In the treatment of DDH, generally we have used the acetabular index (AI) and the center-edge (CE) angle as diagnostic factors for hip dysplasia. However, it is sometimes difficult to mark the exact lateral edge of the acetabulum to measure these factors due to indistinct bony shadows on the image of the dysplastic hip. The purpose of this study was to evaluate the lateral edge of the acetabulum to determine the location of the most accurate marking point on the plain radiograph. Using plain radiograph, we studied 53 patients with DDH which were treated with closed reduction. 26 patients were studied using plain radiograph and another method: 16 patients with 3- DCT, 4 patients with MRI, and 6 patients with arthrograph. According to this study, the most lateral bony margin of the acetabular roof on the plain radiograph indicates the antero-lateral portion of the acetabulum. The lateral edge of the sourcil indicates the lateral margin of the centro-lateral (mid-superior) portion of the acetabulum. The marking point on the lateral end of the sourcil reflects a dysplastic condition of the acetabulum, especially in the mid-superior portion of the acetabulum.
Acetabulum* ; Hip ; Hip Dislocation ; Humans ; Magnetic Resonance Imaging

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

Atopic dermatitis is one of the common dermatoses characterized by its chronicity with an uncertain prognosis and usually occurs in patients with a personal or familial history of atopy. There is a dearth of information on the incidence and clinical manifestation of atopic dermatitis in Korea. This study was aimed to elucidate the relative frequency of atopic dermatitis on the hospital base during 1973~1981 period, and to investigate the clinical manifestation hy analysing 333 patients with atopic dermatitis seen from March, 1981 to July, 1982 at the Department of Dermatology, Seoul National University Hoapital. (countinued..)
Dermatitis, Atopic* ; Dermatology ; Humans ; Incidence ; Korea ; Prognosis ; Seoul ; Skin Diseases

Diseases involving hip may influence on the anatomy of the proximal femur, especially on the endosteal canal shape. The simple radiographic comparative study was performed between normal and diseased hips. For the diseasd hip group, 74 hips ol' femoral head AVN(avascular necrosis) (average age: 49.3 years old, patients were all male) who had limped for average l9 months were selected and 77 male hips (average age: 48.9 years old) who had no prior hip disease were selected for the normal hip group. The external shape of both group showed no significant differences except for the femoral head dimensions. Statistically significant differences were ohserved hetween two groups in the proximal endosteal canal shape and cortical thickness. The femur of the diseased hip group had wider canal from the level of distal to lesser trochanter to the level of isthmus, with a significant reduction in the metaphyseal index (the ratio hetween the canal width proximal to lesser trochanter and distal to lesser trochanter) and the canal flare index (p<0.001). Theoretically this study suggests that the optimal fit and fill to the proximal endostcal canals of normal and diseased hips cannot be obtained by oneshape cementless femoral stcms.
Femur* ; Head ; Hip* ; Humans ; Male

Elderly patient with Genu Varus deformity is commonly treated by high tibial valgus osteotomy to unload the stress concentration medially. Most of these procedures were performed by closing wedge osteotomies and that revealed some problems. Most require a fairly large scar and later reoperation for implant removal. The Ilizarov apparatus and Ilizarov's principles of deformity correction seem to offer several advantages over other methods of high tibial osteotomy. With the Ilizarov method, distractional open wedge technique offers a biomechanically sound, predictably accurate, and reproducible method of correcting an extremity's mechanical axis deviation. From December 1991 to December 1993 at the department of orthopaedic surgery, Pusan National University Hospital, 5 patients(7 tibia) underwent the operation of correction of the genu varum using Ilizarov external fixator for osteoarthritis. The results were summarized as follows: l. All case were female, and the Mean age was 58 years old. 2. Preoperative mean varus angle were 20° and postoperative mean valgus angle were 6° at final follow-up. 3. The complication was not detected includes limb length descrepancy. 4. Mean Ilizarov external fixator fixation period was 5 months. 5. The results after average 1 year 1 month of follow-up were as follows: Excellent in 2 cases(29%), Good in 4 cases(57%), Fair in 1 case(14%), Poor in 0 case()%). 6. The early clinical and radiologic results were encouraging, although a longer follow-up period is necessary.
Aged ; Busan ; Cicatrix ; Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Follow-Up Studies ; Genu Varum ; Humans ; Ilizarov Technique ; Methods ; Osteoarthritis ; Osteotomy ; Reoperation

