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

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

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

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

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

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

To compare corneal endothelial damage in intercapsular cataract extraction with post erior chamber lens implantation (Intercapsular P-ECCE+PCL) to that in conventional extracapsular cataract extraction with posterior chamber lens implantation (P-ECCE+PCL), and to detect the most appropriate index for comparision of the endothelial damage, the author has measured morphologic characteristics of corneal endothelium in 20 cases of intercapsu1ar P-ECCE+PCL (Group 1), and 21 cases of P-ECCE+PCL (Group 2) preoperatively and one week after surgery. Morphometric data (density, area, coefficient of variation, perimeter, shape factor, hexagonality, lengths) were obtained by contact type specular microscope, computer assisted digitizer and image analysis program. The mean endothelial cell loss one week after surgery was 10.82% in group 1, and 20.22% in group 2 respectively. The mean hexagonality loss one week after surgery was 28.05% in group 1, and 38.84% in group 2 (p<0.05). The mean coefficient of variation (CV) loss at postoperative one week was 30.68% in group 1, and 38.84% in group 2. As a whole, group 1 showed less reduction of endothelial damage compared to group 2 but no statiscally significant changes were noted except hexagonality. Therefore, the corneal endothelium was less damaged after intercapsular P-ECCE+PCL than after P-ECCE+PCL, and the adequate index for comparision of endothelial damage are CV and hexagonality as well as cell density, among which hexagonalty is the most important parameter.
Cataract Extraction* ; Cataract* ; Cell Count ; Endothelial Cells ; Endothelium, Corneal*

After the first description of epikeratoplasty for the correction of aphakia, it has been widely used in high myopia and keratoconus for improvement of visual acuity. Seven epikeratoplasties were performed on five high myopia and two keratoconus patients showing intolerance to eye-glasses and contact lens, with the mean follow-up period of 9.7 months. In high myopia, mean spherical equivalent decreased from -15.90D to -2.05D postoperatively. In keratoconus, mean keratometric value decreased more than 4.94D postoperatively and the progression of disease stopped. All patients showed an imporvement in thei uncorrected visual acuity and best corrected visual acuity. In all cases, reepithelialization completed in 4-23 days (mean 14 days).
Aphakia ; Epikeratophakia* ; Follow-Up Studies ; Humans ; Keratoconus ; Myopia ; Visual Acuity

Eighty seven cases of ocular adnexal tumors were excised and studied histologically between January 1, 1967 and March 31,1974 at Department of Ophthalmology, Dong San Presbyterian Medical Center. The incidence of ocular adnexal tumors among 22,420 out-patients was 0.38%. The Sexual distribution revealed 49 males (56.3%) and 38 females (43.7%). The benign tumors were more frequent in 2nd and 3rd decades, but the malignant tumors, on the other hand, after 5th decade. Location-wise, the eye-lid was largest in number (38 cases, 43.7%) followed by the conjunctiva (24 cases, 27.6%), orbit (23 cases, 26.4%) and lacrmal apparatus (2 cases, 2.3%) in order. As asingle disease, the nevus, pseudotumor and malignant melanoma were impressively high in incidence. Over all incidence of malignant tumors was 31% (27 cases) and that of benign tumors 69% (60 cases). Of malignant tumors the eye lid tumors were largest in number (12 cases), the orbit 9 cases and conjunctiva 6 cases.
Conjunctiva ; Female ; Hand ; Humans ; Incidence ; Male ; Melanoma ; Nevus ; Ophthalmology ; Orbit ; Outpatients ; Protestantism