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BMC Ophthalmol ; 21(1): 291, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332561


BACKGROUND: This study aimed to present a simple method for evaluating transient eye closure (TEC) evoked by bright light and find the agreement between TEC and photosensitivity. We also assessed the associated factors with TEC in the patients with intermittent exotropia (IXT). METHODS: In this retrospective study, IXT patients were exposed to different brightness: darkness, low-intensity white light, and high-intensity white light using a near-infrared camera vision monitor system (Mon CV3, Metrovision, France). TEC was considered to be present if the subject closed his or her eyes immediately, and for more than half of the scotopic lid fissure distance in response to the high-intensity or low-intensity photopic stimulus of light, compared with lid fissure distance in the scotopic phase. We assessed the presence of photosensitivity using a questionnaire and evaluated the agreement between TEC and photosensitivity. We also investigated the sensory fusion, motor fusion, and pupil dynamic components for the existence of TEC in IXT patients. RESULTS: Sixty-one patients with IXT were included. With the new method to evaluate TEC under different light intensities, 27 (44.3%) of the 61 IXT patients showed TEC, and 34 (55.7%) did not demonstrate TEC. TEC under high-intensity white light had a strong correlation with self-reporting photosensitivity (r = 0.77). The smaller angle of deviation at near was associated with the presence of TEC, with statistical significance (p = 0.04). Normal sensory status at a distance was significantly associated with TEC (p <  0.01). Multivariate analysis using multiple logistic regression analysis showed that normal sensory status was significantly associated with TEC (p = 0.02). CONCLUSIONS: The test using a near-infrared camera vision monitor system was a simple and objective tool in identifying TEC evoked by bright light. The presence of TEC strongly correlated with self-reporting photosensitivity in patients with IXT. However, TEC may be an independent phenomenon with motor alignment, stereopsis, and pupil reflex pathway in patients with IXT.

Exotropia , Feminino , França , Humanos , Masculino , Pupila , Estudos Retrospectivos , Visão Binocular
Korean J Ophthalmol ; 35(1): 73-79, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33596616


PURPOSE: To review the occurrence of new solitary tumors during and after intravenous chemotherapy against retinoblastoma. METHODS: From 115 eyes of 78 patients with a diagnosis of intraocular retinoblastoma who underwent intravenous chemotherapy and focal treatment without prior treatment, patient demographics, age at diagnosis, laterality, classification (Reese-Ellsworth and International Classification of Retinoblastoma), and treatment options were recorded. In addition, the occurrence of small tumors during and after chemotherapy was documented with a detailed review of medical records and fundus photographs. RESULTS: Of a total of 115 eyes of 78 consecutive patients, new solitary tumors were observed in 50 eyes (50 / 115, 43%) of 40 patients (40 / 78, 51%). Multinominal logistic regression analyses showed that age at diagnosis (before 1 year) and vitreal seeding at diagnosis were linked to the development of isolated and miliary tumors, respectively. Kaplan-Meier analyses demonstrated that all small tumors developed with 20 months from the start of chemotherapy. Twenty-eight eyes (28 / 34, 82%) were salvaged with additional focal treatment in 34 eyes with isolated tumors. CONCLUSIONS: Small tumors were observed during and after chemotherapy against retinoblastoma in patients who underwent intravenous chemotherapy and focal treatment. It is necessary to promptly identify and address small tumors for the preservation of eyeball and vision.

Neoplasias da Retina , Retinoblastoma , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Enucleação Ocular , Humanos , Lactente , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/tratamento farmacológico , Retinoblastoma/diagnóstico , Retinoblastoma/tratamento farmacológico , Estudos Retrospectivos
Korean J Gastroenterol ; 73(1): 35-38, 2019 Jan 25.
Artigo em Coreano | MEDLINE | ID: mdl-30690956


Aortoesophageal fistula (AEF) is an extremely rare but lethal cause of massive gastrointestinal hemorrhage. Characteristic symptoms are mid-thoracic pain, sentinel minor hemorrhage, and massive hemorrhage after a symptom-free interval. Prompt diagnosis and immediate treatments are necessary to reduce mortality. However, AEF is difficult to diagnose because it is uncommon and often leads to death with massive bleeding before proper evaluation. We report a case of endoscopic diagnosis of AEF that did not present with hematemesis; it was treated with thoracic endovascular aortic repair (TEVAR) and surgery. A 71-year-old female presented to the emergency department with epigastric discomfort. Endoscopy demonstrated a submucosal tumor-like protrusion and pulsating mass with blood clots. Contrast-enhanced chest CT confirmed AEF due to descending thoracic aortic aneurysm. The patient immediately underwent TEVAR to prevent massive bleeding and subsequently underwent surgery. Endoscopists should consider AEF if they see a submucosal tumor-like mass with a central ulcerative lesion or a pulsating protrusion covered with blood clots in mid-esophagus during an endoscopy.

