The hydroxyapatites were popularly been used as the ocular implant due to low incidence of post-operative exposure, infections, and excellent motility. For this purpose, it has been known that the drilling and peg implantations are performed after ingrowth of fibrovascularization tissue into the hydroxyapatites, so that ball and socket movement were occur. The authors reviewed 140 patients(140 eyes) who received enucleation or evisceration with the implantation of hydroxypapatite from Dec. 1991 to Jun. 1995. We performed that drilling after confirmation of the fiborvascularized hydroxyapatite by Technetium-99m-MDP bone scan, and investigated the method and complications. Among the 140 eyes(140 Patients), 39 eyes(28%) were found to have complications: 17 cases of peg extraction(44%), 10 cases of peg protrusion(26%), 4 cases of over-growth of granulation tissue(11%), 3 cases of poor motility(7%), 3 cases of hydroxyapatite exposure(7%) and 2 cases of malposition of peg(5%). Redrilling was performed in 20 eyes(51%) and exchanged by the screw peg due to re-extraction of peg in 4 eyes(20%). In a conclusion, overall the frequency of complications after drilling was about 28% and the most frequent complication was peg extraction.
Durapatite* ; Humans ; Hydroxyapatites ; Incidence

Primary meningeal melanocytoma of the central nervous system is extremely rare. We report a case of meningeal melanocytoma associated with Ota's nevus as a recurrent form in a 53-year old male. The meningeal melanocytoma was removed from right parietooccipital lobe 4 years ago and recurred in right parietal, occipital and left frontal lobes. Ultrastructurally, the tumor cells were characterized by the presence of numerous melanosomes and premelanosomes in their cytoplasm. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic schwannoma and prolonged clinical course was different from primary meningeal melanoma or metastatic malignant melanoma.
Neoplasm Metastasis

The clinical analysis on the etiologies was done along with frequency of the patient's complaints of epiphora.The etiologies of the fifty-four patients screened by fluorescein dye disappearance test were classified by the causative location of the lacrimal pathway. The average of the patient's ages was 48.7 years old and average duration of symptom was 26.1 months.The causative locations were punctum[35.2%], nasolacrimal duct, lacrimal pump and nasal cavity in following order.The most common causes of each group were senile lid laxity[5.6%] for lacrimal pump, conjunctivochalasis and punctual atresia[11.1%]for lacrimal pump, idiopathic narrowing[9.3%]for canaliculus and idiopathic narrowing[16.6%]for nasolacrimal duct.Probing was the most common past history[18.5%]and the kinds of treatment were dacryocystorhinostomy, punctoplasty, lid tightening, probing, and conjunctivod acryocystorhinostomy. These data are expected to be a useful guide of rapid diagnosis and appropriate treatment for the epiphora patients without complicate processes and discomfort.
Dacryocystorhinostomy ; Diagnosis ; Fluorescein ; Humans ; Lacrimal Apparatus Diseases* ; Nasal Cavity ; Nasolacrimal Duct

Dural shunts are vascular communications in which blood flows through small meningeal branches of the carotid arteries to enter the venous circulation near the cavernous sinus. The clinical characteristics of 13 eyes[12 patients] with dural cavernous sinus fistula are described. Of these patients, 84.6%[11 eyes]were women with dilated conjunctival and episcler-al vessels, exophthalmos, retinal hemorrhage and venous engorgement, elevation of intraocular pressure, swelling of lid and orbital area, limited eye movement and diplopia, and bruit, in order of frequency. Decreased vision had occurred in only 1 eye, due to central retinal vein obstruction during follow-up periods after embolization. CT or MRI scan showed the enlargement of the extraocular muscle and superior ophthalmic vein. Two eyes had resolved spontaneously. Ten eyes of dural cavernous sinus fistula had the resolution of clinical symptoms after carotid angiography with embolization. The complications after embolization had occurred in one eye with transient sensory deficit of face.
Angiography ; Carotid Arteries ; Cavernous Sinus* ; Diplopia ; Exophthalmos ; Eye Movements ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Hyperemia ; Intraocular Pressure ; Magnetic Resonance Imaging ; Orbit ; Retinal Hemorrhage ; Retinal Vein ; Veins

