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Sample records for ptosis anteverted nares

  1. Anteverted concha: A new ear deformational anomaly

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    Fabrizio Schönauer

    2015-09-01

    Full Text Available Most auricular deformities involve the helix and the antihelix (Stahl's bar, lop and prominent ear; an isolated conchal deformity is uncommon in an otherwise normal ear. When a convexity rather than a concavity of the concha is present, it can be defined as “anteverted concha”. The anteverted concha causes not only aesthetic but also functional problems. It may be so severe as to occlude the external auditory meatus. In a newborn ear amenable to moulding, anteverted concha can be treated non-surgically by splinting. If this time window has passed, then surgical excision of the conchal bulge can give good results in the adult. We present two such cases and their treatment.

  2. [Involutional ptosis].

    Science.gov (United States)

    Morax, S

    2006-06-01

    Aponeurotic defects and disinsertion of the levator aponeurosis are responsible for acquired involutional ptosis. The typical clinical findings in aponeurotic defects are high or moderate ptosis, good to excellent levator function, thinning of the eyelid above the tarsus, high to absent lid crease, and normal Müller's muscle function. The purpose of the treatment is to repair the defect or to advance the aponeurosis on the tarsus. This surgery can be done via the anterior approach with aponeurotic surgery or via the posterior approach with Müller's muscle conjunctival resection. In all cases, upper lid blepharoplasty is down.

  3. Ptosis - infants and children

    Science.gov (United States)

    Blepharoptosis-children; Congenital ptosis; Eyelid drooping-children; Eyelid drooping-amblyopia; Eyelid drooping-astigmatism ... Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can ...

  4. Lipoestructura mamaria y ptosis

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    J.M. Cervilla-Lozano

    2014-12-01

    Full Text Available Desde hace varios años observamos un hecho que ocurre tras la infiltración grasa de la mama, y que es la ptosis o caída de la mama que tiene lugar 2 o 3 meses después de la intervención. Intentamos explicar este fenómeno por la ruptura y elongación de los ligamentos suspensorios de Cooper que tendrá consecuencias directas en los resultados. Este hecho produce una mayor ptosis en la mama madura, pero por el contrario supone un buen resultado en la mama tuberosa, ya que la ptosis provocada es la causa del relleno del polo inferior, principal problema de este tipo de mama. Consideramos en este artículo la técnica de lipoestructura mamaria y la elección del tipo de cánula a utilizar para la infiltración. Mostramos 2 ejemplos prácticos y un cuadro resumen de las indicaciones de la técnica. Tras años de experiencia en lipoestructura mamaria, pensamos que no es una técnica aplicable en todos los casos y que para obtener buenos resultados con ella es imprescindible elegir la mejor indicación para cada paciente.

  5. The clinical review of ptosis

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    Hong Kwon-Eui

    2006-02-01

    Full Text Available Object : This paper aims to report the clinical effectiveness of acupuncture & herbal treatment on ptosis, which has no way to be treated but the operative method like a tarsectomy. Method : This study was carried out, from February 2003 to December 2003, to the twenty patients who were diagnosed as an acquired ptosis and treated by acupuncture and herbal treatment in the department of Acupuncture & Moxibustion, Daejon University Oriental Hospital. The selected acupoints were hasamhwang(下三黃 in normal side, BL 2(攢竹, BL 60(崑崙, BL 66(通谷, ST 41(解谿, ST 44(內庭, LI 4(合谷, LI 5(陽谿, guhu(球後, emi(魚尾 in abnormal side. The method of acupuncture insertion for each point was neutral(平補平瀉. The treatment frequency was once a day. And all patients were administered the Bojungikkitanggamibang(補中益氣湯加味方, which is known to be able to rise up the Gi of spleen(脾氣. Result & Suggestion : The treatment result showed that excellent was 95%(19 and poor was 5%(1. Through this result, we can know that oriental medical treatment for ptosis is effective. But continuous study about oriental medical treatment for ptosis is needed hereafter.

  6. [Surgery of post-traumatic ptosis].

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    Morax, S; Baudoin, F; Hurbli, T

    1995-12-01

    Post-traumatic ptosis may be classified as follows: ptosis occurring during lid avulsion, ptosis associated with fractures of the orbital roof and with foreign bodies, post-contusional ptosis, cicatricial ptosis, neurogenic ptosis and post-surgical ptosis. The patient must be thoroughly examined, including examination of the eye-ball, extra-ocular muscles, eyelid and evaluation of upper eyelid levator function and orbital and facial examination. The various surgical methods proposed include levator muscle surgery, aponeurotic surgery, Müller's muscle surgery and frontalis suspension surgery. Surgical indications and choice of surgical method essentially depend on the anatomo-clinical forms. The general rule is to operate under local anesthesia to obtain better control of the muscular function. Some cases are simple to treat such as post-contusional ptosis with good levator function which allows functional surgery with excellent static and dynamic results. Other relatively simple cases with non functional levators may only be treated on a static basis. Last but not least are more difficult cases in which levator function is difficult to evaluate pre-operatively because of severe fibrosis. The aim in such cases is to explore the eyelid by an anterior approach under local anesthesia and to propose either muscular surgery or a frontalis suspension according to the anatomical and functional status of the levator muscle.

  7. Modified split level lid resection in ptosis

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    Bethria S

    1990-01-01

    Full Text Available 10 patients of congenital simple ptosis having 3 to 5 mm of ptosis with variable levator action were operated. All the patients showed a good response of lid lift after instillation of phenyl ephrine drops showing the activity of Muller′s muscle. With this technique the lagophthalmos was minimal and good lid folds were formed in all cases. The skin muscle lamina was not excised and was utilized for formation of lid folds which were equal in depth and dynamic in nature. However, the lid lag which is an unavoidable complication of any ptosis surgery was present in the present technique also.

  8. Acupuncture Treatment of Ptosis of Eyelid

    Institute of Scientific and Technical Information of China (English)

    Luan Jiping; Duan Shumin

    2006-01-01

    @@ "Ptosis of the eyelid" is clinically manifested itself in half covering of the pupil by the upper eyelid and powerless eye muscle unable to raise the eyelid.Ptosis of both eyelids affects looking upward. In serious condition, the patient can not move the eyeball flexibly with double vision. Since 2002, the author has used acupuncture to treat 34 cases of the disease with a satisfactory therapeutic effect. The report is as follows.

  9. Glacimarine sedimentation in Petermann Fjord and Nares Strait, NW Greenland

    Science.gov (United States)

    Hogan, Kelly; Jakobsson, Martin; Mayer, Larry; Mix, Alan; Nielsen, Tove; Kamla, Elina; Reilly, Brendan; Heirman, Katrina An; Stranne, Christian; Mohammed, Rezwan; Eriksson, Bjorn; Jerram, Kevin

    2017-04-01

    Here we build on preliminary results from 6500 line-km of high-resolution chirp sub-bottom profiles (2-7 kHz) acquired in Petermann Fjord and Nares Strait during the Petermann 2015 Expedition of the Swedish icebreaker Oden. We map the unlithified sediment cover in Peterman Fjord, which consists of up to 3 conformable "drape" units and calculate volumes of this assumed "post-glacial" fill. In Nares Strait we have mapped sediment volumes in local basins just beyond the sill at the Petermann Fjord-mouth: do these sediments represent material flushed out from the grounding zone of Petermann Glacier when it was grounded at the sill? In this vein, and interestingly, some of the thickest sediments that we observe are found close to a grounding-zone wedge (GZW) in Nares Strait that represents a former grounding zone of ice retreating southwards through the strait. We also map conformable units across Nares Strait and consider the similarities between these and the sediment units in the fjord. Do the strong reflections between the units represent the same climatic, oceanographic or process-shift both inside and outside the fjord? We also aim to tie our new acoustic stratigraphy to sediment-core data (lithofacies, dates) and, therefore, to comment on the age of the mapped sediment units and present ideas on the glacimarine flux of material to the Petermann-Nares system. Primary sediment delivery to the seafloor in this environment is thought to be predominantly through sedimentation from meltwater plumes but also of iceberg-rafted debris (IRD). However, sediment redeposition by slope failures on a variety of scales also occurs and has focussed sediments into discrete basins where the seafloor is rugged. This work - which aims to relate past sediment, meltwater and iceberg fluxes to changes in climate - will help us to identify how the system has responded to a past global warming event, namely the last deglaciation. This is particularly relevant in light of the recent

  10. Lagophthalmos and Ptosis in Inclusion Body Myositis.

    Science.gov (United States)

    Shams, Fatemeh; Cauchi, Paul

    Sporadic inclusion body myositis is the most commonly acquired type of idiopathic inflammatory myopathy in people aged 50 and above. There is early weakness and atrophy of forearms and quadriceps and a third of patients also have mild facial weakness. Extraocular muscles are not affected and ptosis is rarely seen. The authors describe a unique case in which inclusion body myositis presented with early mid face weakness and atrophy resulting in unilateral lagophthalmus, and ptosis, which have not been documented before. This case is not only unique in its presentation but also emphasizes the importance of considering differential diagnoses and conservative measures before contemplating surgery.

  11. NMR resonance assignments of NarE, a putative ADP-ribosylating toxin from Neisseria meningitidis

    NARCIS (Netherlands)

    Carlier, L.P.A.; Köhler, Christian; Veggi, D.; Pizza, M.; Soriani, M.; Boelens, R.; Bonvin, A.M.J.J.

    2011-01-01

    NarE is a 16 kDa protein identified from Neisseria meningitidis, one of the bacterial pathogens responsible for meningitis. NarE belongs to the ADP-ribosyltransferase family and catalyses the transfer of ADP-ribose moieties to arginine residues in target protein acceptors. Many pathogenic bacteria

  12. NMR resonance assignments of NarE, a putative ADP-ribosylating toxin from Neisseria meningitidis

    NARCIS (Netherlands)

    Carlier, L.P.A.; Köhler, Christian; Veggi, D.; Pizza, M.; Soriani, M.; Boelens, R.; Bonvin, A.M.J.J.

    2011-01-01

    NarE is a 16 kDa protein identified from Neisseria meningitidis, one of the bacterial pathogens responsible for meningitis. NarE belongs to the ADP-ribosyltransferase family and catalyses the transfer of ADP-ribose moieties to arginine residues in target protein acceptors. Many pathogenic bacteria u

  13. Corneal Topographic Changes After Eyelid Ptosis Surgery.

    Science.gov (United States)

    Savino, Gustavo; Battendieri, Remo; Riso, Monica; Traina, Salvatore; Poscia, Andrea; DʼAmico, Giovanni; Caporossi, Aldo

    2016-04-01

    To evaluate the corneal topography and the topographic changes after ptosis surgery on patients affected by congenital and acquired blepharoptosis. Twenty eyes of 17 patients affected by acquired and congenital ptosis underwent surgical correction through anterior levator complex tightening. Computerized tomography (Syrius Sistem; CSO) was used to analyze any change in corneal astigmatism (CYL), simulated keratometry, anterior corneal symmetry index front, apical keratometry front, and central corneal thickness. Visual acuity, margin reflex distance, and levator function were also measured. After surgical ptosis repair, corneal topography demonstrated a reduction in average keratometry of 0.15 ± 0.47 diopters (D) and in corneal astigmatism of 0.26 ± 1.12 D. Significant differences were found in apical keratometry front (-1.84 ± 1.76 D) and in best-corrected visual acuity (-0.18 ± 0.06 logMAR) in the postoperative examinations. Central corneal thickness did not show significant differences between preoperative and postoperative examinations. Postoperative topographic maps showed a reduction of symmetry index front (0.10 ± 0.64 D). Eyelid ptosis modifies anterior corneal surface inducing refractive errors and modifying corneal astigmatism in patients, thus affecting the quality of vision. The surgical correction of blepharoptosis induces anterior corneal surface modification, restoring corneal symmetry and regular corneal astigmatism. Postoperative corneal topography showed normal corneal contours.

  14. Clinical presentation and management of congenital ptosis

    Science.gov (United States)

    Marenco, Marco; Macchi, Ilaria; Macchi, Iacopo; Galassi, Emilio; Massaro-Giordano, Mina; Lambiase, Alessandro

    2017-01-01

    Congenital ptosis is a rare condition characterized by lower positioning of the upper eyelid that is present at birth and is a clinical condition that is persistent if not treated. It may be unilateral or bilateral and may be associated with other ocular disorders or systemic conditions, including Marcus Gunn, Horner, and Duane syndromes. It is a benign condition but causes functional, cosmetic, and psychological problems in children. However, not all patients need to undergo surgery, and usually only patients at risk of amblyopia need a prompt surgical correction, while in other cases, surgery can be postponed. The grade of ptosis, the eyelid function, and the amblyopic risk are the parameters that affect the ophthalmologist’s decision on timing of surgery and the surgical technique to be used. In fact, there are several types of surgical techniques to correct a congenital ptosis, although very often more than one is needed to obtain an acceptable result. This paper reviews the causes of congenital ptosis and associated diseases. Particular emphasis is given to surgical management and different procedures available to correct the upper eyelid anomaly and avoid permanent damage to visual function. PMID:28280295

  15. Een meisje met ptosis, anisocorie en hemiparese

    NARCIS (Netherlands)

    Uyttenboogaart, Maarten; Postma, Anna G

    2012-01-01

    A 9-year-old girl complained of a sudden severe headache during skiing, there was no previous trauma. She was nauseous, vomited and had weakness of the left arm and leg. She developed a right-sided ptosis, miosis and a contralateral hemiparesis, consistent with Horner's syndrome. MRI showed acute in

  16. Clinical presentation and management of congenital ptosis

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    Marenco M

    2017-02-01

    Full Text Available Marco Marenco,1,* Ilaria Macchi,2,* Iacopo Macchi,3 Emilio Galassi,4 Mina Massaro-Giordano,5 Alessandro Lambiase1 1Department of Sense Organs, University of Rome “Sapienza”, 2Department of Ophthalmology, Campus Bio-Medico University of Rome, Rome, 3Department of Ophthalmology, University of Catania, Catania, 4Ophthalmic Clinic, Department of Ophthalmology, University of L’Aquila, L’Aquila, Italy; 5Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA *These authors contributed equally to this work Abstract: Congenital ptosis is a rare condition characterized by lower positioning of the upper eyelid that is present at birth and is a clinical condition that is persistent if not treated. It may be unilateral or bilateral and may be associated with other ocular disorders or systemic conditions, including Marcus Gunn, Horner, and Duane syndromes. It is a benign condition but causes functional, cosmetic, and psychological problems in children. However, not all patients need to undergo surgery, and usually only patients at risk of amblyopia need a prompt surgical correction, while in other cases, surgery can be postponed. The grade of ptosis, the eyelid function, and the amblyopic risk are the parameters that affect the ophthalmologist’s decision on timing of surgery and the surgical technique to be used. In fact, there are several types of surgical techniques to correct a congenital ptosis, although very often more than one is needed to obtain an acceptable result. This paper reviews the causes of congenital ptosis and associated diseases. Particular emphasis is given to surgical management and different procedures available to correct the upper eyelid anomaly and avoid permanent damage to visual function. Keywords: ptosis, extraocular muscle development, neurologic dysfunction, surgical approach

  17. BIRTH INJURY RELATED UNILATERAL ANTERIOR NARES PARTIAL FIBROUS ATRESIA: A RARE CASE REPORT

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    Jayagar

    2016-02-01

    Full Text Available Congenital atresia of anterior nares has been rarely reported and it may co-exist along with posterior choanal atresia. (1,2 In our case, birth injury caused by forceps delivery has caused unilateral anterior nares partial atresia. Twenty eight years old male patient came with the complaints of left nostril blocked sensation since birth, aggravated with attacks of upper respiratory tract infections. On examination he had left anterior nares partial atresia caused by fibrous bands as a result of birth injury due to instrumental delivery. Rhinoplasty performed to open-up left nostril and patient relieved of his symptoms and also on cosmetic appearance

  18. Large sea ice outflow into the Nares Strait in 2007

    DEFF Research Database (Denmark)

    Kwok, R.; Pedersen, L.T.; Gudmandsen, Preben

    2010-01-01

    ice in the 13-year record between 1997 and 2009. The 2007 area and volume outflows of 87 x 10(3) km(2) and 254 km(3) are more than twice their 13-year means. This contributes to the recent loss of the thick, multiyear Arctic sea ice and represents similar to 10% of our estimates of the mean ice export......Sea ice flux through the Nares Strait is most active during the fall and early winter, ceases in mid- to late winter after the formation of ice arches along the strait, and re-commences after breakup in summer. In 2007, ice arches failed to form. This resulted in the highest outflow of Arctic sea...... at Fram Strait. Clearly, the ice arches control Arctic sea ice outflow. The duration of unobstructed flow explains more than 84% of the variance in the annual area flux. In our record, seasonal stoppages are always associated with the formation of an arch near the same location in the southern Kane Basin...

  19. Axial Globe Length in Congenital Ptosis.

    Science.gov (United States)

    Takahashi, Yasuhiro; Kang, Hyera; Kakizaki, Hirohiko

    2015-01-01

    To compare axial globe length between affected and unaffected sides in patients with unilateral congenital ptosis. This prospective observational study included 37 patients (age range: 7 months to 58 years). The axial globe length, margin reflex distance-1 (MRD-1), and refractive power were measured. The axial globe length difference was calculated by subtracting the axial globe length on the unaffected side from that of the affected side. The relationships among axial globe length differences, MRD-1 on the affected sides, and patient ages were analyzed using multiple regression analysis. No significant differences were found in the axial globe length between sides (P = .677). The axial globe length difference was 0.17 ± 0.30 mm (mean ± standard deviation), and two patients (5.4%), aged 32 to 57 years, showed axial globe length more than 0.67 mm longer (corresponding to a refractive power of 2 diopters) on the affected side compared to the unaffected side. The multiple regression model between axial globe length difference, patient age, and MRD-1 on the affected sides was less appropriate (YAGL = 0.003XAGE-0.048XMRD-1 +0.112; r = 0.338; adjusted r2 = 0.062; P = .127). The cylindrical power was greater on the affected side (P = .046), although the spherical power was not different between sides (P = .657). No significant difference was identified in the axial globe length between sides, and only 5% of non-pediatric patients showed an axial globe length more than 0.67 mm longer on the affected side. Congenital ptosis may have little effect on axial globe length elongation, and the risk of axial myopia-induced anisometropic amblyopia may be low in patients with unilateral congenital ptosis. Copyright 2015, SLACK Incorporated.

  20. Intraoperative discovery of a neurofibroma during routine ptosis surgery.

    Science.gov (United States)

    Gayton, J L; Ledford, J K; Tsai, E

    1993-01-01

    A noncosmetic blepharoplasty with levator tuck was planned to repair a congenital ptosis presumed to be caused by levator maldevelopment. During surgery a mass was found in the lid, revealing the ptosis to be mechanical in nature. Biopsy and subsequent pathological exam revealed this to be a plexiform neurofibroma in a reportedly undiagnosed patient.

  1. Psychogenic unilateral ptosis with ipsilateral muscle spasm of orbicular oculi.

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    Matsumoto, Hideyuki; Shimizu, Takahiro; Igeta, Yukifusa; Hashida, Hideji

    2012-07-01

    This report describes the rare case of a 27-year-old female patient with conversion disorder who presented unilateral ptosis with ipsilateral muscle spasm of orbicular oculi. The co-existing of ptosis and muscle spasm of orbicular oculi indicates that, in accord with prior reports, the overactivity of orbicular oculi is essential in psychogenic pseudoptosis. The co-existing of unilateral ptosis and ipsilateral muscle spasm of orbicular oculi in the present case leads us to the conclusion that the overactivity of orbicular oculi is essential in psychogenic pseudoptosis.

  2. A case of Sheehan's syndrome that manifested as bilateral ptosis.

    Science.gov (United States)

    Lee, Young Sil; Moon, Seong Su

    2011-04-01

    Hypothyroidism can cause a variety of signs and symptoms of the neuromuscular system. However, ptosis in a patient with hypothyroidism is very rare. We report here on a case of central hypothyroidism that was due to Sheehan's syndrome and it manifested as bilateral ptosis in a 51-yr-old woman. She complained of exertional dyspnea and weakness. About 25-yr ago, she had a history of severe postpartum vaginal bleeding. The laboratory studies demonstrated hypopituitarism with secondary hypothyroidism. The ptosis was improved by replacement of thyroid hormone. Hypothyroidism should be considered in the differential diagnosis of patients who manifest with ptosis and that prompt replacement of hormone can lead to a complete recovery.

  3. The Holocene History of Nares Strait: Transition from Glacial Bay to Arctic-Atlantic Throughflow

    DEFF Research Database (Denmark)

    Jennings, Anne; Sheldon, Christina; Cronin, Thomas

    2011-01-01

    Retreat of glacier ice from Nares Strait and other straits in the Canadian Arctic Archipelago after the end of the last Ice Age initiated an important connection between the Arctic and the North Atlantic Oceans, allowing development of modern ocean circulation in Baffin Bay and the Labrador Sea. ...

  4. Narečie postepeno kak leksičeskij kvantifikator

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    Ristić Stana

    2008-01-01

    Full Text Available (ruski V rabote na osnove analiza primerov upotreblenija narečija postepeno vyjavljajutsja ego obščie harakteristiki i opredeljajutsja grammatičesko-semantičeskie uslovija realizacii ego značenija i funkcii. Narečie postepeno otneseno k polnost'ju pragmatičeskim kvantifikatoram partitivno-distributivnogo tipa, pri ëtom ego partitivnost' organizovana v sootvetstvii s kriteriem vremennój linearnosti. Svojstva partitivnosti distributivnosti i sukcessivnosti, vyražennye u narečija postepeno predstavljajut soboj ingerentnuju harakteristiku složnoj situacii, kotoraja zapolnjaet semantičeskuju valentnost' dannogo odnomestnogo predikata. Rasčlenennost' složnoj situacii, kak neobhodimoe uslovie upotreblenija dannogo narečija, možet byt' realizovana v vide predikativnogo soderžanija i / ili v vide soderžanija argumentov predikata. Vozmožnost' zapolnenija semantičeskoj i sintaksičeskoj valentnosti predikata i / ili semantičeskoj valentnosti ego argumentov osuščestvljaetsja na osnove semantičeskih pravil dvuh tipov, kotorymi opredeljaetsja sfera dejstvija netrivial'nyh značenij narečija postepeno i ego grammatičesko-semantičeskaja sočetaemost'. Različnye grammatičesko-semantičeskie uslovija realizacii ego značenija i funkcii vyjavlennye v rabote, predstavleny v prilagaemoj tablice kak varianty osnovnyh tipov, obuslovlennyh obščimi grammatičeskimi imennymi i glagol'nymi kategorijami, takimi, kak množestvennost' / sobiratel'nost', edinstvennoe čislo i nesoveršennyj vid, soveršennyj vid.

  5. Giant eyelid eccrine hidrocystoma-induced progressive ptosis in childhood

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    Dhivya Ashok Kumar

    2017-01-01

    Full Text Available An upper lid eccrine hidrocystoma presenting as early childhood progressive ptosis is very rare. We present a 9-year-old female child with droopy right upper lid since birth and progressive increase in symptoms. She had right upper lid ptosis (marginal reflex distance 1 of −1 mm with fair levator function (8 mm and abnormal cystic change on the conjunctival side. Computerized tomography imaging delineated the well-defined cystic lesion with homogeneous cavity with no contrast enhancement. Following the cyst excision, a giant eccrine hidrocystoma measuring 25 mm × 15 mm was removed, the largest reported in pediatric eyes. The case demonstrates the possibility of giant lid eccrine hidrocystomas presenting as progressive ptosis at a pediatric age and the need for early surgical intervention to prevent amblyopia.

  6. The Holocene history of Nares Strait: Transition from glacial bay to Arctic-Atlantic throughflow

    Science.gov (United States)

    Jennings, Anne E.; Sheldon, Christina; Cronin, Thomas M.; Francus, Pierre; Stoner, Joseph; Andrews, John

    2011-01-01

    Retreat of glacier ice from Nares Strait and other straits in the Canadian Arctic Archipelago after the end of the last Ice Age initiated an important connection between the Arctic and the North Atlantic Oceans, allowing development of modern ocean circulation in Baffin Bay and the Labrador Sea. As low-salinity, nutrient-rich Arctic Water began to enter Baffin Bay, it contributed to the Baffin and Labrador currents flowing southward. This enhanced freshwater inflow must have influenced the sea ice regime and likely is responsible for poor calcium carbonate preservation that characterizes the Baffin Island margin today. Sedimentologic and paleoceanographic data from radiocarbon-dated core HLY03-05GC, Hall Basin, northern Nares Strait, document the timing and paleoenvironments surrounding the retreat of waning ice sheets from Nares Strait and opening of this connection between the Arctic Ocean and Baffin Bay. Hall Basin was deglaciated soon before 10,300 cal BP (calibrated years before present) and records ice-distal sedimentation in a glacial bay facing the Arctic Ocean until about 9,000 cal BP. Atlantic Water was present in Hall Basin during deglaciation, suggesting that it may have promoted ice retreat. A transitional unit with high ice-rafted debris content records the opening of Nares Strait at approximately 9,000 cal BP. High productivity in Hall Basin between 9,000 and 6,000 cal BP reflects reduced sea ice cover and duration as well as throughflow of nutrient-rich Pacific Water. The later Holocene is poorly resolved in the core, but slow sedimentation rates and heavier carbon isotope values support an interpretation of increased sea ice cover and decreased productivity during the Neoglacial period.

  7. Low-level antimicrobial resistance of Enterobacteriaceae isolated from the nares of pig-exposed persons.

    Science.gov (United States)

    Fischer, J; Hille, K; Mellmann, A; Schaumburg, F; Kreienbrock, L; Köck, R

    2016-03-01

    Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) have recently emerged in livestock and humans. Therefore, this study assessed the carriage of Enterobacteriaceae in the anterior nares and associated antimicrobial resistance in pig-exposed persons. Nasal swabs were enriched in non-selective broth and then plated on MacConkey and ESBL-selective agars. Species was confirmed by matrix-assisted laser-desorption ionization-time-of-flight mass spectrometry (MALDI-ToF MS). Antimicrobial susceptibility testing was performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Of 114 pig-exposed persons tested, Enterobacteriaceae were detected in the nares of 76 (66·7%) participants. The predominant species were Proteus mirabilis (n = 17, 14·9%), Pantoea agglomerans (n = 13, 11·4%), Morganella morganii (n = 9, 7·9%), Citrobacter koseri (n = 9, 7·9%), Klebsiella pneumoniae, Escherichia coli and Proteus vulgaris (each n = 8, 7·0%). ESBL-E were not detected. Of all isolates tested, 3·4% were resistant against ciprofloxacin, 2·3% against gentamicin, 23·9% against trimethoprim-sulfamethoxazole and 44·3% against tigecycline. Despite the high prevalence of ESBL-E in livestock, pig-exposed persons did not carry ESBL-E in their nares. This finding is important, because colonization of the nasal reservoir might cause endogenous infections or facilitate transmission of ESBL-E in the general population.

  8. [Surgical treatment of myopathic ptosis. Apropos of 20 surgically treated cases].

    Science.gov (United States)

    Morax, S; Longueville, E; Hurbli, T

    1992-08-01

    Twenty cases of severe progressive ophthalmoplegia (Myopathic ptosis) with significant ptosis were treated by various procedures, including levator resection with blepharoplasty or frontalis suspension using temporalis fascia. Surgical indications were generally limited to cases with poor or absent levator function. The results are analysed after an average follow-up of 6 months. The particular problems concerning surgery of myopathic ptosis are discussed.

  9. Clinical evaluation of nares-vocal cord distance and its correlation with various external body parameters

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    Bhuwan Sareen

    2015-01-01

    Full Text Available Background and Aims: The optimal visualisation of vocal cords during fibreoptic intubation may be utilised for the nares-vocal cord distance (NVD estimation. The present study was conducted to measure NVD and to correlate with various external body parameters. Methods: This study was conducted on 50 males and 50 females. We measured NVD and analysed its relationship with height, nares to tragus of ear distance (NED, nares to angle of mandible distance (NMD, sternal length (SL, thyro-mental distance (TMD, sterno-mental distance (SMD and arm span (AS. Results: The mean NVD of the males was 18.5 ± 1.5 cm, and that of the females was 15.9 ± 1.1 cm. The relationship between the NVD and body height (males P = 0.001, r = 0.463, females P = 0.000, r = 0.555, SL (males P = 0.000, r = 0.463, females P < 0.000, r = 0.801 or AS (males P = 0.000, r = 0.561, females P = 0.000, r = 0.499 showed a significant correlation but NED, NMD, TMD, SMD did not. After combining male and female groups, (n = 100, the correlation of NVD with external body parameters is as follows SL (r = 0.887, height (r = 0.791, AS (r = 0.769, weight (r = 0.531, SMD (r = 0.466, NED (r = 0.459, NMD (r = 0.391, TMD (r = 0.379. Conclusion: The relationship of NVD to external body parameters had strong correlation in all parameters in the combined group; whereas when gender was taken into consideration NVD correlated significantly only with SL, height and AS.

  10. [Choice of treatment in surgery of congenital ptosis].

    Science.gov (United States)

    Morax, S

    1989-01-01

    Because of the great variety of congenital ptosis and surgical procedures, the choice of a definite surgical protocol is rather difficult. The author reports here three surgical techniques which have been used for over 5 years. The levator muscle resection with upper lid fold reconstruction via a skin approach is still the preferred technique in most cases. The main problem is to determine the magnitude of muscle resection which is directly related to the levator function. Frontalis suspension with autogenous fascia-lata or synthetic materials as Goretex is performed in case of levator resection failure: non-functioning muscle, muscular dysfunction as in the Marcus Gunn syndrome. The conjunctiva-Müller's muscle excision avoiding overcorrection is indicated in cases of minor congenital ptosis with good muscular function and positive response to topical 10% epinephrine drops.

  11. The Neisseria meningitidis ADP-Ribosyltransferase NarE Enters Human Epithelial Cells and Disrupts Epithelial Monolayer Integrity.

    Directory of Open Access Journals (Sweden)

    Maria Valeri

    Full Text Available Many pathogenic bacteria utilize ADP-ribosylating toxins to modify and impair essential functions of eukaryotic cells. It has been previously reported that Neisseria meningitidis possesses an ADP-ribosyltransferase enzyme, NarE, retaining the capacity to hydrolyse NAD and to transfer ADP-ribose moiety to arginine residues in target acceptor proteins. Here we show that upon internalization into human epithelial cells, NarE gains access to the cytoplasm and, through its ADP-ribosylating activity, targets host cell proteins. Notably, we observed that these events trigger the disruption of the epithelial monolayer integrity and the activation of the apoptotic pathway. Overall, our findings provide, for the first time, evidence for a biological activity of NarE on host cells, suggesting its possible involvement in Neisseria pathogenesis.

  12. A rare case of complete bilateral ophthalmoplegia and ptosis.

    Science.gov (United States)

    Hall, Daniel John; Bazaraa, Talal

    2014-01-01

    We describe the case of an 85-year-old gentleman admitted with bilateral ptosis and complete bilateral ocular paralysis. Initial differential diagnoses included myasthenia gravis, diabetic cranial neuropathy, an ischaemic event and possible occult neoplasm. Investigations did not support any of the differentials and Miller Fisher syndrome (MFS) was considered. Anti-GQ1b IgG antibody was positive, supporting the possibility of anti-ganglioside syndrome. This gentleman was treated with intravenous immunoglobulin (IVIG) and made a full recovery.

