A 27-year-old woman had a cataract in the left eye and absent radial pulses in both upper extremities. Fundus examination of the right eye disclosed arteriovenous anastomosis about the disc and segmentation of venous blood column. Aortogram revealed complete obstruction of brachiocephalic, left common carotid and left subclavian arteries, which were the branches of aortic arch. Takayasu's arteritis is an uncommon disorder which causes obliteration of branches of aortic arch and pulmonary artery. Its characteristics are absence of pulsation in the upper extremities and arteriovenous anastomosis around the disc. It affects mainly young females and its etiology is uncertain.
Adult ; Aorta, Thoracic ; Arteriovenous Anastomosis ; Cataract ; Female ; Humans ; Pulmonary Artery ; Subclavian Artery ; Takayasu Arteritis* ; Upper Extremity

Squamous cell carcinoma of the bulbar conjunctiva is a rare disease and usually arise at the limbus and spread to the cornea and adjacent bulbar conjunctiva. The authers experienced two cases of squamous cell carcinoma of the bulbar conjunctiva. In the first case, a 30-year old male visited our hospital in February, 1969 with a congested granulomatous hypertrophy in the nasal side of the bulbar conjunctiva(OD) which had showed progressive enlargement of 3 months duration. An excisional biopsy was carried out and histopathological examination revealed bulbar squamous cell carcinoma. In second case, a 51-year old female visited our hospital in January, 1977 with recurrent mild conjunctival injection and a small whitish elevated mass in the temporal side of the bulbar conjunctiva(OD) which had showed progressive enlargement of 7 months duration. The elevated mass was resected and histopathological examination revealed bulbar squamous cell carcinoma. We had a study of the histopathological finding for two cases of squamous cell carcinoma of the bulbar conjunctiva with a brief review of relating literatures.
Adult ; Biopsy ; Carcinoma, Squamous Cell* ; Conjunctiva* ; Cornea ; Estrogens, Conjugated (USP) ; Female ; Humans ; Hypertrophy ; Male ; Middle Aged ; Rare Diseases

The authors present a case of macular dystrophy of the cornea which is inherited as a recessive trait. The patient was 43 years old female housewife who had suffered from photophobia, frequent tearing, foreign body sensation and gradually increasing visual dimness since early childhood. Partial penetrating keratoplasty was performed. We had a study of the histopathologic findings for a case of macular dystrophy of the cornea with a brief review of relating literatures.
Adult ; Cornea* ; Female ; Foreign Bodies ; Humans ; Keratoplasty, Penetrating ; Macular Degeneration* ; Photophobia ; Sensation ; Tears

The authors experienced a case of embryonal rhabdomyosarcoma. The patient was 13 years old bov who had exophthalmos, ocular deviation to upper direction and visual disturbance of his left eye. We excised the exposed mass of tumor by exploration of the orbit and postoperative irradiation with Cobalt-60 was followed. There were no signs of recurrence of the tumor or metastasis to the other part of body until now, 7 months after surgery. We had a study of the histopathologic findings for a case of rhabdomyosarcoma with a brief review of relating literature.
Adolescent ; Exophthalmos ; Humans ; Neoplasm Metastasis ; Orbit* ; Recurrence ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal

Tularemia is a zoonosis caused by Francisella tularensis. It is primarily a disease of wild animals. Human infection is incidental and usually results from interaction with biting or blood-sucking insects, wild or domestic animals, or the environment. An increasing number of cases have been reported in several countries. However, in Korea it has not been reported until now. A 40-year old male patient visited our department on Jan 13, 1997, complaining of multiple swollen lymph-nodes on his axillae and reddish swollen left upper arm which contained an abscess at its central portion for about ten days. On Dec 25, 1996, he found a dead wild rabbit on a nearby mountainside, ate it after cooking it by himself with his hands injured. His abscess was drained and microbiologic examination was done. However no microorganism was isolated. His lymph nodes were surgically removed from both axillae, and we investigated them microbiologically and pathologically. On microbiologic examination, small aerobic gram negative coccobacilli were grown on a chocolate agar plate in an aerobic condition with 5% CO2 at 37 degrees centigrade. On H & E staining, the lymph node showed chronic granulomatous inflammation. We sent the microorganism and lymph nodes to the Centers for Disease Control and Prevention in the United States of America for the definitive diagnosis. Finally the microorganism was identified as F. tularensis by culture morphology, biological tests and immunohistochemical staining. We report the first case of F. tularensis in Korea.
Abscess ; Adult ; Agar ; Americas ; Animals ; Animals, Domestic ; Animals, Wild ; Arm ; Axilla ; Cacao ; Centers for Disease Control and Prevention (U.S.) ; Cooking ; Diagnosis ; Francisella tularensis ; Hand ; Humans ; Inflammation ; Insects ; Korea ; Lymph Nodes ; Male ; Tularemia* ; United States

Rieger's anomaly refers to a dysgenesis that features bilateral hypoplasia of the iris stroma, posterior embryotoxon and the associated angle anomalies, pupillary distortion, polycoria, and a high likelihood of glaucoma. In addition to glaucoma, other defects, usually dental, may be present in Rieger's anomaly. When glaucoma occurs, it usually develops during the first to third decades but infrequently occurs in infancy. Frequently mesodermal dysgenesis accompanies ectopia of the pupil and polycoria. In these anomalies no new synechias are formed such as occur in essential iris atrophy. Cataracts are occasionally part of the picture. The anomaly is extremely variable in its expression with the full-blown disease in one member of a family and only minimun signs in another. The authors experienced a case of Rieger's anomaly which occurred in both eyes of 18 year old male who had above characteristic ocular findings and associated juvenile onset glaucoma.
Adolescent ; Atrophy ; Cataract ; Glaucoma ; Humans ; Iris ; Male ; Mesoderm ; Pupil ; Pupil Disorders

