PURPOSE: Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small sized arteries throughout the vascular system, including ocular tissues. We report a case of orbital polyarteritis nodosa complicated with retinal vasculitis and exophthalmos. METHODS: A 51-year-old woman complained of swelling and hard mass in periorbital region for 3 months. The left eye was anophthalmos after enucleation secondary to corneal infection. The patient has treated marginal ulcer of the cornea and keratomalacia. Posterior synechia and motility disturbance of lateral rectus muscle were also revealed. Fundus examination showed focal retinal hemorrhage, macular hard exudate, and soft exudate, which may mean retinal vasculitis. Both eyes gradually developed exophthalmos. Orbital CT scan revealed homogenous infiltration in the orbit, ethmoid bone, and nasal cavity and perforation of the nasal septum. The pathologic examination for the biopsy specimen from the orbital tissue demonstrated a nongranulomatous vasculitis, diagnosing the polyarteritis nodosa. RESULTS: The authors present ocular manifestations, including marginal corneal ulcer, keratomalacia, dysfunction of the extraocular muscles, posterior synechia, retinal hemorrhage, soft exudate, hard exdate in the macula, and exophthalmos, in this patient with the polyarteritis nodosa.
Anophthalmos ; Arteries ; Biopsy ; Cornea ; Corneal Ulcer ; Ethmoid Bone ; Exophthalmos* ; Exudates and Transudates ; Female ; Humans ; Middle Aged ; Muscles ; Nasal Cavity ; Nasal Septum ; Orbit* ; Peptic Ulcer ; Polyarteritis Nodosa* ; Retinal Hemorrhage ; Retinal Vasculitis* ; Retinaldehyde* ; Tomography, X-Ray Computed ; Vasculitis

No abstract available.
Nipples*

PURPOSE: To report a case of cryptococcal chorioretinitis in the renal transplant patient. MATERIALS AND METHODS: A 31-year old male patient was admitted with visual disturbance, high fever and general weakness. On initial evaluation, visual acuity was 0.9 in the right eye and 0.3 in the left. On fundus exam, right eye showed the lesions which were expanded into posterior pole and equator and left eye showed several yellow white lesions which were larger than optic disc, and some of them were near the fovea. RESULT: Cryptococcus grew in CSF. The ocular diagnosis was cryptococcal chorioretinitis and intra-venous amphotericin B and oral flucytosine were given. In spite of 2-month treatment, the visual acuity of left eye was 0.04 due to the expansion of the lesion toward fovea. The patient refused the treatment after 4 months of treament, and he expired 1 month later.
Adult ; Amphotericin B ; Chorioretinitis* ; Cryptococcus ; Diagnosis ; Fever ; Flucytosine ; Humans ; Male ; Visual Acuity

As a result of surgical orthodontic treatment of mandibular prognathism, changes take place in the skeletal and soft orofacial components. Although some investigators had stated that permanent reduction of airway space was observed agter mandibular setback surgery, it was not clear thath this permanent reduction was sustained during long-term follow-up. The purpose of this study was to assess the changes in oropharyngeal airway space and soft tissue orofacial compoment following the mandibular setback surgery and during the follow-up period. The correlation between the changes of the oropharyngeal airway space and the changes of other soft tissue orofacial component was also assessed. The findings of this study were as follows ; 1. The ofoharyngeal airway space area fecreased following mandibular setback surgery for mandibular prognathism and continued to decrease during the follow-up period(p<0.05). 2. The pharyngeal depth at Xi point level and the 2nd cervical vertebra point level decreased agter the surgery and remained during the follow-up period(p<0.05). The decrease of these pharyngeal depth was correlated with the decrease of oropharyngeal airway space area(p<0.01). 3. The decrease of pharyngeal depth at the 3rd and 4th cervical vertebra point level was not significant after the surgery and during the follow-up period. 4. The hyoid bone moved downwasd after the surgery(p<0.05), but returned to its original position during the follow-up period. 5. The length & height of tongue and the position of epiglottis base did not change significantly(p<0.05). 6. The soft palate was displaced posteriorly after the surgery and remained to its changed position during the follow-up period(p<0.05) due to posterior displacement of tongue. The changes of soft palate were significantly correlated with the decrease of oropharyngeal airway space area(p<0.01). 7. The narrowing of oropharyngeal airway space was due to the posterior displacement of tongue above the level of epiglottis tip. The posterior displacement of tongue following mandibiular setback osteotomy remained during the follow-up period.
Epiglottis ; Follow-Up Studies ; Humans ; Hyoid Bone ; Oropharynx ; Osteotomy* ; Palate, Soft ; Prognathism ; Research Personnel ; Spine ; Tongue

