No abstract available.
Cholesteatoma* ; Facial Paralysis*

BACKGROUND/AIMS: The aim of this study was to evaluate the peritonitis-causing bacteria detected in peritoneal fluid using a blood culture bottle in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: One-hundred and eleven dialysates from 43 patients suspected of peritonitis related to CAPD were retrospectively evaluated between May 2000 and February 2008. In all cases, 5 to 10 mL of dialysate was inoculated into a pair of BacT/Alert blood culture bottles, and 50 mL of centrifuged dialysate was simultaneously inoculated into a solid culture media for conventional culture. The results were compared to those of the conventional culture method. Isolated microorganisms were compared between the two methods. RESULTS: The blood culture method was positive in 78.6% (88 / 112) of dialysate specimens and the conventional culture method in 50% (56 / 112, p < 0.001). CONCLUSIONS: The blood culture method using the BacT/Alert system is useful for culturing dialysates and improves the positive culture rate in patients with suspected peritonitis compared to the conventional culture method.
Culture Media ; Dialysis Solutions ; Gram-Negative Bacterial Infections/*diagnosis/microbiology ; Gram-Positive Bacterial Infections/*diagnosis/microbiology ; Humans ; Kidney Failure, Chronic/*therapy ; Microbiological Techniques/*methods ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Peritonitis/*diagnosis/microbiology ; Sensitivity and Specificity

BACKGROUND/AIMS: Icodextrin (glucose polymer) is metabolized by a-amylase to oligosaccharides such as maltose and maltotriose. The presence of these metabolites could have an effect on the enzymatic glucose measurement especially the glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) based method. Patients treated with icodextrin are at risk for inaccurate blood glucose measurements. In this study we measured the blood glucose with different methods and analyzed the results to determine the test accuracy. METHODS: The blood glucose was measured, in seven outpatients and in seven inpatients using icodextrin, by the glucose hexokinase laboratory technique method as well as the GDH-PQQ method (Accu Chek Active)at the same time. To estimate an icodextrin residual effect, after discontinuing icodextin, the blood glucose was measured by the two methods after 48 hours in 4 inpatients. RESULTS: In seven outpatients the blood glucose was overestimated by the Accu Chek Active method (mean difference 68 mg/dL, p value 0.012). In seven inpatients the mean difference in the glucose was 56 mg/dL at 6am, 52 mg/dL at 11am, 52 mg/dL at 4pm, and 50 mg/dL at 9pm by the two different methods. In the four inpatients after changing their dialysate, the mean difference in the glucose was 58 mg/dL after 10 hours, 45 mg/dL after 24 hours, 24 mg/dL after 34 hours, and 26 mg/dL after 48 hours. CONCLUSION: Blood glucose was overestimated by the GDH-PQQ method and the inaccuracies were observed for more than 48 hours.
Blood Glucose ; Glucans ; Glucose ; Glucose 1-Dehydrogenase ; Hexokinase ; Humans ; Hypoglycemia ; Inpatients ; Maltose ; Oligosaccharides ; Outpatients ; Peritoneal Dialysis, Continuous Ambulatory ; Trisaccharides

PURPOSE: To report the technical effectiveness, outcome, and incidence of complications of combined clear cornea phacoemulsification with intraocular lens implantation and pars plana vitrectomy. METHODS: Single-center prospective, non-comparative, consecutive case series. Twenty-three eyes of 23 patients underwent combined clear cornea phacoemulsification and pars plana vitrectomy for various vitreoretinal disorders due to cataracts by a single surgeon between July 2003 and August 2004. Surgical feasibility, intraoperative and postoperative complications and outcome of clear cornea incisions in all combined procedure were evaluated. RESULTS: No significant adverse effect of clear corneal wound on pars plana vitrectomy procedures was noted in any of the patients. Operatively and postoperatively, no significant complications related to clear corneal wound were noted, even with the variations of pars plana vitrectomy procedures for cases with and without gas-fluid exchange and intravitreal tamponade. CONCLUSIONS: Clear corneal incisions is a safe and more reasonable alternative in combined phacoemulsification with intraocular lens implantation and pars plana vitrectomy. For a more comprehensive conclusion, a comparative study with scleral tunnel incisions may be necessary.
Incidence

PURPOSE: To investigate the visualization of cystoid macular edema (CME) using noninvasive retromode imaging by a new scanning laser ophthalmoscope (SLO) and compare to previous imaging modalities. METHODS: The authors of the present study retrospectively reviewed the medical records of 21 eyes of 20 patients with CME due to various etiologies. All eyes were examined with fundus camera, fluorescein angiography (TRC-50EX, Topcon, Tokyo, Japan), SLO (F-10, Nidek, Gamagori, Japan), and spectral-domain optical coherence tomography (OCT) (3D OCT-1000, Topcon, Tokyo, Japan). In the present study the SLO was used in the retro-mode with an infrared laser. RESULTS: Previous fundus photography could not detect CME adequately although SLO retro-mode could show numerous oval or polygonal cystoid spaces more readily. Furthermore, each individual small cystoid space could be detected and the area of each cystoid space could be measured. The area of the largest cystoid space showed a correlation with its height, as measured with OCT (R = 0.606, p = 0.004). The area of the whole foveal cystoid space showed a correlation with central macular thickness, as measured with OCT (R = 0.493, p = 0.023). CONCLUSIONS: A new commercially available SLO (F-10) in the retro-mode can allow us to detect each cystoid space non-invasively and to measure the extent of CME.
Eye ; Fluorescein Angiography ; Humans ; Macular Edema ; Medical Records ; Ophthalmoscopes ; Ophthalmoscopy ; Photography ; Retrospective Studies ; Tokyo ; Tomography, Optical Coherence

PURPOSE: To compare SLO (scanning laser ophthalmoscope) retromode images with conventional color fundus photography for the detection of drusen. METHODS: We obtained color fundus photography and SLO retromode images of the ten fellow eyes of ten patients with unilateral exudative age-related macular degeneration (AMD) and twenty eyes of 20 patients who had only drusen without exudative AMD. The numbers of druse in each image were compared within the same retinal boundary. RESULTS: In the fellow eyes of unilateral exudative AMD, an average number of 63.1 +/- 81.9 drusen in color fundus photography and an average number of 141.3 +/- 124.1 drusen in SLO retromode images were detected (p = 0.005). In the eyes with only drusen, an average number of 57.0 +/- 43.9 drusen in color fundus photography and an average number of 112.2 +/- 82.0 drusen in SLO retromode images were detected (p = 0.000). In the presence of media opacity like cataract, drusen were better detected in SLO retromode images than they were in color fundus photography. CONCLUSIONS: About twice as many drusen were detected in SLO retromode images than in color fundus photography. Drusen were also better detected in SLO retromode images in cases of media opacity. SLO retromode images might provide more sensitive images for the detection of drusen than does color fundus photography.
Cataract ; Eye ; Humans ; Macular Degeneration ; Photography ; Retinaldehyde

Patellofemoral joint problems refer to a spectrum of conditions affecting the patellofemoral joint, which is the joint between the patella and femur. These conditions can cause pain and instability in the knee and affect an individual’s ability to perform daily activities. Patellofemoral joint problems commonly cause knee pain, particularly among young athletes and physically active individuals. This review article discusses current patellofemoral joint problems, including their epidemiology, pathophysiology, diagnosis, and management.Current Concepts: Patellofemoral joint problems are presented as clinical symptoms of pain and instability. Dividing the diagnostic criteria into anterior knee pain, patella instability, and patellofemoral arthritis is useful. Anterior knee pain is diagnosed after excluding possible causes. Patellar instability is classified into recurrent dislocation, habitual dislocation (extension and flexion types), and permanent dislocation. Moreover, patellar instability can progress to the final stage of patellofemoral arthritis. Thus, patellar instability should be treated according to the Dejour criterion, and patellofemoral arthritis treatment requires artificial joint replacement surgery.Discussion and Conclusion: The pathological mechanism of patellofemoral joint problems still needs to be properly established, and multifactorial causes make it difficult to treat patellofemoral joint problems. Accurate diagnosis is considered an essential factor for successful treatment.

Despite the frequent occurrence of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD), fungal peritonitis is uncommon and usually associated with antibiotics and immunodeficiency. Most of the fungal isolates are usually Candida albicans, Candida parapsilosis, Candida guilliermondii or Candida torulopsis. The authors report a case of fungal CAPD related peritonitis due to Candida zeylanoides that occurred in a patient with the absence of the usual risk factors for fungal peritonitis. Treatment with intravenous fluconazole was successful.
Anti-Bacterial Agents ; Candida ; Candida albicans ; Candida glabrata ; Candidiasis ; Fluconazole ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Risk Factors

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular in general practice. Their adverse renal effects have been well documented. Common NSAID-related renal side effects range from dysfunctional renal hemodynamic responses, nephrotic syndrome, electrolyte disturbances, acute interstitial nephritis, chronic interstitial nephritis with papillary necrosis, and acute flank pain syndrome to acute renal failure. Decreased prostaglandin synthesis can lead to renal ischemia and hemodynamically related acute renal failure. Cases of acute renal failure syndrome accompanied by severe loin pain after anaerobic exercise (ALPE) or binge drinking have previously been reported in individuals taking NSAIDs. However, severe flank pain after high-dose NSAID treatment in the absence of other conditions (exercise or volume contraction) is rare. We report a case of a 51-year-old man who suffered from severe pain in both flanks after NSAID treatment. Computed tomography revealed hypodense lesions in both kidneys.
Acute Kidney Injury ; Anti-Inflammatory Agents, Non-Steroidal ; Binge Drinking ; Flank Pain ; General Practice ; Hemodynamics ; Humans ; Infarction ; Ischemia ; Kidney ; Middle Aged ; Necrosis ; Nephritis, Interstitial ; Nephrotic Syndrome

Nonsteroidal anti-inflammatory drugs (NSAIDs) are popular in general practice. Their adverse renal effects have been well documented. Common NSAID-related renal side effects range from dysfunctional renal hemodynamic responses, nephrotic syndrome, electrolyte disturbances, acute interstitial nephritis, chronic interstitial nephritis with papillary necrosis, and acute flank pain syndrome to acute renal failure. Decreased prostaglandin synthesis can lead to renal ischemia and hemodynamically related acute renal failure. Cases of acute renal failure syndrome accompanied by severe loin pain after anaerobic exercise (ALPE) or binge drinking have previously been reported in individuals taking NSAIDs. However, severe flank pain after high-dose NSAID treatment in the absence of other conditions (exercise or volume contraction) is rare. We report a case of a 51-year-old man who suffered from severe pain in both flanks after NSAID treatment. Computed tomography revealed hypodense lesions in both kidneys.
Acute Kidney Injury ; Anti-Inflammatory Agents, Non-Steroidal ; Binge Drinking ; Flank Pain ; General Practice ; Hemodynamics ; Humans ; Infarction ; Ischemia ; Kidney ; Middle Aged ; Necrosis ; Nephritis, Interstitial ; Nephrotic Syndrome