  13. Impact of strain typing methods on assessment of relationship between paired nares and wound isolates of methicillin-resistant Staphylococcus aureus

    NARCIS (Netherlands)

    J.E. Clarridge III (Jill); R.A. Harrington (Robert Alex); M.C. Roberts (Marilyn); O.O. Soge (Olusegun); K. Maquelin (Kees)

    2013-01-01

    textabstractThe anterior nares are the site of choice for the Veterans Administration methicillin-resistant Staphylococcus aureus (MRSA) surveillance program; however, a correlation between nares colonization and concomitant wound infections has not been well established. The purpose of this study w

  14. Acute Painful Ptosis Secondary to IgG4 Dacryoadenitis

    Directory of Open Access Journals (Sweden)

    Rumana Hussain

    2016-02-01

    Full Text Available A 48-year-old lorry driver presented with 3 weeks of blurred vision, pain and diplopia. There was a right upper lid ptosis with some restriction of eye movements. A CT revealed an enlarged lacrimal gland and lacrimal gland biopsy showed IgG4-positive plasma cells. The patient responded to oral prednisolone and fully recovered. As a condition which mimics a number of diseases, an IgG4-related disease presents a diagnostic challenge and ought to be considered in both acute and chronic presentations.

  15. Optimization of a Nucleic Acids united-RESidue 2-Point model (NARES-2P) with a maximum-likelihood approach

    Energy Technology Data Exchange (ETDEWEB)

    He, Yi; Scheraga, Harold A., E-mail: has5@cornell.edu [Department of Chemistry and Chemical Biology, Cornell University, Ithaca, New York 14853 (United States); Liwo, Adam [Faculty of Chemistry, University of Gdańsk, Wita Stwosza 63, 80-308 Gdańsk (Poland)

    2015-12-28

    Coarse-grained models are useful tools to investigate the structural and thermodynamic properties of biomolecules. They are obtained by merging several atoms into one interaction site. Such simplified models try to capture as much as possible information of the original biomolecular system in all-atom representation but the resulting parameters of these coarse-grained force fields still need further optimization. In this paper, a force field optimization method, which is based on maximum-likelihood fitting of the simulated to the experimental conformational ensembles and least-squares fitting of the simulated to the experimental heat-capacity curves, is applied to optimize the Nucleic Acid united-RESidue 2-point (NARES-2P) model for coarse-grained simulations of nucleic acids recently developed in our laboratory. The optimized NARES-2P force field reproduces the structural and thermodynamic data of small DNA molecules much better than the original force field.

  16. Botulinum toxin-A-induced protective ptosis in the treatment of lagophthalmos associated with facial paralysis.

    Science.gov (United States)

    Yücel, Ozlem Eşki; Artürk, Nurşen

    2012-01-01

    To evaluate the safety and efficacy of the protective ptosis created by botulinum neurotoxin type-A in lagophthalmos cases due to peripheral facial paralysis. Protective ptosis was induced by 7.5 U botulinum neurotoxin type-A injection into levator muscles in 15 patients with peripheral facial paralysis and lagophthalmos. Its efficacy and safety were evaluated prospectively. Complete ophthalmological examinations were performed before and after injections; interpalpebral fissure, upper eyelid margin reflex distance, and levator muscle function were measured. In control visits, degree and duration of ptosis and side effects of the drug were evaluated. The mean age of the patients was 55 ± 14.28 years (22-78 years). Ptosis created by botulinum neurotoxin type-A injection was severe in 12 patients (80%), moderate in 2 patients (13.3%), and mild in 1 patient (6.7%). The effect of botulinum neurotoxin type-A began in 2.33 ± 1.44 days and peaked in 5.73 ± 2.63 days. No patient needed a second injection. The mean duration for ptosis was 10.53 ± 2.89 weeks. After development of ptosis, statistically significant improvement in corneal symptoms (p lagophthalmos, protective ptosis created by botulinum neurotoxin type-A injection into the levator muscle is a reliable and effective technique for the protection of the ocular surface and treatment of existing corneal complications. It represents an alternative treatment modality in cases requiring surgery.

  17. Antimicrobial photodynamic therapy for the decolonization of methicillin-resistant Staphylococcus aureus from the anterior nares

    Science.gov (United States)

    Street, Cale N.; Pedigo, Lisa; Gibbs, Aaron; Loebel, Nicolas G.

    2009-06-01

    The nosocomial infection rate has increased dramatically due to emergence of antibiotic resistant bacterial strains such as methicillin resistant Staphylococcus aureus (MRSA). The primary anatomical site of MRSA colonization is the anterior nares, and this reservoir represents a primary vector of transmission from non-infected carriers to susceptible individuals. Antimicrobial photodynamic therapy (aPDT) has been used successfully for topical disinfection in the oral cavity. The aim of this study was to evaluate the utility of aPDT for nasal MRSA decolonization at the preclinical and clinical level. The nasal aPDT system consists of a 670 nm diode laser fibre-optically coupled to a disposable light diffusing tip, used to activate a methylene blue based photosensitizer formulation. Preclinical testing was done both in a custom nasal reservoir model and on human skin cultures colonized on the epithelial surface with MRSA. Human clinical testing was performed by clinicians in regions in which the system is approved by the regulatory authority. In vitro testing demonstrated that aPDT eradicated planktonic MRSA in an energy and photosensitizer concentration dependent manner. Furthermore, aPDT eliminated sustained colonization of MRSA on cultured human epithelial surfaces, an effect that was sustained over multiple days post-treatment. In preliminary human testing, aPDT eradicated MRSA completely from the nose with total treatment times <10 minutes. aPDT is effective against MRSA when used topically in the nose. Energy dose and photosensitizer parameters have been optimized for the nasal environment. Controlled clinical studies are currently underway to further evaluate safety and efficacy.

  18. Unilateral transient mydriasis and ptosis after botulinum toxin injection for a cosmetic procedure

    Directory of Open Access Journals (Sweden)

    Akkaya S

    2015-02-01

    Full Text Available Sezen Akkaya,1 Hatice Kübra Kökcen,1 Tuğba Atakan2 1Fatih Sultan Mehmet Education and Training Hospital, Ophthalmology Clinics, Bostanci, Istanbul, 2Aksaray Hospital, Ophthalmology Clinics, Konya, Turkey Abstract: We report a case of unilateral transient mydriasis and ptosis after botulinum toxin injection applied by a medical doctor for a cosmetic procedure. A 36-year-old nurse was referred to our eye clinic with unilateral mydriasis and ptosis in the right eye 3 days after botulinum toxin injection for a cosmetic procedure. Botulinum toxin was applied to her eye by a doctor at her hospital who was not an ophthalmologist. She was treated with topical apraclonidine 0.5% ophthalmic solution. Her ptosis decreased to 2 mm with apraclonidine and her visual axis improved. Mydriasis was present for 3 weeks and then disappeared. Mild ptosis continued for 3 months, then resolved completely. Patients seeking treatment with botulinum toxin A for cosmetic purposes should be warned about the possibility of ptosis and mydriasis after injection. If these side effects are seen, the patient must be referred to an ophthalmologist for appropriate management. Keywords: botulinum toxin, mydriasis, ptosis

  19. Approach to eyebrow ptosis through the modified technique of Castanares

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    Giovanni Pires

    2009-01-01

    Full Text Available One of the first signs of facial ageing appears in the forehead, with the descent of the lateral part of the brow. This is a troubling condition for all patients and elevation of the lateral part of the brow becomes a more and more frequent demand. The authors present their experience in 350 consecutive cases of direct eyebrow lift ("butterfly wing" incision alone or in combination with rhytidectomy and/or blepharoplasty. The majority of the patients were female (90%. The age ranged from 43 to 85 years. Eighty per cent of the cases were performed simultaneously with rhytidectomy and blepharoplasty, 16% were performed in association with blepharoplasty and eyebrow lift alone represented 4%. The most common complication was epidermal cyst (3.4% and suture dehiscence (2%. The "butterfly wing" incision provides a useful alternative to correction of eyebrow ptosis. Indication for surgery is dependent more on the ageing signs than on the patient′s chronological age. The final results are consistently very gratifying to the patient and to the plastic surgeon alike.

  20. Goldilocks mastectomy for obese Japanese females with breast ptosis

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    Tomoko Ogawa

    2015-10-01

    Full Text Available The Goldilocks mastectomy is a method that uses redundant mastectomy flap tissue alone to create a breast mound in female American patients with macromastia. Goldilocks mastectomy was performed for obese Japanese females with breast ptosis, and its indications were considered for Japanese female patients. This report presents the results of five patients who underwent Goldilocks mastectomy, including one with bilateral breast cancer. The average age of the patients was 72 years (range: 67–76 years. The body mass index (BMI was more than 25 in all the cases. Four patients had invasive ductal carcinoma, and one patient had noninvasive ductal carcinoma of bilateral breasts. The cosmetic results were found to be good in two cases [a patient with bilateral breast cancer and a severely obese patient (BMI = 39]. The cosmetic results in the other three cases were poor. Although the reconstructed breast size was small, this procedure resulted in better cosmetic results than what would be achieved with the usual method of mastectomy for Japanese patients with bilateral breast cancer and severely obese Japanese patients.

  1. [Suspension of the eyelid to the frontal muscle in the surgery of ptosis. Technic and indications].

    Science.gov (United States)

    Morax, S; Benia, L

    1986-01-01

    Twenty seven frontalis sling procedures were performed with use of autogenous fascia-lata. The choice of this procedure was performed sometimes at the first stage for severe ptosis with poor levator function: isolated congenital ptosis, blepharophimosis syndrome, Marcus Gunn Jaw-Winking ptosis, ptosis with severe myopathy, some traumatic ptosis. This procedure was also performed in a second stage after failure of the useful procedures (levator resection) and after verification that the levator was not exploitable. Sometimes the choice of the procedure is done during the exploration of the eyelid and the levator because there is not always "parallelism" between the levator function and his anatomy. So operative technique must always be performed by a complete anterior palpebral approach, the surgeon can passed the suspensory material from the tarsus to the roof of the orbit, just anterior to the levator aponeurosis, and then out above the eyebrow. The pulley this created by the periosteum of the superior orbital margin prevents vertical traction lines. The skin crease is created with sutures which pick up the tarsus and the lid retractors. If, during the explorations the levator is "exploitable", a super maximum levator resection will be performed at the first stage, the frontalis suspension will be maintained in case of failure of the levator resection.

  2. Blepharophimosis, ptosis, and epicanthus inversus syndrome: clinical and molecular analysis of a case.

    Science.gov (United States)

    Mari, Francesca; Giachino, Daniela; Russo, Lucia; Pilia, Giuseppe; Ariani, Francesca; Scala, Elisa; Chiappe, Francesca; Sampieri, Katia; Caporossi, Aldo; Renieri, Alessandra; Lasorella, Giacomo

    2006-06-01

    Blepharophimosis-ptosis-epicanthus inversus syndrome (OMIM #U10100) is a rare autosomal-dominant disorder in which an eyelid malformation is associated (type I) or not (type H) with premature ovarian failure in the affected female. It is invariably characterized by 4 major features: (1) bilaterally shortened horizontal palpebral fissure (blepharophimosis); (2) severe impairment of the superior palpebral levator (ptosis); (3) a vertical skin fold arising from the lower eyelid, which inserts medially in the upper lid (epicanthus inversus) and (4) an increased inner can-thal distance with a normal outer canthal distance (telecanthus). The mutations causing this disorder are found in the FOXL2 gene, a forkhead transcription factor, located in 3q23. Although many patients with blepharophimosis-ptosis-epicanthus inversus syndrome have an affected parent, a conspicuous number of sporadic cases also have been reported. We describe here a sporadic case with a mutation in the FOXL2 gene that was well characterized both clinically and molecularly.

  3. Congenital eyelid ptosis: onset and prevalence of amblyopia, associations with systemic disorders, and treatment outcomes.

    Science.gov (United States)

    Stein, August; Kelly, John P; Weiss, Avery H

    2014-10-01

    To determine the age at onset of amblyopia, the response to occlusion therapy, and the association with systemic disorders in children with congenital eyelid ptosis. Retrospective chart review of children seen at Seattle Children's Hospital with moderate or severe congenital ptosis. Assessments were longitudinal visual acuity development using objective methods, definition of ptosis severity by eyelid margin to pupillary light reflex distance (margin reflex distance [MRD]), age at amblyopia diagnosis, correlation between amblyopia and MRD, and associated systemic disorders. Eighty-four children with moderate-to-severe congenital ptosis met inclusion criteria; the mean longitudinal follow-up was 49.1 months. Fifteen (18%) of these children had amblyopia, of which 9 had deprivation amblyopia (mean age 17.3 months ± 11.2) and 6 had anisometropic or strabismic amblyopia (mean age 60 months ± 11.8). Eleven (73%) of the children with amblyopia were successfully treated with occlusion therapy. Amblyopia was not correlated with MRD. A systemic disorder was identified in 29 (35%) of the children, the most common being genetic, chromosomal, or neurologic conditions. Patients with systemic disorders and developmental delay have significantly lower visual acuity bilaterally compared with patients without systemic disorders (P ≤ .003). Using longitudinal and objective visual acuity assessments, the incidence of amblyopia was 18% in children with moderate to severe congenital ptosis. Visual deprivation was the predominant risk factor that was reliably distinguished by its earlier onset in young children. The best indicator of amblyopia in children is visual acuity rather than MRD measurements. Systemic disorders are frequent in children with moderate to severe congenital ptosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Cosmetic Outcome of Posterior Approach Ptosis Surgery (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Goldberg, Robert A.; Lew, Helen

    2011-01-01

    Purpose To test the hypothesis that posterior approach ptosis surgery, with or without blepharoplasty, can improve the cosmetic appearance of the eyelid. Methods In a retrospective, observational, consecutive case cohort study, 261 patients who had posterior approach upper eyelid ptosis surgery with or without concurrent blepharoplasty performed by one surgeon, between 1997 and 2009, were reviewed. Patients were included if they had symmetric eyelid position within 1.5 mm at 3 months after surgery. Outcome measures were subjective grading of eyelid margin contour, millimeters of tarsal platform show (TPS), and millimeters of eyebrow fat span (BFS). Paired preoperative and postoperative standardized photographs were viewed in masked fashion by three experts. Results One hundred and forty patients (55 men, 85 women, mean age 70 years, range 20–93) who underwent 233 posterior approach procedures for correction of upper eyelid ptosis had postoperative eyelid symmetry within 1.5 mm. Concurrent blepharoplasty was performed in 67 cases. Eyelid contour scores were significantly improved following surgery (P=.009). Ptosis surgery, without blepharoplasty, decreased the TPS, from 6.1±2.5 mm to 4.8±2.0 mm (P<.001). Patients who underwent concurrent blepharoplasty had a statistically insignificant increase of TPS from 4.0±3.5 mm to 4.3±3.6 mm, had a decrease of BFS from 20.8±6.3 mm to 17.7±6.4 mm (P=.001), and showed similar BFS symmetry postoperatively, compared to patients who had ptosis surgery only. Conclusions Posterior approach surgery alone was often successful in controlling TPS: it shortened the TPS. Blepharoplasty combined with posterior approach ptosis surgery tended to lengthen the TPS and shorten the BFS. PMID:22253486

  5. Thyroid Eye Disease With Significant Levator Involvement and Ptosis: A Case Report.

    Science.gov (United States)

    Scruggs, Ryan T; Black, Evan H

    2015-01-01

    A case of an 87-year-old woman with a history of Graves disease presenting with a 5-year history of severe ptosis and very poor levator function of the left side is presented. MRI revealed marked enlargement of all extraocular muscles and significant enlargement of the left levator muscle. Given the patient's age and atypical presentation of thyroid eye disease (TED), she was taken to the operating room for biopsy and ptosis repair with frontalis suspension. Histopathological analysis revealed chronic inflammation and fibrosis consistent with Graves disease.

  6. Vincristine-Induced Neuropathy Presenting as Ptosis and Ophthalmoplegia in a 2-Year-Old Boy.

    Science.gov (United States)

    Palkar, Amit H; Nair, Akshay Gopinathan; Desai, Roshani J; Potdar, Nayana A; Shinde, Chhaya A

    2015-07-07

    Vincristine is used in the treatment of leukemias, solid tumors, and lymphomas. A case of a 2-year-old boy undergoing treatment for leukemia who developed sudden onset bilateral ptosis and ophthalmoplegia along with generalized neuropathy due to vincristine's neurotoxic effects is presented. He was successfully treated with pyridoxine and pyridostigmine. The possible mechanisms of action and the treatment for vincristine-induced neuropathy are discussed. Prompt treatment and close follow-up is needed, especially in children because prolonged ptosis and motility restriction may have a profound effect on a child's visual function.

  7. Bilateral ptosis as first presentation of cytophagic histiocytic panniculitis: a case report.

    Science.gov (United States)

    Liao, Wang; Xiao, Songhua; Yong, Juanjuan; Fan, Shengnuo; Fang, Wenli; Zheng, Yuqiu; Liu, Jun

    2017-07-01

    Cytophagic histiocytic panniculitis (CHP) is a rare form of nodular panniculitis that may progress to panniculitis-like T-cell lymphoma. We report a case of CHP that first manifested as bilateral ptosis, which is the first reported case of this presentation. A 25-year-old woman without medical history was referred to the neurology department of our hospital for evaluation of bilateral ptosis. Three months previously, she suddenly complained of bilateral ptosis without apparent cause. Simultaneously, non-painful tender subcutaneous nodules and eschar-like skin lesions were observed on her extremities and trunk. A diagnosis of CHP was made based on skin biopsy from the left thigh showing lobular panniculitis, vasculitis, and adiponecrosis, with infiltration of inflammatory cells, including lymphocytes, histiocytes, and phagocytic histiocytes. Her condition continued to worsen with corticosteroid and immunosuppressive agent (thalidomide) treatment. Significant improvement was noticed after three cycles of chemotherapy of THP-COP (pirarubicin, cyclophosphamide, vincristine, and prednisolone). CHP is a rare condition whose clinical presentation may include bilateral ptosis and biopsy is required for diagnosis of CHP.

  8. [The syndrome of blepharophimosis-ptosis-dystopia of the inferior puncta lacrimalia and epicanthus].

    Science.gov (United States)

    Dumitrache, L

    1991-01-01

    The paper presents a family with 28 members belonging to four generations. 12 of them show an association of blepharophimosis--ptosis--dystopia of the inferior lacrimal points and epicanthus. 9 members of the family in the 3rd and 4th generations were examined and a dominant mode of transmission was evidenced.

  9. A Novel Approach to Submandibular Gland Ptosis: Creation of a Platysma Muscle and Hyoid Bone Cradle.

    Science.gov (United States)

    Lukavsky, Robert; Linkov, Gary; Fundakowski, Christopher

    2016-07-01

    Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers. A submental incision with sharp dissection was performed to raise a supraplatysmal flap. A subplatysmal plane was developed until the submandibular gland was identified. Sutures were used to pexy the platysma to the hyoid bone periosteum and deep cervical fascia, tightening the overlying muscle and in turn elevating the submandibular gland. Submandibular gland ptosis must be corrected in order to achieve exemplary aesthetic results. Our approach of creating a cradle with the platysma and hyoid bone avoids the potential complications of previously described sling procedures, while still maintaining the integrity of the gland and surrounding tissues.

  10. Autosomal recessive disorder with retardation of growth, mental deficiency, ptosis, pectus excavatum and camptodactyly

    Energy Technology Data Exchange (ETDEWEB)

    Khaldi, F.; Bennaceur, B.; Hammou, A.; Hamza, M.; Gharbi, H.A.

    1988-07-01

    Two strikingly similar brothers issued from consanguineous parents in the second degree present the following patterns of anomalies: Retardation of growth, mental deficiency, ocular abnormalities, pectus excavatum and camptodactyly. The ocular abnormalities include ptosis, microphthalmia and hypertelorism. No endocrine or metabolic aberrations are found. The authors conclude that the disorder has probably an autosomal recessive mode of transmission.

  11. [Remote results of surgical treatment of aging ptosis of face and neck tissues].

    Science.gov (United States)

    Ezrokhin, V M; Pavlovich, V A

    2008-01-01

    Remote results of surgical treatment of patients with aging ptosis of face and neck tissues during 15 years are presented. Results were good there where suggested incisions marking was carried out and for those face and neck skin regions which should be corrected. Unsatisfactory results were received in the cases when wounds edges were sewn by uninterrupted blanket sutures without skin deeper layers fixing.

  12. A Novel Approach to Submandibular Gland Ptosis: Creation of a Platysma Muscle and Hyoid Bone Cradle

    Directory of Open Access Journals (Sweden)

    Robert Lukavsky

    2016-07-01

    Full Text Available Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers. A submental incision with sharp dissection was performed to raise a supraplatysmal flap. A subplatysmal plane was developed until the submandibular gland was identified. Sutures were used to pexy the platysma to the hyoid bone periosteum and deep cervical fascia, tightening the overlying muscle and in turn elevating the submandibular gland. Submandibular gland ptosis must be corrected in order to achieve exemplary aesthetic results. Our approach of creating a cradle with the platysma and hyoid bone avoids the potential complications of previously described sling procedures, while still maintaining the integrity of the gland and surrounding tissues.

  13. Clinical trial comparing autogenous fascia lata sling and Gore-Tex suspension in bilateral congenital ptosis

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    Elsamkary MA

    2016-03-01

    Full Text Available Mahmoud Ahmed Elsamkary,1 Maged Maher Salib Roshdy1,2 1Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Pediatric Ophthalmology Department, Al Watany Eye Hospital, Cairo, Egypt Purpose: To study the effect of autogenous fascia lata sling (AFLS versus Gore-Tex suspension (GTS regarding the functional and aesthetic outcomes in patients with bilateral congenital ptosis. Patients and methods: A prospective comparative randomized single-center study enrolled 110 patients with bilateral congenital ptosis. One group (n=55 underwent AFLS and the second group (n=55 underwent GTS. Exclusion criteria were good levator function, absent Bell’s phenomenon, and abnormal ocular motility. Follow-up period was 2 years. Functional outcome was measured from digital photos by analysis of upper eyelid margin position relative to the superior limbus and classified as very good (<3 mm, good (3–5 mm, poor (>5 mm, and recurrent. Aesthetic outcome was assessed in terms of lid contour, symmetry of eyelid height, and lid crease presence. Complications were also reported. Results: Failure rate (recurrence and complications was less in AFLS (P=0.035. Symmetrical lid height and good contour were more frequently attained by AFLS (P=0.007 and 0.047, respectively. However, the frequency of very good, good, poor, recurrence, lagopthalmos, ectropion, infection, and formed lid crease individually showed no statistically significant difference (P=0.252, 0.482, 1, 0.489, 0.438, 1, 0.618, and 0.506, respectively. Conclusion: AFLS is a better choice in surgery for patients with bilateral congenital ptosis because it has fewer complications and a lesser recurrence rate than GTS. Keywords: ptosis surgery, surgical outcomes, ptosis recurrence, lagophthalmos

  14. Técnica de Crawford en el tratamiento de la ptosis palpebral congénita

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    Clara Gisela Gómez Cabrera

    Full Text Available Objetivo: evaluar los resultados quirúrgicos de la técnica de Crawford mediante el empleo de silastic y polipropileno 4.0 y las complicaciones presentadas. Métodos: se realizó un estudio descriptivo y prospectivo de 12 pacientes (16 párpados con ptosis palpebral congénita desde enero 2009 a diciembre 2010 en la consulta de Oculoplastia del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Fueron excluidos los que tenían cirugía anterior de dicha enfermedad. Resultados: el 83,3 % fueron del sexo masculino y el 91,6 % menores de 9 años de edad; de ellos, 4 casos de 0 a 2 y de 6 a 8, respectivamente; 3 casos en el grupo de 3 a 5 y solo 1 caso mayor de 9 años. El 75 % fueron ptosis congénita simple y el 56 % severas. La ptosis resultó corregida en 13 párpados para el 81 %. Con el uso de sutura polipropileno 4.0, dos párpados se encontraron hipocorregidos (12,6 % y seis corregidos (37,5 %; con silastic, un párpado quedó hipocorregido, (6,3 % y siete corregidos (43,7 %. Se presentó el 25 % de complicaciones, 3 párpados hipocorregidos y un granuloma supraciliar. Conclusiones: la ptosis resultó más frecuente en menores de 8 años del sexo masculino. Predominó la ptosis congénita simple, unilateral y severa. La técnica de Crawford resultó efectiva en la mayoría de los casos y similar con los dos materiales empleados.

  15. Structure of Palaeogene sediments in east Ellesmere Island: Constraints on Eurekan tectonic evolution and implications for the Nares Strait problem

    Science.gov (United States)

    Saalmann, K.; Tessensohn, F.; Piepjohn, K.; von Gosen, W.; Mayr, U.

    2005-08-01

    The "Nares Strait problem" represents a debate about the existence and magnitude of left-lateral movements along the proposed Wegener Fault within this seaway. Study of Palaeogene Eurekan tectonics at its shorelines could shed light on the kinematics of this fault. Palaeogene (Late Paleocene to Early Eocene) sediments are exposed at the northeastern coast of Ellesmere Island in the Judge Daly Promontory. They are preserved as elongate SW-NE striking fault-bounded basins cutting folded Early Paleozoic strata. The structures of the Palaeogene exposures are characterized by broad open synclines cut and displaced by steeply dipping strike-slip faults. Their fold axes strike NE-SW at an acute angle to the border faults indicating left-lateral transpression. Weak deformation in the interior of the outliers contrasts with intense shearing and fracturing adjacent to border faults. The degree of deformation of the Palaeogene strata varies markedly between the northwestern and southeastern border faults with the first being more intense. Structural geometry, orientation of subordinate folds and faults, the kinematics of faults, and fault-slip data suggest a multiple stage structural evolution during the Palaeogene Eurekan deformation: (1) The fault pattern on Judge Daly Promontory is result of left-lateral strike-slip faulting starting in Mid to Late Paleocene times. The Palaeogene Judge Daly basin formed in transtensional segments by pull-apart mechanism. Transpression during progressive strike-slip shearing gave rise to open folding of the Palaeogene deposits. (2) The faults were reactivated during SE-directed thrust tectonics in Mid Eocene times (chron 21). A strike-slip component during thrusting on the reactivated faults depends on the steepness of the fault segments and on their obliquity to the regional stress axes. Strike-slip displacement was partitioned to a number of sub-parallel faults on-shore and off-shore. Hence, large-scale lateral movements in the sum of 80

  16. The incidence of ptosis following extracapsular and phacoemulsification surgery: comparison of two prospective studies and review of the literature.

    Science.gov (United States)

    Puvanachandra, Narman; Hustler, Adam; Seah, Lay Leng; Tyers, Anthony G

    2010-12-01

    We prospectively compared 120 patients who underwent either phacoemulsification or extracapsular cataract (ECCE) surgery to establish the incidence of postoperative ptosis between the two techniques. Of the 120 patients, 60 underwent ECCE (unpublished data 1989) and 60 had phacoemulsification. Data was collected prospectively on upper and lower margin reflex distance, upper lid skin crease and levator function, preoperatively and 6 weeks postoperatively. Photographs were taken pre and postoperatively and examined by a blinded observer. At 6 weeks, ptosis was present in 18% of ECCE patients compared with 0% in the phacoemulsification group. By changing from ECCE to phacoemulsification the incidence of postoperative ptosis has reduced. The possibility to induce postoperative ptosis remains, potential mechanisms are discussed.

  17. [Dehiscence and disinsertion of the aponeurotic bundle of the upper eyelid levator in acquired ptosis].

    Science.gov (United States)

    Morax, S

    1984-01-01

    Aponeurotic defects and disinsertion of the levator aponeurosis are responsible for many cases of acquired ptosis. The typical clinical findings in aponeurotic defects are: history of prior orbital swelling, injury, ocular surgery, blepharochalasis; good to excellent levator function, thinning of the eyelid above the tarsus, high to absent lid crease, and normal Müller's muscle function. The purpose of the treatment is to repair a defect or advance the aponeurosis onto the tarsus. Levator aponeurosis surgery was used to treat 18 upper eyelids with acquired ptosis. Local anesthesia and surgery from an anterior approach were used in all cases. The advantages of this technique are: The lid height is determined by asking the patient to look in various fields of gaze. A blepharoplasty can be performed when necessary. The lid crease is formed. The exposition of the levator aponeurosis disinsertion is easier to recognize.

  18. Novel occurrence of axenfeld: Rieger syndrome in a patient with blepharophimosis ptosis epicanthus inversus syndrome.

    Science.gov (United States)

    Shah, Bhavin M; Dada, Tanuj; Panda, Anita; Tanwar, Mukesh; Bhartiya, Shibal; Dada, Rima

    2014-03-01

    Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a complex eyelid malformation characterized by the classical tetrad of blepharophimosis, telecanthus, ptosis, and epicanthus inversus. It has been reported to be associated with other ocular anomalies such as euryblepharon, strabismus, nystagmus, amblyopia, microphthalmos, lacrimal drainage apparatus abnormality, extra ocular muscle abnormalities, microcornea, trabecular dysgenesis, optic nerve hypoplasias, and colobomas of the optic disk. We describe a case of BPES with Axenfeld-Rieger syndrome, a neurocristopathy characterized by maldevelopment of the anterior segment with predisposition to development of glaucoma. Interestingly, both syndromes are caused by mutations in the same class of genes, namely the winged-helix/forked transcription factors (FOX) involved in a variety of developmental processes.

  19. [Combining mastopexy and triple-plane breast augmentation in correction of breast atrophy and ptosis].

    Science.gov (United States)

    Long, Xiao; Wang, Yang; Bai, Ming; Zhao, Ru

    2015-01-01

    To investigate the application of combining mastopexy and triple-plane breast augmentation in correction of breast ptosis and atrophy. Peri-areolar incision was performed to finish the fascia and dermal suspension to correct the breast ptosis. The implant was inserted under the pectoralis major muscle through lateral lower border of the gland and a "X" shape full thickness incision was made on the pectoralis major muscle according to the new position of nipple-areolar complex. 14 patients received combined mastopexy and triple-plane breast augmentation to correct breast atrophy and mastopexy simultaneously. All the patients were regularly followed for 6-12 months. No patients suffered severe complication and the results were satisfied. "Triple-plane" breast augmentation could be safely performed with peri-areolar mastopexy with minor injury. The technique could help to ensure the balance between the gland, nipple-areolar complex and the implant.

  20. A case of chronic inflammatory demyelinating polyneuropathy presented with unilateral ptosis.

    Science.gov (United States)

    Izadi, Sadegh; Karamimagham, Sina; Poursadeghfard, Maryam

    2014-01-01

    Chronic Inflammatory Demyelinating Polyneuropathy is an autoimmune disease with progressive and relapsing courses. The main clinical presentations are diffuse deep tendon hyporeflexia or areflexia and symmetric proximal-distal muscles weakness. Myasthenia gravis is also an immune mediated disease with fluctuating ocular and bulbar symptoms and sometimes weakness. Although both myasthenia gravis and chronic inflammatory demyelinating polyneuropathy are immune mediated disorders, clinical presentations are obviously different in the two diseases. Herein, we will report a case of chronic inflammatory demyelinating polyneuropathy who presented with isolated unilateral ptosis. Initially, the patient was managed as ocular type of myasthenia gravis, but after progression to general limb weakness and areflexia, the diagnosis of chronic inflammatory demyelinating polyneuropathy was made. Although unilateral ptosis is a typical feature of myasthenia gravis, it may be seen as the first presentation of chronic inflammatory demyelinating polyneuropathy as well which mimics myasthenia gravis disease.

