The origin of Paget cells in extramammary Pagets disease is uncertain, however, some ultrastructural surveys revealed differentistion of Paget cells toward sweat gland apparatus. This is supported by recent immunohistochemical studies that Paget cells are irnmunohistochemically shown to react with antikeratin monoclonal antibodies specific to simple epithelia. In this siudy, seven cases of extramammary Pagets disease were immunohistochemically investigated with adenokeratin, carcinoembryonic antigen(CEA), involucrin by peroxidase-antiperoxidase(PAP) techniques. The results were as follow : l. Epidermis, hair follicies and sebaceous glands revealed negative immunoreacativity for adenokeratin in all cases. Sweat glands(6/7), Paget cells(6/7) and underlying adenocarcinoma revealed positive immunoreactivity for adenokeratin. 2. Epidermis, hair follicles and sebaceous glands(6/7) revealed negative immunoreactivity for CEA. Sweat glands, Paget cells and underlying adenocarcinoma revealed positive immunoreactivity for CEA in all cases. 3. Lower epidermis, sweat glands(6/7), Paget cells and underlying adenocarcinorna revealed negative irnmunoreactivity for involucrin. Upper epidermis, hair follicles and sebaceous glands(5/7) revealed positive immunoreactivity far involucrin. Based on these results, Paget cells of extramammary Pagets disease are considered to be derived from the sweat glands.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinoembryonic Antigen* ; Epidermis ; Hair ; Hair Follicle ; Paget Disease, Extramammary* ; Sebaceous Glands ; Sweat ; Sweat Glands

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

A statistical analysis was made on the 102 patients of hand injuries and their treatments. The rate of hand injury increases steadily due to the development of industrial activities and traffic accident. The hand has much more delicate functions to be performed and its structural characters should be fully understood to manage them properly. The most important point and to be emphasized is the proper coverage (resurfacing) of the wound as early as possible to avoid infection. For this purpose, early debridement and irrigation of the wound are important previous to the resurfacing. The statistical analysis is concluded as follows: 1. The peak incidence of hand injury was in the age group of 11-20 years (34.3%) and most of all were male in 89.2%. 2. There was no difference rate of dominant side and was almost equal affection of both side. 3. Industrial accident was the main cause and the most cammon type were crushing injuries with open fracture (43.1%). 4. Most of the patient were able to get the chance of early medical care in arriving hospital within six hours in 69.6%. 5. The most common digit of injury was middle finger (25.1%) and 59.8% was monodight involvement. 6. As the final result, the 28.6% (57 out of 199) of finger was amputed at the time of injury or for the purpose of treatment. The most common level of amputation were distal and middle phalanx with the rate of 29.8% each. 7. 46.8% of hand injuries were able to close primarily after debridement including 16.2% with bony amputation. 8. Various complications of hand injuries were observed in 36 case and one of most common complication was the infection in 21 cases (58.3%). About a half (52.4%) of infection were caused by pseudomonas.
Accidents, Occupational ; Accidents, Traffic ; Amputation ; Clinical Study ; Debridement ; Fingers ; Fractures, Open ; Hand Injuries ; Hand ; Humans ; Incidence ; Male ; Pseudomonas ; Wounds and Injuries

Spondylolisthesis, named by Kilian in 1854, is a major cause of low back pain and numerous methods were designed for its treatment. The 80 cases out of 132 spondylolysis and spondylolisthesis were analysed and evaluated the result cf their treatment. The results are summerized as follows. 1. The most common type of spondylolisthesis was isthmic type (58 cases, 72.5%). 2. The most common site of incidence was L5 and L4, L3 were next to it. 3. All of the dysplastic type were in L5, isthmic type were in L3, L4 and the degenerative type were most common in L4, and followed L5,L3 consecutively. 4. The 67 cases out of 80 were treated conservatively and rest of cases had operative care with six cases of anterior fusion and seven cases of posterior fusion. 5. The results of tretment was evaluated and graded more than good in all cases of operative care and 51 cases (76.2%) in conservative management.
Incidence ; Low Back Pain ; Spondylolisthesis ; Spondylolysis

