No Abstract Available.
Humans

OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

BACKGROUND: One of the most, probable pathogenesis of vitiliga is autoimmune. Systemic cor tico st,eroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. OBJECTIVE: We have assessed the clinical effect of a oral small oral dose of corticosteroid to minimize side effects in vitiligo patients. METHODS: Thirty four patients(9;male, 25;female) with vitiligo were evaluated in this study. The patients took 7.5mg-20mg prednisolone initially for 2 months and then the dosage was tapered to half of the initial dosiat the 3rd month and half of dose of 3rd month for the last 4th month. We compared the effcct of treatment of vitiligo before and aft.er the study by photographs. and side efferts were issessed at. 1, 2, 3 and 4 month. RESULTS: The arrest of the progression of vitiligo was noticed in 79% of patients and repigmentation was noticed in 59% of patients which is statistically significant. The effect, of treatment according to extent, duiation, type, and site of vitiligo were not statistically significant. The side effects of treatment were minimal and did not affect the course of treatment. CONCLUSION: Small doses of iral corticosteroids are effective without any significant side effects in preventing progression and loiiduce repigmentation of active spreading vitiligo and generalized type of vitiligo that is difficult to treat with topical corticosteroids.
Adrenal Cortex Hormones* ; Humans ; Prednisolone ; Vitiligo*

PURPOSE: To evaluate the therapeutic efficacy of intravitreal bevacizumab (IVB) in the treatment of branch retinal vein occlusion (BRVO) in eyes with normal tension glaucoma (NTG). METHODS: We included 16 NTG eyes and 48 age- and sex-matched eyes without NTG that had received IVB for BRVO with more than 6 months of follow-up. The main outcome measures were log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and 1, 3, and 6 months after IVB. We compared the results according to the comorbidity associated with NTG. RESULTS: The obstruction site of BRVO was significantly closer to the optic disc in eyes with NTG than in eyes without NTG. Baseline log MAR BCVA and CMT were similar between the two groups. After IVB, postoperative BCVA was significantly improved and CMT was significantly reduced, irrespective of the comorbidity associated with NTG. However, vision improvement was more limited in eyes with NTG, while CMT was similarly reduced compared with that in eyes without NTG. The mean numbers of injections were similar between the two groups, and there were no injection-related complications. CONCLUSIONS: IVB may have therapeutic efficacy in the treatment of BRVO associated with NTG. However, the comorbidity associated with NTG may limit vision improvement, although anatomic recovery of CMT is achieved.
Antibodies, Monoclonal, Humanized ; Comorbidity ; Eye ; Follow-Up Studies ; Low Tension Glaucoma ; Macular Edema ; Outcome Assessment (Health Care) ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Bevacizumab

PURPOSE: To evaluate the effects of occlusion therapy on anisometropic amblyopia and investigate the factors that influence on the final vision. METHODS: Fifty two patients with anisometropic amblyopia, whose age ranged from 3 to 12 years, were treated with full and partial occlusion therapy. RESULTS: The degree of anisometropia was 3.23+/-1.99 D in hyperopia group and 2.00+/-0.98 D in myopia group. The best corrected visual acuity and final vision were 0.29+/-0.14 and 0.52+/-0.22 in hyperopia group, while 0.34+/-0.16 and 0.63+/-0.16 in myopia group. But statistically significant difference was not found between two groups. The best corrected visual acuity was significantly correlated with the degree of anisometropia. The final vision was also significantly correlated with the degree of anisometropia. As expected, the final visual acuity was strongly correlated with the best corrected visual acuity. But no statistically differences were found based on the age of initial treatment and sexual difference. CONCLUSIONS: The severity of amblyopia and the effect of occlusion therapy were more correlated with the degree of anisometropia than the age of initial treatment and the type of anisometropia.
Amblyopia* ; Anisometropia ; Humans ; Hyperopia ; Myopia ; Visual Acuity

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.
Bacteria ; Citric Acid ; Decontamination ; Dental Implants ; Dental Plaque ; Fibroblasts ; Osseointegration ; Peri-Implantitis ; Tetracycline ; Titanium* ; Tooth ; Water

