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PubMed2001

[Penetrating intraocular injuries caused by foreign bodies of organic origin] ].

OBJECTIVE: To demonstrate two eyes of two patients with a penetrating injury by an organic intraocular foreign body (CNT), to outline the course of treatment and to evaluate anatomical and functional results. MATERIAL AND METHODS: During the period between May and July 1999 the authors treated at their department an 11-year-old girl and a 17-year old boy with a penetrating CNT injury of organic origin. In the girl they extracted a CNT which pierced the sclera and protruded into the vitreous body. The foreign body was extracted by means of a forceps, the site of perforation was treated by a cryosurgical procedure with a radial Silastic filling. The man was shot into the OL by a grain of pepper from an air-gun. The organic body in the vitreous body caused a violent inflammatory reaction in the vitreous body and retina. Early extraction of the CNT could not be made because of an adverse corneal finding which made surgery impossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relapsing detachment of the retina (OS). The foreign body was extracted during pars plana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adherence of the retina was achieved during the third PPV, membranectomy and implantation of silicone oil (SO). Final functional success was achieved by eliminating SO and by partial perforating keratoplasty. RESULTS: The CNT in the girl was histologically and parasitologically identified as a fibre of animal origin (animal hair or human eyelash). The follow up period is six months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patient the cultivation finding from the vitreous body was negative. Extensive PVR developed as a result of breakdown products of the organic CNT and led to relapsing OS. Three months after the last operation the bulbus is at rest, the corneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr. CONCLUSIONS: The final results of treatment of severe devastating penetrating injuries by a CNT is determined by the preoperative condition of the ocular tissues. CNT of organic origin damage intraocular tissues by their breakdown products as well as by more frequent contamination with pathological microorganisms. Our experience provided evidence that penetrating injuries by non-infected CNT of organic origin have a favourable prognosis. But even relapsing and prolonged OS after extraction of the CNT of organic origin and endophthalmitis need not lead to loss of the eye or its function.

Adolescent↗
PubMed2000

[A comparison between latanoprost and timolol in treatment of patients with primary open-angle glaucoma and ocular hypertension].

OBJECTIVE: To evaluate the therapeutic value of latanoprost on glaucoma. METHODS: In an open-label fashion, multicenter, randomized control clinical trial, the efficacy and adverse drug reactions of topical application of 0.005% latanoprost once daily were compared with that of 0.5% timolol twice daily for 12 weeks in patients with open-angle glaucoma or ocular hypertension. RESULTS: The study included 128 patients (63 patients in latanoprost group and 65 patients in timolol group) and 117 patients remained at the end of the study (60 cases in latanoprost group and 57 cases in timolol group). Comparing 12 weeks with baseline diurnal intraocular pressure (IOP), the IOP reduction (mean +/- standard deviation) in latanoprost group was (7.5 +/- 0.3) mm Hg (1 mm Hg = 0.133 kPa) (32%, t = 22.73, P < 0.0001) greater than the reduction in timolol group (6.1 +/- 0.3) mm Hg (26%, t = 17.94, P < 0.0001), the difference between the two groups being significant (F = 9.54, P = 0.0026). Two patients treated with timolol and none treated with latanoprost were withdrawn from the study because of inadequate IOP control; 3 patients with latanoprost had foreign body sensation. In latanoprost group, there was one patient whose eyelashes became darker and longer at the last visit (the 12th week). No ocular and systemic adverse events related to the two drugs were found. CONCLUSION: It is demonstrated that 0.005% latanoprost topically applied once daily is well tolerated and more effective in reducing IOP than 0.5% timolol topically applied twice daily. Thus, latanoprost has the potential to be a new first-line antiglaucoma drug.

Adrenergic beta-Antagonists↗
PubMed2002

[The use of laryngeal mask airway in esophagogastroduodenoscopy in children].

