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1.
Arch. argent. pediatr ; 118(2): e204-e207, abr. 2020. ilus
Article in Spanish | LILACS (Americas), BINACIS | ID: biblio-1100484

ABSTRACT

La gangrena de Fournier es una fascitis necrotizante que afecta las regiones genital, perineal y perianal, de inicio súbito y diseminación rápidamente progresiva. Su diagnóstico obliga a una urgente intervención interdisciplinaria. La asociación con enfermedades nefrológicas es rara.Se presenta un caso de gangrena de Fournier en un niño con síndrome nefrótico corticorresistente y anasarca con edema escrotal grave. Recibió un esquema antibiótico de amplio espectro y se realizó un desbridamiento quirúrgico extenso e inmediato de la lesión necrótica. Posteriormente, requirió reparación por parte de Cirugía Plástica. Presentó una respuesta clínica favorable a la terapéutica instaurada.


Fournier gangrene is a necrotizing fasciitis that affects the genital, perineal and perianal regions, of sudden onset and rapidly progressive dissemination. Its diagnosis requires an urgent and interdisciplinary intervention. The association with nephrologic diseases is rare.We present a case of Fournier gangrene in a child with steroid-resistant nephrotic syndrome and anasarca with severe scrotal edema. He received a broad-spectrum antibiotic scheme and extensive an immediate surgical debridement of the necrotic lesion was carried out. Subsequently, it was repaired by Plastic Surgery. He presented a favourable clinical response


Subject(s)
Humans , Male , Child, Preschool , Fournier Gangrene/surgery , Fournier Gangrene/diagnosis , Fasciitis, Necrotizing , Edema , Genital Diseases, Male , Anti-Bacterial Agents/therapeutic use , Nephrotic Syndrome
2.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811332

ABSTRACT

PURPOSE: To report the clinical manifestations and computed tomography (CT) findings of patients with a trapdoor type medial orbital wall blowout fracture.METHODS: From March 2009 to October 2016, the clinical records and computed tomography findings of patients who underwent surgical treatment for a trapdoor type medial orbital wall blowout fracture were retrospectively analyzed.RESULTS: A total of eight patients (six males and two females) were enrolled with a combined mean age of 14.4 years. Clinical manifestations were eyeball movement limitation (abduction and adduction) and ocular motility pain (eight patients, 100%), diplopia (seven patients, 87.5%), and nausea and vomiting (four patients, 50%). On CT, the distance from the orbital apex to the fracture site was an average of 22.0 mm and occurred in the middle position of the entire wall. Two patients had missed rectus completely dislocated into the ethmoid sinus through the fracture gap and six patients had definite involvement in the fracture gap and edema of the medial rectus muscle. The medial rectus muscle cross-sectional area was 47.7 mm² which was edematous compared to the contralateral eye (40.1 mm²). Orbital wall reconstruction was performed an average of 4.1 days after the injury. In all patients with oculocardiac reflex-like nausea and vomiting immediately improved after surgery. Six out of eight patients who had eyeball movement limitations (abduction and adduction) preoperatively showed adduction limitation after surgery. The eyeball movement limitation and diplopia disappeared 11.7 days and 46.7 days after surgery, respectively.CONCLUSIONS: Patients with trapdoor type medial wall blowout fracture showed characteristic computed tomographic findings and clinical manifestations such as eyeball movement limitation, ocular motility pain, diplopia, and oculocardiac reflex. An understanding of clinical findings and quick surgical treatment are therefore required. The type of eyeball movement limitation was abduction and adduction limitation preoperatively and adduction limitation postoperatively.


Subject(s)
Diplopia , Edema , Ethmoid Sinus , Humans , Male , Nausea , Orbit , Reflex, Oculocardiac , Retrospective Studies , Vomiting
3.
Yonsei Medical Journal ; : 79-84, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782120