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

OBJECTIVE: To determine whether the follicle stimulating hormone(FSH) receptor gene mutation (C566T point mutation) is present in Korean women with premature ovarian failure and normal karyotype. METHODS: Genomic deoxyribonucleic acid(DNA) obtained from 40 patients with chromosomally competent premature ovarian failure and from 30 normal fertile women(control group) was amplified by polymerase chain reaction(PCR). PCR products were digested by the enzyme BsmI and polyacrylamide gel(PAG) elctrophoretic patterns of these enzyme-digested products were analyzed. The direct sequencing of PCR products was also performed. RESULTS: All patients with premature ovarian failure and 30 normal control women demonstrated homozygous, normal alleles with 51- and 27- base pairs fragments in PAG elctrophoresis. The absence of C566T point mutation in both group was confirmed by direct DNA sequencing. CONCLUSIONS: A C566T mutation in FSH receptor gene is rare in Korean women with premature ovarian failure and normal karyotype.
Alleles ; Base Pairing ; Female ; Follicle Stimulating Hormone* ; Humans ; Karyotype* ; Point Mutation ; Polymerase Chain Reaction ; Primary Ovarian Insufficiency* ; Receptors, FSH* ; Sequence Analysis, DNA

PURPOSE: To report pathological, histochemical, ultrastructural, and spectrographic analysis of explanted hydrophilic acrylic intraocular lenses obtained from patients who had visual disturbances caused by postoperative opacification of the IOL. METHODS: Forty-three hydrophilic IOLs (ACRL-160, Ophthalmed Inc.) were explanted from 39 patients with decreased visual acuity because of opacification of the IOL itself. All explanted IOLs were examined grossly and by light microscopy. Full-thickness sagittal sections of the optics of the randomly selected 10 IOLs were stained with the von kossa method (special stains for calcium). One of these sectioned IOLs was not stained, and submitted for scanning electron microscopy and energy dispersive X-ray spectroscopy. RESULTS: Microscopic analysis revealed multiple fine, granular deposits within the lens optics and haptics, and these deposits were stained positively with the von Kossa method. They were varible in size, and unevenly distributed in the optics on the scanning electron microscopy, and energy dispersive X-ray spectroscopy of the internal substance of IOL demonstrated the presence of calcium within the deposits. CONCLUSIONS: We evaluated 43 explanted opacified ACRL-160 lenses, and have demonstrated that the opacification was caused by the presence of granular deposits within the IOL. The deposits have the component of calcium.
Calcium ; Coloring Agents ; Humans ; Lenses, Intraocular* ; Microscopy ; Microscopy, Electron, Scanning ; Spectrometry, X-Ray Emission ; Visual Acuity

Immunohistochemical changes of epidermal growth factor receptor (EGFR) and nerve growth factor receptor (NGFR) were investigated in the rat mandibular molar and incisors after submandibular sialadenectomy. In the sham operated rat, any EGFR immunoreactivity was not observed in the teeth but NGFR immunoreactivities were observed exclusively in the periodontal ligament and ameloblasts of incisor. In the sialadenectomized rat, EGFR immunoreac-tivities were observed in the odontoblasts of the mandibular first molar, periodontal ligament cells, ameloblasts of incisor and some cells of bone marrow. NGFR immunoreactivities were more intense and widely distributed in alveolar bone, periodontal ligaments and odontoblasts of the sialadenectomized rat than in the sham operated rat. Both of EGFR and NGFR immunoreactivities gradually increased in their intensities in a time-dependent manner after submandibular sialadenectomy. The results show that expression of EGFR and NGFR in the mandibular molar and incisor is enhanced by submandibular sialadenectomy. Therefore, it is suggested that EGF and NGF derived from submandibular gland may affect to the mandibular molar and incisors by direct and/or indirect mechanism.
Ameloblasts ; Animals ; Bone Marrow ; Epidermal Growth Factor* ; Immunohistochemistry ; Incisor* ; Molar* ; Nerve Growth Factor ; Odontoblasts ; Periodontal Ligament ; Rats* ; Receptor, Epidermal Growth Factor* ; Submandibular Gland ; Tooth

