No abstract available.
Movement Disorders*

BACKGROUND: Epidermis is directly exposed to various external stimuli and protects internal structures. Most studies about skin tension focused on the dermis, and epidermal tension has not been able to attract interest because dermis much thicker than epidermis and dermal collagen fibers play a predominant role in the skin tension. However, circumstances which involve only the epidermis are often shown, and thus it is necessary to study the mechanical property of the epidermis. OBJECTIVE: The purpose of this study is to quantify the role of the epidermis as a mechanical barrier. METHODS: Human epidermal sheets were obtained from suction blisters in 14 patients with vitiligo during epidermal grafting. Maximal tension, that is the power required to break the epidermal sheets, was measured by tensiometer. RESULTS: The maximal tension of the epidermis ranged from 40.0 g/cm² to 84.5g/cm² with a mean values of 56.1g/cm² and did not differ significantly according to the age or anatomical sites. CONCLUSION: The barrier function of epidermis is important and the results are expected to be used as the basic information for other studies about the mechanical property of the epidermis. In addition, this will be important data in developing an artificial skin whose mechanical property is similar to that of the human skin.
Blister* ; Collagen ; Dermis ; Epidermis* ; Humans* ; Skin ; Skin, Artificial ; Suction* ; Transplants ; Vitiligo

BACKGROUND: Ultraviolet light induces sunburn, ageing of the skin, pigmentation and even promotes skin cancers. As there has been a recent decrease in the ozone layer surrounding the earth, increasing attention has been given to the effects of ultraviolet light on the skin. Through human epidermis, ultraviolet light is reflected, scattered, absorbed or transmitted. In caucacians, the rate of transmitted ultraviolet light A from the epidermis to the dermis is 50% and the rate of transmitted ultraviolet light B is below 10%. OBJECTIVE: The purpose of this study was to evaluate the transmittance of UVA and UVB on Korean normal epidermis. METHODS: Pure epidermis was obtained from normal human epidermis by suction of blisters in 12 patients with vitiligo. All specimens were irradiated respectively with UVA and UVB and the amount of transmitted energy was measured. RESULTS: 1. The transmittance of UVA energy density by normal epidermis was 47.7+11.2% of irradiated UVA energy. 2. The transmittance of UVB energy density by normal epidermis was 32.4+3.4% of irradiated UVB energy. CONCLUSION: UVA energy transmission through normal epidermis of Korean is less than those of Caucacians but UVB energy transmission through nor mal epidermis of Korean is more than those of Caucacians. It is suggested that this could be an important basic data to study for photoaging and photoprotection in Korean population.
Blister ; Dermis ; Epidermis* ; Humans* ; Pigmentation ; Skin ; Skin Neoplasms ; Stratospheric Ozone ; Suction ; Sunburn ; Ultraviolet Rays ; Vitiligo

BACKGROUND: The relationship and differentiation among various dendritic cells of the dermis are unclear. Recently it has hecome possible to identify different subpopulat,ions of dermal dendritic cells using anti-CD34 and anti-factor XIIIa antibodies. OBJECTIVE: To elucidate which cell types the fibrous dermal turnors consist of we compared the staining patterns of these antibodies as well as of anti-Mac 387 antibody which are labeled as inflammatory cells of the monocyte-macrophage lineage. METHODS: Tumors studied included dermatofibrosarcoma protuberans(DFSP, n=2), dermato-fibroma(n=22), neurofibroma, n=27), acrochordon(n=15), keloid, hypertrophic scar(n=10), juvenile xanthogranuloma(n=1, and malignant fibrous histiocytoma (MFH, n=1). We performed immunoperoxidase staining(AUSC technique) with polyclonal anti FXIIIa antibody, monoclonal anti-CD34 antibody, and monoclonal anti-Mac 387 antibody on the formalin-fixed-paraffin-embedded tissue specimens of these fibrous tumors. The intensity of staining was graded as negative, weakly staining, or strongly stainiring. RESULTS: FXIIIa reactivity was strongly present in dendritic and spindle-shaped cells of all dermatofibromas and some nurofibromas(11 of 27 specimens), but absent from the other fibrous tumors. Among these tumors, one of the two DFSPs was uniquely expressed CD34. Dendritic and spindle-shaped cells within tiese tumors were MAC 387 negative. In inflammatory conditions, variable numbers of MAC 38 positive cells were observed, corresponding to histiocytes and mac-rophages, but the labeling of ipithelioid cells and multinucleated foreign body giant cells were variable. CONCLUSION: The findings of significant numbers of FXIIIa positive cells in dermal fibrous tumors studied suggest that thet may be diagnostic utility associated with the use of this antit)ody. In addition, CD 34 expression by the tumor cells can be an extremely useful marker in establishing a definitive diagnosis of IFSP.
Antibodies ; Dendritic Cells ; Dermatofibrosarcoma ; Dermis ; Diagnosis ; Factor XIIIa* ; Giant Cells, Foreign-Body ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Keloid ; Langerhans Cells ; Neurofibroma

