BACKGROUND: Improved intranasal visualization with endoscope allowed easy identification and opening of the lacrimal sac, without need for skin incision. OBJECTIVES: We studied and described the endoscopic dacryocystorhinostomy which has success rates comparable to those obtained by external approach. MATERIALS AND METHODS: Endoscopic dacrycystorhinostomy has been used for the treatment of nasolacrimal duct obstruction in 17 patients. The nasolacrimal apparatus related to the lateral nasal wall was approached using endoscopic technique. And bicanalicular nasal silicone tubes were placed during surgery in all cases. RESULTS: In our cases, it appears that lacrimal obstruction is related with congenital, idiopathic, facial trauma and other nasal or paranasal sinus diseases. Epiphora was relieved in 15 patients (88.2%), with a followup of 6 to 9 months. The causes of failure were granulation formation and obstruction of opening of lacrimal sac in 2 patients. CONCLUSION: Endoscopic dacryocystorhinostomy appear to be a safe and effective procedure which should be considered as an alternative to external dacryocystorhinostomy for the surgical treatment of nasolacrimal duct obstruction.
Dacryocystorhinostomy* ; Endoscopes ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Paranasal Sinus Diseases ; Silicones ; Skin

A twenty year old male patient was exposed on his right temporal portion of head to 22,000 volt alternating electric current on December 12, 1978. He lost consciousness for about three days. He sustained second and third degree burn on exposed site and right lower extremity. Right lower leg was amputated months later at orthopedic deparment. And diminution of vision began to be felt on April 1979. So he visited to our ophthalmic O.P.D. on June 11, 1979. On the first ocular examination, the visual acuity of both eyes was similar -Hand Movement- and the intraocular pressure of right was 14.6 mmHg and that of the left was 17.3 mmHg. And light projection and color perception of both eyes were good. There were multiple round punctate opacities in anterior subcapsular region and total opacification of lens cortex were also noted in both eyes by slit lamp examination. On June 12, 1979, intracapsular lens cryoextraction of right eye was done with Zonolysin(R) application and five days later left eye was operated by the same procedure. Corrected visual acuity of both eyes was 20/20 without significant complication.
Burns ; Cataract* ; Color Perception ; Consciousness ; Head ; Humans ; Intraocular Pressure ; Leg ; Lower Extremity ; Male ; Orthopedics ; Visual Acuity

Encephalopathy is a disorder characterized by altered brain function, which can be attributed to various causes. Encephalopathy associated with metronidazole administration occurs rarely and depends on the cumulative metronidazole dose, and most patients with this condition recover rapidly after discontinuation of therapy. Because metronidazole is metabolized in the liver and can be transported by the cerebrospinal fluid and cross the blood-brain barrier, it may induce encephalopathy even at a low cumulative dose in patients with hepatic dysfunction. We experienced a patient who showed ataxic gait and dysarthric speech after receiving metronidazole for the treatment of hepatic encephalopathy that was not controlled by the administration of lactulose. The patient was diagnosed as metronidazole-induced encephalopathy, and stopping drug administration resulted in a complete recovery from encephalopathy. This case shows that caution should be exercised when administering metronidazole because even a low dose can induce encephalopathy in patients with liver cirrhosis.
Anti-Infective Agents/*adverse effects/therapeutic use ; Brain Diseases/*chemically induced/diagnosis ; Hepatic Encephalopathy/*drug therapy/etiology ; Humans ; Liver Cirrhosis/*complications ; Magnetic Resonance Imaging ; Male ; Metronidazole/*adverse effects/therapeutic use ; Middle Aged ; Tomography, X-Ray Computed

Autoimmune hepatitis (AIH) has been reported in association with Sjogren's syndrome (SS). Drug-induced AIH has been rarely reported. A rare case of the co-development of AIH and SS in a 53-year-old woman after the consumption of herbal medicines is described. After admission, the patient complained of dryness in her mouth, and she was subsequently diagnosed with SS, which had not been detected previously. The patient's bilirubin and aminotransferase levels initially decreased following conservative management; however, they later began to progressively increase. A diagnosis of AIH was made based on the scoring system proposed by the International Autoimmune Hepatitis Group. The patient was administered a combination of prednisolone and azathioprine, and the results of follow-up liver-function tests were found to be within the normal range. This is an unusual case of AIH and SS triggered simultaneously by the administration of herbal medicines.
Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Azathioprine/therapeutic use ; Bilirubin/blood ; Female ; Hepatitis, Autoimmune/complications/*diagnosis/drug therapy ; *Herbal Medicine ; Humans ; Liver/pathology ; Liver Function Tests ; Middle Aged ; Prednisolone/therapeutic use ; Sjogren's Syndrome/complications/*diagnosis/drug therapy