Investigation of Stress and Distress Experienced by Guardians of Children with Strabismus and/or Amblyopia.

Purpose: To investigate the stress experienced by the guardians of children with strabismus and/or amblyopia.Patients and Method: This study included 98 guardians of children with strabismus and/or amblyopia. First, guardians were asked to complete an independent questionnaire and the K6 screening scale. We analyzed stress associated with caring for their child. Second, we examined the responses to the free description questions of the consultation contents and benefits acquired from treatments.Results: A relationship between the attitudes of children regarding treatment and the receptive psychology of their guardians was established. Since strabismus and amblyopia treatments require practice and wearing glasses or patches in everyday living, guardians of affected children desired explanation regarding better and more specific treatments to improve the daily lives of their children. On the other hand, they had a feeling of anxiety about the future of their children. In addition, the stress-free guardians mentioned the importance of support, indicating that receiving support contributed to reducing their stress levels.Conclusion: Creating an environment that allows affected children to actively engage in their own treatment, while providing guardians with relevant information on the course of treatment and their children's future, may help reduce stress in guardians of affected children.

HLA-B52-positive vasculo-Behçet disease: usefulness of magnetic resonance angiography, ultrasound study, and computed tomographic angiography for the early evaluation of multiarterial lesions.

We report a case of HLA-B52-positive Behçet disease accompanied by multiarterial lesions. A 24-year-old woman was suffering from sporadic high fever and recurrent oral and genital ulcers, and laboratory data revealed severe inflammation. A diagnosis of Behçet disease was made. Magnetic resonance angiography, ultrasound study, and computed tomographic angiography demonstrated multiarterial lesions that had caused no symptoms. These noninvasive examinations were extremely useful in evaluating asymptomatic early vascular lesions.

A case of interstitial cystitis accompanying Sjögren's syndrome.

A 51-year-old woman with interstitial cystitis was referred for screening of autoimmune disease. She was positive for results of Schirmer and Saxon tests and for ss/A and ss/B antibodies. Autoantibodies to type 3 muscarinic acetylcholine receptor were detected in the patient's serum by Western blotting. We diagnosed her as having interstitial cystitis accompanying Sjögren's syndrome. To enable early treatment, interstitial cystitis should be considered when patients with Sjögren's syndrome complain of urinary symptoms.

Ulcerative colitis occurring in the course of rheumatoid arthritis: a case successfully treated with mesalamine enema.

We report a case of ulcerative colitis (UC) that occurred during the course of rheumatoid arthritis (RA). A 29-year-old woman with a 25-year history of RA was hospitalized for high fever, abdominal pain and hematochezia. Colonoscopy revealed erosive and reddish mucosa from the distal transverse colon to rectum. Histology revealed cryptitis (mainly caused by neutrophils), mild crypt abscess and goblet cell depletion. She was diagnosed with left-sided UC and treated with mesalamine enema. The abdominal symptoms and colonoscopic findings were greatly ameliorated. We conclude that the mesalamine enema was effective in this case of UC occurring during the course of RA.

A case of merged idiopathic portal hypertension in course of mixed connective tissue disease.

We report a case of idiopathic portal hypertension (IPH) complicated with mixed connective tissue disease (MCTD). The patient, a 41-year-old woman, was admitted to another hospital because of tarry stools in March 2000. Emergency endoscopy revealed bleeding from the esophageal varices, and she was referred to our hospital. Twelve years before, she had been diagnosed as having MCTD, because she exhibited Raynaud's phenomenon, pleuritis, pericarditis, and had high titers of anti nuclear antibody (ANA) and anti-U1 ribonucleoprotein (RNP). Laboratory examinations, imaging examinations, and liver biopsy indicated that the esophageal varices were caused by IPH. The association of IPH and MCTD is very rare; to the best of our knowledge, only five cases of MCTD, associated with pulmonary hypertension (PH), have been reported.

Detection and monitoring of methotrexate-associated lung injury using serum markers KL-6 and SP-D in rheumatoid arthritis.

The applicability of monitoring concentrations of serum KL-6 and serum surfactant protein-D (SP-D) in the detection of methotrexate-associated lung injury (MTX pneumonitis) in patients with rheumatoid arthritis (RA) was investigated. The concentrations of these markers, sequentially measured in two patients with RA complicated with MTX pneumonitis, were increased in accordance with the severity of MTX pneumonitis. Conversely, the concentrations of these markers were decreased with the improvement of MTX pneumonitis, suggesting that the monitoring of these markers could be applicable not only for detecting the onset of MTX pneumonitis, but also for detecting the therapeutic response of MTX pneumonitis.