Approximately 15% of all fractures in children involve the physis. Although the majority heal without impairment of the growth mechanism, epiphyseal growth plate fracture-seperation can lead to shortening and angulation. The physiologic events in epiphyseal growth fracture seperation that lead to growth disorders relate to 1) destruction of the epiphyseal circulation and 2) communication between the epiphyseal circulation with its osteoprogenitor cells, thus forming a bony bridge. Although the classic procedure of osreotomy, epitphysiodesis, leg shortening and leg lengthening have not lost their importance in the treatment of the sequeales of partial closure of an epiphyseal plate, the possibility of regaining growth in the affected region should be considered before other measures are taken. Simple excision of the bone bridge is ineffective, since the large cancellous surface thus produced will allow for rapid reformation of the bridge. Thus, a material has to be interposed into the defect created by removal of such a bridge in order to prevent its reformation. Langenskiold first demonstrated that a bone bridge could be effectively resected and its reformation prevented by utilizing fat as an interposition material. Other investigators have used a variety of different interposition materials to prevent bone bridge recurrence following operative removal including cartilage, Silastic, Methymethacrylate, bone wax, muscle flap, Gelfoam as well as fat. Thus it is the purpose of this study to analysis and comparing shortening and angulation by resection of a bone bridge and its replacement with different interposition materials. For this study, a total of 32 rabbits with an initial weight of about 600 to 800 gm was used. Control group comprised 4 rabbits and after appmpriate preparation, the medial condyle of the pmximal tibia was exposed surgically. One plug of bone was removed at the level of the epiphyseal plate using a small curet to a depth of 5 mm. and in the other groups, we made a defect with the same curet and filled it with an interposition material directly. The following experimental groups were created. Group 1 (N-4) Control group: no interposition material Group 2 (N-4) Gelfoam interposition material Group 3 (N-4) Bone was interposition material Group 4 (N-4) Muscle flap interposition material Group 5 (N-4) Fat interposition material Group 6 (N-4) Bone cement interposition material Group 7 (N-4) Silastic interposition material Postoperatively the anirnals were sacrificed 15wks following operation. As sacrifice, tibia including fibular is removed, examined grossly and radiographed. Tibia length and angular deformity were determined by measurement of radiographs. Specimens stained with H-E stain were observed during 15 wks after operation. Through these examination, following results were obtained. l. In control group, coronal histological sections of each curetted proxirnal tibial growth plate revealed osseous bridging as early as 3 wks, and this bridging was found consistently in all control groups for the duration of the study. 2. The groups using gel foam, muscle flap and bone wax as interposition material were found effective for the prevention of the formation of epiphyseometaphyseal bone bridge to some extent. 3. The groups using Silastic or bone cement diminished both the angular deformity and growth retradation to a highly significant degree. Although the use of fat did reduce somewhat the amount of shortening and angular deformity when used as an interposition material, it was not effective as Silastic or bone cement. 4. Coronal histological section of the traumatized, margin of the growth plate, with an interposition material revealed thin fibrous layer and lose columnar orientation, foam rounded clone-like structures and randomness to growth. The injured portion of the cartilage may originate from the regeneration of the adjacent part of the growth plate. From these morphological and radiological results, it is suggested that Silastic or bone cement is better interposition material in the elimination of trahsphyseal closure after physeal damage.
Cartilage ; Child ; Congenital Abnormalities ; Gelatin Sponge, Absorbable ; Growth Disorders ; Growth Plate ; Humans ; Leg ; Rabbits ; Recurrence ; Regeneration ; Research Personnel ; Tibia

The incidental observation of periosteal new bone formation on long bones is common in pediatric radiology without any symptoms in extremities : for example, the humeri on chest examination and the femora on abdominal roentgenograms. The purposes of the author is to report the results of a roentgenologic study of the long bones in 100 normal infants and 100 chilren between 1 and 2 years old who had no symptoms refereble to the skeleton to determine the incidence, roentgen characteristics, pathogenesis and significance of this type of periosteal new bone. The results obtained were as follows : 1. Periosteal new bone occured in 28% in normal infants group but did not occured in children group between 1 and 2 years. 2. The site in order of decreasing frequency were femur, tibia, and humerus. 3. Periosteal new bone is always on the diaphysis and usually extended onto the metaphysis to a variable extent, but it has not been observed to reach the end of metaphysis. 4. It seems most logical that the periosteal new bone found in these infants is simply a roentgen manifestation of normal periosteal bone growth in the period of greatest activity. 5. It is not an indication for treatment unless a definite relationship with a specific disease is proven.
Bone Development ; Child ; Diaphyses ; Extremities ; Femur ; Humans ; Humerus ; Incidence ; Infant ; Logic ; Osteogenesis ; Skeleton ; Thorax ; Tibia

Vitiligo is a relatively common depigmentary disorder occurring in approximately 1-2% of the general population. All races are affected. Both sexes are likely to be affected equally; the female prevalence in some studies can probably be attributed to cosmetic reasons. It can occur and spread at any stage of life and is often associated with a positive family history. Up to 30 percent of patients have reported vitiligo in another family member. The lesion is characterized by discrete, pale-white macules, few or several in number, which tend to enlarge centrifugally over time. It is not contagious, nor is it a serious health problem. However, it can be troublesome in brown and black people as well as in white persons who tan deeply (skin phototype IV), and often leads to social embarrassment and psychological turmoil.
Continental Population Groups ; Female ; Humans ; Prevalence ; Triacetoneamine-N-Oxyl ; Vitiligo*

