PURPOSE: With its increasing popularity, several complications, such as infection, exposure, and extrusion have been reported in the use of the porous orbital implants. Exposure of the implants is one of the most difficult complications to treat. We evaluate the effect of treatment in exposed porous orbital implants with various techniques. METHODS: From January 1995 to December 2000, 15 patients visited our clinic with exposure of implant after porous orbital implantation. The following procedures were used to cover the implants: observation with delayed prosthesis fitting and posterior vaulting of the prosthesis, burring away the anterior surface of the hydroxyapatite implant and placing dermis fat graft, removing infected implants and dermis fat graft, and removal and 180degrees rotation and replacement of porous implants according to the degree of exposure. RESULTS: Porous implants exposures occurred 1 to 12 weeks after implantations (mean, 5.2 weeks). Small areas of exposure (<3mm) closed spontaneously (2 cases), remained stationary (2 cases), and increased the exposure area requiring dermis fat graft (1 case). During the follow-up period (mean, 19 months), no porous orbital implant was exposed again except 1 case who received previous orbital irradiation therapy. CONCLUSIONS: Small exposure of porous orbital implants less than 3 mm in diameter may be closed with nonsurgical methods. In the case of exposure larger than 4 mm, dermis fat graft or removal and 180degrees rotation and replacement of porous implants were effective in the treatment of exposure.
Dermis ; Durapatite ; Follow-Up Studies ; Humans ; Orbit* ; Orbital Implants* ; Prostheses and Implants ; Prosthesis Fitting ; Transplants

PURPOSE: The aim of this study is to evaluate the effect of radiotherapy for the patients with Graves' orbitopathy who were intolerable to corticosteroid therapy. METHODS: From December 1995 to June 2000, We reviewed medical records of thirteen patients who had received orbital radiation delivering 2000 cGy in 10 fractions over 2 weeks. RESULTS: Compressive optic neuropathy was improved in 3 of 4 patients (75%), and soft tissue swelling was improved in eight of 9 patients (88%). Proptosis was reduced in 3 of 13 (30%) patients. However, diplopia and ocular motility responded poorly and was improved only in 2 of 10 (20%) patients. No adverse effects of radiotherapy occurred in any patient. Specifically there was no sign of radiation-induced injury to optic nerve, retina, or lens. CONCLUSIONS: Radiotherapy was successful in patients with acute Graves' orbitopathy especially who had compressive optic neuropathy or soft tissue swelling. This modality was useful for those who showed intolerable side effects from the use of corticosteroid or the recurrence with corticosteroid treatment.
Diplopia ; Exophthalmos ; Humans ; Medical Records ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Radiotherapy ; Recurrence ; Retina ; Thyroid Gland*

In the past, liquid paraffin had been used to restore the atrophy of body for cosmetic purposes. The injected paraffine had resulted in granulomatous foreign reaction. causing the paraffinoma. Because of the severe complications, currently the therapeutic use of paraffin had generally been abandoned. We examined a 62-year old woman who complained of irregular masses of both upper lids and difficulties of eye opening and ptosis and had undergone injection of foreign material into both lids 30 year ago for the restoration of superior sulcus deformities. We removed the mass and did the levator resection of the upper lids. Histologic findings showed multiple irregular shaped vacuole with peri vacuolar dense fibrotic rim and chronic inflammatory cell infiltration in interstitium. These findings were consistent with paraffinoma. We report our experience of a case of the paraffinoma which showed foreign body granuloma composed of many vacuoles and severe fibrosis.
Atrophy ; Congenital Abnormalities ; Female ; Fibrosis ; Granuloma, Foreign-Body ; Humans ; Middle Aged ; Mineral Oil ; Paraffin ; Vacuoles

One-hundred cases of consecutive, unselected female urethritis revealing so-called "trigonitis-urethritis syndrome" were studied endoscopically during the period January 1, 1976 to September 15, 1976. The bladder neck and adjacent urethra were thoroughly examined and they were classified into four groups as follows: Group I: Almost normal urethra and bladder neck or with mild mucosal changes, 4 cases. Group II: Irregular and/or narrow bladder neck with or without a few pseudopolyps. 23 cases. Group III: Irregular or diffuse swelling of the bladder neck and the adjacent urethral mucosa with or without a few pseudopolyps, 52 cases. Group IV: Many pseudopolyps or irregular polypoid projections, 21 cases. Endoscopic examination is a necessity to establish the correct diagnosis and the therapeutic choice of female urethritis.
Diagnosis ; Endoscopy ; Female* ; Humans ; Mucous Membrane ; Neck ; Urethra ; Urethritis* ; Urinary Bladder

PURPOSE: To investigate the incidence and clinical course of canaliculitis after dacryocystorhinostomy (DCR) with silicone tubes. METHODS: A retrospective analysis was performed on 521 eyes in 484 patients who had undergone DCR with silicone tubes between October 1994 and May 2006. RESULTS: Canaliculitis occurred in 11 eyes (2.1%). The mean age of the 10 patients involved in this study was 62.1 years (47~71 years) with a mean follow-up period of 11.1 months (6~36 months). The mean onset of canaliculitis was 3.2 months (1~5 months) after the surgery. All cases of canaliculitis were resolved with antibiotic treatment after silicone tube removal, and the surgical outcomes were successful in all patients. CONCLUSIONS: The incidence of canaliculitis after DCR with silicone tubes was rare. In such cases, the final surgical outcome was successful after appropriate treatment.
Corneal Ulcer ; Dacryocystitis ; Dacryocystorhinostomy ; Eye ; Follow-Up Studies ; Humans ; Incidence ; Retrospective Studies ; Silicones ; Canaliculitis