OBJECTIVE: p16INK4 and p15INK4B genes are known to be tumor suppressor genes which reside in p21 region of chromosome 9 and are related to cell cycle control as an inhibitor of cyclin-dependent-kinase. We designed this study to search for deletion and decreased expression of p16INK4 and p15INK4B genes in advanced ovarian carcinomas. METHODS: Polymerase chain reaction (PCR)-based analysis was performed to search for deletion of p16INK4 and p15INK4B using DNA extracted from frozen tissue in liquid nitrogen of thirty-one advanced ovarian carcinoma patients. The intensities of PCR bands were analyzed using an imaging densitometer to determine gene dosage in tumor samples and the relative gene dosage was calculated by comparing band intesity of p16INK4 or p15INK4B with that of beta-globin gene. Homozygous deletions were assigned to tumors in which the ratio was reduced to less than 25% in any one of exons of p16INK4 and p15INK4B. Immunohistochemical techniques were used to study the expression of p16INK4. p16-negative cells were characterized by the absence of nuclear staining, whereas cytoplasmic staining was variable. Clinico-pathologic features, complete remission rates and survivals were analyzed according to the status of p16INK4 and p15INK4B genes. RESULTS: Homozygous deletion of p16INK4 was detected in 12.9% of advanced ovarian carcinoma patients and that of p15INK4B in 35.5%. Clinico-pathologic features such as FIGO stage, histological grade, serum CA-125 levels were not different from groups with homozygously deleted p16INK4 and p15INK4B to those with normal genes. The survival of patients (13 [6-20] months) with homozygously deleted p16INK4 was significantly shorter than that (30 [8-52] months) of patients with normal p16INK4 (p=0.046; Log-rank test). CONCLUSION: These observations indicate that deletions of p16INK4 and p15INK4B gene might be involved in tumorigenesis of ovarian carcinoma and could be useful as a prognostic factor. A prospective, controlled study with more patients will be mandatory in the future.
beta-Globins ; Carcinogenesis ; Cell Cycle Checkpoints ; Chromosomes, Human, Pair 9 ; Cytoplasm ; DNA ; Exons ; Gene Dosage ; Genes, Tumor Suppressor ; Humans* ; Immunohistochemistry ; Nitrogen ; Polymerase Chain Reaction

Condyloma acuminatum occurs in perianal and genital area by infection of human papillomavirus (HPV) and appeais as fairly soft verrucous papules or a cauliflower-like mass. So far 60 HPV types have been identified. Among them, condyloma acuminatum is predomi-nantly associated with HPV 16, 18 and rarely with 16, 18. HPV 16, 18 is regarded as a high-risk HPV infection because of the association of HPV 16, 18 with Bowens disease, cervical cancer, and anogenital cancer. In additioin, a significant appearance of cervical anaplastic lesions is preceded by condyloma acuminatum and a high prevalence of cervical dysplasia has been found in female consorts of men with geriital warts. Malignant transformation has been observed in rare incidences of condyloma acumina a on the external genitalia. We present a case of condylc ma acuminatum showing malignant transforrnation. The patient also has uterine cervical carcinonia. We detected HPV 16 in the lesion using polymerase chain reaction.
Bowen's Disease ; Female ; Genitalia ; Human papillomavirus 16 ; Humans ; Incidence ; Male ; Polymerase Chain Reaction ; Prevalence ; Uterine Cervical Neoplasms ; Warts

The treatment of spondylolysis is a rest, curtailment of activity and a back support. But in the case of increasing the back pain and disability, the surgical procedure is necessary such as the removal of posterior part of spine, posterior fusion of spine and anterior fusion of spine for lower back pain. If the patient had a radiating pian and positive neurological finding. the laminectomy is necessary. The another surgical procedure is the intertransverse fusion. In any way, after spine fusion, the motinn of spine is inevitably limited. Recently I had an experience of bone grafting between the transverse precess and lamina by the paraspinal sacrospinal mnscle splitting approach and semilunal transverse skin insion. The purpose of my experiences is the control of lumbago withont the lumbar motion limitation. The cases that I reported here are no any radiating pain and neurologically no any spinal nerve root irritation sign. I think, on the patient side, our method will be good idea for the chronic lower back pain without a radiating pain when the fusion becomes sucessful because of none of intervertebral fusion, non-cast immobilization and easily consealed surgical scar.
Back Pain ; Bone Transplantation ; Cicatrix ; Humans ; Immobilization ; Laminectomy ; Low Back Pain ; Methods ; Skin ; Spinal Nerve Roots ; Spine ; Spondylolysis

