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PubMed2003

[The skin manifestations in patients with lung cancers].

It is also common to observe skin manifestations in many internal malignancies. The lung cancer is a frequently seen internal cancer. Due to its gradually increasing incidence, it has become the first reason of death from cancer also in women by overtaking the breast cancer. Although pathognomonic skin manifestations are not reported in lung cancers, it is emphasized that lung cancer must be remembered when non specific signs such as digital clubbing, hypertrophic osteoatropathy, cyanosis due to superior vena cava syndrome, oedema, telengiectasia, acanthosis nigricans are observed. Because a few reports are present about this subject in literature, 44 patients which had the diagnosis of lung cancer in Cumhuriyet University Faculty of Medicine were evaluated according to the their dermatological manifestations. 47.7% of these patients had digital clubbing; meanwhile 25% telengiectasia of the chest forewall, 22.7% lip cyanosis, 9% long eyelash, 2.27% pruritus, 2.27% hypertrophic pulmonary osteoarthropathy and 2.27% Leser Trelat sign were established.

Adult↗
PubMed2004

Hypertrichosis, Fallot tetralogy, growth and developmental delay.

We report a female patient with a unique pattern of pre- and postnatal growth deficiency, tetralogy of Fallot, very long eyelashes (trichomegaly), progressive and generalized hypertrichosis lanuginosa, brain atrophy with epilepsy, and puffy hands and feet. This appears to be a "new" entity within the group of syndromal hypertrichoses, possibly pathogenetically related to, but clinically distinct from Ambras or Oliver-McFarlane syndromes.

Child, Preschool↗
PubMed1992

A case of Vogt-Koyanagi-Harada syndrome.

A previously healthy 32-year-old female contact lens patient presented with a constant headache of several days duration and a sudden painless loss of vision in the right eye. Examination revealed a serous elevation of the sensory retina with whitish plaque-like lesions and decreased visual acuity. Fluorescein angiography suggested a diagnosis of Vogt-Koyanagi-Harada syndrome (V-K-H). V-K-H syndrome is a chronic bilateral exudative uveitis associated with whitening of the hair and eyelashes and varying signs of meningeal irritation. A discussion of this case with photos and fluorescein angiography results will be presented.

Adult↗
PubMedDate not supplied

[Formation of radiation and involution cataracts in man exposed to radiation].

An ophthalmologic follow-up of subjects exposed to chronic total external gamma-irradiation (747 subjects) and to gamma-neutron irradiation (1083 subjects) in total doses of 1 to 10 Gy has revealed no cases of radiation involvement of the eyes. Besides, a group of 8 patients with a history of acute radiation sickness were followed up, who were exposed to external gamma-neutron irradiation in total doses of 4 to 9.8 Gy. All these patients developed radiation burns of the skin of the face and eyelids, eyelashes and eyebrows epilation, 6 of these radiation cataracts and 2 mixed-type cataracts (radiation involutional ones). Radiation cataracts were developing within 10-32 months (the first stage). A forty-years' follow-up of the formation of radiation and involution cataracts permitted the authors single out the pathogenetic differences between these types and use these data for the solution of expert evaluation problems and problems related to social protection of people with acute radiation injuries of the eyes. The authors' results and the literature data evidence that, with due consideration for the irradiation dose and the patient's age, one can predict the type of a would-be cataract, periods of its formation and progress, and the treatment strategy.

Adult↗
PubMed1992

[Propofol anesthesia for ophthalmologic surgery in the elderly].

Fifty patients more than 70 years old, ASA I and II, NYHA I and II, were anaesthetized by propofol for cataract or retinal detachment surgery. Induction was carried out by a propofol slow injection (0.5-1 mg.s-1) until loss eyelash reflex (mean dose 0.728 mg.kg-1) and completed by fentanyl 2 micrograms.kg-1 and vecuronium 0.08 mg.kg-1. After intubation, anaesthesia was maintained with nitrous oxide and continued infusion of propofol (mean dose 4.48 mg.kg-1.h-1) according to haemodynamic parameters. These were noted repeatedly and statistically analyzed. No significative differences were observed with younger patients undergoing identical surgical procedures. Haemodynamic effects were the same during cataract or retinal detachment surgery and in hypertensive treated patients vs non hypertensive ones. Recovery was as fast and good as in younger patients. It should be emphasized that propofol doses must be reduced in elderly patients so as to preserve a satisfactory haemodynamic stability. Reasons for increased sensitivity to propofol in elderly patients are briefly discussed.