BACKGROUND: The use of laryngeal mask airway (LMA) for inducing and maintaining sedation during EGDS has never been reported in the literature but for a brief letter written by Gajraj in 1996. This study proposes the use of sevoflurane administered through LMA. METHODS: At the Pediatric Clinic of the University of Rome "La Sapienza" 80 children un-derwent EGDS. After premedication, immediate 8% sevoflurane and 60/40% N2O/O2 induction was delivered. Concentration of sevoflurane was reduced to 1% for maintaining general anesthesia. Heart rate (HR), systemic blood pressure (SBP), respiratory rate (RR), EtCO2 and SpO2 were not invasively monitored. Time for induction, time for emergence as well as complications, if any, were also evaluated. RESULTS: The monitored parameters did not show any significant changes. The time for loss of eyelash reflex and the time for end of induction were of 121+/-15 sec. 3.5+/-1.3 min respectively. The time for emergence was 3.4+/-1.8 min. Only minor complications were reported. CONCLUSIONS: The results obtained show that the use of LMA associated to sevoflurane as single inhaling agent can be a valid technique for EGDS in pediatric patients.

Anesthesia Recovery Period↗
PubMed1975

Chromosome 3 duplication q21 leads to qter deletion p25 leads to pter syndrome in children of carriers of a pericentric inversion inv(3) (p25q21).

Close phenotypic similarity between two cases carrying a rec(3) dup q,inv(3) (p25q21), 12 additional infants from the same inv (3)(p25q21) kindred who lived less than 1 year, and eight cases studied in other medical centers has led us to postulate the existence of a distinct chromosome 3 duplication-deletion syndrome. In the presence of trisomy for (3)q21 leads to qter and monosomy for (3)p25 leads to pter, the facial dysmorphy is unique: a distorted head shape due to irregular cranial sutures, thick low eyebrows, long eyelashes, persistent lanugo, distended veins on the scalp, hypertelorism, oblique palpebral fissures, a very short nose with a broad depressed bridge and anteverted nares, protruding maxilla, thin upper lip, micrognathia, low-set ears, and a short webbed neck. Port-wine stains, congenital glaucoma, cloudy corneas, cleft palate and harelip also occur frequently. Each infant has difficulty sucking and swallowing. Congenital anomalies of the cardiovascular system, of midgut rotation, and of the urogenital system are noted for the infants who died neonatally. Most frequent is a ventricular septal defect, followed by atrial septal defect, patent ductus arteriosus, patent foramen ovale, and coarctation of the aorta. Omphalocele, umbilical hernia, hyperplastic kidneys, polycystic kidneys, double ureter, hydro-ureter, hydronephrosis, and undescended testes often occur. The extremities are short in proportion to the length of the trunk. Clinodactyly, coxa valga, talipes, and spina bifida are frequently observed.

Abnormalities, Multiple↗
PubMedDate not supplied

[Griscelli syndrome in a Mexican girl].

Griscelli syndrome is an infrequent disease first described in 1978. It is inherited in autosomal recessive form, and is distinguished by partial albinism, pigmentation dilution, cellular immunodeficiency, neurological involvement and uncontrolled phases of macrophage and lymphocyte activation. We report the case of a female child who started with ataxic gait when she was 23 months old. At physical examination a phenotype with brown skin and silvery gray hair, eyebrows and eyelashes was observed. Neurological evolution was with remissions and exacerbations, with cerebellar and, finally, bulbar compromise.

Albinism↗
PubMed2002

Double partial monosomies (10p- and Xp-) in a female baby with choanal atresia.

Chromosomal abnormalities involving double partial monosomies are very rare. A female infant with non-mosaic monosomy 10p13-->10pter along with monosomy Xp11.4-->Xpter which arose de novo is described. The clinical manifestations of this patient included microcephaly, mild synophrys, short and down-slanted palpebral fissures, ptosis of the left eye, long eyelashes, a depressed nasal bridge, dysplastic ears, micrognathia, a short neck. sensorineural hearing impairment, and severe growth retardation. Left choanal atresia and laryngomalacia were detected by flexible fibroscopy. No signs of hypoparathyroidism or defective cellular immunity could be found. Fluorescence in situ hybridization (FISH) with whole-chromosome painting probes for chromosomes 10 and X was performed, which excluded the possibility of cryptic translocations of the involved chromosome segments. No submicroscopic chromosome 22q11 deletion could be found by FISH. Thus this very rare coexistence of double independent partial monosomies was confirmed. There are no previous reports of such concurrent double partial monosomies.

