Objective To investigate the clinical value of FDG PET imaging in the follow up of nasopharyngeal carcinoma after radiotherapy. Methods Twelve patients with nasopharyngeal carcinoma underwent FDG PET, CT and/or MRI during the follow up of 12 18 months after radiotherapy. The results of FDG PET were double blind evaluated and compared with these of CT and MRI. The recurrent lesions in six of these patients were pathologically confirmed and six by CT scan. Results Nine of 12 patients did not show any recurrence by CT and MRI scans. However, FDG PET scans showed significantly increased FDG metabolism, indicating recurrence in 3 of these patients. In 2 patients, both CT/MRI and FDG PET indicated recurrence. The remaining one patient had radiotherapy induced cerebral necrosis. He was misdiagnozed as an intracranial recurrence by MRI, but FDG imaging was negative. Conclusions FDG PET imaging has an advantage in distinguishing the relapse or necrosis in the follow up of post radiotherapy nasopharyngeal carcinoma patients. PET, CT and MRI is able to give a detail both in morphological and functional changes of disease. They are especially useful in the follow up or the set up of treatment planning for recurrent nasopharyngeal carcinoma.

A 1-month randomized study comparing the intraocular pressure (IOP) reducing effect of latanoprost 0.005% administered in the evening with unoprostone 0.12% given twice a day in primary open angle glaucoma and ocular hypertension was performed.A total of 27 patients were included:12 were in the latanoprost group and 15 in the unonoprostone group.Mean IOP was reduced from 27.38 mm HG with latanoprost and from 26.59 to 22.16 mm Hg with unoprostone as determined at the end of the 1-month period.No upward drift in IOP was seen with either drug during the treatment period.Thus,latanoprost 0.005% administered once daily in the evening, reduced IOP more than the unoprostone given twice daily in primary open angle glaucoma and ocular hypertension.
Human ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; GLAUCOMA ; LATANOPROST ; UNOPROSTONE

Methods: A prospective cross-sectional study was performed among Filipino patients consulting at the General Ophthalmology Clinic of the Philippine General Hospital. They underwent a comprehensive eye examination. CCT obtained by ultrasonic pachymetry and IOP by Goldmann applanation tonometry were correlated using linear regression analysis. Factors affecting CCT measurements were analyzed by ANOVA. Results: Two hundred twenty two eyes of 112 patients were included in the study. CCT ranged from 451.0 mm to 653.6 mm with a mean of 531.5 mm +/- 33.8 mm. There was a significant linear correlation between CCT and IOP (r=0.63). The IOP was noted to rise by 4.3 mm Hg/100 mm CCT. Conclusion: The CCT among Filipinos is normally distributed and is comparable to the distribution obtained by metaanalysis of worldwide data. The study also found a direct correlation between CCT and IOP among Filipinos.
Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; MANOMETRY ; TONOMETRY, OCULAR ; INTRAOCULAR PRESSURE ; GLAUCOMA

BACKGROUND: A myriad of foreign studies have shown the advantage of a pencil-point spinal needle (Whitacre) in reducing the incidence of post-ducal puncture headache (PDPH), especially in the population most at risk for PDPH - the obstetric patients. In the Philippines, there has been no data comparing the incidence of PDPH between the standard spinal needle (Quincke) and the newer Whitacre needle. This study aims to compare the incidence of spinal headache between the Quincke and the Whitacre spinal needle in Filipino obstetric patients. METHODS: A randomized double-blind study was conducted on 200 obstetric patients for elective cesarean sections under subarachnoid anesthesia using either a Quincke or a Whitacre spinal needle of the same gauge (G25). The incidence and quality of post-ducal puncture headache was compared between the two groups. Both groups were also compared in terms of ease of lumbar puncture, quality of motor block, and the incidence of postoperative complications RESULTS: The incidence of PDPH was significantly higher in the Quincke group (8 percent) as compared to the Whitacre group (1 percent). The case of insertion of the spinal needle was considered effortless (1 attempt) in 67 percent of the Quincke group and in 61 percent of the Whitacre group. Degree of motor blockade was noted to be more solid in the Whitacre group (93 percent) as compared to 83 percent in the Quincke group. There were 2 failed spinal attempts in the Quincke group and 3 in the Whitacre group for which general anesthesia was resorted to. Other postoperative complications of non-spinal headache (Quincke- 4 percent vs. Whitacre- 3 percent) and backache or back soreness as specified by the patients (Quincke 12 percent vs Whitacre 15 percent) did not differ significantly. CONCLUSION: Results imply that the G25 Whitacre needle with a conical, non-cutting bevel is an improved alternative to the G25 Quincke needle in terms of reducing the incidence and quality of postdural puncture headache in Filipino obstetric patients. The design of the spinal needle tip influences the occurrence of PDPH. (Author)
Human ; Middle Aged ; Adult ; Young Adult ; Adolescent ; OBSTETRICS ; POST-DURAL PUNCTURE HEADACHE

