Regression of thymoma-induced lichenoid hypersensitivity reactions of the oral mucosa following thymoma treatment: a case report.

Thymomas are neoplasms associated with paraneoplastic disorders. Severe hypersensitivity reactions involving the oral cavity may be the first sign of an undiagnosed thymoma. Oral manifestations of an underlying thymoma may present as recurrent severe painful lesions with associated significant morbidity, often not responding to standard therapeutic measures. This case report describes the treatment of a 75-year-old woman who presented with severe oral lichenoid hypersensitivity reactions secondary to an undiagnosed underlying thymoma. No substantial improvement of the oral conditions was achieved with conventional therapies (topical and systemic steroids); however, almost complete resolution of the lesions was achieved following completion of radiation therapy for the thymic neoplasm. This article is intended to serve as a resource for clinicians to understand early, rare manifestations of an undiagnosed thymoma.

In vivo clinical and histological thermal effect of a 445 nm diode laser on oral soft tissues during a biopsy.

Blue diode laser emits a 445 nm wavelength light, which is extremely effective with hemoglobin, and has an optimal hemostatic effect. This work analyzes its thermal effects and clinical efficacy, when used to perform excisional biopsies. Forty-two excisional biopsies were performed with the laser; then, the extent of perincisional thermal effects was evaluated and patients were followed up. Average alteration on epithelial tissue was 507.07 µm, and on connective tissue was 320.39 µm. In all the cases, it was possible to obtain a histological diagnosis. Diode lasers can be safely used to perform biopsies; various intra- and postoperative advantages were confirmed.

Histological Effects of an Innovative 445 Nm Blue Laser During Oral Soft Tissue Biopsy.

Continuously evolving laser devices can be used in various fields; they are an alternative to the traditional cold blade surgery to perform biopsies of oral soft tissues. The aspect focused on in this paper is the possibility to use the 445 nm diode laser (Eltech K-Laser srl, Treviso, Italy) in complete safety, by evaluating its thermal effects during microscopy. A histological evaluation of the alteration of the peri-incisional edges on 10 samples was realized. All excisional biopsies were related to clinically unsuspected lesions and performed by the same expert operator. The surgical procedure was performed with the same laser parameters and the same pathologist evaluated the thermal effect on the samples. An average value of the detected tissue alteration was calculated; the average damage of the epithelium was 650.93 µm, while in the connective tissue it was 468.07 µm. In all the cases a clear diagnosis was possible, and no clinical complications were observed; so, the 445 nm diode laser proved to be a device that can be safely used for biopsies of clinically unsuspicious lesions. Due to the small number of cases, this in vivo preliminary experience needs to be extended.

Chronic postoperative Mycobacterium gordonae endophthalmitis in a patient with phakic intraocular lens.

METHODS: Case description of a 34 year old woman with chronic granulomatous anterior uveitis following implantation of a phakic anterior chamber intraocular lens (IOL). Aqueous humor was processed for bacterial, fungal culture, and PCR analysis. RESULTS: PCR for 16S ribosomal RNA universal primers was positive and Southern-blot for Propionibacterium spp was negative. Panfungal PCR was negative. Growth of a pigmented yellow colony was detected on Lowenstein-Jensen medium. The isolate was subsequently identified as Mycobacterium gordonae. The patient was treated for atypical mycobacteria as well as an intracameral injection of moxifloxacin, with resolution of inflammation and improvement in visual acuity. CONCLUSIONS: This is the first reported case of Mycobacterium gordonae chronic postoperative endophthalmitis, and of chronic endophthalmitis following phakic IOL surgery. PCR and cultures were invaluable in making the diagnosis.

The effect of ketorolac on biofilm of Staphylococcus epidermidis isolated from post-cataract endophthalmitis.

PURPOSE: The purpose of this study is to investigate the effect of ketorolac on biofilm formation of Staphylococcus epidermidis isolated from patients with post-cataract endophthalmitis. METHODS: Forty S. epidermidis strains isolated from postoperative endophthalmitis were used for this study. Biofilms were grown on microtitre plates for 24 h, dyed, and stained with crystal violet. The mean optical density (OD) and the OD ratio (ODr = OD of the treated biofilm/OD of the untreated biofilm) were used for quantification. The biofilms were incubated with 13 mM ketorolac and without ketorolac for controls. RESULTS: The biofilm ODs of the S. epidermidis isolates untreated and treated with ketorolac were significantly different (0.335 ± 0.06 versus 0.158 ± 0.03, respectively; mean ± SD; P < 0.001). Ketorolac reduced S. epidermidis biofilm formation by 47.6 %. CONCLUSIONS: Ketorolac, at a concentration of 13 mM, significantly reduces the formation of biofilm by strains of S. epidermidis that caused endophthalmitis.

Queratitis por Acanthamoeba sp / Keratitis by Acanthamoeba sp

Desde su primera descripción en 1973 la demostración de Acanthamoeba sp. como causa de queratitis se ha incrementado. De acuerdo a nuestro conocimiento, no se han descripto casos de esta enfermedad en la Argentina. El propósito de esta comunicación es presentar dos pacientes portadores de lentes de contacto que desarrollaron queratitis ulcerada y que en el estudio histopatológico de la córnea obtenida por queratoplastia se demostró quistes de Acanthamoeba sp. El diagnóstico prequirúrgico depende del índice de sospecha del oftalmólogo, para utilizar las técnicas de laboratorio adecuadas. Los resultados del tratamiento médico son controvertidos y la mayoría de los casos requieren una queratoplastia penetrante