1/28. Complete capsulorhexis opening occlusion despite capsular tension ring implantation.An 89-year-old woman and an 86-year-old woman had continuous curvilinear capsulorhexis, phacoemulsification, and implantation of a silicone plate-haptic intraocular lens. Because of presumed weak zonules (high age, pseudoexfoliation), a poly(methyl methacrylate) capsular tension ring was also implanted. Despite this, both patients reported deterioration in visual acuity that was the result of complete occlusion of the anterior capsule opening by fibrotic tissue 4 and 3 months postoperatively, respectively.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/28. Posterior chamber intraocular lens dislocation with the bag.We report a rare case of a 46-year-old man presenting with a luxation of a posterior chamber intraocular lens (IOL) with the capsular bag after ocular contusion. Preoperative axial length was 36.58 mm. After trauma, pars plana extraction of the dislocated IOL inside the capsular bag was performed using a forceps. Capsular fibrosis had probably weakened the zonules, which were ruptured by the trauma. This observation confirms the necessity of a large continuous curvilinear capsulotomy and meticulous cleaning of the anterior and posterior capsules to minimize postsurgical fibrosis and capsule contraction.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/28. Radial entrapment neuropathy due to chronic injection-induced triceps fibrosis.We report two patients who developed progressive, severe, painless radial neuropathies (bilateral in one, unilateral in the other) as a delayed complication of chronic intramuscular analgesic injection. In each instance, exploration of the radial nerve revealed multifocal entrapment within a densely fibrotic triceps muscle at sites between the spiral groove and distal course of the radial nerve near the elbow. Release of the nerve from constriction within the fibrotic triceps muscle produced improvement in all three affected nerves.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/28. Clinicopathological correlation in exudative age-related macular degeneration: recurrent choroidal neovascularization.PURPOSE: To report the pathology of surgically removed submacular tissue in recurrent choroidal neovascularization after laser photocoagulation of classic choroidal neovascularization in age-related macular degeneration. methods: A recurrent subfoveal choroidal neovascular membrane was surgically removed in two patients. The recurrence was identified as a classic membrane on fluorescein angiography at the foveal border of the laser scar. A net was visualized in the early venous phase of the indocyanine green angiogram, with associated late hyperfluorescence. Both patients had undergone laser photocoagulation for a classic interpapillomacular choroidal neovascular membrane about 1 1/2 years earlier. The specimens were serially sectioned and stained with hematoxylin-eosin, periodic acid-Schiff, Masson trichrome and phosphotungstic acid-hematoxylin. RESULTS: The two specimens consisted of subretinal fibrovascular tissue with fibrin exudation. Fibrovascular tissue bordered subretinal fibrous tissue adherent to Bruch's membrane and remnants of the choroid in one patient. The fibrovascular portion most likely corresponded to the recurrence, whereas the fibrous portion represented the original membrane, being obliterated after photocoagulation. Some peripapillary tissue was additionally removed in the other patient. The latter lesion was invisible on fluorescein angiography but stained in the late phase of indocyanine green angiography and corresponded histopathologically to poorly vascularized intra-Bruch's fibrovascular tissue. Granular deposits, periodic acid-Schiff positive and metachromatically purple on Masson trichrome stain, representing diffuse drusen (basal laminar/linear deposits), were identified in the three specimens. CONCLUSION: A subretinal fibrovascular membrane corresponded with the classic recurrent choroidal neovascularization.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/28. capsulorhexis phimosis in retinitis pigmentosa despite capsular tension ring implantation.A 56-year-old man with retinitis pigmentosa presented with dense nuclear sclerosis and scattered zonular loss with laxity confirmed by ultrasound biomicroscopy. He had extracapsular cataract extraction with a 6.0 mm continuous curvilinear capsulorhexis and implantation of a capsular tension ring (CTR) and a single-piece poly(methyl methacrylate) (PMMA) intraocular lens (IOL) in the capsular bag in his left eye. Severe anterior capsule fibrosis and contracture of the capsulorhexis opening with nasal decentration of the IOL were noted 4 months after surgery. A neodymium:YAG (Nd:YAG) laser anterior capsulotomy was performed to prevent further zonular stress and IOL decentration. The centripetal forces of capsular fibrosis after cataract surgery may exceed the centrifugal resistance of the standard CTR and PMMA IOL in patients with retinitis pigmentosa. Such patients must be carefully monitored postoperatively. An Nd:YAG laser anterior capsulotomy is a safe and effective option to manage anterior capsule fibrosis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/28. Rapidly progressive interstitial renal fibrosis associated with Chinese herbal medications.BACKGROUND/AIM: Nephropathy after ingestion of Chinese herbs is known as a rapidly progressive form of interstitial renal fibrosis after a slimming regimen containing aristolochic acid that was identified first in belgium. Intake of traditional Chinese herbal medicines is very popular in taiwan. So we looked for similar cases in our hospital. methods: From 1994 to 1998, we observed 20 Taiwanese patients who underwent renal biopsy for rapidly progressive renal failure of unknown origin. The medical history of these patients gave no clue to the origin of renal impairment, except for the administration of Chinese