Choanal Atresia↗
PubMedDate not supplied

Shah-Waardenburg syndrome and Dandy-Walker malformation: an autopsy report.

Autopsy reports of individuals with Shah-Waardenburg syndrome are rare, and to the best of our knowledge, have never been reported in association with Dandy-Walker malformation. This report documents the autopsy findings of a 2.5-year-old boy with Shah-Waardenburg syndrome (Type IV Waardenburg syndrome) and a Dandy-Walker malformation. The patient had a past medical history of congenital deafness, skin and hair pigmentary disturbances, Hirschsprun disease and hydrocephalus. At autopsy, multiple patches of dermal and hair hypopigmentation were observed over the face, trunk, eyelashes and eyebrows. The brain had a small, underdeveloped anterior cerebellar vermis, bilateral atrophic cerebelli, a markedly dilated ventricular system and a large incomplete midline cerebellar cyst. The entire colon and much of the small bowel had been previously excised secondary to the Hirschsprung disease. This case expands the spectrum of pathologic findings in Shah-Waardenburg syndrome to include the Dandy-Walker malformation.

Autopsy↗
PubMedDate not supplied

Ankyloblepharon filiforme adnatum (AFA) associated with trisomy 18.

Ankyloblepharon filiforme adnatum (AFA) is a rare congenital anomaly which is characterized by single or multiple strands joining the upper and lower lids. Its etiology is unknown. A girl with a gestational age of 38 weeks is presented. It was interesting to find an association of AFA with hypoplasia of hair, eyelashes, eyebrows and nails and a karyotype of trisomy 18 in this case.

Abnormalities, Multiple↗
PubMedDate not supplied

Frequency of ocular complications of leprosy in institutionalized patients in NWFP Pakistan.

BACKGROUND: There is no systemic disease, which so frequently gives rise to disorders of the eye as leprosy does. The study was conducted to determine the prevalence and gravity of ocular complications in institutionalized leprosy patients in NWFP. It is important to provide necessary information to leprosy health workers and general physicians in order to sensitize them to early detection and treatment or referral to appropriate centre. METHODS: A prospective study of ocular complications of leprosy patients was conducted at the leprosy centre of Lady Reading Hospital Peshawar and the Leprosy Hospital Balakot, district Mansehra. The study included a record of the name, age, sex, type, duration of disease and completion of multi-drug therapy (MDT). Classification of the patients was done according to Ridley and Jopling 5-group system. Visual acuity was tested by Snellen chart and those patients having a vision of less than 3/60 were labelled as blind. Ocular adnexa were examined by naked eye and lacrimal sac regurgitation test was done. Slit lamp biomicroscopy was done for anterior segment examination and direct ophthalmoscope was used for fundoscopy. RESULTS: The authors studied 143 patients in the above mentioned leprosy centres. Out of these, 59 had lepromatous leprosy, 39 borderline tuberculoid leprosy, 9 tuberculoid leprosy, 33 borderline lepromatous leprosy, and 33 borderline leprosy. The majority of patients came from the northern districts of NWFP, including Malakand division and district Mansehra. The male to female ratio was 4:1. The age of the patients ranged from 14 to 80 years and the duration of the disease ranged from 1 year to 48 years. Ocular complications were found in 73% of the patients. These complications included loss of eyebrows in 57 patients, loss of eyelashes in 37, corneal changes (including opacity, ulceration, and/or anaesthesia) in 44, iridocyclitis in 31, lagophthalmos in 36, ectropion in 13, and chronic dacryocystitis in 3. Of the total of 15 (11%) patients who went blind from ocular complications, 16 eyes did so due to corneal opacities, 6 eyes due to cataract, 5 eyes due to chronic anterior uveitis and one eye due to corneal ulcer, panophthalmitis and phthisis bulbi each. CONCLUSIONS: A significant number of leprosy patients (73%) have ocular complications. The frequency of ocular complications increases with the increasing age and duration of disease of the patients.

Adolescent↗
PubMed2003

Role of prophylactic intravitreal antibiotics in open globe injuries.

