The anatomic and physiologic changes of the anopthalmic orbit affect cosmetic appearance of the patient and function of the socket and the prosthesis. During the past three years, the authors studied 13 cases of dermis-fat graft and 27 cases of posterior Tenon's capsule suturing with a plastic implant, and compared the post'operative effects of the two procedures. Dermis-fat graft produced good fornix formation with no remarkable fat atrophy after both primary and secondary proceddure. Posterior Tenon's capsule suture technique showes good effect to keep implant from migration or extrusion. Size of the plastic implant and fixation of the extraocular muscles were important factors also for good cosmesis and implant motility. There revealed no significant difference between the two procedures in EOM motility, enophthalmos, deep superior sulcus deformity, implant migration or prolapse etc.

The effect of Minizide(R) (prazosine 1mg and polythiazide 0.5mg) was studied in 34 hypertensive patients (female 16 cases, male 18 cases) at the Department of Internal Medicine, Paik Hospital, In-Je Medical College between July, 1979 and August 1980 for 14 months. The patients didn't take the any drugs for one week before the clinical trial with Minizide(R), and thereafter they took minizide 1 tablet 3 times daily for 2 weeks. The blood pressure was checked before and after the trial in the supine and standing position. The results were as followings: 1) The systolic blood pressure before the treatment with Minizide in the supine position was 196+/-24mmHg and in the standing position 188+/-22mmHg. The systolic blood pressure after the treatment with minizide in the supine position was 148+/-16mmHg and in the standing position 139+/-9mmHg. 2) The diastolic blood pressure before the treatment with minizide in the supine position was 118+/-11mmHg, and in the standing position 113+/-10mmHg. The diastolic blood pressure after the treatment with minizide in the supine position was 87+/-6mmHg and in the standing position 84+/-5mmHg. 3) There was no significant orthostatic hypotension after the 34 patients. 4) There was no changes of laboratory findings after the treatment. 5) 3 of 34 hypertensive patients after the treatment complained of headache, 3 palpitation, 2 edema, 2 drowsiness, and 1 fatigability and 1 patient complained of weakness.
Blood Pressure ; Edema ; Headache ; Humans ; Hypotension, Orthostatic ; Internal Medicine ; Male ; Polythiazide ; Sleep Stages ; Supine Position

No abstract available.
Humans ; Pityriasis* ; Tinea Versicolor* ; Treatment Outcome*

Idiopathic CD4+ T lymphocytopenia (ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma (KS) and pneumocystis carinii pneumonia (PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Extremities ; Female ; HIV Infections ; HIV-1 ; Humans ; Lung ; Lymphopenia* ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Scalp ; Serologic Tests ; T-Lymphocyte Subsets ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Thorax ; Toes

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

PURPOSE: To analyze the radiologic findings of facial nerve schwannoma. MATERIALS AND METHODS: The authors retrospectively reviewed CT and/or MR images and clinical history of eight patients with histologically provenfacial nerve schwannoma. After classifying this extratemporal and intratemporal types, clinical and radiologic findings were analysed. RESULTS: The most common clinical findings of facial nerve schwannoma were facial nervepalsy and hearing impairment in an intratemporal schwannoma(4/5), and a palpable parotid mass in an extratemporal schwannoma(3/3). On CT, each involved segment of intratemporal schwannomas(five cases) showed characteristic radiologic findings, while extratemporal schwannomas(three cases) showed masses of various types. On MRI, all tumors(two cases) showed hypointensity on T1WI, hyperintensity on T2WI, and strong enhancement on Gd-DTPA enhanced T1WI. CONCLUSION: Intratemporal facial nerve schwannomas can be easily diagnosed by characteristic clinical and radiologic findings. Extratemporal facial nerve schwannomas show nonspecific findings. However, if the tumor islocated between the superficial and the deep lobe of the parotid gland and extends to the posterior portion of thestyloid process, then facial nerve schwannoma is strongly suspected.
Facial Nerve* ; Gadolinium DTPA ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma* ; Parotid Gland

This study was carried out to compare the clinical effect of the endonasal lacrimal surgery done in 75 eyes of the 62 patients with that of the conventional lacrimal surgery done by the same operator in 72 eyes of the 57 patients. The diameter of intranasal ostium was 1.9 +/- 0.4 mm in endonasal approach and 2.6 +/- 1.4 mm in skin approach (p<0.05), respectively. Postoperative hospitalization were 1.7 - 2.5 days shorter in endonasal lacrimal surgery than those of conventional lacrimal surgery (p<0.001). Satisfactory tear drainge was observed in 29 eyes (90.6%) after endonasal dacryocystorhinostomy and in 28 eyes (90.3%) after conventional dacryocystorhinostomy, and 41 eyes (95.3%) revealed astisfactory tear drainge after endonasal conjunctivodacrystorhinostomy and 39 eyes (95.1%) showed good results after conventional conjunctivodacr yocystorhinostomy. In summary, endonasal lacrimal surgery showed no cutaneous scar, less edema and hematoma with short recovery time and similar success rate to the conventional lacrimal surgery. Thus, endonasal lacrimal surgery might be better than conventional lacrimal surgery.
Cicatrix ; Dacryocystorhinostomy ; Edema ; Hematoma ; Hospitalization ; Humans ; Skin ; Tears

Hypergammaglobulinemic purpura of Waldenstrom is characterized by recurrent episodes of petechiae, hypergammaglobulinemia, an elevated erythrocyte sedimentation rate, and the presence of rheumatoid factor, and leukocytoclastic vasculitis or mild lymphocytic perivasculitis. There is a primary type and a secondary type which is associated with other autoimmune diseases. We present a csae of a 48 year-old female with hypergammaglobulinemic purpura of Waldenstrom. She showed characteristic clinical, histopathological and laboratory findings consistent with hypergammaglobulinema purpura of Waldenstrom. Although there was a decrease in the Schimer test, we couldt den ostrate an association with Sjogrens syndrome. We think that this case may be a secondary type and needs a follow-up study.
Autoimmune Diseases ; Blood Sedimentation ; Female ; Follow-Up Studies ; Humans ; Hypergammaglobulinemia ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor ; Sjogren's Syndrome ; Vasculitis

Leiomyosarcoma arising in the skin is rare tumor, and diagnosis usually is made microscopically. After local excision, these lesions recur in large proportion of pat ients. The authors herein report a 53-year-old male with leiomyosarcoma appeared in the skin of the right forearm and presenting as a dark reddish colored, 5*6cm in diameter, superficial ulcerated single firm nodule with intermittent pain. Histopathological examination showed poorly circumscribed tumor consisting of interlacing bundles of spindle shaped smooth muscle cells in the middle and lower parts of the dermis. The nuclei were hyperchromatic, large, vacuolated, and irregular in shape. Electron microscopic findings revealed cytoplasmic organelles such as rough endoplasmic reticulum and mitochondria of malignant smooth muscle cells in the paranuclear area, Characteristic subsarcoelmmal caveolae and dense plaque were noted and myofilaments were distributed in the peripheral cytoplasm. The tumor did not recur in 10 months' follow-up.
Caveolae ; Cytoplasm ; Dermis ; Diagnosis ; Endoplasmic Reticulum, Rough ; Follow-Up Studies ; Forearm ; Humans ; Leiomyosarcoma* ; Male ; Middle Aged ; Mitochondria ; Myocytes, Smooth Muscle ; Myofibrils ; Organelles ; Skin* ; Ulcer