herbs before the development of renal failure in all cases. RESULTS: Although these patients took herbal medications from various sources for different purposes, their renal biopsy specimens showed strikingly similar histological patterns: extensive paucicellular interstitial fibrosis and tubular atrophy, but the glomeruli were apparently intact. They also had similar clinical features, such as a nearly normal blood pressure, obvious anemia, insignificant edema, low-grade proteinuria, and glucosuria. The renal function declined rapidly in most cases; 15 patients underwent dialysis within 3 months of renal biopsy, and 7 patients received emergency dialysis when they first came to our hospital. On clinical and morphological grounds, the nephropathy in our patients appears similar to Chinese herb nephropathy. CONCLUSIONS: Because of the diversity of the herbal regimens used, in addition to aristolochic acid, other unidentified phytotoxins may also play a role in this particular disease entity. There is a strong relation between rapidly progressive interstitial renal fibrosis and the consumption of Chinese herbs.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/28. emperipolesis in a common breast malignancy. A case report.BACKGROUND: emperipolesis is a phenomenon characterized by the presence of leukocytes/lymphocytes within the cytoplasm of other cells. The present report describes this unusual observation within epithelial cancer cells of the breast. CASE: A 52-year-old female presented with a hard, adherent lump over the right breast for one year. Fine needle aspiration and histopathologic examination of the tumor showed features of infiltrating duct carcinoma with emperipolesis as a striking feature of the tumor cells. The tumor showed a near-total response to neoadjuvant chemotherapy. CONCLUSION: The mechanism and biologic significance of emperipolesis in producing a near-total response to neoadjuvant chemotherapy in the present case suggest its role in inducing a tumoricidal effect, possibly involving a cascade of chemokines.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
8/28. keloid-like scleroderma.A 62-year-old female who developed concomitantly acrosclerosis and keloid-like lesions is described. biopsy specimens from these linear lesions showed a fibrous proliferation in the dermis composed mostly of normal-appearing, horizontally oriented collagen bundles and myofibroblasts, thus resembling a scar. Keloidal scleroderma is a rare variant of scleroderma. The diagnosis is considered for patients with scleroderma who develop lesions clinically and histologically indistinguishable from keloids. This case demonstrates for the first time that the histopathologic findings can mimic those of a scar, rather than a keloid, and hence is appropriately designated as keloid-like scleroderma. Clinical pathological correlation is mandatory for the correct diagnosis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/28. Phlebosclerotic colitis coincident with carcinoma in adenoma.Phlebosclerosis of the colon is a rare disease characterized by a thickening of the wall of the colon with fibrosis, hyalinization and calcification to the affected veins. These symptoms result in a type of ischemic colitis known as phlebosclerotic colitis. A case of phlebosclerotic colitis coincident with carcinoma in adenoma is reported. A 74-year-old Japanese woman was admitted to hospital because of a mass in her right lower abdomen. Abdominal computed tomography examination revealed linear calcifications in the wall of the cecum and the ascending colon. colonoscopy revealed dark purple mucosa with multiple ulcers in the cecum and the ascending colon. biopsy specimens showed a marked hyalinous thickening of the wall of small blood vessels in the mucosa. Phlebosclerotic colitis was suspected because of negative results with amyloid stain. Alternative ileocolic angiography showed the serpentine of the peripheral nature blood vessels and pooling at the late venous phase. Microscopic examination of the surgically resected colon revealed mucosal and submucosal fibrosis, and a thickening of the venous wall with fibrosis, hyalinization and calcification from the mucosa to the serosa, which caused a marked luminal narrowing. A small polypoid lesion was also found in the affected region and was diagnosed histologically as carcinoma in adenoma. To our knowledge, this is the first reported case of phlebosclerotic colitis complicated by carcinoma.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/28. Dynamic MR imaging of brain tumors in low field using undersampled projection reconstruction.A new application of the projection reconstruction method was developed, enabling dynamic T(1)-weighted contrast-enhanced magnetic resonance image (MRI) of brain tumors in a low-field imager. Two undersampled projection reconstruction spin echo sequences were implemented in an open low-field (0.23-T) MR imager, one with 64 and another with 42 projections in [0,pi], repetition time 150 ms, echotime 15 ms, and six slices were used in both sequences. The possibility of using these sequences to image dynamic contrast enhancement of brain tumors was studied in laboratory experiments and in two patient cases, one with fibrotic and the other with meningothelial meningioma. The laboratory experiments showed a nearly linear response in signal intensity to the concentration of gadopentetate dimeglumine in purified water up to 1.25 mM. Increasing concentrations up to 5.0 mM did not significantly affect the signal intensity, though starting from 3.0 mM concentration T(2) shortening decreased intensities slightly. The patient cases showed results consistent with an earlier study performed in a high-field imager. The results show that the studied sequences can be used to follow dynamic contrast enhancement in a low-field imager.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
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