The delayed blanch is one of the most discussed but undecided facets of atopic dermatitis as yet. At present, they favor the theory that delayed blanch is due to vasoconstriction, but it is not obvious whether this is due to "true" vasoconstriction or to the blood vessels being narrowed by the surrounding exudative edema, resulted from vasodilatation and increased capillary per meability. We compared cutaneous response of severe atopic dermatitis with that of age matched non-atopic individuals after intradermal injection of acetylcholine by means of naked eye and laser Doppler flowmeter examination, control group showed flare and wheals while at,opy group resulted in delayed blanch in addition to flare and whealing. The results of laser Doppler flowmeter examination revealed that, as compared to baseline, atopy group showed statistically significantly increase in spite of delayed blanch. We suggested that the delayed blanch may be not due ta va.soconstriction but due to the vasadilatation and aceumulation of edema fluid.
Acetylcholine ; Blood Vessels ; Capillaries ; Dermatitis, Atopic* ; Edema ; Flowmeters ; Injections, Intradermal ; Vasoconstriction ; Vasodilation

No abstract available.
Korea*

237 patients with Legg-Calve-Perthes disease were treated during past 12 years. Among them, a comparative study was done for 87 patients who were followed up over 2 years. They were analyzed according to Catteralls classification and divided into a group of conservative treatment and of surgical treatment. 74 patients were boys and 13 patients were girls and the ratio of boys to girls was 5.7 to 1. The mean age was about 6.9-year-old. Bilateral involvement was observed in 6 patients. According to Catterall classification. 1(1.1%) was classified as group I, 27(29.0%) as group II, and 36(38.7%) as group III, and 29(31.2%) as group IV. According to assessment by Harrison et al., satisfactory result was achieved in 63.2% of cases of conservative treatment and 34.3% of cases of operative treatment. The measurement of epiphyseal quotient and femoral head sphericity(by Mose) were considered meaningful methods for assessing the result of the treatment. The most frequent one of “Head-at-Risk” factors was lateral subluxation of femoral head. The result of treatment was not always coincided with the classification by Catterall. In bilateral involvement, the first affected hip had better prognosis than contralateral one.
Classification ; Female ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Prognosis

The anterior cruciate ligament injury is one of the most common ligament injury of the knee joint, and anterior cruciate ligament is as important structure for stabilization as a primary restraint. Noyes reported that the diagnosis of a tek of the anterior cruciate ligament was made by the original treating physician in only 6.8%. And there are many controversies in its treatment. It is certain thatearly diagnosis and treatment are th most important clue. Authors studied 48 patients of isolated anterior cruciate ligament injury who were diagnosed by same physician from Jan. 1983 to Dec. 1985 after follow ups ranging from six mnths to 4 years, average beimng one year and two months. The results were as followings: 1. The most common cause was sports injury. 2. The most common sign and symptom were hemarthrosis in acute injury and giving way in chronic injury. 3. Anterior drawer test without anesthesia had 25% of diagnostic accuracy but pivot shift test under anesthesia 95.8%. 4. 31 cases in 48 cases (64.8) had associated meniscal injury. 5. In acute torn ACL, the primajy repair was preparable but conservative treatment with arthroscopic partial menisectomy was eful in chronic case.
Anesthesia ; Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Hemarthrosis ; Humans ; Knee ; Knee Joint ; Ligaments

No abstract available.
Purpura, Thrombocytopenic, Idiopathic*

Authors analysed 36 cases(33 patients) of Peroneal Buoy Flap to investigate branching pattern, course, length of vascular pedicle, and perforating level of the perforating cutaneous branches from Oct. 1985 to July 1988. The results were as follows. 1. The perforating cutaneous branchea were classified into four types, the Straight Branch (18 cases), the Proximal Oblique Branch (8 cases), the Branch from Muscular Artery (8 cases), the Distal Oblique Branch(2 cases) respectively. The most common patten was Straight Branch. 2. There were 3 pathways of these branches, the most common one passed between the Soleus and Peroneus muscles(23 cases, 64%), and second one passed through the snterior part of Soleus muscle(8 cases, 22%), the third one passed through the posterior part of Peroneus muscle(5 cases, 14%). 3. The length of vascular pedicle in Buoy Flap was variable from 3cm to 15cm, but 27 cases(75%) were distributed between 4cm and 6cm. 4. The perforating level of branches were 6.3cm in average from Fibular Neck, 88% of them were distributed within 10cm. 5. Peroneal Buoy Flap in possible to reconstruct both seperated bone and skin defect in some distance by One-Stage Operation.
Arteries ; Neck ; Skin