BACKGROUND: Recently, it has been suggested that autoantibodis face of melanocytes are prevent in the sera of vitiligo patients. However, these autoantibodies exist, whether they are specific for vitiligo a vitiligo patients possess them. In addition, the specificity of the iti lecular weight of the antigen are all unsolved areas demanding further. OBJECTIVE: To investigate the possible role of autoimmune microvitiligo, this study was designed to verify the presence of auto and vitiligo antigen from the surface of melanocytes, the specificity of gene specific antigens on the sunever, it is not known whether ents, and what percentage of goantigen and the exact moier research. anisms in the development of bodies in vitiligo patients, the utoantibodies and vitiligo anti. METHODS: Indirect immuvofluorescent microscopy, flow cytoriiety, and ELISA was done to compare the reactions between melanocytes and sera. SDS-PAC island immunoblotting were used for the identification of vitiligo antigen. RESULTS: Vitiligo sera showed more prominent fluorescence and higher optical density on the surface of melanocytes than normal sera. Forty-four percent of vitiligo sera was directed to melanocytic surface antigen with a molecular weight of 65kDa. The sition assay using rabbit antimelanocytic antibody showed an inhibition of the reaction betw er vitiligo sera and melanocytes in ELISA and immunoblotting. CONCLUSION: A surface antigen of 65kd was identified from melanocytes and 44.4% of the vitiligo sera showed positive reactions to this antigen.
Antigens, Surface ; Autoantibodies* ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; Humans ; Immunoblotting ; Melanocytes* ; Microscopy ; Molecular Weight ; Sensitivity and Specificity ; Vitiligo*

BACKGROUND: Epidermal grafting using cryotherapy for recipient sites is in widespread use. However the peripheral hypopigmented haloes that occur around the recipient sites require prolon gation of the treatment period. OBJECTIVE: We used a CO2 laser to remove the epidermis of the recipient sites for betteri results. METHODS: We treated lie localized vitiligo patients with CO2 laser to remove t.he epidermis and grafted suction blister rooves. We observed repigmentation and complications 1 month later. RESULTS & CONCLUSIONS : The superiority of this method is demonstrated by the fact 1) all prodedures can be completed on the day of operation 2) the incidence of hypertrophic scar and peripheral hypopigmented halos can be observed.The problems of this method are 1) uneven repigmentation of recipient. sites 2) hyperpigrnentation of recipient sites
Blister ; Cicatrix, Hypertrophic ; Cryotherapy ; Epidermis* ; Humans ; Incidence ; Lasers, Gas* ; Suction ; Transplants* ; Vitiligo*

BACKGROUND: Recent ad vances and innovation in laser technology encourages us to learn and use it experimentally and clinically. The pulsed dye laser(Candela SPTL-1) is a flashlamp excited dye laser, using the princ ples of selective photothermolysis that targets the abnormal microvascu lature of cutaneous lesions while sparing adjacent structures including the epidermis. The laseemits a 585nm wavelength, and has a pulse duration of 450 usec. It is now being widely used in the treatment of vascular diseases in the dermatology field. OBJECTIVE & METHOD : Buring the period of about 3 years from August 1994 to March 1992, at the out patient clinin of Department of Dermatology of Yonsei University. 252 patients who were treated with SPTL was analyzed to evaluate the clinical effects of the pulsed dye laser. Patient di@st.ributition f the cutaneous vascular lesions included 1fil pat.ients with nevui flammeus, 68 with telangcetasia, 15 with spider angima, 5 with strawberry hemangiona and 2 with cavernous hemangior ia. RESULTS: The results and summarized as follows : 1. Nevus flammeus 4b.7% of early childhood, 41.5% of late childhood and 47.3% of adults showed excellent or good results. 2. Telangiectasia 78.1% of patients she wed excellent or good results. 3. Spider angioma 66.7% of patients she wed excellent or good results. 4. Strawberry hemangioma and cavernous hemangioma Most, of the patients,howed fair or poor results. 5. Complications included hyperpigmentation(26.5%), hypopigmentation(1.6%) and atrophic scar(4.5% ). CONCLUSION: Our experince with pulsed dye laser during the last 3 years revealed that it was superior in treating vascular disease than other existing lasers.
Adult ; Dermatology ; Epidermis ; Fragaria ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Lasers, Dye* ; Port-Wine Stain ; Spiders ; Telangiectasis ; Vascular Diseases

A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of 5.9+/-0.97mm from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is 4.2+/-1.15mm and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being 7.4+/-1.65mm.
Connective Tissue* ; Humans ; Palate ; Postoperative Period ; Tooth Cervix ; Transplants*