The mechanism of back pain arising from change in intervertebral disc has not been clearly defined. So that the diagnosis and treatment were variable. The 26 cases of herniated intervertebral discs, treated by surgically, were analysed and evaluated as follows. 1 In 26 cases of herniated intervertebral discs, 18 cases (69%) were male and 8 cases (31%) was female. 2. The most common age group was 30 to 40 years old. 3. The most common site of incidence was L4-5 with 15 cases (57%) and L5-S1 10 cases (38%). 4. The over all followup result to surgical treatment was evaluated as 80% (21 cases) in excellent & good. 5. The end results correlated with myelographic findings was that the lateral indentation and asymmetry of nerve sleeve sleeve groups were better than the hour-glass appearance group.
Back Pain ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Male

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

The term of blow-out fracture refers to a fracture of an orbital wall, typically the orbital floor or medial wall. Especially the medial blow-out fracture is difficulty to approach. Transcutaneous approaches could remain postoperative scars and transconjunctival approaches could give bad visual field and technically difficulties in approaching the medial orbital wall. But the medial transconjunctival incision could avoid an external scar, save the operating time, and decrease injuries of surrounding tissue. Authors operated the medial blow-out fractures through the medial transconjunctival approach and porous high-density polyethylene sheet was placed on fracture site for the prevention of relapse of the orbital contents. 30 cases of medial blow-out fractures were treated using the medial transconjunctival incision. All patients were corrected satisfactorily without leaving any visible scar. Thus the medial transconjunctival approach was an effective way to repair medial blow-out fracture.
Cicatrix ; Humans ; Orbit* ; Orbital Fractures ; Polyethylene ; Recurrence ; Visual Fields

No Abstract Available.
Hair*

'Pubic atrichosis or hypotrichosis' is defined as the agenesis or the insufficient amount of pubic hair nevertheless the presence of other secondary sexual characteristics are normal. Such females may suffer from low self-esteem and psychological problem in addition to the aesthetic problem. In past, the treatment of atrichosis or hypotrichosis was done mainly with such medical therapeutics as hormonal drug therapy, but treatment tends toward the single hair transplantation in these days. Therefore, the importance of preoperative design have been emphasized to obtain more natural appearances and satisfactory results. We have studied for the pattern, hair line, distribution, density, direction, and angle to skin surface of pubic hair in 50 adult females. In pattern of pubic hair, the most common type was the horizontal type(64%) and the acuminate, the dispersed, the few type followed in order. But, the sagittal type was not observed. In the horizontal type, the upper border of line of pubic hair was located at 3/6-4/6(53%) or 4/6-5/6(47%) point of the distance from junctional point of both inguinal ligaments to the horizontal line passing both anterior superior iliac spines. In the acuminate type, most of them(75%) were located at 4/6-5/6 point of the distance from junctional point of both inguinal ligaments. In the horizontal and the acuminate type, the most lateral points of pubic hair were located, between right and left symmetrically, at 2/6-3/6 point of distance between both anterior superior iliac spines. The density of pubic hair at mons pubis, superior and lateral region of labium major didn't have no statistical difference and the central region had higher density than peripheral region. The direction of pubic hair was equal to Langer's line, angle of hair shaft to skin surface was about 60 degrees at central region and it was more acute angle at the peripheral region. In transplantation of pubic hair, it is important to know anatomical shape of pubic hair in normal adult female. If a surgeon considers the pattern, hair line, distribution, density, direction, and angle of hair shaft to skin in preoperative design and hair transplantation, one can obtain more natural-appearing and satisfactory results.
Adult* ; Drug Therapy ; Female* ; Hair* ; Humans ; Hypotrichosis ; Ligaments ; Skin ; Spine

Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4mm ptosis and more than 5mm of levator function, but three of the four acquired ptosis cases had more than 4mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.
Blepharoplasty ; Blepharoptosis* ; Conjunctiva ; Eyelids ; Humans ; Nylons ; Orbit ; Sutures