The authors operated 46 cases of pterygia by the modifed Walter's procedure, which was combined with excision, baring the sclera at the limbus, cautery of the limbus, limbal groove, and transplantation. The following results were obtained. 1) 39 cases out of 46 cases were successfully treated, however 7 cases recurred. The rate of recurrence was 15.2 percent 4 cases of pterygia which recurred received a free graft from the upper bulbar conjunctiva, using a modified Walter's procedure. The results of reoperation were satisfactory in 3 cases. 2) The recurrence rate was greater in cases of the highly vascular, thick, inflamed, and rapid growing type. 3) To date, no evidence of astigmatism and other complications due to the utilization of these modifications have been noted in our cases. 4) The authors believe that good technique, treatment of chronic conjunctival inflammation, and improvement of life environment are the most important factors in the prevention of recurrence. However, the last factor is a very difficult problem in Korea. 5) Using the best developments from several standard surgical procedure for the treatment of pterygia the authors was able to lower their recurrence rate.
Astigmatism ; Cautery ; Conjunctiva ; Fibrinogen ; Inflammation ; Korea ; Pterygium* ; Recurrence ; Reoperation ; Sclera ; Transplants

No abstract available.
Antibodies* ; Immunoglobulin G* ; Immunoglobulin M*

PURPOSE: To document the radiologic characteristics of Korean Gaucher disease. MATERIALS AND METHODS: Fifteen bone marrow biopsy and laboratory data confirmed Gaucher disease patients (age 1 -21, mean 10.9 yr) wereundertaken plain X ray and MRI. Number of type I were 10, type II, 2, type III, 3. Seven were splenectomized oninitial evaluation or during follow up. Five enzyme treated patient were undertaken follow-up MR examinationduring 6 -40 month with 6 month interval. Conventional T1 and T2WI of spine and femur was performed and FMPSPGR inand out of phase image was also done. Volume of liver and spleen were measured, and bone marrow infiltration andpresence of infarction were scored according to 6 scale scoring system. Clinical data were also reviewed andcorrelated with the MR findings. RESULTS: Marrow infiltration was noted in 71.4% of all patients in MRI, while itwas in 45.7% with plain radiography. Type I group showed marrow infiltration in all but one cases, which wasparallel with ages, SGPT, and presence of osteopenia, reversely correlated with spleen size. Severe bonecomplications (infarction or fracture) were noted in 7 of 10 type I group, and 6 patients showed severe growthretardation (below 3rd percentile). Follow up MR examination of 5 patient showed decrease in liver and spleen sizefirst without bone change until 6 months. There showed bone regeneration in 2 patient 1 year after, and increasedfat signal in one patient 3.5 years after. In and out of phase images couldn't help in quantifying fatcomposition in bone marrow. CONCLUSION: Korean Gaucher patients revealed as more severe skeletal complicationsthan others reported from Western groups. MR examination is a effective modality to evaluate and monitor ofGaucher patients.
Alanine Transaminase ; Biopsy ; Bone Diseases, Metabolic ; Bone Marrow ; Bone Regeneration ; Femur ; Follow-Up Studies ; Gaucher Disease* ; Humans ; Infarction ; Liver ; Magnetic Resonance Imaging ; Metabolism ; Radiography ; Spine ; Spleen

Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis.
Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Development ; Bone Resorption ; Collagen Type I ; Deafness ; Dentinogenesis Imperfecta ; Diagnosis ; Fractures, Bone ; Genetic Diseases, Inborn ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Sclera ; Scoliosis ; Spine

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital disorder of type I collagen, with variable phenotypes, due to increased bone fragility and low bone mass. Previous pharmacological treatments for OI have been attempted with calcitonin and growth hormone but with little beneficial effects. Recently, Glorieux reported the beneficial effects of bisphosphonates in OI. METHODS: In this study, the effects of pamidronate treatment were evaluated in 9 patients with OI. All patients received intravenous pamidronate infusions, which was dose adjusted according to the patients' age. The outcome measures included the biochemical bone markers; serum alkaline phosphatase, urine deoxy-pyridinoline, urine Ca/Cr ratio, and bone mineral density (BMD). RESULTS: Serum alkaline phosphatase, urine deoxypyridinoline, and urine Ca/Cr ratio were slightly decreased after 1 year of therapy, although these changes were not statistically significant. The BMDs of the lumbar spine and proximal femur were significantly increased after 1-year of pamidronate treatment. No fractures were reported during the 1 year treatment periods. CONCLUSION: Pamidronate treatment had an effect on the BMD in osteogenesis imperfecta, probably due to decreasing bone resorption
Alkaline Phosphatase ; Bone Density ; Bone Resorption ; Calcitonin ; Collagen Type I ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diphosphonates ; Femur ; Growth Hormone ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Outcome Assessment (Health Care) ; Phenotype ; Spine