mainly Staphylococcus epidermidis, S. aureus, Enterobacter cloacae and Escherichia coli. Anaerobic isolates were Bacteroides fragilis, Porphyromonas intermedia and Clostridium paraputrificum. Fungal isolates were Candida albicans, C. krusei and Saccharomyces cerevisiae. CONCLUSIONS: It is necessary that all allografted heart valve for transplantation enter into a sterilization program. In this experiment, pre-treatment cultured organisms were not discovered after antibiotics treatment in all the samples. It was thus concluded that the effectiveness of CLPV solution for sterilization of heart valves was effective. The disadvantage was that the viability of the allograft after sterilization using CLPV solution was reduced. The author, therefore, proves the need for the development of more effective antibiotic mixtures with regard to cellular viability, host ingrowth rate, disinfection efficiency and valve survival rate.
Allografts* ; Anti-Bacterial Agents ; Aortic Valve* ; Bacteroides fragilis ; Brain Death ; Candida albicans ; Clostridium ; Disinfection ; Enterobacter cloacae ; Escherichia coli ; Fungi ; Heart Valves ; Humans ; Lincomycin ; Polymyxin B ; Porphyromonas ; Saccharomyces cerevisiae ; Staphylococcus epidermidis ; Sterilization* ; Survival Rate ; Swine ; Tissue Donors ; Tissue Survival ; Transplantation

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

Sixty-two patients with primary liver cancer were treated by surgical resection during a period of 10 years. There were 41 hepatocellular carcinomas, 19 cholangiocellular carcinomas, one mixed hepatocellular and cholangiocellular carcinoma, and one hepatoblastoma. Liver cirrhosis and positive hepatitis B surface antigen were noted in 78.0% and 75.7%, respectively, of the patients with hepatocellular carcinomas. In cholangiocellular carcinomas, clonorchiasis and hepatolithiasis were common associated diseases. The tumor was larger than 5 cm in 61.3% of the patients, and was multiple in 21.0%. Multiplicity of the tumor was more common in hepatocellular carcinomas, and regional lymph node metastases were present in 47.4% of the cholangiocellular carcinomas. The types of surgical procedures were a trisegmentectomy in one patient, an extended lobectomy in four, a lobectomy in 24, a segmentectomy in 12, a subsegmentectomy in 11, and a partial resection in 10. A curative resection with a negative resection margin was obtained in 75.8% of the patients. Operative morbidity developed in 29 patients (46.8%), and pulmonary problems, wound infection, and intra-abdominal abscess were common complications. The operative mortality was 3.2% (two out of 62 patients). The overall cumulative 5-year survival rate was 24.6%, and the median survival time was 14.0 months. The cumulative 5-year survival rate for hepatocellular carcinomas and cholangiocellular carcinomas were 28.2% and 20.0%, respectively. The presence of capsule formation, the absence of vascular invasion, a tumor-free resection margin, and the absence of associated liver cirrhosis were favorable prognostic factors. In patients with hepatocellular carcinomas, a high level of serum alpa -fetoprotein and a large tumor (over 5 cm) were significantly related to a shorter survival time.
Abdominal Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Clonorchiasis ; Hepatectomy ; Hepatitis B Surface Antigens ; Hepatoblastoma ; Humans ; Liver Cirrhosis ; Liver Neoplasms* ; Liver* ; Lymph Nodes ; Mastectomy, Segmental ; Mortality ; Neoplasm Metastasis ; Survival Rate ; Wound Infection

The epidemiology of children with cortical visual impairment(CVI)has been poorly defined till now, so the purposes of this study were to define the visual prognosis and prevalence of ophthalmologic problems in Korean children. The 20 children with follow-up of over 3 months were included out of 24 children diagnosed with CVI. The causes of CVI were periventricular leukomalacia in 7, congenital malformation in 4, and cerebral infarct or atrophy. Twelve of 19 children who had visual impairment at their initial visit showed visual improvement with follow-up. There were strabismus in 14, nystagmus in 6, and abnormal optic disc in 8 of the 20 children. All visualevoked response results were abnormal, but were not providing a more reliable prognosis in vision. The children who had abnormal electroencephalogram had poor visual prognosis as well as delayed developmental level. In conclusion, this study identified that children with CVI may be presented with a variety of ocular abnormalities, including strabismus, nystagmus, and abnormal optic disc. These findings suggest that a better understanding of the natural course will be required in children with CVI.
Atrophy ; Child* ; Electroencephalography ; Epidemiology ; Follow-Up Studies ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Prevalence ; Prognosis ; Strabismus ; Vision Disorders*