  1. Ptose palpebral associada a paquidermoperiostose: relato de caso Eyelid ptosis associated with pachydermoperiostosis: case report

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    Ana Paula Ximenes Alves

    2005-06-01

    Full Text Available Descreve-se caso clínico de um indivíduo acometido por paquidermoperiostose, cuja queixa principal foi ptose palpebral bilateral. Trata-se de doença hereditária, autossômica dominante, que acomete a pele, os ossos e os tecidos moles, resultando em acentuada hipertrofia tarsal. Discute-se a fisiopatologia da ptose e o tratamento executado no caso.We describe a clinical case of a patient with pachydermoperiostosis and bilateral palpebral ptosis. It is a hereditary, dominant autosomic disease, which affects skin, bones and soft tissues. In the eyelid, it causes an important tarsal hypertrophy. We discuss the physiopathology and treatment of the ptosis.

  2. Novel occurrence of axenfeld: Rieger syndrome in a patient with blepharophimosis ptosis epicanthus inversus syndrome

    Directory of Open Access Journals (Sweden)

    Bhavin M Shah

    2014-01-01

    Full Text Available Blepharophimosis ptosis epicanthus inversus syndrome (BPES is a complex eyelid malformation characterized by the classical tetrad of blepharophimosis, telecanthus, ptosis, and epicanthus inversus. It has been reported to be associated with other ocular anomalies such as euryblepharon, strabismus, nystagmus, amblyopia, microphthalmos, lacrimal drainage apparatus abnormality, extra ocular muscle abnormalities, microcornea, trabecular dysgenesis, optic nerve hypoplasias, and colobomas of the optic disk. We describe a case of BPES with Axenfeld-Rieger syndrome, a neurocristopathy characterized by maldevelopment of the anterior segment with predisposition to development of glaucoma. Interestingly, both syndromes are caused by mutations in the same class of genes, namely the winged-helix/forked transcription factors (FOX involved in a variety of developmental processes.

  3. Aarskog syndrome: report of a family with review and discussion of nosology.

    Science.gov (United States)

    Teebi, A S; Rucquoi, J K; Meyn, M S

    1993-06-15

    Five individuals in one family, including dizygotic male twins, a half brother and their mother, had Aarskog syndrome (AS). Phenotypic variability is wide not only between mother and sons but also between sibs. Collectively, the affected relatives have the full spectrum of findings seen in AS. Based on analysis of this family and others from the literature, we derive primary and secondary diagnostic criteria for AS. Primary criteria include: short stature, hypertelorism, short nose with anteverted nares, maxillary hypoplasia, a crease below the lower lip, mild interdigital webbing with short and broad hands, short fifth finger with clinodactyly, and shawl scrotum. Secondary criteria include: abnormal auricles with fleshy lobules, posteriorly angulated ears, widow's peak, ptosis, downward slant of palpebral fissures, joint hyperextensibility, broad feet with bulbous toes, cryptorchidism, inguinal hernia, and prominent umbilicus. Literature pertaining to the clinical manifestations and genetics of AS is reviewed and nosology of similar syndromes is discussed.

  4. Two different techniques for frontalis suspension using Gore-Tex to treat severe congenital ptosis.

    Science.gov (United States)

    Zaky, Adel Galal; Mandour, Sameh Saad; Zaky, Marwa Aly; Ebrahem, Asmaa Mohamed

    2017-04-01

    Severe congenital ptosis is commonly associated with poor levator function. This study compares the functional and cosmetic outcomes of open versus closed frontalis sling using Gore-Tex in the treatment of such conditions. Randomized interventional comparative case series of 20 eyes of 13 patients with severe congenital ptosis with levator excursion Gore-Tex string sutures either through a skin crease incision (group 1) or supraciliary incisions (group II). Mean age was 5.10 ± 3.10 years in group I and 7.30 ± 4.47 years in group II. Ptosis was unilateral in six patients and bilateral in seven patients. Following surgery, there was a statistically significant improvement in the palpebral fissure width (PFW) and marginal reflex distance (MRD) in both groups (p value 0.001) with better functional outcome in group II (closed approach). The cosmetic results were better in group I (open approach). The mean operative time in group II was 18.1 ± 2.4 min, which was significantly shorter than group I (30.2 ± 3.1 min). No recurrence or grave complications were encountered during follow-up. Gore-Tex is a useful sling material for correction of severe congenital ptosis due to poor frontalis action. Open transcrease approach is recommended in absence of lid crease whereas closed approach is better used in cases with preserved crease due to its superior functional outcome.

  5. EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS

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    Nagaraju

    2015-02-01

    Full Text Available INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is based on available levator function and also other factors like etiology, severity, Bell’s phenomenon etc. If such varied procedure s are performed in a group of patients based on standard criteria and results are evaluated systematically we can determine what works best for a given patient . AIM : Evaluation of outcome of various surgical procedures for upper eyelid ptosis . METHODOLOGY : 25 eyelids of 20 patients who presented to a tertiary centre in south India with complaint of drooping of upper lid were considered. All subjects underwent complete ocular examination corrected visual acuity and detailed ptosis evaluation with particular emphasis on measurement of levator muscle function, MRD1 (margin reflex distance - 1, palpebral fissure width in different gazes and margin crease distance. The effect of various factors like MRD1, MCD, levator function were assessed, the amount of correction required and appropriate surgical procedure was chosen. Surgical procedure of Levator resection, frontalis sling operation, anterior levator aponeurosis advancement, o r other ptosis correction procedures under appropriate anaesthesia were performed. Post - operative evaluation in terms of visual acuity, MRD, Interpalpebral fissure height, lid symmetry, lagophthalmos and complications (if any was done. RESULTS : Levator muscle resection was done in 28% of eyelids, frontal sling surgery in 60% of eyelids, Levator muscle plication in 8% eyelids and levator muscle disinsertion with frontal sling surgery in 4% eyes. Undercorrection was seen in about 44% of eyelids in varying degrees. 56% of the eyes had optimal correction. Symmetric correction was achieved in 76% of eyelids. CONCLUSION: The influence of various preoperative factors on the

  6. Effect on the treatment of congenital ptosis in two kinds of operation method

    OpenAIRE

    Yun-Jia Jiang; Song Sun; Ting-Ting Zhu

    2014-01-01

    AIM:To compare the functional and cosmetic effects of two different surgical techniques for congenital ptosis. METHODS: The patients were divided into four groups according to the operation method: Patients undertook bilateral fascial suspension surgery as Group A(42 eyes of 21 cases); Patients undertook bilateral levator muscle shortening surgery as Group B(38 eyes of 19 cases); Patients undertook unilateral fascial suspension surgery as Group C(24 eyes of 24 cases); Patients undertook unila...

  7. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

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    A. Novo Torres

    2006-09-01

    Full Text Available Se entiende por blefaroptosis el nivel anormalmente bajo del párpado superior durante la mirada directa. Los mejores resultados se obtienen con las técnicas de resección o avance del músculo elevador o su aponeurosis, siempre que el elevador posea una función adecuada. Nuestra intención es presentar una modificación a la técnica de Blaskovics para la corrección de blefaroptosis moderadas, con buena función del elevador Presentamos una serie de 10 casos donde se utilizó una variante de la operación de Blaskovics de resección del elevador para la corrección quirúrgica de la ptosis palpebral. De los 10 casos, 7 fueron bilaterales y 3 unilaterales. En todos ellos la función del elevador se situaba entre 4 y 8 mm y el grado de ptosis fue mayor de 4 mm con disminución del campo visual en la mirada directa. La técnica quirúrgica incluyó un abordaje cutáneo mediante la incisión horizontal de Blefaroplastia superior, la exposición amplia del músculo elevador y su aponeurosis, respetando las bolsas grasas orbiculares y separándolo de la conjuntiva palpebral. En todos los casos se obtuvo corrección de las ptosis. El grado de asimetría fue inferior a 0,3 cm. Un caso presentó en el postoperatorio inmediato dehiscencia de la sutura en su lado medial y tuvo que ser reintervenido a los 10 días. El edema palpebral postoperatorio se resolvió a partir del 2º día postoperatorio desapareciendo hacia el día 8º y permitiendo una valoración fiable en dicha fecha. El grado de satisfacción de los paciente fue bueno o muy bueno y el campo visual fue completo en todos los pacientes Las técnicas clásicas y sus modificaciones para la corrección de los casos de ptosis siguen teniendo validez. Con esta modificación que respeta la conjuntiva palpebral ocular se evita añadir morbilidad al proceso quirúrgico. Pensamos que la integridad de la conjuntiva redunda en un mayor confort postoperatorio al paciente, disminuye el edema conjuntival

  8. Disruption of the gene Euchromatin Histone Methyl Transferase1 (Eu-HMTase1) is associated with the 9q34 subtelomeric deletion syndrome.

    NARCIS (Netherlands)

    Kleefstra, T.; Smidt, M.; Banning, M.J.G.; Oudakker, A.R.; Esch, H. van; Brouwer, A.P.M. de; Nillesen, W.M.; Sistermans, E.A.; Hamel, B.C.J.; Bruijn, D.R.H. de; Fryns, J.P.; Yntema, H.G.; Brunner, H.G.; Vries, L.B.A. de; Bokhoven, J.H.L.M. van

    2005-01-01

    BACKGROUND: A new syndrome has been recognised following thorough analysis of patients with a terminal submicroscopic subtelomeric deletion of chromosome 9q. These have in common severe mental retardation, hypotonia, brachycephaly, flat face with hypertelorism, synophrys, anteverted nares, thickened

  9. Molecular epidemiology of methicillin resistant staphylococcus aureus colonizing the anterior Nares of school children of Udupi Taluk

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    S Govindan

    2015-01-01

    Full Text Available Context: Community associated methicillin resistant Staphylococcus aureus (CA-MRSA cause serious skin and soft tissue infections including necrotizing fasciitis and necrotizing pneumonia. Production of Panton Valentine Leucocidine (PVL toxin is implicated in its enhanced virulence. A variant of epidemic MRSA-15 (EMRSA-15 which produces PVL toxin has been isolated and characterized by pulsed-field gel electrophoresis (PFGE method from the Indian population both in hospital and community settings. Aims: Identify the epidemiological type of MRSA colonizing the anterior nares of school children in Udupi taluk. Settings and Design: The study population included children of the age group of 5-16 years belonging to the Udupi taluk of Karnataka, India. A total of 1503 children were screened for MRSA colonization during July 2009 to December 2010. Materials and Methods: PVL assay, Staphylococcal Cassette Chromosome (SCC mec typing and PFGE typing were carried out with all the MRSA isolates. Statistical Analysis Used: Frequency distribution of different variables was assessed by SPSS. Results: Among the 1.1% of MRSA, 58.8% (10/17 of isolates were positive for pvl and 41.7% (7/17 were identified as SCC mec type IV. PFGE patterns of all the strains were identical with Indian variant EMRSA-15; however they were different from classical EMRSA-15 in 3-4 bands. Conclusions: The Indian variant EMRSA-15 gains much epidemiological relevance owing to the acquisition of pvl gene. In spite of low prevalence of nasal colonization of MRSA, emergence of the virulent Indian variant EMRSA-15 in our community is a worrisome fact to be reckoned with.

  10. Frontalis Sling Operation using Silicone Rod Compared with Autogenous Fascia Lata for Simple Congenital Ptosis

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    Purnima Rajkarnikar Sthapit

    2014-09-01

    Full Text Available Introduction: To evaluate the cosmetic results and recurrence of unilateral frontalis sling surgery using a silicone rod compared with autogenous fascia lata in cases of simple congenital ptosis. Methods: This is a retrospective comparative study of 59 patients who underwent a frontalis sling operation for congenital ptosis. Patients were divided into two groups according to the sling material used; an autogeneous fascia lata (fl group (n = 24 and a silicone rod group (sl (n = 35. Cosmetic results and recurrence rates were compared between these 2 groups. The cosmetic results of the frontalis sling operation were assessed as good, fair, or poor based on the difference between the Margin Reflex Distance of both eyelids and graded as good if the difference in two eyes was ≤1mm and poor if it was 2mm or more. Recurrence was defined as the conversion of the cosmetic result from good or fair to poor category. Results: At postoperative day seven and 30, MRD of both the groups were good but on three months follow-up MRD of silicon rod group dropped, however it was not statistically significant .Lid contour was good in both the groups, however, lid symmetry was poor in two cases of fascia lata at three months follow-up. Repeat surgery for poor outcome was done in 8.6% of cases in silicon rod and 8.3% of fascia lata group. Conclusions: The frontalis sling operation using either a silicone rod or autogenous fascia lata showed equally good cosmetic results and lower recurrence rate at three months follow up. Keywords: congenital ptosis; fascia lata; frontalis sling surgery; margin reflex distance; silicone rod.

  11. Efficacy of skin and nasal povidone-iodine preparation against mupirocin-resistant methicillin-resistant Staphylococcus aureus and S. aureus within the anterior nares.

    Science.gov (United States)

    Anderson, Michele J; David, Maren L; Scholz, Matt; Bull, Sally J; Morse, Dan; Hulse-Stevens, Michelle; Peterson, Marnie L

    2015-05-01

    Mupirocin decolonization of nasal Staphylococcus aureus prior to surgery decreases surgical-site infections; however, treatment requires 5 days, compliance is low, and resistance occurs. In 2010, 3M Company introduced povidone-iodine (PVP-I)-based skin and nasal antiseptic (Skin and Nasal Prep [SNP]). SNP has rapid, broad-spectrum antimicrobial activity. We tested SNP's efficacy using full-thickness tissue (porcine mucosal [PM] and human skin) explant models and human subjects. Prior to or following infection with methicillin-resistant Staphylococcus aureus (MRSA) (mupirocin sensitive and resistant), explants were treated with Betadine ophthalmic preparation (Bet), SNP, or mupirocin (Bactroban nasal ointment [BN]) or left untreated. One hour posttreatment, explants were washed with phosphate-buffered saline (PBS) plus 2% mucin. One, 6, or 12 h later, bacteria were recovered and enumerated. Alternatively, following baseline sampling, human subjects applied two consecutive applications of SNP or saline to their anterior nares. One, 6, and 12 h after application of the preparation (postprep), nasal swabs were obtained, and S. aureus was enumerated. We observed that treatment of infected PM or human skin explants with SNP resulted in >2.0 log10 CFU reduction in MRSA, regardless of mupirocin sensitivity, which was significantly different from the values for BN- and Bet-treated explants and untreated controls 1 h, 6 h, and 12 h after being washed with PBS plus mucin. Swabbing the anterior nares of human subjects with SNP significantly reduced resident S. aureus compared to saline 1, 6, and 12 h postprep. Finally, pretreatment of PM explants with SNP, followed by a mucin rinse prior to infection, completely prevented MRSA infection. We conclude that SNP may be an attractive alternative for reducing the bioburden of anterior nares prior to surgery. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  12. Diplopia and variable ptosis as the sole initial findings in a case of orbital plasmacytoma and multiple myeloma.

    Science.gov (United States)

    Galea, Martin; McMillan, Nigel; Weir, Clifford

    2015-05-01

    Plasmacytomas are monoclonal plasma cell tumors. They represent 3% of all orbital tumors. We present an unusual case of orbital plasmacytoma and advanced multiple myeloma where the sole presenting symptoms were those of diplopia and ptosis. Clinical examination revealed right hypertropia and variable left upper lid ptosis but no proptosis. The visual acuity and the rest of the ocular examination were normal in both eyes. An MRI scan of the brain and orbits revealed a frontal bone lesion consistent with a plasmacytoma. A bone marrow biopsy showed a light chain multiple myeloma with free lambda light chains. Although the literature reports diplopia and ptosis as being clinical features of orbital plasmacytomas, to our knowledge this is the first reported case where these symptoms were the only presenting features, despite widespread disease.

  13. A mixed toxidrome presenting with bilateral ptosis with normal pupils: The first case in the literature

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    Sanket Mahajan

    2016-01-01

    Full Text Available Snakebite is an environmental hazard associated with a significant morbidity and mortality. Two main types of toxicity occur due to snakebite, namely vasculotoxicity and neurotoxicity. Neurotoxic snakebites present mainly with bilateral ptosis with dilated pupils and/or difficulty in breathing. Jatropha curcas belongs to the family Euphorbiaceae and is commonly referred to as " Ratanjyot" in Gujarati. It has got many medicinal uses such as anticancerous properties and bio-oil. There are very few cases of its toxicity in adults. Toxicity from it causes meiosis, vomiting, diarrhea, etc., We will hereby discuss one such patient who consumed J. curcas seeds intentionally, became drowsy and accidentally got bit by a snake, and then, the patient started having bilateral ptosis, but with normal-sized pupils. There is no case reported yet in the literature mentioning the combined toxicity of snakebite and J. curcas, so we thought to publish this first case report of its kind in the world, thus discussing its diagnosis, symptoms, and treatment modalities.

  14. Cluster headache with ptosis responsive to intranasal lidocaine application: a case report

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    Bakbak Berker

    2012-02-01

    Full Text Available Abstract Introduction The application of lidocaine to the nasal mucosal area corresponding to the sphenopalatine fossa has been shown to be effective at extinguishing pain attacks in patients with a cluster headache. In this report, the effectiveness of local administration of lidocaine on cluster headache attacks as a symptomatic treatment of this disorder is discussed. Cases presentation A 22-year-old Turkish man presented with a five-year history of severe, repeated, unilateral periorbital pain and headache, diagnosed as a typical cluster headache. He suffered from rhinorrhea, lacrimation and ptosis during headaches. He had tried several unsuccessful daily medications. We applied a cotton tip with lidocaine hydrochloride into his left nostril for 10 minutes. The ptosis responded to the treatment and the intensity of his headache decreased. Conclusion Intranasal lidocaine is a useful treatment for the acute management of a cluster headache. Intranasal lidocaine blocks the neural transmission of the sphenopalatine ganglion, which contributes to the trigeminal nerve as well as containing both parasympathetic and sympathetic fibers.

  15. Ptosis Palpebral in a Urban Area named: December 5. Paez Municipality, Portuguesa State. Venezuela 2007.

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    Milenis López León

    2010-04-01

    Full Text Available A descriptive longitudinal prospective study was made in the Urban Area named December 5 of Páez Municipality, Portuguesa State, in The Venezuela’s Republic, including only the period since September 4 to December 11, 2007 with the objective to define the clinical epidemiological state of Ptosis Palpebral in the Region mentioned. The universe was conformed by 7000 patients of all ages, being a sample of 60 ill persons, for obtaining the information a structural interview was used made by the authors, having productiveness the use of Ophthalmology clinical backgrounds of each person; the obtaining data were introduced in a Pentium IV computer by means of EPINFO Program to calculate them. The female sex was the one that predominate, and it happens the same wit the skin colour (not white finding the ages between 21 and 41 years as high frequency. The moderate ptosis was the most usual, predominating the unilaterals and from etiological point of view: The acquires; obtaining the traumatics the highest incidence within them; resulting ametropias as the ocular pathologies more notables in studied patients and a considerable number of them were tributary of the surgical treatment even though the latest diagnostic, that´s why a previous detection is imposed of the referred entity, helping to improve your Qualitiy Life and reincorporating to your society .

  16. Treatment of bilateral mammary ptosis and pectus excavatum through the same incision in one surgical stage

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    Fernando Passos Rocha

    Full Text Available CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.

  17. Effect on the treatment of congenital ptosis in two kinds of operation method

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    Yun-Jia Jiang

    2014-12-01

    Full Text Available AIM:To compare the functional and cosmetic effects of two different surgical techniques for congenital ptosis. METHODS: The patients were divided into four groups according to the operation method: Patients undertook bilateral fascial suspension surgery as Group A(42 eyes of 21 cases; Patients undertook bilateral levator muscle shortening surgery as Group B(38 eyes of 19 cases; Patients undertook unilateral fascial suspension surgery as Group C(24 eyes of 24 cases; Patients undertook unilateral levator muscle shortening surgery as Group D(29 eyes of 29 cases. Each group patients were followed for postoperative function and appearance effect. RESULTS: 1Early postoperative of two operation function success rate was up to 100%, the function of levator muscle shortening surgery was 97.01% in the late postoperative, was higher than bilateral fascial suspension surgery(87.88%, with statistical difference in both surgerys(PP >0.05; In the late postoperative, the mean grades for “Lid Contour” and “Lid Crease” of Group B were better than that of Group A(PPCONCLUSION: Two kinds of operation method have good effects on the treatment of congenital ptosis. In terms of cosmetic effect, levator muscle shortening surgery is better.

  18. Blepharophimosis, ptosis, epicanthus inversus syndrome (BPES and cleft lip and palate. Report of two Brazilian families

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    N.M. Kokitsu-Nakata

    1998-06-01

    Full Text Available We have evaluated a girl and a boy with the blepharophimosis, ptosis and epicanthus inversus syndrome (BPES. The girl presented cleft palate and the boy showed cleft lip and palate as additional clinical signs. Both showed familial recurrence in fourth and third generations, respectively. The other family members also presented blepharophimosis, ptosis, and epicanthus inversus, but without lip and palatal involvement. There were no additional clinical signs nor infertility in these patients. To our knowledge this is the first instance of cleft lip and palate reported as additional signs of the BPES syndrome.Os autores descrevem uma menina e um menino com a síndrome de blefarofimose, ptose e epicanto inverso (BPES. A menina apresentou fissura de palato e o menino mostrou fissura de lábio e palato como sinais clínicos adicionais. Ambos mostraram recorrência familial em quatro e três gerações, respectivamente. Outros membros de ambas as famílias apresentaram também blefarofimose, ptose e epicanto inverso, mas sem envolvimento de lábio e palato. Não existem sinais clínicos adicionais nem infertilidade nestes pacientes. De acordo com o nosso conhecimento, este é o primeiro relato de fissura de lábio e palato registrada como sinal adicional na síndrome BPES.

  19. [Surgical treatment of ptosis by resection of the superior tarsal muscle employing a cutaneous approach (author's transl)].

    Science.gov (United States)

    Morax, S

    1982-01-01

    A simple technique for resection of the superior tarsal muscle through a cutaneous approach, for the surgical treatment of ptosis, was employed in severe or moderate, congenital and acquired forms of the affection. Muller's muscle and the aponeurotic fascia are removed in a single piece, while conserving the tarsus.

  20. Gull Wing Midforehead Lift When a Poor Man's Forehead Lift Becomes the Treatment of Choice for Brow Ptosis

    NARCIS (Netherlands)

    Huijing, Marijn A.; van der Lei, Berend

    In case of both medial and lateral brow ptosis in a balding candidate with a furrowed forehead, one may consider a midforehead lift, a technique that has not gained much popularity because of concerns regarding clearly visible scarring. We have applied this technique in a selected group of patients

  1. Effectiveness of Pyridoxine and Pyridostigmine in the Treatment of Vincristine-Induced Bilateral Ptosis and External Ophthalmoplegia: A Case Report

    Directory of Open Access Journals (Sweden)

    Osman Okan Olcaysu

    2014-08-01

    Full Text Available In this manuscript, we present the case of a patient with acute lymphoblastic leukemia who developed vincristine-induced bilateral ptosis and external ophthalmoplegia and who was treated successfully with pyridoxine and pyridostigmine. Pyridostigmine and pyridoxine are promising treatment option in cases of vincristine-induced neuropathy. (Turk J Ophthalmol 2014; 44: 330-1

  2. Effectiveness of Pyridoxine and Pyridostigmine in the Treatment of Vincristine-Induced Bilateral Ptosis and External Ophthalmoplegia: A Case Report

    OpenAIRE

    2014-01-01

    In this manuscript, we present the case of a patient with acute lymphoblastic leukemia who developed vincristine-induced bilateral ptosis and external ophthalmoplegia and who was treated successfully with pyridoxine and pyridostigmine. Pyridostigmine and pyridoxine are promising treatment option in cases of vincristine-induced neuropathy. (Turk J Ophthalmol 2014; 44: 330-1)

  3. Cosmetic and functional outcomes of frontalis suspension surgery using autologous fascia lata or silicone rods in pediatric congenital ptosis

    Science.gov (United States)

    Chung, Hsi-Wei; Seah, Lay Leng

    2016-01-01

    Purpose Cosmetic and functional outcomes of frontalis suspension surgery using autologous fascia lata (FL) or silicone rods (SRs) in pediatric congenital ptosis. Design Retrospective case series. Study subjects Patients with congenital ptosis, aged 18 years or younger, during the period under study (2005–2011) at the Singapore National Eye Centre. Methods Review of case records for functional and cosmetic outcome measures after frontalis suspension surgery using either SRs or autologous FL. Results A total of 18 patients were studied (14 eyelids had FL, 16 eyelids had SRs) with mean ages of 7.1 (range 5–12) and 7.2 (range 4–18) years for the FL and SR groups, respectively. Mean follow-up period was 41.6 (range 11.2–77.9) and 48.6 (16.1–87.4) months, respectively. Patients in the FL group had better functional and cosmetic results compared to those in silicone group, with no recurrence of ptosis. More complications were experienced by patients in the SR group. Conclusion Autologous FL for frontalis suspension remains an excellent choice for (and should be considered as useful surgical armamentarium for) repair of severe congenital ptosis. PMID:27695282

  4. Breast shape (ptosis) as a marker of a woman's breast attractiveness and age: Evidence from Poland and Papua.

    Science.gov (United States)

    Groyecka, Agata; Żelaźniewicz, Agnieszka; Misiak, Michał; Karwowski, Maciej; Sorokowski, Piotr

    2017-07-08

    A women's breast is a sex-specific and aesthetic bodily attribute. It is suggested that breast morphology signals maturity, health, and fecundity. The perception of a woman's attractiveness and age depends on various cues, such as breast size or areola pigmentation. Conducted in Poland and Papua, the current study investigated how breast attractiveness, and the further estimate of a woman's age based on her breast's appearance, is affected by the occurrence of breast ptosis (ie, sagginess, droopiness). In the Polish sample, 57 women and 50 men (N = 107) were presented with sketches of breasts manipulated to represent different stages of ptosis based on two different breast ptosis classifications. The participants were asked to rate the breast attractiveness and age of the woman whose breasts were depicted in each sketch. In Papua, 45 men aged 20 to 75 years took part in the study, which was conducted using only one of the classifications of breast ptosis. Regardless of the classification used, the results showed that the assessed attractiveness of the breasts decreased as the estimated age increased with respect to the more ptotic breasts depicted in the sketches. The results for Papuan raters were the same as for the Polish sample. Breast ptosis may be yet another physical trait that affects the perception and preferences of a potential sexual partner. The consistency in ratings between Polish and Papuan raters suggests that the tendency to assess ptotic breasts with aging and a loss of attractiveness is cross-culturally universal. © 2017 Wiley Periodicals, Inc.

  5. Correction of congenital ptosis of the eyelid by frontal muscle transposition

    Directory of Open Access Journals (Sweden)

    Jevtović Dobrica

    2002-01-01

    Full Text Available Congenital ptosis (CP represents a significant reconstructive problem Numerous studies have not yet provided full and satisfactory results. In this study, we have presented our experience in the surgical treatment of 108 patients by the use of Son Ye Guang's modified method - frontal muscle transposition. A total of 108 patients with CP were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy in the period 1991-2000. Unilateral ptosis was operated in 85 patients, and bilateral in 23 patients. CP was more frequently found in males (58.34% than in females (41.66%. The youngest patient was only 5.5 years old, and the oldest was 42, the average age was 21.3 years. All patients were operated on by the same surgeon, and were monitored monthly during the first six months and then twice a year for the next 3 years. Postoperative results were evaluated after 6 months: the action of raising the eyelids was compared to the full amplitude of movement of the eye on the healthy side. The closure of the eyelids and the symmetry of the palpebral fissure in a steady horizontal view was also assessed. The action of the opening as well as closure of the eyelids in full amplitude was obtained in all operated patients. Asymmetry of the palpebral fissure in a steady horizontal view up to 1 mm did not require additional correction. In 9 cases, asymmetry of the palpebral fissure greater than 1 mm was subsequently corrected. The advantages of this surgical method compared to the other, previously described techniques, were emphasized in the conclusion. The main advantage was the elimination of postoperative lagophthalmos, which represented the problem in all previously used methods.

  6. High prevalence of methicillin resistance and PVL genes amongStaphylococcus aureus isolates from the nares and skin lesions of pediatric patients with atopic dermatitis

    Energy Technology Data Exchange (ETDEWEB)

    Cavalcante, F.S. [Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Abad, E.D. [Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Lyra, Y.C. [Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Saintive, S.B.; Ribeiro, M. [Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Ferreira, D.C. [Centre for Ecological and Evolutionary Studies (Microbial Ecology), Faculty of Mathematics and Natural Science, University of Groningen, Groningen (Netherlands); Programa de Pós Graduação em Odontologia, Universidade Estácio de Sá, Rio de Janeiro, RJ (Brazil); Santos, K.R.N. dos [Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2015-05-08

    Staphylococcus aureus is highly prevalent among patients with atopic dermatitis (AD), and this pathogen may trigger and aggravate AD lesions. The aim of this study was to determine the prevalence of S. aureus in the nares of pediatric subjects and verify the phenotypic and molecular characteristics of the isolates in pediatric patients with AD. Isolates were tested for antimicrobial susceptibility, SCCmectyping, and Panton-Valentine Leukocidin (PVL) genes. Lineages were determined by pulsed-field gel electrophoresis and multilocus sequence typing (MLST). AD severity was assessed with the Scoring Atopic Dermatitis (SCORAD) index. Among 106 patients, 90 (85%) presented S. aureus isolates in their nares, and 8 also presented the pathogen in their skin infections. Two patients had two positive lesions, making a total of 10 S. aureusisolates from skin infections. Methicillin-resistant S. aureus(MRSA) was detected in 24 (26.6%) patients, and PVL genes were identified in 21 (23.3%), including 6 (75%) of the 8 patients with skin lesions but mainly in patients with severe and moderate SCORAD values (P=0.0095). All 24 MRSA isolates were susceptible to trimethoprim/sulfamethoxazole, while 8 isolates had a minimum inhibitory concentration (MIC) to mupirocin >1024 μg/mL. High lineage diversity was found among the isolates including USA1100/ST30, USA400/ST1, USA800/ST5, ST83, ST188, ST718, ST1635, and ST2791. There was a high prevalence of MRSA and PVL genes among the isolates recovered in this study. PVL genes were found mostly among patients with severe and moderate SCORAD values. These findings can help clinicians improve the therapies and strategies for the management of pediatric patients with AD.

  7. Unilateral anterior persistent fetal vasculature in a child with blepharophimosis-ptosis-epicanthus inversus syndrome: A surgical challenge

    Directory of Open Access Journals (Sweden)

    Vasudha Kemmanu

    2016-01-01

    Full Text Available Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES is a rare autosomal dominant genetic disease. It is clinically characterized by four major features; blepharophimosis, ptosis, epicanthus inversus, and telecanthus. We report a case of a 1-year-old female with BPES with unilateral anterior persistent fetal vasculature (PFV. On examination, she was found to have all the clinical features of BPES, along with calcified and partially absorbed cataract with elongated ciliary processes in her left eye. B-scan of left eye showed attached retina with no evidence of posterior PFV. Systemic examination was normal. She underwent cataract surgery with primary posterior capsulotomy with intraocular lens implantation under general anesthesia. Literature search did not reveal any previous reports of unilateral anterior PFV and BPES. The clinical features, other associations, and the difficulties in the surgical management of this condition are discussed.

