Adult-onset asthma and severe periocular xanthogranuloma: a case report.

A 55-year-old obese Mexican American male with a 3-year history of adult-onset asthma presented with a 10-year history of disfiguring eyelid edema. A biopsy revealed lymphoid aggregates consisting of reactive lymphoid follicles and Touton giant cells. He was diagnosed with adult-onset asthma associated with periocular xanthogranuloma and treated with systemic steroids. This case highlights an uncommon disease in its most severe presentation.

Surgical management of inner lamellar macular hole.

The purpose of this study was to determine whether pars plana vitrectomy membrane peeling and fluid-air exchange could improve optical coherence tomography and visual acuity outcomes in a patient with an inner lamellar macular hole when the patient remains in the face-down position for 3 days after surgery. Three weeks postoperatively, optical coherence tomography revealed a normal macular contour. Two months postoperatively, best-corrected visual acuity improved from 20/60 to 20/30. Surgery may be a useful option to study further in patients with symptomatic inner lamellar macular holes.

Utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for dementia in a Japanese-American population.

Ethnic diversity among older patients in Hawai'i is common; yet few data exist concerning the applicability of cognitive testing instruments in non-Caucasian populations. This project aimed to determine the specificity and sensitivity of the IQCODE for the detection of cognitive impairment in a Japanese-American population. Results confirm that the IQCODE is a valuable tool for primary care physicians to detect impairment in this population.

Teaching suturing in a workshop setting: a comparison of several models.

OBJECTIVES: Suturing is taught in workshops using a variety of models. The purpose of this study is to compare the resemblance to human skin of four models commonly used to teach suturing: pig skin, beef tongue, hot dog and latex glove. METHODS: 5 centimeter biconvex incisions were made in each of the models and closed by 50 physician study volunteers comprised of 33 board-certified physicians and 17 resident physicians. They rated each model on a scale of 1 to 4, where 4 closely resembles human skin and 1 does not resemble human skin. RESULTS: The following mean ratings were given by study volunteers: beef tongue 3.5 +/- 0.5, pig skin 3.2 +/- 0.8, latex glove 1.6 +/- 0.7, hot dog 1.4 +/- 0.6. CONCLUSION: Beef tongue and pig skin were rated highest by study volunteers. However, pig skin is much cheaper than beef tongue. Pig skin is the best inexpensive model for teaching skin suturing of the four models studied.

Retinal pigment epithelium tear in vogt-koyanagi-harada disease.

PURPOSE: The purpose of this study was to report a case of Vogt-Koyanagi-Harada disease causing large tears of the retinal pigment epithelium (RPE). METHODS: Case report and literature review. RESULTS: A 41-year-old woman presented with headache, tinnitus, and bilateral panuveitis with multiple serous retinal detachments. She was started on oral prednisone, and the inflammation and serous detachments subsided. However, 2 weeks later, she developed large RPE tears. CONCLUSION: Vogt-Koyanagi-Harada disease is an inflammatory disorder of the choroid; however, irregularities in the RPE have been noted, most recently with the use of spectral domain ophthalmic coherence tomography. The finding of RPE tear with resolution of serous retinal detachment may further implicate involvement of the RPE in the disease process.