Aged↗
PubMedDate not supplied

Management of trachomatous cicatricial entropion of the upper eye lid: our modified technique.

BACKGROUND: Management of trachomatous cicatricial entropion of the upper eye lid presents a difficult problem. Many surgical approaches have been developed to address it. We report the functional and cosmetic results of our modified surgical technique we have developed in the management of trachomatous cicatricial entropion of the upper eye lid. METHODS: 45 lids of 43 patients having trachomatous cicatricial entropion of upper eye lids were operated by our modified surgical technique in which we combine bilamellar tarsal margin rotation procedure with blepharoplasty. The technique and results were evaluated in a follow up period of up to 40 months. RESULTS: In all 45 upper eye lids, the normal eyelashes rotated away from the surface of the eye and were no longer in contact of the eye ball in all position of gaze. All eyes had adequate lid closure and regular lid margin. No eye had any overhanging baggy fold of skin at operation site. Three eyes had conjuctival granuloma which was excised under local anaesthesia Three eyes needed Diode laser ablation to treat isolated cilia posterior to normal lash line. Three eyes had mild over correction which regressed without any surgical intervention. One lid had segmental necrosis of distal part of eye lid which recovered spontaneously in following days. CONCLUSION: Our modified technique of combining bilamellar tarsal rotation procedure (BTR) with blepharoplasty appears to be an effective surgical technique in the management of the trachomatous cicatricial entropion of the upper eye lid. It achieves successful anatomical correction along with more acceptable cosmetic appearance.

Aged↗
PubMed2005

Incontinentia pigmenti (IP2): familiar case report with affected men. Literature review.

UNLABELLED: Incontinentia pigmenti is a genodermatosis described by Garrod and in 1920 by Bloch, Sulzberger, Siemens y Bardach. It is an ectodermic disorder that affects skin, teeth, eyes and may also have neurological problems. The IP2 name describes the histological characteristics, the incontinence of melanin into the melanocytes cells in the epidermal basal layer and its presence in superficial dermis. IP2 is an x-linked dominant condition but genetic heterogeneity may exist. CASE REPORT: The patient was 4 yrs 5 months old when she came for the first time. In a physical exploration she presented sparse and thin hair, eyelashes and eyebrows, beaked nose, labial protrusion, the four central teeth have a conic crown and there was also a delayed eruption of other teeth, right eye strabismus, hipoacusia, language defects and a trunk, legs, feet, and face dermatosis characterized by grouped vesicles, hyperkeratotic and warty lesions and brownish-gray lesions in a lineal pattern. The patient s father had hypopigmented lesions in the posterior regions of both legs. The oral clinical and radiographic exams showed diverse anomalies. Both the patient's and the father's chromosomal studies were normal. DISCUSSION: In the present case we can see that the father has IP2 without supernumeraries X, with the antecedent that his mother had something similar. It is possible that the inheritance was autosomic dominant or it is a different mutation of NEMO (NF-kappa-B essential modulator) gene to a classical one, which was found in some affected men. It is necessary to carry out a molecular study of these patients.

Child, Preschool↗
PubMed2005

Ocular leishmaniasis: a case report.

Cutaneous leishmaniasis (CL) is a protozoal disease which is endemic in Iran usually caused by Leishmaniasis major and Leishmaniasis tropica and transmitted by the bite of a sandfly. In Isfahan province CL is highly prevalent and we observe some unusual clinical features of disease. The eyelid is rarely involved possibly because the movement of the lids prevents the fly vector from biting the skin in this region. We report a case of ocular leishmaniasis with eyelid and conjunctival involvement that had simulated chalazion and was complicated with trichiasis. The patient was diagnosed by direct smear, culture, and PCR from the lesions. He was treated with systemic sodium stibogluconate (20 mg/kg/day) for 20 days and subsequently surgery for trichiasis. The patient was clinically cured with this treatment, however the disease had left complications, including palpebral and conjanctival scaring, corneal opacity, and eyelash loss.