OBJECTIVE:To determine the current leading causes of new patient consults at the out-patient general clinic of the Department of Ophthalmology and Visual Sciences (DOVS), Sentro Oftalmologico Jose Rizal (SOJR).
METHODS: The data were gathered from the DOVS out-patient general clinic monthly census. Compilation and tabulation of the diagnoses of all new patients from January to December 2009 were done.
RESULTS: The leading causes of new patient consults were cataract (30.8%), error of refraction (20.1%), pterygium (6.1%), conjunctivitis (4.9%), dysfunctional tear syndrome (4.5%), glaucoma (4.3%), diabetic retinopathy (3.7%), and hypertensive retinopathy (3.4%).
CONCLUSION: Cataract and error of refraction comprise the majority of all causes of consultation among new patients.

Human ; Cataract ; Censuses ; Conjunctivitis ; Diabetic Retinopathy ; Glaucoma ; Hypertensive Retinopathy ; Ophthalmology ; Outpatients ; Pterygium ; Referral And Consultation ; Vision Tests

ObjectiveToinvestigatetheriskfactorsofepilepticseizuresanditseffectonclinical outcome in patients w ith cerebral venous sinus thrombosis (CVST). Methods The patients w ith CVST w ere enrol ed retrospectively. The risk factors, clinical manifestations, and imaging data w ere col ected. The data of an epileptic seizure group and a non-epileptic seizure group w ere compared. Results A total of 69 patients with CVST were enroled, including 32 (46.38%) secondary epileptic seizures. In the aspect of clinical manifestations, more patients show ed hemiplegia in the epileptic seizure group (37.50%vs.15.63%; χ2 =5.240, P=0.020). Imaging examination show ed that more patients in the epileptic seizure group presented w ith bleeding ( 29.41%vs. 10.81%; χ2 = 3.818, P= 0.047 ), more lesion involving frontal lobe (31.25%vs.10.81%; χ2 =5.008, P=0.023), and temporal lobe (43.75%vs.8.11%; χ2 =7.318, P=0.005), and the thrombosis sites w ere more common in the superior sagittal sinuses (65.63%vs.40.54%;χ2 =4.264, P=0.036). Multivariate logistic regression analysis show ed that focal neurological deficits (odds ratio 5.167, 95% confidence interval 1.993-15.764; P=0.004) and superior sagittal sinus thrombosis (odds ratio 0.126, 95% confidence interval 0.042-0.370; P=0.039) w ere the independent risk factors for patients w ith secondary epileptic seizures. There w ere no significant differences in hospital mortality (6.25%vs.2.7%; χ2 =0.512, P=0.469 ) and 90 day 90-day ful recovery rate ( defined as Barthel Index >60) (81.25%vs.86.47%; χ2 =0.346, P=0.793) betw een the epileptic seizure group and the non-epileptic seizure group. Conclusions Focal neurologic deficits and superior sagittal sinus thrombosis are the independent risk factors for secondary epileptic seizures, how ever, secondary epileptic seizures is not associ-ated w ith in-hospital mortality risk and 90-day clinical outcomes in patients w ith CVST.