ABSTRACT

PURPOSE: Hyaluronidase (HAase) has many uses in medicine, and reports suggest that it affects perineal tissue during fetal passage through the vaginal canal. However, its potential use for preventing perineal trauma has yet to be determined. This study sought to evaluate the efficacy and safety of perineal HAase injections in reducing perineal trauma during vaginal delivery.MATERIALS AND METHODS: A multi-center, double-blind, placebo-controlled, randomized study was conducted from January 2016 to March 2017. Nulliparous women who planned to undergo vaginal delivery were recruited, and the enrolled women were randomly assigned to the HAase injection group (HAase injection, 5000 IU, n=75) or the control group (normal saline injection, n=73). The degree of perineal laceration, rate of episiotomy, and grade of perineal edema at 1 hour and 24 hours after spontaneous vaginal delivery were compared between the two groups.RESULTS: A total of 148 women who underwent vaginal delivery were recruited. No significant differences were observed between the HAase injection and control groups in the rates of perineal laceration (p=0.422). Perineal edema significantly decreased 24 hours after delivery in the women treated with perineal HAase injections, compared to women in the control group (p=0.008). The overall incidences of adverse events, such as redness of the injection site, infection, and wound dehiscence, were similar between the two groups.CONCLUSION: HAase injections in nulliparous women afforded no reductions in the rates of perineal lacerations and episiotomy. However, the use of perineal HAase injections did reduce perineal edema without severe adverse events.


Subject(s)
Edema , Episiotomy , Female , Humans , Hyaluronoglucosaminidase , Incidence , Lacerations , Parity , Wounds and Injuries
4.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 37(2): 51-58, Septiembre 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1025037

ABSTRACT

La insuficiencia cardiaca debida a hipocalcemia es una extraña forma de cardiopatía metabólica, reversible en la mayoría de casos, secundaria a alteraciones endocrinológicas que provocan la disminución persistente del calcio sérico, como el hipoparatiroidismo. A continuación, se presenta el caso de una mujer de 23 años, a quien, al ingreso, se le diagnóstico de insuficiencia cardiaca severa. Durante su hospitalización, se evidenció sin-tomatología asociada con hipocalcemia, secundario a hipoparatiroidismo, por lo que inmediatamente se inició la reposición con calcio. Para prevenir el riesgo de muerte súbita, por la prolongación persistente del intervalo Q-T, se colocó un cardiodesfibrilador implantable; sin embargo, luego de 6 meses de tratamiento, a pesar de la suplementación con calcio oral, no se evidenció mejoría en la fracción de eyección, determinando un pronóstico incierto de la enfermedad


Heart failure due to hypocalcemia is a strange presentation of metabolic heart disease; it is reversible in most cases, and secondary to endocrinal alterations that cause the persistent decrease in serum calcium, such as hypoparathyroidism.A case of a 23-year-old woman who was diagnosed with severe heart failure is presented. During her hospitalization, there was evidence of symptoms associated with hypocalcemia, secondary to hypoparathyroidism, so the patient was treated with replacement of calcium immediately. To prevent the risk of sudden death, by the persistent prolongation of the Q-T interval, an implantable cardiac defibrillator was placed; however, after 6 months of treatment, despite oral calcium supplementation, there was no improvement in the ejection fraction, determining an uncertain prognosis of the disease.


Subject(s)
Humans , Female , Adult , Heart Failure , Hypocalcemia , Hypoparathyroidism , Diagnosis , Edema , Heart Diseases
5.
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 81-85, sept. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1048229

ABSTRACT

El dolor crónico constituye un reto terapéutico especial. Se presenta una revisión narrativa sobre el papel del tratamiento de oxigenación hiperbárica (TOHB) en el tratamiento del dolor neuropático, y sus aplicaciones en dolor crónico, síndromes neurosensitivos disfuncionales y oncodolor. El conocimiento de las indicaciones de TOHB en algiología y su aplicación en la práctica médica puede contribuir a mejorar la calidad de vida del paciente. (AU)


Chronic pain represents a special therapeutic challenge. We present a narrative review on the role of Hyperbaric Oxygen Therapy (HBOT) in the treatment of neuropathic pain, and its applications in chronic pain, dysfunctional neurosensitive syndromes and oncological pain. The knowledge of the indications of HBOT in algiology and its application in medical practice can contribute to improve the quality of life of the patient. (AU)


