Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, we reevaluate the results of radiofrequency rhizotomy and review the effectiveness of other surgical procedures for the treatment of trigeminal neuralgia. Five hundred patients with trigeminal neuralgia underwent radiofrequency rhizotomy at the University of Cincinnati Medical Center, Cincinnati, OH, between 1981 and 1986. Their results are compared with those of patients reported in the literature who underwent radiofrequency rhizotomy (6205 patients), glycerol rhizotomy (1217 patients), balloon compression (759 patients), microvascular decompression (MVD) (1417 patients), and partial trigeminal rhizotomy (250 patients). Comparisons were based on the following outcome parameters: technical success, pain relief and recurrence, facial numbness, dysesthesia, corneal anesthesia, keratitis, trigeminal motor dysfunction, permanent cranial nerve deficit, intracranial hemorrhage or infarction, perioperative morbidity, and perioperative mortality. We found that MVD had the lowest rate of technical success. Radiofrequency rhizotomy and MVD had the highest rates of initial pain relief and the lowest rates of pain recurrence. Glycerol rhizotomy had the highest rate of pain recurrence. Balloon compression had the highest rate of trigeminal motor dysfunction. Balloon compression and MVD had the lowest rates of corneal anesthesia or keratitis. MVD had the lowest rates of facial numbness and dysesthesia. All percutaneous procedures had similar rates of dysesthesia. Posterior fossa exploration had the highest rates of permanent cranial nerve deficit, intracranial hemorrhage or infarction, and perioperative morbidity and mortality. On the basis of our experience and a review of the literature, we conclude the following: 1) percutaneous techniques and posterior fossa exploration offer advantages and disadvantages, 2) radiofrequency rhizotomy is the procedure of choice for most patients undergoing first surgical treatments, and 3) MVD is recommended for healthy patients who have isolated pain in the first ophthalmic trigeminal division or in all three trigeminal divisions and patients who desire no sensory deficit.
 ...
PMID:Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. 914 78

Hereditary sensory neuropathies are a rare group of neurological disorders manifested from early childhood by diminished or absent sensibility to pain, touch and temperature. A Kashmiri family with four members affected by congenital sensory neuropathy and its oral manifestations is described. Pain and temperature sensation was lost in various parts of the body including the orofacial region resulting in mutilating acropathy, particularly of the limbs and face. Orofacial motor function was normal. Three of the four members had corneal opacification due to scarring from keratitis. To prevent any further mutilation, any corrective surgery is best delayed until the patient is old enough. A discussion of the oral manifestations of this condition with a review of the literature is presented.
 ...
PMID:Oral and maxillofacial manifestations of hereditary sensory neuropathy. 890 40

The 260 cases of acute hemorrhagic conjunctivitis seen at Siriraj Hospital during October to December, 1992 were studied. Evidence of coxsackie virus A24 variant (CA24v) infections was demonstrated in 76.8% of 95 cases. The isolation rates from conjunctival swabs and throat swabs were 68.2% and 32.8%, respectively. A four-fold rising titer of neutralizing antibody was shown in 59.5% of 42 cases. The disease was characterized by a short incubation period, sudden onset, a mild and self-limited course within 5 days without ocular sequelae. Lacrimation, swelling lida, itching, foreign body sensation and periorbital pain were common features with bilateral involvement in the majority of cases. Approximately 48% of eyes had a mucopurulent discharge. Preauricular lymphadenopathy, keratitis and subconjunctival hemorrhage were observed in 16.2%, 12.6%, and 10.1% of affected eyes, respectively. Respiratory disturbances accompanied the eye signs in some cases. Only one case developed neurological complications: facial palsy was observed for three months without recovery.
 ...
PMID:Acute hemorrhagic conjunctivitis outbreak in Thailand, 1992. 927 84

A 29-year-old Hispanic man who had bilateral radial keratotomy (RK) and astigmatic keratotomy (AK) in his right eye 1 year previously went swimming in a lake. He subsequently developed foreign-body sensation and pain with a gradual decrease in vision over the following 5 weeks, despite treatment with ciprofloxacin hydrochloride (Ciloxan) and diclofenac sodium (Voltaren). The patient sought a second opinion. On examination, best corrected visual acuity was 20/40 in the right eye and 20/20 in the left. Slitlamp examination revealed mild conjunctival and scleral injection and a 3.5 mm diameter stromal infiltrate densest at the edges (Figure 1). The infiltrate involved one RK and one AK incision with gaping of both, approximately 90% depth incisions (Figure 2). The anterior chamber was deep and quiet. Examination was otherwise unremarkable. The cornea was scraped, but the smears were negative. The Ciloxan and Voltaren were stopped, and scopolamine four times a day was started. Cultures for aerobic, anaerobic, fungal, acid-fast bacilli, and Acanthamoeba were performed but showed no growth in the following week. Except for vascular ingrowth, there was no change in the appearance of the microbial keratitis during this week. An incisional biopsy and rescraping were performed, but there was again no growth of micro-organisms and no change in the microbial keratitis in the following 4 days. How would you manage this patient at this time?
 ...
PMID:Consultation section. Refractive surgical problem. 929 62

