Of the shoulder injuries in trauma, none are more common than those involving the acromioclavicular joint. There are many procedures described for treatment of injuries of the acromioclavicular separation but difficulties continues to be encounted. To know the functional anatomy of this joint and mechanism of injuries makes more proper treatment. We operated the 16 cases of acromioclavicular separation in the Dept of Orthopedic Surgery, Kyung Hee College of Medicine from January 1975 to August 1978. The following results were obtained. 1. This injuries is more prevalent in male with peak incidence in the third and fourth decades. 2. The mechanism of injuries were traffic accident, falling down and the other direct injuries with in orders. 3. The difference of distance between coracoid process and clavicle gives the information of Type II and Type III. 4. The operative procedures in Type II and Type III are good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Clavicle ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Shoulder ; Surgical Procedures, Operative

PURPOSE: Pachydermoperiostosis is a rare hereditary disease characterized by finger clubbing, periosteal reaction, and pachydermia. The underlying pathogenic mechanism of this disease remains unclear. This disease is known to be associated with a variety of diseases such as cranial suture defect, bone marrow failure, hypertrophic gastropathy, Crohn's disease, and female escuchen. METHODS: A 50-year-old male had digital clubbing of both hands, coarse hypertrophic skin changes of face, progressive thickening and furrowing on the scalp(cutis verticis gyrata), persistent pain in the limbs and joints. Other cutaneous features include moderate blepharoptosis, pole-like lower legs and feet. RESULTS: We performed surgical excision for hypertrophic skin change of scalp because of frequent eczematous skin change, severe itching sensation and cosmetic problem. Diagnosis is confirmed by bony proliferative periosteal reaction, pathologic findings, and characteristic clinical findings. CONCLUSION: Pachydermoperiostosis is manifested by finger clubbing, and hypertrophic skin changes causing coarse facial features with thickening and periosteal bone formation. We experienced a case of pachydermoperiostosis. Brief review of related literature is given.
Blepharoptosis ; Bone Marrow ; Cosmetics ; Cranial Sutures ; Crohn Disease ; Extremities ; Female ; Fingers ; Genetic Diseases, Inborn ; Hand ; Humans ; Joints ; Leg ; Male ; Middle Aged ; Osteoarthropathy, Primary Hypertrophic ; Osteogenesis ; Pruritus ; Scalp ; Sensation ; Skin

PURPOSE: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. MATERIALS AND METHODS: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). RESULTS: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands > or =20 Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. CONCLUSION: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
Brain ; Humans ; Parotid Gland ; Xerostomia

PURPOSE: Pancretojejunostomy leakage is the most dreaded complication after a pancratoduodenectomy. However, little is known about what causes the leakage and how to prevent it. The aim of this study was to dentify the risk factors for pancreatic leakage. This paper describes our experience of its management. METHODS: Between Aug. 1996 and Aug. 2003, 75 consecutive patients with periampullary cancer or benign disease received a pancreatoduodenectomy. The patients' clinical characterisitcs, pathological features and surgical findings were retrospectively evaluated. The patients were classified into those with major complication and rhose with no complications and the risk factors were analyzed. Pancreatic leakage, intraabdomnial fluid collection and abscess, intraabdomnial bleeding were categorized as major complications related to a pancreatic fistula. RESULTS: The postoperative mortality and morbidity rate was 2.6% and 36%, respectively. Univariate analysis showed that the pancreatic texture, pathologic diagnoses and comorbidity were significant risk factors for major complications (P= 0.003, 0.045, 0.02). Multivariate analyses revealed that the, pancreatic texture was the only significant risk factor (P=0.003). The preoperative serum albumin level and pancreatic texture were significant risk factors for pancreatic leakage (p=0.03, 0.025) and multivariate analysis showed that the pancreatic texture was also the most significant risk factor. CONCLUSION: Considering that the pancreatic texture is the most significant risk factor for a pancreatic fistula, the technical skill and experience of the surgeon appears to be important for its prevention.
Abscess ; Comorbidity ; Diagnosis ; Hemorrhage ; Humans ; Mortality ; Multivariate Analysis ; Pancreatic Fistula* ; Pancreaticoduodenectomy ; Retrospective Studies ; Risk Factors* ; Serum Albumin

