PURPOSE: Direct injection of doxorubicin into the eyelids results in permanent loss of muscle fiber and it is considered an attractive nonsurgical method in essential blepharospasm therapy. However, necrosis of skin overlying orbicularis oculi muscle is the most serious side effect of this therapy. The purpose of this study is to determine the effect of doxorubicin delivered by osmotic pump which release doxorubicin slowly, and to evaluate the degree of overlying skin injury following chemical myectomy. METHODS: Thirty three rabbits were assigned to three groups according to the doxorubicin concentration. The first group received direct injections of 0.5 mg doxorubicin diluted in 0.1 ml of saline in the right lower eyelid. and osmotic pump was inserted into the left lower eyelid which contained 0.5 mg doxorubicin in 0.1 ml of saline. The second group received 1 mg doxorubicin and the third group received 2 mg doxorubicin. Eight weeks after injection, the eyelids were assessed for the degree of muscle fiber loss microscopically. For the evaluation of functional change of muscle, an EMG study was carried out. RESULTS: Skin necrosis developed in all rabbits except for one which received injection of 0.5 mg doxorubicin. Skin necrosis appeared earlier in the direct injection group. The duration of skin necrosis was shortened at lower concentrations(0.5 mg, 1.0 mg) with a pump delivery(P<0.05). But there was no statistical differences in the 2.0 mg concentration. The size of necrosis was much smaller in rabbits using pump delivery than those of direct injection group in high doxorubicn concentrations(1.0 mg, 2.0 mg)(P<0.05). The total size of muscle fiber was decreased after a doxorubicin injection. There was no statistical difference between the direct injection group and the pump group(P<0.05). The similar effect on the muscle was noted regardless of the slow release of the doxorubicin into the muscle. Light microscopic study demonstrated destructive change of muscle and it was replaced by connective tissues. Electron microscopic study showed destruction of micro-architecture of muscle fibers. Functionally, in EMG study, there was no motor activity in the injection area. But some motor unit potentials appeared in the periphery of skin necrosis site. CONCLUSIONS: These results suggest that the osmotic pump may be used as an effective adjuvant in preventing skin necrosis in blepharospasm treatment.
Blepharospasm ; Connective Tissue ; Doxorubicin* ; Eyelids* ; Motor Activity ; Necrosis* ; Rabbits ; Skin*

We report 10 cases of the patients with telecanthus undergone modified transnasal wiring procedure between May, 1986 and December, 1990. The procedure of this operation is characterized as follow: Each wire is traversed through 2 holes in nasal bone to the medial canthal ligament. After piercing through the ligament, the wire is returned to the opposite medial canthal ligament over the nasal bone. Ultimately 2 ends of each wire are tied together on one side without silicone sheath. We believe that this modified procedure is more effective and simple for the correction of telecanthus with less recurrence rates than conventional method.
Humans ; Ligaments ; Nasal Bone ; Recurrence ; Silicones

Squamous cell papilloma is one of epitheial tumors. Squamous cell papilloma of the lacrimal sac is so rare that the indrvidual clinician rarely acquires substantial experience in their management. The patients with benign squamous cell papilloma present with epiphora, palpable mass and bloody discharge that can be mistaken clinically as evidence of chronic dacryocystitis. The choice of treatment is simple excision and recurrence rate is approximately 20-30%. Most of the papilloma does not reveal any malignant change. We experienced a 40-year-old woman who had a soft, irregular surfaced palpable mass and unilateral epiphora for one year in the lower lid and inner canthus of the left eye. We treated with dacryocystectomy including tumor mass. The histopathologic evaluation revealed the tumor to be a benign squamous cell papilloma. The general conditions of the patient and operation sites are good so, we present our case with a brief review of the literature.
Adult ; Dacryocystitis ; Female ; Humans ; Lacrimal Apparatus Diseases ; Papilloma* ; Recurrence

