Purpose: To report a case of nutritional optic neuropathy due to folic acid deficiency and who recoverd from oral supplementation with folic acid.Case summary: A 45-year-old man was referred to our hospital because of visual disturbance and color vision on the both eye without pain. There were no abnormal findings in the anterior segment and retina. An afferent pupillary defect was found in the left eye. Visual field examination showed central scotoma in both eyes and total color blindness on Hahn color vision test. The patient had a history of chronic alcoholism and had not eaten often recently. The folic acid level was decreased in the blood and after oral folic acid supplementation, visual acuity and visual field recovered after 6 weeks. Conclusions We report a new case of nutritional optic neuropathy due to folic acid deficiency and who recovered from oral supplementation with folic acid.

Purpose: To evaluate the surgical outcomes of microincision pars plana vitrectomy (PPV) and intravitreal torsional phacoemulsification in eyes with dropped nuclear fragments following complicated cataract surgery. Methods: A retrospective analysis of 22 eyes of 22 patients who underwent microincison PPV for lens fragments dropped into the vitreous cavity during cataract surgery between January 2014 and December 2017 with a minimum 6-month follow-up was performed. Pre- and postoperative visual acuity, and intra- and postoperative complications (retinal detachment, retinal tear, cystoid macular edema, and thermal burns of the sclerotomy site) were recorded. Results: The study included 17 males and 5 females. The mean age of patients was 71.3 ± 8.2 years. The mean interval between cataract surgery and PPV was 0.4 ± 0.8 days, and all PPV procedures were performed within 3 days after cataract surgery. The mean best-corrected visual acuity (LogMAR) was 1.37 ± 0.79 in the preoperative state, which improved significantly to 0.21 ± 0.15 in the postoperative state (p < 0.001). No complication such as thermal burns of the sclerotomy site and retinal damage due to lens fragments occurred during intravitreal torsional phacoemulsification. Postoperative cystoid macular edema occurred in two eyes, which was managed medically. No retinal detachment was noted. Conclusions Microincision PPV and intravitreal phacoemulsification using a torsional phacoemulsification probe for lens fragments dropped into the vitreous cavity during cataract surgery was a safe and effective method, which resulted in visual improvement without any complication directly attributable to the probe.

Purpose: To report a case of nutritional optic neuropathy due to folic acid deficiency and who recoverd from oral supplementation with folic acid.Case summary: A 45-year-old man was referred to our hospital because of visual disturbance and color vision on the both eye without pain. There were no abnormal findings in the anterior segment and retina. An afferent pupillary defect was found in the left eye. Visual field examination showed central scotoma in both eyes and total color blindness on Hahn color vision test. The patient had a history of chronic alcoholism and had not eaten often recently. The folic acid level was decreased in the blood and after oral folic acid supplementation, visual acuity and visual field recovered after 6 weeks. Conclusions We report a new case of nutritional optic neuropathy due to folic acid deficiency and who recovered from oral supplementation with folic acid.

PURPOSE: To report a case of bilateral corneal opacities and rare spinal muscular atrophy type III (Kugelberg-Welander disease) in a galactokinase-deficiency patient.CASE SUMMARY: A 6-year-old female presented with bilateral ground glass-like superficial stromal corneal opacities in the corneal center. The patient exhibited developmental motor delay. On muscle biopsy, skeletal muscle neurogenic atrophy consistent with spinal muscular atrophy type III, i.e., Kugelberg-Welander disease, was diagnosed, as well as galactokinase deficiency. On genetic examination, mutation analysis showed an A198V mutation of galactokinase in chromosome 17q24 (“Osaka” variant). CONCLUSIONS Bilateral corneal opacities and spinal muscular atrophy type III was found in a galactokinase-deficiency patient.

