To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine

Shortening and angular deformities in children are one of important orthopedic management problem. Conceptually, lengthening of the short side in treatment of limb length inequality is, in most instance, the most attractive approach to this problem. Throughout the evolution of lengthening procedures, the method that has remained most consistently acceptable is osteotomy followed by gradual distraction. However, the idea of increasing the length of or modifying the axis of s bone during growth by means of distraction of the grwoth plate is relatively new. Recently, Monticelli and Spinelli have had experience with a new and novel method of lower limb lengthening by physeal distraction. We have studied the results of effect of distraction epiphysiolysis and the use of nonsteroidal anti-inflammatory agents to impede bone bridge as well as premature epiphyseal closure. There are some reports in which indomethacin could prevent reformation of a bone bridge between the epiphysis and metaphysis without inhibiting normal growth and bone remodeling. For this study, a total of 30 rabbits with an initial weight of about 600 gram was used. At operation two K-wires(l.lmm in diameter) were drilled percutaneously on parallel trscks through the epipaysis and diaphysis of proximal tibia. Epiphyseal distraction of Turnbuckle type designed at our school was applied on each side of K-wire insertion at the tibia. The correct position of pin was confirmed by radiography and the rate of distraction is 0.5–1mm per day. Distrsction was continued for 3–6 weeks and radiographs was taken every 2 weeks. Some rabbits was sacrified sfter removal of distractor. Through these examination, following results were obtained. 1. Seperation of the epiphysis from the metaphysis occurred after average 3 days, and it always occurred in the zone of provisional calcification. 2. Short term results of growth plate distraction looked promising and longer limbs were seen, but long term results were unsstisfactory with premature epiphyseal closure and bone bridge formation occuring in many cases. 3. The role of indomethacine to impede bone bridge formation across the seperated growth plate could be observed, and was found that shortening could be possibly decreased. 4. Distraction epiphysiolysis would be one of valuable leg lengthening procedure at an age when the subjects bone growth is nearly complete, and also the administration of indomethacin with growth plate distraction might be effective to diminish the significant Change of shortening or angulation in high-risk juvenile fractures.
Anti-Inflammatory Agents, Non-Steroidal ; Bone Development ; Bone Remodeling ; Child ; Congenital Abnormalities ; Diaphyses ; Epiphyses ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Indomethacin ; Leg ; Lower Extremity ; Methods ; Orthopedics ; Osteotomy ; Rabbits ; Radiography ; Socioeconomic Factors ; Tibia

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue

In analyzing the postoperative results or evaluating the velopharyngeal incompetence after palatoplasty, speech evaluation is the inevitable factor. However, a standardized method for evaluating the speech problem in Korean cleft palate patients has not been available until now. So, the authors tried to establish a method of speech evaluation which is simple, economic and applicable to young patients, and to make a scoring method of the speech results in cleft palate patients based on the 'hypernasality diagnosing tool for cleft palate patient (OK Ran Jung)' which is commonly used by domestic speech therapists. The authors adopted the 'hypernasality diagnosing tool for cleft palate patients (OK Ran Jung)' male and female of children and adults, each consisting of 10 patients and make them speak according to the items about hypernasality and misarticulation evaluation, and record the results. We also calcuted the degree of the formants of the vowels (/a/, /o/, /u/)using sound spectrography. We examined the interjudge and intrajudge reliance of speech evaluation among the 10 inverstigators, revised the evaluation tool, devised the scoring method according to the above results, and compared the scoring results with those of sound spectrography to prove the reliance of our speech evaluation tool. With the scoring method, the authors could estimate the degree of hypemasality and misarticulation in cleft palate patients with evidence of reliability based on point-to-point agreement in two items. In comparing the results of our scoring method with the formant of vowels using sound spectrography, staistical significance existed except /u/F2 and that meant that our scoring method was reliable. We suggest that this simple, economic and reliable method of speech evaluation in cleft palate patients can create the basis for speech evaluation in patients of cleft palate and velopharyngeal incompetence under circumstances in which the results of various speech treatments are evaluated in comparison to various methods of speech evaluation.
Adult ; Articulation Disorders ; Child ; Cleft Palate* ; Female ; Humans ; Male ; Research Design ; Sound Spectrography ; Velopharyngeal Insufficiency