Topical fibronectin, autologous and homologous, was used to treat nine patients (eleven eyes) with persistent corneal epithelial defects and corneal ulcers that failed to improve with standard therapy. The fibronectin was purified from autologous and homologous plasma by gelatin-Sepharose 4B affinity chromatography and administered topically, 500 micrograms/ml five times a day, for three weeks. Complete or nearly complete reepithelialization was achieved in all patients regardless of the source of fibronectin, autologous or homologous. But healing times varied. The average healing time was 41.7 +/- 14.7 days (35.7 +/- 12.4 days for autologous, 50.8 +/-14.4 days for homologous). Ocular symptoms were relieved significantly, and no side effects were observed. Over an average follow-up period of 5.2 months, no recurrences were noted. The results showed that homologous, as well as autologous, fibronectin was effective in patients with persistent corneal epithelial defects and corneal ulcers.
Administration, Topical ; Adult ; Aged ; Blood Proteins/isolation & purification ; Chromatography, Affinity ; Corneal Diseases/*drug therapy ; Corneal Ulcer/*drug therapy ; Epithelium/drug effects ; Female ; Fibronectins/administration & dosage/isolation & purification/*therapeutic use ; Humans ; Male ; Middle Aged ; Visual Acuity ; Wound Healing/drug effects

Proliferative vitreoretinopathy (PVR) is the main cause of failure in retinal reattachment surgery, Vitrectomy combined with pharmacologic therapy to inhibit proliferating and contracting epiretinal membranes appears to be a promismg approach in the management of PVR. We investigated the inhibitory effect of intravitreal 5-fluorouracil (5-FU) on experimental PVE induced by intravitreal injection of homologous dermal fibroblast in pigmented rabbits. At 6 weeks after intravitreal injection, Goup I (fibroblast only), Group II (early treatment with 1mg of 5-FU), and Group Ill (delayed treatment with 1mg of 5-FU) developed the retinal detachment in 85.7%, 33.3%, and 58.3% respectively. The rate of retinal detachment was lower in treatment groups than in non-treatment group, but there was a statistically significant difference only between non-treatment group (Group I) and early-treatment group (Group II) (p<0.05). In the group that only 5-FU was injected (Group IV), the retinas were preserved in normal clinically and pathologically. These results show that 5-FU may exert a significant anti proliferative effect on intraocular proliferative disorders including PVR especially if the drug is administered more earlier.
Epiretinal Membrane ; Fibroblasts ; Fluorouracil* ; Intravitreal Injections ; Rabbits ; Retina ; Retinal Detachment ; Retinaldehyde ; Vitrectomy ; Vitreoretinopathy, Proliferative*

The measurement of levator muscle function is the most important step in the evaluation of patients with blepharoptosis and also the most important factor in the choice of operation for blepharoptosis. There are two methods in measuring the levatormuscle function; one is Berke's method and the other is margin limbal distance(MLD). When the levator muscle resection procedure is indicated in blepharoptotic patients, preoperative MLD value is the clue to determine the amount of levator muscle to be resected by the MLD formula. MLD was measured in 419 normal Koreans who were examined in the Depart ment of Ophthalmology, Keimyung University School of Medicine from October 1987 to August 1988. The results were as follows: 1. The average value of MLD was 6.3 +/- 1.2mm. 2. The average value of MLD in males was 6.3 +/- 1.3mm and 6.2 +/- 1.2mm in females. 3. The average value of MLD in both eyes was 6.3 +/- 1.2mm. 4. The average value of MLD in different age groups was 5.7 +/- 1.0mm in the below 10 age gruop, 6.0 +/- 1.1mm in the 11-20 age group, 6.8 +/- 1.2mm in the 21-30 age group, 6.8 +/- 1.3mm in the 31-40 age group, 6.4 +/- 1.2mm in the 41-50 age group, 6.1 +/- 1.3mm in the 51-60 age group and 6.3 +/- 1.1mm in the above 60 age group, respectively. The average value of MLD was significantly different in the different age groups(p<0.01). Thus, the average value of MLD in normal Koreans was 6.3 +/- 1.2mm, which is significantly different from the 9mm of Putterman's. So we must consider 6.3 +/- 1.2mm as the normal value of MLD when determining the amount of levator muscle resection by the MLD formula.
Blepharoptosis ; Female ; Humans ; Male ; Ophthalmology ; Reference Values

Collagen shields made of porcine scleral collagen were immersed in a solution containing tobramycin sulfate(40 mg/ml) for five minutes, then applied to rabbit corneas. One, four and eight hours after application, the corneas were assayed for antibiotics by agar diffusion bioassay. We divided study groups as 4 groups, that is, collagen shield, subconjunctival, therapeutic soft contact lens and topical group, and compared the corneal concentradon of tobramycin in each group. Shields immersed in 40 mg/ml tobramycin produced significantly higher concentrations of tobramycin in the cornea at one and four hours than those of the other groups. Tobramycin concentrations in cornea eight hours after application became lower than those of one and four hours after application but, higher than minimal inhibitory concentration of Pseudomonas aeruginosa. Collagen shield containing antibiotics can serve as a vehicle for drug delivery and may prove superior to current methods for the initial treatment of bacterial keratitis, and preoperative and postoperative antibiotic prophylaxis.
Agar ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Biological Assay ; Collagen* ; Contact Lenses, Hydrophilic ; Cornea* ; Diffusion ; Keratitis ; Pseudomonas aeruginosa ; Tobramycin*