PURPOSE: We evaluated the morphologic change of the hydroxyapatite(HA)-coated porous alumina as a new orbital implant when it was used in rabbit. METHODS: After evisceration of 18 eyes of 18 New Zealand white rabbits, we implanted 12 mm-diameter-sized HA-coated porous alumina with different pore sizes; 300, 500, and 800 micrometer, and then the implants were extracted back to evaluate their morphologic change according to different time interval; 2, 4, and 12 weeks. RESULTS: Fibrovascularization was noted at periphery of the implant 2 weeks after implantation in all of the three groups, and to the center of the implant 4 and 12 weeks after implantation. This fibrova-scularization was most predominant in 500 micrometerpore-sized group compared to the rest two groups. CONCLUSIONS: HA-coated porous alumina showed similar appearance of fibrovascularization with relatively more affordable price and easy manufacture, compared to the other porous implants.
Aluminum Oxide* ; Anophthalmos ; Durapatite ; Orbit* ; Orbital Implants* ; Rabbits

Hertel and Naugle exophthalmometers were used to compare the variability and reproducibility, produced by various observers. Five examiners measured fifty two eyes of twenty-six normal subjects each by using two different exophthalmometers, respectively. The average coefficient of variation among five measurements was 5.6% in the right eye, 5.2% in the left eye and 2.1% in base line by Hertel exophthalmometer. The average coefficient of variation measured by Naugle exophthalmometer was 1.9% in both eyes and 0.8% in pupillary distance. In conclusion, Naugle exophthalmometer showed less variability and better reproducibility; it is more appropriate for comparative exophthalmetry.
Reading*

PURPOSE: This study was comprised of patients diagnosed with orbital pseudotumor classified according to the location and evaluated the clinical symptoms and treatment efficacy. PATIENTS AND METHOD: This study included 24 patients diagnosed with orbital pseudotumor between 1994 and 1999. The pseudotumor was localized by computed tomography and magnetic resonance imaging and classified into anterior, diffuse, apical, myositic, and lacrimal. The patients were all initially treated with steroid and additional biopsies were done in 4 patients (5 eyes) who exhibited prolonged symptoms, non-steroid responders and cases of recurrence. Cases diagnosed as sclerosing orbital pseudotumor were excluded. RESULTS: The response to treatment was high in the apical and diffuse types of orbital pseudotumor being 100% and 80% while the lacrimal and myositic types were 57.1% and 54.5%. The lacrimal type showed the highest recurrence rate of 42.9% followed by the myositic and anterior types being 25% and 20%. CONCLUSION: This study is the first in our country to reveal the treatment efficacy of orbital pseudotumors according to location. The orbital pseudotumors were localized by computed tomography and magnetic resonance imaging and classified to compare treatment efficacy and recurrence rates between the different types providing a basis upon which further studies may eventually help in the treatment and prognosis of orbital pseudotumors.
Biopsy ; Classification* ; Humans ; Magnetic Resonance Imaging ; Orbit* ; Orbital Pseudotumor* ; Prognosis ; Recurrence ; Treatment Outcome*

A case of left parietal pleomorphic xanthoastrocytoma that occurred in a 58-year-old woman is reported clinicopathologically. Histopathologic diagnosis of pleomorphic xanthoastrocytoma was made because of the unique pleomorphic histologic features, positive glial fibrillary acidic protein in immunohistochemical staining. The flow cytometric analysis reveals DNA aneuploidy and relatively high S-phase fraction. The pleomorphic xanthoastrocytoma is considered as a special subgroup of glioma on the basis of superficial cortical location, GFAP expression, marked cellular atypia, xanthomatous cells, and relatively favorable prognosis.
Female ; Humans

Subperiosteal hematoma of the orbit is uncommon and mostly produced by trauma or diseases such as leukemia, hemophilia and scurvy. A spontaneous occurrence which is not associated with any of these causes, however, is extremely rare. We report a case of a 27-year-old woman. The presenting symptoms were proptosis, lid edema and diplpia which developed suddenly. Clinical features, orbital echography, computerized tomography and magnetic resonance imaging established the diagnosis of spontaneous subperiosteal hematoma of the orbit. It was managed successfully by conservative treatment. A patient profile, mode of clinical presentation, imaging findings, pathogenesis and management options are discussed.
Adult ; Diagnosis ; Edema ; Exophthalmos ; Female ; Hematoma* ; Hemophilia A ; Humans ; Leukemia ; Magnetic Resonance Imaging ; Orbit* ; Scurvy ; Ultrasonography

Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior and histogenesis are still unclear. We report a case of goblet cell carcinoid of the appendix in a 54-year-old male, who exhibited pain in the right lower abdomen. Microscopically, the tumor contained smooth-bordered, widely separated nests composed of tumor cells with abundant mucin. The principal tumor cell type had a close resemblance to the normal goblet cell. Histochemically, the tumor cells revealed positive reaction for PAS and alcian blue stain. Immunohistochemically, the tumor showed strong reactivity for carcinoembryonic antigen, chromogranin and, neuron specific enolase but none for cytokeratin and epithelial membrane antigen.
Adenocarcinoma