Τρίτη 28 Αυγούστου 2018

Prenatal diagnosis and implications of microphthalmia and anophthalmia with a review of current ultrasound guidelines: two case reports

Microphthalmia and anophthalmia are rare congenital fetal abnormalities. The combined incidence is estimated at 1 in 10,000 births. These two conditions arise from complex and incompletely understood genetic a...

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Ankylosing spondylitis, chronic fatigue and depression improved after stromal vascular fraction treatment for osteoarthritis: a case report

Osteoarthritis is a prevalent chronic disease that impacts quality of life and imposes a heavy economic burden. Despite this there is no confirmed treatment that could prevent progressive destruction of osteoa...

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BrightOcular® Cosmetic Iris Implant: A Spectrum from Tolerability to Severe Morbidity

Purpose: The BrightOcular® implants are the newest model of cosmetic iris devices that are currently advertised as safe. The previous generation known as NewColorIris® have had severe ocular side effects and were subsequently withdrawn from the market. There is little literature on the safety profile of BrightOcular® implants. Case Report: Herein we describe two cases with varying degrees of ocular tolerability. The first case had a normal ocular exam 1 year after implantation, whereas the second case had unilateral severe corneal edema requiring explantation of the iris device and Descemet membrane endothelial keratoplasty 9 months after bilateral implantation. Conclusions: These two cases attest to the unpredictability of the results of these cosmetic surgeries. Patients should be counseled about the vision-threatening complications of iris implants.
Case Rep Ophthalmol 2018;9:395–400

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A Case of Focal Choroidal Excavation Development Associated with Multiple Evanescent White Dot Syndrome

Focal choroidal excavation (FCE) is described as an excavated lesion of the choroid that can be detected by optical coherence tomography (OCT). While the exact pathogenesis of FCE remains unclear, it has been proposed in some cases that there is an association with the inflammation in the outer retina. We present a case of FCE development that was detected by spectral domain OCT (SD-OCT) and found to be associated with multiple evanescent white dot syndrome (MEWDS). A 40-year-old Japanese woman was diagnosed with MEWDS based on multiple white dots observed from the posterior pole to the midperiphery, along with yellow granularity in the fovea. SD-OCT revealed separation between the retinal pigment epithelium (RPE) and Bruch's membrane (BM) and discontinuations of the ellipsoid zone, RPE, and BM. At 4 weeks after onset, several of the white dots disappeared, the yellow granularity in the fovea became small, and we detected nonconforming choroidal excavation under the central fovea. The choroidal excavation gradually deepened and changed to a conforming pattern. These findings suggest that the degree of the impairment caused by inflammation and the plasticity of the BM and RPE complex may be associated with different types of acquired FCE.
Case Rep Ophthalmol 2018;9:388–394

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VV-ECMO during subsequent segmentectomy after right pneumonectomy

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Abstract
Several reports have described subsequent pulmonary surgery after pneumonectomy. We herein report the case of an 82-year-old woman with metachronous multiple lung cancer who had undergone surgery for adenocarcinoma of the right upper lobe 17 years earlier. Completion pneumonectomy had been performed for residual lung adenocarcinoma 11 years before the presentation in question. The patient was elderly and had a poor pulmonary function, although her performance status and her cardiac function were good. Therefore, we decided to improve the safety of surgery with venovenous extracorporeal membrane oxygenation (VV-ECMO). Segmentectomy of S6 + S10a was performed under VV-ECMO support. The 30 months after surgery, the patient has had no complications but continues home oxygen therapy. Imaging has shown no evidence of recurrence.

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Traumatic Epiglottitis following a Blind Insertion of the Hand during Convulsion

Traditionally, it has been recommended that first-responders should place chopsticks or their hand in a child's mouth to prevent the child from biting their tongue during convulsion. The practice persists locally in parts of Japan and can cause adverse events. We report a traumatic epiglottitis following the thrusting of a guardians' hand into a 13-month-old girl's mouth to prevent her from biting her tongue.

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