No abstract available.
Child* ; Humans ; Humerus*

Aplasia cutie congenita is a rare congenital disease showing focal abscence of skin. In the msjority of instances it is limited ta the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformation have been reported to ccur with ACC odcasionally. Diagnosis depends on primarily clinical findings. The histologic finding virious from an absence of appendages to the involvement of varying layers of skin, occasionally extending to the bane or dura. Healed lesions often demonstrate a flattened epidermis, a proliferation of fibrobasts in a loose connective tissue stroma, newly formed capillaries, and a complete absence of adnexa stuctures. We observed a newborn infant with aplssia cutis congenita. The akir, defect was found on the posterior fontanelle. No associating cangenital anomalies were found in this case.
Capillaries ; Connective Tissue ; Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Epidermis ; Humans ; Infant, Newborn ; Scalp ; Skin

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a.
Adult ; Down Syndrome ; Hemangioma ; Humans ; Knee ; Leg ; Male ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Thigh

A statistical observations were made on total 79 In-Patients in the departments of dermatology, Dongsan Presbyterian Hospital, Kyungpook National University and Fatima Hospital, Taegu, Korea during the period from Sept. 1, 1975 to August 31, 1976.
Daegu* ; Dermatology* ; Gyeongsangbuk-do* ; Korea* ; Protestantism*

Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.
Child ; Classification ; Clinical Study ; Female ; Femur ; Humans ; Leukocytosis ; Lost to Follow-Up ; Osteomyelitis ; Radius ; Tibia

The lower eyelid is anatomically composed of three layers consisting of the anterior lamellar, the middle lamellar and the posterior lamellar. The anterior lamellar is composed of skin and the orbicularis muscle. The middle lamellar is composed of the orbital septum and orbital fat. The posterior lamellar is composed of the tarsus and the capsulopalpebral fascia and conjunctiva. The function of the lower eyelid is dependent upon a net result of balanced forces from the tarsal plate, canthal tendon and the orbicularis muscle sling acting on the lower eyelid. These forces provide the intrinsic support required to maintain contact between the lower eyelid and the globe. Forces acting against the intrinsic support of the lower eyelid (extrinsic forces) provide inferior and anterior net vector from the globe. The normal anatomic function and aesthetic appearance of the eyelid is achieved when the intrinsic forces are greater than or equal to extrinsic forces. The lower lid descent and ectropion characterized by unfavorable imbalance are a result of either a decrease in intrinsic forces by weaking the support as in senescence or an increase in extrinsic forces by strengthening the distraction forces as a result of surgery, laser treatment, or trauma. Either way, the extrinsic forces become greater than intrinsic forces. Facial nerve palsy of a leprosy patient causes paralysis of the orbicularis muscle but its antagonistic action muscles (the levator muscle of the upper lid and the capulapalpebral fascia of the lower lid) are functioning resulting in retraction and lapophthalmus of the upper and lower eyelid. Ectropion and retraction in the lower eyelid require various traditional surgical methods such as cantopexy, canthoplasty, lateral tarsal strip procedure as well as medial tarsorrhaphy. In addition to traditional methods, we used a spacer graft consisting of hard palate mucosa or Alloderm. Spacer grafts can be used in either a posterior or anterior method. In the posterior method, the spacer graft is used to create separation between the tarsal plate and the capsulopalpebral fascia / conjunctiva structure. A 5 to 25mm elliptical strip of hard palate mucosa is harvested from the patient and insterted between the two structures. The conjunctiva is dissected in this procedure. In the anterior method, we disinserted the lower edge of the tarsus and the capsulopalpebral fascia. A 5 to 25mm elliptical shaped strip of Alloderm was then inserted between the two structures. The conjunctiva remains intact in this procedure. In addition, a 5 to 35mm Alloderm strip was inserted to immitate the function of the fascia sling and increase the elevation of the lower lid as a spacer graft. The spacer graft with traditional surgical methods was more effective in elevating the lower lid and significantly reducing retraction than using traditional methods alone.
Aging ; Ankle ; Conjunctiva ; Ectropion ; Eyelids ; Facial Nerve ; Fascia ; Humans ; Laser Therapy ; Leprosy ; Mucous Membrane ; Muscles ; Orbit ; Palate, Hard ; Paralysis ; Skin ; Tendons ; Transplants