BACKGROUND: Monofunctional psoralens plus UVA radiation are not severely phototoxic and have less mutagenic activity than bifunctional psoralens plus UVA radiation. OBJECTIVE: The purpose of this study was to evaluate pigment producing effect using various concentrations(0.02%, 0.1%, 0.5%) of monofunctional psoralens such as angelicin, khellin and comparing it's effect with TMP in topical photochemotherapy. METHOD: Ninty three C57BL mice were painted with either angelicin, khellin or TMP solution in concentrations of 0.02%, 0.1% and 0.5% each and were UVA irradiated. Skin biopsies were performed at 1,3,5 weeks after UVA irradiation. The pigment producing effects were measured by the number, area and perimeter of the melanocytes after topical PUVA. RESULTS: The comparison of melanocyte numbers between different psoralens after five weeks of photochemotherapy showed a significant difference in decreasing order of TMP, khellin and angelicin. The area and perimeter of melanocytes were larger in the TMP group after five weeks photochemotherapy than the other group. However in the khellin and angelicin group, the area and perimeter of melanocytes were not increased by increasing the frequency of the UVA irradiation. CONCLUSION: The number, area and perimeter of melanocytes after topical PUVA increased in the TMP group compared to angelicin or khellin group. We expect the clinical application of angelicin and khellin in vitiligo is possible considering the result of the study of pigment producing effect with a higher concentration and higher dose of UVA.
Animals ; Biopsy ; Ficusin* ; Furocoumarins ; Khellin ; Melanocytes* ; Methods ; Mice* ; Mice, Inbred C57BL ; Paint ; Photochemotherapy* ; Skin ; Thymidine Monophosphate ; Vitiligo

Down syndrome is the most, well known autosomal trisomy and e large number of abnormal skin features have been reported to occur in patients with Down syndromir. including syringoma. Syringomas occur with increased frequency in patients with Down syringoma, usually limited to the region around the eyes. but few cases of eruptive syringoma with Down syndrome have been reported. We reported the case of familial eruptive syringoma in a 13 years old patient with Down syndrome.
Adolescent ; Down Syndrome* ; Humans ; Livedo Reticularis ; Skin ; Syringoma* ; Trisomy

Ehlers-Danlos syndrome is an inherited disorder of connective tissue in which joint hypermobility, hyperelasticity of skin, bleeding tendency, and scar formation are the most prominent features. It is a generalized disease with essentially universal involvement. A 3-year-old female child had velvety skin, skin hyperextensibility, joint hypermobility, subcutaneous mobile masses on the left shin, many scars on both knees, subcutaneous hematoma, and thick and very folded skin on both palms and soles, but no evidence of internal disorder. Cutaneous histopathologic findings were nonspecific without increase of dermal elastic fibers on Verhoeff stain. Diagnosis was confirmed by clinical and histopathological findings as Ehlers-DanIos syndrome.
Child ; Child, Preschool ; Cicatrix ; Connective Tissue ; Diagnosis ; Ehlers-Danlos Syndrome ; Elastic Tissue ; Female ; Hematoma ; Hemorrhage ; Humans ; Joint Instability ; Knee ; Skin

No Abstract available.
Diagnosis* ; Sleep Apnea, Obstructive*

No abstract available.
Calcium* ; Diet* ; Hypercalciuria* ; Osteocalcin*

This is an analysia of 126 cases(14.1%) of segmental vitiligo among 892 vitiligo patient who had visited vitiligo special clinie in Severance Hospital. The results are summarized as follow : 1. There were 53 males(42.1%) and 73 females(57.9%). 2. The mean age of onset was 15.4 years, the mean age on the first visit was 19.3 years, and mean duration of the disease was 4.8 years. 3. Mode of onset was single in 86.5% and the disease was table in 57.1% of patients at the visit. 4. The mean percentage of depigmented lesions was 3.3% and less than 5% of body surface area was involved in 86.5% of patients. 5. The most common site of involvement was head and necl(59.6%), especially face(43.7%) and the trigerminal dermatome was most commonly involved. 6. Poliosis was observed in 39.7%. 7. Family history of vitiligo was obtained in 11.1% of patients. There was no precipitating factors in 126 cases prior to development of vitiligo. 8. Koebner phenomenon was found in 4% of patients. 9. Association with diseases of a proven or suggested allergic or immunologic etiology including atopic dermatitis, halo nevus, uveitis, thyroid disease, lopecia areata and premature graying of hair was found in 10.3% of patients.
Age of Onset ; Body Surface Area ; Dermatitis, Atopic ; Hair ; Head ; Humans ; Nevus, Halo ; Precipitating Factors ; Thyroid Diseases ; Uveitis ; Vitiligo*

Livedo vasculitis clinically shows purpuric papules and recurrent ulcers in the lower extremities, mainly on the ankles, leaving characteristic scars called atrophie blanche after the healing of the ulcers. Its characteristic histopathologic features and clinical evolution indicate that the common pathologic event is occlusion of vessels in the middle and deep dermis. In Korean literature, seven cases of this disease have been reported but the response of the treatment was not, satisfactory. We report three cases of livedo vasculitis cleared by combined ther by of acetylsalicylic acid, dipyridamole and nifedipine, which has not been reported in Korean literatur.
Ankle ; Aspirin* ; Cicatrix ; Dermis ; Dipyridamole* ; Lower Extremity ; Nifedipine* ; Ulcer ; Vasculitis*