No abstract available.
Vibrio vulnificus* ; Vibrio*

The malignant transformation of fibrous dysplasia is a rare condition and the incidence is estimated at 0.4% for fibrous dysplasia and 4% for Albright's syndrome. And fronto-orbital fibrous dysplasia can have a devastating outcome with high rates of recurrence and blindness, especially following incomplete resection. So a radical and extensive approach to treatment is recommended. We report the case of a multiostotic fronto-orbital fibrous dysplasia in a 54-year-old male patient which had a malignant transformation to osteosarcoma. There had been a recurrence after partial removal and no effect by chemotherapy. Although we had have a favorable outcome in functional and aesthetic aspects without any evidences of recurrence by total removal and reconstruction with titanium mesh, the patient died with lung metastasis 4 and half years later after the first operation.
Blindness ; Drug Therapy ; Fibrous Dysplasia, Polyostotic ; Humans ; Incidence ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Osteosarcoma ; Recurrence ; Titanium

PURPOSE: To report a case of unilateral Purtscher's retinopathy that spontaneously resolved within 24 hours. CASE SUMMARY: A 54-year-old man presented with decreased visual acuity in his left eye after a vehicle accident. When the accident occurred, his chest region was compressed by the safety belt. The case was diagnosed with Purtscher's retinopathy based on fundus examination, flourescein angiography (FAG) and optical coherent tomography (OCT). At presentation, the best corrected visual acuity (BCVA) was 0.3 in the affected eye. Tiny Purtscher-flecken and macular edema were observed but there was no sign of retinal hemorrhage. Immediately after the trauma, OCT detected abnormally increased hyperreflectivity in the nerve fiber layer and ganglion cell layer, severe cystoid edema and serous foveal detachment. Without any treatment, BCVA was improved to 1.0 within 12 hours. Recovery of visual acuity was followed by improvement of abnormal hyperreflectivity in the nerve fiber layer, cystoid macular edema and serous foveal detachment. CONCLUSIONS: The authors of the present study report a dramatically resolved unilateral Purtscher's retinopathy after blunt chest trauma.
Angiography ; Edema ; Eye ; Ganglion Cysts ; Humans ; Macular Edema ; Middle Aged ; Nerve Fibers ; Retinal Hemorrhage ; Thorax ; Visual Acuity

PURPOSE: To report a case of ciliary body tuberculoma, which induced scleral melting. CASE SUMMARY: A 32-year-old man, who was diagnosed with miliary pulmonary tuberculosis 1 week earlier, presented with a conjunctival injection and mass on his right eye 3 months in duration. On excisional biopsy, melted sclera and exposed uveal tissue were found; acid-fast stain was positive. Two months after anti-tuberculosis treatment, anterior granulomatous uveitis and granuloma formation on the anterior chamber angle developed. A low-dose systemic steroid therapy was added. Six weeks after systemic steroid therapy, anterior uveitis and granuloma on anterior chamber angle disappeared. CONCLUSIONS: We experienced a case of ocular tuberculosis on the ciliary body. A low-dose systemic steroid along with multi-drug anti-tubercular therapy may be an effective treatment of ciliary body tuberculoma.
Adult ; Anterior Chamber ; Biopsy ; Ciliary Body ; Eye ; Freezing ; Granuloma ; Humans ; Sclera ; Tuberculoma ; Tuberculosis, Ocular ; Tuberculosis, Pulmonary ; Uveitis ; Uveitis, Anterior

Both frontal sinus ablation and osteoplastic frontal surgery with obliteration have limitations in treatment of injury to the frontal sinus that extends into the posterior wall and frontal lobes of the brain. In these problematic cases, cranialization of the frontal sinus is the method of choice. The purpose of the cranialization of the frontal sinus was as follows: (1) ablation of the sinus, precluding later infection or mucocele, mucopyocele formation (2) restoration of a normal aesthetic frontal bony contour (3) protection of frontal lobe by allowing space for the expansion of the edematous brain. From May 1999 to December 2003, we performed cranialization of involved frontal sinus in 23 patients who had malignant tumor, fibrous dysplasia, osteoma, mucoele, and fracture event in the frontal sinus on each other. After the frontal sinus was exposed through a bicoronal incision, the excision of posterior wall and removal of mucosa remaining on the floor of the sinus and residual anterior wall were done. The nasofrontal ducts were occluded with pericranial flap or/and bone source(R), or bone graft. Reconstruction of anterior wall was done with autogenous bone or/and bone source(R), or mesh plate, bone graft, and mesh plate with bone source(R).The average follow-up period was one and half years (from 1 year to 4 years).There were no serious complications including CNS infections, mucocele formation and CSF leakage, with an exception of one person who was expired of recurrence of skull base tumor. Also, the overall functional and aesthetic outcome was excellent except one case in which there was irregularity in the frontal area. The cranialization of the frontal sinus is a safe surgical procedure without complications if prevented.
Bone Plates ; Brain ; Follow-Up Studies ; Frontal Lobe ; Frontal Sinus* ; Humans ; Mucocele ; Mucous Membrane ; Osteoma ; Recurrence ; Skull Base ; Transplants