Adolescent↗
PubMed2005

Comparative analysis of the efficacy and safety of latanoprost, travoprost and the fixed combination timolol-dorzolamide; a prospective, randomized, masked, cross-over design study.

PURPOSE: To analyse comparatively the efficacy and tolerance of latanoprost, travoprost and the fixed combination timolol-dorzolamide in the treatment of primary open angle glaucoma and ocular hypertension. METHOD: Prospective, investigator masked, randomized study that included 38 patients (38 eyes) with primary open angle glaucoma uncontrolled under beta blockers. Each patient received latanoprost, travoprost and the fixed combination timolol-dorzolamide (for 3 months each). The first drug and the order of the next drugs administered were randomized. The follow up period was 9 months. At the baseline and at the end of each therapeutic period (3 months) we determined the IOP (at 8, 10 a.m. and 4 p.m.), visual acuity, C/D ratio, blood pressure, heart rate and local tolerance. We have also photographed the eyelids, lashes, conjunctiva and iris. After each month of treatment we determined the IOP (at 8 and 10 am), visual acuity, blood pressure, heart rate and local tolerance. RESULTS: The mean initial IOP was 25.1 2.89 mmHg and after 9 months of treatment 21.67 4.59 mmHg. Each drug induced a statistically significant IOP decrease (the fixed combination timolol-dorzolamide decreased IOP with 14.33%, travoprost with 18.39% and latanoprost with 22.1%). The IOP lowering was comparable for the prostaglandin derivatives and superior to the fixed combination timolol-dorzolamide. None of these drugs had a negative influence on the visual field, C/D ratio, visual acuity, blood pressure and heart rate. There was good local tolerance. The side effects were more frequent after travoprost (37) and latanoprost (22) than after the fixed combination timolol-dorzolamide (4 cases). The most important adverse events for the prostaglandin derivatives were conjunctival hyperemia, eyelashes pigmentation and growth, iris pigmentation. There was no necessary to stop the medication because of these effects. CONCLUSIONS: Travoprost, latanoprost and the fixed combination timolol-dorzolamide are efficient in the treatment of primary open angle glaucoma. The prostaglandin derivatives determined similar IOP decrease, which was superior to the fixed combination timolol-dorzolamide; the local tolerance was good, the fixed combination causing the fewest side effects.

Aged↗
PubMed2005

Cerebral electrical activity as a tool in evaluating anesthetic effect during balanced anesthesia with sevoflurane.

OBJECTIVES: The present study was undertaken to provide basic information about bilateral frontal cerebral electrical activity after induction, before and after skin incision, and at a steady state during sevoflurane anesthesia at the end tidal concentration 1, 1.2, 1.4 and 1.6 MAC and determine the association between the electrical cerebral activity with other clinical end points, i.e. motor responses and post-operative recall. MATERIAL AND METHOD: the Dual Channel Brain Activity, ABM2 (DATEX) was used to continuously monitor frontal EMG and electrical cerebral activities (i.e. frequency and amplitude) of both hemispheres in 20 adult female patients undergoing balanced anesthesia in Maharaj Chiang Mai Hospital. The eligible patients were randomly assigned to receive 1.0 MAC, 1.2MAC, 1.4MAC or 1.6MAC of a mixture of sevoflurane and 66.67% nitrous oxide in oxygen during anesthesia. The anesthesia was induced with 5 mg/kg thiopental and supplemented with 1-1.5 microgram per kilogram of fentanyl. The standard dose of pancuronium or atracurium was given during maintenance. RESULTS: After induction with 5 mg/kg thiopental, the mean (95% confidence interval) of frontal EMG significantly decreased from 2.66 (1.63,4.29) to 1.41 (0.2,1.61). When eyelash reflex was absent, the mean (95%CI) frequency and amplitude of the right frontal EEG was 3.89 (3.29, 4.497) Hz, 39.58 (32.11, 47.05) microvolt and left frontal EEG was 3.84 (3.43, 4.25) Hz, 33.55 (28.59, 38.61) microvolt. The findings were consistent with the raw EEG shown on the monitor, i.e. a progressive decrease in the frequency and an increase in the amplitude. During maintenance with the inhaled anesthetics, there was a statistically significant decrease in frequency of right frontal in those who had received the inhaled anesthetic concentration to reach 1.4 and 1.65 MAC (p < 0.05) (repeated measure ANOVA). At the steady state of end tidal concentration of the sevoflurane there was consistency in decreasing frequencies and increasing amplitudes of both hemispheres of the groups with higher MAC values (p < 0.05) (Table 3). However, the authors failed to demonstrate the relationships between EEG changes and other clinical responses. CONCLUSION: The present study has provided basic information about cerebral electrical activity during the balanced anesthesia with sevoflurane. As anesthesia deepened by increased MAC, the frequency decreased and the amplitude increased.