Aneurisma da Aorta Torácica/diagnóstico , Fístula Esofágica/diagnóstico , Idoso , Aneurisma da Aorta Torácica/complicações , Endoscopia Gastrointestinal , Fístula Esofágica/etiologia , Feminino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Hematemese/patologia , Humanos , Stents , Tomografia Computadorizada por Raios X
World J Gastroenterol ; 21(16): 5105-9, 2015 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-25945028


Nonconvulsive status epilepticus has become an important issue in modern neurology and epileptology. This is based on difficulty in definitively elucidating the condition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological processes. Despite nonconvulsive status epilepticus being a situation that requires immediate treatment, this disorder may not be appreciated as the cause of mental status impairment. Although the pathophysiology of nonconvulsive status epilepticus remains unknown, this disorder is thought to lead to neuronal damage, so its identification and treatment are important. Nonconvulsive status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental status. We report a case of a 52-year-old male with liver cirrhosis presenting an altered mental status. He was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

Encéfalo/fisiopatologia , Eletroencefalografia , Encefalopatia Hepática/diagnóstico , Cirrose Hepática/diagnóstico , Estado Epiléptico/diagnóstico , Anticonvulsivantes/uso terapêutico , Encéfalo/efeitos dos fármacos , Ondas Encefálicas/efeitos dos fármacos , Erros de Diagnóstico , Evolução Fatal , Encefalopatia Hepática/terapia , Encefalopatia Hepática/virologia , Hepatite B/complicações , Hepatite B/diagnóstico , Humanos , Cirrose Hepática/terapia , Cirrose Hepática/virologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estado Epiléptico/complicações , Estado Epiléptico/tratamento farmacológico , Estado Epiléptico/fisiopatologia , Resultado do Tratamento
Korean J Gastroenterol ; 65(4): 241-5, 2015 Apr.
Artigo em Coreano | MEDLINE | ID: mdl-25896159


A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn's disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn's disease.

Linfoma Difuso de Grandes Células B/diagnóstico , Idoso , Anticorpos/sangue , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Endoscopia por Cápsula , Doença de Crohn/diagnóstico , Doença de Crohn/tratamento farmacológico , Erros de Diagnóstico , Humanos , Imunoglobulina A/sangue , Perfuração Intestinal/cirurgia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Mesalamina/uso terapêutico , Tomografia por Emissão de Pósitrons , Saccharomyces cerevisiae/imunologia , Tomografia Computadorizada por Raios X
J Biophotonics ; 7(8): 597-606, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23650149


The smooth muscle cell is the principal component responsible for involuntary control of visceral organs, including vascular tonicity, secretion, and sphincter regulation. It is known that the neurotransmitters released from nerve endings increase the intracellular Ca(2+) level in smooth muscle cells followed by muscle contraction. We herein report that femtosecond laser pulses focused on the diffraction-limited volume can induce intracellular Ca(2+) increases in the irradiated smooth muscle cell without neurotransmitters, and locally increased intracellular Ca(2+) levels are amplified by calcium-induced calcium-releasing mechanisms through the ryanodine receptor, a Ca(2+) channel of the endoplasmic reticulum. The laser-induced Ca(2+) increases propagate to adjacent cells through gap junctions. Thus, ultrashort-pulsed lasers can induce smooth muscle contraction by controlling Ca(2+), even with optical stimulation of the diffraction-limited volume. This optical method, which leads to reversible and reproducible muscle contraction, can be used in research into muscle dynamics, neuromuscular disease treatment, and nanorobot control.

Lasers , Contração Muscular , Miócitos de Músculo Liso/citologia , Fenômenos Ópticos , Cálcio/metabolismo , Sinalização do Cálcio , Espaço Extracelular/metabolismo , Humanos , Espaço Intracelular/metabolismo , Miócitos de Músculo Liso/metabolismo , Fatores de Tempo , Bexiga Urinária/citologia , Bexiga Urinária/fisiologia