Methods: A prospective, randomized, comparative study was performed involving patients undergoing trabeculectomy who were randomly assigned to either 0.2 mg/ml MMC for 4 minutes or 0.4 mg/ml for 2 minutes. The IOP, bleb characteristics, and occurrence of complications were compared. Age and gender of the patients, preoperative IOP, MMC concentration, bleb characteristics, angle status, and age of the surgery were analyzed to determine if they are predictive factors of the postoperative IOP using univariate and multivariate analyses. Results Seventy-four eyes of 68 patients underwent trabeculectomy: 36 eyes were treated with 0.2 mg/ml MMC for 4 minutes and 38 eyes with 0.4 mg/ml MMC for 2 minutes. There was no statistically significant difference in the mean preoperative IOP and postoperative IOP, as well as in the mean percent change in IOP (p = 0.87) between the 2 groups. Univariate and multivariate analyses showed the preoperative IOP (p = 0.02) and the type of filtering bleb (cystic p < 0.001; diffuse p = 0.045) as predictive factors of postoperative IOP. KaplanMeier survival curves showed no significant difference between the 2 groups at an average follow-up of 20 weeks. Conclusion: There is no significant difference in the outcomes of trabeculectomies using 0.2 mg/ml and 0.4 mg/ml MMC. Preoperative IOP and bleb characteristics are factors predictive of successful filtration surgery.
Male ; Female ; Middle Aged ; TRABECULECTOMY ; MITOMYCIN ; INTRAOCULAR PRESSURE ;

Methods: A prospective, randomized, controlled trial was performed involving patients requiring laser iridotomy who were randomized either to Nd:YAG laser or sequential argon-Nd:YAG laser iridotomy. Iris-perforation success rate, the average number of laser shots and amount of laser energy used, the intraocular pressure (IOP) after laser treatment, and the rate of complications were compared. The prelaser pupil size was correlated with the iris perforation success rate. Results: Forty-one eyes underwent laser iridotomy (23 Nd:YAG and 18 sequential). All eyes had patent iridotomies. There was no difference between the two groups in terms of the number of Nd:YAG laser shots delivered (p=0.97) and amount of Nd:YAG energy used (p=0.64). The total amount of laser energy used was higher in the sequential group (p=0.003). There was no significant difference in the IOP and complication rates after treatment. A positive correlation was seen between prelaser pupil size and number of Nd:YAG shots needed to enlarge (r=0.38, P=0.01). Conclusion: Nd:YAG laser alone and sequential argon-Nd:YAG have comparable success in attaining patency of laser iridotomy, IOP control, and rate of complications in dark irides of Filipinos.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; GLAUCOMA ; LASERS, SOLID-STATE ; NEODYMIUM ;

Objective To evaluate the cerebrovascular reserve (CVR) of patients with unilateral middle cerebral artery (MCA) steno-occlusion with single-photon emission computed tomography (SPECT) and CO2 inhalation test.Methods SPECT were performed in patients diagnosed as having unilateral MCA steno-occlusion disease in our hospital from October 2010 to March 2012.SPECT were performed in 24 unilateral MCA steno-occlusion patients before and after CO2 inhalation text.Twelve regions of interests (ROIs),6 in the right and 6 in the left,were chosen in each patient; the ratio of regional cerebral blood flow (rCBF％) of all ROIs were calculated,compared between the normal side and the steno-occlusive side,and before and after CO2 inhalation test for CVR.Results Two of 24 patients had normal CVR.And there were four types of cerebrovascular reactivity to CO2:the first,there were no differences ofrCBF％ before and after CO2 inhalation text in 121 ROIs; the sencond,rCBF％ was normal before the CO2 inhalation text and then decreased after the test in 119 ROIs; the third,rCBF％ was decreased before the CO2 inhalation text and then further decreased after the text in 12 ROIs; and the forth,rCBF％ was decreased before the CO2 inhalation text and increased after the text in 72 ROIs.Conclusion There is normal CVR in patients with unilateral middle cerebral artery steno-occlusion;there are four reactions for CVR in patients with unilateral middle cerebral artery steno-occlusive.