Adult↗
PubMed2006

[Anesthetic circle system failure caused by a plastic film--a case report].

A 44-year-old woman, ASA I, with breast cancer was scheduled for mastectomy. The anesthetic induction was performed by inhalation of 5% sevoflurane and 66% nitrous oxide in oxygen. After the loss of eyelash reflex assisted ventilation was initiated. At this point, the capnograph indicated inspired carbon dioxide tension of 18mmHg. Anesthetic machine check was soon carried out again. A visual check of non-return valves detected a plastic film, 18 x 21mm large, caught in the expiratory valve. This plastic film impaired complete occlusion of the orifice for the expiratory gas flow. As a result, the patient was rebreathing carbon dioxide. After removing it, the wave form of the capnograph was normalized and end-tidal carbon dioxide tension decreased immediately from 45mmHg to 33mmHg. As we did not detect any foreign matters at the non-return valves on anesthetic machine check before use, the plastic film might have already existed in the disposable corrugated tube before use. The capnograph is a useful device for detecting anesthetic circle system failure in such a case. It is important that the patients' airway is separated from the anesthetic circle system through the use of a filter to prevent foreign matter from being inhaled.

Adult↗
PubMed2006

[A method of iris image quality evaluation].

Iris image quality evaluation plays a very important part in iris computer recognition. An iris image quality evaluation method was introduced into this study to distinguish good image from bad image caused by pupil distortion, blurred boundary, two circles appearing not concentric, and severe occlusion by eyelids and eyelashes. The tests based on this method gave good results.

Humans↗
PubMed2006

Phthiriasis palpebrarum: 2 case reports.

Phthiriasis palpebrarum, caused by the phthirus pubis, is a rare cause of blepharoconjunctivitis, and is therefore often neglected. We present 2 patients who suffered itching and irritation at the right upper eyelid. Biomicroscopic examination showed a few lice and nits anchored to the eyelashes. Dermatologic examination revealed the presence of numerous lice and nits at the trunk and pubic area. The lice and nits were manually removed if possible, and the patients were asked to put vaseline on the eyelid margins. The patients were also treated with malathion 0.5% lotion. After control, two weeks later, no more lice nor nits were present in the first patient.

Adult↗
PubMed1990

Pediculosis.

Pediculosis can be caused by two distinctly different organisms, the head louse and the pubic louse. Although differing anatomically, they produce equivalent disorders, with itching, bites, and nits on the hairs. The head louse causes disease of the scalp, while the pubic louse lives in short hair in the pubic regions, the body, the axillae, the eyebrows, and the eyelashes. Both can be treated with gamma isomer of hexachlorobenzene, but various mixtures of pyrethrins seem more effective. The body louse, which exactly resembles the head louse, is the only one that can transmit disease. Treatment of body louse infestation is mainly cleanliness: washing the patient and changing his clothing.

Animals↗
PubMed1990

[Loose anagen hair syndrome].

