A Case of Malignant Proliferating Trichilemmal Tumor with Spindle Cell Carcinoma

Proliferating trichilemmal cyst(proliferating trchilemmal tumor, PTC) most commonly occurs in the scalp and is generally benign. Malignant transformation of PTC is rare, and the appearance of a spindle cell(sarcomatoid) carcinoma is extremely rare. The authors experienced a case of malignant proliferating trchilemmal tumor with spindle cell carcinoma on the scalp in a 41-year-old male. The tumor was widely resected and covered with split thickness skin graft after Terudermis(R) graft. Imaging studies and fine needle aspiration cytology showed no regional lymph node involvement or distant matastasis.

Muller's Muscle-Levator Aponeurosis Advancement Procedure for Blepharoptosis

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.

Distribution and Density of Pubic Hair of the Korean Adult Female

'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.

Treatment of Medial Orbital Wall Fracture Using Medial Transconjunctival Approach

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.

Clinical application of single hair transplantation

No Abstract Available.