Subject(s)
Chronic Pain/therapy , Hyperbaric Oxygenation/methods , Phantom Limb/therapy , Quality of Life , Reflex Sympathetic Dystrophy/therapy , Vascular Headaches/therapy , Brain Diseases/therapy , Facial Pain/therapy , Fibromyalgia/therapy , Causalgia/therapy , Diabetic Neuropathies/therapy , Edema/therapy , Neuralgia, Postherpetic/therapy , Chronic Pain/epidemiology , Cancer Pain/therapy , Hyperbaric Oxygenation/trends , Analgesia/methods , Inflammation/therapy , Neuralgia/therapy
6.
Nursing (Säo Paulo) ; 22(250): 2745-2750, mar.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-996509

ABSTRACT

Objetiva-se sintetizar as melhores intervenções de Enfermagem para a redução do edema de pacientes com Insuficiência Cardíaca hospitalizados. Trata-se de uma revisão sistemática quantitativa baseada no modelo do Instituto Joanna Briggs. A busca foi realizada nas bases de dados MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Cinahl, Cochrane Library, Joanna Briggs Institute Library, PubMed, LILACS e Scopus. Os estudos relevantes foram avaliados metodologicamente por dois revisores. Dentre os 269 resumos encontrados nos bancos de dados, dois artigos atingiram padrão de qualidade por dois revisores independentes. As intervenções para redução do edema incluíam o gerenciamento de caso e a restrição hidrossalina associada a acompanhamento por telefone. A adesão ao tratamento e qualidade de vida melhoraram após as intervenções, mas não houve diminuição da readmissão hospitalar. Conclui-se que a base de evidências sugere monitoramento constante de pacientes com insuficiência cardíaca hospitalizados para mensuração do edema, peso e ingesta hidrossalina, porém a literatura é escassa e oferece baixa possibilidade de síntese.(AU)


The aim of this study is to synthesize the best nursing interventions to reduce the edema of hospitalized patients with heart failure. This is a systematic quantitative review based on the Joanna Briggs Institute. The search was performed in the MEDLINE, Cumulative Index to Nursing and Allied Health Literature Cinahl, Cochrane Library, Joanna Briggs Institute Library, PubMed, LILACS and Scopus databases. The methodology of the studies was evaluated by two reviewers. The search identified 269 abstracts, and the two independent reviewers selected 02 studies. Interventions to reduce edema included case management and the hydrosaline restriction associated with telephone follow-up. Adherence to treatment and quality of life improved after interventions, but there was no decrease in hospital readmission. It is possible to conclude that the evidence base suggests a constant monitoring of patients with hospitalized heart failure to evaluate edema, weight and hydrosaline intake, however the literature is scarce and offers a low possibility of synthesis.(AU)


El objetivo del estudio fue sintetizar las mejores intervenciones de enfermería para la reducción del edema de pacientes con Insuficiencia Cardiaca hospitalizados. Se trata de una revisión sistemática cuantitativa basada en el modelo del Instituto Joanna Briggs. La búsqueda se realizó en las bases de datos MEDLINE, Cumulative Index to Nursing and Allied Health Literature Cinahl, Cochrane Library, Joanna Briggs Institute Library, PubMed, LILACS y Scopus. La metodología de los estudios fue evaluada por dos revisores. La búsqueda identificó 269 resúmenes, siendo que los dos revisores independientes seleccionaron 02 estudios. Las intervenciones para reducir el edema incluyeron la gestión de casos y la restricción hidrosalina asociada a seguimiento por teléfono. La adhesión al tratamiento y calidad de vida mejoraron después de las intervenciones, pero no hubo disminución de la readmisión hospitalaria. Es posible concluir que la base de evidencias sugiere monitoreo constante de pacientes con insuficiencia cardíaca hospitalizados para evaluación del edema, peso e ingesta hidrosalina, sin embargo la literatura es escasa y ofrece baja posibilidad de síntesis.(AU)


Subject(s)
Humans , Edema , Heart Failure , Nursing Care , Risk Factors , Evidence-Based Nursing
7.
Int. arch. otorhinolaryngol. (Impr.) ; 23(2): 221-228, 2019. tab, ilus
Article in English | LILACS (Americas) | ID: biblio-1015570

ABSTRACT

Introduction: Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of thirdmolars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective: To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis: An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus. Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions: Cryotherapy applied on thefirstday aftermandibular third molar removal can manage edema in the patients.Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication (AU)


