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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Results of treatment of torsion of the testicle can be measured only by determining the rate of testicular salvage, which has been low but has improved in recent years. The Doppler instruments and the technique of scrotal imaging with the gamma camera provide noninvasive and rapid diagnostic aids with a high degree of accuracy. There is evidence that these techniques will aid in the differential diagnosis of equivocal cases, and thus lower the incidence of delay in the diagnosis of torsion, a cause of lower than optimal salvage rates in the past. Fluorescein staining can also be used in the operating room if there is a question of testicular viability. The availability of these new modalities, however, is no substitute for early evaluation. Quick referral from primary physicians and a high awareness of torsion as a cause of acute scrotal pain and swelling are extremely important. Reviews clearly indicate that improved salvage rates are achieved with early evaluation and treatment. Therefore the urologist has a continuing responsibility to educate pediatricians, family practitioners, and emergency room physicians in the urgency of diagnosis and treatment in cases of testicular torsion. Although new diagnostic aids are useful, only early surgical exploration can save a torsive testis.
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PMID:Torsion of the testis: techniques of assessment. 46 83

Posterior scleritis was diagnosed in four adolescent boys. These patients represented a distinct subgroup of patients with posterior scleritis that differed from the adult variant by gender, lack of systemic disease, and absence of the associated ocular findings often seen in the adult variant of the disorder. The four patients had diminished visual acuity, ocular pain, and exudative retinal detachments at initial examination. Fluorescein angiography demonstrated multiple pinpoint leaks at the level of the retinal pigment epithelium in three patients with late-phase patchy staining of a mass-like lesion in one patient. B-scan ultrasonography demonstrated choroidal and scleral thickening with increased acoustic density of the choroid in all patients. Systemic evaluation of these patients disclosed no underlying disease. Clinical signs and symptoms resolved in three of the patients after treatment with low-dose, orally administered corticosteroid or noncorticosteroid anti-inflammatory medication. High systemic doses of corticosteroid in combination with noncorticosteroid anti-inflammatory medication and local corticosteroid therapy was required to induce remission in one patient. All patients recovered good visual acuity.
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PMID:Posterior scleritis in children. 154 20

Corneal ulcers to the depth of the anterior third of the stroma were created surgically in both eyes of 10 ponies. One eye in each pony was treated topically with chloramphenicol and 1% atropine ophthalmic ointments 3 times per day; the contralateral eye was not treated topically. All ponies were given phenylbutazone orally for relief of ocular pain. Fluorescein-stained ulcers were measured once a day. The median healing time of the treated eyes (11 days) and the median healing time of the nontreated eyes (13.5 days) were found not to be significantly different. Clinically, however, more severe complications arose in the nontreated eyes.
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PMID:Healing of experimentally induced corneal ulcers in horses. 356

A 36-year-old white man abruptly developed painless visual loss in his left eye. Fundoscopic evaluation revealed a shallow left superotemporal retinal detachment with an underlying yellowish choroidal infiltrate. Fluorescein angiography disclosed indistinct choroidal leakage, and both B-scan ultrasonography and computed tomography demonstrated superotemporal thickening of the choroid and the sclera. The patient was diagnosed clinically as having a scleritis and an associated exudative retinal detachment. He was placed on a several months' course of systemic prednisone, and despite this regimen, his condition worsened with the appearance of severe pain, proptosis and displacement of the eye, glaucoma, and intense episcleral and scleral injection. The eye was enucleated and displayed externally a massively thickened sclera superotemporally. Light microscopic evaluation of the enucleated globe revealed an extensively necrotic tumor growing diffusely within the choroid; infiltrating viable tumor cells were discovered within the sclera and episclera. The tumor cells had the characteristics of a well-differentiated, mucin-producing adenocarcinoma. Electron microscopic studies demonstrated lumen-forming tumor cells with apical villi, cytoplasmic pseudolumens, pools of cytoplasmic glycogen, and multiple types of inclusions, including mucin, lipid, and electron-dense secretory granules similar to those in pulmonary Clara cells. These findings were consistent with a bronchiolo-alveolar carcinoma. The patient subsequently developed bilateral reticulo-nodular pulmonary infiltrates, also typical of this tumor. The unusual clinical features of this case of "malignant scleritis" are discussed in light of the final diagnosis.
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PMID:Metastatic carcinoma masquerading as scleritis. 630 88

The major goal in the evaluation of posterior uveal tumours is to determine whether an intra-ocular malignancy is present and whether intervention is necessary. Small uveal pigmented tumours can safely be managed by observation until growth is documented. However, extensive evaluation for each suspicious lesion is necessary in order not to miss any signs of malignancy. A case is presented of a 41 year old male patient with orbital pain as initial symptom of a choroidal melanoma. Fluorescein-angiography revealed signs of double circulation. Abnormal choroidal vessels inside the tumour showed up clearly on indocyanine-green angiography. By ultrasonography we were able to detect scleral perforation and extra-scleral extension. Computed tomography confirmed the extra-scleral extension. As there were no signs of metastasis, an orbital exenteration with sparing of the eyelids was performed. Histopathology is compared with the results of clinical investigation.
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PMID:The value of medical imaging techniques in the diagnosis of extra-ocular extension of malign melanoma of the choroid: a case report. 804 31