In 1984, Zaun described a new type of pilary dysplasia characterized by easily pluckable hair. We were able to observe three patients with this anomaly, and this paper is an attempt at reviewing the subject on the basis of these new cases compared with those previously published. Clinical features. The major sign of the anomaly is that hairs can be pulled off in tufts easily and painlessly, and promptly grow again (our cases). In all cases reported so far the hair was blond or dark-blond; in some patients it is described as scintillating (our cases). The hair shaft is usually thin (one of our cases), but it may be of normal caliber (two of our patients). In the occipital region the hairs are entangled, dry and short (our cases). They are implanted wide apart or at normal intervals (our patients); areas of alopecia are sometimes encountered (our cases). Hair growth may be slow (one of our cases) or of normal speed (two of our cases). The eyelashes and eyebrows, as well as other body hairs, are normal in all patients (fig. 1). Microscopy. The trichogram is exclusively composed of anagenic and dystrophic roots (our cases). Pathological examination by biopsy of the scalp is characteristic: transverse and oblique sections of the follicles show that the hairs are oval, triangular or trapezoidal in shape (fig. 7). Alterations of the inner epithelial sheath are also present, including keratinization and early decomposition (fig. 8), lack of complementation (fig. 7) and fissures between the cuticle of the inner epithelial sheath and of the hair, in the keratogenic area (fig. 9). (ABSTRACT TRUNCATED AT 250 WORDS)

Alopecia↗
PubMed2006

Managing the blue man: multiple traumas involving a paint-carrying truck.

INTRODUCTION: This report describes the difficulty in evaluating a patient with multiple traumas because he was covered with paint poured from a truck in a car accident. Cleansing with paint thinner and isotonic saline solution was necessary. CASE REPORT: A 29-year-old male patient was admitted to the emergency department following the collision of his car with a paint-carrying truck. His head, face, neck and hands were covered with a cyan-blue oil paint, and bloody "paint mud" covered all frontal and occipital areas of the scalp. Abdominal guarding was identified. A rapid cleansing with normal saline solution (0.9% NaCl) was attempted in order to expose the lesions of the patient, but it had no effect on the drying paint. The patient's scalp, face and neck were cleaned with paint thinner (60% toluene). The patient was then diagnosed as having a maxillofacial fracture and underwent surgery for open reduction and rigid fixation by plastic and reconstructive surgeons. Thinner was not used for the eyes for fear of further chemical injury. Normal saline removed corneal and conjunctival paint remnants but proved ineffective for cleansing of the eyelids and eyelashes. CONCLUSION: Removal of the paint from the skin and the eyes was a prerequisite for the evaluation of the underlying structures. It is difficult to find a cleansing material that can be used effectively and safely in different parts of the body.

Accidents, Traffic↗
PubMed1991

Midazolam as a main anesthesia induction agent--a comparison with thiopental and diazepam.

A clinical randomized investigation was undertaken to determine the value of midazolam as a narcotic adjuvant for anesthetic induction. Thirty ASA I-II adult patients undergoing selective surgery were allocated randomly into two groups to receive one of the following agents: midazolam 0.3 mg/kg, thiopental 5 mg/kg, or diazepam 0.4 mg/kg. The induction time as measured from the onset of injection to loss of the eyelash reflex was shortest in the case of thiopental; while a lower frequency of apnea, lesser suppression of circulation, and lack of venous irritation were points favoring midazolam. However, further study is needed to clarify the moderate cardiovascular response seen during intubation in some cases as well as to elucidate any patient population differences.

Adams-Stokes Syndrome↗
PubMed1991

Pili torti and onychodysplasia. Report of a previously undescribed hidrotic ectodermal dysplasia.

Ectodermal dysplasias are a large and heterogeneous groups of clinically and genetically distinct syndromes. We studied a family suffering from dystrophies of the distal part of the nails and trichodysplasia. Scalp, beard, pubic and axillary hair were broken off leaving a stubble 1-10 mm in length. Eyebrows, eyelashes and body hair were completely absent. Serum levels of copper and plasma levels of amino acids were within the normal range. Inheritance was autosomal recessive. Previous reports of ectodermal dysplasias and other complex syndromes with pili torti are reviewed.

Abnormalities, Multiple↗