The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

No abstract available.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans

No abstract available.

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

On July 3, 1928, the Wonsan Labor Union established the Wonsan Laborers' Hospital in Seoku-dong, Wonsan for the purpose of reducing medical consultation fees for its members. The union's efforts to improve the welfare of its members include the establishment of an educational institute, a consumers union, a barbershop, and a relief department. The Laborers' Hospital, which began with ten wards, was led by a team of two doctors, one midwife, two pharmacists, and four nurses. The two doctors were Cheol-sun Cha and Jeong-kwon Lee, and the midwife/nurse was Sun-jeong Kim. Union members received a 40% discount on medicine, and this was utilized by a daily average of 60 to 70 workers, or 21,000 workers annually. The Laborers' Hospital was clearly distinct from medical facilities founded as charity institutions in that funds were raised by the recipients themselves, and that the recipients formed a community based on their common status as laborers. However, the Wonsan Laborers' Hospital was shut down in roughly April 1929 due to the breaking of the general strike, and the heightened suppression of union activities prevented any additional opening of laborers' hospitals until Korea's liberation from Japan. Nevertheless, the history of the Wonsan Laborers' Hospital represents a key development in Korea's health coverage. It is not adequate to declare, as was the case in past research, Korea's health coverage to be simply an imitation of the Western system and lacking its own history. Despite some differences in scale and operation, the development of health coverage in the Korean peninsula is in line with the history of health coverage development in the West. The Wonsan Laborers' Hospital, founded and operated by the laborers themselves, thus holds great significance in the history of Korea's health coverage, The findings of this study are expected to stimulate new and more diverse discussions on the history of health coverage in Korea.
Asian Continental Ancestry Group* ; Charities ; Fees and Charges ; Financial Management ; Humans ; Japan ; Korea ; Labor Unions ; Midwifery ; Occupations* ; Pharmacists ; Strikes, Employee

Radial artery cannulation is a well established clinical technique for continuous monitoring of arterial blood pressure and serial sampling of arterial blood in critically ill patients. This method is regarded generally as safe, but complications are reported uncommonly. We report a case of false aneurysm of the radial artery following repeated puncture and catheter indweling for 8 days, and discuss briefly about the complication of arterial cannulation. It should be remembered that in arterial cannulation, we must use aseptic techniques, and the catheter must not be indwelt at one point for a long time.
Aneurysm* ; Aneurysm, False ; Arterial Pressure ; Catheterization ; Catheters* ; Critical Illness ; Humans ; Kidney Failure, Chronic* ; Punctures ; Radial Artery*

Cutaneous papillomas or acrochorda usually appear after the 4th decade of life in areas with skin folds. Conventional methods of removal are associated with bleeding problems, pain and prolonged sequelae. Thus, acrochorda removal with lasers has gained attention. In this study, we compared the efficacy of two popular laser types with different wavelengths and pulse widths for removal of skin tags. A 60-year-old Korean male noticed skin tags on his neck bilaterally. All tags were treated in a single session, on one side with a picosecond (ps)-domain 532 nm Nd:YAG laser and on the contralateral side with a long-pulsed (LP) 755 nm alexandrite laser. The endpoint for the ps-532 laser was immediate whitening, while that for the LP and quasi-LP (QLP) 755 lasers were visible changes on the surface of the lesion. Antibiotic ointment was applied, dressing was done and clinical photographs were taken. Both lasers effectively removed the skin tags at all settings in a single session without bleeding and with minimal discomfort. Crust formation occurred on both sides with natural shedding within 1 to 2 weeks. Transient erythema lasted longer in the tags treated with the ps-532 laser. At the 5th month of follow-up, residual lesions were detected on the field treated with the ps-532 laser. No persistent side effects such as scarring or postinflammatory hyperpigmentation (PIH) were observed. In conclusion, both the ps-532 nm Nd:YAG and the 755 nm alexandrite lasers ensured safe and effective removal of skin tags in a single session without adverse sequelae.

A 78-year-old male presented with an asymptomatic pinkish multi-nodular mass on his frontal scalp. The lesion had recurred twice after incomplete surgical excision. Initial punch biopsy was diagnosed with cylindroma. He revisited after one year with exophytic enlargement of the mass, and two staged Mohs micrographic surgery identified well-differentiated malignant cylindroma. Histopathology in the lower dermis and periosteal layer showed atypical cells with mitosis and hyperchromatic nucleoli with increased Ki-67 index of 10% to 30%. The postoperative wound was successfully treated with negative wound pressure therapy (NPWT) and secondary intentional healing. We report this case showing malignant transformation of solitary cylindroma, and good result for secondary intention healing using NPWT for postoperative defect.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent abscesses, nodules, and fistulous tracts. Recently, novel staging systems, including sonographic scoring system of hidradenitis suppurativa (SOS-HS), have been widely introduced in HS. Objective: To assess the efficacy of SOS-HS compared with Hurley staging and modified sartorius scoring (MSS) system and determine the necessity of ultrasound evaluation. Methods: A radiologist performed an ultrasound evaluation, and three dermatologists reviewed the images and videos. Clinical characteristics, including staging and demographic data, were recorded by three dermatologists. The correlation of each staging system and the significance of vascularity (Doppler mode) and lesion depth on sonography were statistically analyzed. Results: Among the 46 patients, 34.8% were classified as stage 1 and 3, and 30.4% were classified as stage 2 in the SOS-HS system, which was statistically higher than the Hurley staging (p＜0.0005). MSS score increased according to the SOS-HS stages (p＜0.0005, p=0.001). Vascularity and depth of involvement also increased with SOS-HS and Hurley staging. Conclusion Sonographic examination can be applied in HS severity assessment and documentation of the clinical characteristics of each lesion in detail. Special tools, such as Doppler mode and depth assessment, can also be useful in HS evaluation.