The present investigation has been undertaken to understand the mechanism of implantation process, by demonstrating the role of ovarian steroids in the differentiation of uterine endometrium for implantation. We observed that the phosphatase activities seem to be dependent upon the ovarian steroids ; that is the activity showed higher level in progesterone treated group than in estradiol treated one, and the highest activity was found in the group treated with both estradiol and progesterone. The differentiation of the uterine endometrial tissue seemed to be closely related to ovarian steroid hormones ; estradiol seemed to effect on the differentiation of the luminal and glandular cell and progesterone on the formation of collagen fiber of the stromal cells, thereby inducing decidualization. Ovarian steroids might stimulate phosphatase synthesis thereby inducing differentiation of luminal and glandular tissues and then development of the uterine stromal cell for triggering decidualization in pregnant rats.

The present study carried out to obtain further information on the relationship between primary carcinoma of the liver and infection with a liver-fluke, Clonorchis sinensis. A group of 50 male albino mice were used. Approximately 500 metacercariae were given orally to each mouse. Maturity of worms was followed up by fecal examination. Distribution of worms in the hepatobility system was also checked by using 5 egg positive mice at the end of the 1st month of infection. For histopathological examination, 4-5 mice were sacrificed monthly through the 9th month of infection. The liver tissues including common bile duct and the gall bladder were fixed in 10% formalin, sectioned serially, and stained with hematoxylin and eosin. The results obtained are summarized as follows; 1. The initial day of egg output was the 28th day in average ranging from 22nd to 33rd day of infection. 2. Recovery rate of worms was revealed as low as 16.8%, and of which 64.5% was found in the intrahepatic ducts, 33.2% in common bile duct and 2.3% in the gall bladder. 3. Parasites were found in the intrahepatic ducts throughout the observation. 4. At the end of the 1st month of infection, epithelial cells of bile ducts showed varying degrees of hyperplasia and desquamation, marked adenomatous tissue proliferation, enormous acini formation with remarkable mucinous cell metaplasia and definite atypia. Stratification was scanty. Periductal and portal spaces demonstrated the extensive chronic mononuclear leucocytes and the moderate fibrosis. Similar pictures persisted up to the 4th month of infection. 5. After the 5th month, all of the outstanding features of epithelial cells showed gradual regression. On the other hand, the most striking picture in this period was the great increase of collagen fibers in periductal and portal spaces. Although tumors were not found in the present study, overall results obtained were strongly suggestive to make an inference that clonorchiasis is responsible for the neoplastic transformation of epithelial cells of intrahepatic bile ducts in experimentally infected albino mice.

It is purpose of this study to determine the benificial effect of treatment with methylprednisolone on the enhancement of Na⁺·K⁺-ATPase activity and the increased ATP level during the 4 hours after a 400gm-cm injury to the spinal cord of cat. These results demonstrate that high dose(30mg/kg) of methylprednisolone can benificially enhance the activity of neuronal Na⁺·K⁺-ATPase during the first 4 hour after spinal cord injury. But the enharrcement of this enzyme activity is not significantly increased with mega dose(60mg/kg) of methylprednisolone. Tissue level of ATP in the high dose-treated cat at 1 hour after trauma was significantly elevated, but those in high dose-treated cat at 4 hour and the 1 and 4 hours with mega dose-treated groups were not significantly increased. The protective effects of methylprednisolone in experimental spinal cord trauma are the enhancement of Na⁺·K⁺-ATPase, inhibition of the free-radical reaction and the lipid peroxidation, the increment of neuronal activity and ATP utilization. High dose(30mg/kg) of methylprednisolone is required in order to produce the acute effect in the early phase experimental spinal cord injury.

No abstract available.