PURPOSE: This study was designed to analyze the short-term clinical and functional outcomes of perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse. METHODS: The data were prospectively collected and consisted of the clinical data, the functional status before and after surgery, the operation record, and the postoperative course. The functional status was evaluated by using Wexner's constipation score (0-30), Wexner's incontinence score (0-20), anorectal manometry, and pudendal nerve terminal motor latency. Follow-up was performed at 3-6 months after the operation by using both a standardized questionnaire completed in the outpatient clinic or telephone interview (n=23) and an anorectal physiology test (n=7). RESULTS: During a one-year period, 23 patients (male=10) underwent perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse. The median duration of the operations was 88 minutes. The median length of postoperative hospital stay was 6 days. There was one urinary tract infection and no mortalities. The constipation score was significantly decreased after the operation (9.8 vs 3.8; P<0.001), and constipation was improved in 90 percent (19/21) of the cases. The incontinence score was significantly decreased after surgery (mean preop.=11.6, postop.=3.7; P<0.001) and incontinence was improved in 17 of 21 patients with impaired continence (81 percent). Anal sphincter function was not improved but rectal reservoir capacity was significantly decreased after surgery (rectal urgent volume (45.7 cc vs 37.1 cc; P=0.045), maximal tolerable volume (120 cc vs 85.7; P=0.011). Most patients (83 percent) felt that the operation had improved their symptoms. The major reasons for dissatisfaction after surgery were frequent defecation, fecal soiling, persistent or aggravated fecal incontinence, and recurrence. One patient had a complete recurrence (4.3 percent), and another patient had a mucosal prolapse which was treated. CONCLUSIONS: Perineal rectosigmoidectomy with levatoroplasty for complete rectal prolapse is a safe technique with acceptable short-term functional results; however, it is not recommended for rectal prolapse patients with diarrhea-predominant irritable bowel syndrome.
Ambulatory Care Facilities ; Anal Canal ; Constipation ; Defecation ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Interviews as Topic ; Irritable Bowel Syndrome ; Length of Stay ; Manometry ; Mortality ; Physiology ; Prolapse ; Prospective Studies ; Pudendal Nerve ; Surveys and Questionnaires ; Rectal Prolapse* ; Recurrence ; Soil ; Urinary Tract Infections

Kaposi's sarcoma is a rare lympho-angioproliferative neoplasm with four types of variants: classic, iatrogenic immunosuppressive drug-associated, AIDS-related and Africa-endemic Kaposi's sarcoma. Most immunosuppressive drug- associated Kaposi's sarcomas usually occur after a kidney transplant or after receiving immunosuppressive therapy. A 64-year-old female patient showed numerous purpuric nodules and smaller erythematous plaques on the right lower leg for three months. Previously, the patient was treated with an immunosuppressive drug for rapidly progressive glomerulonephritis for a five-week period. A skin biopsy was performed under the clinical diagnosis of Kaposi's sarcoma. We performed immunohistochemical staining and polymerase chain reaction to detect human herpes virus 8 (HHV-8). We report a case of iatrogenic immunosuppressive drug-associated zosteriform Kaposi's sarcoma that rapidly occurred five weeks after prednisolon therapy in a rapidly progressive glomerulonephritis patient.
Biopsy ; Female ; Glomerulonephritis ; Humans ; Kidney ; Leg ; Middle Aged ; Polymerase Chain Reaction ; Sarcoma, Kaposi ; Skin ; Transplants ; Viruses