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

Growing skull fracture is a rare complication of a closed head injury during infancy and childhood. Most growing skull fracture are located in the parietal region. The authors report a case of growing skull fracture of the orbital roof using three dimentional computerized tomography(3-D CT) imaging, the shpae and the size of defect were clearly demonstrated.
Head Injuries, Closed ; Orbit* ; Rabeprazole ; Skull Fractures* ; Skull*

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*

Spontaneous spinal epidural hematoma (SSEH) is a rare entity that has been reported to occur in different age groups, from pediatric to elderly patients. The etiology and the pathogenesis remain unclear. By definition, SSEH excludes that due to obvious trauma, anticoagulant therapy, coagulopathy, vascular malformation, and tumors. The pre-senting symptoms vary, but the usual earliest presentation is a sudden stabbing pain associated with a nerve-root type of irradiation. A variable degree of sensorimotor deficit then rapidly develops. An urgent computed tomography (CT) myelography and magnetic resonance imaging (MRI) can be performed to diagnose the hematoma. For patients with incomplete sensorimotor deficit, favorable outcomes are thought to correlate highly with surgery (decompressive laminectomy) within 48 hours. This critical time is sharply reduced to 12 hours for patients with complete sensorimotor deficit.
Aged ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Myelography ; Spine ; Vascular Malformations

The diagnosis of neurocysticercosis is relatively easy with brain computed tomo-grarhy(CT) and/or magnetic resonance imaging(MRI) and ELISA test of serum and cerebrospinal fluid(CSF). The clinical manifestation of the disease are varied and correlated with the infection sites. The use of praziquantel and/or surgical excision are effective in treatment of the disease. The effect of treatment has been evaluated with imaging studies and changes of clinical manifestation. The authors reviewed 97 neurocysticercosis patients to evaluate the prognostic predictability of serum and CSF ELISA titers after treatment . We classified the patients into two groups. Rebound group was patients which showed higher ELISA titers after praziquantel medication than pretreatment. The responses to treatment were evaluated with the changes on brain CT or MRI. The Initial ELISA titers were lower in rebound group than those of nonrebound group, but three month after treatment, rebound group showed higher titers. The changes of ELISA titers in rebound group were greater in CSF than those in serum. The reduction of cyst on brain CT or MRI was more remarkable in rebound group than in nonrebound group and the prognosis of rebound group was better. Changes of ELISA titers was valuable in predicting the effect of treatment and prognosis.
Brain ; Diagnosis ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Magnetic Resonance Imaging ; Neurocysticercosis* ; Praziquantel ; Prognosis*