No abstract available.
Alzheimer Disease* ; Animals ; Cerebral Amyloid Angiopathy* ; Mice*

The symptom of crocodile tears refers to an abnormal gusto-lacrimal reflex whereby any stimulus causing parotid secretion also induces lacrimation. It is a sequelae lesion of facial nerve, usually after the facial paralysis. The authors found the symptom of crocodile tears in one case after facial paralysis due to herpes zoster oticus and two cases after Bell's palsy.
Alligators and Crocodiles* ; Bell Palsy ; Facial Nerve ; Facial Paralysis* ; Herpes Zoster Oticus ; Reflex ; Tears*

PURPOSE: To report a case of chemical injury of the cornea caused by high-dose ethanol during orbital wall fracture repair. CASE SUMMARY: A 56-year-old male presented with pain after blowout fracture repair surgery. During the surgery, 2% hexethanol solution (2% chlorhexidine and 72% ethanol mixture), which was used for disinfection of the face, flowed into the left eye. Conjunctival injection in the left limbus, a large corneal epithelial defect, and severe stromal edema were subsequently observed. The patient was treated with topical antibiotics, steroids, and autologous serum eye drops. After 1 week, the corneal epithelial defect was improved, but at the second month of therapy, recurrent corneal erosion with deterioration of the endothelial cell function occurred. Anterior stromal puncture and laser keratectomy were performed. The corneal epithelial defect and erosion improved, but the endothelial cell density was severely decreased. CONCLUSIONS: The 2% hexethanol solution is usually used for preoperative skin disinfection, but it contains a high concentration of ethanol. The surgeon should be aware that high concentrations of ethanol may result in severe corneal damage, including corneal endothelial dysfunction and limbal cell deficiency.
Anti-Bacterial Agents ; Chlorhexidine ; Cornea ; Corneal Injuries ; Corneal Surgery, Laser ; Disinfection ; Edema ; Endothelial Cells ; Ethanol ; Humans ; Male ; Middle Aged ; Ophthalmic Solutions ; Orbit ; Punctures ; Skin ; Steroids

Purpose: We evaluated the efficacy and safety of a 0.05% cyclosporine ophthalmic nanoemulsion and a 0.1% cyclosporine ophthalmic cationic emulsion in patients with moderate-to-severe dry-eye syndrome. Methods: This was a multi-center, double-blinded, comparative, prospective, randomized clinical trial. Three ophthalmological institutions enrolled a total of 105 patients with moderate-to-severe dry eye who were randomly assigned to a 0.05% cyclosporine nanoemulsion group (the test group) and a 0.1% cyclosporine cationic emulsion group (the control group). The corneal staining scores were obtained, and the tear film breakup time (TBUT) and Schirmer test performed, at the initial visit and after 1 and 3 months of eyedrop use. The safety results were compared by recording discomfort and compliance during drug instillation. Results: The corneal staining scores and the TBUT and Schirmer test results showed that both groups showed significant improvements. The corneal staining scores significantly (and similarly) decreased in both groups. In the test group, the TBUT showed significant prolongation after 1 month of treatment and the Schirmer test score increased significantly after 3 months. Both groups reported less ocular discomfort and better compliance with drug use at 3 months than 1 month; the control group demonstrated a significant decrease in ocular discomfort at 3 months. Conclusions Both drugs improved the dry eye symptom index and relieved eye discomfort. No patient complained of serious discomfort or side-effects. The drugs were equivalent in terms of efficacy and safety.

Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used to detect and characterize focal hepatic lesions. Because gadoxetic acid is a hepatocytespecific contrast agent, its patterns during hepatobiliary phase enhancement provide useful information for differential diagnoses of focal hepatic lesions. Hepatic angiomyolipoma (AML) is a rare mesenchymal hepatic neoplasm composed of blood vessels, epithelioid cells, and varying amounts of adipose tissue components. Hepatic AMLs usually show marked hypointensity during the hepatobiliary phase of gadoxetic acid-enhanced MRI as hepatic AMLs are devoid of hepatocytes and fibrotic components. The present study describes a patient with hepatic AML and an atypical imaging feature. This tumor showed hyperintensity during the hepatobiliary phase of gadoxetic acid-enhanced MRI, mimicking hepatocellular tumors such as hepatocellular adenoma. The hepatobiliary hyperintensity of this lesion was likely due to multifocal entrapped hepatocytes resulting from an intrasinusoidal growth pattern of tumor cells and insufficient hepatic parenchymal enhancement during the hepatobiliary phase of gadoxetic acid-enhanced MRI.