PURPOSE: To evaluate the efficacy and safety of acellular human dermis (AlloDerm) as a spacer graft in the correction of eyelid retraction. METHODS: We used acellular human dermis (AlloDerm) as a spacer in 8 patients with eyelid retraction. Two patients had upper eyelid retraction and 6 had lower eyelid retraction. The causes of the former were congenital (1) and ptosis operation (1), and of the latter were strabismus surgery (1), necrotizing blepharitis (1), blow-out fracture (1), anophthalmic socket contracture (1), cicatricial entropion (1), and lower lid blepharoplasty (1). The follow-up period ranged from 5 to 14 months (mean 9 months). RESULTS: Surgical results in 7 eyelids were satisfactory. There was mild overcorrection in one eyelid with congenital upper eyelid retraction. There were no other complications such as exposure, infection, or rejection. CONCLUSIONS: AlloDerm was easy to manipulate, closely approximated the eyelid tarsus in contour and thickness, and appeared to be nontoxic and nonallergenic. We suggest AlloDerm as the spacer material of choice for the treatment of eyelid retraction.
Allografts* ; Ankle ; Blepharitis ; Blepharoplasty ; Contracture ; Dermis ; Entropion ; Eyelids* ; Follow-Up Studies ; Humans ; Orbital Fractures ; Strabismus ; Transplants

PURPOSE: The aim of this study is to evaluate the effects and complications of periocular injections of triamcinolone acetonide in patients with thyroid orbitopathy who could not tolerate systemic corticosteroid therapy. METHODS: Six patients with a mean age of 48.7 years showed symptoms of severe acute thyroid orbitopathy. They received four doses of 20 mg of triamcinolone acetonide via periocular injection into the inferotemporal orbital quadrant every 2 weeks. The response to treatment and the presence of adverse effects were evaluated retrospectively. RESULTS: Three of six patients (50%) showed significant improvement in soft tissue swelling in both eyes. Only one patient (17%) showed improvement of proptosis. No patients showed improvement in diplopia and ocular motility. The mean thickness of the extraocular muscles measured by CT scan remained unchanged. Compressive optic neuropathy developed in one patient and resolved after intravenous high-dose steroid treatment. Two patients received radiation therapy for resistant inflammatory symptoms. One patient underwent extraocular muscle surgery. In one patient, there was no adverse effect at the injection site, except for a foreign body granuloma. CONCLUSIONS: Periocular triamcinolone injection could be effective for patients with thyroid orbitopathy in the acute inflammatory phase in reducing soft tissue swelling. The procedure showed no significant effect on exophthalmos or ocular motility.
Diplopia ; Exophthalmos ; Granuloma, Foreign-Body ; Humans ; Injections, Intraocular* ; Muscles ; Optic Nerve Diseases ; Orbit ; Retrospective Studies ; Thyroid Gland* ; Tomography, X-Ray Computed ; Triamcinolone Acetonide ; Triamcinolone*

BACKGROUND: It has been known that blood group antibodies are not produced in the neonatal period and that if the antibodies exist, they are probably maternal in origin which had crossed the placenta. There have been several studies conducted abroad on when these antibodies are formed but none has been done in Korea. This study was carried out to determine the ABO blood type and blood group antibodies in children from neonates up to 5 year old. We hoped to determine when and in what pattern blood group antibodies were produced. METHODS: We selected 337 children from neonates up to 5 year old who were admitted to Hanyang university Hospital in Seoul or Kuri from 1994 to 1996. Cell typing was done immediately by the slide method. The anti-A and anti-B used for cell typing were supplied by Immucor (Norcrosis, Ga) . Sera were stored at -70 degrees C until they were tested for ABO blood group antibodies by the standard saline test tube method. When uncertain results were obtained, a drop of the mixture was placed on a slide and observed under a microscope. RESULTS: ABO blood group antibodies were detected in 9 of 50 (18%) infants less than 1 week old and in 10 of 51 (20%) infants between 1 week and 3 months of age. The pattern of ABO blood group antibody production was similar to that of the fetal period up to 3 months after birth, after which antibody production increased rapidly to reach approximately 80% at 6 months of age, There was no difference in ABO antibody production between boys and girls. The antibody formation pattern of group A and group B infants less than 6 months of age showed anti-A to be 35% and anti-B to be 20%. In group O infants of the same age, anti-A was positive In 42% and antral-B In 33%. However, after 6 months of age, there was no difference in antibody production among groups A, B, or O. CONCLUSIONS: Antibodies directed toward ABO antigens were detected in 19 out of 101 (19%) infants less than 3 months old. We therefore believe it is necessary to Perform serologic typing as well as cell typing in these Infants. Furthermore, the emergency transfusion of type A or B blood to a type O infant under the impression that anti-A and anti-B do not exist should be forbidden.
Antibodies* ; Antibody Formation ; Child* ; Child, Preschool ; Emergencies ; Female ; Hope ; Humans ; Infant ; Infant, Newborn ; Korea ; Parturition ; Placenta ; Seoul

No abstract available.
Brain* ; Central Nervous System Diseases* ; Central Nervous System* ; Child* ; Humans

No abstract available.
Brain* ; Central Nervous System Diseases* ; Central Nervous System* ; Child* ; Humans