Oxycephaly, which is a frontal deformity in which the forehead is recessed and tilted backwards, is usually caused by the premature fusion of mainly the coronal and sagittal suture. In 1926, David M. Greig proposed to classify oxycephaly into three different forms; true oxycephaly, delayed oxycephaly and false oxycephaly. False oxycephaly is a simple morphotype of the skull without any clinical symptoms which does not affect the brain in any way. Surgical repair of oxycephaly for adults can include cosmetic considerations and the prevention or possible improvement of functional symptoms such as headaches, vomiting and visual disturbance. Furthermore, in adults who does not have any functional problems, cosmetic surgery can be done. But oxycephaly of adult patients need more complex and extensive surgical interventions than that of infant patients. A-21-year-old male who had a retroverted forehead, pointed head and a flat fronto-nasal angle, without any functional problems, was treated by a fronto- orbital advancement and a transposition between the frontal and fronto-parietal bone. This method provided us with a good frontonasal angle and a gently backward sloping forehead above the supraorbital bar. An acceptable aesthetic appearance was achieved 6 months after the operation. This remodeling technique is adequate for resolving the aesthetic problems of adult false oxycephalic patients who does not have any functional problems.
Adult* ; Brain ; Congenital Abnormalities ; Craniosynostoses* ; Forehead ; Head ; Headache ; Humans ; Infant ; Male ; Orbit ; Skull ; Surgery, Plastic ; Sutures ; Vomiting

Cytomegalovirus retinitis (CMV), an opportunistic infection of a immunocompromised patient, is a necrotizing retinitis occurred in AIDS or the patient using immunosuppressants. A 31-years-old male taken immunosuppressants after renal transplantation, had white granular foci and perivascular sheathings in the uper temporal retina of both eyes. Serologic test demonstrated positive response to bith IgG and IgM antibody against CMV. Argon laser photocoagulation was done and ganciclovir was intravenously treated 300 mg every 12 hours for three weeks without maintenance therapy. Nine months after treatment, there was no recurrence of retinitis. This result suggests CMV retinitis of renal transplanted patient may not need the maintenance therapy of ganciclovir.
Argon ; Cytomegalovirus Retinitis* ; Cytomegalovirus* ; Ganciclovir* ; Humans ; Immunocompromised Host ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppressive Agents ; Kidney Transplantation ; Light Coagulation ; Male ; Opportunistic Infections ; Recurrence ; Retina ; Retinitis ; Serologic Tests

PURPOSE: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load- bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. METHODS: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from 1.0 X 1.5 cm to 12 X 10 cm. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. RESULTS: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. CONCLUSION: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.
Follow-Up Studies ; Foreign-Body Reaction ; Humans ; Mandible ; Maxilla ; Nasal Bone ; Orbit ; Recurrence ; Skull ; Skull Base ; Tissue Donors ; Titanium* ; Weight-Bearing ; Wound Infection ; Zygoma

PURPOSE: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load- bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. METHODS: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from 1.0 X 1.5 cm to 12 X 10 cm. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. RESULTS: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. CONCLUSION: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.
Follow-Up Studies ; Foreign-Body Reaction ; Humans ; Mandible ; Maxilla ; Nasal Bone ; Orbit ; Recurrence ; Skull ; Skull Base ; Tissue Donors ; Titanium* ; Weight-Bearing ; Wound Infection ; Zygoma

Purpose: Clinical factors affecting the recovery period in patients with vascular or idiopathic paralytic strabismus were evaluated. Methods: This study involved a retrospective review of medical records of patients diagnosed with vascular and idiopathic acquired paralytic strabismus. Vascular paralysis was defined in cases of hypertension, diabetes mellitus, or cardiovascular disease. The angle of deviation and limitation of extraocular movement were evaluated at each visit. Recovery was defined as the absence of diplopia and complete resolution of limitation of extraocular movement. Factors affecting recovery success and recovery period were analyzed. Results: We retrospectively reviewed data of 145 patients consisting of 87 with vascular paralytic strabismus (cranial nerve [CN] III: 21, CN IV: 28, CN VI: 38) and 58 with idiopathic paralytic strabismus (CN IV: 20, CN VI: 24, CN III: 14). The recovery rate did not significantly differ between vascular (60.9%) and idiopathic (63.8%) groups (p = 0.15). The recovery period was longer in the vascular group (130.1 ± 145.1 days) than in the idiopathic group (92.6 ± 76.6) (p = 0.02). Age at onset was significantly associated with the recovery period in both vascular and idiopathic groups. In the vascular group, the recovery periods were 107.4 ± 74.8 days in CN III palsy, 97.2 ± 51.9 days in CN IV palsy, and 159.3 ± 194.1 days in CN VI palsy. The recovery period was significantly longer in patients with CN VI palsy (p = 0.03). Hypertension was significantly influencing the recovery period in patients with vascular CN VI palsy (odds ratio = 2.54, p = 0.01). Conclusions The recovery period was longer in patients with vascular paralytic strabismus than in patients with idiopathic paralytic strabismus. Recovery rates were not significantly different between groups. In patients with vascular CN VI palsy, a history of hypertension was significantly associated with the recovery period.