PURPOSE: We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR). METHODS: We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes). RESULTS: The PCA ratios of the study group were 0.52 ± 0.11 before PE, 0.43 ± 0.12 after PE, and 0.51 ± 0.11 after PPV, respectively. Changes in pupil size were significant (p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were 0.52 ± 0.10 before PE, 0.39 ± 0.15 after PE, and 0.43 ± 0.15 after PPV, respectively. Changes in pupil size after PE were significant (p = 0.011) but the change after PPV was not (p = 0.056). CONCLUSIONS: Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.
Cornea ; Diabetic Retinopathy ; Epinephrine ; Humans ; Mydriatics ; Passive Cutaneous Anaphylaxis ; Phacoemulsification ; Pupil ; Vitrectomy

Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.
Burns ; Dental Clinics ; Facial Pain ; Humans ; Male ; Mandibular Nerve ; Pain Clinics ; Temporomandibular Joint Disorders ; Trigeminal Neuralgia

The hallucal interphalangeal sesamoid bone is usually asymptomatic, but it is not uncommon for it to be symptomatic in cases of undue pressure, overuse, or trauma. Even in symptomatic cases, however, patients often suffer for extended periods due to misdiagnosis, resulting in depression and anxiety that can steadily worsen to the extent that symptoms are sometimes mistaken for a somatoform disorder. Dynamic ultrasound-guided evaluations can be an effective means of detecting symptomatic sesamoid bones, and a simple injection of a small dose of local anesthetics mixed with steroids is an easily performed and effective treatment option in cases, for example, of tenosynovitis.
Anesthetics, Local ; Anxiety ; Depression ; Diagnostic Errors ; Humans ; Sesamoid Bones ; Somatoform Disorders ; Steroids ; Tenosynovitis

Right atrial aneurysm is an extremity rare congenital heart defect. We report a case which was diagnosed during the early fetal stage and operated on in a 2 week old neonate. Following median sternotomy, aneurysmectomy was performed under a cardiopulmonary bypass. Histopathological examination of the resected atiral tissue showed a lipotomatous degeneration and reduction of the muscular elements. There were no postoperative complications.
Aneurysm ; Cardiopulmonary Bypass ; Extremities ; Heart Aneurysm ; Heart Atria ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Postoperative Complications ; Sternotomy

INTRODUCTION: Studies evaluating rats and mice have provided convincing evidence that renal adenoma and carcinoma are induced by oral doses of lead acetate and lead subacetate, as well as by parenteral doses of lead phosphate. In addition, at least 2 cases of kidney cancer associated with heavy exposure to lead have been reported. However, there is still not enough information to confirm or rule out an association between kidney cancer and exposure to lead. CASE REPORT: In this study, we describe a case of kidney cancer in 54-year-old male worker that was exposed to lead-stearate while employed in the polyvinyl chloride processing industry for 17 years. The patient presented with gout and hypertension. Further examination revealed proteinuria, glucose in the urine and elevated blood urea nitrogen/creatinine levels. Renal ultrasonography, renal computed tomography and renal biopsy revealed chronic renal failure and renal cell cancer. CONCLUSION: We concluded that the gout and chronic renal failure in this case was caused by chronic lead exposure. However, further study is required to determine if the renal cancer was induced by lead exposure.
Adenoma ; Animals ; Biopsy ; Glucose ; Gout ; Humans ; Hypertension ; Kidney Failure, Chronic ; Kidney Neoplasms ; Lead ; Lead Poisoning ; Male ; Mice ; Middle Aged ; Occupational Diseases ; Organometallic Compounds ; Polyvinyl Chloride ; Proteinuria ; Rats ; Renal Insufficiency ; Urea

OBJECTIVE: This study was performed to investigate the association between work ability and job stress factors in three manufacturing industries. METHODS: The data were gathered from 705 workers of 3 manufacturing industries, from August 2007 to January 2008. A structured, self-reported questionnaire was used to access the demographic, socioeconomic and work related characteristics. Work ability and job stress factors were determined using two questionnaires: the work ability index (WAI) of the Finnish Institute of Occupational Health and the Korean Occupational Stress Scale (KOSS), respectively. RESULTS: According to the logistic regression analysis results, WAI was related to job stress factors after adjustment for age, shift work, employment type and exercise. Of the eight subscales, job demand, interpersonal conflict, lack of reward, occupational climate and total score were significantly associated with WAI. In the analysis of each factory, interpersonal conflict, job insecurity and lack of reward were significantly associated with WAI in factory II, and organizational system, lack of reward and total score in factory III, but there was no significant association in factory I. CONCLUSIONS: Job stress factors were significantly associated with WAI in two of the three manufacturing industries. Further and more detailed study needs to be conducted to reduce the job stress and improve the work ability.
Climate ; Employment ; Logistic Models ; Occupational Health ; Questionnaires ; Reward