PURPOSE: To report a case of corneal edema caused by an iatrogenic lidocaine injection into the corneal stroma created while performing a local anesthetic (lidocaine) injection into the eyelid for a blepharoplasty procedure. CASE SUMMARY: A 15-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection in the upper blepharon for a blepharoplasty procedure. At the first clinical visit, visual acuity was hand motion and an accurate anterior chamber examination was difficult because of corneal edema. The Seidel test was negative. On corneal optical coherence tomography, the corneal thickness was 1,580 µm without any sign of Descemet's membrane detachment. We prescribed 5% NaCl four times a day and prednisolone acetate eight times a day. On the next day after injury, the corneal edema was significantly improved (central corneal thickness: 660 µm), and Descemet's membrane detachment was still not observed. One week after injury, the naïve visual acuity was 20/20, the central corneal thickness was 560 µm, and the endothelial cell count was 3,260 cells/cm². Three weeks after injury, the corneal edema was fully resolved and only slight temporal corneal haziness remained. After 2 months, the cornea was clear without any subjective discomfort. CONCLUSIONS: Corneal edema without Descemet's membrane detachment can be resolved spontaneously without aggressive treatment such as gas or air injection. However, endothelial cell count and corneal opacity need to be monitored on follow up exam. This clinical experience suggests that severe corneal edema in anterior stromal layer could be spontaneously resolved without severe complication.
Adolescent ; Anesthesia, Local ; Anterior Chamber ; Blepharoplasty ; Cornea ; Corneal Edema ; Corneal Opacity ; Corneal Stroma ; Descemet Membrane ; Edema ; Endothelial Cells ; Eyelids ; Female ; Follow-Up Studies ; Hand ; Humans ; Lidocaine ; Prednisolone ; Tomography, Optical Coherence ; Visual Acuity

OBJECTIVES: Hyposexuality is defined as diminished sexual drive or libido. There has been little research into the sexuality in patients with obstructive sleep apnea (OSA). We investigated the prevalence and relating factors for hyposexuality in OSA men. METHODS: Consecutive 182 male (mean age 48.3 y) were enrolled who were newly diagnosed with OSA through polysomnography. All completed Symptom checklist-90-Revised (SCL-90-R), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subjects were divided into non-hyposexuality (score 0) and hyposexuality (score > or =1) groups according to the question "Loss of sexual interest or pleasure" in SCL-90-R. RESULTS: 110 of 182 subjects (60.4%) answered hyposexuality (score > or =1). Significant correlations were found between hyposexuality and following factors; age (rho=0.248), BDI (rho=0.450), BAI (rho=0.410), ESS (rho=0.221), and percentage of non-REM stage 3 (N3%) (rho=-0.184). Apnea-hypopnea index was significantly correlated with nocturia (rho=0.320), ESS (r=0.230), N1% (r=0.596), N2% (r=-0.540), N3% (r=-0.195), and lowest oxygen saturation (r=-0.641). Comparing two groups, hyposexuality group showed significantly lowered total sleep time (380.2 min vs. 359.1 min), and sleep efficiency (83% vs. 76%). The severity of hyposexuality was correlated with BDI (rho=0.330), BAI (rho=0.253), and N3% (rho=-0.215) in subjects with hyposexuality. After controlling for age, polysomnographic parameters were not correlated with hyposexuality. CONCLUSIONS: About half of untreated OSA male subjects reported diminished libido. Age, daytime sleepiness, mood disorders, and decreased sleep quality were associated with hyposexuality. Of these, aging process was the most important factor for hyposexuality.
Aging ; Anxiety ; Depression ; Humans ; Libido ; Male ; Mood Disorders ; Nocturia ; Oxygen ; Polysomnography ; Prevalence ; Sexuality ; Sleep Apnea, Obstructive*

