Juvenile nasopharyngeal angiofibromas in Denmark 1981-2003: diagnosis, incidence, and treatment.

CONCLUSIONS: Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor in young males, with a non-negligible potential for recurrence. Preoperative embolization is a safe procedure that diminishes the peroperative blood loss and the need for blood transfusion. The endoscopic approach was used with good results in JNA stage I and II (Chandler). OBJECTIVES: To estimate the incidence rate of JNA in the Danish population and to describe symptoms and treatment. PATIENTS AND METHODS: This was a national retrospective cohort study. All cases of JNA diagnosed in Denmark from 1981 to 2003 were identified. Data were extracted from medical records. RESULTS: Forty-five male (no female) JNA cases were identified. In 43 cases, clinical data were recovered. Median age was 15 years. The incidence rate in Denmark was 0.4 cases per million inhabitants per year and 3.7 cases per million males (aged 10-24) per year. All patients underwent surgery, and the endoscopic approach was increasingly being used. The embolization procedure proved to be safe and decreased the intraoperative blood loss statistically to 650 ml in the embolized group from an average of 1200 ml in the non-embolized group (p<0.05). Similarly, the need for peroperative blood transfusion was reduced (p<0.005). The primary recurrence rate was 23% and no patients died.

A new ventilation tube for long-term middle ear ventilation.

OBJECTIVES: The treatment of secretory otitis media often requires repeated tubulation of the tympanic membrane as the standard ventilation tubes are extruded before the disease of the middle ear has remitted. The T-tube and its modification have been developed to remain longer in situ, often requiring surgical removal. The rates of subsequent persisting tympanic membrane perforations and granulations around the tube have been unacceptably high. In the search for a long-term ventilation tube with fewer complications, the Duravent tube (Smith and Nephew) has been developed. The aim of the study was to estimate duration in situ and observe complications in using the Duravent tube compared with standard tubes and T- tubes. STUDY DESIGN: Retrospective study. METHODS: In all, 51 patients have been treated with the Duravent tube over a 2-year period. In all, 72 Duravent tubes have been inserted. All patients were subsequently invited for a follow-up examination at a median time of 28 months (range, 11-43 mo) after the tube insertion and were followed up for 5 years. RESULTS: The duration in situ was optimal with a median duration of 17 months. The Duravent tube was extruded spontaneously in all but four cases in which surgical removal was necessary. The rate of persisting perforations of the tympanic membrane was low (4.2%) compared with 24% after the use of the T-tube. Likewise, the usual complications connected with long-term ventilation tubes were less frequent (14% compared with 35% when using the T-tube). CONCLUSIONS: In the present study, the Duravent tube has proved superior to other known long-term ventilation tubes. The problem of granulations, otorrhoea, and tube occlusion was significantly less than reported in other studies using the T-tube.

[Measuring corneal thickness in photo-keratectomy with a reflectometry incorporated into the laser beam of the excimer laser]. / Messung der Hornhautdicke bei der Photo-Keratektomie mit einem in den Strahlengang des Excimer-Lasers integrierten Reflektometer.

PURPOSE: To integrate a newly developed OLCR instrument into the optical system of the excimer laser. The instrument is designed to perform corneal pachymetry before, during, and after corneal photoablation and thus allow for a precise and continuous on-line measurement of the corneal photoablation process. METHODS: The conditions required to integrate the OLCR instrument into the excimer laser optics were investigated. With a technical setting providing on-line data of corneal thickness, three groups of 8-10 corneae received central keratectomies of 27 (group 1), 82 (group 2) and 163 (group 3) microns calculated central depth and 7.38 mm diameter. All measurements were performed with OLCR and ultrasound. RESULTS: The OLCR instrument was coupled into the optical system of the excimer laser and a useful signal obtained at SLD power levels of 40 microW incident on the cornea. Individual corneal thickness measurements were obtained before, during and after the photoablation procedure. In group 1, the ablation was 50.3 (40-68) microns measured with ultrasound and 30.2 (27-38) microns measured with OLCR. In group 2, the ablation was 101.1 (80-113) microns measured with ultrasound and 93.3 (76-109) microns measured with OLCR. In group 3, the ablation was 210.6 (190-227) microns measured with ultrasound and 188.4 (181-197) microns measured with OLCR. The precision (standard deviation) for measurements of individual corneas was 1-2 microns with OLCR and up to 12 mm in Ultrasound measurements. CONCLUSION: With this interferometric method, continuous, non-contact measurement of corneal thickness before, during and after excimer laser photoablation were performed. By establishing a feed-back control between the pachymetric measurements and the photoablation process, the precision of excimer ablation may possibly be further increased.

Brain abscess caused by Salmonella enteritidis in an immunocompetent adult patient: successful treatment with cefotaxime and ciprofloxacin.

A previously healthy 43-y-old man, who had spent 2 weeks in northern India, was admitted to hospital after a 2-day history of pyrexia, confusion and frontal headache. Cranial computerized tomography (CT) showed an abscess in the right parietal lobe. Spinal fluid and blood cultures gave growth of Salmonella enteritidis within 24 h. Treatment with cefotaxime was initiated, but ceased after 3 weeks due to drug fever, and ciprofloxacin was then given orally for 4 months. After 6 months, the patient was considered cured. Cases of salmonella brain abscesses are reviewed.

Rapid and precise in vivo measurement of human corneal thickness with optical low-coherence reflectometry in normal human eyes.

An optical low-coherence reflectometer is used for rapid noncontact measurements of the human corneal thickness in vivo. Thickness measurements on ten volunteers show a standard deviation of 3.4 µm. The experiments reveal that the optical reflectometer benefits from a 2.5 fold enhancement of the measurement precision and a 2.8 fold reduction in measurement time compared to a standard clinical ultrasonic pachometer. © 1998 Society of Photo-Optical Instrumentation Engineers.