The patients initially underwent epikeratoplasty for keratoconus but a penetrating kerato plasty was required due to the opacity in the cornea. By using of this specimen, which was obtained by trephination the healing process of the host-Ienticule cornea could be examined by electron microscopy and immunofluorescence method. Epithelial ingrowth over the lenticule was well formed by the regeneration of the basement membrane over the Bowman's membrane. However, the poor attachment of the lenticule over the host corneal stroma made the interface easily separated during the sectioning processes. Electron microscopic study revealed the keratocytes in the lenticule stroma vacuolized with large number of degenerated microorganelles. These results suggest that it may take a long time to complete the wound healing of the host-Ienticule interface despite the epithelial ingrowth onto the lenticule was well formed.
Basement Membrane ; Bowman Membrane ; Cornea ; Corneal Stroma ; Epikeratophakia* ; Extracellular Matrix ; Fluorescent Antibody Technique ; Humans ; Keratoconus ; Microscopy, Electron ; Regeneration ; Trephining ; Wound Healing

Prurigo pigmentosa is a chronic pruritic inflammatory dermaoss characterized by erythematous papules in a reticulated pattern that resolve leaving a reticulated, mottled hyperpigmentation. Most cases have been reported from Japan. Two cases of prurigo pigmentosa have been reported in Korean women. We experienced a casc of prurigo pigmentosa in a Korean man of 20 years of age. Histopathological findings of reddish papule showed exocytosis, sponsiosis, intraepidermal vesicles, hydropic degeneration of basal cells in the epidermis, and hyphohistiocytic infiltration in the upper dermis. Direct irnmunofluorescence was negetive. Therapy with dapsone, 50 mg given daily, resulted in a rerinable regression of the reddish papules. The daily dose of clapsone was reduced to 25mg; however, no new reddish, pruritic papules have appeared.
Dapsone ; Dermis ; Epidermis ; Exocytosis ; Female ; Humans ; Hyperpigmentation ; Japan ; Prurigo*

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal*

No abstract available.

No abstract available.
Microvascular Decompression Surgery*

PURPOSE: Recently, there are many good reports on the arthroscopic management of tibial condylar fractures. But, it may be appropriate for selected tibial condylar fractures and also needs a skilled technique. So we report the results of the tibial condylar fractures treated by the arthroscopy and limited percutaneous fixation or the arthroscopic-assisted management with conventional internal fixation without arthrotomy. MATERIALS AND METHODS: From June 1996 to December 1997, we treated 22 cases of the tibial condy- lar fractures including relatively comminuted one and analysed the results of patients who have been observed at least 1 year with Porters knee evaluation criteria. RESULTS: In 18 out of 22 cases, the results were Acceptable on symptoms(excellent 3, good 15, fair 4), in 18, on function(excellent 10, good 8, fair 3), in 21, on appearance(excellent 12, good 9, fair 1) and in 20, on radiographic appearance(excellent 11, good 9, fair 2). Overall results were Acceptable in 18 cases(82%) and Unacceptable in 4 cases(18%). CONCLUSION: The arthroscopic-assisted management with conventional internal fixation without arthrotomy can be the recommendable treatment for the tibial condylar fractures, including relatively comminuted one, without complications.
Arthroscopy ; Humans ; Knee

Atlantoaxial joint is a complex and unique structure which promotes rotation of head. Disruption of the transverse ligament and odontoid process fracture caused by trauma result in atlantoaxial instability. The instability must be corrected to relieve pain and to reduce the risk of neural damage and possibility of sudden death. The most recent and technologically advanced fixation method of C1-2 instability is the use of C1-2 transarticular screw fixation. The transarticular screw fixation augmented with interspinous wiring technique provide immediate multidirectional rigid fixation and increase the fusion rate of atlantoaxial instability. It can be employed in situations where the posterior arch of C1 is absent or fractured and in situations where standard wiring techniques pose risky posterior subluxation of C1 on C2, or for congenital odontoid anomalies. Twenty-one patients with atlantoaxial instability were operated with posterior transarticular screw fixations augmented with interspinous C1-2 strut graft and posterior wire fixation technique. All patients restored C1-2 stability without complication. This technique seems to be superior biomechanically when compared with other posterior fixation methods. Precaution is needed to avoid the vertebral artery injury.
Atlanto-Axial Joint ; Death, Sudden ; Head ; Humans ; Ligaments ; Odontoid Process ; Transplants ; Vertebral Artery