No abstract available.
Arthritis, Rheumatoid ; Corneal Ulcer ; Humans ; Ulcer

PURPOSE: To report brain metastasis of hepatocellular carcinoma presenting as homonymous hemianopia. CASE SUMMARY: A 51-year-old female with a history of hepatectomy and diagnosis of hepatocellular carcinoma (HCC) 19 months earlier was referred to our neuro-ophthalmology clinic for evaluation due to headache and decreased visual acuity over the past several months. Best visual acuity was 20/20, and the results of all other aspects of our examination were normal except Humphrey automatic perimetry, which showed complete left homonymous hemianopia. Brain magnetic resonance imaging showed a large mass in the right occipital lobe. Craniotomy and removal of tumor were performed. HCC was confirmed by histopathologic examination. CONCLUSIONS: Metastasis of hepatocellular carcinoma to the occipital lobe is extremely rare but can present as homonymous hemianopia. Therefore, clinicians should be aware of this when examining a patient with a history of HCC.
Brain ; Brain Neoplasms ; Carcinoma, Hepatocellular* ; Craniotomy ; Diagnosis ; Female ; Headache ; Hemianopsia* ; Hepatectomy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Occipital Lobe* ; Visual Acuity ; Visual Field Tests

PURPOSE: We wanted to introduce a nail lengthening technique with an eponychial flap for treating finger tip amputation, and we review the relevant literature. MATERIALS AND METHODS: Twenty-five patients who received eponychial flap surgery between November 2001 and April 2006 were enrolled in this study. Retrospectively, the patients were asked, by using a questionnaire, about their satisfaction with their nail shape and length. The preoperative findings and the findings at the last follow up and the contralateral finger nail lengths were measured with a ruler and those were all compared according to the percentage of change. RESULTS: The average operation time was fourteen minutes (range: 10 to 19 minutes). All the flaps survived and there was no infection, congestion of the flap, or additional deformity of nail. The average follow up period was five months. The nails were lengthened an average of 0.35 cm. The last follow up questionnaire showed that the patients were satisfied with their nail's appearance with an average score of 95.5 points. CONCLUSION: Nail lengthening using an eponychial flap is a convenient, safe and aestheticall pleasing procedure.
Amputation ; Congenital Abnormalities ; Estrogens, Conjugated (USP) ; Fingers ; Follow-Up Studies ; Humans ; Nails ; Surveys and Questionnaires ; Retrospective Studies

PURPOSE: We report an unusual case of presumptive diagnosis of herpes-induced anterior uveitis with acute hypopyon after trauma. CASE SUMMARY: A 82-year-old male was diagnosed with herpes keratitis due to dendritic keratitis in the left eye, and the lesion disappeared after antiviral treatment. However, 1 year later, the patient visited again with visual loss, pain, and tearing of the left eye after trauma. At the examination, best-corrected visual acuity was counting fingers and the intraocular pressure was 27 mmHg in the left eye. Slit-lamp examination revealed corneal epithelial erosion, moderate corneal edema, and prominent inflammation with 2 mm high hypopyon in the anterior chamber. We thought that bacterial endophthalmitis had rapidly progressed after trauma, so we performed bacterial cultures and an intravitreal antibiotics injection. Considering the clinical manifestations of lesions and herpes keratitis in the past, we could not exclude herpes virus infection. Cultures were negative and the symptoms improved, so the antiviral treatment was gradually reduced and stopped at 2 months. However, recurrence was observed on day 5 after stopping antiviral therapy. We therefore assumed that recurrent herpes virus caused anterior uveitis, and then, antiviral and steroid therapy was resumed. The patient subsequently showed improvement in his symptoms and recovered his visual acuity. CONCLUSIONS: When acute hypopyon is observed in the anterior chamber after trauma, not only bacterial iritis and endophthalmitis but also viral-induced anterior uveitis should be considered in the differential diagnosis.
Aged, 80 and over ; Anterior Chamber ; Anti-Bacterial Agents ; Corneal Edema ; Diagnosis ; Diagnosis, Differential ; Endophthalmitis ; Fingers ; Humans ; Inflammation ; Intraocular Pressure ; Iritis ; Keratitis ; Keratitis, Dendritic ; Male ; Recurrence ; Simplexvirus ; Tears ; Uveitis, Anterior ; Visual Acuity