  8. Unilateral anterior persistent fetal vasculature in a child with blepharophimosis-ptosis-epicanthus inversus syndrome: A surgical challenge

    Science.gov (United States)

    Kemmanu, Vasudha; Rathod, Pragnya; Anaspure, Hemant; Yadav, Naresh K

    2016-01-01

    Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare autosomal dominant genetic disease. It is clinically characterized by four major features; blepharophimosis, ptosis, epicanthus inversus, and telecanthus. We report a case of a 1-year-old female with BPES with unilateral anterior persistent fetal vasculature (PFV). On examination, she was found to have all the clinical features of BPES, along with calcified and partially absorbed cataract with elongated ciliary processes in her left eye. B-scan of left eye showed attached retina with no evidence of posterior PFV. Systemic examination was normal. She underwent cataract surgery with primary posterior capsulotomy with intraocular lens implantation under general anesthesia. Literature search did not reveal any previous reports of unilateral anterior PFV and BPES. The clinical features, other associations, and the difficulties in the surgical management of this condition are discussed. PMID:27488160

  9. Frontal suspension for congenital ptosis using an expanded polytetrafluoroethylene (Gore-Tex(®)) sheet: one-year follow-up.

    Science.gov (United States)

    Nakauchi, Kazuaki; Mito, Hidenori; Mimura, Osamu

    2013-01-01

    The frontalis suspension technique is the surgical method of choice in patients with ptosis and a levator function of 4 mm or less. Several types of materials have been used, including Gore-Tex(®), which has been used successfully as a frontalis sling material since 1986. Recently, a Gore-Tex sheet (wider than a sling or strip) suspension was reported. This paper reports the results of 27 eyes from 20 patients with congenital ptosis treated using the frontalis suspension technique with the newly developed Gore-Tex Most Versatile Patch (MVP) sheet. All patients underwent surgery between April 2007 and September 2011 and were followed up for at least one year. The average follow-up duration was 18 months, with a range of 12-36 months. The average patient age was 45 (5-85) years, and the group included 11 males and nine females. Thirteen cases demonstrated ptosis in one eye, and seven cases involved both eyes. The patients were divided by age into a younger group and an older group. All ptosis procedures were performed using the Gore-Tex MVP sheet. The implant was normally 7 mm wide for adults and 5 mm wide for children. The implantation method was the same as that used for the sheet shape fascia. In all patients, satisfactory functional results were observed at the 6-month follow-up examination. Eyelid opening heights were also obtained. The average marginal reflex distance (MRD) was -0.5 mm preoperatively, which improved to +1.9 mm after surgery. After one year, average MRD was +1.6 mm. MRD attenuation was more frequent in the younger group. There were no cases requiring redo surgery and only one case of exposure.

  10. Nipple-Sparing Mastectomy and Ptosis: Perforator Flap Breast Reconstruction Allows Full Secondary Mastopexy with Complete Nipple Areolar Repositioning

    Science.gov (United States)

    Blum, Craig A.; Sullivan, Scott K.; Stolier, Alan; Trahan, Chris; Wise, M. Whitten; Duracher, Dustin

    2015-01-01

    Background: Patients with moderate to severe ptosis are often considered poor candidates for nipple-sparing mastectomy. This results from the perceived risk of nipple necrosis and/or the inability of the reconstructive surgeon to reliably and effectively reposition the nipple-areola complex on the breast mound after mastectomy. Methods: A retrospective review identified patients with grade II/III ptosis who underwent nipple-sparing mastectomy with immediate perforator flap reconstruction and subsequently underwent a mastopexy procedure. The mastopexies included complete, full-thickness periareolar incisions with peripheral undermining around the nipple-areola complex to allow for full transposition of the nipple-areola complex relative to the surrounding skin envelope. Results: Seventy patients with 116 nipple-sparing mastectomies met inclusion criteria. The most common complications were minor incisional dehiscence (7.7 percent) and variable degrees of necrosis in the preserved breast skin (3.4 percent) after the initial mastectomy. There were no cases of nipple-areola complex necrosis following the secondary mastopexy. Conclusions: The authors demonstrate that full mastopexy, including a complete full-thickness periareolar incision and nipple-areola complex repositioning on the breast mound, can be safely performed after nipple-sparing mastectomy and perforator flap breast reconstruction. The underlying flap provides adequate vascular ingrowth to support the perfusion of the nipple-areola complex despite complete incisional interruption of the surrounding cutaneous blood supply. These findings may allow for inclusion of women with moderate to severe ptosis in the candidate pool for nipple-sparing mastectomy if oncologic criteria are otherwise met. These findings also represent a significant potential advantage of autogenous reconstruction over implant reconstruction in women with breast ptosis who desire nipple-sparing mastectomy. CLINICAL QUESTION/LEVEL OF

  11. Histological and ultrastructural study on the medial canthal ligament of blepharophimosis, ptosis and epicanthus inversus syndrome

    Institute of Scientific and Technical Information of China (English)

    HUANG Dan-ping; ZHUO Ye-hong; CAI Jian-hao; XU Nuo; ZHONG Xiu-feng; YU Yang-yang; LAI Zhao-guang; GONG Di; GE Jian

    2009-01-01

    Background Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a rare congenital ophthalmic disorder,characterized by congenital eyelid malformation including bilateral ptosis, shortening of the horizontal eyelid fissure,epicanthus inversus, and increased distance between the inner canthi. In this research, we studied the histological structure and ultrastructure of medial canthal ligament of patients with BPES.Methods Thirty patients with BPES who received plastic surgery at the Zhongshan Ophthalmic Center from March 2006 to January 2008 were studied. There were 17 males and 13 females with an average age of (8.73±3.37) years (3-31 years). The medial canthal ligaments of patients were collected during the plastic surgery to analyze the histological structure by hematoxylin and eosin (HE), Congo red, van Gieson's (VG), Masson trichrome and aldehyde-fuchsin staining. The ultrastructures of the medial canthal ligaments were also analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Fifteen samples of medial canthal ligament from healthy persons with an average age of (9.02±3.12) years (6-30 years) were collected as a control group.Results Morphological and histological study showed that the medial canthal ligaments of BPES patients were composed of collagen fibers, a few elastic fibers and striated muscles. The collagen fibers assemblies were disorganized and the fibrous connective tissues were undergoing hyaline degeneration. The karyopycnosis of fibroblasts was located among the collagen fibrils and the numbers of fibroblasts were decreased. Ultrastructural study with SEM showed that the collagen fibers were larger than normal, irregular and loose. Parts of the collagen fibers were broken and had a coarse surface. Ultrastructural study with TEM showed that the fibroblasts had less cytoplasm, fewer organelles and the nucleus displayed pyknosis.Conclusions The medial canthal ligament in BPES patients is composed

  12. Deficiency for the ubiquitin ligase UBE3B in a blepharophimosis-ptosis-intellectual-disability syndrome.

    Science.gov (United States)

    Basel-Vanagaite, Lina; Dallapiccola, Bruno; Ramirez-Solis, Ramiro; Segref, Alexandra; Thiele, Holger; Edwards, Andrew; Arends, Mark J; Miró, Xavier; White, Jacqueline K; Désir, Julie; Abramowicz, Marc; Dentici, Maria Lisa; Lepri, Francesca; Hofmann, Kay; Har-Zahav, Adi; Ryder, Edward; Karp, Natasha A; Estabel, Jeanne; Gerdin, Anna-Karin B; Podrini, Christine; Ingham, Neil J; Altmüller, Janine; Nürnberg, Gudrun; Frommolt, Peter; Abdelhak, Sonia; Pasmanik-Chor, Metsada; Konen, Osnat; Kelley, Richard I; Shohat, Mordechai; Nürnberg, Peter; Flint, Jonathan; Steel, Karen P; Hoppe, Thorsten; Kubisch, Christian; Adams, David J; Borck, Guntram

    2012-12-07

    Ubiquitination plays a crucial role in neurodevelopment as exemplified by Angelman syndrome, which is caused by genetic alterations of the ubiquitin ligase-encoding UBE3A gene. Although the function of UBE3A has been widely studied, little is known about its paralog UBE3B. By using exome and capillary sequencing, we here identify biallelic UBE3B mutations in four patients from three unrelated families presenting an autosomal-recessive blepharophimosis-ptosis-intellectual-disability syndrome characterized by developmental delay, growth retardation with a small head circumference, facial dysmorphisms, and low cholesterol levels. UBE3B encodes an uncharacterized E3 ubiquitin ligase. The identified UBE3B variants include one frameshift and two splice-site mutations as well as a missense substitution affecting the highly conserved HECT domain. Disruption of mouse Ube3b leads to reduced viability and recapitulates key aspects of the human disorder, such as reduced weight and brain size and a downregulation of cholesterol synthesis. We establish that the probable Caenorhabditis elegans ortholog of UBE3B, oxi-1, functions in the ubiquitin/proteasome system in vivo and is especially required under oxidative stress conditions. Our data reveal the pleiotropic effects of UBE3B deficiency and reinforce the physiological importance of ubiquitination in neuronal development and function in mammals.

  13. Frontal suspension for congenital ptosis using an expanded polytetrafluoroethylene (Gore-Tex® sheet: one-year follow-up

    Directory of Open Access Journals (Sweden)

    Nakauchi K

    2013-01-01

    Full Text Available Kazuaki Nakauchi,1 Hidenori Mito,2 Osamu Mimura11Hospital of Hyogo College of Medicine, Hyogo, 2Ide Eye Hospital, Yamagata, JapanBackground: The frontalis suspension technique is the surgical method of choice in patients with ptosis and a levator function of 4 mm or less. Several types of materials have been used, including Gore-Tex®, which has been used successfully as a frontalis sling material since 1986. Recently, a Gore-Tex sheet (wider than a sling or strip suspension was reported. This paper reports the results of 27 eyes from 20 patients with congenital ptosis treated using the frontalis suspension technique with the newly developed Gore-Tex Most Versatile Patch (MVP sheet.Methods: All patients underwent surgery between April 2007 and September 2011 and were followed up for at least one year. The average follow-up duration was 18 months, with a range of 12–36 months. The average patient age was 45 (5–85 years, and the group included 11 males and nine females. Thirteen cases demonstrated ptosis in one eye, and seven cases involved both eyes. The patients were divided by age into a younger group and an older group. All ptosis procedures were performed using the Gore-Tex MVP sheet. The implant was normally 7 mm wide for adults and 5 mm wide for children. The implantation method was the same as that used for the sheet shape fascia.Results: In all patients, satisfactory functional results were observed at the 6-month follow-up examination. Eyelid opening heights were also obtained. The average marginal reflex distance (MRD was -0.5 mm preoperatively, which improved to +1.9 mm after surgery. After one year, average MRD was +1.6 mm. MRD attenuation was more frequent in the younger group. There were no cases requiring redo surgery and only one case of exposure.Keywords: polytetrafluoroethylene, Gore-Tex®, frontalis suspension, congenital ptosis, recurrence

  14. Variabilidad genética de Brycon henni (Characiformes: Characidae en la cuenca media de los ríos Nare y Guatapé, sistema Río Magdalena, Colombia

    Directory of Open Access Journals (Sweden)

    Julio César Hurtado-Alarcón

    2011-03-01

    Full Text Available Brycon henni es una especie nativa de la cuenca del río Magdalena, Colombia, donde es fuertemente explotada, por lo cual en este trabajo se estudió la variabilidad genética y estructura poblacional en individuos provenientes de la cuenca media de los ríos Nare y Guatapé, Antioquia. Se recolectaron 195 ejemplares y se les extrajo ADN genómico total del tejido muscular y/o sanguíneo. Se evaluaron 14 cebadores para la técnica RAPD (Random Amplifyed Polimorphic DNA, siendo cuatro de ellos polimórficos, los cuales generaron 66 fragmentos diferentes (63% polimorfismo. Por medio de un análisis de varianza molecular (AMOVA, se determinó la estructuración poblacional para todos los sitios evaluados y la cuenca del río Nare ( ΦST =0.297 y ΦST =0.163, respectivamente. Las distancias genéticas de Nei mostraron que todas las poblaciones diferían entre sí y que la mayor diferenciación genética se dio para las poblaciones del río Guatapé y la quebrada El Cardal. Un test de Mantel mostró correlación entre las distancias genéticas y geográficas (ambas cuencas, r=0.431; cuenca del río Nare, r=0.377. Esto sugiere aislamiento por distancia y separación de grupos genéticos producidos por los embalses sobre los ríos Nare y Guatapé, lo cual puede tener implicaciones relevantes en la conservación de la variabilidad genética de las poblaciones naturales de esta especie en el oriente antioqueño.Genetic variability of Brycon henni (Characiformes: Characidae in the middle basin of Nare and Guatapé rivers, Magdalena River system, Colombia. Brycon henni is a native species in Magdalena´s River basin, and because of its cultural and economic importance, is strongly overexploited. This study aimed to describe the genetic variability and population structure of this species from Nare and Guatapé rivers basins. A total of 195 individuals were collected and DNA extractions were obtained from muscle and blood tissue. Fourteen primers were

  15. Variabilidad genética de Brycon henni (Characiformes: Characidae en la cuenca media de los ríos Nare y Guatapé, sistema Río Magdalena, Colombia

    Directory of Open Access Journals (Sweden)

    Julio César Hurtado-Alarcón

    2011-03-01

    Full Text Available Brycon henni es una especie nativa de la cuenca del río Magdalena, Colombia, donde es fuertemente explotada, por lo cual en este trabajo se estudió la variabilidad genética y estructura poblacional en individuos provenientes de la cuenca media de los ríos Nare y Guatapé, Antioquia. Se recolectaron 195 ejemplares y se les extrajo ADN genómico total del tejido muscular y/o sanguíneo. Se evaluaron 14 cebadores para la técnica RAPD (Random Amplifyed Polimorphic DNA, siendo cuatro de ellos polimórficos, los cuales generaron 66 fragmentos diferentes (63% polimorfismo. Por medio de un análisis de varianza molecular (AMOVA, se determinó la estructuración poblacional para todos los sitios evaluados y la cuenca del río Nare ( ΦST =0.297 y ΦST =0.163, respectivamente. Las distancias genéticas de Nei mostraron que todas las poblaciones diferían entre sí y que la mayor diferenciación genética se dio para las poblaciones del río Guatapé y la quebrada El Cardal. Un test de Mantel mostró correlación entre las distancias genéticas y geográficas (ambas cuencas, r=0.431; cuenca del río Nare, r=0.377. Esto sugiere aislamiento por distancia y separación de grupos genéticos producidos por los embalses sobre los ríos Nare y Guatapé, lo cual puede tener implicaciones relevantes en la conservación de la variabilidad genética de las poblaciones naturales de esta especie en el oriente antioqueño.

  16. Three novel FOXL2 gene mutations in Chinese patients with blepharophimosis-ptosis-epicanthus inversus syndrome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES, OMIM # 110100) is a rare autosomal dominant disorder affecting the eyelid and ovarian development. When co-occurred together, it is type I and when only the eyelid abnormalities are present, it is type II. Both types had been mapped to the same locus 3q23 on the basis of cytogenetic rearrangements 1-3 and linkage analyses. 4-6 Subsequently, haploinsufficiency of the FOXL2 gene (OMIM# 605597) was identified as the cause for both types. 7 This FOXL2 gene is a small gene consisting of a single exon of 2.7 kb. It belongs to the family of winged helix/forkhead transcription factors. The predicted protein of 376 amino acids contains the characteristic 100 amino acids (from amino acid position 52 to 152) DNA binding forkhead domain. Downstream of the forkhead is an alanine rich domain, consisting of 14 alanines (from amino acid position 221 to 234). This protein has been shown to express in the developing mouse eyelids, in both the fetal and adult ovarian follicular and stromal cells. 7, 8 Since the identification of the gene, increasing number of mutations are being described. Recently, a database (http://medgen.ugent.be/foxl2/) has been created to facilitate tracking of all the known FOXL2 intragenic mutations and variants. 9 Whether it is type I or II BPES depends on the FOXL2 genotype plus other unknown mechanism because for the same genotype, there is inter and intra-familial phenotypic variability.10 Furthermore, FOXL2 mutation might be associated with non-syndromic premature ovarian failure. In this work, we screened for FOXL2 mutations in our Chinese patients using multiplex ligation-dependent probe amplification (MLPA) and direct sequencing techniques.

  17. Tratamento cirúrgico da ptose palpebral adquirida (linfocitoma cútis Surgical treatment of acquired palpebral ptosis (lymphocitoma cutis

    Directory of Open Access Journals (Sweden)

    L.M. Ferreira

    1997-12-01

    Full Text Available Os autores descrevem um caso clínico de ptose palpebral causada por uma patologia rara, o linfocitoma cútis. A paciente apresentava o quadro clínico do linfocitoma cútis em sua forma disseminada, com sintomatologia visual causada por nódulos palpebrais. A conduta cirúrgica realizada foi a ressecção dos nódulos palpebrais por meio de incisão de blefaroplastia, e o exame histológico confirmou o diagnóstico de linfocitoma cútis. O tratamento cirúrgico realizado foi eficiente para a melhora funcional das pálpebras.A clinical case of acquired palpebral ptosis caused by a rare pathology, lymphocitoma cutis, is reported. An eyelid ptosis was characterized with the patient unable to lift the eyelid. The resection of the eyelid nodules was performed using blefaroplasty incision as access and the result of the anatomopathological examination confirmed the diagnosis: lymphocitoma cutis. The surgical result was satisfactory not only esthetically but also functionally (2-year follow-up.

  18. A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease

    Science.gov (United States)

    Mo, Miao; Chen, Jia-jian; Yang, Ben-long; Huang, Xiao-yan; Wu, Jiong

    2017-01-01

    Objectives The current study aims to summarize breast anthropomorphic measurement features in Chinese patients with breast diseases and to investigate their potential correlations with demographic factors. Materials and methods Fifteen breast anthropomorphic parameters of 605 Chinese female patients were collected prospectively. Breast ptosis status was scaled by two methods and breast volume was calculated according to a modified formula of BREAST-V. Results Among 1210 breasts, the average breast volume was 340.0±109.1 ml (91.8–919.2 ml). The distance from the nipple to the inframammary fold was 7.5±1.6 cm in the standing position. The width of the breast base was 14.3±1.4 cm (8.5–23.5 cm). The incidence of breast ptosis was 22.8% (274/1204), of which 37 (23.5%) and 79 (31.7%) women had severe ptosis assessed by different criteria. Increased height (OR[odds ratio] = 1.500, Pcosmetic and reconstructive breast surgery decisions. Post-menopausal status, increased BMI, and breastfeeding for more than six months were independent risk factors for both increased breast volume and breast ptosis. PMID:28192525

  19. The Long-Term Results of Frontalis Suspension Using Autogenous Fascia Lata in Children with Congenital Ptosis under 3 Years Old

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    Lale Kozer Bilgin

    2010-01-01

    Full Text Available Purpose. To describe the long-term results of frontalis suspension using autogenous fascia lata in children with congenital ptosis under 3 years old. Methods. Forty three-eyes of 35 patients were enrolled in the study. Frontalis suspension using autogenous fascia lata was performed in all patients. The postoperative eyelid level, ptosis recurrence, visual acuity, and cosmetic results were evaluated. Results. The mean age of the patients was 16.8±9 months (7–36 months. The mean follow-up time was 52.8±15 months (14–95 months. All patients had good (ptosis <2 mm or moderate (2-3 mm ptosis eyelid level after the operation. All patients achieved satisfactory cosmetic results. Succesfull harvesting was performed in all cases and no additional materials or surgical manipulation were needed during the surgery. Conclusion. Frontalis suspension using autogenous fascia lata can be used in children under 3 years old without harvesting problems. Surgical experience and good knowledge of anatomy are important factors for successful results after the surgery.

  20. Large Enhancements of Nitrogen Oxides Over the Central North Atlantic Lower Free Troposphere Resulting From Boreal Wildfires: Observations at the PICO-NARE Station During Summer 2004

    Science.gov (United States)

    Val Martin, M.; Honrath, R. E.; Owen, R. C.; Kleissl, J.; Fialho, P.; Pfister, G.; Lapina, K.

    2005-12-01

    Extensive wildfires burned in Alaska and western Canada during the summer of 2004. Boreal wildfires are a large source of trace gases and aerosols in the atmosphere. However, little is known about the impact of their emissions on the nitrogen oxides and O3 levels over the Northern Hemisphere. During the summer of 2004, measurements of NO_x and NO_y were made at the PICO-NARE station (Azores Islands, Portugal, 2225 m asl), a location 5--15 days downwind from the fires. Measurements in 10 fire plumes between July and September were analyzed in combination with CO and aerosol black carbon observations, backward trajectories, satellite images, and MOZART simulations, in order to study the effect of boreal fire emissions on nitrogen oxides levels over the central North Atlantic lower free troposphere, and their further potential for O3 formation over this region. During the fire-impacted periods, NO_x, NO_y, and CO levels were extremely high for such a remote region, with enhancements up to 110 pptv, 1000 pptv, 150 ppbv above background, respectively. NO_y was significantly correlated to CO, with an average enhancement ratio of approximately 6 pptv/ppbv. The magnitude of the NO_y/CO enhancement ratio is a significant fraction (~20%) of the estimated NO_x/CO emission ratio from boreal forest fires and is only moderately smaller than previous measurements closer to fires, indicating limited NO_y removal during transport to the site. In addition to NO_y, NO_x was typically correlated to CO, with an average enhancement ratio of approximately 1 pptv/ppbv. Since the major component of NO_y in boreal fires plumes is believed to be PAN, this suggests that decomposition of PAN to NO_x is a significant source of NO_x in the fire plumes arriving to this region. These observations indicate that nitrogen oxides emissions from wildfires can be efficiently transported to the lower free troposphere over the central North Atlantic region. Furthermore, high levels of NO_x and NO_y in

  1. Temporalis Muscle Transfer for the Treatment of Lagophthalmos in Patients With Leprosy: Refinement in Surgical Techniques to Prevent Postoperative Ptosis.

    Science.gov (United States)

    Ahn, Sung Yul; Park, Hyang Joon; Kim, Jong Pill; Park, Tae Hwan

    2016-01-01

    Facial paralysis resulting from leprosy has a serious impact on the entire face especially in the areas innervated by the facial nerves. In particular, lagophthalmos in patients with leprosy causes exposure keratitis, corneal, and conjunctival dryness, which can progress to blindness and disfigurement. Recently, we conducted 4 different temporalis muscle transfer (TMT) methods over the last 4 years to reduce ptosis. The methods used included Brown-McDowell, McCord-Codner, modified Gillies-Anderson, and modified Gillies. Seventy-five TMT operations in 60 patients were performed between 2011 and 2014. The mean age was 70.1. Fifteen patients had bilateral TMT procedures. As a result, ptosis appeared in 14(18.7%) of 75 TMT procedures for 4 years. To prevent or correct this complication, the following 4 technical refinements have simplified the surgery and yield better surgical outcomes. First, an increase in the length of the temporalis muscle flap to approximately 8 cm with a parallel course to the lateral canthus will reduce oblique pull. Second, the width of the fascia sling in the upper eyelid is narrowed (3-4 mm) to reduce weight on the eyelid. Third, the fascia sling in the upper lid should not be located along the full length of the upper lid but terminate 3.5 cm medial to lateral canthal tendon and in other words, should not be tied at the medial canthal tendon to reduce tension and weight. Lastly, the fascia sling in the eyelid should be located shallow (probably in subdermal layer) and as near as possible to the lid margin to prevent any functional disturbance in levator aponeurosis.

  2. Diplopía y ptosis palpebral izquierda como primera manifestación de metástasis hipofisarias de adenocarcinoma pulmonar Diplopia and left palpebral ptosis as a first manifestation of hypophysary metastases of pulmonary adenocarcinoma

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    S. Junquera

    2012-04-01

    Full Text Available Paciente sin antecedentes patológicos de interés que debuta con diplopía y ptosis palpebral izquierda como primera manifestación de metástasis hipofisarias de un cáncer de origen pulmonar ampliamente diseminado y no conocido previamente. El diagnóstico se hizo con pruebas de imagen específicas del área hipofisaria en donde se apreció una neoformación en silla turca, que invadía el seno cavernoso izquierdo con erosión del dorso selar, junto con la presencia de nódulos pulmonares y múltiples adenopatías, además del estudio histológico de las lesiones. Se detectó un hipogonadismo hipogonadotropo como única alteración hormonal debido a la infiltración de la hipófisis anterior por las metástasis óseas en la base del cráneo. El paciente, a pesar de recibir varias sesiones de radioterapia, sufrió un deterioro neurológico progresivo falleciendo a las pocas semanas.A patient, without significant previous medical history, who started with diplopia and left palpebral ptosis as the first manifestation of hypophysary metastases of a widely disseminated and previously undetected cancer of pulmonary origin. Together with a histological study of the lesions, the diagnosis was made with specific image tests of the hypophysary area, which detected a neoformation in the sella turca that was invading the left cavernous sinus with erosion of the verso of the sellar, together with the presence of pulmonary nodules and numerous adenopathies. An hypogonadotropic hypogonadism was detected as the only hormonal alteration due to the infiltration of the anterior hypophysis due to the osseous metastases at the base of the cranium. The patient, in spite of receiving several weeks of radiotherapy, suffered a progressive neurological deterioration and died after a few weeks.

  3. X-linked congenital ptosis and associated intellectual disability, short stature, microcephaly, cleft palate, digital and genital abnormalities define novel Xq25q26 duplication syndrome

    DEFF Research Database (Denmark)

    Møller, R S; Jensen, L R; Maas, S M

    2014-01-01

    Submicroscopic duplications along the long arm of the X-chromosome with known phenotypic consequences are relatively rare events. The clinical features resulting from such duplications are various, though they often include intellectual disability, microcephaly, short stature, hypotonia, hypogona...... suggested three critical regions with candidate genes (AIFM1, RAB33A, GPC3 and IGSF1) for the common phenotypes, including candidate loci for congenital bilateral ptosis, small head circumference, short stature, genital and digital defects....

  4. Bilateral lid/brow elevation procedure for severe ptosis in Kearns-Sayre syndrome, a mitochondrial cytopathy

    Science.gov (United States)

    Sebastiá, Roberto; Fallico, Ester; Fallico, Matteo; Fortuna, Eduardo; Lessa, Sergio; Neto, Guilherme Herzog

    2015-01-01

    Background The purpose of this work was to determine the effectiveness and possible complications encountered with bilateral fascia lata lid suspension used to correct blepharoptosis in patients with Kearns-Sayre syndrome. Methods This was a retrospective study of seven patients with Kearns-Sayre syndrome who had a minimum of 1 year of follow-up. A bilateral fascia lata sling was used to correct the ptosis. Preoperative and postoperative measurements of the vertical lid fissure width (VFW) and marginal reflex distance (MRD) were performed. The Student’s t-test was used to analyze the results. Results The mean preoperative VFW and MRD measurements were 4±2.45 mm and 0.14±0.92 mm, respectively. The mean postoperative VFW and MRD measurements were 7.71±1.85 mm, and 2.86±1.69 mm, respectively. All preoperative and postoperative values were considered to be statistically significant (Plagophthalmos, and one patient developed corneal ulceration and scarring due to corneal exposure and a weak Bell’s phenomenon. Conclusion The surgical technique described to correct the blepharoptosis found in patients with Kearns-Sayre syndrome was found to be efficient and relatively safe. The correction should be conservative to decrease the risk of postoperative corneal damage that occurred in one patient. PMID:25565765

  5. PARK2 Microduplication: Clinical and Molecular Characterization of a Further Case and Review of the Literature

    Science.gov (United States)

    Palumbo, Orazio; Palumbo, Pietro; Leone, Maria P.; Stallone, Raffaella; Palladino, Teresa; Vendemiale, Marcella; Palladino, Stefano; Papadia, Francesco; Carella, Massimo; Fischetto, Rira

    2016-01-01

    We report on a patient with psychomotor deficits, language delay, dyspraxia, skeletal anomalies, and facial dysmorphisms (hirsutism, right palpebral ptosis, a bulbous nasal tip with enlarged and anteverted nares, and a mild prominent antihelix stem). Using high-resolution SNP array analysis, we identified a 0.49-Mb microduplication in chromosome 6q26 inherited from the mother involving the PARK2 gene: arr[hg19] 6q26(162,672,821-163,163,143)×3 mat. To the best of our knowledge, this is the third patient to date described in whom a 6q26 microduplication encompassing only the PARK2 gene has been reported in medical literature. The PARK2 gene is a neurodevelopmental gene that was initially discovered as one of the causes of autosomal recessive juvenile Parkinson disease and subsequently reported to be linked to autism spectrum disorders and attention-deficit hyperactivity disorders. We provide an overview of the literature on PARK2 microduplications and further delineate the associated phenotype. Taken together, our findings confirm the involvement of this gene in neurodevelopmental disorders and are useful to strengthen the hypothesis that, although with variable expressivity and incomplete penetrance, the PARK2 microduplication is associated with a new emerging neurodevelopmental delay syndrome. However, clinical and molecular evaluations of more patients with the microduplication are needed for full delineation of this syndrome. PMID:27867343

  6. X-linked congenital ptosis and associated intellectual disability, short stature, microcephaly, cleft palate, digital and genital abnormalities define novel Xq25q26 duplication syndrome.

    Science.gov (United States)

    Møller, R S; Jensen, L R; Maas, S M; Filmus, J; Capurro, M; Hansen, C; Marcelis, C L M; Ravn, K; Andrieux, J; Mathieu, M; Kirchhoff, M; Rødningen, O K; de Leeuw, N; Yntema, H G; Froyen, G; Vandewalle, J; Ballon, K; Klopocki, E; Joss, S; Tolmie, J; Knegt, A C; Lund, A M; Hjalgrim, H; Kuss, A W; Tommerup, N; Ullmann, R; de Brouwer, A P M; Strømme, P; Kjaergaard, S; Tümer, Z; Kleefstra, T

    2014-05-01

    Submicroscopic duplications along the long arm of the X-chromosome with known phenotypic consequences are relatively rare events. The clinical features resulting from such duplications are various, though they often include intellectual disability, microcephaly, short stature, hypotonia, hypogonadism and feeding difficulties. Female carriers are often phenotypically normal or show a similar but milder phenotype, as in most cases the X-chromosome harbouring the duplication is subject to inactivation. Xq28, which includes MECP2 is the major locus for submicroscopic X-chromosome duplications, whereas duplications in Xq25 and Xq26 have been reported in only a few cases. Using genome-wide array platforms we identified overlapping interstitial Xq25q26 duplications ranging from 0.2 to 4.76 Mb in eight unrelated families with in total five affected males and seven affected females. All affected males shared a common phenotype with intrauterine- and postnatal growth retardation and feeding difficulties in childhood. Three had microcephaly and two out of five suffered from epilepsy. In addition, three males had a distinct facial appearance with congenital bilateral ptosis and large protruding ears and two of them showed a cleft palate. The affected females had various clinical symptoms similar to that of the males with congenital bilateral ptosis in three families as most remarkable feature. Comparison of the gene content of the individual duplications with the respective phenotypes suggested three critical regions with candidate genes (AIFM1, RAB33A, GPC3 and IGSF1) for the common phenotypes, including candidate loci for congenital bilateral ptosis, small head circumference, short stature, genital and digital defects.

