Lamellar keratoplasty was done to six eyes with preserved rabbit corneas including scleral rim of 1-2mm which were preserved in three kinds of 5cc. alcohol-glycerine (A.G) solution at room temperature for the period of one month to three years and their macroscopical and histological study was carried out. Three kinds of solution were; 1. A.G. No.1 solution; 50% ethyl alcohol and 100% glycerine mixed by equal ratio. 2. A.G. No.2 solution; 50% ethyl alcohol and 100 % glycerine mixed by two to one ratio. 3. A.G. No.3 solution; 50% ethyl alcohol and 100% glycerine mixed by three to one ratio. The results of the above mentioned lamellar keratoplasty with the corneas preserved in three solutions were uniformly good in all groups. The results of keratoplasty with the corenas preserved for 3 years were as follows; 1. Transplantation of the preserved corneas in A. G. No.1 solution showed transparent adhesions in two eyes, partial opacity in one, total opacity in two, and rejection in one. Neo-vascularization in this groupwas more prominent than in other groups. 2. Transplantation of the corneas preserved in A.G. No.2 solution resulted in transparent adhesion in four eyes, partial pacity one, and total opacity in one and this result could be evaluated as the best of all three groups. 3. Transplantation of the corneas preserved in A.G. No. 3 solution showed transparent adhesion in two eyes, partial opacity in three, and total opacity in one and this result was slightly inferior to that of the second group. 4. Lamellar keratoplasty with human cornea preserved in A.G. No.2 solution for 18 and 33 months in the 2 cases of corneal leucoma after recurrent meta-herpetic keratitis, resulted in success respectively.
Cornea* ; Corneal Transplantation* ; Ethanol ; Glycerol ; Humans ; Keratitis

No abstract available.
Free Tissue Flaps* ; Lower Extremity*

No abstract available.
Skin*

Three cases of orbital rhabomyosarcoma are reported here. Histological studies comfirmed the lesion 1:0 be the alveolar type in all cases. This tumor is a rare disease entity in Orient than Europe and America and accordingly, rarely encountered in our ophthalmologic practice, although it is the commonest primary malignant orbital tumor in children. Of the three cases reported here one occurred in adu1t and the other two in children. Case I. This 15 month old male showed a swelling of the left upper lid toward the medial side for 2 months and visited to our hospital on March 10, '69 with complaints of progressive swelling on the region with ptosis. The eye ball was slightly displaced toward the lower temporal side and ocular movement is limitted to upward. On palpation, the childthumb sized tumor was palpable in the upper nasal portion of the orbit. On excision of the tumor, the mass was found to be originated from the superior oblique muscle. The mass round measuring 2.5 X 2.5 X 1.5 cm in size. Histological diagnosis was alveolar rhabdomyosarcoma without cross-striation. No follow-up could be done. Case II. This patient of 15 month old male showed a swelling on the right lower lid existed 6 months and visited to our hospital on September 8, '69. The physical examination revealed that the left eye and the other routine examinations were within normal limits. The right eye showed the swelling of the lower lid, congestion of the palpebral conjunctiva, limitted movement of the eye ball toward the lower side and a palpable bean-sized mass on the region. The excision of tumor was performed under the general anesthesia. This mass was attached with the inferior oblique muscle with no other recognizable adhesion seemingly originating from that muscle. The mass was round and oval in shape, measuring 2 X 2 X 1 cm in size, diagnosis was alveolar rhabdomyosarcoma. The post-operative follow-up studies were unavailable. Case III. This case in one of adult alveolar rhabdomyosarcoma. At the age of 25 years, this man showed a proptosis of the right eye associated with migrain like headache, ocular pain and visual disturbance. This symptoms existed 6 months and gradually increased in intensity. On the physical examination, the left eye was found to be normal. The skull and orbit x-ray and c.b.c. were with in normal limits. The right eye revealed about 5mm proptosis compared with left eye and the adult thumb sized tumor was palpated on the inner side of the lower orbital rim. The visual acuity was in zero. The right optic disc was edematous and elevated about 4.0 D. The pupil showed marked dilatation and the light reflex was abscent and ocular movement was markedly limitted and eye ball is deviated toward the upper side. Under the general anesthesia, the exenteration of the orbit associated with the removal of tumor was carried out with no untoward complications. Origin of the mass was the inferior oblique muscle penetrating to the deeper part of the optic foraman and optic nerve was surrounded by the tumor completely Histology confirmed alveolar rhabdomyosarcoma. Follow-up study was impossible.
Adult ; Americas ; Anesthesia, General ; Child ; Conjunctiva ; Diagnosis ; Dilatation ; Estrogens, Conjugated (USP) ; Europe ; Exophthalmos ; Headache ; Humans ; Infant ; Male ; Optic Nerve ; Orbit* ; Palpation ; Physical Examination ; Pupil ; Rare Diseases ; Reflex ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Alveolar ; Skull ; Thumb ; Visual Acuity

No abstract available.
Biopsy, Fine-Needle* ; Neck*

No abstract available.
Histiocytosis*

BACKGROUND: PUVA photochemotherapy has been accepted as an effective mode of treatment for psoriasis. Many combination therapies have been tried to reduce the possible adverse effects of long-term exposure to UV radiation. OBJECTIVE: This study was performed to compare calcipotriol-PUVA combination therapy(D-PUVA) with conventional PUVA in the treatment of Korean psoriasis patients. METHODS: We treated 38 Korean psoriasis patients with conventional PUVA and 12 with D-PUVA. We compared the total number, duration and total UVA dose of PUVA therapy to reach grade 4 between the two groups. We categorized each patient into clearing, improvement, or failure groups based on the therapeutic efficacy, and measured the PASI score at each of the patients visits. RESULTS: The total cumulative dose of D-PUVA phototherapy was significantly smaller than PUVA phototherapy. CONCLUSION: Combining PUVA with a vitamin D analogue, calcipotriol, in the treatment of psoriasis may lead to lowering the risk of long-term exposure to UV radiation with higher efficacy.
Humans ; Photochemotherapy ; Phototherapy ; Psoriasis* ; PUVA Therapy ; Vitamin D

No abstract available.
Foot*

BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). METHODS: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. RESULTS: Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. CONCLUSIONS: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Arthroplasty* ; Clavicle ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder* ; Visual Analog Scale

The aim in arthrodesis of ankle is to gain a painless, normal walking gait of destroyed ankle joint caused by various origins. Despite more than 30 different fusion techniques have been described in the literature, but the results were not always satisfactory. Blair introduced tibial sliding graft, rectangular hone block donated at distal tibia, to the neck of talus. His method has advantages of a normal apperance of the foot, no shortening, and the weight bearing thrust on normal tissue. The purpose of this study was to compare the ankle arthrodesis according to surgical procedures & introduce the method which could produce excellent results for ankle arthrodesis. We reviewed 23 patients(24 cases) undergone ankle arthrodesis from Jan. 1989 to Dec. 1996 in Kyung Hee Medical Center. Male were twelve(13 cases) and female were eleven. Mean age was 42.6(l8-75)years. The Blair fusion method was used in ten cases. Iliac bone graft followed by internal fixation using Steinmann pin in 4 cases, using cancellous screw in I case, and using both Steinmann pin and staple in 1 case, while tibiotalar coaptation without bone graft followed by internal fixation using Steinmann pin in 3 cases, using staple in 1 case, and using cancellous screw in 1 case. In 3 cases, arthroscopic abrasion and cancellous screw was used. The mean duration of follow-up was 46(6-99) inonths. Time to union was average l4.6(8-23) weeks in Blair fusion and 17.5(8-40) weeks in other methods. Delayed union was observed in three cases, but no case was found in Blair fusion. Pain was ohserved in 5 cases, 3 in Blair fusion and 2 in other methods. Nonunion or pseudoarthrosis was not ohserved. On the clinical criteria for Boston Childrens Hospital ankle-scoring system, we ohserved nineteen excellent and five good cases. The difference in results according to fusion method was not ohserved. The results in tibiopedal motion using cineroentgenography were seven good and three fair cases in Blair, while two good, ten fair and two poor in other methods. By using Blair fusion, we expect early bony union and better clinical results.
Ankle Joint ; Ankle* ; Arthrodesis* ; Child ; Female ; Follow-Up Studies ; Foot ; Gait ; Humans ; Male ; Neck ; Pseudarthrosis ; Talus ; Tibia ; Transplants ; Walking ; Weight-Bearing