No abstract available.
Fingers*

No abstract available.
Angiogenesis Inducing Agents* ; Intracranial Aneurysm*

No Abstract available.
Cross Infection* ; Korea*

Conegenital anomalies of the ribs are common but rarely result in shadow which might be mistaken forpathological lesions. Careful inspection of the bony parts, which should be a routine, will usually be sufficientto avoid mistakes. Authors reviewed 6,921(5,865 male, 1,056 female) chest P-A films in adult (older than 16years), and radiolographic findings of congenital anomalies of the ribs were analized. The result were as follows;1. Congenital anomalies of the ribs were present in 193 patients. The incidence of congenital anomalies of theribs were 2.7% in male, 3.3% in female. 2. Among the 193 cases of congenital rib anomalies, 7 cases(0.1%) ofcervical ribs, 31 cases (0.4%) of underdeveloped ribs, 81 cases (1.2%) of anterior bifurcation, 34 cases (0.5%) ofbroadned ribs, 19 cases (0.3) of complete fusion and 21 cases (0.3%) of pseudathrosis were included. 3. 11.4% ofthe cases were bilateral, and right to left was 4:3 in unilateral involvement. 4. The location of the ribanomalies were as follows; (1) Underdeveloped ribs; 1st rib 31 case (79.5%), 2nd rib 3 cases(7.7%), 4th rib 3cases(7.7%), 5th rib 2 cases(5.1%). (2) Anterior bifurcation; 3rd rib 37 cases. 4th rib 29 cases, 5th rib 12cases, 6th rib 6cases, 2nd rib 2 cases. (3) Broadened ribs; 3rd 17 cases, 4th rib 15 cases, 5th rib 4 cases, 2ndrib 1 case. (4) Complete fusion; 1st-2nd rib 13 cases (68.4%), 5-6th ribs 4 cases (21.0%), 4-5th ribs 1case(5.3%), 6-7 ribs 1case(5.3%). The fusion occur in the posterior portion of 1st-2nd and 4-5th ribs,and in theposterior portion of 5-6th and 6-7ribs. (5) Pseudarthrosis; 1st-2nd and 2nd-3rd ribs, and in the posterior portionof 3-4th, 4-5 and 5-6th ribs. 5. In the cases of anterior bifurcation, the rib bifurcates almost in its anterior2.1-5.0 cm and most common in 3.1-4.0cm. 6. The characteristic radiographic findings in anterior bifurcation wereas follow;
Adult ; Female ; Humans ; Incidence ; Male ; Pseudarthrosis ; Ribs ; Thorax

Acute myeloid leukemia (AML) is a heterogeneous malignancy that comprises 25-30% of pediatric leukemias in Korea. Several inherited diseases, such as Down syndrome and Fanconi anemia, predispose towards AML leukemogenesis. Subgrouping of AML is a key diagnostic step, previously done with the French-American-British (FAB) classification and recently complemented by that of the World Health Organization (WHO). An important feature of AML is the possibility of chloroma at diagnosis, which, if detected, requires follow-up evaluation to determine treatment response. Numerous genetic abnormalities with prognostic relevance have recently been found, the most important of which include those of the core-binding factor (CBF) leukemias, and FLT3-ITD mutation. These genetic abnormalities, combined with patient response to initial treatment, allow for a scheme of risk stratification, and the current consensus is to treat low risk patients with chemotherapy only, whereas high risk patients may receive allogeneic transplant in first remission, although the benefits of transplant remain inconclusive. Overall, the outcome of children and adolescents with AML has improved significantly so that many clinical trials now report event-free survival of around 60%. However, much of this improvement stems from better supportive care and transplant methods, and the genetics-based diagnostic advances in AML have yet to result in enhanced treatment. New therapeutics, including possibly targeted therapy, are necessary to further improve the outcome of pediatric AML.
Adolescent ; Child ; Classification ; Complement System Proteins ; Consensus ; Core Binding Factors ; Diagnosis ; Disease-Free Survival ; Down Syndrome ; Drug Therapy ; Fanconi Anemia ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid, Acute ; Sarcoma, Myeloid ; World Health Organization

Fluoride is one of the most reactive elements in nature, and commonly used in toothpaste since it helps to prevent cavities. Despite this advantage, excessive ingestion of fluoride can cause acute toxicity and gastric disturbance from hydrofluoric acid that was formed in the stomach. We report a case of previously healthy, 41-month-old girl who visited the emergency department with persistent abdominal pain and hematemesis after ingestion of fluoride-containing toothpaste. Though the ingested dose of fluoride was below the toxic dose, serious symptoms developed. We performed esophagogastroduodenoscopy, and confirmed a hemorrhagic gastritis caused by hydrofluoric acid. The girl was uneventfully discharged on day 3 after receiving conservative care. When managing children who ingested fluoride-containing toothpaste, physicians need to consider their symptoms, not the ingested amount. In addition, parents should be cautious when their children use fluoride-containing toothpaste.

Fluoride is one of the most reactive elements in nature, and commonly used in toothpaste since it helps to prevent cavities. Despite this advantage, excessive ingestion of fluoride can cause acute toxicity and gastric disturbance from hydrofluoric acid that was formed in the stomach. We report a case of previously healthy, 41-month-old girl who visited the emergency department with persistent abdominal pain and hematemesis after ingestion of fluoride-containing toothpaste. Though the ingested dose of fluoride was below the toxic dose, serious symptoms developed. We performed esophagogastroduodenoscopy, and confirmed a hemorrhagic gastritis caused by hydrofluoric acid. The girl was uneventfully discharged on day 3 after receiving conservative care. When managing children who ingested fluoride-containing toothpaste, physicians need to consider their symptoms, not the ingested amount. In addition, parents should be cautious when their children use fluoride-containing toothpaste.