  7. Resultados postquirúrgicos de la ptosis palpebral asociada a Síndromes. ICO Ramón Pando Ferrer.2005- 2006.

    Directory of Open Access Journals (Sweden)

    María Elena Ríos Rodríguez

    2007-10-01

    Full Text Available Se realizó un estudio observacional, descriptivo, retrospectivo, en pacientes con síndromes asociados a ptosis palpebral en el ICO Ramón Pando Ferrer en el período comprendido entre enero 2005 y diciembre del 2006. Se estudiaron un total de 32 pacientes y 44 ojos. El 43.7% tenían entre 20 – 39 años. No hubo diferencias en la distribución por sexo, aunque con ligera inclinación hacia el sexo femenino. Más del 50% de las ptosis eran bilaterales. Según etiología predominaron las miogénicas para un 59.3%, y dentro de ellas las congénitas representadas por el síndrome de blefarofímosis (31.2%, y las adquiridas por la Miastenia Gravis (15.6%. Las ptosis neurogénicas constituyen un 34.3% representadas por la parálisis el III par y el síndrome de Marcus Gunn, para un 12.5% y 9.3% respectivamente. El 81.2% de los síndromes tuvieron posibilidades quirúrgicas. Al 66% del total de ojos se les realizó la suspensión al músculo frontal y al resto el reforzamiento de la aponeurosis y la Fasanella Servat Modificada en un 20.4% y 13.6% respectivamente. Los resultados se calificaron de buenos en el 54.5%, regulares en el 45.4% y ninguno tuvo malos resultados. Las complicaciones que se presentaron fueron mínimas representadas por la hipocorrección en el reforzamiento de la aponeurosis para un 44.4%. El 79.5% no presentaron complicaciones. Concluimos que muchos síndromes asociados a las ptosis palpebral pueden ser corregidos quirúrgicamente contribuyendo a mejorar la calidad de vida de estos pacientes.

  8. Sporadic and familial blepharophimosis -ptosis-epicanthus inversus syndrome: FOXL2 mutation screen and MRI study of the superior levator eyelid muscle.

    Science.gov (United States)

    Dollfus, H; Stoetzel, C; Riehm, S; Lahlou Boukoffa, W; Bediard Boulaneb, F; Quillet, R; Abu-Eid, M; Speeg-Schatz, C; Francfort, J J; Flament, J; Veillon, F; Perrin-Schmitt, F

    2003-02-01

    The analysis of the FOXL2 gene (3q23) in a series of two families and two sporadic cases affected with Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome (BPES) is presented. This study detected two novel FOXL2 mutations (missence and nonsens mutations) and confirmed the recurrence of a previously described duplication. Magnetic Resonance Imaging (MRI) of the orbit, in one family, showed absence or hypotrophy of the eyelid superior levator muscle suggesting a possible role of FOXL2 in the development of this extra-ocular muscle.

  9. Bilateral lid/brow elevation procedure for severe ptosis in Kearns-Sayre syndrome, a mitochondrial cytopathy

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    Sebastiá R

    2014-12-01

    Full Text Available Roberto Sebastiá,1,2 Ester Fallico,3 Matteo Fallico,4 Eduardo Fortuna,5 Sergio Lessa,2,6 Guilherme Herzog Neto1 1Department of Ophthalmology, Fluminense Federal University, Niterói, 2Oculoplastic Surgery Department, 38th Infirmary of the Santa Casa de Misericordia do Rio de Janeiro, Instituto Ivo Pitanguy, Pontifícia Universidade Catolica do Rio de Janeiro, Rio de Janeiro, Brazil; 3Clinica Gretter, 4Facoltà di Medicina e Chirurgia, Università degli Studi di Catania, Catania, Italy; 5Hospital da Plástica, 6Post-Graduate Program in Physiopathology in Surgical Science, State University of Rio de Janeiro, Rio de Janeiro, Brazil Background: The purpose of this work was to determine the effectiveness and possible complications encountered with bilateral fascia lata lid suspension used to correct blepharoptosis in patients with Kearns-Sayre syndrome.Methods: This was a retrospective study of seven patients with Kearns-Sayre syndrome who had a minimum of 1 year of follow-up. A bilateral fascia lata sling was used to correct the ptosis. Preoperative and postoperative measurements of the vertical lid fissure width (VFW and marginal reflex distance (MRD were performed. The Student’s t-test was used to analyze the results.Results: The mean preoperative VFW and MRD measurements were 4±2.45 mm and 0.14±0.92 mm, respectively. The mean postoperative VFW and MRD measurements were 7.71±1.85 mm, and 2.86±1.69 mm, respectively. All preoperative and postoperative values were considered to be statistically significant (P<0.01. Adequate elevation of the lids was obtained in all patients, both functionally and aesthetically. All of the patients showed a mild symmetric postoperative inferior version lagophthalmos, and one patient developed corneal ulceration and scarring due to corneal exposure and a weak Bell’s phenomenon.Conclusion: The surgical technique described to correct the blepharoptosis found in patients with Kearns-Sayre syndrome was found to

  10. Syndrome of short stature, widow's peak, ptosis, posteriorly angulated ears, and joint problems: exclusion of the Aarskog (FGD1) gene as a candidate gene.

    Science.gov (United States)

    LaDine, B J; Simmons, J A; Shrimpton, A E; Hoo, J J

    2001-03-15

    A syndrome encompassing postnatal onset of short stature, widow's peak, ptosis, posteriorly angulated ears, and limitation of forearm supination is reported in a boy and his mother. The boy has not yet experienced dislocation of patella or other joint anomaly except for limitation of supination of the forearms. On the other hand, the mother has a milder limitation of supination only on the left arm and is devoid of ptosis. Their condition is reminiscent of that described in the family reported by Kapur et al. [1989: Am. J. Med. Genet. 33: 357-363.], which showed an X-linked dominant mode of inheritance. DNA study on our family using an intragenic polymorphism of the Aarskog syndrome (FGD1) gene and four other adjacent markers convincingly excludes the possibility that their condition could be caused by a mutation of the FGD1 gene. Our family and the family reported by Kapur et al. may suggest segregation of a novel X-linked dominant condition.

  11. Antimicrobial resistance profile of Methicillin-resistant Staphylococcus aureus colonizing the anterior nares of health-care workers and outpatients attending the remotely located tertiary care hospital of North India

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    Seema Singh

    2017-01-01

    Aims and Objectives: To determine the prevalence of MRSA colonisation, two hundred HCWs and 200 consecutive outpatients attending our tertiary care hospital were studied. Material and Methods: Two sterile pre-moistened cotton tipped swabs were used to collect specimens from their anterior nares. These were inoculated immediately on Blood agar with oxacillin, Mannitol salt agar with oxacillin and CHROM agar. Resistance to cefoxitin was confirmed by PCR by demonstration of mecA gene. Antibiotic susceptibility was determined by Kirby Bauer's disc diffusion method and MIC of vancomycin by using broth dilution and Vitek-2 Compact system. Results: The nasal carriage of MRSA among HCWs was found to be 7.5% and in outpatients 3%. All strains of MRSA from HCWs and outpatients grew on three selective media and mecA gene amplified in all of them. All the isolated strains of MRSA showed high degree of resistance to co-trimoxazole (93.3%, ciprofloxacin (80% and erythromycin (66.66%. However, there was 100% susceptiability to vancomycin, teicoplanin, linezolid and Rifampicin. Conclusion: Although a direct casual relationship could not be established, it could be assumed that the transmission from colonised health care worker is responsible atleast in part for MRSA infection among patients. Therefore emphasis should be laid on strict implementation of standard infection control practices which would help in minimizing the carriage and transmission of MRSA in the hospital.

  12. Formación y pronóstico del precio diario de la energía eléctrica en la cadena Nare-Guatapé-San Carlos

    Directory of Open Access Journals (Sweden)

    Alejandro Romero

    2003-01-01

    Full Text Available Este trabajo plantea tres tipos de metodologías para la comprensión y pronóstico de los precios diarios de la energía eléctrica de la cadena Nare-Guatapé-San Carlos: modelo lineal multivariado, modelo autorregresivo determinístico y descomposición en series de Fourier. El precio de la energía eléctrica de una central depende no solamente del nivel del embalse y del caudal del río propio, sino también del embalse y sus respectivos afluentes aguas abajo o aguas arriba. En cuanto al pronóstico de los precios estos se pueden modelar con un proceso autorregreviso. El pronóstico sigue la tendencia y captura de los precios con aceptable precisión, especialmente para los valores máximos debido a los bajos caudales y volúmenes de embalse y teniendo en cuenta la variabilidad del precio para embalses de regulación diaria, semanal y mensual.

  13. Quantidade de gordura no músculo levantador da pálpebra de portadores de ptose congênita Congenital ptosis associated with fatty infiltration of levator eyelid muscle

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    Cristiano Pinheiro Leite

    2006-12-01

    Full Text Available OBJETIVO: Quantificar a gordura presente no músculo levantador da pálpebra de portadores de ptose congênita, correlacionando este achado com fatores clínico-epidemiológicos desta afecção. MÉTODOS: Vinte e duas amostras de músculo levantador da pálpebra superior, provenientes de portadores de ptose congênita, foram avaliadas morfometricamente, com o intuito de quantificar a gordura presente nos espécimes e correlacionar este achado com características como idade, sexo, grau de ptose e função do músculo levantador. RESULTADOS: Não houve correlação entre a quantidade de gordura encontrada no músculo levantador de portadores de ptose congênita e os dados clínicos dos pacientes estudados. CONCLUSÃO: A quantidade de gordura presente no músculo levantador da pálpebra superior, nas condições do presente estudo, não está associada com idade, sexo, grau de ptose ou função do músculo levantador. Novos estudos serão necessários para avaliar a real alteração que ocorre no músculo levantador da pálpebra de indivíduos com ptose palpebral.PURPOSE: To quantify the fat in the levator muscle of patients with congenital ptosis, as related to clinical and epidemiological aspects of this disease. METHODS: Twenty-two levator muscle samples of the superior eyelid from patients with congenital ptosis were morphometrically evaluated with aim of establishing a relationship between the fat quantity and age, sex, ptosis degree and levator muscle function. RESULTS: According to our results the fat in the levator muscle of patients with congenital ptosis is not related to gender or epidemiologic aspects. CONCLUSION: Fat amount in the levator muscle from congenital ptosis is not related to age, sex, ptosis degree or levator muscle function. Other studies will be necessary to show the real alterations in the levator muscle related to eyelid ptosis.

  14. 老年获得性上睑下垂术式及疗效观察%Observation of surgical and therapeutic methods for senile acquired ptosis

    Institute of Scientific and Technical Information of China (English)

    周柳红; 周世宏; 黄再林; 程亚中

    2012-01-01

    Objective To explore the etiology and the surgical approach on those drug treatment failure elderly acquired ptosis,and to evaluate its effectiveness. Methods The 56 cases (72 eyes)of elderly acquired ptosis were treated from March 2007 to March 2010.The causes were analyzed and characteristic operation modes were designed according to the status of each individual patient.Of frontalis muscle flap suspension was performed on 8 cases (12 eyes),superior levator muscle shortening united tarsal plate resection on 13 cases (16 eyes),simple superior levator muscle shortening on 30 cases (36 eyes) and superior levator aponeurosis folding on 5 cases (8 eyes). Results After the surgery,1 eye was overcorrected,1 eye undercorrected,3 eyes fallback,and all cases were properly corrected that followed-up for more than one year with good effect,beauty,and without complications.Satisfaction rate was 93%. Conclusions In accordance with the etiology,age and function of superior levator muscle of elderly acquired ptosis,choosing the reasonable and characteristic operation modes are able to achieve ideal,safety,and satisfied results.%目的 探讨病因和药物性治疗无效的老年获得性上睑下垂的手术方式,并对其效果进行评价.方法 对2007年3月至2010年3月间收治的56例(72只眼)老年获得性上睑下垂患者,进行个性化手术设计,其中,额肌瓣悬吊术8例(12只眼),提上睑肌缩短联合睑板切除术13例(16只眼),单纯提上睑肌缩短术30例(36只眼),提上睑肌腱膜折叠术5例(8只眼).结果 1只眼过矫,1只眼欠矫,3只眼回退,其余随访一年以上均疗效满意,外形美观,无并发症,满意率达93%.结论 依照老年获得性上睑下垂病因、年龄特点以及提上睑肌功能情况,合理选择手术方式,能达到安全、可靠、满意的矫正效果.

  15. Diversified seabed substrate, sediment remobilisation and fluid migration features offshore NW Greenland - new insights from marine seismic data acquisition in the Northern Nares Strait during the RV Oden cruise 2015

    Science.gov (United States)

    Andresen, Katrine Juul; Heirman, Katrien; Kamla, Elina; Nielsen, Tove; Rønø Clausen, Ole; Jakobsson, Martin; Mix, Alan C.; Andersen, Søren T.; Nørmark, Egon; Piotrowski, Jan A.; Knutz, Paul; Larsen, Nicolaj K.; Hogan, Kelly

    2016-04-01

    We present some preliminary observations from acquired seismic data from the Northern Nares Strait, NW Greenland. The studied area covers the Hall Basin in front of the Petermann Glacier and extends southward into the Kennedy Channel. It represents an area intensely affected by glacial related processes as well as deep tectonics. The data were acquired during the RV Oden cruise in late summer 2015, and thus represent valuable input to the understanding of the geological development of this scarcely accessed area of the Arctic. The data were acquired in nearly ice-free conditions and consist of >700 km 2D seismic airgun data, supplemented by high-resolution subbottom profiler data and multibeam data. The different acoustic data acquired simultaneously enable us to correlate deeper geological observations (e.g. faults observed on airgun seismics) with shallow depositional architectures (observed on subbottom profiler) and finally correlate the relatively scattered 2D interpretation with the detailed 3D seafloor morphology obtained by the multibeam. The seismic data reveal several provinces of varying seabed substrate geometry. The provinces include A: confined mini-basins; B: larger sedimentary basins; C: larger structural highs and D: "rough-and-faulted" terrain. The data also reveal a number of seismic anomalies, which indicate fluid flow and sediment remobilisation. The mini-basins are 100-600 m wide, in contrast to the larger basins which typically extend over 6-12 km. The mini-basins are characterized by a flat, smooth and continuous seafloor reflection and have an infill dominated by parallel and sub-horizontal reflections onlapping the edges of the basins. The larger basins, where the internal reflection pattern appears more diverse and less parallel, have much greater relief at the seafloor. Vertical disturbance zones typically emerging above minor structures at the floor of the mini-basins are likely related to vertical fluid migration. The zones

  16. The Relationship of Amount of Resection and Time for Recovery of Bell’s Phenomenon after Levator Resection in Congenital Ptosis

    Science.gov (United States)

    Goel, Ruchi; Kishore, Divya; Nagpal, Smriti; Jain, Sparshi; Agarwal, Tushar

    2017-01-01

    Background: Recovery of Bell`s phenomenon after levator resection is unpredicatable. Delayed recovery can result in vision threatening corneal complications. Aim: To study the variability of Bell’s phenomenon and time taken for its recovery following levator resection for blepharoptosis and to correlate it with the amount of resection. Methods: A prospective observational study was conducted on 32 eyes of 32 patients diagnosed as unilateral simple congenital blepharoptosis who underwent levator resection at a tertiary care center between July 2013 and May 2015. Patients were followed up for 5 months and correction of ptosis, type of Bell`s, duration of Bell`s recovery and complications were noted. Results: The study group ranged from 16-25 years with 15:17 male: female ratio. There were 9 mild, 16 moderate and 7 severe ptosis. Satisfactory correction was achieved in all cases. Good Bell`s recovery occurred in 13 eyes on first post-op day, in 2-14 days in 19 eyes and 28 days in 1 eye. Inverse Bell`s was noted along with lid oedema and ecchymosis in 2 patients. Large resections (23-26mm) were associated with poor Bell`s on the first postoperative day (p=0.027, Fisher`s exact test). However, the duration required for recovery of Bell`s phenomenon did not show any significant difference with the amount of resection. (p=0.248, Mann Whitney test). Larger resections resulted in greater lagophthalmos (correlation=0.830, p<0.0001). Patients with recovery of Bell`s delayed for more than 7 days were associated with greater number of complications (p=0.001 Fisher`s Exact Test). Conclusion: Close monitoring for Bell`s recovery is required following levator resection. PMID:28584563

  17. Third cranial nerve palsy (ptosis, diplopia accompanied by orbital swelling: case report of unusual clinical presentation of giant cell arteritis associated with polymyalgia rheumatica

    Directory of Open Access Journals (Sweden)

    Prassede Bravi

    2012-12-01

    Full Text Available IntroductionGiant cell arteritis (GCA is the most common systemic vasculitis in older individuals, characterized by granulomatosus inflammation of the wall of large and medium-sized arteries. The wide spectrum of arterial sites involved leads to ischemia of different organs resulting in a wide range of clinical signs and symptoms. Temporal artery is commonly involved (temporal arteritis. Unusual patterns of presentation, such as extraocular motility disorders and orbital swelling, may be early and transient manifestations of GCA and precede the permanent visual loss due to ischemic optic neuropathy.Case reportWe describe a patient with uncommon manifestations of GCA consisting of transient recurrent diplopia, ptosis, orbital swelling together with more typical clinical features of the disease such as musculoskeletal manifestations (polymyalgia rheumatica and facial pain: all signs and symptoms promptly resolved under corticosteroid therapy without relapse.Conclusions A high level of suspicion of GCA in individuals over the age of 50 years is needed to prevent the development of severe complications. Clinicians should be aware of uncommon manifestations of the disease such as head–neck swelling and ophthalmoplegia: management guidelines have stated that prompt administration of adequate dose of corticosteroids as soon as ocular manifestations of GCA are noted may almost totally prevent blindness.

  18. The analysis of visual evoked potential in patients with monocular congenital ptosis%单眼先天性上睑下垂患儿图形视觉诱发电位分析

    Institute of Scientific and Technical Information of China (English)

    黄业贤; 周瑾; 胡兰香; 宋生芳; 项道满

    2014-01-01

    目的:探讨单眼先天性上睑下垂患儿图形视觉诱发电位(P-VEP)的特点,评估P-VEP对上睑下垂患儿双眼视觉功能检测的意义。方法对53例2~4岁单眼先天性上睑下垂患儿进行P-VEP检查,比较双眼P-VEP的P100潜伏期及振幅是否存在差异。结果上睑下垂眼VEP P100波潜伏期较正常组延长(P<0.01),振幅低于正常眼(P<0.01)。轻度上睑下垂眼P-VEP P100波振幅与中度及重度相比,差异有统计学意义(P<0.01),中度与重度相比差异无统计学意义,轻度上睑下垂眼P-VEP P100波潜伏期与中度相比差异无统计学意义,与重度比差异有统计学意义(P<0.01),中度与重度比较差异有统计学意义(P<0.05)。结论单眼先天性上睑下垂患者双眼P-VEP P100波振幅及潜伏期存在差异,根据患儿视觉发育程度进行手术时机选择的同时,应注意术后矫正弱视。%Objective To investigate the visual evoked potential (P-VEP) feature in patients with monocular congenital ptosis. To evaluate the significance of P-VEP in binocular vision.MethodsP-VEP response was recorded in 53 monocular congenital ptosis children who were 2-4 years old. Then compared the differences of latency period and waver of P100 wave.ResultsCompared with normal eye,the latency period of ptosis eyes was longer and the amplitude was lower(P<0.01).The differences of amplitude between mild ptosis eyes and midrange or severe ptosis eyes were significant (P<0.01) while they were not significantly between midrange and severe group.The differences of latency period between mild ptosis eyes and midrange eyes were not significant while they were significantlly between midrange and severe group(P<0.01,P<0.05).Conclusion Patients with monocular congenital ptosis edured differences response of P-VEP P100 in amplitude and latency period between two eyes.Attention should be focused on mblyopia after surgery.

  19. Efficacy of autologous fascia lata frontalis suspension surgery for severe ptosis%自体阔筋膜额肌悬吊术治疗重度上睑下垂疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘虹; 马朋举

    2015-01-01

    Objective To explore the autogenous broad fascia suspension curative effect for the treatment of severe ptosis.Methods Thirty cases (42 eyes) diagnosed with severe congenital ptosis patients with autologous broad fascia sling operation, postoperative over 3 months to 1 year.Results Correction of 26 cases (37 eyes), 4 cases (5 eyes) with basic correction without proper, owe affair.Conclusions Autologous wide fascia suspension conforms to the characteristics of physiological anatomy, fewer complications, surgical success rate is high, the correct severe ptosis safe and reliable.%目的 探讨自体阔筋膜额肌悬吊术治疗重度上睑下垂的疗效.方法 对2012年3月至2013年3月在石河子市人民医院眼科就诊的30例(42只眼)确诊为先天性上睑下垂患者行自体阔筋膜悬吊术,术后随防3个月至1年.结果 矫正良好26例(37只眼),基本矫正4例(5只眼),无过矫、欠矫者.结论 自体阔筋膜悬吊术符合生理解剖的特点,治疗重度上睑下垂并发症少,手术成功率高,矫正重症上睑下垂安全可靠.

  20. 乳腺组织瓣联合真皮帽悬吊术矫正轻中度乳房下垂%Correction of mild and moderate breast ptosis with glandular flap combined with dermal flap suspension

    Institute of Scientific and Technical Information of China (English)

    熊凌云; 孙家明; 郭能强; 杨杰

    2011-01-01

    目的 探讨乳腺组织瓣旋转联合真皮帽悬吊的垂乳上提技术矫正轻中度乳房下垂的临床效果.方法 根据乳房下垂程度设计形成真皮帽后,分离乳房皮肤和腺体,于乳腺外上方行部分腺体切除或直接纵行切开腺体,并同时形成外侧腺体瓣,掀起腺体瓣向内侧旋转固定,缩小乳房基底,再行真皮帽上提固定和乳房塑形.结果 2006年3月至2010年3月,于临床应用46例,术后效果满意,其中2例出现单侧血肿,无其他严重并发症.对40例患者随访6个月至4年,乳房外形满意,无继发下垂、乳房扁平、乳头乳晕感觉障碍等并发症.结论 乳腺组织瓣旋转联合真皮帽悬吊垂乳上提术可商塑造饱满、坚挺的乳房,术后瘢痕不明显,远期效果满意.%Objective To investigate the therapeutic effect of glandular flap combined with dermal flap suspension for correction of mild and moderate breast ptosis. Methods The dermal flap was formed according to the breast ptosis and dissection was performed between the skin and gland. The superior-lateral gland was partially resected or cutted vertically only to form the lateral glandular flap. Then the glandular flap was rotated medially and fixed to shrink the glandular base area. Then the breast was up-positioned and fixed with dermal flap to remodel the breast shape. Results From Mar. 2006 to Mar. 2010, 46 cases were treated with satisfactory result. There was no severe complication, except for 2 cases of unilateral hematoma. 40 cases were followed up for 6 months to 4 years with good breast shape. No secondary ptosis,breast flatten and NAC sensation disorder was happened. Conclusions Glandular flap combined with dermal flap suspension is a good method for mild and moderate breast ptosis with reliable long-term results.The breasts have busty appearance and good projection with inconspicious scar.

  1. 上睑解剖结构及其在上睑下垂矫正术中的意义%Anatomy of the upper eyelid and its significance in correction of eyelid ptosis

    Institute of Scientific and Technical Information of China (English)

    唐建兵; 程飚; 李勤; 余文林; 吴燕虹; 曾东; 齐向东

    2011-01-01

    Objective To explore anatomic features of the upper eyelid for improving clinical effect on the ptosis correction. Methods 132 patients with mild or moderate ptosis were followed up during 3 years.Most cases were treated with surgical levator shortening or folding. Levator muscle flap was dissected carefully intraoperatively, which was shortened or folded according to the degree of ptosis. The aortic arch, lacrimal gland and other important structures were protected during the operation. Whitnall ligament was cut or not according to the specific conditions. Results The correction was satisfied for most patients, except for 3 cases of under-correction, one case of over-correction, and 2 cases of asymmetrical eyelid lines.Conclusions The key process for the correction of eyelid ptosis is to isolate levator muscle flap, and evaluate the shorten degree of the levator, according to the anatomic features of the upper eyelid.%目的 熟悉上睑解剖结构,进一步提高上睑下垂的矫治疗效.方法 近3年共治疗132例轻中度上睑下垂患者,大部分采用上睑提肌缩短或者折叠的手术方式,术中精细解剖上睑提肌肌瓣,注意勿损伤动脉弓、泪腺等结构,Whitnall韧带视情况予以切断.再按照上睑下垂的程度进行肌瓣缩短或者折叠.结果 大部分病例术后矫正效果满意,3例患者矫正不足,1例患者矫正过高,2例患者重睑线不完全对称,经过进一步处理效果满意.结论 按照解剖结构精细分离上睑提肌肌瓣,按照上睑下垂程度估测上睑提肌缩短的距离是成功进行上睑下垂矫正的关键.

  2. Interstitial deletion in 3q in a patient with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) and microcephaly, mild mental retardation and growth delay: clinical report and review of the literature.

    Science.gov (United States)

    de Ru, M H; Gille, J J P; Nieuwint, A W M; Bijlsma, J B; van der Blij, J F; van Hagen, J M

    2005-08-15

    We present a boy with blepharophimosis, ptosis, epicanthus inversus, microcephaly, mild mental retardation, and growth delay. Chromosomal analysis revealed a male karyotype with an interstitial deletion in the long arm of chromosome 3. DNA-analysis showed that the deletion is of maternal origin and encompasses the region between markers D3S1535 and D3S1593. The deletion contains not only the FOXL2 gene, but also the gene encoding ataxia-telangiectasia and Rad3-related protein (ATR). Mutations in FOXL2 have been shown to cause blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). ATR has been identified as a candidate gene for Seckel syndrome, an autosomal recessive syndrome that comprises growth retardation, microcephaly, and mental retardation. We hypothesize that our patient has a contiguous gene syndrome and that the non-BPES-associated abnormalities (microcephaly, mild mental retardation, and growth delay) are the result of the deletion of the maternal ATR gene. However, it has not yet been excluded that haploinsufficiency of some other gene in this region plays a role. Copyright 2005 Wiley-Liss, Inc.

  3. 先天性上睑下垂患者100例弱视致病原因的探讨%Assessing amblyogenic factors in 100 patients with congenital ptosis

    Institute of Scientific and Technical Information of China (English)

    Abolfazl Kasaee; Alireza Yazdani-Abyaneh; Syed Ziaeddin Tabatabaie; Alireza K.Jafari; Ahmad Ameri; Bahram Eshraghi; Vafa Samarai; Meysam Mireshghi; Mohammad Taher Rajabi

    2011-01-01

    AIM: To study the frequency of amblyogenic factors in patients with congenital ptosis.congenital ptosis more than 1 year old were included. Amblyopia was defined as best-corrected visual acuity (BCVA) less than 10/10 or a difference between the two eyes of at least 2/10. In patients too young to be measured by the linear Snellen E test, fixation behavior was observed. Different types of amblyopia were assessed for each patient as: 1) anisometropic amblyopia: astigmatic anisometropia≥ 1dpt, hyperopic spherical anisometropia≥ 1dpt, myopic spherical anisometropia≥ -3dpt (with cycloplegia);2) strabismic amblyopia, and 3) stimulus deprivation amblyopia (SDA). Then the total incidence of amblyopia and each type of it were obtained. Patients with uni-and bi-lateral ptosis were also compared. Each specific cause was refractive amblyopia in 29.8%, SDA in 10.5%, strabismic amblyopia in 4.3%. Amblyopia was more frequent in severe ptosis, 76% in patients with covered optical axes (OA), compared to non-covered OA (22.5%). In unilateral ptosis with covered OA, astigmatic anisometropic amblyopia was more frequent, and in bilateral ptosis with at least one eye covered OA, spherical anisometropic amblyopia was more frequent. In both unilateral and bilateral ptosis, SDA was more common if the OA was covered. Paying attention to all causes of amblyopia may be important in preventing amblyopia in a child with a ptotic eye.%目的:评估先天性上睑下垂患者的弱视发病情况.方法:在本横断面研究中,包括1岁以上的先天性上睑下垂患者100例(114眼).最佳矫正视力小于10/10或两眼之间至少相差2/10者定义为弱视.年幼患者不能进行斯内伦视力表检测者, 观察其注视情况.不同弱视患者的类型:1)屈光参差性弱视:散光性屈光参差≥1.00D;远视性球镜屈光参差≥1.00D,近视性球镜屈光参差≥-3 00D(睫状肌麻痹);2)斜视性弱视,3)形觉剥夺性弱视(SDA).观察弱视的总发病率及类型,

  4. Transposição da rima palpebral em ptose miogênica mitocondrial Tarsal switch levator for mitochondrial myogenic ptosis

    Directory of Open Access Journals (Sweden)

    Lucia Miriam Dumont Lucci

    2009-04-01

    Full Text Available OBJETIVO: Relatar o uso da ressecção do tarso da pálpebra superior e enxerto na pálpebra inferior para a elevação da rima palpebral e liberação do eixo visual, sem causar complicações corneanas em pacientes portadores de ptose miogênica mitocondrial. MÉTODOS: Estudo prospectivo. A técnica cirúrgica consiste na tarsectomia da pálpebra superior e autoenxerto do tarso na lamela posterior da pálpebra inferior. As cirurgias foram realizadas sob anestesia local. No caso de diplopia, a cirurgia foi realizada em apenas um olho. RESULTADOS: O procedimento foi realizado em 9 olhos de 6 pacientes com miopatia mitocondrial. Cinco pacientes eram do sexo feminino, a média de idade foi de 59,8 anos e o seguimento variou de 30 a 60 meses. A rima palpebral elevou em todos os pacientes, descobrindo o eixo visual na posição primária do olhar e melhorando a posição viciosa de cabeça. Não houve complicações decorrentes da exposição do globo ocular. CONCLUSÃO: A técnica de transposição da rima palpebral é útil na correção do mau posicionamento das pálpebras em pacientes sem mecanismos de proteção porque eleva a pálpebra superior e a inferior, diminuindo ou eliminando o risco de causar lagoftalmo com complicações corneanas.PURPOSE: To report the use of tarsal switch levator resection procedures that lift the palpebral fissure to visual axis without causing corneal complications in patients with mitochondrial myogenic ptosis. METHODS: Prospective study. The technique consists of an upper eyelid tarsectomy, with transfer of the autologous tarsoconjunctival graft to the posterior lamella of the lower eyelid. The surgeries were performed under local anesthesia. In case of diplopia, the surgery was performed in one eye. RESULTS: Tarsal switch procedure was performed in 9 eyes of 6 patients with mitochondrial myopathy. There were 5 women; the average age was 59.8 years and the follow-up ranged from 30 to 60 months. The palpebral

  5. 两种术式治疗重度先天性上睑下垂的效果观察%Comparative study on the two surgical procedures for severe congenital ptosis

    Institute of Scientific and Technical Information of China (English)

    罗晓亮; 雷澄

    2012-01-01

    Objective To investigate the superiority and disadvantage of two operations for severe congenital ptosis. Methods 37 eyes of 32 patients with severe congenital ptosis undergoing therapy were divided into two groups. 18 cases (22 eyes) with myodynamia of levator palpabra muscle ≥ 4 mm were treated by levator palpebra superioris muscle shortening, 14 cases (15 eyes) with myodynamia of levator palpabra muscle < 4 mm were treated by frontal muscle flap suspension surgery. The postoperative effects, upper eyelid radian, double eyelid forming conditions and complications were compared. Results The cases which were conducted levator palpebra superioris muscle shortness had short recovery time, natural appearance and satisfactory results. And the others had long recovery time and unnatrual appearance. Conclusion Both surgical methods can treat congenital ptosis effectively. Shortening levator muscle of upper eyelid is more suitable for physiology status and has the best effects and fewer complications.%目的 探讨应用上睑提肌缩短术、额肌瓣悬吊术治疗重度先天性上睑下垂的疗效.方法 重度先天性上睑下垂患者32例37眼,上睑提肌肌力≥4 mm患者18例(22眼)行上睑提肌缩短术,上睑提肌肌力<4 mm患者14例(15眼)行额肌瓣悬吊术,比较术后效果、上睑弧度、双重睑成形情况及手术并发症.结果 采用上睑提肌缩短术患者术后兔眼恢复时间短,外观自然,效果满意;采用额肌瓣悬吊术患者兔眼恢复时间长,外形欠自然.结论 两种手术方式均能有效治疗先天性上睑下垂,但上睑提肌缩短术更符合生理状态,手术效果更好,且并发症少.

