ABSTRACT
PURPOSE: Compression of the optic nerve by a dolichoectatic internal carotid artery is known to cause of visual field defects. We experienced a case of optic nerve compression by a normal-appearing internal carotid artery. METHODS: A 22-year-old man presented with left eye visual field defect without obvious cause and magnetic resonance imaging revealed compression of the left optic nerve by ipsilateral internal carotid artery. RESULTS: At eight-month follow-up, there was no improvement in visual field defect or optic disc change. CONCLUSIONS: In an unexplained optic neuropathy, T1-weighted MRI is needed to evaluate the relationship between the optic nerve and internal carotid artery.
Subject(s)
Humans , Young Adult , Carotid Artery, Internal , Follow-Up Studies , Magnetic Resonance Imaging , Optic Nerve Diseases , Optic Nerve , Visual FieldsABSTRACT
In the present study, we attempted to reveal the response of lens on induced traumatic cataract which were removed the anterior capsule with 0.5 mm, 1.0 mm, 2.0 mm, 4.0 mm size in six rabbits. We examined histopathological change of the wounded lenses by means of the slit-lamp and electronmicroscope. We found opacities in wounded area increased regardless of wound diame-ter. Electronmicroscopic findings were similar to normal single-layer cuboidal anterior epithelial cells at 0.5 mm, 1.0 mm, 2.0 mm, 4.0 mm one day after injury. There were, however, elongated epithelial cells with abun-dant fine filaments and slightly edematous lens fiber cells in 0.5 mm, 1.0 mm, 2.0 mm groups at 1 week after injury. These were observed as a small superficial scars at the wound site. We considered these changes as an effort of lens to delay the progression to the total cataract . We noted the widening of intercellular spaces, loss of cell membrane, decrease of intracel-lular organelles and severe change of the lens fiber rows in 4.0 mm group at 3 weeks after injury. We observed these changes as the total cataract in gross. Taken together, we revealed that lens epithelial cells in 0.5 mm, 1.0 mm, 2.0 mm in wound diameter stop the progression toward to the total cataract. However, lens epithelial cells at 4.0 mm in wound diameter could not obstruct the progression toward to the total cataract. We documented different stages of cataract formation and microstructure of the wounded lens, which have different wound sizes.
Subject(s)
Rabbits , Cataract , Cell Membrane , Cicatrix , Epithelial Cells , Extracellular Space , Organelles , Wounds and InjuriesABSTRACT
One of the purposes of this experiment is to observe the structure of crystalline lens with cataract, which is formed artificially, using the light microscope and electron microscope. The other is to observe the differences of structural variations in the cataract developed inside body. Twelve eyes of six pigs were used for this experiment. Two of them are normal crystalline lens, five are cystalline lens in distilled water, and the rest are in balanced salt solution through intact or ruptured capsule. We examined the time of cataract formation and compared the ultrastructural changes. Ruptured capsule and high osmotic pressure difference induced more rapid opacity. In case of distilled water, the capsule is maintained but it is very difficult to distinguish between epithelium and lens fibers. Also, there is a severe crack in the lens fibers. In electron microscopic, as the cataract progresses, the osmotic swelling becomes more prominent. One of the striking changes was a marked intercellular cyst formation. Lens cells became irregular in size and density and were extensively vacuolated. The swelling of the lens cells continuously induced large intracellular vacuoles and liquefied the cytoplasmic protein. In conclusion, the structural change of cataract, which was seen by an electron microscope, resulted from change in osmolarity from previously announced in vivo experiment and structural change resulted from this experiment are similar.
Subject(s)
Cataract , Crystallins , Cytoplasm , Epithelium , Lens, Crystalline , Microscopy, Electron , Osmolar Concentration , Osmotic Pressure , Strikes, Employee , Swine , Vacuoles , WaterABSTRACT
Dieulafoy lesion is very small and easily overlooked as a course of massive, often recurrent hemorrhage that results from the crosion of a submucosal artery, typically in the gastric cardia or fundus. The clinical picture of Dieulafoy lesion is quite uniform: patients commonly present with massive hemorrhage and melena without any relevant history. The diagnostic procedure of choice in patients with severe gastrointestinal bleeding is emergency endoscopy. The lesion is rare but potentially life threatening source of upper gastrointestinal bleeding. Before the endoscopic era, the prognosis for patients with these lesions was quite poor. However, recent reports have described the success of endoscopic therapy in the management of Dieulafoy lesion. We performed emergency endoscopy in 3 patients who had massive or recurrent episode of upper gastrointestinal bleeding, identified to the Dieulafoy lesion. We tried to Endoscopic "0" band ligation, successfully in hemostasis and prevention of recurrence.
Subject(s)
Humans , Arteries , Cardia , Emergencies , Endoscopy , Gastrointestinal Hemorrhage , Hemorrhage , Hemostasis , Ligation , Melena , Prognosis , RecurrenceABSTRACT
The complications of bile duct stone are cholangitis, pancreatitis, obstructive jaundice, liver abscess, and secondary biliary cirrhosis. Liver abscess may produce pyothorax, peritonitis, subphrenic abscess, and pyogenic pericarditis. The case studies of pyogenic pericarditis secondary to pyogenic liver abscess are rarely reported. Stones greater than 20mm in diameter are difficult or impossible to remove with a standard basket or balloon after sphincterotomy. There are several nonsurgical treatment options for large bile duct stone: mechanical lithotripsy, endoprosthesis, extracorporeal shock-wave lithotripsy (ESWL), electrohydraulic lithotripsy, contact dissolution therapy, and laser lithotripsy. We experienced a case of large bile duct stone which complicated by pyogenic pericarditis, liver abscess, and pyothorax. He treated with antibiotics, closed thoracostomy, partial pericardiectomy, and removal of bile duct stones by extracorporeal shock-wave and mechanical lithotripsy after endoscopic sphincterotomy and nasobiliary drainage.
Subject(s)
Anti-Bacterial Agents , Bile Ducts , Bile , Cholangitis , Drainage , Empyema , Empyema, Pleural , Jaundice, Obstructive , Lithotripsy , Lithotripsy, Laser , Liver Abscess , Liver Abscess, Pyogenic , Liver Cirrhosis, Biliary , Liver , Pancreatitis , Pericardiectomy , Pericarditis , Peritonitis , Sphincterotomy, Endoscopic , Subphrenic Abscess , ThoracostomyABSTRACT
Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.