70 patients of abdominal trauma were reviewed for 8 years from June 1974 to June 1982 and the results were as follows:1) The monthly distribution indicated prominant incidence was September. 2) The male to female ratio was 5:1 and the prevalent age was third decade(42.9%). 3) The most common mode of injury was traffic accident(34.3%), stabbing(31.4%), blowing and kicking(25.7%), in order of frequency. 4) Among 70 cases, 48 cases(68.6%) were blunt trauma whereas 22 cases(31.4%) were penetrating injury. 5) 24 cases(49%) of injuried patients were operated within 6hrs. after injury and 40 cases(81.6%) of injuried patients were operated within 24hrs. after injury. 6) The clinical manifestations were abdominal pain(90%), tenderness(82%), rigidity(68.6%), rebound tenderness(60%). 7) Abdominal paracentesis was performed in 23 cases, of which 18 cases(78.3%) revealed positive findings. 8) The injuried intraperitoneal organs were small intestine(36.9%), mesentery(21.9%), spleen(10.9%), retroperitoneum in the order of frequency. 9) The associated injuries were chest injury, fracture of lower extremities, rib fracture, pelvic bone fracture in the order of frequency. 10) Primary closure of G-I tract, splenectomy was done mostly. 11) The complication were seen in 12 cases and the wound infection(41.7%) was the most common. 12) Overall mortality rate was 4.3% and the cause of death was hypovolemic shock in most part.

In this study, 160 cases of breast tumor which had been treated for 6 years and 6 months(from Jan. 1977 to Jun. 1983) were reviewed and summarized as follows:1) 160 cases of breast tumor(157 cases in females, and 3 cases in males) were classified as fibroadenoma. 64 cases(40%), dysplasia 42 cases(26.25%), and breast cancer. 33 cases(20.63%). 2) The abundant age groups were first and second decades in fibroadenoma, third decade in dysplasia. and fourth decade in breast cancer. 3) The most predominant complaint was palpable mass in breast(93.75%), and the duration of symptom was less than 1 year in almost patients(48.75%). 4) The right side of breast was more frequently affected than left side in patients with fibroadenoma or dysplasia(right side : 52.5%, left side : 41.25%) but in patients with breast cancer, the left side was more frequently affected. (right side : 27.27%, left side : 42.43%). 5) The most frequent site of distant metastasis was ipsilateral axllary lymph nodes(30.3%). 6) Excision was performed in most cases(69.38%), and radical mastectomy was performed in 25 cases(15.63%). 7) The size of tumor was 2cm to 5cm in most cases(51.25%).

Fractures of the distal third of the femur proved to be very difficult to treat regardless of selection of treatment method whether surgical or nonsurgical. There are too many difficulties in both accurate reduction with traction and subsquent maintenance of reduction with cast when nonsurgical methods were used, as compared with the problems encountered with accurate internal fixation. Also, there are too many complications when nonoperative methods were used. Recent development of more efficient metallic devices for internal fixation and cast brace, and traction methods will improve the results of the treatments. Forty one cases of supracondylar, intercondylar, and condylar fractures of the femur, which were treated at the department of orthopaedic surgery, college of medicne, Ewha Womans Univeristy during the period from March 1970 to December 1982 has been analysed clinically, and following results were obtained:1) Among 41 cases, 27 cases(65.9%) were male. The most common cause was traffic accident with 25 cases(61.0%) and next was slipping with 7 cases(17.1%). 2) By the Neer's classification, intercondylar fractures of the femur were observed in 27 cases(65.9%), and the most commcn was type III with 11 cases. 3) By the evaluation of Schatzker and Lambert, the results of treatment were satisfactory in 72.7% of the patient with operative method, and only in 37.5% of the patient with conservative method. 4) The results, in the cases of inadequate initial management, severe comminuted supracondylar and intercondylar fractures of the femur, open fractures, prolonged immobilization of the knee joint for 13 weeks, and delayed operative internal fixation of more than 4 weeks were usually fair to good. 5) The results, in the cases of mobilization of the knee joint at 6 weeks from injuries and at 1 week from operative internal fixation were usually excellent to good. 6) Author's methods which consist of making the Z-incision of tensor fascia lata for wide exposure of the operative field, using bone hooks, and temporary fixation by two K-wires were satisfactory for easy reduction of the distal fragment-