Soft tissue reconstruction of the hand remains a challenge for the hand surgeon, who must choose whether to use a local flap, a distant flap or a free flap. Local flaps, derived from tissue immediately adjacent to the primary defect, are the first choice. But there is a shortage of skin in the hand and there are regions of the hand that should not be used as donor sites since cover of the resultant secondary defect with a skin graft would be inappropriate. We used island flaps for the small soft tissue defects in the hand which were difficult to cover with a conventional skin graft or local flap. The results were as follows; 1. The causes of the soft tissue defects were traumatic amputation in 4 cases, camptodactyly in 4 cases, replantation in 3 cases, infection in 3 cases and tumor in 1 case. 2. The sites of the soft tissue defects were thumb tip in 6 cases, fifth finger PIP joint volar aspect in 3 cases, index tip in 2 cases, thumb volar and dorsal surface in 2 cases, third and fourth MP joint dorsal surface in 1 case, fourth finger PIP joint volar aspect in 1 case and first interdigital web space in 1 case. 3. The donor flaps were fourth finger neurovascular island flap in 8 cases, reverse dorsal matacarpal flap in 5 cases and first dorsal metacarpal artery flap in 4 cases. 4. The sizes of the flap were from 1. 0×1. 5cm to 2.0×4.0cm and and average of 1.5×2.0cm. 5. The flaps were survive completely with a touch sensat,ion except 2 cases which were covered by reverse 5th dorsal metacarpal flap.
Amputation, Traumatic ; Arteries ; Fingers ; Free Tissue Flaps ; Hand ; Humans ; Joints ; Replantation ; Skin ; Surgical Flaps ; Thumb ; Tissue Donors ; Transplants

Ankle fractures in children often involve the physis. They are of particular importance because partial or entire growth arrest can occur and result in significant complications. We followed thirty-four ankle fracture involving distal physis of tibia and fibula for more than 1 year and analyzed them using the modified Salter-Harris classification, the Dias-Tachdjian classification and the type of fracture (closed or open), Complications occurred in eight cases (23.5%) – two of twenty-six closed fractures (7.7%) and six of eight open fractures (75%). The complications were more significant in open fractures. Angular deformity (5 cases), limb-length discrepancy (4 cases), incongruity of the joint surface (2 cases), fibular overgrowth (2 cases) and synostosis (1 case) occurred alond or combined. In three cases of them we performed surgical management (bone bridge resection or/and supramalleolar corrective osteotomy) and had satisfactory results. This study suggests that the incidence of complications is difficult to anticipate, but is correlated with severity of initial injuries of growth plate and soft tissue, and is much higher in open fracture. After physeal injury, children should be followed until skeletal maturity and the severe deformities can be prevented by early detection and correction of growth plate disturbance.
Ankle Fractures ; Ankle ; Child ; Classification ; Congenital Abnormalities ; Fibula ; Fractures, Closed ; Fractures, Open ; Growth Plate ; Humans ; Incidence ; Joints ; Synostosis ; Tibia

PURPOSE: To compare of results between open interlocking intramedullary nailing combined with cerclage wiring and closed interlocking intramedullary nailing in treatment of femoral shaft comminuted fracture, we reviewed retrospectively 62 femoral shaft fractures. MATERIALS AND METHODS: We reviewed retrospectively 62 femoral shaft comminuted fractures, who had been followed up for a minimum one year including Winquist-Hansen classification II, III, IV from January 1996 to December 2002. The group I include the patients who treated with closed interlocking intramedullary nailing. The group II include the patients who treated with open interlocking intramedullary nailing combined with cerclage wiring. RESULTS: The average bone union time was 18.6 weeks in group I, 27.6 weeks in group II. The complication included 3 delayed unions, 1 nonunion and shortening of more than two centimeters in 1 patents in group I. In group II, The complication included 2 infections, 7 delayed unions and 3 nonunions. CONCLUSION: We can use open interlocking intramedullary nailing with cerclage wiring in some femur shaft comminuted fractures, but there are many problems and complications. So we must consider it carefully before using this method.
Classification ; Femur ; Fracture Fixation, Intramedullary* ; Fractures, Comminuted ; Humans ; Retrospective Studies

PURPOSE: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system (MUTARS(R)) used in patients with a malignant bone tumor. MATERIALS AND METHODS: Thirty one cases which used MUTARS(R) tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. RESULTS: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. CONCLUSION: Our results suggest limb salvage with the MUTARS(R) endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.
Extremities ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Leg ; Limb Salvage ; Neoplasm Metastasis ; Prostheses and Implants ; Recurrence ; Retrospective Studies ; Tibia

PURPOSE: To describe the high-resolution CT findings of varicella-zoster pneumonia. MATERIALS AND METHODS: Seven adult patients with clinically and serologically diagnosed varicella-zoster pneumonia underwent HRCT scanning. One had undergone a kidney transplant, and the others were immunocompetent. The HRCT findings were retrospectively analyzed by two radiologists in terms of the presence of a nodule, pneumonic consolidation, ground-glass attenuation and pleural effusion, and with regard to the number, size and distribution of nodules. RESULTS: HRCT findings of varicella pneumonia included nodule (n=7), consolidation (n=3), diffuse groundglass attenuation (n=1) and pleural effusion (n=1). Nodules were mostly 2-10 mm in size, and multiple (n=6), and zonal predominancy was not apparent. One case in which HRCT demonstrated diffuse groundglass opacity and slight bilateral pleural effusion involved a patient in whom complications of acute respiratory distress syndrome occured. CONCLUSION: When HRCT demonstrates the presence of nodules 2-10 mm in size multiple nodules, or nodule surrounded by ground-glass attenuation, or the coalescence of nodules and consolidation is observed in adults with chickenpox, the varicella-zoster pneumonia should be included in the differential diagnosis.
Adult ; Chickenpox ; Diagnosis, Differential ; Fluconazole ; Humans ; Kidney ; Pleural Effusion ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Retrospective Studies