Computed tomography is helpful in delineating the extent and configuration of pelvic fracture. These injuries are frequently complex, and the precise pathologic anatomy is not easily demonstrated by conventional radiographs. In some case CT will reveal a fracture which may not be seen on the radiograph. In addition, the extent of soft tissue damage and joint involvement is precisely demonstrated with CT. The twenty-three patients admitted to our Inchon Christian Hospital with pelvic fracture with or without hip dislocation from October 1981 to October 1984. We could assess the applicability of C-T scan in pelvic fracture and the following conclusions were obtained. 1. The axial plane of CT was shown to be the most suitable for evaluation of pelvic fracture. 2. C-T could detect the pattern of hip fracture including degree of fracture fragment displacement, and rotation, hip joint stability, intra-articular osseous fragment and interposed soft tissues in hip joint. 2. C-T permitted better evaluation of associated injuries in soft tissue and viscera on the pelvic and retroperitoneal cavity, and also gave information about other associate fractures. 4. C-T was more sensitive than plain radiography in detecting fracture involving the sacrum, quadrilateral surface, acetabular roof, and posterior acetabular hip.
Acetabulum ; Diagnosis ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Incheon ; Joints ; Pelvis ; Radiography ; Sacrum ; Viscera

PURPOSE:Craniopharyngioma is one of the most important intracranial tumors in pediatric age which causes multiple pituitary hormone deficiencies. We have studied clinical characteristics in patients with craniopharyngioma, focusing on changes of endocrine function, change of growth pattern, and change of body mass index before and after surgery. In addition, we wanted to know the effect of growth hormone therapy on growth velocity and body mass index, and to identify contributing factors for spontaneous growth in spite of growth hormone deficiency. METHODS:A total number of 17 patients who were diagnosed as having craniopharyngioma at the Department of Pediatrics, Asan Medical Center during the period of January, 1991 to December, 1997 were included in this study. Retrospectively, we reviwed medical records as to their endocrine function tests and auxoloogical data before, after surgery. RESULTS: 1)The number of patients of male and female were 9 and 8 respectively. Mean age was 7.3+/-4.3 years. 2)Preoperatively, 3 patients were thyroid hormone deficient, 3 patients were corticosteroid deficient, and 3 patients suffered from diabetes inspidus. 3)Postoperatively, GH and TSH deficiency were found in 100%, ACTH in 88.2%, ADH in 82.3%, and LH/FSH in 60%, 53% respectively. 4) Mean growth velocity in 14 GH deficient patients without growth hormone treatment for 2 years were 3.5+/-2.4cm/year during the 1st year and 3.1+/-1.7cm/year during the 2nd year. Although height standard deviation score(Ht. SDS) was decreasing trend as -0.24+/-2.19 at diagnosis, -0.94+/-1.73 at 1 year later, and -0.76+/-1.76 at 2 years later, it was not statistically significant. To our suprise, 4 out of 14 patients achieved greater growth velocity than nomal in spite of growth hormone deficiency during the 1st year after operation. 5) Although the mean body mass index of 14 GH deficient patients without GH treatment was increasing trend as 17.9+/-3.5 at diagnosis, 19.0+/-4.5 at 1 year later, and 19.9+/-4.8 at 2 year later, it was not statistically significant. 6) The mean Ht. SDS increased significantly in 7 patients treated with growth hormone(P<0.05) for 2 years, but change of body mass index was not significant. 7) Comparision of postoperative serum prolactin levels and changes of body mass index between spontaneous growth and stunted growth group did not reveal significant difference. CONCLUSION: Since most patients with craniopharyngioma become multiple pituitary hormone deficient after operation, it is important to predict and detect pituitary dysfunction to manage it effectively. Although patients with postoperative GH deficiency responded well to GH treatment, further study is needed to clarify what are the main contributing or prognostic factors for spontaneous growth without growth hormone treatment.
Adrenocorticotropic Hormone ; Body Mass Index ; Chungcheongnam-do ; Craniopharyngioma* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Male ; Medical Records ; Obesity ; Pediatrics ; Prolactin ; Retrospective Studies ; Thyroid Gland

Portable gamma radiography for nondestructive testing with 192Ir is commonly used in various industrial fields to defect possible internal defects of metals in pipelines, tanks, bridges, ships and so forth in Korea. Compared to the numerous researches about biologic effects and potential risks of radiation, only a Jew papers were reported about radiodermatitis from occupational exposure to 192Ir. In this study, we investigated six patients with occupational radiodermatitis with developed during portable gamma radiography for nondestructive testing with 192Ir. All six patients had developed radiodermatitis on their hands and fingers. They noticed painful swelling, erythema, and bullae on their fingers or palms 1 to 2weeks after exposure. Three patients suffered from chronic fibrosis and recurrent ulcerations. We also discussed about the working situation of our patients and reviewed the literatures about the radiodermatitis from occupational exposure to 192Ir. In conclusion, we think ionizing radiation, though it is a useful tool in industry, must be carried out in accordance with radiation protection rules and regulations.
Erythema ; Fibrosis ; Fingers ; Hand ; Humans ; Jews ; Korea ; Metals ; Occupational Exposure* ; Radiation Protection ; Radiation, Ionizing ; Radiodermatitis* ; Radiography ; Ships ; Social Control, Formal ; Ulcer