Changes in the eye resulting from leprosy include lagophthalmos, ectropion and the eyelid retraction. In lagophthalmos, an interpalpebral gap(lid gap) of 2mm or less, which is most preferred after correction, does not have any adverse effect on the vision. However, a gap of 3mm or greater can cause or make the eye susceptible to the dryness of the cornea or other vision problems. Bell's phenomenon will adequately prevent eye damages, especially corneal damage when the lid gap is less than 3mm. Although static methods such as autogenous canthal sling, lateral tarsal strip, medial tarsorrhaphy and gold implant had a positive cosmetic effect when used in combination, the lid gap could hardly reduce to less than 3mm. Frequent recurrence of lagophthalmos and ectropion after static methods required further definite surgical treatment. We applied a dynamic method of modified Gillies to correct lagophthalmos and it was successful in reducing the lid gap to less than 2mm in most cases.
Cornea ; Cosmetics ; Ectropion ; Eye ; Eyelids ; Leprosy ; Recurrence ; Vision, Ocular

The untreated leprosy skin takes on a waxy appearance & feel full. Thickening is most marked over the face, which starts to devolp into folds, hanging down to produce the classical lion-like facies. The deep folds in disease state change to the numerous compacted shallow wrinkle with less elasticity of the skin. To correct these wrinkles of the patients healed from the leprosy, we tried the stone-VK formula application to the 14 patients, who are men 10 & women 4 in the age distribution of 55~78 years old. The use of the phenol & croton oil chemical peeling this method is more effective than other chemical & conventional surgical method to remove facial wrinkle. We need more experience of this peeling. In preliminaxy report, our superior results in removing facial wrinkle is presented.
Age Distribution ; Croton Oil ; Elasticity ; Facies ; Female ; Humans ; Leprosy* ; Male ; Phenol* ; Skin

Recently, there has been a strong decrease in the number of temporalis muscle transfer(TMT) operations in cases of lagophthalmos. The primary cause of this decline is patient dissatisfaction with drawbacks of eye clinching in concert with mouth closure, ectropion and ptosis. This is mostly true of patients who are now more commonly exposed to urban social environments. In 1997, I discontinued the use of TMT as part of my combination treatment method reported in this journal. Since 1998, I have removed the fascia in 20 TMT cases due to complications in the upper and lower eyelid areas. I then corrected these complications using my combination method. I still use TMT in cases of lower lip drooping. Lagophthalmos patients are treated using my combination method of gold lid loading in the upper eyelid and Alloderm insertion in the lower eyelid through fixation of both ends to the medial and lateral canthal ligaments respectively. Previously, I recommended the use of conchal cartilage but noted the complication of cartilage warping which caused creating new partial ectropion several months later. Alloderm has shown no complications and the results of its use remain most satisfactory.
Cartilage ; Ectropion* ; Eyelids ; Fascia ; Humans ; Leprosy* ; Ligaments ; Lip ; Mouth ; Social Environment

BACKGROUND: Eyelash ptosis(ELP) is a common finding in patients with long-standing leprosy. However, it has rarely been reported in the literature previously, because it has been diagnosed as trichiasis or entropion. OBJECTIVE: To determine the prevalence of ELP in Hansen's disease. METHODS: We took both frontal and lateral photographs of eyes in 20 patients and evaluated the degree of ptosis using a 4-point rating scale, in which 0 indicates no ptosis; 1, minimal; 2, moderate; and 3, severe. The evaluation was also performed in 20 normal persons as control group. RESULTS: All patients demonstrated ELP. In general, severity of ptosis in patient group is greater than that in control group. While the mean eyelash ptosis rating was 2.0+/-0.6 in the latter, it was 0.6+/-0.4 in the former, which is statistically significant (p<0.01). CONCLUSIONS: ELP is common in the patients with Hansen's disease and moderate to severe forms occurred more commonly in disease group compared with control group. ELP must be considered as a characteristic ocular finding in long-standing leprosy.
Eye ; Humans ; Leprosy ; Prevalence ; Trichiasis