Accessory hamstring muscle is rare in incidence. In the popliteal region, it often simulates soft tissue tumor since it may be manifest as popliteal swelling. We experienced a case of accessory hamstring muscle which simulated popliteal tumor on physical examination.
Incidence ; Physical Examination

Supracondylar fracture of the Humerus is the most common fracture of the elbow in children and frequently there are accompanying complications. A total of 78 children with supracondylar fracture of the humerus were treated at the Wallace Memorial Baptist Hospital, Busan, Korea, during a recent 5 year period. Of these, 33 patients were treated by lateral skeletal traction through olecranon pin and 14 of these were followed up for more than 6 months. 1. The average age was 7.2 years and the male and female ratio was 2.4:1. The left humerus was involved in 49 patients (62.5%). 2. Of all fractures, 94.4% were the extension type and 5.6% were the flexion type. 3. Satisfactory results wire obtained in 31 of 33 cases who were treated by lateral skeletal traction. Among these, 14 cases were followed up for more than 6 months. Final results were analyzed according to Mitchells classification; excellent results were obtained in 11 cases (78.6%), good results in 3 cases (21.4%) and there were no unsatisfactory results. 4. In 11 cases in which immediate closed reduction or Dunlops traction followed by closed reduction was unsuccessful, satisfactory results were obtained in 10 of 1 1 cases by using lateral skeletal traction. Therefore, we think that it is possible to treat most of the manual reduction failure patients by lateral skeletal traction. 5. There were two treatment failures using lateral skeletal traction. In one case, the brachialis muscle was buttonholed by the proximal fragment, and in the other case, the patient was treated 8 days after injury and marked hematoma formation between the fracture fragment was noted. 6. During treatment by lateral skeletal traction, infection developed through the pin tract in 2 cases. These were treated by the administration of antibiotics and there were no complications such as osteomyelitis nor did this effect the final results. 7. Incomplete radial nerve palsy developed in 3 cases. However, in all cases recovery was spontaneous with 4 weeks. 8. The average hospital stay for patients treated by lateral skeletal traction was 14.2 days. Prologed hospitalization is ane of the chief disadvantages of lateral skeletal traction. However, if we can minimized the number of hospital days by early cast immobiiization when the fracture is stable, lateral skeletal traction will prove to be a good method which can be expected to yield unlformly satisfactory results which are not surpassed by any other method of treatment. Since this method has been instituted at this hospital, very few patients have undergone open reduction because of fracture malalignment.
Anti-Bacterial Agents ; Busan ; Child ; Classification ; Elbow ; Female ; Hematoma ; Hospitalization ; Humans ; Humerus ; Korea ; Length of Stay ; Male ; Methods ; Olecranon Process ; Osteomyelitis ; Paralysis ; Protestantism ; Radial Nerve ; Traction ; Treatment Failure

Injuries involving epiphyseal plate is important because of special problems in diagnosis, management and tl later complications of serious disturbance of growth which may be predictable and preventable. We revieviewed 40 cases of epiphyseal injuried in 35 patients, managed at Department of Orthopaedic Surgery, Nation Medical Center from Jan. 1975 to Dec. 1981. The longest follow up was 4 ywars and 6 months and the shortest, year, the average being 2 years. The results were as follows: 1. The incidence of epiphyseal injuries was 35 patients in 211 patients of padiat.c fractures. 2. There were 29 males and 6 females. 3. The causes were falling down accident, slipping down accident, impinging injury, direct blow and traff accident in order 4. Roentgenographically, 23 cases were Type II of Salter & Harris classification, 8 cases were Type IV, cases were Type I, 2 cases were Type III, and 1 case was Type V. 5. Epiphyseal Injuries were found with order of decreasing frequency of distal radius, distal humerus, dist femur, phalanges, distal tibia, proximal humerus, distal fibula and proximal humerus. 6. The methods of treatment were C/R & 'cast immobilization, C/R & K-wire fixation, 0/R & K-wire fixation and C/R & screw fixation. 7. Complications were found in 2 cases of angular deformity in Type IV injury, 1 case of shortening in Type injury, and 1 case of angular deformity in Type V injury.
Accidental Falls ; Classification ; Congenital Abnormalities ; Diagnosis ; Female ; Femur ; Fibula ; Follow-Up Studies ; Growth Plate ; Humans ; Humerus ; Immobilization ; Incidence ; Male ; Radius ; Tibia