Recurrent lumbar disc herniation after standard lumbar discectomy was the mostcommon complication among the failed back surgery syndrome. Clinical manifestations and radiologic findings were analyzed in 56 paients who were proved to have recurrent lumbar disc herniation. Comparative analysis with Lumbar Disc Surgery Predictive Score(LDSPS) between 160 patients of failed back surgery syndrome and 56 patients of recurrent disc herniation was performed. LDSPS of the recurrent disc herniation was 81.3. The interval of the reoperation after onset of symptom was considered to be one ofthe major factors in the prognosis of the recurrent disc herniation. The patient must be educated how to prevent lumbar disc herniation. When recurrency was suspected one must diagnose precisely with the help of MRI andreoperate as soon as possible.
Diskectomy ; Failed Back Surgery Syndrome ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Reoperation

PURPOSE: Using transmission electron microscopy (TEM), we studied the ultrastructures of rapidly proliferating preretinal membranes of young patients with very extensive ischemic proliferative diabetic retinopathy and diabetes with uncontrollable blood sugar level. METHODS: Nine cases of preretinal membranes were obtained from six eyes of five patients with rapidly progressed proliferative diabetic retinopathy (mean age, 35 years) during vitrectomy. We obtained each preretinal membrane bimanually as one single sheet membrane using intraocular scissors and forceps. Each tissue was fixed in 3% glutaraldehyde in the operating room. All specimens were prepared and studied using TEM. RESULTS: The preretinal membranes were composed of blood vessels and some interstitial cells. The blood vessels within the preretinal membranes varied in developmental stages, from the immature stage to the mature stage. The blood vessels were highly active, in that primitive cells showed a large nucleus and prominent chromatin clumping with abundant cytoplasm. Highly active fibroblast-like cells were also noted. CONCLUSIONS: We observed highly active angiogenesis in preretinal membranes, which rapidly proliferated in cases of severe retinal ischemia in young diabetes patients. This is the first report of such a finding, which may help to explain the poor prognosis of this disease modality.
Blood Glucose ; Blood Vessels ; Chromatin ; Cytoplasm ; Diabetic Retinopathy ; Eye ; Glutaral ; Humans ; Ischemia ; Membranes ; Microscopy, Electron, Transmission ; Operating Rooms ; Prognosis ; Retinaldehyde ; Surgical Instruments ; Vitrectomy

Hemobilia is defined as hemorrhage into the biliary tract as a result of a communication between the biliary tract and arteriovenous circulation. A classical triad of symptoms and signs are upper abdominal pain, gastrointestinal bleeding, and jaundice. Hemobilia is a rare condition that may be difficult to recognize; it is, nevertheless, important to include it in the differential diagnosis of gastrointestinal bleeding. The causes include accidental and iatrogenic trauma, gallstones, inflammation, vascular malformation, and tumors. Due to the frequent use of diagnostic and therapeutic procedures involving hepatobiliary and portal systems, there has been an increase in the incidence of iatrogenic hemobilia during the last two decades. Like hematuria and epistaxis, hemobilia may also occur in coagulopathy, but acquired coagulopathy with anticoagulation therapy is very rarely associated with this condition. We present a case of acquired coagulopathy following warfarin therapy that resulted in spontaneous hemobilia complicating acalculous cholecystitis and cholangitis.
Abdominal Pain ; Acalculous Cholecystitis ; Biliary Tract ; Cholangitis ; Diagnosis, Differential ; Epistaxis ; Gallstones ; Hematuria ; Hemobilia* ; Hemorrhage ; Incidence ; Inflammation ; Jaundice ; Portal System ; Vascular Malformations ; Warfarin*