Malignant melanoma of the lacrimal sac is extremely rare. To our knowledge, there have been 17 cases of malignant melanoma of the lacrimal sacreported in the literature and no case has been reported in Korea. The authors have experienced a 56 year-old male patient complaining of epiphora and mass in the medial canthal and neck areas for two month duration in the left eye. Excisional biopsy showed typical malignant melanoma which was treated with radiation therapy. Metastasis occurred in spinal cord during follow-up period. Although malignant melanoma of lacrimal sac is very rare, it should be considered in differential diagnosis of a growing tumor in the lacrimal sac.
Biopsy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Korea ; Lacrimal Apparatus Diseases ; Male ; Melanoma* ; Middle Aged ; Neck ; Neoplasm Metastasis ; Spinal Cord

Antiestrogen tamoxifen (TMX) is thought to elicit its therapeutic effect by competing with endogenous estrogens for the estrogen receptor. Several more recent studies asserted that the antitumor effect of TMX is not due solely to the inhibition of estrogen receptor-mediated action, but due partly to its capacity to inhibit angiogenesis and impair neovascularization. Despite extensive research and clinical experience with this drug, its exact mode of action in inducing tumor regression is still not clear. The present study is aimed toward the investigation of the effects of TMX on dimethylbenzanthracene- induced rat mammary carcinomas with respect to the tumor response to the drugs, histological changes, cell proliferative acitivity and angiogenesis inhibition, and if TMX has antiangiogenic action, to compare it with that of pentosan polysulfate (PPS), an already known antiangiogenic substance. Female Sprague-Dawley rats, aged 50 days, were divided into normal control, test control (tumor induction by dimethylbenzanthracene), TMX (TMX administration after tumor induction), and PPS (PPS administration after tumor induction) groups. Tumor response to the drug administration was classified according to changes of tumor volume as follows; complete response (CR), partial response (PR), no response (NR), and progressive disease (PD). The response rate of rat mammary carcinomas to the drug administration was significantly higher (p<0.05) in the TMX and PPS groups as compared with the test control group. There was, however, no statistical significance between the TMX and PPS groups. Necrosis was considerably frequent in tumors of the TMX and PPS groups. Hyaline change of the stroma was strikingly more common and marked in the TMX group and it was associated with atrophy of epithelial cells of the tumor glands. Proliferating cell nuclear antigen (PCNA)- labeling index of the tumors was significantly higher (p<0.05) in the tumors with NR and PD of the TMX group when compared with those with PR of the same group, which suggested a higher cell proliferative activity in these response groups. In the PPS group, however, there was no significant difference in PCNA index according to response. Microvessel density of the tumors was significantly lower (p<0.05) in the PPS group as compared with the test control and TMX groups and it was not related with response. The TMX group, however, did not show any significant difference in microvessel density when compared with the test control group. Microvessel density was significantly higher (p<0.05) in tumors with PD than those with PR in all 3 groups, which suggested a positive relation of increase in tumor size and angiogenesis. Based on these results it is thought that TMX and PPS inhibit growth of chemically-induced rat mammary carcinomas. It seems that the antitumor action of PPS is related with its antiangiogenic capability, but that of TMX does not have a relationship with angiogenenesis inhibition.
Female ; Humans ; Rats ; Animals ; Breast Neoplasms

No abstract available.
Hypersensitivity* ; Meperidine* ; Skin*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Acquired Immunodeficiency Syndrome ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans

The authors studied retrospectively on the surgical results of modified Fasanella-Servat operation for blepharoptosis. The 58 patients underwent modified Fasanella-Servat operation for blepharoptosis and were followed for at least 6 months. We obtained 74.1% primary success rate in the 58 cases of blepharoptosis. The undercorrection, the most common complication, could be correctable by any other ptosis procedures such as levator resction. However, severe complications such as overcorrection and eyelid contour abnormalities were very rare. We also obtained good surgical results even in groups of moderate degree of ptosis and fair levator function which had not been indicated for Fasanella-Servat operation in general.
Blepharoptosis ; Eyelids ; Humans ; Retrospective Studies

Among total 108 cases of biopsy-proven fibroadenomas of the breast, which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-leading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) in 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proliferative breast lesions with atypia(26.1%). None were subject to the category of carcinoma. Cytologic features leading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pleomorphism without nuclear enlargement, and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.
Neoplasm Metastasis

Orbital lymphangioma is a benign vascular hamartoma that may be found in the conjunctiva, eyelids, orbit, or elsewhere in the head and neck region. Deep lymphangiomatous lesions are classically characterized by acute onset of a fulminant proptosis resulting from spontaneous hemorrhage within the orbit. Complete surgical excision is often difficult because of the infiltrative nature of the tumor. Moreover, because of the hemorrhagic and friable nature of the tumor, conventional surgical techniques are frequently complicated by bleeding. We treated a case of pathologically-proven orbital lymphangioma with the ultrapulse CO2 laser. The ultrapulse CO2 laser permits a precise form of treatment with the ultimate form of hemostasis[tissue vaporization], resulting in minimal trauma, edema, and scarring, and thus offers a safe alternative to surgical excision of this lesion. The ultrapulse CO2 laser is an best ideal instrument for subtotal excision of this lesion because of its hemostatic cutting-vaporizing actions.
Cicatrix ; Conjunctiva ; Edema ; Exophthalmos ; Eyelids ; Hamartoma ; Head ; Hemorrhage ; Lasers, Gas* ; Lymphangioma* ; Neck ; Orbit* ; Volatilization*

The hydroxyapatite orbital implant has been known to be a biocompatible and nontoxic implant with good fibrovascular ingrowth, few postoperative complications, and excellent prosthesis motility. The complications after implantation of hydroxyapatite were included peg extrusion, implant exposure, conjunctival dehiscene, granulation tissue overgrowth, and infection of implant. Infected hydroxyapatite implants are, to date, rare. When they occur, implant removal has been the only successful treatment modality. Infection of hydroxyapatite implant occurred in 37months after surgery on conjuctival culture. Pseudomonas aeruginosa was identified as a causative microorganism. To our knowledge, this is the first report of complications with the latest infected hydroxyapatite after implantation of hydroxyapatite. The case also unique because causative microorganism is Pseudomonas aeroginosa instead of Staphylococcus aureus. Persistent conjunctival inflammation postoperatively despite using systemic and topical antimicrobial drops, persist orbital discomfort, discharge, conjunctival dehiscence and the development of a pyogenic grauloma after hydroxyapatite implant should be suspected possibility of hydroxyapatite implant infection.
Durapatite ; Granulation Tissue ; Granuloma, Pyogenic ; Inflammation ; Orbit ; Orbital Implants ; Postoperative Complications ; Prostheses and Implants ; Pseudomonas aeruginosa ; Pseudomonas* ; Staphylococcus aureus

BACKGROUND: The pathogenesis of atopic dermatitis is still unknown. Many reports have suggested that the house dust mite antigen may play a role in the pathogenesis of atopic dermatitis. The IgG4 allergen-specific subclass has been considered to be involved both in allergic reactions and associated with the appropriate response to allergen-specific immunotherapy. OBJECT: The purpose of this study was to evaluate the positive rate of the allergic prick test to D. farinae and the levels of D. farinae-specific IgE and Ig64. METHODS: We performed the allergy prick test, RAST for D. farinae-specific IgE and ELISA for D. farinae-specific IgG subclasses and compared the values between atopic dermatitis patients and normal controls. RESULTS: 1. D. farinae was the most common allergen in patients with atopic dermatitis and the positive rate of the allergic prick test was 61.0%. The positive rate of the allergic prick test and the positive rate to D. farinae increased as c]inical grading increased. 2. The Positive reaction rate of D. farinae-specific IgE(RAST) in those with atopic dermatitis was 68.8% and increased as the positive reactions of the allergic prick test to D. farinae and chnical grading increased. 3. Among the IgG subclasses, only the level of D. farinae-specific IgG4 was significantly higher in atopic dermatitis than normal controls. 4. The level of D. farinae-specific IgG4 showed a tendency to decrease in accordance with the clinical severity grades. CONCLUSION: These results suggested that D. farinae might play an important role in the development of atopic dermatitis and well-designed studies should continue to be performed in order to delineate the biological significance of IgG4.
Antibodies* ; Dermatitis, Atopic* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G* ; Immunotherapy ; Pyroglyphidae*