  6. Observation of individual therapeutic methods based on degenerative change of levator aponeurosis in patients with senile ptosis%老年性上睑下垂退行性改变个性化治疗临床分析

    Institute of Scientific and Technical Information of China (English)

    庞润晖; 张宏斌; 李妍; 史俊虎; 梁旭; 白萍

    2015-01-01

    目的 依据老年性上睑下垂术中提上睑肌退行性改变实施个性化手术治疗,并对其效果进行评价.方法 对2007年9月至2014年5月间在河北省眼科医院收治的40例(74只眼)老年性上睑下垂患者行手术治疗,术中根据提上睑肌腱膜改变将其分为3类:提上睑肌腱膜松弛无力为乏力型,行提上睑肌折叠术20只眼;提上睑肌腱膜部分断裂或裂孔为裂孔型,行裂孔修补术28只眼;提上睑肌增厚并呈现脂肪样改变为变性型,切除变性组织并行提上睑肌缩短术26只眼.结果 上睑活动轻度受限、重睑欠对称3只眼(4%),上睑活动受限、重睑不对称2只眼(2%),其余患者重睑弧度自然,外形美观,随访2年,满意率达94%.结论 根据老年上睑下垂提上睑肌解剖结构的改变行个性化合理选择手术方式,可取得最佳的治疗效果.%Objective According to the anatomy of levator aponeurosis in patients with senile ptosis, implete different operation and evaluate the effect.Methods 40 patients with senile ptosis were selected from our department between September 2007 and May 2014.According to the status of anatomy of levator aponeurosis each individual patient,they were divided into 3 types: the patients with levator aponeurosis weakness, were performed levator aponeurosis folding on 20 eyes, levator aponeurosis partial rupture were performed levator aponeurosis repair on 28 eyes,levator aponeurosis thickening and fat change,were performed superior levator muscle shortening on 26 eyes.Results After the surgery, 3 eyes slightly restricted(4%), 2 eye was overeorrected(2%),The remaining patients were properly corrected that followed for more than 2 years with good effect, beauty, and without complications.Satisfaction rate was 94%.Conclusions In order to achieve the best correction in patients with senile ptosis, it is important that selecting appropriate operation modes according to the anatomy of levator aponeurosis.

  7. FOXL2 gene mutations and blepharophimosis-ptosis-epicanthus inversus syndrome (BPES): a novel mutation detected in a Chinese family and a statistic model for summarizing previous reported records.

    Science.gov (United States)

    Xu, Yan; Lei, Huo; Dong, Hong; Zhang, Liping; Qin, Qionglian; Gao, Jianmei; Zou, Yunlian; Yan, Xinmin

    2009-09-01

    Previous studies found that the forkhead transcription factor 2 (FOXL2) gene mutations are responsible for both types of blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) but have not established any systematic statistic model for the complex and even contradictory results about genotype-phenotype correlations between them. This study is aimed to find possible mutations of FOXL2 gene in a Chinese family with type II BPES by using DNA sequencing and to further clarify genotype-phenotype correlations between FOXL2 mutations and BPES by using a systematic statistical method, namely Multifactor Dimensionality Reduction (MDR). A novel mutation (g.933_965dup) which could result in an expansion of the polyalanine (polyAla) tract was detected in all patients of this family. MDR analysis for intragenic mutations of FOXL2 gene reported in previous BPES studies indicated that the mutations which led to much stronger disturbance of amino acid sequence were responsible for more type I BPES, while other kinds of mutation were responsible for more type II BPES. In conclusion, the present study found a novel FOXL2 gene mutation in a Chinese BPES family and a new general genotype-phenotype correlation tendency between FOXL2 intragenic mutations and BPES, both of which expanded the knowledge about FOXL2 gene and BPES.

  8. 上睑下垂矫正术后发生角膜溃疡的特殊原因及处理%The cause and treatment for corneal ulcer after ptosis surgery

    Institute of Scientific and Technical Information of China (English)

    叶琳; 彭云; 王媛; 路璐; 郭萍; 曾琨

    2014-01-01

    目的 探讨上睑下垂术后角膜溃疡发生的特殊原因及处理措施.方法 回顾性分析深圳市眼科医院2012年1月至2013年12月进行的上睑下垂矫正术89例(110眼),其中5例(6眼)发生了角膜溃疡,分析其原因及治疗效果.结果 5例(6眼)发生角膜溃疡,3例是因为术后下睑倒睫加重而引起,1例与心因性疾病有关,1例是因为脑膜瘤术后,角膜营养不良引起.进行了睑裂缝合、营养角膜、对症治疗等处理,患者角膜均恢复透明,上睑下垂手术效果满意.结论 上睑下垂患者虽然在术前、术后均采取措施避免角膜溃疡的发生因素,但还是有少数患者术后发生角膜溃疡,其原因并不常见.术前完善检查,术后出现溃疡后积极处理,是可以避免或治愈角膜溃疡的.%Objective To analyze special cause and treatment for corneal ulcer after ptosis surgery.Methods 110 eyes of 89 patients who underwent blepharoptosis correction surgery between January 2012 and December 2012 were retrospectively analyzed.Corneal ulcer occurred in 5 cases (6 eyes).The causes and treatment were analyzed.Results In 5 cases (6 eyes),corneal ulcer was caused by entropion and trichiasis in 3 eyes of 3 cases.The corneal ulcer was related to the psychological illness in 2 eyes of 1 case.The nerve nutritional corneal ulcer occurred in 1 eye of 1 case because of meningioma surgery.After the treatments,such as tarsorrhaphy,cornea nutritional therapy and symptomatic treatment,all the corneal ulcer restored transparent and the effect of surgery was satisfactory.Conclusion Before and after ptosis surgery,patients have been taken measures to prevent the occurrence of corneal ulcer,but corneal ulear still occurs.The causes are not common.So improving preoperative examinations and postoperative active treatment are very necessary.

  9. 两种手术方式治疗先天性上睑下垂的疗效%Effect on the treatment of congenital ptosis in two kinds of operation method

    Institute of Scientific and Technical Information of China (English)

    蒋韵佳; 孙松; 朱婷婷

    2014-01-01

    AlM:To compare the functional and cosmetic effects of two different surgical techniques for congenital ptosis. METHODS: The patients were divided into four groups according to the operation method: Patients undertook bilateral fascial suspension surgery as Group A ( 42 eyes of 21 cases ); Patients undertook bilateral levator muscle shortening surgery as Group B ( 38 eyes of 19 cases );Patients undertook unilateral fascial suspension surgery as Group C ( 24 eyes of 24 cases ); Patients undertook unilateral levator muscle shortening surgery as Group D (29 eyes of 29 cases). Each group patients were followed for postoperative function and appearance effect. RESULTS: 1 ) Early postoperative of two operation function success rate was up to 100%, the function of levator muscle shortening surgery was 97. 01% in the late postoperative, was higher than bilateral fascial suspension surgery (87. 88%), with statistical difference in both surgerys (P0. 05); ln the late postoperative, the mean grades for “Lid Contour” and “Lid Crease” of Group B were better than that of Group A (P CONCLUSlON: Two kinds of operation method have good effects on the treatment of congenital ptosis. ln terms of cosmetic effect, levator muscle shortening surgery is better.%目的:探讨先天性上睑下垂两种不同手术方式的疗效。  方法:根据手术方式分为四组:行双眼额肌筋膜瓣悬吊术组( A组,21例42眼),行双眼提上睑肌缩短术组( B组,19例38眼),行单眼额肌筋膜瓣悬吊术组( C组,24例24眼),行单眼提上睑肌缩短术组( D组,29例29眼)。随访观察各组患者术后的功能和外观疗效。  结果:(1)术后早期两种手术方式功能成功率均达100%,术后晚期提上睑肌缩短术的功能成功率(97.01%)高于额肌筋膜瓣悬吊术(87.88%),两者差异具有统计学意义(P0.05);术后晚期,B 组“眼睑弧度”、“双重睑”两项外观疗效指标优于 A 组(P  结论:两种手术方

  10. A novel mutation in the FOXL2 gene in a Chinese family with blepharophimosis, ptosis, and epicanthus inversus syndrome%小睑裂综合征家系的FOXL2基因突变研究

    Institute of Scientific and Technical Information of China (English)

    李武修; 王小柯; 孙岩; 王艳丽; 林立新; 唐胜建

    2005-01-01

    Objective To screen mutations in the forkhead transcriptional factor 2 gene (FOXL2) in six Chinese families with blepharophimosis, ptosis, and epicanthus inversus syndrome(BPES). Methods PCR amplification and direct sequencing of the FOXL2 coding region in genomic DNA were performed in affected patients and 80 healthy controls. BLAST analysis of the sequence was made on Internet.Results A novel 951-953(delC) was found in the two affected patients of a Chinese family with BPES. No mutations were found in the healthy controls. The 951-953(delC) may cause a frameshift mutation after codon 238 that exists downstream of the forkhead domain, resulting in the production of truncated proteins. Conclusion These findings indicated that the 951-953(delC) deletion mutation in the two patients resulted in truncated proteins and hence led to their BPES. To the authors' knowledge, the 951-953(delC) in FOXL2 has not been previously reported.%目的对小睑裂综合征家系患者的 FOXL2基因突变进行研究,寻找突变位点.方法设计 FOXL2基因特异性引物进行PCR扩增,然后测序,并对突变位点进行克隆后测序.结果在一个类型尚不明确的家系中2例患者 FOXL2基因PCR扩增后测序发现951-953(delC),克隆后多克隆位点测序亦证实951-953(delC).所有正常人均未发现突变.951-953(delC)引起238位S后出现移码突变,终止密码子提前,蛋白截短.结论 951-953(delC)致蛋白截短,可能是导致小睑裂综合征的原因.经查新验证,951-953(delC)是一个新的突变位点,国内外未见报道.

  11. The application of modified musculi levator palpebrae superioris - Müller′s musculi folding and shortening in correction of congenital ptosis%改良上睑提肌- Mǘller′s 肌折叠缩短术在先天性上睑下垂矫正中的应用

    Institute of Scientific and Technical Information of China (English)

    刘唯; 郭丽娟

    2016-01-01

    目的:探讨上睑提肌折叠缩短术在先天性上睑下垂治疗中的疗效及手术方法。方法对38例轻、中度上睑下垂患者采用改良上睑提肌折叠缩短术治疗,设计重睑切口,水平切开眼轮匝肌至睑板前筋膜,在眶隔与上睑提肌腱膜之间分离粘连,沿上睑提肌腱膜向上分离至节制韧带(whitnallu 韧带),根据下垂程度将上睑提肌、Mǘller′s 肌分内中外三点折叠缝合至睑板上缘(即睑板上1/3),其余部分连续缝合。修剪多余皮肤及眼轮匝肌后缝合切口。结果38例患者中23例双眼,15例单眼,获随访6~12个月。治愈35例,占92.1%,欠矫正3例。过度矫正1例,无穹窿部结膜脱垂,无暴露性角膜炎,效果满意。结论改良上睑提肌 Mǘller′s 肌折叠缩短术治疗先天性上睑下垂是一种可靠有效、创伤较小且容易掌握的手术方法。%Objective To explore the effect and operating procedures for modified musculi levator palpebrae superios Muller′s musculi folding and shortening in correction of congenital ptosis. Methods A total of 38 patients with mild or moderate ptosis were treated with modified muscular levator palpebrae superios folding and shortening. The treatment was designed for double - eyelid incision with horizontal incision from muscular orbicularis oculi to pretarsal fascia,and to separate the stickiness between septa orbitale and muscular levator palpebrae superios along muscular levator palpebrae superios aponeurosis up to Whitnallu ligament,with inside - middle - outside folding suture of muscular levator palpe-brae superios and Mǘller′s muscle to the upper edge of tarsus(i. e. 1 / 3 tarsus)according to the degree of ptosis,with continuous suture of the rest parts,and trimmed excess skin and muscular orbicularis oculi,then sutured the incision. Results Among these 38 patients,both eyes were cor-rected in 23 cases and one eye was corrected in 15 cases. After

  12. 提上睑肌缩短术治疗学龄前儿童先天性上睑下垂临床分析%CLINICAL EFFECT OF PRESCHOOL CHILDREN WITH CONGENITAL PTOSIS TREATED WITH LEVA-TOR MUSCLE SHORTENING SURGERY

    Institute of Scientific and Technical Information of China (English)

    张玉蓉; 王卫星; 刘利军

    2016-01-01

    Objective To analyze the clinical effect of levator shortening surgery treated preschool children with congenital ptosis.Methods A retrospective analysis the surgery and follow- up data of preschool children with congenital ptosis,according to the surgical divided into two groups,children with the obser-vation group received levator shortening treatment and the control group was given fascial suspension sur-gery,then the immediate postoperative and long-term efficacy were analyzed.Results Immediate postop-erative outcomes were occurred between the groups of patients with varying degrees of lagophthalmos,up-per eyelid over - corrected and hysteresis.Long - term effect levator shortening was significantly better than muscle suspension surgery.Conclusions Levator shortening in treating preschool children with con-genital ptosis shows a significant clinical effect and fewer complications,it is worth to be applied widely.%目的:分析提上睑肌缩短术在学龄前儿童先天性上睑下垂中的临床疗效。方法回顾性分析在该院治疗的先天性上睑下垂学龄前儿童手术及随访资料,根据术式分为观察组和对照组,观察组患儿采用提上睑肌缩短术治疗,对照组采用额肌悬吊术治疗,分析二组患者术后即时及长期疗效。结果术后即时疗效二组患者均出现不同程度的眼睑闭合不全、矫正过度及上睑迟滞现象。远期疗效提上睑肌缩短术要显著优于额肌悬吊术。结论采用提上睑肌缩短术治疗学龄前儿童先天性上睑下垂临床疗效显著,并发症少,值得推广应用。

  13. 27例全层睑板部分切除的提上睑肌缩短术治疗上睑下垂的护理体会%Nursing Experience of 27 Cases of Shortening Palpabrae of Partial Tarsectomy on Treating Ptosis

    Institute of Scientific and Technical Information of China (English)

    王惠; 耿栋芸; 陈晓明

    2014-01-01

    目的:探讨全层睑板部分切除的提上睑肌缩短术治疗上睑下垂围手术期护理措施。方法:回顾性分析27例上睑下垂患者的临床资料,术前给予心理护理、饮食指导、新斯的明试验,提上睑肌肌力测试,手术部位准备,术后给予病情观察及专科护理,做好健康指导。结果:27例患者均手术成功,住院时间7-10 d,均康复出院。结论:做好全层睑板部分切除的提上睑肌缩短术治疗上睑下垂围手术期的护理,可提高治疗效果,减少术后并发症的发生,并取得良好的临床治疗效果。%Objective:To investigate nursing measures of shortening palpabrae of partial tarsectomy on treating ptosis during operation. Method:Retrospectively analyzing the clinical data of 27 patients with ptosis,giving preoperative mental nursing,dietary instruction,neostigmine tests,levator force measurement, surgical site preparation,monitoring patients‘condition carefully and giving post-operative care and health guidance. Result:The operation of 27 cases was successful,and the median length of hospital stay was 7~10 days. All patients recovered and discharged. Conclusion:The nursing of shortening palpabralis of partial tarsectomy on treating ptosis during operation can improve the therapeutic effect,reduce the postoperative complications,and obtain good clinical treatment.

  14. Efficacy comparison of severe congenital ptosis treated with excessive levator shortening and frontalis muscle flap suspension%超常量提上睑肌缩短及额肌瓣悬吊治疗重度先天性上睑下垂效果比较

    Institute of Scientific and Technical Information of China (English)

    关小荣; 董永孝; 张少华; 赖鹍; 蒲晓莉; 付芳; 杜建英

    2015-01-01

    目的::比较提上睑肌缩短术与额肌瓣悬吊术治疗重度先天性上睑下垂的疗效与并发症。方法:对40例58眼重度先天性上睑下垂患者进行手术治疗,其中,20例28眼行额肌腱膜瓣悬吊术,20例30眼行改良的提上睑肌缩短术,术后随访6mo,观察两种手术方式治疗重度先天性上睑下垂的治疗效果及术后并发症的发生情况。结果:术后随访6mo,提上睑肌缩短术组及额肌瓣悬吊术组治疗重度先天性上睑下垂的正矫率分别为:83%、82%,差异无统计学意义(P>0.05),但术后并发症的发生,如倒睫、闭合不全、暴露性角膜炎、结膜脱垂等,提上睑肌缩短术组少于额肌瓣悬吊术组,且有更好的外观。提上睑肌缩短术后6 mo复诊时,眼睑闭合不全15眼,暴露性角膜炎共1眼,结膜脱垂2眼;额肌瓣悬吊术后6 mo随诊,眼睑闭合不全23眼,暴露性角膜炎2眼,上睑倒睫3眼。结论:提上睑肌缩短术及额肌瓣悬吊术均能有效矫正重度先天性上睑下垂,但前者并发症少,术后外观好。%Abstract•AlM: To compare the outcomes of severe congenital ptosis treated with levator shortening and frontalis muscle flap suspension.• METHODS: Forty cases ( 58 eyes ) with severe congenital ptosis were retrospective analyzed. Shortening levator muscle of upper eyelid was conducted in 30 eyes, and 28 eyes were treated with frontalis muscle flap suspension. All cases were followed up for 6mo. The ptosis correction rates were analyzed. Post - operative complications such as blepharelosis, hypophasis, exposure keratitis and conjunctival prolapse were recorded.• RESULTS: There was no statistically significant difference in the complete correction rate between levator shortening group and frontalis muscle flap suspension group ( 83% vs 82%, P>0. 05 ). However, the levator shortening had better appearance and fewer complications, such as blepharelosis ( 0 vs 3 ) , hypophasis ( 15 vs 23

  15. Diminuição da função do músculo levantador da pálpebra superior em pacientes submetidos à cirurgia de ptose palpebral involucional e dermatocálase Decrease of upper eyelid levator muscle function after involutional ptosis and dermatochalasis surgery

    Directory of Open Access Journals (Sweden)

    Eliana Forno

    2008-12-01

    Full Text Available OBJETIVO: Avaliar a diferença da função do músculo levantador da pálpebra superior (FMLPS, distância margem reflexo (DMR1 e altura do sulco palpebral (AS antes e depois da cirurgia de blefaroplastia superior associada à correção de ptose palpebral. MÉTODOS: Quarenta e quatro pacientes com blefaroptose e dermatocálase foram incluídos. Intervenção: exploração do tendão do músculo levantador da pálpebra superior (MLPS durante a blefaroplastia, em portadores de blefaroptose e dermatocálase. Nos casos de desinserção, o tendão foi refixado ao tarso. Desfechos analisados: foram analisados de forma bilateral a diferença entre FMLPS, DMR1 e AS antes e depois da intervenção. A dependência entre os olhos foi corrigida por meio de equações de estimativa generalizada. Foi utilizada a correlação de Pearson para quantificar a dependência entre os olhos para FMLPS, DMR1 e AS. RESULTADOS: Houve diferença significante entre as medidas de FMLPS antes e depois da cirurgia, havendo redução da excursão do MLPS após a cirurgia, diminuindo, em média, 1,1 mm (P0,01. CONCLUSÃO: A função do músculo levantador da pálpebra superior diminui após a cirurgia para a correção da ptose.PURPOSE: To evaluate the differences between upper eyelid levator muscle function (UELMF, margin reflex distance (MDR1, and eyelid crease height (ECH before and after ptosis and dermatochalasis surgery. METHODS: Forty-four patients with blepharoptosis and dermatochalasis were enrolled. Intervention: An exploration of the levator tendon (LT during a blepharoplasty procedure in patients with blepharoptosis and dermatochalasis and in case of its disinsertion, the tendon was reattached to the tarsus. Measured outcome: The differences between UELMF, MDR1, ECH before and after surgery were evaluated bilaterally. Dependency between both eyes was corrected by generalized estimating equations. Pearson correlation was used to evaluate the dependency of the two

  16. “双环法”乳房整形治疗乳房肥大及乳房下垂患者的随访观察研究%Observation Study of“Double Ring Method”on Breast Surgery Treatment of Patients with Breast Hyperplasia and Breast Ptosis

    Institute of Scientific and Technical Information of China (English)

    刘照

    2014-01-01

    Objective:To make an analysis of the plastic treatment of breast hypertrophy and bicyclo breast sagging curative effect. Methods:From June, 2012 to June, 2013, 14 cases with macromastia or breast ptosis took bicyclo breast plastic surgery, and the curative effect was observed. Results:In 15 patients, 14 cases are satisfied. 1 cases with mammary gland tissue resection is too large and too much, so the early form is not ideal. But after 6 months follow-up, morphology is improved obviously. Conclusion:“Double ring method” on breast surgery treatment of patients with breast hyperplasia and breast ptosis is ideal, with simple operation. The blood supply and breast suspension fixation is better, the incision is relatively hidden, and breast plasticity is good, so it is worthy of clinical application.%目的:对双环法整形治疗乳房肥大与乳房下垂的治疗效果进行分析探讨。方法:对2012年6月-2013年6月收治的14例巨乳症或乳房下垂患者采取采取双环法乳房整形术,观察治疗效果。结果:15例患者中14例效果比较满意,1例患者因乳过大,腺体组织切除过多,早期形态不太理想,经6个月随访观察形态得到明显改善。结论:双环法整形治疗乳房下垂或乳房肥大效果比较理想,操作简便,血供与乳腺悬吊固定较好,切口比较隐蔽,乳房塑性较好,值得临床推广应用。

  17. A case of Toriello-Carey syndrome with severe congenital tracheal stenosis.

    Science.gov (United States)

    Yokoo, Noritaka; Marumo, Chieko; Nishida, Yoshinobu; Iio, Jun; Maeda, Shinji; Nonaka, Michiko; Maihara, Toshiro; Chujoh, Satoru; Katayama, Tetsuo; Sakazaki, Hisanori; Matsumoto, Naomichi; Okamoto, Nobuhiko

    2013-09-01

    Toriello-Carey syndrome is rare condition characterized by agenesis of the corpus callosum, the Pierre Robin sequence, and facial anomalies such as telecanthus, short palpebral fissures, and a small nose with anteverted nares [Toriello and Carey, 1988]. In addition, tracheal and laryngeal anomalies are common complications in patients with Toriello-Carey syndrome, and these anomalies can lead to death [Kataoka et al., 2003]. Congenital tracheal stenosis is a life-threatening condition with high mortality. Even if surgery is successful, several serious complications can result in a high risk of mortality. We describe a case of a Japanese boy with Toriello-Carey syndrome who had severe congenital tracheal stenosis, in whom surgical tracheal plasty was avoided because of adequate respiratory care, allowing the patient to be alive at 18 months of age. Copyright © 2013 Wiley Periodicals, Inc.

  18. Abundance of Atlantic walrus in Western Nares Strait, Baffin Bay Stock, during summer

    Directory of Open Access Journals (Sweden)

    Robert EA Stewart

    2014-12-01

    Full Text Available Atlantic walruses (Odobenus rosmarus rosmarus belonging to the Baffin Bay subpopulation occur year round in the North Water polynya (NOW between NW Greenland and eastern Ellesmere Island (Canada. They are hunted for subsistence purposes by residents of the Qaanaaq area (NW Greenland bordering the NOW to the east and by Canadian Inuit at the entrance to Jones Sound in Nunavut. During the open-water period NW Greenland is virtually devoid of walruses which concentrate along eastern and southern Ellesmere Island at this time of the year. To determine the abundance of walruses in the NOW area, aerial surveys were conducted in August of 1999, 2008, and 2009. In July 2009, nine satellite-linked transmitters were deployed in nearby Kane Basin. Surveys on 9 and 20 August 2009 along eastern Ellesmere Island were the most extensive and were augmented with concomitant data on haul-out and at water surface activity from three (1 F, 2 M of the nine tags that were still functioning. We therefore focus on the 2009 surveys. Walruses were observed on the ice and in water primarily in Buchanan Bay and Princess Marie Bay where the remaining functional tags were located. The Minimum Counted population (MCP was 571 on 20 August. Adjusting the MCP of walruses on ice for those not hauled out, the estimate of abundance of walruses in the Baffin Bay stock was 1,251(CV=1.00, 95% CI = 1,226 when adjusted by the proportion of tags ‘dry’ at the time of the survey and 1,249 (CV=1.12, 95% CI = 1,370 when adjusted by the average time tags were dry. The surveys did not cover all potential walrus summering habitat along eastern Ellesmere Island and are negatively biased to an unknown degree.

  19. Amenorrhea, ptosis and high insulin requirement in a young girl.

    Science.gov (United States)

    Hari Kumar, K V S; Kumar, Sandeep

    2016-01-01

    Lipodystrophy is an uncommon condition leading to excessive insulin requirement and menstrual abnormalities in young girls with diabetes. Neurological symptoms are uncommon in patients of generalized or partial lipodystrophy. We recently encountered a young girl, who presented with high insulin requirement, amenorrhea and neurological symptoms. Detailed evaluation led to the diagnosis of congenital lipodystrophy and we describe the same in this report. We also highlight the atypical features of the congenital lipodystrophy and the reasons for the excessive insulin requirement in patients with diabetes mellitus.

  20. Blepharophimosis, ptosis, epicanthus inversus syndrome type 2 with ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2015-01-08

    Jan 8, 2015 ... tory of red hair and fair skin color in both the paternal and maternal sides. Both feet ... caused by two different kinds of melanin [11]: eumelanin which ... Nephrolithiasis, a rare but well-described entity in children, is unknown in ...

  1. 睑裂狭小综合征Ⅱ型一家系未检测到FOXL2基因突变%Lack of association between FOXL2 gene mutation and pedigree affected by blepharophimosis ptosis epicanthus inversus syndrome type Ⅱ

    Institute of Scientific and Technical Information of China (English)

    温臣婷; 唐微; 李国保; 张有顺

    2012-01-01

    Objective To detect the mutation of FOⅪ2 gene in a Chinese pedigree affected by autosomal dominant blepharophimosis ptosis epicanthus inversus syndrome ( BPES) type Ⅱ - Methods The peripheral blood samples 2 mL, with EDTA as decoagulant, from 4 patients and 5 healthy people in a Chinese family affected with BPES type II and other 30 normal individuals were collected. The genomic DNA from peripheral blood leukocytes was extracted. Five pairs of primers were designed by the Oligoo according to the sequence of the FOⅪ2 gene( Gene ID: 668). The coding region and the putative core promoter of the FOⅪ2 gene were amplified by polymerase chain reaction (PCR) ,and mutation was analyzed by sequencing DNA fragments. Results The genomic DNA was extracted successfully from peripheral blood leukocytes from the 4 patients and 5 healthy people in the family and 30 normal individuals. The coding region and the core promoter of the FOⅪ2 gene were amplified. But sequence analysis of 5 DNA fragments showed that sequences were same and no mutation was found in any of the members in this family or 30 normal individuals. Conclusion The pathogenesis for BPES type H in this Chinese family is not mutation of the FOⅪ2 gene.%目的 对一个常染色体显性遗传的睑裂狭小综合征Ⅱ型家系FOXL2基因突变进行研究.方法 采集一个中国人睑裂狭小综合征Ⅱ型家系的4例患者及家系中5例健康人和30例正常对照者外周静脉血样,提取基因组DNA,参考FOXL2基因序列,设计5对引物,应用PCR和DNA测序技术对FOXI2基因的编码区和启动子区进行扩增和突变检查.结果 成功提取了该家系中4例患者和5例健康人与30名正常对照者外周血基因组DNA,分段扩增出了FOXL2基因的编码区及启动子区,但5段测序结果显示该家系中4例患者和5例健康人与30名正常对照者的FOXL2基因测序结果相同.该家系患者FOXL2基因编码区及启动子区均未发现突变.结论 该家系

  2. Regnbågsfamiljer och könsöverskridande barn. Bilderbokens nya invånare

    OpenAIRE

    Heggestad, Eva

    2013-01-01

    Rainbow families and transgendered children. New inhabitants in Swedish picture books for children This study is an analysis of Swedish picture books for children with queer themes. It includes books published since 1999, questioning the heterosexual norm regarding sex, gender, and sexuality. The books deviate from the traditional nuclear family ideal in that they depict children or adults who have not adapted to a traditional gender representation or families with one or two of the parents l...

  3. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

    OpenAIRE

    A. Novo Torres; J.F. Salvador Sanz; E. Lorda Barraguer; C. Laredo Ortiz

    2006-01-01

    Se entiende por blefaroptosis el nivel anormalmente bajo del párpado superior durante la mirada directa. Los mejores resultados se obtienen con las técnicas de resección o avance del músculo elevador o su aponeurosis, siempre que el elevador posea una función adecuada. Nuestra intención es presentar una modificación a la técnica de Blaskovics para la corrección de blefaroptosis moderadas, con buena función del elevador Presentamos una serie de 10 casos donde se utilizó una variante de la oper...

  4. Fibular dimelia and mirror polydactyly of the foot in a girl presenting additional features of the VACTERL association

    Directory of Open Access Journals (Sweden)

    Pricila Bernardi

    Full Text Available CONTEXT: The association between fibular dimelia and mirror polydactyly of the foot is considered to be a very rare lower-limb abnormality. On the other hand, VACTERL is an acronym for a nonrandom association of congenital anomalies for which the etiology is still poorly understood. CASE REPORT: The patient was a seven-month-old white girl whose mother had used misoprostol in the second month of pregnancy to induce abortion. On clinical evaluation, she was small for her age and presented hypotonia, anteverted nares, long philtrum and carp-like mouth. Her left hand had a reduction defect, with absence of the extremities of the second, third and fifth fingers and camptodactyly of the fourth finger. The ipsilateral lower limb presented significant shortening, especially rhizomelic shortening. Her left foot had a mirror configuration with seven toes and no identifiable hallux. The pelvis was hypoplastic. Esophageal atresia with tracheoesophageal fistula and imperforate anus were detected during the neonatal period. Abdominal ultrasound identified agenesis of the right kidney and left pyelocaliceal duplication. Radiographic evaluation on the left side showed iliac and femoral hypoplasia, absence of the tibia with a duplicated fibula and seven metatarsals and toes with no identifiable hallux on the foot. Echocardiography demonstrated an atrial septal defect. Based on the literature, we believe that the spectrum of malformations presented by our patient may be related to the vascular disruptive effect of the misoprostol. However, we cannot rule out the possibility that this association might simply be a coincidence.

