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

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

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.
Acquired Immunodeficiency Syndrome ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans

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

Surgical approaches to blowout fracture have been made through a skin inci-sion in the lower eyelid placed just below the eyelashes[a subciliary pproach], a conjunctival approach, a transantral approach, or a combined approach. Authors repaired the orbital floor fracture through the transconjunctival and transantral approaches simultaneously in 4 patients confirmed orbital floor fracture on CT scan from April to September 1998. Transconjunctival approach could avoid ectropion, lower eyelid retraction and transantral endoscopic orbital floor exploration could allow precise determination of fracture size, location, and replacement of prolapsed tissue and placement of implant over the bony defect. So it was possible to repair with a minimal size of implant and could avoid the complications caused by a too large implant in the posteriorly located orbital floor fracture.
Ectropion ; Endoscopy ; Eyelids ; Humans ; Orbit* ; Orbital Implants* ; Skin ; Tomography, X-Ray Computed

To investigate the correlation of peripapillary atrophy with optic disc dupping and disc hemorrhage in primary open angle glaucoma(POAG) patients, tomographic measurements were performed with Heidelberg Retina Tomograph(HRT, Heidelberg Engineering, Germany). We analyzed cup to disc area ratio(C/D ratio) and peripapillary atrophy to disc area ratio(P/D ratio) from 28 eyes of 14 POAG patients with peripapillary atrophy(Group A), only C/D ratio from 28 eyes of 14 POAG patients without peripapillary atrophy(Group B), and only P/D ratio from 28 eyes of non-glaucomatous subjects with peripapillary atrophy(Group C). Group A was subclassified into thos with disc hemorrhage (Group A-1) and those without dixd hemorrhage(Group A-2), and changes of visual field defects were also analyzed from each subgroup witn Humphrey automated perimetry (Allergan Humphrey, USA, C24-2) at the six-month follow-up. Cup to disc area ratio(0.54+/-0.160)in the Group A was signifcantly higher than that(0.406+/-0.130) in the Group B, and P/D ratio was higher in Group A(0.619+/-0.203) than in the Group C(0.484+/-0.130). P/D ratio was also higher in Group A-1(0.725+/-0.34) than in the Group A-2(0.605+/-0.273). There was no significant difference in mean deviation(M/D) and corrected pattern standard deviation(CPSD) between Group A-1 and Group A-2. The results led us to the conclusion that peripapillary atrophy had significant correlation with glaucomatous damage on optic disc and disc hemorrhage in glaucoma patients. Therefore more attention should be paid tod a glaucoma patient especially when he or she presents with peripapillary atrophy.
Atrophy* ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle* ; Hemorrhage* ; Humans ; Retina ; Visual Field Tests ; Visual Fields

Subperiosteal hematoma of the orbit is uncommon and mostly caused by trauma or some general diseases such as leukemia, hemophilia, and scurvy. Subperiosteal yhematoma associated with sinusitis which is not related to trauma and general diseases, however, is extremely rare. The authors report a case of subperiosteal hematoma of the orbit in 22-year-old man without a history of trauma and general diseases. He had proptosis, and sudden decreased visual acuity. Clinical features, and computerized tomography established the diagnosis of subperiosteal orbital hematoma secondary to ethmoid and maxillary sinusities. We could make definitive diagnosis by needle aspiration of blood using 18-gauge needle with a 10ml syringe at our OPD. To avoid complications such as compressive neuropathy, central retinal occlusion, and recurrence of hematoma, we managed it successfully by evacuation of blood and thermal cauterization to bleeding areas of periosteum, or bone.
Cautery ; Diagnosis ; Exophthalmos ; Hematoma* ; Hemophilia A ; Hemorrhage ; Humans ; Leukemia ; Maxillary Sinus* ; Maxillary Sinusitis* ; Needles ; Orbit* ; Periosteum ; Recurrence ; Retinaldehyde ; Scurvy ; Sinusitis ; Syringes ; Visual Acuity ; Young Adult

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*

It is the purpose of this study to compare the postoperative results of 168 patients with exotropia of basic and simulated divergence excess type over 40 prism diopters; 86 patients had bilateral rectus muscle recessions and 82 patients underwent lateral rectus muscle recession and medial rectus muscle resection. The patients in the former group had averaged 13.7 years of age and 8.2 months of postoperative follow-up period. Those in the latter group averaged 22.9 years and had been followed up for 7.1 months. The postoperative success rates are as follows: 66.7%(57/86) in the bilateral rectus muscle recession group and 68.1%(58/82) in the lateral rectus muscle recession and medial rectus muscle resection group(P>0.05). And the success rates of those older than 16 years without amblyopia are 60.0%(18/30) in the former group and 75.0%(24/32) in the latter group(P>0.05). The lateral rectus muscle recession and medial rectus muscle resection group showed somewhat higher rates of success even though it proved statistically insignificant.
Amblyopia ; Exotropia* ; Follow-Up Studies ; Humans