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nose* ; Stents

The search for the ideal augmentation material of facial soft tissues has been an ongoing effort for many years. Injectable soft tissue substitutes provide an affordable, non-surgical alternative for correcting contour defects in facial skin. A safe and effective material for this purpose should respect certain characteristics that it should be biocompatible, non-antigenic, nonpyrogenic, noninflammatory, noninflammatoy, nontoxic, easy to use, stable after injection, non-migratory, long-lasting but reabsorbable, natural looking and not too expensive. Although many biomaterials are currently on the market, none meets all the above criteria. The recent development of hyaluronic acid gels(Restylane ) for dermal implantation is therefore particularly interesting in treating the aging face. Restylane is produced in cultures of Equine streptococci by fermentation in presence of sugar, the hyaluronic acid chains are then chemically stabilized through permanent epoxidic cross-links that the manufacturer reports to alter only about 1% of the hyaluronan molecular network. The resulting viscoelastic transparnet gel, suitable for intradermal infection, has a concentration of 20 mg/ml, is delivered in disposable syringes (0.7 ml) ready for use, using a 30 gauge needles. The twenty-one patients in thirty area were treated with facial intradermal implantation of hyaluronic acid gel for augmentation therapy of wrinkles and folds for recoutouring. The results were evaluated in all patients by subjective judgment by the physician and the patients. This study provides a clinical evaluation of safety and efficacy of a cross-linked stabilized non-animal hyaluronic acid gel to determine its characteristics, advantages, disadvantages, and side-effects in Korean. We concluded that Restylane implantation was soft, easy to use and long lasting effective materials in augmentation therapy of soft tissue of face.
Aging ; Biocompatible Materials ; Fermentation ; Humans ; Hyaluronic Acid ; Judgment ; Needles ; Skin ; Syringes

Augmentation mammoplasty can be done in various manners according to the way of approach. the type of implant or implatation site depending on the status and demand of the patients or the operator's preferrence. In reviewing the many published reports about augmentation mammoplasty, they compare their surgical outcomes with mixed factors, so it is difficult to compare the results of mammoplasty simply with one factor under the same conditions. We think that analyzing the surgical results with one consistent method enables to compare and decide the influencing effect of one factor within it in augmentation mammoplasty. We could find the fact that the Korean women who wanted augmentation mammoplasty had same physical characteristics and demands, so developed the standardized method of augmentation mammoplasty among those debatable data for the purpose of increasing the patients' satisfaction, decreasing the complications, and shortening the operation time. The method we adopted was placing the implant through transaxillary subpectoral approach and using the endoscope auxiliarily in additional dissection and hemostasis. We employed saline-filled implants of round, textured type with the size ranging fro 125cc to 175cc and overinflated them by 10 to 30% beyond its original volume. After irrigation of the dissected pocket, we placed the suction drainage system into the subpectoral pocket. We educated the patients to massage their breasts right after removal of the drain. During the period of follow-up (from 6 months to 24 months), most of the patients were satisfied with their operative results. Though we experienced one case of capsular contracture, one case of malposition of the implant, and three cases of scar contracture on axillar incision site, as a whole, we could minimize the complications associated with augmentation mammoplasty. We present our postoperative results with the conclusion that our standardized method of augmentation mammoplasty can bring results of high satisfaction rate, minimal complication, predictability of postoperative results, shortening of operation time when applied consistently to the Korean patients whose physical characteristics are similar. We also hope that stanadardized method can be used to compare the influencing effect of many factors in the case of changing one factor within the standardized in the future follow up period.
Breast ; Cicatrix ; Contracture ; Endoscopes ; Female ; Follow-Up Studies ; Hemostasis ; Hope ; Humans ; Mammaplasty* ; Massage ; Suction

Hair takes a great role in featuring man's appearance and absence of hair can causes troubles in physical and psychological aspects. Many efforts have been made to treat male pattern baldness, including medical therapy and surgical correction, but there is not a definite and eternal method of treatment. Even though the diagnosis of male pattern baldness can be made with its characteristic clinical manifestations, histopathological study must be done for definite diagnosis. Author obtained biopsy material from the frontal progressive baldness area and the occipital non-baldness area with punch biopsy in 20 patients who were diagnosed to be Type II and III male pattern baldness according to the Norwood classification. A comparative study was done in the basis of histopathology using serial vertical section of the biopsy materia with the aid of light microscope and the results are as follows : 1. The average number of total hair in the frontal area was on third than that of occipital area and the number of anagen hair was less in the frontal area. The number of telogen hair in the frontal area was seven times more than that of occipital area. 2. The thickness of epidermis and dermis in the frontal area was thinner than that of occipital area. 3. The infiltration of inflammatory cells in the periadnexal field like blood vessels, hair follicles, sebaceous glands, eccrine glands was more prominent in the frontal area than in the occipatal area. 4. Perifollicular fibrosis and hypertrophy of arrector pilli muscle were more remarkable in the frontal area compared with that of occipital area. 5. There was no difference between the frontal and occipiral area in the number of lobules of sebaceous glands.
Alopecia* ; Biopsy ; Blood Vessels ; Classification ; Dermis ; Diagnosis ; Eccrine Glands ; Epidermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Hypertrophy ; Male* ; Sebaceous Glands

No abstract available.
Paralysis* ; Tourniquets*

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin