No abstract available.
Infectious Mononucleosis*

Lymphangiomas are congenital, benign, slowly progressive tumors of the lymphovascular system. Those located in the ocular adnexa are uncommon and may appear clinically as isolated orbital, eyelid, or conjunctival lesions, or some combination of these. The authors have experienced a case of lymphangiomas of the eyelid and conjunctiva in 8 years old male. This patient was seen with a history of a lump on the superonasal aspect of the left upper eyelid present since birth and intermittent hemorrhagic edematous swelling of the left bulbar conjunctiva beginning at the age of 4 year. The lid mass was partially excised and a biopsy of the conjunctival lesion was also undertaken. Microscopic examination of the excised tissues revealed cavernous lymphangiomas with a moderate lymphocytic infiltration. So, the authors report this case with a brief review of the literature.
Biopsy ; Child ; Conjunctiva* ; Eyelids* ; Humans ; Lymphangioma* ; Male ; Orbit ; Parturition

The macula may be displaced by retinal scarring or fibrous strands, often as a result of retrolental fibroplasia. The displacement is usually temporal and may occur bilaterally but may also be superior or inferior and unilateral after severe retinitis(Toxocara canis). Ectopic macula causes a displacement of the visual line and thus occasionally produces a large positive angle kappa that simulates exotropia. Displacement of the macula also may be congenital. Ocular toxocariasis is recognized to be an important cause of childhood blindness. It usually results as a sequela of systemic infestation with the second or third stage larva of T. canis(visceral larval migrans). The roundworm Toxocara canis is an intestinal parasite of dogs. Humans are infected accidentally by ingesting infective ova from contaminated soil. Only on rare occasions has ocular involvement been reported in visceral larva migrans. Ocular toxocariasis can assume a variety of clinical forms. The authors experienced a case of ectopic macula in presumed ocular toxocariasis which was diagnosed on the basis of the clinical appearance and a history of exposure to puppy. A review of this subject is provided, with emphasis upon pathogenesis, clinical features, diagnostic approaches and therapeutic techniques.
Animals ; Blindness ; Cicatrix ; Dogs ; Exotropia ; Humans ; Larva ; Larva Migrans, Visceral ; Ovum ; Parasites ; Retinaldehyde ; Retinopathy of Prematurity ; Soil ; Toxocara canis ; Toxocariasis*

We analyzed preoperative clinical characteristics, incidence of amblyopia, surgical results according to the type, resolution of preoperative symptoms and postoperative complications in 62 patients with intermittent exotropia, who were more than 15 years of age. The most frequent preoperative annoying symptom was eye strain from fatigue(40%), and the next one was cosmesis(23%). But, diplopia(14%) was relatively infrequent presenting complaint. Among 62 patients, 45 (72%) patients had equal vision, and 11 patients (18%) had amblyopia with two line difference between two eyes. The overall surgical success rate were seventy-seven percent. The 3 patients with postoperative esodeviation more than 5 prism diopters(PD) showed persistent uncrossed diplopia. The 4 patients with undercorrection more than 15 PD did not improve symptomatically. All patients with` postoperative exodeviation less than 15 PD had improvement or resolution of the symptoms. Our results suggest that overcorrection often resulted in unexpected diplopia in adults with intermittent exotropia. Therefore, it may be desirable to make undercorrection within 15 PD or orthotropic state in the patients more than 15 years of age.
Adult ; Amblyopia ; Diplopia ; Esotropia ; Exotropia* ; Humans ; Incidence ; Postoperative Complications

PURPOSE: We report a case of bilateral cavernous sinus thrombosis and unilateral intraorbital abscess in a patient suffering proptosis, a limitation of ocular movement, and visual disturbance. METHODS: After several days of febrile and chilling sensation, a 49-year-old man suffered from vision loss, a limitation of ocular movement in all directions, proptosis in the right eye and mild abduction limitation in the left eye. Brain MRI, indicated inflammation in the bilateral cavernous sinuses and intraorbital abscess in the right eye, leading to a diagnosis of cavernous sinus thrombosis. Systemically, the patient was treated with antibiotics and steroid injection. For intraorbital abscess, aspiration and antibiotics injection were administered locally. The patient improved overall and the abscess size decreased. Blood culture showed alpha-hemolytic Streptococcus. The Gram stain of the specimen from the intraorbital abscess revealed Gram-positive cocci but no specific strain was cultured. RESULTS: We believe that proptosis in the right eye, intraorbital abscess, limitation of ocular movement, retinal hemorrhage, and optic atrophy were due to alpha-hemolytic Streptococcus, which had spread to the cavernous sinus and right orbit through the vascular system. CONCLUSIONS: We report a case of bilateral cavernous sinus thrombosis and intraorbital abscess in the right eye in a patient who suffered from sepsis caused by alpha-hemolytic Streptococcus.
Abscess* ; Anti-Bacterial Agents ; Brain ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Diagnosis ; Exophthalmos ; Gram-Positive Cocci ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Optic Atrophy ; Orbit ; Retinal Hemorrhage ; Sensation ; Sepsis ; Streptococcus

To investigate the changes in refractive error following strabismus surgery, we stratified a total of 32 exotropic patients; 11 patients with horizontal recess/resect procedure in one eye; 11 patients with lateral rectus recession in one eye; and 10 patients with medial rectus resection in one eye. The cycloplegic refraction and corneal topography were examined prospectively in each group. We found a significant decrease in the refractive power at 180degrees meridian resulting in with the rule astigmatism in lateral rectus muscle recess group (p<0.05) and a significant decrease in the refractive power at 90degrees meridian resulting in against the rule astigmatism in medial rectus resection group in the first week after surgery (p<0.05). However, there was no statistically significant change due to mixture of the two procedures in recess/resect group. The changes in refractive power in four months after surgery gradually recovered to preoperative state in each group except 90degrees meridian in medial rectus resection group. These results indicate that the changes in refractive error in one week after strabismus surgery involved steepening of 180degrees meridian in medial rectus resection group, and flattening of 180degrees meridian in lateral rectus muscle recession group. However, there was no statistically significant change due to mixture of the two procedures in recess/resect group.
Astigmatism ; Corneal Topography ; Humans ; Prospective Studies ; Refractive Errors* ; Strabismus*

PURPOSE: To report a patient with an eyeball movement disorder due to a chondrosarcoma in the left cavernous sinus. CASE SUMMARY: A 33-year-old woman visited our clinic complaining of diplopia she hand for one month. She had been undergone two operation for the removal of chondrosarcoma in the left cavernous sinus, and she had left esotropia of 25 prism diopters in the primary position and limited abduction of approximately -1.5 in the left eye. Therefore she was treated with radiotherapy for six weeks. Three weeks after radiotherapy she had esotropia of 2 prism diopters in the primary position and limited abduction of approximately -1 in the left eye. Six weeks later, only limited abduction of approximately -0.5 in the left eye was present. CONCLUSIONS: Eyeball movement disorders, like abducent nerve palsy, may develop as a result of tumors of the cavernous sinus and may be improved by the appropriate treatment of such tumors.
Abducens Nerve ; Adult ; Cavernous Sinus ; Caves ; Chondrosarcoma ; Diplopia ; Esotropia ; Eye ; Female ; Hand ; Humans ; Movement Disorders ; Paralysis

PURPOSE: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. MATERIALS AND METHODS: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. RESULTS: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. CONCLUSION: We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
Calcium/blood ; Humans ; Hypocalcemia/*diagnosis ; Magnesium/blood ; Odds Ratio ; Parathyroid Hormone/*blood ; Phosphates/blood ; Postoperative Complications/blood/*diagnosis ; Prospective Studies ; Serum Albumin ; Thyroidectomy/*adverse effects

PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.
Age of Onset ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Prognosis ; Psychotic Disorders ; Schizophrenia* ; Suicide

Squamous cell carcinoma (SCC) of the lower lip is the most common malignant tumor, comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. After resection, reconstruction is important both aesthetically and functionally, because the lower lip is a prominent location in the face and it is where essential functions of the sphincter are carried out as in assisting mastication, swallowing, phonation, and expressing emotion. Depending on the location and size of the tumor, different types of flaps are used. We describe here a successful technique to reconstruct a large lower lip defect using a submental island flap and a mucosal flap for patients.
Carcinoma, Squamous Cell ; Deglutition ; Humans ; Lip ; Lip Neoplasms ; Mastication ; Phonation ; Surgical Flaps ; Ulcer