  5. Monosomy 21 Seen in Live Born Is Unlikely to Represent True Monosomy 21: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Trent Burgess

    2014-01-01

    Full Text Available We report a case of a neonate who was shown with routine chromosome analysis on peripheral blood lymphocytes to have full monosomy 21. Further investigation on fibroblast cells using conventional chromosome and FISH analysis revealed two additional mosaic cell lines; one is containing a ring chromosome 21 and the other a double ring chromosome 21. In addition, chromosome microarray analysis (CMA on fibroblasts showed a mosaic duplication of chromosome region 21q11.2q22.13 with approximately 45% of cells showing three copies of the proximal long arm segment, consistent with the presence of a mosaic ring chromosome 21 with ring instability. The CMA also showed complete monosomy for an 8.8 Mb terminal segment (21q22.13q22.3. Whilst this patient had a provisional clinical diagnosis of trisomy 21, the patient also had phenotypic features consistent with monosomy 21, such as prominent epicanthic folds, broad nasal bridge, anteverted nares, simple ears, and bilateral overlapping fifth fingers, features which can also be present in individuals with Down syndrome. The patient died at 4.5 months of age. This case highlights the need for additional studies using multiple tissue types and molecular testing methodologies in patients provisionally diagnosed with monosomy 21, in particular if detected in the neonatal period.

  6. Pallister-Killian syndrome: meiosis Ⅱ non-disjunction may be the first step in the formation of isochromosome 12p

    Institute of Scientific and Technical Information of China (English)

    SHEN Jian-dong; LIANG De-sheng; ZHOU Zhong-min; XIA Yan; LONG Zhi-gao; WU Ling-qian

    2010-01-01

    @@ Pallister-Killian syndrome (PKS) is a rare and sporadic genetic disorder due to tissue-limited mosaicism for supernumerary isochromosome 12p(i(12p)), which is usually absent or at low-level mosaicism in cultured lymphocytes but present in fibroblasts. PKS was first described in adults by Pallister in 19771 and later in children by Killian and Teschler-Nicola in 1981.2 An accurate incidence is unknown. It is clinically characterized by profound mental retardation, seizures,hypotonia, supernumerary nipples, pigmentary dysplasia,diaphragmatic hernia, "coarse" face, including prominent forehead with sparse anterior scalp hair, hypertelorism,short nose with anteverted nares, flat nasal bridge, long philtrum, cleft palate and short neck. Here we report a patient with PKS, who is the first confirmed case with PKS in mainland China. Molecular analysis was performed to explore the formation mechanism of i(12p).The results suggest that the maternal meiosis Ⅱ sister chromatid non-disjunction was likely the first step in the formation of i(12p), followed by postzygotic mitotic centromeric misdivision.

  7. De novo microdeletions of chromosome 6q14.1-q14.3 and 6q12.1-q14.1 in two patients with intellectual disability - further delineation of the 6q14 microdeletion syndrome and review of the literature.

    Science.gov (United States)

    Becker, Kerstin; Di Donato, Nataliya; Holder-Espinasse, Muriel; Andrieux, Joris; Cuisset, Jean-Marie; Vallée, Louis; Plessis, Ghislaine; Jean, Nolwenn; Delobel, Bruno; Thuresson, Ann-Charlotte; Annerén, Göran; Ravn, Kirstine; Tümer, Zeynep; Tinschert, Sigrid; Schrock, Evelin; Jønch, Aia Elise; Hackmann, Karl

    2012-01-01

    Interstitial 6q deletions can cause a variable phenotype depending on the size and location of the deletion. 6q14 deletions have been associated with intellectual disability and a distinct pattern of minor anomalies, including upslanted palpebral fissures with epicanthal folds, a short nose with broad nasal tip, anteverted nares, long philtrum, and thin upper lip. In this study we describe two patients with overlapping 6q14 deletions presenting with developmental delay and characteristic dysmorphism. Molecular karyotyping using array CGH analysis revealed a de novo 8.9 Mb deletion at 6q14.1-q14.3 and a de novo 11.3 Mb deletion at 6q12.1-6q14.1, respectively. We provide a review of the clinical features of twelve other patients with 6q14 deletions detected by array CGH analysis. By assessing all reported data we could not identify a single common region of deletion. Possible candidate genes in 6q14 for intellectual disability might be FILIP1, MYO6, HTR1B, and SNX14. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  8. Surgically mismanaged ptosis in a patient with congenital fibrosis of the extraocular muscles type I

    Directory of Open Access Journals (Sweden)

    Hatem A Tawfik

    2012-01-01

    Full Text Available Fibrosis syndromes comprise a rare form of severe limitation of ocular motility. An 11-year-old girl was referred for the correction of eyelid retraction. The eyelid retraction occurred immediately following levator resection surgery performed by a plastic surgeon who missed the restrictive extraocular muscle abnormalities. On examination, both eyes were fixed in an infraducted position (20 prism diopters (Δ, with a chin-up position and significant lagophthalmos. Bilateral 12-mm inferior rectus recession with adjustable sutures was performed, which resulted in significant reduction of lagophthalmos and elimination of the head tilt.

  9. Presentation of two cases with periocular cutaneous leishmaniasis leading to ptosis

    Directory of Open Access Journals (Sweden)

    Enver Turan

    2013-03-01

    Full Text Available Leishmaniasis is a parasitic disease caused by flagellate protozoan of the genus Leishmania that are transmitted to humans through sand fly bites. The disease is a major health problem in our country as in many regions in the world. Although the disease is more often seen in children, it could affect any age group. The lesions usually occur on the exposed areas of the body such as face, neck, hands, arms and lower legs. Also, it could be seen in other areas of the body such as scalp, trunk, eyelids and, penis. Eyelid involvement is not common because, the eyelid is moving and so female phlebotomine sandfly probably could not freely touch down. We present two cases diagnosed cutaneous leishmaniasis on the basis of clinical and laboratory findings and we want to take attention if palpebral lesions are not treated early, they can lead to the dysfunction of palpebrae along with the cosmetic problems.

  10. Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis

    Directory of Open Access Journals (Sweden)

    Michele Pascali

    2016-01-01

    Full Text Available Context: Brow lifting is an essential element in the rejuvenation of the ageing face. Various surgical techniques have been described. Among these, the direct brow lifting is an easy and effective technique that is often neglected because the scar can remain visible. Thus, this approach is usually reserved for elderly patients and males, with thick bushy brows. Aims: The authors present their result from a series of fifty consecutive patients treated over 2 years with direct brow lift. The aim is to demonstrate when the hairline is high or temporal alopecia is present and whether this technique is the best in bald patients, when some surgical steps are carefully adhered to. In these cases, the scar is less visible, hidden in the brow and is a good solution in women too. Subjects and Methods: Between January 2011 and January 2013, fifty patients underwent direct brow lift surgery. All were men. In all the cases, brow lifting was undertaken together with an upper blepharoplasty. The amount of brow elevation produced was assessed by comparing the vertical distances between the superior eyebrow hairline and the inter-pupillary line, pre- and post-operatively. The result and the scar quality were assessed both by the patient and the surgeon. Statistical Analysis Used: The paired t-test. Results: The authors obtained statistically significant results in brow elevation in 98% of the patients after a 12-month follow-up. The main complication associated with this procedure was visibility of the scar in two patients. Conclusions: The direct brow lift technique in bald men and with a high anterior hairline provides excellent and long-lasting results.

  11. Kabuki make-up syndrome with genitourinary anomalies, ophthalmologic features and hyperpigmentation in an Egyptian child

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2017-01-01

    Full Text Available We report a 3.5 year old male child, first in order of birth of healthy consanguineous Egyptian parents with typical characteristics of Kabuki make-up syndrome. The patient had microcephaly, high arched sparse eyebrows, hypertelorism, long palpebral fissures with eversion of the lateral third of the lower eyelids, bilateral ptosis, long eyelashes, blue sclera, depressed nasal bridge, broad nose with everted nares, and low set small deformed ears, thin lips, low post hair line, short neck, persistent fingertip pads, dysplastic nails, hypermobile joints, pigmented nevus on the back, lateral side of right foot and right leg and mild hypertrichosis over the lower back. Our patient had also a non-functioning left kidney, multiple chalazions in upper eyelids, enlargement of the glans penis, which were not reported previously, and moderate mental retardation.

  12. Efectos fiscales de los asentamientos hidroeléctricos: el caso de la cuenca de los ríos Negro y Nare en Colombia

    Directory of Open Access Journals (Sweden)

    Juan Pablo Ríos Ocampo

    2016-03-01

    Full Text Available Con la presencia de asentamientos hidroeléctricos en su territorio, los municipios del oriente y nordeste antioqueño han visto afectada su estructura tributaria y territorial, a pesar de la reglamentación compen­satoria del sector eléctrico. Este artículo, analiza los efectos tributarios generados por la compensación del impuesto predial. Para lograrlo se revisan los montos recibidos por los municipios de las empresas generadoras y se realiza una indagación empírica del impuesto bajo los escenarios con y sin asenta­mientos hidroeléctricos. De esta forma se determina el diferencial tributario. Se concluye que, además de la insuficiencia de las transferencias para compensar la pérdida del capital natural de las cuencas hidroeléctricas, la expansión del sector eléctrico genera regresividad tributaria, por causa de privilegios y exenciones concebidos por las Leyes. With the presence of hydroelectric settlements in their territory, the municipalities of the eastern and northeastern regions of Antioquia have seen their fiscal and territorial structure affected despite the regulatory compensation established for the electric sector. This article analyses the taxation effects gener­ated by the compensation of property taxes. To do so, different sums received by different municipalities from generating companies are analyzed and an empiric tax analysis is done for both types of territories (with and without hydroelectric settlements. This is how the taxation differential is determined. It is also concluded that, besides the influence of transfers for compensating the loss of the natural capital of the hydroelectric basins, the expansion of the electric sector generates taxation digressivety due to the privileges and exemptions conceived by the law

  13. Infantile lethal variant of Simpson-Golabi-Behmel syndrome associated with hydrops fetalis

    Energy Technology Data Exchange (ETDEWEB)

    Terespolsky, D.; Siegel-Bartelt, J.; Weksberg, R. [Univ. of Toronto (Canada); Farrell, S.A. [Credit Valley Hospital, Mississauga (Canada)

    1995-11-20

    Simpson-Golabi Behmel syndrome (SGBS) is an X-linked disorder characterized by pre- and postnatal macrosomia, minor facial anomalies, and variable visceral, skeletal, and neurological abnormalities. Since its first description by Simpson et al., a wide clinical range of cases has been reported. There is great variability in severity, ranging from a mild form associated with long-term survival to an early lethal form with multiple congenital anomalies and severe mental retardation. In 8 reported families, affected individuals died in infancy. Here we present 4 maternally related, male cousins with a severe variant of SGBS. One of these males was aborted therapeutically at 19 weeks of gestation following the detection of multicystic kidneys on ultrasound. The 3 liveborn males were hydropic at birth with a combination of craniofacial anomalies including macrocephaly; apparently low-set, posteriorly angulated ears; hypertelorism; short, broad nose with anteverted nares; large mouth with thin upper vermilion border; prominent philtrum; high-arched or cleft palate; short neck; redundant skin; hypoplastic nails; skeletal defects involving upper and lower limbs; gastrointestinal and genitourinary anomalies. All 3 patients were hypotonic and neurologically impaired from birth. With the exception of a trilobate left lung in one patient, the cardiorespiratory system was structurally normal. All patients died within the first 8 weeks of life of multiple complications including pneumonia and sepsis. Two SGBS kindreds, with moderate expression of the condition, have been mapped to Xq27. It is not known whether severe, familiar cases, such as ours, are genetically distinct from and map to another locus. Final resolution of the genetic basis of the phenotypic variability in SGBS must await cloning and mutation analysis of the SGBS gene(s). 21 refs., 4 figs., 1 tab.

  14. PTOSIS DUE TO CAVERNOUS SINUS SYNDROME AS A RARE PRESENTATION OF ADVANCED BREAST METASTASIS IN A PATIENT WITH DELAYED DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    KW Khaw

    2012-08-01

    Full Text Available Complications of breast cancer metastasis may be the first manifestation of the disease. We report a rare case of left eyeptosis secondary to cavernous sinus syndrome in a 34-year-old lady due to refusal of proper medical treatment for metastaticbreast cancer. The delay in seeking medical treatment was attributed to her use of Traditional Chinese Medicine (TCM.

  15. Comparison of MRSASelect Agar, CHROMagar Methicillin-Resistant Staphylococcus aureus (MRSA) Medium, and Xpert MRSA PCR for detection of MRSA in Nares: diagnostic accuracy for surveillance samples with various bacterial densities.

    Science.gov (United States)

    Wolk, D M; Marx, J L; Dominguez, L; Driscoll, D; Schifman, R B

    2009-12-01

    Rapid laboratory methods provide optimal support for active surveillance efforts to screen for methicillin-resistant Staphylococcus aureus (MRSA). Most laboratories struggle to determine the optimal use of resources, considering options to balance cost, speed, and diagnostic accuracy. To assess the performance of common methods, the first comparison of MRSASelect agar (MS) and CHROMagar MRSA (CA), with and without broth enrichment followed by a 24-h subculture to MS, was performed. Results were compared to those of the Xpert MRSA assay. For direct culture methods, the agreement between MS and CA was 98.8%. At 18 h, direct MS identified 93% of all positive samples from direct culture and 84% of those identified by the Xpert MRSA. For Trypticase soy broth-enriched MS culture, incubated overnight and then subcultured for an additional 24 h, the agreement with Xpert MRSA was 96%. The agreement between direct MS and Xpert MRSA was 100% when semiquantitative culture revealed a bacterial density of 2+ or greater; however, discrepancies between culture and Xpert MRSA arose for MRSA bacterial densities of 1+ or less, indicating low density as a common cause of false-negative culture results. Since 1+ or less was established as the most common MRSA carrier state, broth enrichment or PCR may be critical for the identification of all MRSA carriers who may be reservoirs for transmission. In this active-surveillance convenience sample, the use of broth enrichment followed by subculture to MS offered a low-cost but sensitive method for MRSA screening, with performance similar to that of Xpert MRSA PCR.

  16. Tinea corporis around the anterior nares in a child after close contact with a pet rabbit:a case report%密切接触宠物兔后幼儿鼻孔周围体癣1例

    Institute of Scientific and Technical Information of China (English)

    张瑞峰; 冉玉平; 代亚玲; 张朝良

    2008-01-01

    报道1例密切接触宠物兔后发生在幼儿双侧鼻孔周围及上唇部的体癣.患儿4岁,因"鼻唇部红斑、鳞屑、伴瘙痒10余日"就诊.取皮屑镜检见真菌菌丝及毳毛内孢子,培养见棒形分隔大分生孢子、葡萄串状小分生孢子及螺旋菌丝.尿素酶试验阳性、毛发穿孔试验阳性,鉴定为须癣毛癣菌.经内服伊曲康唑胶囊和外用萘替芬酮康唑乳膏治疗6 d后红斑瘙痒明显减轻,34 d后皮损消退.复查真菌阴性.

  17. 白内障术后复视及上睑下垂的相关因素分析%Analysis of diplopia and ptosis after cataract extraction

    Institute of Scientific and Technical Information of China (English)

    王时力; 张亚琴

    2003-01-01

    目的:探讨白内障术后复视及上睑下垂的机制.方法:对8例白内障术后复视及上睑下垂患者进行病史查阅,眼球运动检查,复视像检查及上睑运动功能检查,并对相关因素进行分析.结果:所有病例均为球后或球旁麻醉、开睑器开睑引起,而与上直肌牵引缝线、结膜下注射无关.结论:白内障术后复视及上睑下垂可能与球后或球旁麻醉时麻醉药的肌毒性作用有关.

  18. X-linked congenital ptosis and associated intellectual disability, short stature, microcephaly, cleft palate, digital and genital abnormalities define novel Xq25q26 duplication syndrome

    DEFF Research Database (Denmark)

    Møller, R S; Jensen, L R; Maas, S M

    2014-01-01

    Submicroscopic duplications along the long arm of the X-chromosome with known phenotypic consequences are relatively rare events. The clinical features resulting from such duplications are various, though they often include intellectual disability, microcephaly, short stature, hypotonia, hypogona...

  19. 眶隔筋膜瓣联合额肌瓣悬吊矫正重度上睑下垂%Use the orbital musculo-fascial flap and frontalis muscle flap suspension to correct serious ptosis of upper eyelid

    Institute of Scientific and Technical Information of China (English)

    杨文华; 熊曼; 韩岩

    2009-01-01

    目的:研究利用眶隔筋膜瓣联合额肌瓣悬吊矫正重度上睑下垂的临床效果.方法:采用该方法,手术形成蒂在睑板上缘的眶隔筋膜舌形瓣,并与额肌建立连接,治疗重度上睑下垂24例.结果:临床治疗33只眼(24例)随访3~6个月,外形自然,闭合自如,无复发现象,均获得满意效果.结论:与单纯的额肌悬吊不同,该术式形成的上提眼睑系统更符合生理结构,并具备动态矫正效果,手术后外形满意,功能良好.

  20. Unknown syndrome: peculiar face, severe hypodontia of permanent teeth, and precocious choroid calcifications.

    OpenAIRE

    Pallotta, R; Fusilli, P

    1998-01-01

    We describe a mother and her twin daughters affected with severe hypodontia of the permanent teeth, precocious calcification of the choroid plexus, and minor digital anomalies. The presence of inner telecanthus, broad and flattened nasal bridge, mild ocular proptosis, small nose with anteverted nostrils, and slight microretrognathia gives them an unusual appearance. All three affected persons are of normal intelligence.

  1. Sagittal Balance in Adolescent Idiopathic Scoliosis: A Radiographic Study of Spinopelvic Compensation After Selective Posterior Fusion of Thoracolumbar/Lumbar (Lenke 5C) Curves.

    Science.gov (United States)

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-11-01

    The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have an LL

  2. Bacterial findings in optimised sampling and characterisation of S. aureus in chronic rhinosinusitis.

    Science.gov (United States)

    Thunberg, Ulrica; Söderquist, Bo; Hugosson, Svante

    2017-01-01

    The bacterial spectrum in chronic rhinosinusitis (CRS) is clinically relevant. This study aimed to compare two sampling techniques and to characterise Staphylococcus aureus isolated from CRS patients. Bacterial specimens were collected from the nares and maxillary sinus in 42 CRS patients and from the nares in 57 healthy controls. Maxillary sinus sampling was performed in two ways in each patient: with a cotton-tipped aluminium swab through the enlarged sinus ostium, and with a protected brush. S. aureus was characterised by DNA-sequencing of the repeat region of the S. aureus protein A gene, spa typing. The protected brush technique was superior to the cotton-tipped aluminium swab in reducing contamination rate. However, the two sampling methods were consistent in terms of clinically relevant bacterial findings, and the easy-to-handle cotton-tipped swab can still be recommended when culturing the maxillary sinus. Patients showed a significantly higher presence of S. aureus in the nares compared with healthy controls, and healthy controls showed a significantly higher presence of coagulase-negative staphylococci in the nares compared with patients. The spa types were identical for the nares and maxillary sinus in all patients except one. The sampling techniques showed equivalent results, indicating a low risk of unnecessary antibiotic treatment when using the easy-to-handle cotton-tipped aluminium swab. The high rate of identical spa types of S. aureus isolated from the nares and maxillary sinus of CRS patients might indicate colonisation of the maxillary sinus from the nares.

  3. Anatomical Variance in Acetabular Anteversion Does Not Predict Hip Fracture Patterns in the Elderly: A Retrospective Study in 135 Patients

    OpenAIRE

    Kamath, Megan Y.; Coleman, Nathan W.; Belkoff, Stephen M.; Mears, Simon C.

    2011-01-01

    It has been suggested that variances in the anatomy of the acetabulum determine the type of hip fracture in elderly patients. Based on this concept, an overly anteverted acetabulum would lead to impingement of the femoral neck against the posterior rim of the acetabulum, causing a femoral neck fracture, whereas with a retroverted acetabulum, external rotation of the hip would be limited by the capsular tissues attached to the trochanteric region, causing a trochanteric fracture. To test the h...

  4. Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2011-02-01

    Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

  5. Persistence of nasal colonization with human pathogenic bacteria and associated antimicrobial resistance in the German general population

    NARCIS (Netherlands)

    Köck, R; Werner, P; Friedrich, A W; Fegeler, C; Becker, K

    2016-01-01

    The nares represent an important bacterial reservoir for endogenous infections. This study aimed to assess the prevalence of nasal colonization by different important pathogens, the associated antimicrobial susceptibility and risk factors. We performed a prospective cohort study among 1878 nonhospit

  6. Dual Site Sampling Improved Detection Rates for MRSA Colonization in Patients with Cutaneous Abscesses

    Science.gov (United States)

    May, L.; McCann, C.; Brooks, G.; Rothman, R.; Miller, L.; Jordan, J.

    2014-01-01

    Extranasal sites are common reservoirs of Staphylococcus aureus colonization, and may be relevant for methicillin-resistant S. aureus (MRSA) screening and infection control strategies. The objective here was to determine whether inguinal specimens could also be screened using Xpert SA Nasal Complete assay for MRSA. Results were compared to broth enrichment culture. Among 162 consented adults seeking care in the Emergency Department for cutaneous abscesses, inguinal specimens were found positive for MRSA more often than nares specimens; 24% and 26% by PCR or culture, respectively compared to 19% each by PCR or culture. Overall, 6% of adults colonized with MRSA would have been missed by nares screening alone. Compared to culture, Xpert SA Nasal Complete assay demonstrated sensitivity and specificity of 89% and 97%, respectively for detecting nares and/or inguinal MRSA colonization. In conclusion, inguinal specimens were a more common reservoir for MRSA than nares specimens in this population of patients. PMID:24958641

  7. Staphylococcus aureus intestinal colonization is associated with increased frequency of S. aureus on skin of hospitalized patients

    Directory of Open Access Journals (Sweden)

    Donskey Curtis J

    2007-09-01

    Full Text Available Abstract Background Intestinal colonization by Staphylococcus aureus among hospitalized patients has been associated with increased risk of staphylococcal infection and could potentially contribute to transmission. We hypothesized that S. aureus intestinal colonization is associated with increased frequency of S. aureus on patients' skin and nearby environmental surfaces. Methods Selected inpatients were cultured weekly for S. aureus from stool, nares, skin (groin and axilla, and environmental surfaces (bed rail and bedside table. Investigator's hands were cultured after contacting the patients' skin and the environmental surfaces. Results Of 71 subjects, 32 (45.1% had negative nares and stool cultures, 23 (32.4% had positive nares and stool cultures, 13 (18.3% were nares carriers only, and 3 (4.2% were stool carriers only. Of the 39 patients with S. aureus carriage, 30 (76.9% had methicillin-resistant isolates. In comparison to nares colonization only, nares and intestinal colonization was associated with increased frequency of positive skin cultures (41% versus 77%; p = 0.001 and trends toward increased environmental contamination (45% versus 62%; p = 0.188 and acquisition on investigator's hands (36% versus 60%; p = 0.057. Patients with negative nares and stool cultures had low frequency of S. aureus on skin and the environment (4.8% and 11.3%, respectively. Conclusion We found that hospitalized patients with S. aureus nares and/or stool carriage frequently had S. aureus on their skin and on nearby environmental surfaces. S. aureus intestinal colonization was associated with increased frequency of positive skin cultures, which could potentially facilitate staphylococcal infections and nosocomial transmission.

  8. Chlorpromazine induced ocular myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Nitya S

    2013-10-01

    Full Text Available Drug induced bilateral ptosis is a very rare adverse drug reaction. Here we report a case of ten year old male child with chlorpromazine induced bilateral ptosis due to ocular myasthenia. [Int J Basic Clin Pharmacol 2013; 2(5.000: 653-654

  9. Vincristine induced cranial polyneuropathy.

    Science.gov (United States)

    Bay, Ali; Yilmaz, Cahide; Yilmaz, Nebi; Oner, Ahmet Faik

    2006-06-01

    We describe a 5-year-old girl showed recovery of vincristine induced cranial polyneuropathy with pyridoxine and pyridostigmine treatment. A 5-year-old girl was diagnosed preB cell Acute Lymphoblastic Leukemia (ALL). She received chemotherapy according to the previously described modified St. Jude total therapy studies XIII. Five days after the fourth dose of vincristine, she presented with bilateral ptosis. Neurological examination revealed bilateral ptosis, and complete external opthalmoplegia with normal pupillary and corneal reflexes. She received 3.8 mg cumulative dose of vincristin before development of ptosis. A neuroprotective and neuroregenerative treatment attempt with pyridoxine and pyridostigmine was initiated. The bilateral ptosis markedly improved after 7 days of pyridoxine and pyridostigmine treatment and completely resolved after two weeks. The both agents were given for 3 weeks and were well tolerated without any side effects. During the follow up period we did not observe residue or recurrence of the ptosis.

  10. Avaliação dos resultados cirúrgicos com a técnica da ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose Evaluation of the surgery results of Müller's muscle-conjunctival resection in the treatment of ptosis

    OpenAIRE

    Serge Morax; Tânia Pereira Nunes; Houyem Ben-Ayed; Mehrad Hamedani; Suzana Matayoshi

    2005-01-01

    OBJETIVO: Avaliar os resultados obtidos com a ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose e analisar suas vantagens. MÉTODOS: Trinta e oito pacientes (39 pálpebras) foram submetidos à ressecção do músculo de Müller-conjuntiva. Blefaroptose no pré-operatório variou de 1,0 mm a 3,0 mm (média: 2,0 mm). O valor de elevação palpebral produzido pelo teste da fenilefrina indicou a quantidade de tecido a ser ressecado. RESULTADOS: 33 pálpebras (85%) que foram tratadas com ...

  11. Avaliação dos resultados cirúrgicos com a técnica da ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose Evaluation of the surgery results of Müller's muscle-conjunctival resection in the treatment of ptosis

    Directory of Open Access Journals (Sweden)

    Serge Morax

    2005-06-01

    Full Text Available OBJETIVO: Avaliar os resultados obtidos com a ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose e analisar suas vantagens. MÉTODOS: Trinta e oito pacientes (39 pálpebras foram submetidos à ressecção do músculo de Müller-conjuntiva. Blefaroptose no pré-operatório variou de 1,0 mm a 3,0 mm (média: 2,0 mm. O valor de elevação palpebral produzido pelo teste da fenilefrina indicou a quantidade de tecido a ser ressecado. RESULTADOS: 33 pálpebras (85% que foram tratadas com este procedimento tiveram resultado estético satisfatório. CONCLUSÃO: Ressecção do músculo de Müller-conjuntiva é técnica relativamente simples para o tratamento da blefaroptose, quando houver boa função do músculo levantador da pálpebra superior e teste da fenilefrina 10% positivo. Suas vantagens são a preservação do tarso e o resultado cirúrgico previsível.OBJETIVE: To evaluate the results of Müller's muscle-conjunctival resection for correction of blepharoptosis and to discuss the advantages of this procedure. METHODS: 38 patients (39 eyelids were submitted to Müller's muscle-conjunctival resection. Blepharoptosis varied from 1.0 mm to 3.0 mm (mean: 2.0 mm. The amount of eyelid elevation produced by phenylephrine guided the amount of tissue to be resected. RESULT: 33 eyelids (85% treated with this procedure were cosmetically acceptable. CONCLUSIONS: Müller's muscle-conjunctival resection procedure is a relatively simple technique for blepharoptosis, with good levator function and positive 10% phenylephrine test. The advantages are: preservation of tarsus and predictable results.

  12. A Study of the Infant Nasal Microbiome Development over the First Year of Life and in Relation to Their Primary Adult Caregivers Using cpn60 Universal Target (UT) as a Phylogenetic Marker.

    Science.gov (United States)

    Peterson, Shelley W; Knox, Natalie C; Golding, George R; Tyler, Shaun D; Tyler, Andrea D; Mabon, Philip; Embree, Joanne E; Fleming, Fiona; Fanella, Sergio; Van Domselaar, Gary; Mulvey, Michael R; Graham, Morag R

    2016-01-01

    Whereas the infant gut microbiome is the subject of intense study, relatively little is known regarding the nares microbiome in newborns and during early life. This study aimed to survey the typical composition and diversity of human anterior nare microflora for developing infants over time, and to explore how these correlate to their primary caregivers. Single nare swabs were collected at five time points over a one-year period for each subject from infant-caregiver pairs. Our study comprised of 50 infants (recruited at 2 weeks, post delivery) and their 50 primary caregivers. Applying the chaperonin-60 (cpn60) universal target (UT) amplicon as our molecular barcoding marker to census survey the microbial communities, we longitudinally surveyed infant nares microbiota at 5 time points over the course of the first year of life. The inter- and intra-subject diversity was catalogued and compared, both longitudinally and relative to their adult primary caregivers. Although within-subject variability over time and inter-subject variability were both observed, the assessment detected only one or two predominant genera for individual infant samples, belonging mainly to phyla Actinobacteria, Firmicutes, and Proteobacteria. Consistent with previously observed microbial population dynamics in other body sites, the diversity of nares microflora increased over the first year of life and infants showed differential operational taxonomic units (OTUs) relative to their matched primary caregiver. The collected evidence also support that both temporal and seasonal changes occur with respect to carriage of potentially pathogenic bacteria (PPBs), which may influence host predisposition to infection. This pilot study surveying paired infant/caregiver nare microbiomes provides novel longitudinal diversity information that is pertinent to better understanding nare microbiome development in infants.

  13. A Study of the Infant Nasal Microbiome Development over the First Year of Life and in Relation to Their Primary Adult Caregivers Using cpn60 Universal Target (UT as a Phylogenetic Marker.

    Directory of Open Access Journals (Sweden)

    Shelley W Peterson

    Full Text Available Whereas the infant gut microbiome is the subject of intense study, relatively little is known regarding the nares microbiome in newborns and during early life. This study aimed to survey the typical composition and diversity of human anterior nare microflora for developing infants over time, and to explore how these correlate to their primary caregivers. Single nare swabs were collected at five time points over a one-year period for each subject from infant-caregiver pairs. Our study comprised of 50 infants (recruited at 2 weeks, post delivery and their 50 primary caregivers. Applying the chaperonin-60 (cpn60 universal target (UT amplicon as our molecular barcoding marker to census survey the microbial communities, we longitudinally surveyed infant nares microbiota at 5 time points over the course of the first year of life. The inter- and intra-subject diversity was catalogued and compared, both longitudinally and relative to their adult primary caregivers. Although within-subject variability over time and inter-subject variability were both observed, the assessment detected only one or two predominant genera for individual infant samples, belonging mainly to phyla Actinobacteria, Firmicutes, and Proteobacteria. Consistent with previously observed microbial population dynamics in other body sites, the diversity of nares microflora increased over the first year of life and infants showed differential operational taxonomic units (OTUs relative to their matched primary caregiver. The collected evidence also support that both temporal and seasonal changes occur with respect to carriage of potentially pathogenic bacteria (PPBs, which may influence host predisposition to infection. This pilot study surveying paired infant/caregiver nare microbiomes provides novel longitudinal diversity information that is pertinent to better understanding nare microbiome development in infants.

  14. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  15. Does radiographic coxa profunda indicate increased acetabular coverage or depth in hip dysplasia?