Subject(s)
Humans , Male , Female , Adult , Tooth Extraction/adverse effects , Cryotherapy , Inflammation/therapy , Postoperative Care , Trismus/therapy , Treatment Outcome , Oral Surgical Procedures/rehabilitation , Edema/therapy , Pain Management , Molar/surgery
8.
Rev. med. (Säo Paulo) ; 98(3)maio-jun. 2019. ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1009758

ABSTRACT

A síndrome de Morbihan é uma doença rara, de fisiopatologia pouco conhecida, tipicamente caracterizada por edema e eritema facial, de aparecimento lento, simétrico, afetando terço superior da face. Este relato de caso se trata de um paciente com caso atípico de Síndrome de Morbihan, com acometimento assimétrico de face. Foram ressaltados aspectos clínicos e histopatológicos para diagnóstico dessa rara patologia, possíveis diagnósticos diferenciais e opções de tratamento. Também foi buscado difundir formas menos típicas desta doença.


Morbihan syndrome is a rare condition and its pathogenesis is not fully known. This entityh is characterized by facial edema and facial erythema, with a slow, symmetrical appearance, affecting the upper portion of the face. This case report is about a patient with an atypical case of Morbihan syndrome, with asymmetric facial involvement. Clinical and histopathological aspects were highlighted aiming the diagnosis of this rare pathology, as well as possible differential diagnoses and treatment options. It has also been aimed to call attention to less typical forms of this disease.


Subject(s)
Humans , Male , Middle Aged , Rosacea/diagnosis , Edema/physiopathology , Erythema/physiopathology , Face/physiopathology , Dermatology
9.
Int. arch. otorhinolaryngol. (Impr.) ; 23(2): 241-249, 2019. ilus, tab
Article in English | LILACS (Americas) | ID: biblio-1015650

ABSTRACT

Introduction: The importance of our study lies in the fact that we have demonstrated the occurrence ofmechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective: To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data: Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion: The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP (AU)


Subject(s)
Humans , Nasal Polyps/physiopathology , Nasal Polyps/pathology , Inflammation/physiopathology , Sinusitis/physiopathology , Biomechanical Phenomena , Brazil , Flow Mechanics , Chronic Disease , Edema/physiopathology , Extracellular Matrix/pathology , Hydrostatic Pressure , Nasal Mucosa/physiopathology , Nasal Mucosa/pathology
10.
Yonsei Medical Journal ; : 700-703, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-762089

ABSTRACT

Congenital analbuminemia (CAA) is an autosomal recessive disease characterized by extremely low serum levels of albumin. CAA is caused by various homozygous or heterozygous mutations of the ALB gene. Patients often exhibit no clinical symptoms, aside from rare accompanying conditions, such as fatigue, ankle edema, and hypotension. This case report describes the case of a 28-year-old asymptomatic Korean male referred to our center with hypocalcemia, vitamin D deficiency, and hypoalbuminemia who was diagnosed with CAA. To determine the cause of hypoalbuminemia in the patient, laboratory tests, radiological examination, and DNA sequencing were performed. The patient was confirmed to not exhibit any other clinical conditions that can induce hypoalbuminemia and was diagnosed with CAA using DNA sequencing. The present case of CAA is the first to be reported in Korea.


Subject(s)
Adult , Ankle , Edema , Fatigue , Humans , Hypoalbuminemia , Hypocalcemia , Hypotension , Korea , Male , Polymorphism, Single Nucleotide , Sequence Analysis, DNA , Vitamin D Deficiency
11.
Clinical Pain ; (2): 107-110, 2019.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811485

ABSTRACT

Flexor carpi radialis (FCR) muscle is located in the forearm anteriorly that runs through a synovial fibro-osseous tunnel in the forearm. We described a case of FCR tendon rupture due to repetitive overuse injury. A 55-year-old man, right-hand dominant, presented with right forearm pain and swelling which started 3 days ago while playing amateur golf. Focal tenderness and bruising over volo-ulnar region of the right forearm were examined. Plain radiographs showed soft tissue edema around lesion area and no detectable fracture. Ultrasonography showed multiple hypoechoic lesions suspected as hematoma of the flexor muscle group. After done magnetic resonance imaging, he was diagnosed with rupture of FCR tendon at proximal origin and strain of flexor digitorum superficialis and palmaris longus muscle. He received compressive dressing and restriction of wrist range of motion for three weeks. Two months later, remaining traces of lesions were observed at the follow-up ultrasonography and the pain disappeared.