BACKGROUND AND OBJECTIVES: Salicylates are well-known for producing reversible hearing loss and tinnitus. However, the site and mechanism of salicylate ototoxicity remain unresolved. Recent experiments suggest that reversible biochemical and/or metabolic changes in the cochlea seem to play an important role in salicylate ototoxicity. The purpose of this study was to investigate the site of lesion in salicylate ototoxicity by audiometric study. MATERIALS AND METHOD: ABRs and DPOAEs were observed after intraperitoneal injection of 500 mg/kg of sodium salicylate on 24 ears of guinea pigs. RESULTS: Salicylate produced a significant increase in the ABR threshold. Maximum changes were obtained in 4 hours, and recovered to the baseline in 24 hours after salicylate administration. The pattern of hearing loss shown by latency-intensity function was compatible with the cochlear type of hearing loss. The echo amplitude on DPOAEs at f2=2002, 4004 Hz was significantly decreased at 2, 4, 6, 8 hours, and returned to the baseline in 24 hours after salicylate administration. The time course of the change of DPOAEs was parallel with that of ABRs. CONCLUSION: These results reflect that the cochlear outer hair cells may be the main site of lesion in salicylate ototoxicity.
Animals ; Audiometry ; Cochlea ; Ear ; Guinea Pigs* ; Guinea* ; Hair ; Hearing Loss ; Injections, Intraperitoneal ; Salicylates ; Sodium Salicylate ; Tinnitus

BACKGROUND AND OBJECTIVES: Large doses or long-term use of salicylate may cause reversible tinnitus and hearing loss. The exact cause of salicylate ototoxicity in unknown. Decreased cochlear blood flow following reversible biochemical changes in the cochlea seems to play an important role in salicylate ototoxicity. Protopanaxatriol and protopanaxadiol saponin of the Panax ginseng are known to have a vasodilatory effect. We investigated the effect of Panax ginseng saponin on salicylate induced hearing loss in guinea pigs. MATERIALS AND METHODS: Guinea pigs were divided into two groups. The control group was injected with salicylate (300 mg/kg, IM) and the experimental group was pretreated with Panax ginseng saponin (100 mg/kg, IP) before salicylate injection. ABR threshold was measured hourly after salicylate injection. RESULTS: The control group showed a maximal hearing loss (20+/-3.54 dBnHL) in 3 hours after the salicylate injection. Comparing with the control group, the experimental group revealed a significantly different maximal hearing loss (5+/-3.54 dBnHL). CONCLUSION: These results suggest that the protopanaxatriol and protopanaxadiol saponin of the Panax ginseng can attenuate salicylate induced hearing loss.
Animals ; Cochlea ; Guinea Pigs* ; Guinea* ; Hearing Loss ; Panax* ; Saponins* ; Tinnitus

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.
Anxiety ; Dizziness ; Follow-Up Studies ; Humans ; Incidence ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Semicircular Canals ; Vertigo

OBJECTIVE: This study is designed to evaluate the relationship between bone mineral density (BMD) and life-style factors such as physical activity, smoking, and alcohol consumption and to offer the information for the modification of life-style. METHOD: Eight hundred and sixty nine inhabitants (354 males and 515 females whose age was 55.0+/-13.9 years- old) were participated in this study. BMD was measured in the right calcaneus by quantitative ultrasound (Mark 6000(R), Medison). Amount of physical activity, smoking, and alcohol consumption were got through the closely designed interview. Independent sample T-test and simple regression were used for data analysis. RESULTS: Amount of physical activities were 2656.8+/-732.3 cal/day, smokers were 329 persons (37.9% of inhabitants), and amount of alcohol consumption were 26.2+/-53.3 g/day. Increasing the amount of physical activity, BMD showed significantly higher T-score (p<0.01). Increasing the amount of alcohol consumption, BMD showed significantly lower T-score (p<0.01). BMD in smokers appeared significantly lower T-score than non-smokers (p<0.01). CONCLUSION: Life-style factors significantly effect on bone mineral density. Therefore prevention of osteoporosis through maintenance or augmentation of BMD needs proper physical activity, cessation of smoking, and no heavy drinking.
Alcohol Drinking ; Bone Density* ; Calcaneus ; Drinking ; Female ; Humans ; Male ; Motor Activity ; Osteoporosis ; Smoke ; Smoking ; Statistics as Topic ; Ultrasonography

