Complete Resolution of an Alveolar Echinococcosis Liver Lesion Following Percutaneous Treatment

Herein we present a 63-year-old male patient with a solid hepatic alveolar echinococcosis diagnosed by surgical biopsy. His liver lesion, which was infected, was drained by percutaneous catheterization. The lesion surprisingly disappeared completely after the treatment. The patient was followed-up without any symptoms for 20 months after the drainage. As alveolar echinococcosis of the liver behaves like a slow-growing liver cancer, the disappearance of our patient’s lesion was a very unusual and rare outcome, which, to the best of our knowledge, has never been published in the literature.     

Regression of conjunctival tumor during dietary treatment of celiac disease

A 3-year-old girl presented with a hemorrhagic conjunctival lesion in the right eye. The medical history revealed premature cessation of breast feeding, intolerance to the ingestion of baby foods, anorexia, and abdominal distention. Prior to her referral, endoscopic small intestinal biopsy had been carried out under general anesthesia with a possible diagnosis of Celiac Disease (CD). Her parents did not want their child to undergo general anesthesia for the second time for the excisional biopsy. We decided to follow the patient until all systemic investigations were concluded. In evaluation, the case was diagnosed with CD and the conjunctival tumor showed complete regression during gluten-free dietary treatment. The clinical fleshy appearance of the lesion with spider-like vascular extensions and subconjunctival hemorrhagic spots, possible association with an acquired immune system dysfunction due to CD, and spontaneous regression by a gluten-free diet led us to make a presumed diagnosis of conjunctival Kaposi sarcoma.     

Nocturnal enuresis in sickle cell disease and thalassemia major: associated factors in a clinical sample

In this study, we aimed to investigate the prevalence and associated factors of nocturnal enuresis in sickle cell disease (SCD) and thalassemia major (TM) patients in a single center from Turkey. One hundred and six patients, 51 (48.1 %) with TM and 55 (51.9 %) with SCD, and 80 age-matched healthy controls were included in the study. Semi-structured interviews were conducted with the caregivers of pediatric and adult patients. The interview included questions on nocturnal enuresis and psychosocial variables. Patients’ hospital files were reviewed to search for disease-related factors. Twenty-eight of the patients (26.4 %) and three (3.7 %) of the controls had nocturnal enuresis. Younger age, TM diagnosis, family history of nocturnal enuresis and family problems were found to be more frequent in patients with nocturnal enuresis. Among the patients with SCD, frequencies of hospitalization and painful crises were found to be higher in those with enuresis. According to the binary logistic regression analysis, diagnosis of TM (p = 0.031, OR = 0.262) and younger age (p = 0.005, OR = 0.869) were found to be independent risk factors for nocturnal enuresis in the patient group. Nocturnal enuresis is a common problem in children and young adults with TM and SCD. Associated factors in both conditions will be clarified with future studies.     

Congenital mesenchymal chondrosarcoma of the orbit: case report and review of the literature

PURPOSE: To report the first case of congenital extraskeletal mesenchymal chondrosarcoma arising in the orbit. DESIGN: Interventional case report and review of the literature. METHODS: Ophthalmologic examination and computed tomography scan of the orbit were performed. Histologic and histochemical examination and immunohistochemistry of the biopsy specimen were evaluated. MAIN OUTCOME MEASURES: Ocular and systemic disease control. RESULTS: A 5-month-old girl was seen with a papillomatous lesion in the right lower tarsal conjunctiva present from birth. Histologic examination demonstrated an admixture of undifferentiated mesenchymal cells and islands of mature hyaline cartilage, and immunohistochemistry studies revealing positivity for vimentin and S-100 were consistent with the diagnosis of mesenchymal chondrosarcoma. The patient was treated with combined chemotherapy (ifosfamide, epirubicin, and cisplatin), radiotherapy, and surgery (exenteration). She is alive with no evidence of disease after 4 years of follow-up. Facial asymmetry and dental malformations have developed as late effects. Further reconstructive surgery is planned for the malformations. CONCLUSIONS: Extraskeletal mesenchymal chondrosarcoma in the orbit is extremely rare. This study reports the first case of congenital extraskeletal mesenchymal chondrosarcoma arising in the orbit (also the youngest patient) both in skeletal and extraskeletal sites. Multimodality treatment (surgery, chemotherapy, and radiotherapy) may lead to long-term survival.     

The antibacterial effect of topical anesthetic proparacaine on conjunctival flora

Purpose: To investigate the antibacterial effect of topical anesthetic proparacaine on conjunctival flora.Methods: One hundred and forty-four eyes of 72 patientsawaiting cataract surgery were included in the study. A commercially available solution of proparacaine, preserved with benzalkonium chloride 0.01%, was instilled in one eye of all subjects while the vehicle solution, including the same concentration of preservative in aqueous solution, was administered to the other eye. Conjunctival cultures were taken from all eyes before and 15 minutes after the instillation of proparacaine and the vehicle.Results: Of the 144 eyes, 76 (52.8%) had positive-conjunctival cultures with the most commonly isolated organisms being coagulase-negative staphylococci in each group. Of the 76 culture-positive eyes, 40 (52.6%) received proparacaine and 36 (47.4%) the vehicle preparation. Fifteen minutes after the instillation of proparacaine and the vehicle eyedrops, four eyes (10%) and 12 eyes (33.3%) had culture-positive conjunctival smears, respectively. Proparacaine significantly reduced the number of culture-positive eyes (p = 0.0003), in contrast to the vehicle (p = 0.21).Conclusion: A topicalanesthetic, proparacaine, demonstrates antibacterial effects on the conjunctival flora.