Subject(s)
Bandages , Cumulative Trauma Disorders , Edema , Follow-Up Studies , Forearm , Golf , Hematoma , Humans , Magnetic Resonance Imaging , Middle Aged , Range of Motion, Articular , Rupture , Tendon Injuries , Tendons , Ultrasonography , Wrist
12.
Article in English | WPRIM (Western Pacific) | ID: wprim-760345

ABSTRACT

A 6-year-old intact male Maltese dog presented with a history of blindness and ataxia. Neuro-ophthalmic examination revealed dilated pupils with absent pupillary light reflexes and menace response in both eyes. Mild peripapillary edema was noted in the fundus of the right eye. After magnetic resonance imaging, the dog was provisionally diagnosed with meningoencephalitis of unknown etiology. Follow-up funduscopy was performed to monitor the condition of the optic discs for three years. Despite of the treatment with prednisolone, the optic nerve progressed to atrophy and the dog couldn't restore vision.


Subject(s)
Animals , Ataxia , Atrophy , Blindness , Child , Dogs , Edema , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Meningoencephalitis , Optic Nerve , Optic Neuritis , Prednisolone , Pupil , Reflex
13.
Article in English | WPRIM (Western Pacific) | ID: wprim-760194

ABSTRACT

PURPOSE: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. METHODS: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. RESULTS: During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: 20.8±16.6 months) presented with seizure. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizures in 13 patients (13 of 27, 48.1%) and complex febrile seizures in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient. CONCLUSION: Although febrile seizures are the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizures was higher than that of those with general febrile seizures. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.


Subject(s)
Brain , Brain Diseases , Child , Diagnosis , Edema , Epilepsy , Female , Humans , Korea , Magnetic Resonance Imaging , Medical Records , Meningitis , Neurologic Manifestations , Respiratory Syncytial Viruses , Retrospective Studies , Seizures , Seizures, Febrile , White Matter
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-739665

ABSTRACT

Choroid plexus tumors are uncommon brain tumors that primarily occur in children. Most of these tumors originate from the intraventricular area, and the most common clinicalpresentation is increased intracranial pressure. Dissemination through the cerebrospinal fluid space is the inevitable natural course of the disease. Here, we present 2 rare cases of adult choroid plexus carcinoma (CPC), each with distinct clinical presentation and progression. The first case was a 40-year-old male who presented with multiple intraventricular masses. After surgical biopsy, radiation and intrathecal chemotherapy failed to elicit any response. The patient progressed with spinal cord dissemination and expired 1 year later. The second case presented with visual disturbance, and brain MRI revealed a large ovoid juxtaventricular mass with peritumoral edema. This 49-year-old female patient underwent craniotomy for what was thought to be a high-grade glioma; however, the mass was connected to the choroid plexus at the operative field. Her pathology specimen was diagnosed as CPC, and adjuvant systemic chemotherapy was administered. She has now been free of recurrence for 10 months. The description of the presentation and progression of these rare adult-onset CPC provides insight for the diagnosis and treatment of other rare instances of choroid plexus tumors.


Subject(s)
Adult , Biopsy , Brain , Brain Neoplasms , Cerebrospinal Fluid , Child , Choroid Plexus Neoplasms , Choroid Plexus , Choroid , Craniotomy , Diagnosis , Drug Therapy , Edema , Female , Fourth Ventricle , Glioma , Humans , Intracranial Pressure , Magnetic Resonance Imaging , Male , Middle Aged , Pathology , Recurrence , Spinal Cord
15.
Experimental Neurobiology ; : 104-118, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-739527