Purpose : As the recombinant human growth hormone has been widely available, a lots of parents having short statured children are interested in promoting growth of them whatever the etiologies of short stature they have. However, the growth hormone therapy for growth-promoting effect is only justified in well-established indications such as growth hormone deficiency, fumer syndrome, and chronic renal insufficiency. This study was undertaken to classify the children with chief complaint of short stature by its cause and giving the basic epidemiologic data for it so that the size of population in which growth hormone is indicated can be estimated. Methods : According to Ranke's etiologic classification, we categorized the 579 children who visited our pediatric endocrinology clinic with chief complaint of short stature during the period of March 1994 to August 1996. In this prospective study, history regarding growth was taken, physical examination and laboratory tests including bone age, thyroid function, blood chemistry were carried out. The auxological data were analyzed. Additional chromosomal study or growth hormone provocative tests were performed when needed. Results : Out of 579 patients, 360(62.2%) were classified as normal and 127(21.9%) were classified as normal variants which consist of familial [74(12.8%)], constitutional [48(8.5%)], and mixed familial & constitutional short stature[5(0.9%)]. Pathologic short stature was found in only 80(13.8%). Those are growth hormone deficiency(28), Tumer syndrome(16), intrauterine growth retardation(14) in order. Other etiologies list varieties of dysmorphism, skeletal dysplasia, chromosomal disorders. Conclusions : This results suggest the vast majority of children with chief complaint of short stature are normal or normal variants. Only 7.8% of children who visited our clinic were indicated for growth hormone therapy.
Chemistry ; Child* ; Chromosome Disorders ; Classification* ; Endocrinology ; Growth Hormone ; Human Growth Hormone ; Humans ; Parents ; Physical Examination ; Prospective Studies ; Renal Insufficiency, Chronic ; Thyroid Gland

PURPOSE:Although Hashimoto's thyroiditis is the most common cause of goiter in children and adolescents, it is not clear what proportion of patients become hypothyroid and which tests are the best predictors of this state. To determine whether these kinds of variations occur in the course of Hashimoto's thyroiditis and whether the size of the thyroid gland or immunologic markers correlate with the course or outcome of Hashimoto's thyroiditis are main objects of our study. METHODS:A total number of 48 patients who were diagnosed as having Hashimoto's thyroiditis at the Department of Pediatrics, Asan Medical Center during the period of January, 1992 to December, 1997 were included in this study. Retrospectively, we reviewed medical records as to their clinical and labaratory data. RESULTS:Thyroid function status at initial diagnosis of Hashimoto's thyroiditis were euthyroidism(33.3%), compensatory hypothyroidism(33.3%), overt hypothyroidism (27.1%), hyperthyroidism(8.3%) in order. Positivity of antithyroglobulin antibodies and antimicrosomal antibodies were 77.1% and 66.7% respectively. In 33 patients, 12(36.4 %) were on remission status after 3 years from initial diagnosis. Antithyroglobulin antibody titer was significantly decreased after 2-year follow up in remission group. Initial antithyroglobulin antibody titer and thyroid function status were not related to remission status after 3-year from diagnosis. CONCLUSION: About 36% of patients with Hashimoto's thyroiditis can be in remission after 3-year from diagnosis. Decrease of antithyroglobulin antibody titer is related to remission status. Further study is necessary to know what can be the predicting factors for early remission, for example, initial thyroid function status, initial antithyroid antibody titier, circulating immune complex, age, sex and size of thyroid.
Adolescent ; Antibodies ; Antigen-Antibody Complex ; Biomarkers ; Child ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Goiter ; Humans ; Hypothyroidism ; Medical Records ; Pediatrics ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis*

