Tretinoin(all-trans retinoic acid) is a metabolite of vitamin A and it is useful in the treatment of photoaging skin. Photoaging skin is characterized by wrinkles, mottled pigmentation, dry and rough skin, and loss of skin tone. Current use of topical tretinoin mainly acts on the epidermis, requires a long period to obtain the desired results and may cause skin hyperpigmentation. A combination of topical and injectable tretinoin has been used to reduce the treatment period as a result of its potentialized effect on the dermis when compared to graditional topical cream use. in this study, we observed histologic alterations in 5 white rabbits after using 0.05% topical tretinoin cream and 0.1% injectable tretinoin. Tretinoin was treated on the rabbits ears-group 1 and 2 on the right ear for study 1, and group A and B on the left ear for study 2. Study 1 was done to differentiate whether the dermal thickening is due to the simple physical stretching of dermis by intradermal injection, or whether it is duer to the histologic change by tretinoin. In group 1, saline was injected intradermally and in group 2, tretinoin was injected intradermally. Study 2 was done to compare the dermal thickening between the topical tretinoin cream treatment group (group A) and the combined topical and injectable tretinoin group (group B). Injection was done once a week immediately followed by 340nm blue light skin exposure. These treatment were done for 12 weeks. We harvested skin stripe from all group, group 1 and 2, and group A and B respectively, after 2, 6, and 12 weeks after treatment. Histologic differences were observed and measured. Dermal thickening was observed in group 2 and in group B(p<0.05). The results showed that intradermal injection of tretinoin mainly acts on the dermis and potentialtes the effect on photo-aging skin and fine wrinkles.
Dermis ; Ear ; Epidermis ; Hyperpigmentation ; Injections, Intradermal* ; Pigmentation ; Rabbits ; Skin ; Tretinoin* ; Vitamin A

No abstract available.
Burns* ; Humans

Purpose: Genu valgum in Legg-Calve-Perthes disease (LCPD) is not a known complication. We investigated whether this valgus tendency is a complication of femoral varus osteotomy (FVO) or the sequela of the disease process itself, and what are the related factors. Materials and Methods: 35 patients treated by FVO and 38 by abduction orthosis (AO) were selected for this study. Only those patients with unilateral involvement, fragmentation stage, Catterall Group III or IV, and who were followed-up to full skeletal maturity were included in the study. We measured mechanical axis deviation percentage and hip-knee-ankle angle for femorotibial alignment, and mechanical lateral distal femoral angle and medial proximal tibial angle (mMPTA) for knee orientation on teleoroentgenograms and compared the affected and normal limbs. Results: All measurements, excluding the mMPTA, demonstrated a tendency of relative genu valgum versus the opposite normal limbs. This tendency was observed in both groups. There was no statistically significant difference between the two groups. Conclusion: Genu valgum occurred in 66% to 70% of the LCPD patients. Four factors were found to be significantly correlated with valgus shift: increased medial bowing of the femoral neck, decreased acetabulum head index, coxa magna, and limb shortening. Multivariate regression analysis identified limb shortening as the factor most responsible for valgus shift.
Acetabulum ; Axis, Cervical Vertebra ; Extremities* ; Femur Neck ; Genu Valgum* ; Head ; Hip ; Humans ; Knee ; Legg-Calve-Perthes Disease* ; Orthotic Devices ; Osteotomy

PURPOSE: To evaluate outer retinal tubulation (ORT) found in chronic central serous chorioretinopathy (CSC) using color fundus photography and spectral domain optical coherence tomography (SD-OCT). METHODS: ORT identified in patients with chronic CSC was examined using color fundus photography, fundus autofluorescence image, fluorescein angiography, indocyanin green angiography, and SD-OCT. The images were analyzed for morphological features, location, and size of ORT in the retinal layers. RESULTS: ORT was detected in 3 of 342 (0.88%) chronic CSC patients. Color fundus photography revealed circular or ovoid shape with hollow lumen and deep yellowish border mainly appearing at the affected retinal pigment epithelium layer in the macular area. SD-OCT B-scan revealed hyperreflective material observed inside the hyporeflective internal space with hyperreflective border. ORT had circular or ovoid shape on the SD-OCT C-scan. ORT was primarily located on the outer nuclear layer in the retina, emanating to the inner nuclear layer and was not greater than 170 x 170 microm in size when measured with SD-OCT B-scan image. CONCLUSIONS: ORT was identified in patients with chronic CSC which was observed using color fundus photography and circular or ovoid structure was observed using a SD-OCT C-scan.
Angiography ; Central Serous Chorioretinopathy* ; Fluorescein Angiography ; Humans ; Photography ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde* ; Tomography, Optical Coherence

