Latanoprost-associated recurrent herpes simplex keratitis

PURPOSE/METHOD: We present a case of a patient who developed recurrent epithelial herpes simplex keratitis after starting treatment with latanoprost. Her ophthalmic history was only remarkable for a past episode of herpetic keratitis 21 years previously. RESULTS/CONCLUSIONS: Episodes of herpetic keratitis were under remission only when latanoprost was discontinued. No recurrences of herpes simplex keratitis have been observed since then. Latanoprost usage might be associated with recurrent episodes of herpes simplex keratitis in patients with previous history of ocular herpes simplex virus infection.     

Lymphangioma. An otolaryngologic perspective

Lymphangiomas are relatively rare congenital hamartomas of the lymphatic system usually diagnosed in infancy and early childhood. Although the precise pathogenesis has not been clearly defined, abnormal development leads to formation of fluid-filled sinuses lined by vascular endothelium. In the head and neck, lymphangioma may encroach on vital structures and infiltrate surrounding tissues making complete surgical removal difficult. A number of children (n = 137) with lymphangioma have been treated at Texas Children's Hospital from 1972-1985. In 45 (33%), the tumors were diagnosed at birth and in an additional 51 (37%), by two years of age. Commonly affected areas included the head and neck (45%), trunk (26%), and axilla (17%). Mediastinal involvement occurred in 4%. Surgical removal was the preferred treatment method and with complete removal the recurrence rate was 6%; known incomplete removal increased this rate to 35%. Although lymphangiomas are slow growing, early removal was preferable: recurrences increased as the time interval between tumor identification and surgical intervention lengthened. Size fluctuation with a history of infection, another unfavorable prognostic factor, also increased recurrence rate.     

The long-term effect of specific type II 5alpha-reductase inhibition with finasteride on bone mineral density in men: results of a 4-year placebo controlled trial

PURPOSE: We determine the effect of long-term suppression of dihydrotestosterone with finasteride, a specific type II 5alpha-reductase inhibitor, on bone mineral density. MATERIALS AND METHODS: As part of a large (3,040 cases) 4-year, double-blind, placebo controlled trial designed to assess the long-term effects of finasteride in men with benign prostatic hyperplasia, 157 men 46 to 76 years old who were randomized to receive either 5 mg. finasteride or placebo underwent dual energy x-ray absorptiometry of the lumbar spine at baseline and at years 2, 3 and 4. RESULTS: Of 117 patients who had a baseline measurement and at least 1 additional measurement during the study baseline mean plus or minus standard deviation bone mineral density values were 1.12 +/- 0.17 gm./cm.2 in the finasteride group (63) and 1.10 +/- 0.17 gm./cm.2 in the placebo group (54). After 4 years bone mineral density was not different between treatment groups (finasteride 1.14 +/- 0.17 gm./cm.2 and placebo 1.13 +/- 0.18 gm./cm.2). Similar results were obtained for the 33 finasteride and 25 placebo treated patients who completed the study with year 4 bone mineral density measurements. CONCLUSIONS: These data demonstrate that long-term inhibition of type II 5alpha-reductase with finasteride does not adversely affect bone mineral density.     

Peripheral multineuritis pointing at systemic sarcoidosis

We report a patient with a peripheral neuropathy as the first symptom of sarcoidosis. The systemic illness was proved by the presence of typic granulomes in the bone marrow. The fact that sarcoidosis is the cause for the neuropathy is supported by the temporary relation and by the good response of all clinical picture to the corticosteroid therapy.Sarcoid neuropathy can rarely be the presenting feature of sarcoidosis.     

Variability of results of cavernous nerve stimulation during radical prostatectomy

PURPOSE: We assess the reliability of intraoperative cavernous nerve stimulation for producing an erectile response during radical prostatectomy. MATERIALS AND METHODS: In 61 patients cavernous nerve function was assessed during radical retropubic prostatectomy using a CaverMap nerve stimulator. Control stimulation was also performed before and after prostatic dissection by placing the nerve stimulator tip on the anterior bladder wall. An increase in penile circumference measured by the device was considered a tumescence response while any measurable detumescence was also categorized. RESULTS: Patient age ranged 43 to 72 years (mean 59.8). Before apical dissection 41% and 46% had tumescence, 31% and 21% had detumescence, and 28% and 33% had no response with stimulation of the neurovascular bundle and anterior bladder wall, respectively. After dissection 42% and 25% had tumescence, 16% and 18% had detumescence, and 42% and 57% had no response with stimulation of the neurovascular bundle and anterior bladder wall, respectively. CONCLUSIONS: A response to neurovascular bundle stimulation using this device does not necessarily correlate with the precise anatomical location of the cavernous nerves. There is considerable background variability related to anesthesia, surgical manipulation and other undefined factors that may cause minor but measurable changes in penile circumference.     

胃肠道、食管、腹膜后、腹腔干、颈部多发血管瘤1例

湘雅三医院消化科近年收治1例胃肠道、食管、腹膜后、腹腔干及颈部多发血管瘤患者,对其给予食管、胃血管瘤套扎及鱼肝油酸钠注射治疗,出院后随访,患者一般情况可.因本病罕见,现将其报告如下.     

Electrical burn injuries in children

Aim: Electrical burns account for up to 10% of burns admissions worldwide. Although a potentially serious mechanism of injury in children, there exists limited Australian data. This study aimed to describe the epidemiology, presentation, management and complications of electrical burn injuries in children. Methods: We performed a retrospective case note review of all children under 16 years of age with electrical burns admitted to the New South Wales Paediatric Burns Centre over an 8‐year, 2‐month study period between November 1995 and December 2003. Results: Twenty‐two cases were identified. The mean age at presentation was 7.6 years (range 8 months to 14.3 years). Eighty‐six percent of cases were sustained from a Low Voltage (<1000 W) power source and 55% occurred in males. The total body surface area burnt ranged from 0.5% to 35% with an average of 4%. Fourteen children had their burns managed non‐operatively, but eight required various surgical procedures ranging from local debridement and primary closure to full‐thickness skin grafting. The average length of hospital stay was 6 days (range 1–58 days). Complications occurred in 4 of the 22 patients (18%) and included wound infections, acute renal failure because of myoglobinuria, permanent electrocardiogram changes and long‐term paraesthesia. Three patients (14%) suffered continued morbidity because of scarring, amputation and psychological disturbance. There was no mortality. Conclusions: Electrical injury was an infrequent but potentially serious cause of injury in children. Minor injuries were successfully managed non‐operatively. Neurological sequelae, cardiac arrhythmias and renal failure remain serious complications in up to 20% of cases.     

Fat-to-glucose interconversion by hydrodynamic transfer of two glyoxylate cycle enzyme genes

The glyoxylate cycle, which is well characterized in higher plants and some microorganisms but not in vertebrates, is able to bypass the citric acid cycle to achieve fat-to-carbohydrate interconversion. In this context, the hydrodynamic transfer of two glyoxylate cycle enzymes, such as isocytrate lyase (ICL) and malate synthase (MS), could accomplish the shift of using fat for the synthesis of glucose. Therefore, 20 mice weighing 23.37 ± 0.96 g were hydrodinamically gene transferred by administering into the tail vein a bolus with ICL and MS. After 36 hours, body weight, plasma glucose, respiratory quotient and energy expenditure were measured. The respiratory quotient was increased by gene transfer, which suggests that a higher carbohydrate/lipid ratio is oxidized in such animals. This application could help, if adequate protocols are designed, to induce fat utilization for glucose synthesis, which might be eventually useful to reduce body fat depots in situations of obesity and diabetes.