The retinal pigment epithelium (RPE) can undergo reactive hyperplasia and metaplasia following a variety of ocular insults. However, true neoplasms of the RPE are rare. We report a case of a papillary adenocarcinoma of the RPE arising in the blind staphylomatous right eye of a 79-year-old woman with a long history of bilateral posterior staphylomas who was seen with increasing pain and exophthalmos of the right eye. Findings from ultrasonography and computed tomography demonstrated linear calcification consistent with osseous metaplasia of the RPE. Progression of the exophthalmos and worsening exposure keratitis led to enucleation of the eye. Gross pathology showed a 79-mm-long globe. Histopathologic findings revealed a largely amelanotic papillary adenocarcinoma arising from the RPE. Positive immunoreactivity for cytokeratin supported the epithelial origin of the tumor. Adenocarcinoma of the RPE is rare but may develop in a blind eye.
 ...
PMID:Presumed adenocarcinoma of the retinal pigment epithelium in a blind eye with a staphyloma. 956 54

Acanthamoeba species are an important cause of microbial keratitis that may cause severe ocular inflammation and visual loss. The first cases were recognized in 1973, but the disease remained very rare until the 1980s, when an increase in incidence mainly associated with contact lens wear was reported. There is an increased risk when contact lens rinsing and soaking solutions are prepared with nonsterile water and salt tablets. The clinical picture is often characterized by severe pain with an early superficial keratitis that is often treated as herpes simplex infection. Subsequently a characteristic radial perineural infiltration may be seen, and ring infiltration is common. Limbitis and scleritis are frequent. Laboratory diagnosis is primarily by culture of epithelial samples inoculated onto agar plates spread with bacteria. Direct microscopy of samples using stains for the cyst wall or immunostaining may also be employed. A variety of topically applied therapeutic agents are thought to be effective, including propamidine isethionate, clotrimazole, polyhexamethylene biguanide, and chlorhexidine. Various combinations of these and other agents have been employed, often resulting in medical cure, especially if treatment is commenced early in the course of the disease. Penetrating keratoplasty is preferably avoided in inflamed eyes, but may be necessary in severe cases to preserve the globe or, when the infection has resolved, to restore corneal clarity for optical reasons.
 ...
PMID:Acanthamoeba keratitis. 963

During a 3-year period, 25 caudalis dorsal root entry zone (DREZ) operations were done for severe, facial pain. Intraoperative brainstem recordings were done before and after DREZ in all patients. Primary diagnosis included refractory trigeminal neuralgia, atypical headaches or facial pain, posttraumatic closed head injuries, postsurgical anesthesia dolorosa, multiple sclerosis, brainstem infarction, postherpetic neuralgia and cancer-related pain. At the time of discharge, good to excellent pain relief was present in 24/25 patients and fair relief in 1. At 1 month, 19/25 (76%) patients had good to excellent results and at 3 months following surgery, 17/25 (68%) continued to have good to excellent pain relief. One year following surgery, 18 patients could be evaluated, 12/18 (67%) still considered their relief as good to excellent, 2 fair and 4 poor. Transient postoperative ataxia was present in 15/25 patients (60%), but was largely resolved at 1 months. In 3/18 (17%) patients, a degree of ataxia was still present at 1 year although in none was it disabling. Two patients had transient diplopia, and 3 had increased corneal anesthesia with 1 later developing a keratitis. No surgical or postsurgical mortality was noted. This procedure has proven to be a satisfactory treatment for many patients with debilitating facial pain syndromes with acceptable morbidity.
 ...
PMID:The caudalis DREZ for facial pain. 971 11

A 24-year-old healthy male underwent uncomplicated laser in situ keratomileusis (LASIK) in left eye. One day after the surgery, he complained of ocular pain and multiple corneal stromal infiltrates had developed in left eye. Immediately, the corneal interface and stromal bed were cleared, and maximal antibiotic treatments with fortified tobramycin (1.2%) and cefazolin (5%) were given topically. The causative organism was identified as 'Streptococcus viridans' both on smear and culture. Two days after antibiotic therapy was initiated, the ocular inflammation and corneal infiltrates had regressed and ocular pain was relieved. One month later, the patient's best corrected visual acuity had returned to 20/20 with -0.75 -1.00 x 10 degrees, however minimal stromal scarring still remained. This case demonstrates that microbial keratitis after LASIK, if treated promptly, does not lead to a permanent reduction in visual acuity.
 ...
PMID:Streptococcal keratitis after myopic laser in situ keratomileusis. 1018 71

Acanthamoeba keratitis is caused by protozoa and characterised by a protracted course. All patients presenting with a therapy-resistant keratitis, even non-contact lens wearers, should be examined for the presence of Acanthamoeba by means of specific cultures, histopathological stainings and--if necessary--a corneal biopsy. The combination of clinical signs, such as excessive pain, a radial keratoneuritis and in a later phase a stromal ring infiltrate, together with a suggestive history (contact lenses, polluted water) is an important factor for the early diagnosis. Because of improved clinical detection and earlier diagnosis, the infection can often be controlled with a combination therapy of polyhexamethylene biguanide or chlorhexidine with propamidine and neomycine. This results in a better visual prognosis and a decreased need for therapeutic keratoplasty.
 ...
PMID:Acanthamoeba keratitis: a review. 1067 Jan 64

Topical ocular anesthetic abuse is uncommon in our clinical experience. The complications associated with topical ocular anesthetic abuse included persistent corneal epithelial defect, ring-shaped stromal infiltrate, and anterior segment inflammation. This disorder can masquerade as Acanthamoeba keratitis or other infectious keratitis. We report a suspicious case of infectious keratitis unresponsive to antibiotics. The patient had an irritable manner, low pain-control threshold, and an analgesic drug abuse history. This information, along with finding a topical ocular anesthetic bottle at bedside helped alert us to possibility of drug abuse. After discontinuing use of the topical anesthetic and using lubricants, topical steroid, and a therapeutic soft contact lens, the condition improved.
 ...
PMID:Topical ocular anesthetic abuse: case report. 1095 42


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>