PURPOSE: To determine the efficacy of prophylactic intravitreal antibiotics in reducing the incidence of endophthalmitis after trauma. METHODS: This was a prospective, randomised, case control study of 70 consecutive patients with open globe injury. The patients were prospectively randomised into group I (32 eyes) and group II (38 eyes). Group I patients were given prophylactic intravitreal injection of vancomycin 1 mg and ceftazidime 2.25 mg at the conclusion of primary repair. Group II patients were not given prophylactic intravitreal antibiotics. All the patients received intravenous ciprofloxacin. RESULTS: The incidence of endophthalmitis was higher in group II (7 of 38 eyes; 18.42%) compared to group I (2 of 32 eyes; 6.25%). Both the patients who developed endophthalmitis despite prophylactic intravitreal antibiotics in group I had an initially undetected intraocular foreign body (eyelash) in the vitreous cavity. CONCLUSIONS: Prophylactic intravitreal broad spectrum antibiotic injection decreases the risk of post-traumatic endophthalmitis.

Adolescent↗
PubMed2001

[Sevofluran in pediatric practice--personal experience].

Sevofluran a new inhalational anesthetic is a preferred anesthetic agent for induction and maintenance of pediatric anesthesia because of its rapid induction, recovery characteristics and acceptable cardiovascular profile--now also accessible in Poland. Sevofluran isn't an ideal anesthetic, and the issue of postoperative excitement, potential nephrotoxicity requires clarification. This study was designed to compare the emergence characteristics of sevoflurane with halotane anaesthesia in paediatric patients having various surgical intervention. 102 children divided for subgroup of premedicated and nonpremedicated, underwent inhalation induction with nitrous oxide/oxygen and sevofluran or halotane. Incremental doses of either study drug were added until loss of eyelash reflex was achieved. We didn't use higher concentrations of sevoflurane than 5.5 Vol% and 3.5 Vol% for halothane. Sevoflurane patients has a greater incidence of emergence agitation.

Adolescent↗
PubMed2003

[Merkel cell carcinoma of the eyelid: a case report].

PURPOSE/METHODS: We report the case of a 73-year-old white female suffering from Merkel cell carcinoma (MCC) of the eyelid with an evolution of two and half months. MCC is a cutaneous neuroendocrine malignant tumor arising from Merkel cells. These cells are common along the eyelid margin in between the eyelashes. It is infrequent but highly aggressive and with potential metastases. Immunohistochemical and ultrastructural studies may be necessary for an histopathological diagnosis. RESULTS/CONCLUSIONS: Tumor resection with wide security margins must be undertaken as soon as possible. In addition, the patient may require postoperative radiotherapy.

Aged↗
PubMed2003

Partial monosomy 11q and trisomy 12q: variable expression in two siblings.

Clinical and cytogenetical findings are reported and discussed on two siblings with discordant phenotypes despite having both a terminal 11q deletion and a distal 12q duplication resulting from an unbalanced segregation of a balanced translocation t(11:12)(q23:q24.1) mat. The oldest child, a girl, is the index patient. Her clinical features include intrauterine and postnatal growth retardation, fetal distress, mild hypotonia, early feeding difficulties, moderate developmental delay, especially in language acquisition, a velopharyngeal insufficiency with repeated otorhinopharyngeal infections, facial dysmorphism, heart ventricular septal defect, and abnormal hyperactive behaviour with sometimes autistic tendencies. The facial dysmorphic features notably consist of microcephaly, hypertelorism, large palpebral fissures, large eyes with alternant divergent strabismus, long eyelashes, a long and broad nasal bridge, a short "crested" nose with salient tip, a fishmouth with large spaces between teeth and flat palate, retrognathism, large ears and multiple dimples. The second affected child is a boy showing low birthweight, moderate developmental retardation with mainly no active language at 32 months, behaviour abnormalities with an autistic tendency, and no major physical anomalies apart from a slight facial hypotonia with often open mouth, dimples on the shoulders and right cryptorchidism. The authors stress the variable clinical expression of the chromosomal imbalance in this family resulting in low birthweight, developmental delay, abnormal behaviour, but different degrees of physical features and dysmorphism. The possible contribution of each of the two aneusomies to the phenotype is discussed.

Child↗
PubMed2003

Prostaglandin analogs for hair growth: great expectations.