Purpose: We evaluated the 3-month, postoperative clinical outcomes of patients implanted with refractive, aspheric, bifocal, Lentis Comfort (LS313-MF15, Oculentis) intraocular lenses (IOLs). Methods: Eighty-two eyes of 51 cataract patients underwent phacoemulsification and were implanted with LentisComfort IOLs. The uncorrected distant visual acuity (UCDVA), the 80-cm uncorrected intermediate visual acuity (UCIVA), the 40-cm uncorrected near visual acuity (UCNVA), and refractive values were evaluated 1 and 3 months postoperatively. At the latter time, defocus curves were drawn, contrast sensitivity tested, and satisfaction surveyed. Results: At the 3-month postoperative follow-up, the mean spherical equivalent was -0.12 ± 0.21 D; and the mean LogMAR UCDVA, 80-cm UCIVA, and 40-cm UCNVA were 0.02 ± 0.03, 0.13 ± 0.07, and 0.42 ± 0.10 respectively. The defocus curves revealed visual acuities in excess of 0.2 LogMAR at points between the distant and intermediate targets. The mean contrast sensitivity fell in the range of 90% of a normal population under both photopic and mesopic conditions. In terms of satisfaction, 71.8% of patients were satisfied or very satisfied, but about 20% reported dysphotopsia. Conclusions Implantation of the refractive, aspheric, bifocal, intraocular, LentisComfort in patients with cataracts improved both the distant and intermediate visual acuities by 3 months after surgery and the visual quality was comparable to that afforded by other IOLs both objectively and subjectively.

Retinotomy, cutting of the retina, can be helpful in hte management of giant retinal tears, subretinal strands, and retinal incarceration. Relaxing retinotomies are used in the presence of retinal shortening or fibrous proliferation and contraction, and usually performed in the peripheral or equatorial retina. To fascilitate retinal attachment, the authors used intraocular scissors to perform radial retinotomy in the macula of two patients during vitrectomy surgery. We obtained a successful result using retinotomy in the macula as an adjunct to repair of retinal detachment with macular hole formation.
Humans ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Vitrectomy

No abstract available.
Chilblains*

No abstract available.
Humans

No abstract available.
Humans

Xanthogranuloma (XG) is a benign self-healing disorder that's characterized by multiple yellowish papulonodular lesions of the skin and other visceral organs. It appears within the first year of life in approximately 80 percent of the cases and it disappears spontaneously within 3 to 6 years. Adult XG clinically differs from juvenile XG in that the adult lesion is usually solitary, it generally does not involve internal organs and it does not resolve spontaneously. Multiple adult XG is classified as the presence of more than 5 XG lesions. A review of the literature shows that its disseminated form is exceptional, and only a few cases have been reported so far. We herein report on an atypical case ofadult XG with numerous papulonodular lesions.
Adult ; Humans ; Skin

Dendritic cells (DCs) play a critical role in various immune responses involving CD4 T cells and have been used to generate anti-tumor immunity. Chemotherapy induces severe side effects including immunosuppression in patients with cancer. Although immunosuppression has been studied, the effects of anticancer drugs on DCs are not fully determined. In this study, we demonstrated that CD40 activation strongly protected DCs from 5-fluorouracil (5-FU) or mitomycin C-induced apoptosis. DC- specific surface markers, including CD11c and major histocompatibility complex (MHC) class II, were used for identifying DCs. CD 40 activation with anti-CD40 mAb significantly enhanced the viability of DCs treated with 5-FU or mitomycin C, assayed by MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide). Fluorescence staining and analysis clearly confirmed the enhancing effect of anti-CD40 mAb on the viability of DCs, suggesting that CD40 activation may transduce critical signals for the viability of DCs. Annexin V staining assay showed that CD40 significantly protected DCs from 5-FU or mitomycin C-induced apoptosis. Taken together, this study shows that CD40 activation with anti-CD40 mAb has strong anti-apoptosis effect on DCs, suggesting that CD40 activation may overcome the immunosuppression, especially downregulation of number and function of DCs in chemotherapy- treated cancer patients.
Annexin A5 ; Apoptosis* ; Dendritic Cells* ; Down-Regulation ; Drug Therapy ; Fluorescence ; Fluorouracil ; Humans ; Immunosuppression ; Major Histocompatibility Complex ; Mitomycin ; T-Lymphocytes

Hyperglycemic state frequently presents with neurologic manifestations including choreoathetosis, ballismus, dysphagia, seizures, and coma. Also, hyperglycemic hemianopia has been rarely reported to cause temporary damage to the visual cortex, resulting in homonymous hemianopia. A 65-year-old man was admitted because of right homonymous hemianopia accompanied by hyperglycemia. Brain single-photon emission computed tomography showed focal hyperperfusion in the left occipital lobe. Herein we report a case of reversible homonymous hemianopia with cerebral hyperperfusion associated hyperglycemia without seizure.