STUDY DESIGN: Authors experienced three cases of malignant schwannoma arising from multiple neurofibromatosis and invading the vertebrae. OBJECTIVE: To report treatment results and preventive idea in three cases of malignant schwannoma transformed from neurofibromatosis within the retroperifoneal area and invading the vertebrae. SUMMARY OF BACKGROUND DATA: The patients with neurofibromatosis are clearly at increased risk to develop the malignant schwannoma. A review of Korean literature revealed no such cases. RESULTS: The first case presented in the L4 body and was treated by surgical excision and chemotherapy, but she expired due to secondary metastasis in six months after diagnosis. The second case was treated by diagnostic biopsy and chemotherapy with adriamycin, ifosfamide, DTIC, mesna. He eventually lived for 14 months. After a diagnostic biopsy, the third case died due to lung metastasis before we could begin the treatment. CONCLUSION: We recommend that neurofibromatsis patients be regularly followed-up and if necessary, CT examination of spine or abdomen should be done. If a malignant schwannoma is detected, then early treatment can be started.
Abdomen ; Biopsy ; Dacarbazine ; Diagnosis ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Lung ; Mesna ; Neoplasm Metastasis ; Neurilemmoma* ; Neurofibromatoses ; Spine*

PURPOSE: To discover the characteristics and rates of myopic progression with increasing age in children who have had history of retinopathy of prematurity (ROP). METHODS: Retrospective chart review was performed of 72 eyes in 36 children who were diagnosed with ROP. Inclusion criteria were myopia over -0.5 diopter and the children that could have been followed for at least 5 years or longer. The subjects with stage 4 or 5 ROP were excluded. Data on the retinoscopic refractions at every 6 month in each patient were recorded. We measured the annual rates of myopic progression in each subgroup which were divided according to the severity of ROP, treatment modality, and the different age intervals. RESULTS: Overall annual rates of myopic progression was -0.53 D/year. The severity of ROP was not correlated with the degree of myopia and the rates of myopic progression. In terms of the rates of myopic progression, statistical significance was found only in subgroups who were treated by cryotherapy. The myopia in age group over 5 years showed less progression than that in age group under 5 years. In the patients with anisometropia, there was a tendency that the discrepancy in the refractions of both eyes decreased gradually with increasing age although there was no statistical significance. CONCLUSIONS: The rate of myopic progression was not directly correlated with the severity of ROP. But the myopia in patients who had undergone cryotherapy showed a marked progression with significantly higher rate.
Anisometropia ; Child ; Cryotherapy ; Humans ; Myopia* ; Retinopathy of Prematurity* ; Retrospective Studies

No abstract available.

No abstract available.

No abstract available.
Membranes* ; Pregnancy* ; Rupture*

PURPOSE: Bilateral internuclear ophthalmoplegia (INO) has been reported mostly in bilateral medial longitudinal fasciculus (MLF) lesion. To report a case who presented with typical bilateral internuclear ophthalmoplegia (INO) with no brainstem lesion on brain MRI. METHODS: Case presentation. RESULTS: Seventy two year-old woman presented with bilateral marked adduction limitation and diplopia. Bilateral marked adduction limitation did not cross midline. Nystagmus occured in abducting eye. Elevation and depression were normal in duction. Transcranial doppler revealed moderated stenosis of right internal carotid artery and severe stenosis of left intracranial internal carotid artery. Brain MRI revealed focal old infarction of right corona radiata and circumscribed acute infarction at more upper level of corona radiata, however, no pathologic finding was identified in brainstem. Initial severe exotropia was improved to 30 PD exotropia in primary position. Adduction limitation was markedly improved 2 months later but bilateral horizontal nystagmus in abducting eye persisted
Brain Stem* ; Brain* ; Carotid Artery, Internal ; Constriction, Pathologic ; Depression ; Diplopia ; Exotropia ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging ; Nystagmus, Pathologic ; Ocular Motility Disorders*