No abstract available.
Ovotesticular Disorders of Sex Development*

No abstract available.
Lower Extremity* ; Melanoma*

No abstract available.
Free Tissue Flaps* ; Neck*

Alopecia areata is a relatively common disorded but the exact psthogenesis is still unknown and there is no satisfactory treatment. Recently contact immunotherapy has been studied with dinitrochlorogenzene(DNCB) which is known to have in vitro mutagenecity limiting its clinieal application. In contrast, diphencyprone (DPCP) is a potent contact sensitizing agent which is not known to be mutagenic. We treated 40 patients with alopecia areata who were refraetory to standard treatment.DPCP was dissolved in acetone in concentrations of 0.0001 2%. After sensitization, DPCP was topically applied to the right side of the scalp with left side sewing as control. After obvious hair growt,h, DPCP was applied on both sides of the scalp. A positive respanse was defined as growth of terminal hairs on the scalp. The response rate was estimated by determing the percentage of hair covered areas com- pared to the total area of the scalp. The results were as follows. 1) Of 20 patients who were followed over 3months, 9 patients(45% ) showed positive response, and 6 patients(30%) showed almost complete regrowth of terminal hairs (above 90% of scalp area). 2) The response time varied from 4 weeks to 33 weeks, with average duration of 10.6 weeks. 3) Nine out of forty patients developed side effects such as severe contact eczema, cervical lymph node swelling and vitiligo. Three out of 40 patients had to discontinue therapy due to side effects. 4) Patients with mild alopecia areata ganerslly showed a higher response rate(50%) than those with alopecis totalis(33%) and alopecia universalis(43%), but the differences were not statistically signifieant(p>0.05). 5) No correlation was found between reaponse rates and clinical factors such as age, sex and duration ot the disease. In conclusion, treatment with DPCP was thought to be effective in patients with alopecis areata who were refractory to standard treatment. Further long-term studies may be neees- sary to find out clinical course of the disease after trestment, and long-term safety of this treatment.
Acetone ; Alopecia Areata* ; Alopecia* ; Dermatitis, Contact ; Hair ; Humans ; Immunotherapy ; Lymph Nodes ; Reaction Time ; Scalp ; Vitiligo

BACKGROUND: Pharmacological stress tests for the diagnosis of GH deficiency are unpleasant, labor intensive and potentially dangerous. Reports on urinary GH measurement for the assessment of GH have been published after highly sensitive immunoassaies were developed. The aim of this study was to determine whether a 24- hour urine GH as an alternative method for GH assessment were reliable in predicting GH deficiency defined by L-dopa stimulation test. METHODS: Thirty women, ages 45 to 67, were studied. L-dopa stimulation tests were performed with an ingestion of 500 mg of L-dopa. Serum GH and IGF-1 were measured by a radioimmunoassay using commercially available reagents and uGH was estimated from the 24-hour urine. Then, the mean and its distribution of uGH values were compared according to the GH status defined by L-dopa stimulation test. RESULTS: The correlation between the uGH and the peak values after L-dopa stimulation test was significant (r=0.46; p<0.01). The mean value of uGH in the GH deficiency group was significantly lower than that of the normal group P<0.05). But because of the broad overlap of uGH in the two groups uGH showed no good separation GH deficiency from normal group although uGH reflects GH status significantly. CONCLUSION: uGH reflects GH status significantly, but because of broad overalp uGH couldn't separate GH deficiency form normal group defined by L-dopa stimulation test.
Diagnosis ; Eating ; Exercise Test ; Female ; Growth Hormone* ; Humans ; Indicators and Reagents ; Insulin-Like Growth Factor I ; Levodopa ; Radioimmunoassay