ABSTRACT

Subarachnoid hemorrhage (SAH) is a devastating cerebrovascular event that often is followed by permanent brain impairments. It is necessary to explore the pathogenesis of secondary pathological damages in order to find effective interventions for improving the prognosis of SAH. Blockage of brain lymphatic drainage has been shown to worsen cerebral ischemia and edema after acute SAH. However, whether or not there is persistent dysfunction of cerebral lymphatic drainage following SAH remains unclear. In this study, autologous blood was injected into the cisterna magna of mice to establish SAH model. One week after surgery, SAH mice showed decreases in fluorescent tracer drainage to the deep cervical lymph nodes (dcLNs) and influx into the brain parenchyma after injection into the cisterna magna. Moreover, SAH impaired polarization of astrocyte aquaporin-4 (AQP4) that is a functional marker of glymphatic clearance and resulted in accumulations of Tau proteins as well as CD3⁺, CD4⁺, and CD8⁺ cells in the brain. In addition, pathological changes, including microvascular spasm, activation of glial cells, neuroinflammation, and neuronal apoptosis were observed in the hippocampus of SAH mice. Present results demonstrate persistent malfunction of glymphatic and meningeal lymphatic drainage and related neuropathological damages after SAH. Targeting improvement of brain lymphatic clearance potentially serves as a new strategy for the treatment of SAH.


Subject(s)
Animals , Apoptosis , Aquaporin 4 , Astrocytes , Brain , Brain Ischemia , Cisterna Magna , Drainage , Edema , Hippocampus , Lymph Nodes , Mice , Neuroglia , Neurons , Prognosis , Spasm , Subarachnoid Hemorrhage , tau Proteins
16.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-738619

ABSTRACT

PURPOSE: When there is a mass in the superior temporal orbit area, a lacrimal gland tumor should be suspected. We report a rare case of orbital lymphatic malformation that was histologically diagnosed in a patient with typical clinical features of the lacrimal gland. CASE SUMMARY: A 55-year-old female with no underlying disease and no ophthalmic history visited our clinic with a right upper eyelid edema associated with an enlarged painless eyelid mass 1 month prior to her visit. The patient stated that she discovered the mass 1 year previously.The palpebral lobe of the lacrimal gland protruded slightly with congestion of the surrounding conjunctiva. Enhanced computed tomography showed a 3 cm well-defined heterogeneous mass in the right lacrimal gland area and several well-defined round calcifications within the mass. Orbital tissue or bone involvement was not observed. The pleomorphic adenoma of the lacrimal gland was the most clinically suspicious, so complete resection of the mass was performed using lateral orbitotomy. Histopathologically, lymphangioma (lymphatic malformation) originating from the lacrimal gland was diagnosed. CONCLUSIONS: Orbital lymphatic malformation can occur in the lacrimal gland. The present case showed that differential diagnosis can reveal the presence of an adult lacrimal gland tumor.


Subject(s)
Adenoma, Pleomorphic , Adult , Conjunctiva , Diagnosis, Differential , Edema , Estrogens, Conjugated (USP) , Eyelids , Female , Humans , Lacrimal Apparatus , Lymphangioma , Middle Aged , Orbit
17.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-738618

ABSTRACT

PURPOSE: To report a case of chemical injury of the cornea caused by high-dose ethanol during orbital wall fracture repair. CASE SUMMARY: A 56-year-old male presented with pain after blowout fracture repair surgery. During the surgery, 2% hexethanol solution (2% chlorhexidine and 72% ethanol mixture), which was used for disinfection of the face, flowed into the left eye. Conjunctival injection in the left limbus, a large corneal epithelial defect, and severe stromal edema were subsequently observed. The patient was treated with topical antibiotics, steroids, and autologous serum eye drops. After 1 week, the corneal epithelial defect was improved, but at the second month of therapy, recurrent corneal erosion with deterioration of the endothelial cell function occurred. Anterior stromal puncture and laser keratectomy were performed. The corneal epithelial defect and erosion improved, but the endothelial cell density was severely decreased. CONCLUSIONS: The 2% hexethanol solution is usually used for preoperative skin disinfection, but it contains a high concentration of ethanol. The surgeon should be aware that high concentrations of ethanol may result in severe corneal damage, including corneal endothelial dysfunction and limbal cell deficiency.