BACKGROUND: In mitral stenosis with atial fibrillation, it is known that there is a significant linear correlation between end-diastolic mitral pressure gradient(EDMG) in cardiac catheterization and the corresponding RR interval. And using this, the equations to calculate the mitral valve area(MVA) in several heart retes has been inducing. However, as cardiac catheterization has a limitation not to be practiced repeatedly in all patients due to invasive procedure. In this study, using transthoracic doppler echocardiography, we tried to investigate the correlation of EDMG, RR interval and MVA and we tried to get the nomogram to predict MVA in different heart rates using it. METHODS: We made 9 patients an abject of this study whose measured MVA is from 0.5cm2 to 1.55cm2 by pressure half time(PHT) method among patients who have no any valvular heart disease except mitral stenosis with atrial fibrillation and whose condition is stable. We investigated the linear correlation between EDMG and RR interval, RR interval=a×EDMG+b(a ; slope, b ; intercept), using doppler echocardiography. We got the equation and nomogram to make an estimate of MVA with multiple regression analysis using the relation of measured MVA, slope and intercept. RESULTS: There was a linear correlation between EDMG and RR interval in all the patients. There was a mutual correlation of slope=53.0×(measured MVA)−101.2 between measured MVA and slope. There was a negative correlation of intercept=1,497−470×(measured MVA) between measured MVA and intercept. Using these, we could get multiple regression analysis equation, estimated MVA=0.0113×slope−0.0007×intercept+2.2497 and nomogram to estimate MVA. CONCLUSION: We could get the nomogram to estimate MVA easily using doppler echocardiography in mitral stenosis with atrial fibrillation.
Atrial Fibrillation ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography, Doppler ; Heart ; Heart Rate ; Heart Valve Diseases ; Humans ; Methods ; Mitral Valve Stenosis ; Mitral Valve ; Nomograms

Ventricular tachycardias(VTs) usually complicate iscemic heart disease. Cardiomyopathy or other organic heart disease and are aften associated with sudden cardiac death. Ventricular tachycardias with no apparent cardiac abnormalities, however, have been known to have different clinical features comprising a unique clinical entity among other tachycardias. Eleven patients(7men, 4 women) were investigated on their clinical features, electrophysiologic studies and late potentials. 1) The mean age at diagnosis was 23.4+/-6.5 years and the predominating clincal features were palpitation, syncope or congestive heart failure. No death occured over a mean follow up period of 29.2+/-26.5 months. 2) The resting ECGs were within normal limits in 8 patients and showed nonspecific ST-T changes in 3 patients. 3) Ventricular pacing induced sustained ventricular tachycardias in 7 patients and nonsustained VT in 1 aptient. Atrial pacing could provoke sustained VTs in 3 patients. 4) His bundle electrograms(HBE) were obtained in 7 patients during tachycardial. The HV intervals of the induced VTs distributed between 0 to -25msec in 5 patients and there was no definite His potentials in two patients. 5) The coupling interval of premature stimuli and the echo interval(the interval from the stimulus to the initiation of resulting VT) showed inverse relationship in 5 cases. No direct relationship was observed. 6) The termination mode, observed in 7 patients, showed delayed ternmination in 2 patients. 7) Late potentials(LPs) were pisitive in three patients but there was no significant statistical difference between LPs in normal control and those with idiopathic sustained left VTs. 8) Verapamil terminated VTs in 8 patients and slowed the rate of tachycardial in 1 patient. In conclusion, idiopathic sustained left ventricular tachycardias occur in younger age group and have more favorable prognosis. The findings of EPS and LPs suggest microreentry or triggered activity as their basic mechanism and verapamil can be used effectively for their termination.
Bundle of His ; Cardiomyopathies ; Death, Sudden, Cardiac ; Diagnosis ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Humans ; Prognosis ; Syncope ; Tachycardia ; Tachycardia, Ventricular* ; Verapamil