We studied 75 cases of conventional Kuntscher intramedullary nailing and 52 cases of interlocking intramedullary nailing from July 1980 to October 1988 for femur shaft fractures. The conventional Kuntscher intramedullary nailing was used for fresh fracture and the interlocking intramedullary nailing was used not only fresh fracture, but also unstable fracture, nonunion and pathologic fracture. The conventional Kuntscher intramedullary nailing was frequently used in middle one-third level, but the interlocking intramedullary nailing could be applied widely from subtrochanteric area to supracondylar level in femur. The average operation time in patient who had no associated injury was 3.6 hours in conventional Kuntscher intramedullary nailing and 3.25 hours in interlocking intramedullary nailing. Time period for union was much less in interlocking intramedullary nailing than conventional Kuntscher intramedullary nailing. Some kinds of immobilization was needed shortly in conventional Kuntscher intramedullary nailing but immediate postoperative ambulation was possible in interlocking intramedullary nailing. Interlocking intramedullary nailing can prevent the angulation, shortening and trochanteric bursitis due to migration of the intramedullary nail.
Bursitis ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Immobilization ; Walking

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine

The main problem in peripheral nerve repair is adhesion, axonal escape, and the ingrowth of extraneurial tissue into the wound. Meticulous microsurgical neurorrhaphy is one of possible answer for these problem. Shielding of nerve suture is another attractive practice. But the results are still unpredictable. We compared the results of nerve repair between microsurgical epineurial neurorrhaphy plus silastic cuff shielding group and epineurial neurorrhaphy group in the sciatic nerve of white rat. The reasults we obtained are as follows; 1. Silastic cuff shielding method was effective for reducing abnormal neurial growth and neuroma formation into the surrounding soft tissue. 2. Some adhesion was formed over the silastic cuff, but there was no adhesion at the inner space of the cuff. 3. Silastic cuff could prevent fibrous tissue ingrowth into the nerve. 4. The slit of the silastic cuff provided vascular ingrowth between surrounding connective tissue and nerve tissue. 5. No evidence of foreign body reaction was observed in and out of the silastic cuff. 6. Nerve conduction test showed a little supperior results in the silastic cuff shielding group. Silastic cuff shielding method in nerve suture might be recommanded to prevent axonal escape, fibrous scar tissue ingrowth to the nerve, and fibrous adhesion in clinical practice. But, it seemed that the final evaluation of the functional recovery of the nerve needed long term follow-up and nerve conduction study.
Animals ; Axons ; Cicatrix ; Connective Tissue ; Follow-Up Studies ; Foreign-Body Reaction ; Methods ; Nerve Tissue ; Neural Conduction ; Neuroma ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Sutures ; United Nations ; Wounds and Injuries

Four total knee arthroplasties were performed in 3 patients with the diagnosis of classical Charcot's joints associated with syphilis during past 4 years from 1985 to 1988. All patients had positive reaction in serology test(VDRL, TPHA). We corrected the bone loss and severe joint instability with allograft or autogenous bone grafting and ligament balancing. The knee score was increased from preoperative 37 points to postoperative 87.3 points. We expect that total knee arthroplasty may be the alternative treatment to the conservative treatment or knee arthrodesis in Charcots joints.
Allografts ; Arthrodesis ; Arthropathy, Neurogenic ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Bone Transplantation ; Diagnosis ; Humans ; Joint Instability ; Knee ; Ligaments ; Syphilis