Subject(s)
Anti-Bacterial Agents , Chlorhexidine , Cornea , Corneal Injuries , Corneal Surgery, Laser , Disinfection , Edema , Endothelial Cells , Ethanol , Humans , Male , Middle Aged , Ophthalmic Solutions , Orbit , Punctures , Skin , Steroids
18.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-738614

ABSTRACT

PURPOSE: To report a patient stung by a bee, who was diagnosed with sterile endopthalmitis and another patient diagnosed with optic neuritis, with decreasing visual acuity, after refined bee venom injection around the orbital tissue. CASE SUMMARY: A 82-year-old female visited our hospital for decreased visual acuity in the right eye and ocular pain due to a bee sting. The bee sting penetrated the sclera into the vitreous. In the anterior segment, severe cornea edema and anterior chamber cells were seen. Using ultrasonography, inflammation was seen around the intravitreal area. After 3 months, intravitreal inflammation regressed but the patient's visual acuity was light perception negative, and corneal opacity, neovascularization, and phthisis bulbi were detected. A 55-year-old male visited our hospital for ocular pain in the right eye and decreasing visual acuity after refined bee venom injection around the orbital tissue. The best-corrected visual acuity in the right eye was 15/100, there was moderate injection on the conjunctiva. A relative afferent pupillary defect, abnormal color vision test results, and a defect in the visual field test were observed. There was no pain during external ocular movement, and other general blood tests, and a brain MRI were normal. Based on these symptoms, methylprednisolone megatherapy was started for treatment of optic neuritis. After treatment, visual acuity of the right eye was 9/10 and all other clinical optic neuritis symptoms regressed. CONCLUSIONS: Based on these two cases, ocular toxicity from bee venom could result from both direct and indirect courses. Treatment using refined bee venom might be harmful, and caution is recommended in its use.


Subject(s)
Aged, 80 and over , Anterior Chamber , Bee Venoms , Bees , Bites and Stings , Brain , Color Vision , Conjunctiva , Cornea , Corneal Opacity , Edema , Female , Hematologic Tests , Humans , Inflammation , Magnetic Resonance Imaging , Male , Methylprednisolone , Middle Aged , Optic Neuritis , Orbit , Pupil Disorders , Sclera , Ultrasonography , Visual Acuity , Visual Field Tests
19.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-738605

ABSTRACT

PURPOSE: We report two cases of uveo-meningeal syndrome involving the retina, uvea, and optic disc in both eyes after viral meningitis. CASE SUMMARY: A 16-year-old female was referred to our department with blurred vision in both eyes. She was hospitalized in the pediatric ward with viral meningitis. She showed a norma best-corrected visual acuity (BCVA) and normal intraocular pressure in both eyes, but had severe inflammation in the anterior chamber on slit lamp examination, and optic disc edema and multiple whitish lesions on fundus examination. She was treated with intravenous antibiotic injections and steroid eye drops. After close observation, inflammation in the anterior chamber, optic disc edema, and the multiple whitish lesions in the retina were improved. A 27-year-old male who was treated for viral meningitis at the neurology department was referred to us with blurred vision in both eyes. His BCVAs were 0.7 (right eye) and 0.6 (left eye). The intraocular pressure was normal in both eyes. Slit lamp examination revealed inflammation in the anterior chamber and optic disc edema, and a fundus examination revealed multiple infiltrations. He received treatment for presumed herpes virus infection. After close observation, inflammation in the anterior chamber, optic disc edema, and multiple infiltrations with hemorrhage in the retina were improved. CONCLUSIONS: Clinicians should consider the possibility of uveo-meningeal syndrome, which can cause inflammation in the uvea,retina, and optic disc simultaneous with viral meningitis accompanying blurred vision.


Subject(s)
Adolescent , Adult , Anterior Chamber , Edema , Female , Hemorrhage , Humans , Inflammation , Intraocular Pressure , Male , Meningitis , Meningitis, Viral , Neurology , Ophthalmic Solutions , Retina , Slit Lamp , Uvea , Vision Disorders , Visual Acuity
20.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-738589

ABSTRACT

PURPOSE: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.


Subject(s)
Abscess , Aged , Anti-Bacterial Agents , Dacryocystitis , Dacryocystorhinostomy , Delayed Diagnosis , Drainage , Edema , Eyelids , Female , Fistula , Humans , Hyperemia , Magnetic Resonance Imaging , Nasolacrimal Duct , Orbit , Orbital Cellulitis , Pseudomonas aeruginosa , Rupture , Tears , Tomography, X-Ray Computed
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