There have been many advances in the treatment of suppurative inflammation of the middle ear; however, the problem of chronic otitis media remains a significant part of the otologist's practice. There have been remarkable advances in antibiotic therapy. The otologist is still faced with the challenge of treating the affects of chronic inflammation of the middle ear and mastoid. This challenge is particularly difficult if the chronic ear problem is affected by the formation of cholesteatoma. If an ear develops a cholesteatoma that can not be completely exteriorized by office management, the treatment is surgical. It is the purpose of this paper to report the author's experience over 10 years of treating cholesteatoma using the radical mastoidectomy technique. Because the author realizes that long term results of surgery for cholesteatoma are important. From Jan. 1, 1973 to Dec. 30, 1982, 81 ears were treated by the author with radical mastoidectomy with tymapnoplasty, radical mastoidectomy without tympanoplasty and atticotomy for chronic otitis media accompanied with cholesteatoma. The result of this study as follow; 1) Sex distributions were male : famale ; 1:1.02. 2) Age distributions were 35(43.2%) in second decade, 30(37.0%) in first decade, 14(17.3%) in third decade in order. 3) Site distribution were 44(54.3%) in left, 37(45.7%) in right. 4) Character of otorrhea were 67(82.7%) cases in purulent states, 9(11.1%) cases in sero-mucinous states and 5(6.2%) cases in dry states. 5) Sites of drum perforation were 29(35.8%) cases in total defect, 22(27.2%) cases in central perforation, 10(12.3%) cases in attic perforation and 9(11.1%) cases in marginal perforation in order. 6) Condition of E-tube function were 40(49.4%) cases in poor states, 26(32.1%) cases in fair states and 6(7.4%) cases in good states. 7) X-ray findings of temporal bone were 68(83.9%) cases in sclerotic, 6(7.4%) cases in pneumatic and 2(2.5%) cases in diploic type. 8) Degree of preoperative hearing loss; 22(27.2%) cases were moderately severe degree, 17(21.0%) cases were severe and 21(25.9%) cases were not checked or missing of record. 9) Type of preoperative hearing loss were 39(48.1%) cases in conductive type. 14(17.3%) cases in mixed type and 5(6.2%) cases in sensorineural hearing loss. 10) Type of anesthesia were 61(75.3%) cases under the general anesthesia, 20(24.7%) cases under the local anesthesia. 11) Type of operation were 56(69.1%) cases in mastoidectomy without tympanoplasty, 11(13.6%) cases in mastoidectomy with tympanoplasty and 14(17.3%) cases in atticotomy technique. And operation hours were taken 38(46.9%) cases within 2 hours, 23(28.4%) cases within 3 hours and 4(4.9%) cases within 4 hours in order. 12) Route of approach were 66(81.5%) cases in endaural, 12(14.8%) cases in postauricular and 3(3.7%) cases in transmeatal approach. 13) Condition of middle ear mucosa were 59(72.9%) cases in diseased(It's means of edema, granulation and missing). 14(17.3) cases were squamous and 7(8.6%) cases were intact. 14) Condition of ossicles; missing were 58(71.6%) cases, fixed were 18(22.2%) cases and 5(6.2%) cases in intact. 15) Extent of cholesteatoma were 23(34.3%) cause in attic antrum, 20(29.9%) cases in attic antrum middle ear and 16(23.9%) cases in attic in order. 16) Incidence of destructed outer structure of mastoid antrum were 25.9% and surrounding structure of mastoid antrum were 32.1%. 17) Post-operative change of pure tone average were 15(60%) cases in no change, 6(24%) cases in improvement of 11-15 dB and 2(8%) cases in worse than-10dB, Postoperative audiometry rate is 30.9%.