Latanoprost, a prostaglandin analog, has been reported to stimulate eyelash growth in patients using it in eye preparations for glaucoma and body and scalp hair growth when used topically in various animal models. Will prostaglandin analogs be the next agents used for forms of alopecia?

Alopecia↗
PubMed1992

[Forum: dermopigmentation or medical tattooing. Dermography in cancerology. Apropos of 220 clinical cases].

Based on a series of 220 cases of reconstruction (63 cases) or correction (67 cases) of the nipple-areolar complex and various extramammary procedures (tattoo scar revision, lips, eyebrows, eyelashes) (90 cases), the authors present their 2-year experience of medical dermography in a cancer centre. Dermography allows breast reconstruction to be completed in a large number of patients who had initially refused to complete their reconstruction. This minimally aggressive outpatient technique which reconstitutes the areolo-nipple complex with sufficient quality, is now part of reconstruction protocols and is gradually replacing surgical techniques.

Breast Neoplasms↗
PubMed1964

THE DE LANGE SYNDROME: REPORT OF THREE CASES.

Three cases of de Lange's syndrome are described. This condition is characterized by generally severe mental retardation, reduced stature, mild microcephaly, hypertrichosis, various anomalies of hands and feet, and a peculiar facies. The most outstanding features of the latter are the low forehead, profuse, generally confluent eyebrows, abundant long eyelashes, eyes that frequently slant downwards and outwards in antimongoloid fashion, pug nose with prominent anteverted nostrils, increased distance between nose and vermilion border of upper lip, slight reduction in size of chin, and often abnormally low-placed ears. The etiology of de Lange's syndrome is at present unknown.

Adolescent↗
PubMed2003

A Turkish case of subcortical/subependymal heterotopia associated with corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation.

The patient is a 12-year-old boy with a history of learning disability, growth retardation, and strabismus. Weight, height and head circumference were below the 3rd percentile. A café-au-lait spot, 1x1 cm a diameter, on the back region and pectus excavatum deformity were diagnosed. He had facial asymmetry, a broad nose, sparse eyebrows and eyelashes, a rudimentary frontal sinus, deviation of the nasal septum, and bilateral small maxillary bones. The left orbital fossa was also mildly rudimentary. On eye examination the movements of the left globe to the upward and lateral side were limited and internal strabismus was noted at this side. Visual acuity was 1/10, bilaterally. Bilateral choroid coloboma, glaucoma, vertical and horizontal nystagmus were diagnosed. Fundoscopic examination revealed bilateral optic atrophy and macular and paramacular granulation tissues on the left side. Intelligence quotient was 46. Electroencephalography revealed bilateral frontal slow-wave activity. Visual evoked potential revealed prolonged p100 wave latencies bilaterally. Magnetic resonance imaging of the brain demonstrated corpus callosum dysgenesis, bilateral subcortical heterotopia in the frontal lobes and subependymal heterotopia in the posterior horn of the left ventricle. Chromosomal analysis revealed a normal male karyotype, 46, XY. Although several cases of heterotopia in association with mental retardation, craniofacial dysmorphism, cerebral, and eye abnormalities have been described the combination of abnormalities diagnosed in our case has not previously been reported. We hypothesize that the combination of subcortical/subependymal heterotopia, corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation may be a new syndrome.

Abnormalities, Multiple↗
PubMed2003

Midazolam and thiopentone co-induction: looking for improvement in quality of anaesthesia.

OBJECTIVE: To evaluate improvement in quality of anaesthesia induction using thiopentone and midazolam for co-induction of anaesthesia. An additional end point was taken as loss of response to a tetanic stimulation (50 Hz) delivered for 5 seconds after the loss of verbal contact and eyelash reflex. METHODS: Ninety ASA I and II patients, within the age range of 20-60 years were studied. Patients were randomly divided into three equal groups; A, B and group C. RESULTS: Onset of induction and loss of response to a tetanic stimulation was achieved earlier in group B as compared to the other study groups (p<0.05). CONCLUSION: Co-induction with midazolam 0.02 mg x kg(-1) followed by thiopentone 3 mg x kg(-1) was superior to other two groups. Induction of anaesthesia in this group was found to be smoother and faster, provided better hemodynamic stability, better airway maintenance and with lesser incidence of untoward effects.

Adult↗