We retrospectively reviewed magnetic resonance image findings of primary CNS lymphomas in six patients. All patients showed parenchymal masses (n=8), a solitary mass in 4 and multiple in the other two. One patients showed leptomeningeal lesion. Parenchymal masses were located in forntal lobe (n=4), cerebellum (n=2), basal ganglia (n=1), and parietal lobe (n=1), These masses showed hypointensity on T1-weighted images (WI). On T2 WI, the signal intensity of mass was isointense to the brain parenchyma in 5 and hyperintese in 3. After Gadlinium-DTPA injection, seven lesions were enhanced homogeneously, and the margin of the mass was smooth in 5 and irregular in 3. Peritumoral edema was moderate in 4, absent in 3, and severi in 1. These characteristics may be useful in the diagnosis of primary CNS lymphoma.
Basal Ganglia ; Brain ; Cerebellum ; Diagnosis ; Edema ; Humans ; Lymphoma* ; Magnetic Resonance Imaging* ; Parietal Lobe ; Retrospective Studies

In contrast to younger patients, geriatric patients are generally considered to be a poor risk for anesthesia and surgery and greater care should be taken in anesthetic management, because many have chronic systemic diseases in addition to a decrease in physiologic function. To evaluate geriatric anesthetic experiences, we received clinical records of 1,062 patients aged over 65 out of 21,656 surgical cases performed at Korea University Hye-Wha Hospital from January 1980 to December 1986. The cases were analysed according to age, sex, department, preoperative physical status, anesthetic techniques and agents, duration of anesthesia, operation site, length of hospital stay, laboratory data(Chest X-ray, EKG), associated diseases, postoperative complications and mortality. The results are as follows: 1) Of the 1,062 geriatric surgical patients, 516 cases(48.6%) were 65~69 years of age. 2) The number of geriatric surgical cases was 1,062 of which 672(63.3%) were male and 390(36.7%) were female. 3) Most surgical cases were general surgery(401 cases, 37.8%). 4) The rate of elective and emergency surgery was 78.0%(829 cases) and 22.0%(233 cases), respectively. The ratio of insurance patients (737 cases, 69.4%) versus noninsurance patients(325 cases, 30.6%) was approximately 2:1. 5) The number of general anesthesia cases was 777 (73.2%), spinal anesthesia 244( 23.0%), epidural anesthesia, 21(.20%), and brachial plexus block, 5( 0.5%). The anesthetics were thalamonal and meperidine hydrochloride(238 cases, 22.4%), halothane(204 cases, 19.2%) and tetracaine(244 cases, 23.0%). 6) The duraion of anesthesia was within 1hour in 88 cases( 8.3%), 1~2 hours in 421 cases(39.6%), and 2~3 hours in 291 cases(27.4%). 7) The number of lower abdominal surgery cases was 497 (46.8%) and the number of upper abdominal surgery cases was 188(17.7%). 8) Preoperative laboratory findings were as follows: The findings of preoperative chest X-rays revealed that 219 cases(21.4%) were within normal mits. 182 cases(17.8%) had hypertensive heart, and 208 cases(20.4%) had atherosclerosis. The EKG, which was done on 90.8% of the patients, revealed that 333 cases (34.5%) were within normal limits, 77 cases(8.0%) showed left ventricular hypertrophy, 65 cases(6.7%) showed sinus bradycardia, and 27 cases(2.8%) showed myocardial ischemia. 9) Hypertension(88cases, 49.4%) was the most commonly associated disease. 10) The total number of postoperative complication cases was 73(6.9%). Seventeen cases showed wound infection and delayed skin closure, 19 cases showed pneumonia, and 7 cases showed atelectasis. 11) The total number of postoperative deaths was 18 cases(1.7%).
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Anesthetics ; Atherosclerosis ; Brachial Plexus ; Bradycardia ; Electrocardiography ; Emergencies ; Female ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Insurance ; Korea ; Length of Stay ; Male ; Meperidine ; Mortality ; Myocardial Ischemia ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Skin ; Thorax ; Wound Infection

OBJECTIVE: The purpose of this study was to measure and compare temporal lobe volumes of geriatric depressive patients and normal controls. Temporal lobe volume was measured with computerized volumetric technique using brain MRI films. METHOD: We studied 15 patients of 50 years or older with major depressive disorder (MDD) and 14 normal control subjects, measured temporal lobe volumes and cerebral volumes of both groups using semi-automated imaging analysis program from brain MRI films. A statistical analysis was done to compare right and left volumes in both groups and to compare right and left volumes in each group. The comparison of right and left volumes between early-onset MDD group and late-onset one and correlation with duration of illness of MDD group were taken too. RESULTS: There was no difference in right and left temporal volumes between MDD group and normal control (right p=.760, left p=.219) but there was statistically significant difference between right and left volume in normal controls who have larger right temporal lobe volume than left temporal lobe volume (p=.002) compared to MDD patients who have no difference between right and left temporal lobe volume (p=.644). In MDD patients, there were no difference between early-onset MDD group and late-onset one and no correlation of volume with duration of illness. CONCLUSION: This study aiming at identifying the structural change of brain in geriatric depressive patients did not reveal any difference of temporal lobe volume between MDD patients and normal controls, and between right and left temporal lobe in geriatric MDD patients. The loss of laterality in patients was partially identical with the previous results of other studies, so it needs further following studies which have larger size of subjcets with various implicated variables and more fine brain structures.
Brain ; Depressive Disorder, Major ; Humans ; Magnetic Resonance Imaging* ; Temporal Lobe*

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography