Orbital mesenchymal chondrosarcoma, first described by Luis et. al in 1971, is a very rare tumor of characteristic histologic features. A 21-year-woman was admitted with a 4-month histoiry of rapidly progressive proptosis and visual disturbance. Right orbital exenteration was performed under the clinical diagnosis of orbital calcifying tumor. Grossly, the tumor presented as a multibloblated, circumscribed mass that measures 5.5 cm in the greatest dimentsion. Cut sections resembled ordinary chonrosarcoma. Microscopically, the tumor was composed of undifferentiated mesenchymal cells, interspersed nodules of well differentated cartilagenous tissue, areas of gradual transition from undifferentiated mesenchymal cells to cartilage, and hemangiopericytoma-like areas. A brief summary of the histopathological aspect of this tumor and a review of literature are presented.
Female ; Humans

It was reported that muscle-scleral tuck with nonabsorbable suture material helps to preserve anterior ciliary artery circulation and to prevEnt anterior segment ischemia. The authors measured maximum adhesion power and obsesved histopathologic findings at 1st, 2nd, 4th, and 8th week following a muscle-scleral tuck procedure with absorbable suture material in rabbits. Maximum adhesion powers were increasing with time, 110, 120, 150, and 250gm at each week respectively, and kept enough tension for using absorbable suture material Histopathologic findings demonstrated that inflammatory and foreign body reactions decreased with time, and collagen fibers were proliferated at muscle scleral contact area, and fibers in muscle and sclera connected each other and formed firm adhesion. We concluded that muscle-scleral tuck with absorbable suture material maintained adhesion power enough as a rectus muscle strengthening procedure.
Ciliary Arteries ; Collagen ; Foreign Bodies ; Ischemia ; Muscles* ; Rabbits* ; Sclera ; Sutures*

To investigate the pathogenicity, genomic pattern, and o-like hemolysin of Staphylococcus lugdunensis (S. lugdunensis) in acute oral infection, S. lugdunensis was isolated from patients with an acute oral infection and from healthy persons. Antibiotic susceptibility, in vitro cellular toxicity, in vivo virulence, and hemolytic activity were tested, and plasmid DNA and restriction pattern of whole genomic DNA were analyzed to characterize the staphylococci. The dot blot and Southern blot hybridization analysis of staphylococcal DNA were performed with o-hemolysin gene probe. The isolation ratio of S. lugdunensis in the patients was higher than that in the healthy persons. S. lugdunensis from the patients with an acute oral infection showed resistance to penicillin, ampicillin, methicillin, cephalothin, and clindamycin. In the analysis of plasmid, there was a clear band about 6.5 kb in three strains of S. lugdunensis isolated from the patients with infection. S. lugdunensis in the patients had cellular toxicity in vitro and virulence in vivo. All strains of S. lugdunensis had o-like hemolysin activity against rabbit erythrocytes. Four of the six strains of S. lugdunensis gave synergistic hemolysis with Staphylococcus aureus (S. aureus) on sheep blood agar plates. In the analysis of genomic pattern, four strains of S. lugdunensis that gave synergistic hemolysis with S. aureus showed a similar genetic pattern with HindIII enzyme digests. In dot blot analysis, all strains of S. lugdunensis showed a positive reaction with the probe of 5-hemolysin gene in S. aureus. In Southern blot analysis, a 7.3 kb HindIII fragment was observed in DNA of S. lugdunensis that gave synergistic hemolysis with S. aureus, and a 2.5 kb band was observed in HindIII digests of S. aureus in the patients. These results suggest that S. lugdunensis may be an important pathogen in an acute oral infection and the 7.3 kb HindIII fragment from S. lugdunensis DNA may contain o-like hemolysin gene.
Agar ; Ampicillin ; Blotting, Southern ; Cephalothin ; Clindamycin ; DNA ; Erythrocytes ; Hemolysis ; Humans ; Methicillin ; Penicillins ; Plasmids ; Sheep ; Staphylococcus aureus ; Staphylococcus lugdunensis* ; Staphylococcus* ; Virulence

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Incidence*

Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

We performed surgery for correction of abnormal head turn in 10 patients with congenital nystagmus. For 3 patients with a head turn of 30 degrees, a 40% augmented modified kestenbaum operation was performed. For 4 patients with a head turn of 45 degrees, a 40% augmented modified kestenbaum operation combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. Finally, for 3 patients with a head turn of 60 degrees, a 60% augmented modified kestenbaum procedure combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. At the final follow-up visit(averaging 5.9 months), 7 patients showed complete corrections of previous head turn and 3 patients showed a small residual head turn of less than 10 degrees to the same side of the preoperative head turn. The average amount of correction we obtained from the surgery described above were 26.7, 42.5 and 56.7 degrees for the patients who had had a preoperative head turn of 30, 45 and 60 degrees respectively. Among the 10 patients, 4 showed no change in corrected visual acuity, but 6 showed increased corrected visual acuity by over 1 Snellen line. From the above results, we concluded that if recession procedure of the conjunctival and subconjunctival tissues was combined with augmented modified Kestenbaum procedure, its effect for correction of abnormal head turn in a patient with congenital nystagmus could be enhanced.
Follow-Up Studies ; Head* ; Humans ; Nystagmus, Congenital* ; Visual Acuity

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Foot ; Humans ; Incheon ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tarsal Bones ; Transplants

The clinicopathology of nine cases of eccrine spiradenoma was examined. The ages of the patients ranged from 32 to 65 years, with an average age of 46 years. There were four males and five females. Eight tumors out of the nine presented on the ventral surface of the upper body. The tumors were solitary in seven cases and multiple in two cases(cases 8 and 9). Six tumors were either painful or tender to palpation. Histologically, two cases(cases 1 and 2) were adenomas with well developed tubular structures, while the remaining seven cases were epitheliomas with poor organization and prominent reticular pattern. All tumors were composed of two distinct cell types. Since four cases showed considerable edema with a lot of cystic change, it was difficult in some areas to differentiate these from other adnexal tumors or vascular tumors. Immunohistochemical staining was performed on paraffin-embedded sections of 5 eccrine spiradenomas. CEA and EMA were expressed in the cytoplasm of tumor cells in all cases. Cytokeratin was expressed in 4 out of 5 cases, and S-100 in 3 out of 5 cases. There has been no evidence of recurrence in 8 cases. In one case(case 9) the tumor recurred locally with carcinomatous transformation- characterized by the presence of solid areas of tumor which was composed of large cells with irregularly shaped nuclei and mitotic figures. There were foci of ductal differentiation, extensive areas of tumor necrosis and invasion into surrounding connective tissue. The carcinomatous portion revealed positive reaction for CEA, EMA, S-100 protein and cytokeratin.
Female ; Male ; Humans ; Adenoma

Idiopathic thrombocytopenic purpura (ITP) is an immunologic disorder that destroys platelets and megakaryocytes. Hemorrhagic complications are common in patients with ITP. However, thrombotic complications such as coronary artery disease and cerebral infarctions are infrequent. We report a patient with ITP who developed a cerebral infarction despite thrombocytopenia after long-term danazol therapy and was negative for the antiphospholipid antibody.
Antibodies, Antiphospholipid ; Cerebral Infarction* ; Coronary Artery Disease ; Danazol ; Humans ; Megakaryocytes ; Purpura, Thrombocytopenic, Idiopathic* ; Stroke ; Thrombocytopenia

Clinical chemotherapy refractoriness is characterized by resistance to multiple drugs. Multidrug resistance(MDR) is caused by over-reactivity of a unidirectional drug efflux pump, transmembrane glycoprotein(P-glycoprotein), which is encoded by the MDR1 gene. P-glycoprotein leads to increased drug efflux and decreased intracellular drug concentration. Clinical trials that attempt to reverse or modulate MDR have been done. Cyclosporin-A and verapamil are the most extensively studied agents and several trials of cyclosporin-A as a MDR modulator have been reported. We report a case of an 8-year-old girl with acute mixed type leukemia who failed to respond 3 times to remission-induction therapy. It led us to conclude she had multidrug resistance. We tried a fourth induction chemotherapy including cytarabine, idarubicin and 6-thioguanine to which cyclosporin-A was added. Then, she showed signs of severe bone marrow depression and fulminant perianal cellulitis. But she recovered and successfully achieved complete remission. The addition of cyclosporine could be useful in achieving complete remission for cases of acute leukemia that resist to usual chemotherapy. Futher observation including more cases will be needed to assess long-term survival and efficacy of adding cyclosporine.
Bone Marrow ; Cellulitis ; Child ; Cyclosporine ; Cytarabine ; Depression ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Female ; Humans ; Idarubicin ; Induction Chemotherapy ; Leukemia* ; P-Glycoprotein ; Thioguanine ; Verapamil