We examined a 67-year-old man who complained of headache and pain and decreased visual acuity in both eyes. The patient had dilated conjunctival and episcleral vessels, intracameral cells, shallow anterior chambers, hyperemic swollen optic disks, exudative retinal detachment and choroidal detachment. Fluorescein angiography showed leakage of dye from the optic disks and choroid into the subretinal space. Scleral thickening was found by computed tomography. These abnormal findings disappeared within 1 week after treatment with a systemic corticosteroid. Laboratory test results showed positive rheumatoid factor. Sunset glow fundi and vitiligo developed a few months after the treatment. We believe that concurrent bilateral posterior scleritis, Vogt-Koyanagi-Harada disease and positive rheumatoid factor, as demonstrated in our patient, may be rare.
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PMID:Concurrent bilateral posterior scleritis and Vogt-Koyanagi-Harada disease in a patient with positive rheumatoid factor. 928 10

The objective of the research was to characterize the clinical, fluorescein angiographic, pathologic and microscopic features of feline pulmonary carcinoma with ocular metastasis that resulted in ischemic chorioretinopathy. Four cats with confirmed or presumed primary pulmonary neoplasia with posterior segment metastasis were studied. The medical records from four cats with a diagnosis of bronchogenic carcinoma and intraocular metastasis were reviewed. Physical and ophthalmic examinations and thoracic radiographs were performed in all cases, and fluorescein angiography was performed in two cases. Classification of the neoplasms was determined by fine-needle aspiration and biopsies of peripheral metastatic lesions, and/or complete necropsies. All four cases had unilateral or bilateral blindness and ophthalmoscopic lesions characterized by a wedge-shaped, tan discoloration in the tapetal fundus, variable but mild serous exudation under the retina, and profoundly attenuated retinal vasculature. Painful swelling and necrosis of the distal extremities and/or mass lesions in the appendicular musculature were also present. Clinical findings, along with microscopic findings from biopsy specimens or complete postmortem examination, documented widespread metastasis of variably differentiated, neoplastic, columnar epithelial cells presumed to be of bronchial origin. Tumor cells were predominately located within the systemic vasculature, consistent with classification of angioinvasive pulmonary carcinoma. Fluorescein angiographic and histopathologic findings in the affected globes suggested that the posterior segment lesions resulted from invasion and growth of neoplastic cells within the chorioretinal vasculature, resulting in secondary ischemic necrosis of the retina and choroid. Ischemic chorioretinopathy and necrosis of the distal extremities, associated with primary bronchogenic carcinoma, appear to be a unique neoplastic syndrome in the domestic cat.
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PMID:Angioinvasive pulmonary carcinoma with posterior segment metastasis in four cats. 1139 54

A case of nodular posterior scleritis simulating both a choroidal tumor and birdshot chorioretinopathy is described. Fluorescein angiography, indocyanine green angiography, and ultrasound were performed. Results of laboratory tests were normal, including HLA-A29, erythrocyte sedimentation rate, rheumatoid factor, and antinuclear antibodies. A chest x-ray was normal. A diagnosis of nodular posterior scleritis was made and the minimally symptomatic patient without ocular pain was observed unless symptoms progressed. In this case, certain clinical features led to the proper diagnosis.
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PMID:Giant nodular posterior scleritis simulating choroidal melanoma and birdshot retinochoroidopathy. 1450 67

A novel peptide with the binding characteristics of tetanus toxin was identified with phage display, for application in therapeutic protein and vector motor and sensory neuron targeting. A 12mer phage library was biopanned on trisialoganglioside (G(T1b)) and eluted with the tetanus toxin C fragment (rTTC). Phage ELISAs revealed increases in G(T1b) binding for the Tet1 and Tet2 phage clones when compared to peptideless phage (PLP). rTTC displaced both Tet1 and Tet2 phage clones from G(T1b), and both clones reduced rTTC-G(T1b) binding. Comparison of Tet1, Tet2, PLP, and the random phage library binding to PC12 and HEK293 cells revealed enhanced cellular binding by Tet1 and Tet2 phage. Tet1 phage binding was selective for neurons. Immunofluorescence also confirmed selective PC12 binding of Tet1 and Tet2 phage. Fluorescein-conjugated synthetic Tet1, but not Tet2, peptide showed strong binding to cultured PC12, primary motor neurons, and dorsal root ganglion (DRG) cells. Synthetic Tet1 bound DRG and motor neurons but not muscle in tissue sections. The enhanced neuronal binding affinity and specificity of Tet1, a novel 12 amino acid peptide, suggests potential utility for targeting neurotherapeutic proteins and viral vectors in the treatment of motor neuron disease, neuropathy, and pain.
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PMID:A novel peptide defined through phage display for therapeutic protein and vector neuronal targeting. 1602 83

We report a case of blindness due to occlusion of the ophthalmic artery following injection of autologous fat into the glabellar region for cosmetic surgery. A 30-year-old woman underwent aspiration of autologous fat from her gluteal region and injection of it into her breasts, nose, and glabellar area. At the time of injection into the glabellar area, she suffered nausea, pain, and visual loss in her right eye. She consulted an ophthalmologist. The first examination revealed that her right eye had loss of light perception, widespread retinal whitening, and obstruction of the retinal vessels of the fundus. It was suspected that she had occlusion of the central retinal artery, and drip infusion of urokinase and hyperbaric oxygen therapy were implemented. Since no improvement was seen, she was referred to Shinshu University hospital. Fundoscopy showed remarkable edema of the entire right retina and whitened retinal vessels. Fluorescein angiography showed no filling of the right retinal arterioles. Cerebral angiography showed complete obstruction of the right ophthalmic artery at its bifurcation. Subsequent administration of urokinase and corticosteroid had no effect. We considered that occlusion of the ophthalmic artery happened when autologous fat was injected into the glabellar area.
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PMID:[A case of ophthalmic artery obstruction following autologous fat injection in the glabellar area]. 1730 92


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