To evaluate the intra-articular pathology of popliteal cysts of knee, we performed arthroscopy on patients with popliteal cysts between February 1992 and February 1995. Thirty-one patients (32 cases) have been treated by excision of cyst after arthroscopy. Mean duration of follow-up was 15 months (13-19 months). Location of cysts was in the right knee in 17 cases, in the left knee in 13 cases, and bilateral in one case. Pain or swelling was present in 12 (38%), giving-way was reported by 4 cases. Three cases revealed quadryceps atrophy. The McMurray test was postive in 6 cases. After arthroscopy, the cysts were excised. Ninteen cases (59%) had associated intra-articular lesions: seven medial meniscal tears, two lateral meniscal tears, seven had chondral damages, one had medial plica syndrome, and one had rheumatoid arthritis, Communication between the cyst and the knee was present in 7 cases (22%), all of whom were over 40 years of age. Thirteen cases was younger than 30 years of age, and 11 cases of these cases had no intra-articular pathology. Two other cases had lateral meniscal tears and medial plica syndrome, respectively. We recommend arthroscopy in middle and older aged patients with popliteal cysts for evaluating and treating intra-articular lesions.
Arthritis, Rheumatoid ; Arthroscopy* ; Atrophy ; Follow-Up Studies ; Humans ; Knee* ; Pathology ; Popliteal Cyst*

After reconstruction of anterior cruciate ligament, increased idameter of femoral or tibia1 bone tunnel has been obsened on plain radiogram. The etiology of radiographic tunnel enlargement is not well understood and the significance of this tunnel enlargement is unknown. This retrospective study reviewed tibial tunnel diameter in 34 cases of anterior cruciate ligament reconstructions. And we evaluated the correlation between the tibial tunnel enlargement and the position of screw fixation, instability, choice of graft, and clinical results at 1 year postoperatively. AII operation was per formed using a single incision technique. After 3 or 4 months and one year after operation, the diameter of tibial tunnel was measured with digital caliper on the plain radiogram. Tibial tunnel sclerotic margins were measured in the level Of medial tibial plateau on the lateral view of knee. Average tunnel enlargement of 3 allografts was 1.62mm and that of 15 autografts was 2.03mm. No significant difference was seen in KT-10000 arthrometer measurements between enlarged group (amount of enlage-ent >+1 S.D) and not-enlarged group (less than +1 S.D). No coelation was present between the increased tunnel diameter and Lysholm score. Cases with 10mm or more vertical distance between the most proximal point of tihial interference screw and the level of m4eial tibial plateau had average 1.15mm tibial tunnel enlargement and cases with less than 10mm vertical distance ha & I average 2.52mm tibial tunne] enlargement;the difference was not significant (P>0.05). The tibial tunnel enlargement was not correlated with position of screw, clinical results, stability of knee. The tibial tunnel enlargement was not caused hy only mechanical factor such as motion of intra-tunnel portion of graft-tendon.
Allografts ; Anterior Cruciate Ligament* ; Autografts ; Knee ; Retrospective Studies ; Transplants

The original technique for endoscopic anterior cruciate ligament reconstruction has several potential complications because of constraints imposed by working through the tibial tunnel: improper femoral tunnel placement, violation of the femoral tunnel posterior wall, femoral interferenc screw divergence, graft laceration during screw insertion, and distal tibial bone block prr>trusion. We performed 25 endoscopic anterior cruciate ligament reconstructions with bone-tendon-bone graft using a mo3ified technique that minimizes each of these problems, through the use of a anteromedial portal more centrally and distally placed than the original that portal. Postoperative radiographic review showed femoral screw divergence in 20% of cases (2 in the anteroposterior plane, 2 in the lateral plane and 1 in both planes), but the average angles (AP: 0.52+- 1.85, Lateral: 1.48+-3.30) were insignificant. There was no graft damage during screw insertion or grafttunnel mismatch. We concluded that this modified technique allows simplified, reproducible tunnel and interference screw placement.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Knee ; Lacerations ; Transplants

No abstract available.
Chylothorax* ; Lymphangiectasis*

BACKGROUND: The 5α-reductase inhibitor finasteride blocks the conversion of testosterone to dihydrotestosterone(DHT), the androgen responsible for androgen- etic alopecia in genetically predisposed men. OBJECTIVE: The purpose of this study was to determine the efficacy of finaster- ide treatment according to the type of androgenetic alopecia in Korea. METHODS: 196 patients with finasteride(1.25mg/day) were registered in this study and 68 patients were followed over 8 months. Efficacy was evaluated by globa1 photographs, investigator assessment of clinical change,and patients' self assessment via self administered hair growth questionnaire. RESULTS: Patients' self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by objective assessments after 4 months of treatment. Adverse effects such as sexual dysfunction were minimal. CONCLUSION: Oral finasteride 1.25mg/day slowed the progression of hair loss and increased hair growth in clinical tria1s of men with androgenetic alopecia over 8 months. With its generally good tolerability profile, finasteride is a new approach to the management of this condition, for which treatment options are few.
Alopecia* ; Finasteride* ; Hair ; Humans ; Korea ; Male ; Research Personnel ; Self-Assessment ; Testosterone