No abstract available.
Adult* ; Growth Hormone* ; Humans

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

In order to group the pelvic obliquity into clinically useful classification and to develop appropriate guidelines for treatment, we evaluated 55 patients who had been treated between 1985 and 1993 for pelvic obliquity after poliomyelitis. Age at surgery ranged from 15 years to 49 years (average 27 years). Fixed pelvic obliquity after poliomyelitis was classified into two major types according to the level of the pelvis relative to the short limb and into four subtypes in each type according to the direction and severity of scoliosis. Forty-six patients had obliquity with the pelvis down (type I), and nine patients had the pelvis up (type II) on the short limb side. Subtype A: straight spine with localized lower lumbar compensatory angulation, mainly at the L4-5 intervertebral space. Subtype B: mild scoliosis with convexity to the short limb side, Subtype C: mild scoliosis with convexity opposite to the short limb side. Subtype D: moderate to severe paralytic scoliosis, which has a convexity to the short limb side in type I and opposite to the short limb side in type II. In the pelvis of type I-A, I-B and I-C deformities, abduction contracture of the hip was released on the side of affected short limb, and lumbodorsal fasciotomy was performed on the contralateral side of short limb, where iliolumbar angle converged and the pelvis was elevated, if necessary. In most cases, hip instability existed on the side of short limb and it was treated with triple innominate osteotomy, which also contributed to leg length equalization by lengthening. In type II-A, II-B and II-C deformities, it was necessary to perform a triple innominate osteotomy on the side of affected short limb with adducted unstable hip in most cases. Lumbodorsal fasciotomy was performed above the iliac crest of elevated hemi-pelvis with short limb, where iliolumbar angle converged. In case of abduction contracture of contralateral hip, contracted fascia was released. In the pelvis that had a type I-D or type II-D deformities, treatment might include bony surgeries such as spinal fusion or triple innominate osteotomy, with appropriate soft tissue release. We propose a systemic and comprehensive classification for fixed pelvic obliquity after poliomyelitis. According to this classification, we and decide to combine corrective surgeries, and find the side where the surgery should be performed.
Classification ; Congenital Abnormalities ; Contracture ; Extremities ; Fascia ; Hip ; Humans ; Leg ; Osteotomy ; Pelvis ; Poliomyelitis ; Scoliosis ; Spinal Fusion ; Spine

BACKGROUND: HBsAg carriers are 6-12% of population in Korea. The patients knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. METHODS: From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctors recommendation. RESULTS: Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positve, 10% answered HBsAg negative, and 26% answered I dont know. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% from carrier mother at birth, 29 % by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctors recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). CONCLUSIONS: The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctors recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.
Biomarkers ; Coitus ; Education ; Follow-Up Studies* ; Health Promotion ; Hematologic Tests ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Neoplasms ; Mothers ; Parturition ; Postal Service ; Ultrasonography ; Vaccination ; Surveys and Questionnaires

The purpose of this study was to investigate kinetics of the osteblast cell lineage in the periosteum and endosteum according to different distraction rates in callotasis of rats' Tibiae. 120 rats underwent osteotomy at the proximal metaphysio-diaphyseal junction of the left tibia for callotasis. Lengthening was started with varying distraction rates of 0.25 mm (group I), 0.5 mm (group II), 0.75 mm (group III), 1.0 mm (group IV) until 3.5 mm length gain was achieved. The animals that had osteotomy alone without lengthening served as a control(group V). Immunohistochemical staining of proliferating cell nuclear antigen(PCNA), osteocalcin and transglutaminase C(TGase C) were done on the four animals on each group sacrified at post-distraction 1, 3, 5, 7, 14, 28 days in order to observe the temporal changes among the experimental and control groups. At each examination, radiographic and histological studies were also done in order to correlate the immunohistochemical findings. The results obtained are summarized as follow; 1. The staining rate of PCNA was highest at the early distraction(day 1) phase and subsequently decreased in all groups. The staining rate of the cells in the periosteum was significantly higher than that of the cells in the endosteum (p < 0.01). 2. The expression rates of osteocalcin in the periosteum of all groups were significantly higer than those in the endosteum (p < 0.01). 3. The expression rates of TGase C in the periosteum of all groups were significantly higer than those in the endosteum (p < 0.05). 4. Radiological and histological studies revealed that successful regenerate bone healing was achieved in groups, I, II and III but not complete in group IV. In conclusion, immunohistochemical study on callotasis of rats' tibiae revealed that the osteoblast cell lineage in the periosteum is more activated than that in the endosteum for proliferation and differentiation by distraction, suggesting that the periosteum plays a more important role in neo-osteo-genesis in the distraction gap. Daily distraction rate range of 0.25 mm to 0.75 mm in two increments is the appropriate for successful distraction osteogenisis of rat's tibia, but the rate of 0.25 mm a day is significantly better than that of 0.75 mm upon immunohistochemical observation.
Animals ; Cell Lineage ; Kinetics ; Osteoblasts ; Osteocalcin ; Osteogenesis, Distraction ; Osteotomy ; Periosteum ; Proliferating Cell Nuclear Antigen ; Rats ; Tibia