Herpes zoster characterized by the several groups of vesicles on an erythematous and edematous base situated unilaterally along the distribution of a cranial or spinal nerve leading to one posterior ganglion, often with some overflow into the neurotomes above and below. The onset is rapid, with fever and neuralgic pain(except in persons under 30, as a rule) after an incubation period of seven to 12 days. Zoster is the result of a recrudescence of varicella-zoster virus(VZV) infection. The pathogenesis of herpes zoster is not fully understood. During the course of varicella. VZV passes from lesions in the skin and mucosal surfaces into the contiguous endings of sensory nerves and transported centripetally up the sensory fibers to the sensory ganglia. Although the latent virus in the sensory ganglia retains its potential for full infectivity, reversions are sporadic and infrequent. The mechanisms involved in the reactivation of latent VZV are unclear, but a number of conditions have been associated with the occurrence and localization of herpes zoster. These include immunosuppression in Hodgkin's disease and other malignancies, administration of immunosuppressive drugs and corticosteroids, irradiaion of the spinal column, tumor involvement of the cord, dorsal root ganglia, or adjacent structures, local trauma, surgical manipulation of the spine, heavy-metal poisoning or therapy, and frontal sinusitis as a precipitant of ophthalmic zoster. To detect the general tendency of herpes zoster on these days, 120 patients of herpes zoster at the OPD of dermatology department in Ewha Womans University Hospital during 2 years from Jun 1 1978 to May 31 1980 were analized. The results are as follows: 1) It occurs frequently among females(Male:Female = 1:1.6). 2) Peak age incidence is from 50 to 59(20.0%). 3) There seems to be no seasonal predilection or correlation with varicella epidemics. Monthly distribution: from 5.0% to 11.7% Seasonal distribution: from 20.8% to 30.0% 4) Herpes zoster associated with tuberculosis and hypertension were 4 cases respectively. 5) The most frequently affected dermatomes are thoracie nerve(50.8%), cervical nerve and ophthalmic division of trigerminal nerve.

Endodermal sinus tumor is characterized by perivascular structures(Schiller-Duval bodies). which simulate endodermal diverticula of yolk sac origin. Endodermal sinus tumor has generally been reported to be in ovary and testis. Very few cases of endodermal sinus tumor originating from extragonadal sites such as mediastinum, pelvis, vagina, sacrococcygeal region, pineal gland have been described. The authors report a case of endodermal sinus tumor arising from pineal gland and briefly review literatures.

The authors experienced a 29 year old female patient with hypoplastic anemia during her illness of typhoid fever. Because that is very rare and unreported, we are reporting this patient. She was promptly recovered from hypoplastic anemia with antibiotics for typhoid fever.

Tuberculous tenosynovitis of the hand is a rare condition and it should be differentiated from other soft tissue mass. The authors treated the case with surgical treatment and antituberculous chemotherapy.

Management of bed-ridden patients with polyarticular rheumatoid arthritis poses a considerable challenge to the orthopaedic surgeon. Current techniques of total joint replacement provide for the potential restoration of joint function in patients previously considered inoperable due to far-advanced joint destruction. Because many patients with far advanced polyarticular rheumatoid arthritis will predictably require more than one total joint replacement before an improved functional status will occur, the question of multiple joint replacement arises. We have had a bilateral total kneereplacement in the chronic polyarticular rheumatoid patient. Three years after the operation, the patient has slight pain and motion of full extension to 90'flexion. Bilateral total knee replacement improved mobility and reduced pain in this patient.

Sebaceous hyperplasia, also called senile sebaceous hyperplasia refers to a benign enlargement of normal sebaceous unit in the old age group. The lesions, single or multiple, elevated, cream to yellowish colored round papules with frequent central umbilication have a predilection for the forehead and cheeks. We present an atypical case of sebaceous hyperplasia on a 31-year-old man. About 15 years ago, a small skin colored papule developed on his right cheek without pre-existing skin eruption or trauma history. The asymptomatic papule enlarged slowly reaching up to a walnut sized plaque.

Fertilized egg is implanted anywhere except intrauterine cavity is reffered to as ectopic pregnancy. Ectopic pregnancy was increased recently in spite of effective modern antibiotics therapy, because partial occlusion following episode of gonorrheal or non-gonorrheal salpingitis. Increasing incidence is contributed to IUD, artificial abortion and laparoscopic sterilization as means of birth control. Bilateral tubal pregnancy is rare condition, which incidence was 1 in 1580 ectopic pregnancies, 232 cases have been reported until 1979. Etiologic factor of bilateral tubal pregnancy is similar as general ectopic pregnancy, but this condition may increase in the near future because of prevalent case of clomiphene and pituitary gonadotropin, the increase frequency of tubal surgery and the practice of conservation of the tubal in ectopic pregnancy. We present a case of bilateral pregnancy with brief review of literature.