    Science.gov (United States)

    Fujii, Masanori; Nakamura, Tetsuro; Hara, Toshihiko; Nakashima, Yasuharu; Iwamoto, Yukihide

    2015-06-01

    Although radiographic coxa profunda has been considered an indicator of acetabular overcoverage, recent studies suggest that radiographic coxa profunda is a nonspecific finding seen even in hip dysplasia. The morphologic features of coxa profunda in hip dysplasia and the frequency with which the two overlap are not well defined. We determined (1) the prevalence of radiographic coxa profunda in patients with hip dysplasia; (2) the morphologic differences of the acetabulum and pelvis between patients with hip dysplasia and control subjects; and (3) the morphologic differences between hip dysplasia with and without coxa profunda. We retrospectively reviewed the pelvic radiographs and CT scans of 70 patients (70 hips) with hip dysplasia. Forty normal hips were used as controls. Normal hips were defined as those with a lateral center-edge angle between 25° and 40°. Coxa profunda was defined as present when the acetabular fossa was observed to touch or was medial to the ilioischial line on an AP pelvic radiograph. CT measurements included acetabular version, acetabular coverage, acetabular depth, and rotational alignment of the innominate bone. The prevalence of coxa profunda was 44% (31 of 70 hips) in dysplastic hips and 73% (29 of 40 hips) in the control hips (odds ratio, 3.32; 95% CI, 1.43-7.68). Dysplastic hips had a more anteverted and globally shallow acetabulum with inwardly rotated innominate bone compared with the control hips (p hips with coxa profunda had a more anteverted acetabulum (p hip dysplasia, but rather indicates classic acetabular dysplasia, defined by an anteverted acetabulum with anterolateral acetabular deficiency and an inwardly rotated pelvis. Thus, the presence of coxa profunda does not indicate a disease in addition to hip dysplasia, and the conventional maneuvers during periacetabular osteotomy are adequate for these patients. Level IV, diagnostic study.

  16. Enteral vancomycin and probiotic use for methicillin-resistant Staphylococcus aureus antibiotic-associated diarrhoea.

    Science.gov (United States)

    Sizemore, Elizabeth Nicole; Rivas, Kenya Maria; Valdes, Jose; Caballero, Joshua

    2012-07-27

    A geriatric patient status post intraabdominal surgery presented with persistent diarrhoea and heavy intestinal methicillin-resistant Staphylococcus aureus (MRSA) growth after multiple courses of antibiotic therapy. Additionally, swab cultures of the anterior nares tested positive for MRSA. In order to impede infection and prevent future complications, the patient received a 10-day course of vancomycin oral solution 250 mg every 6 h, 15-day course of Saccharomyces boulardii 250 mg orally twice daily and a 5-day course of topical mupirocin 2% twice daily intranasally. Diarrhoea ceased during therapy and repeat cultures 11 days after initiating therapy demonstrated negative MRSA growth from the stool and nares. Further repeat cultures 5 months later revealed negative MRSA growth in the stools and minimal MRSA growth in the nares. Overall, enteral vancomycin and probiotics successfully eradicated MRSA infection without intestinal recurrence. Although the results were beneficial treating MRSA diarrhoea for our patient, these agents remain highly controversial.

  17. The dup(3q) syndrome: report of eight cases and review of the literature.

    Science.gov (United States)

    Steinbach, P; Adkins, W N; Caspar, H; Dumars, K W; Gebauer, J; Gilbert, E F; Grimm, T; Habedank, M; Hansmann, I; Herrmann, J; Kaveggia, E G; Langenbeck, U; Meisner, L F; Najafzadeh, T M; Opitz, J M; Palmer, C G; Peters, H H; Scholz, W; Tavares, A S; Wiedeking, C

    1981-01-01

    Clinical and cytogenetic examinations were performed on eight unrelated infants with duplication of part of the long arm of chromosome 3. A review of published cases shows a clinical syndrome characterized by statomotoric retardation, shortened life span, and a multiple congenital anomalies (MCA) syndrome of abnormal head configuration, hypertrichosis, hypertelorism, ocular anomalies, anteverted nostrils, long philtrum, maxillary prognathia, down-turned corners of the mouth, highly arched or cleft plate, micrognathia, malformed auricles, short, webbed neck, clinodactyly, simian crease, talipes, and congenital heart disease. The dup(3q) syndrome is a clinically easily recognizable entity.

  18. The retroverted uterus: ignored to date but core to prolapse.

    Science.gov (United States)

    Haylen, Bernard T

    2006-11-01

    The retroverted uterus has been largely ignored in urogynaecological research to date. The prevalence of the retroverted uterus is 79% more common in the urogynaecological patient population (34%) than in the general gynaecological population (19%). Its diagnosis requires the use of (a) transvaginal ultrasound with (b) an empty bladder. Recent data demonstrate that the prevalence of grade 2-4 uterine prolapse for a retroverted uterus is 4.5 times that for an anteverted uterus. Alternatively, 69% grade 2-4 uterine prolapse involves the retroverted uterus. The retroverted uterus, when diagnosed by transvaginal ultrasound (bladder empty), is far more common in urogynecology patients due to their higher incidence of prolapse.

  19. Ocular Myasthenia Gravis

    Science.gov (United States)

    ... alignment. The medical term for double vision is diplopia. Some people experience blurred vision rather than double ... have primarily cosmetic problems due to ptosis or diplopia may consider nonpharmacological treatment, such as: • Wearing dark ...

  20. A novel de novo mutation of the mitochondrial tRNA(lys) gene mt.8340G>A associated with pure myopathy

    DEFF Research Database (Denmark)

    Jeppesen, Tina Dysgaard; Duno, Morten; Risom, Lotte

    2014-01-01

    epithelial cells (mother, carried the mutation. She presented with exercise intolerance from age 9, and since age 20 she experienced ptosis and reduced ocular motility. A muscle biopsy revealed ragged red fibres (10%), no COX negative fibres, and many fibres...

  1. Mitochondrial Disease: Possible Symptoms

    Science.gov (United States)

    ... tubular acidosis or wasting HEART Cardiac conduction defects (heart blocks) Cardiomyopathy LIVER Hypoglycemia (low blood sugar) Liver failure EARS & EYES Visual loss and blindness Optic atrophy Acquired strabismus Ptosis Ophthalmoplegia Retinitis pigmentosa Hearing loss ...

  2. Topical treatment options for allergic conjunctivitis

    African Journals Online (AJOL)

    play a role in ocular allergy. H1- and H2- receptor ... fibroblast proliferation, microvascular permeability and the production of .... such as increased intraocular pressure, delayed wound healing, immunosuppression, secondary infection, ptosis.

  3. Case report

    African Journals Online (AJOL)

    iamong

    2016-08-10

    Aug 10, 2016 ... This accident has damaged the orbital region and led to upper left eyelid's necrosis, ... rules, measures and precautions of its use in caring environments ... and family medical history except a congenital ptosis in the left eye.

  4. Genetics Home Reference: Baraitser-Winter syndrome

    Science.gov (United States)

    ... shallow orbits, ptosis, coloboma, trigonocephaly, gyral malformations, and mental and growth retardation. Am J Med Genet. 1995 Jul 3;57(3):403-9. Review. Citation on PubMed Rivière JB, van Bon BW, ...

  5. Comparison of Surgical Efficacy of Levator Muscle Short-ening and Modified Levator Aponeurosis Tucking in Treat-ing Minimal and Moderate Congenital Blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    Chong Wang; Yanli Wang

    2015-01-01

    Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis. Methods:.Clinical data of 28 patients (40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was eval-uated and statistically compared between these two techniques. Results:.During 14 months follow-up,.16 eyes with ptosis un-dergoing levator muscle shortening were treated,.3 with un-dercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis. Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.

  6. Eyelid lift

    Science.gov (United States)

    Eyelid lift surgery is done to repair sagging or drooping upper eyelids ( ptosis ). The surgery is called blepharoplasty. Sagging or drooping eyelids occur with increasing age. Some people are born with ...

  7. Escobar syndrome mimicing congenital patellar syndrome

    National Research Council Canada - National Science Library

    Ezirmik, Naci; Yildiz, Kadri; Can, Cahit Emre

    2012-01-01

    ...) syndrome is a rare syndrome. Intrauterin growth reterdation, abnormal face, wide-spead pterygiums that resulted in joint contractures, ptosis, chryptoorchidism, patellar dysplasia and foot deformities are seen on this syndrome...

  8. Escobar syndrome mimicking congenital patellar syndrome/Konjenitol patella sendromunu taklit eden Escobar sendromu

    National Research Council Canada - National Science Library

    Ezirmik, Naci; Yildiz, Kadri; Can, Cahit Emre

    2012-01-01

    ...) syndrome is a rare syndrome. Intrauterin growth reterdation, abnormal face, wide-spead pterygiums that resulted in joint contractures, ptosis, chryptoorchidism, patellar dysplasia and foot deformities are seen on this syndrome...

  9. Escobar Syndrome Mimicing Congenital Patellar Syndrome/Konjenital Patella Sendromunu Taklit Eden Escobar Sendromu

    National Research Council Canada - National Science Library

    Naci Ezirmik; Kadri Yildiz; Cahit Emre Can

    2012-01-01

    ...) syndrome is a rare syndrome. Intrauterin growth reterdation, abnormal face, wide-spead pterygiums that resulted in joint contractures, ptosis, chryptoorchidism, patellar dysplasia and foot deformities are seen on this syndrome...

  10. 77 FR 47296 - Flutriafol; Pesticide Tolerances

    Science.gov (United States)

    2012-08-08

    ... weights, and histopathology findings ranging from hepatocyte vacuolization to centrilobular hypertrophy...; centrilobular hypertrophy, and increases in alkaline phosphatase release. Slight indications of effects in the... fur, ungroomed coat, ptosis, decreased motor activity, prostration, limp muscle tone, muscle...

  11. Granulocyte-Macrophage Colony-Stimulating Factor Production and Tissue Eosinophilia in Chronic Rhinitis

    Directory of Open Access Journals (Sweden)

    Peric, Aleksandar

    2016-02-01

    Full Text Available Introduction Granulocyte-macrophage colony-stimulating factor (GM-CSF is a strong proinflammatory cytokine that takes part in allergic nasal inflammation as an eosinophil colony-stimulating factor. However, the role of GM-CSF in non-allergic rhinitis has not been fully explored. Objectives The aim of this investigation was to assess the concentration of GM-CSF in nasal secretions of patients with non-allergic rhinitis with eosinophilia syndrome (NARES in comparison to patients with perennial allergic rhinitis (PAR and healthy subjects, as well as to assess the relationship with the degree of eosinophilic inflammation and clinical characteristics of the patients. Methods Fourteen patients with diagnosis of NARES, 14 PAR patients, and 14 healthy subjects were included in this cross-sectional study. All patients underwent symptom score assessment, nasal endoscopy, allergy testing, and cytological evaluation. The concentration of GM-CSF in nasal secretions of all participants was measured by enzyme-linked immunosorbent assay (ELISA. Results We found significantly higher levels of GM-CSF in patients with NARES than in the control group (p = 0.035. The percent of eosinophils in nasal mucosa was higher in NARES patients in comparison to patients with PAR (p < 0.001 and control patients (p < 0.0001. We found positive correlations between GM-CSF levels and eosinophil counts only in NARES patients. Conclusion The concentrations of GM-CSF in nasal secretions correlate well with eosinophil counts in the nasal mucosa of NARES patients. These facts indicate a possible role of GM-CSF as a favorable marker for assessment of nasal disease severity and the degree of chronic eosinophilic inflammation in the nasal mucosa.

  12. Addenda to Allied Medical Publication 8, NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) to Consider the Impact of Medical Treatment on Casualty Estimation

    Science.gov (United States)

    2013-05-01

    Botulism Survivor Injury Profile Stage 1 Stage 2 Stage 3 Signs and Symptoms (S/S) Fatigue; dry mouth; ptosis; diplopia (blurred or double vision...reflex; diplopia ; dysarthria; dysphonia; fatigue. Gradual reversal of muscle paralysis. The title of Table C-50 should be changed to read...signs and symptoms provided in Table C-50 should be changed to read: Fatigue; dry mouth; ptosis; diplopia (blurred or double vision); photophobia

  13. Extrusion of hydrogel exoplant into upper eyelid 16 years after a scleral buckle procedure

    Directory of Open Access Journals (Sweden)

    Chirag P Shah

    2011-01-01

    Full Text Available Sixteen years after scleral buckle surgery with a hydrogel episcleral exoplant, a 43-year-old woman presented with progressive binocular diplopia, ptosis, and an expanding mass in her upper eyelid. She underwent surgical removal of the hydrogel exoplant through an anterior approach. The exoplant proved to be friable, fragmented, and encapsulated in a fibrous tissue; the exoplant was removed in its entirety. Postoperatively, the eyelid mass resolved, while her diplopia and ptosis improved slightly.

  14. Apraxia of lid opening

    Directory of Open Access Journals (Sweden)

    Jebasingh Y

    2006-01-01

    Full Text Available Apraxia of lid opening is a condition where patients do not have ptosis but have difficulty in overcoming levator palpebrae inhibition. We report a patient who presented with difficulty in opening eyelids with out diurnal variation, ptosis or blepharospasm. The diagnosis of Apraxia of lid opening is confirmed by electro physiology. The possibility of apraxia of lid opening should be considered in patients who present with difficulty in opening eyes. Various causes of Apraxia of lid opening are discussed.

  15. [Laparoscopic approach of Dielt's syndrome].

    Science.gov (United States)

    Estébanez Zarranz, J; Anta Román, A; Amón Sesmero, J; Camacho Parejo, J; Conde Redondo, C; Martínez-Sagarra Oceja, J M

    1999-09-01

    Dielt's syndrome is generally known as nephritic colic due to the dilation of the urinary tract that results from a renal ptosis. In spite of renal ptosis being a commonly seen occurrence, sometimes it can be the cause of a serious painful clinical manifestation. This paper presents one case successfully treated through laparoscopic nephropexy. It also includes a discussion on the various diagnostic and therapeutical techniques.

  16. Structure, Function and Diversity of the Healthy Human Microbiome

    Science.gov (United States)

    2012-06-14

    universal on the skin and present in 93% of nares samples, and at the opposite extreme Pseudomonas aeruginosa (a representative Gram - negative skin pathogen...ra y– C ur tis ) Actinobacteria|Actinobacteria Bacteroidetes|Bacteroidia Firmicutes| Bacilli Firmicutes|Negativicutes Proteobacteria|Gammaproteobacteria

  17. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat

    NARCIS (Netherlands)

    Grundmann, Hajo; Aires-de-Sousa, Marta; Boyce, John; Tiemersma, Edine

    2006-01-01

    Staphylococcus aureus is a gram-positive bacterium that colonises the skin and is present in the anterior nares in about 25-30% of healthy people.(1) Dependent on its intrinsic virulence or the ability of the host to contain its opportunistic behaviour, S aureus can cause a range of diseases in man.

  18. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat.

    NARCIS (Netherlands)

    Grundmann, Hajo; Aires-de-Sousa, Marta; Boyce, John; Tiemersma, Edine

    2006-01-01

    Staphylococcus aureus is a gram-positive bacterium that colonises the skin and is present in the anterior nares in about 25-30% of healthy people. Dependent on its intrinsic virulence or the ability of the host to contain its opportunistic behaviour, S aureus can cause a range of diseases in man. Th

  19. Prevalence of genes encoding pyrogenic toxin superantigens and exfoliative toxins among strains of Staphylococcus aureus isolated from blood and nasal specimens

    NARCIS (Netherlands)

    Becker, Karsten; Friedrich, Alexander W; Lubritz, Gabriele; Weilert, Maria; Peters, Georg; Von Eiff, Christof

    2003-01-01

    A total of 429 different Staphylococcus aureus isolates encompassing 219 blood isolates and 210 isolates taken from anterior nares were systematically searched by two multiplex PCR-DNA enzyme immunoassays (PCR-DEIA) for exfoliative toxin (ET) genes eta and etb, as well as for the classical members o

  20. Long-term cortisol levels are not associated with nasal carriage of Staphylococcus aureus

    NARCIS (Netherlands)

    L. Manenschijn (Laura); A.M. Jetten; W.J.B. van Wamel (Willem); M. Tavakol (Mehri); E.L.T. van den Akker (Erica); J.W. Koper (Jan); A.F. van Belkum (Alex); E.F.C. van Rossum (Liesbeth)

    2012-01-01

    textabstractStaphylococcus aureus (S. aureus) colonizes the anterior nares in part of the population and the persistent carrier state is associated with increased infection risk. Knowledge concerning the determinants of S. aureus nasal carriage is limited. Previously, we found that glucocorticoid re

  1. Analyses of firn gas samples from Dronning Maud Land, Antarctica : Study of nonmethane hydrocarbons and methyl chloride

    NARCIS (Netherlands)

    Kaspers, K.A.; Wal, R.S.W. van de; Gouw, J.A. de; Hofstede, C.M.; Broeke, M.R. van den; Veen, C. van der; Neubert, R.E.M.; Meijer, H.A.J.; Brenninkmeijer, C.A.M.; Karlöf, L.; Winther, J.G.

    2004-01-01

    Firn air was sampled on the Antarctic plateau in Dronning Maud Land (DML), during the Norwegian Antarctic Research Expedition (NARE) 2000/2001. In this paper, we describe the analyses for methyl chloride and nonmethane hydrocarbons (NMHCs) in these firn air samples. For the first time, the NMHCs eth

  2. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat

    NARCIS (Netherlands)

    Grundmann, Hajo; Aires-de-Sousa, Marta; Boyce, John; Tiemersma, Edine

    2006-01-01

    Staphylococcus aureus is a gram-positive bacterium that colonises the skin and is present in the anterior nares in about 25-30% of healthy people.(1) Dependent on its intrinsic virulence or the ability of the host to contain its opportunistic behaviour, S aureus can cause a range of diseases in man.

  3. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat.

    NARCIS (Netherlands)

    Grundmann, Hajo; Aires-de-Sousa, Marta; Boyce, John; Tiemersma, Edine

    2006-01-01

    Staphylococcus aureus is a gram-positive bacterium that colonises the skin and is present in the anterior nares in about 25-30% of healthy people. Dependent on its intrinsic virulence or the ability of the host to contain its opportunistic behaviour, S aureus can cause a range of diseases in man.

  4. The role of human innate immune factors in nasal colonization by Staphylococcus aureus

    NARCIS (Netherlands)

    van Belkum, Alex; Emonts, Marieke; Wertheim, Heiman; Bartels, Hans; Cole, Alexander; Lemmens-den Toom, Nicole; Snijders, Susan Susan; Verbrugh, Henri; van Leeuwen, Willem

    2007-01-01

    Slaphylococcus aureus colonization of the human nares predisposes to sometimes severe auto-infection. To investigate whether genetic polymorphism affects the S. aureus carriage status, sequence variation in alpha-defensin and beta-defensin, and mannose-binding lectin (MBL) genes were determined for

  5. Non-allergic rhinitis with eosinophilia syndrome is not associated with local production of specific IgE in nasal mucosa.

    Science.gov (United States)

    Becker, Sven; Rasp, Julia; Eder, Katharina; Berghaus, Alexander; Kramer, Matthias F; Gröger, Moritz

    2016-06-01

    Non-allergic rhinitis with eosinophilia syndrome (NARES) is an eosinophilic inflammation of the nasal mucosa without evidence of an allergy or other nasal pathologies. Patients complain about perennial symptoms like nasal obstruction, rhinorrhea, itchiness and sneezing of the nose sometimes accompanied by hyposmia. The aim of the study was to better characterize NARES patients using immunoassay-biochip technology to examine serum and nasal secretion. Sera and nasal secretion of patients with NARES (perennial nasal symptoms, no evidence of acute or chronic rhinosinusitis with or without polyps, negative SX1-Screening test and/or negative skin prick test, eosinophilic cationic protein in nasal secretion >200 ng/ml) were tested by immunoassay-biochip technology (ImmunoCAP(®) ISAC, Phadia). 112 different allergen components from 51 allergen sources were tested on the chip. Furthermore, serum and nasal secretion were tested for specific IgE to Staphylococcus aureus enterotoxin TSST-1 by fluorescence-enzyme-immunoassay (UniCAP(®), Phadia). Unrecognized systemic sensitization could be ruled out by negative ISAC results in sera of all patients. Testing of nasal secretion for allergen-specific IgE by ISAC chip technology was negative as well in all cases. In one patient, a systemic sensitization to Staphylococcus aureus superantigen TSST-1 was detectable but no allergen-specific IgE to TSST-1 was measurable in nasal secretion of any patient. The results demonstrate that NARES is not associated with local allergy (entopy) nor with a local inflammation driven by Staphylococcus aureus enterotoxin TSST-1. Further studies are necessary to better understand the underlying mechanisms of NARES.

  6. Surgical management of hypotropia in congenital fibrosis of extraocular muscles (CFEOM presented by pseudoptosis

    Directory of Open Access Journals (Sweden)

    Tawfik HA

    2012-12-01

    Full Text Available Hatem A Tawfik,1 Mohammad A Rashad21Oculoplastic Service, 2Pediatric Ophthalmology Service, Ophthalmology Department, Ain Shams University, Cairo, EgyptPurpose: To describe the demographics, characteristics, management pitfalls, and outcomes of pseudoptosis associated with congenital fibrosis of the extraocular muscles (CFEOM.Methods: A retrospective review was performed of eight patients presenting with ptosis and hypotropia to oculoplastic service. All patients underwent full ocular evaluation and magnetic resonance imaging of brain and orbit. Five of these patients underwent stepwise correction of hypotropia by single-stage adjustable strabismus surgery (SSASS, followed by a frontalis sling if needed.Results: Eight patients had congenital strabismus with severe ptosis and a positive forced duction test. There was a highly significant improvement from preoperative mean hypotropia angle of 30 prism diopters (PD to 9 PD mean postoperative angle (P = 0.006. Surgery for ptosis was not needed in 80% of eyes.Conclusion: CFEOM involving both ptosis and hypotropia could be properly managed with the correct sequence of surgical steps. Proper vertical alignment by correction of hypotropia utilizing SSASS may alleviate the need for ptosis surgery.Keywords: congenital fibrosis of extraocular muscles, CFEOM, single-stage adjustable suture surgery, SSASS, pseudoptosis

  7. [An adult case of congenital Horner's syndrome with heterochromia iridis--with special reference to alteration of Horner's sign associated with development].

    Science.gov (United States)

    Uyama, E; Maeda, J; Adachi, K; Yu, T C; Araki, S

    1989-10-01

    It is well known that when the Horner's syndrome is congenital, a defect in pigmentation of the iris is usual; all or part of the iris remains light brown. We reported an adult case of congenital Horner's syndrome with remission and relapse of unilateral ptosis. A 25-year-old man was admitted to our hospital for ophthalmologic surgical treatment of right ptosis. According to the patient's mother, the patient was delivered with the aid of forceps at birth, and the right ptosis was observed during the first few days of his life. At 2 to 3 years of age, his parents noted lighter color of the right eye. The right ptosis was gradually improved as he grew older. However, he developed right ptosis again with left meralgia paresthesia since eighteen age. At age 25 years, he was noted to have right ptosis, right miosis (the left pupil measured 4.5 mm in diameter and the right 3.0 mm), right heterochromia iridis with pigmented iris nevi, and left meralgia paresthesia . Laboratory data of urine, blood and CSF as well as radiological studies of chest X-ray, skull X-ray, spine X-ray, brain MRI and spinal cord MRI showed unremarkable. Sweating test was intact, pharmacologic test to Horner's syndrome with 5% cocaine and 1.25% 1-epinephrine indicated that the damage was pointed to the post ganglionic sympathetic neuron. Ten patients with congenital Horner's syndrome reported in Japan since 1953 were reviewed including our case. Ten of eleven were male and Horner's sign was recorded on the left eye in 8 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. [Advantages of a double approach to upper blepharoplasty associated with eyelid malpositions].

    Science.gov (United States)

    Morax, S; Ben Ayed, H; Pereira-Nunes, T; Hamedani, M

    2003-11-01

    During upper blepharoplasty, myocutaneous excess and fat pads are treated using an anterior approach. Eyelid malpositions such as involutional ptosis or lid retraction could be associated and should be treated with associated procedures. Aponeurotic surgery on the levator muscle can make use of the same anterior approach, with the major difficulty of dosage. In cases of ptosis with a positive epinephrine test or minor muscular retraction, the Müller muscle-conjunctival surgery via a posterior approach seems to be more reproducible. Double-approach techniques are described.

  9. Diagnosis of Tensilon-Negative Ocular Myasthenia Gravis By Daily Selfie.

    Science.gov (United States)

    Guterman, Elan L; Botelho, James V; Horton, Jonathan C

    2016-09-01

    The initial symptoms of myasthenia gravis are usually ptosis and diplopia. The diagnosis is often confirmed by testing for anti-acetylcholine receptor antibodies or by observing the effects of intravenous edrophonium (Tensilon) injection. However, these standard tests may be negative in patients with isolated ocular findings. We present the case of an 83-year-old woman with negative serologic and Tensilon testing. She was asked to photograph herself daily. The resulting sequence of daily selfies captured striking fluctuations in her ocular alignment and ptosis. Daily selfies may be a useful strategy for confirming the clinical diagnosis of ocular myasthenia gravis.

  10. Diagnosis and behavior in autonomic trigeminal headaches

    Directory of Open Access Journals (Sweden)

    Erélido Hernández Valero

    2008-04-01

    Full Text Available Autonomic trigeminal headaches are primary headaches which include: cluster headaches, paroxistical hemicranea, and syndrome of unilateral headache in a neuralgic way, of short duration, accompanied by cojunctival injection and tearing and the continuous hemicranea. It is also accompanied by autonomic manifestations such as: palpebrate ptosis, tearing, nasal congestion, rhinorrhea, Horner syndrome (palpebrate ptosis, miosis, and enophthalmos and changes in the coloration of the periocular skin and in the cheek. In this paper we propose the most likely diagnosis and therapeutic to this nosologic entity

  11. Correction of Anophthalmic Enophthalmos with a Three-Staged Procedure: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Tomohiro Minagawa

    2011-01-01

    Full Text Available Surgical correction of an anophthalmic enophthalmos secondary to inappropriate repair of the eye socket involves several difficult aesthetic issues associated with long-term use of a poorly fitting prosthetic eye. In this paper, we present two cases of anophthalmic enophthalmos. During the treatment of the first patient, unsatisfactory cosmetic problems including lower eyelid retraction, hypoglobus, and severe upper eyelid ptosis were revealed. Accordingly, a three-staged procedure was performed on the second patient, including autologous augmentation of the eye socket, correction of lower eyelid retraction with a cartilage graft, and a frontalis sling procedure to correct upper eyelid ptosis.

  12. Giant epidermal cyst of the tarsal plate

    Directory of Open Access Journals (Sweden)

    Mohana Majumdar

    2012-01-01

    Full Text Available A 35-year-old male patient presented with a right upper eyelid mass with mechanical ptosis. The patient gave no history of trauma or surgery. On examination, there was a huge cystic mass fixed to the tarsal plate. Excisional biopsy with tarsectomy was done. Histopathology sections demonstrated a keratin-filled cyst arising from the tarsus. A thorough Pubmed search did not reveal an epidermal cyst of the tarsal plate of this size which was successfully managed. The incision was made in such a way that postoperative ptosis would be avoided. Excess skin was removed during the surgery.

  13. Síndrome de Horner tras amigdalectomía

    OpenAIRE

    Díaz de Cerio Canduela, Pedro

    2010-01-01

    [ES]Se expone el caso de un paciente que, tras la realización de una amigdalectomía complicada por sangrado, presenta un cuadro de ptosis, miosis y enoftalmos junto con dolor ocular ipsilateral al lado del sangrado. El cuadro se circunscribe dentro del denominado síndrome de Horner y constituye una complicación poco frecuente de las amigdalectomías. [EN] There is exposed the case of a patient who, after the accomplishment of a tonsillectomy complicated for bled, presents ptosis, miosis an...

  14. Prenatal sonographic diagnosis of Aarskog syndrome.

    Science.gov (United States)

    Sepulveda, W; Dezerega, V; Horvath, E; Aracena, M

    1999-10-01

    In 1970, Aarskog described a rare X-linked developmental disorder characterized by short stature in association with a variety of structural anomalies involving mainly the face, distal extremities, and external genitalia (faciodigitogenital syndrome). The major facial manifestations of this syndrome include hypertelorism, broad forehead, broad nasal bridge, short nose with anteverted nostrils, long philtrum, widow's peak hair anomaly, and ocular and ear anomalies. Limb abnormalities consist of short broad hands, brachydactyly, interdigital webbing, hypoplasia of the middle phalanges, proximal interphalangeal joint laxity with concomitant flexion and restriction of movement of distal interphalangeal joints, and flat broad feet with bulbous toes. Genital anomalies are characteristics and include shawl scrotum, cryptorchidism, and inguinal hernia. Most affected patients have normal intelligence, but some authors have noted mild neurodevelopmental delay in up to 30% of the cases. We describe a case of Aarskog syndrome diagnosed prenatally by sonography at 28 weeks' gestation in a high-risk pregnancy for this disorder.

  15. Muscle activation during four Pilates core stability exercises in quadruped position.

    Science.gov (United States)

    Queiroz, Bergson C; Cagliari, Mariana F; Amorim, César F; Sacco, Isabel C

    2010-01-01

    Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four Pilates core stability exercises in quadruped position. To compare the activity of stabilizing trunk and hip muscles in 4 variations of Pilates stabilizing exercises in the quadruped position. Repeated-measures descriptive study. A biomechanics laboratory at a university school of medicine. Healthy subjects (N=19; mean age +/- SD, 31+/-5y; mean weight +/- SD, 60+/-11kg; mean height +/- SD, 166+/-9cm) experienced in Pilates routines. Surface electromyographic signals of iliocostalis, multifidus, gluteus maximus, rectus abdominis, and external and internal oblique muscles were recorded in 4 knee stretch exercises: retroverted pelvis with flexed trunk; anteverted pelvis with extended trunk; neutral pelvis with inclined trunk; and neutral pelvis with trunk parallel to the ground. Root mean square values of each muscle and exercise in both phases of hip extension and flexion, normalized by the maximal voluntary isometric contraction. The retroverted pelvis with flexed trunk position led to significantly increased external oblique and gluteus maximus muscle activation. The anteverted pelvis with trunk extension significantly increased multifidus muscle activity. The neutral pelvis position led to significantly lower activity of all muscles. Rectus abdominis muscle activation to maintain body posture was similar in all exercises and was not influenced by position of the pelvis and trunk. Variations in the pelvic and trunk positions in the knee stretch exercises change the activation pattern of the multifidus, gluteus maximus, rectus abdominis, and oblique muscles. The lower level of activation of the rectus abdominis muscle suggests that pelvic stability is maintained in the 4 exercise positions. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Subseabed Disposal Project annual report, FY85 to termination of project: Physical Oceanography and Water Column Geochemistry Studies, October 1984 through May 1986

    Energy Technology Data Exchange (ETDEWEB)

    Kupferman, S.L. (ed.)

    1987-05-01

    This report covers the work of the Physical Oceanography and Water Column Geochemistry (POWCG) Studies Group of the Subseabed Disposal Project (SDP) from October 1984 to termination of the project in May 1986. The overview of the work includes an introduction, general descriptions of the activities, and a summary. Detailed discussions are included as appendices. During the period of this report the POWCG Studies Group held a meeting to develop a long-term research plan for the Nares Abyssal Plain, which was recently designated as a study area for the Environmental Study Group of the SDP. The POWCG Studies Group has also planned and participated in two interdisciplinary oceanographic missions to the Nares which have resulted in the acquisition of data and samples which can be used to begin to understand the workings of the ecosystem at the site, and for developing a preliminary site assessment. The papers in the appendices have been processed for inclusion in the Energy Data Base.

  17. Beak necrosis in Hungarian partridges (Perdix perdix) associated with beak-bits and avian poxvirus infection.

    Science.gov (United States)

    Brower, Alexandra I; Cigel, Francine; Radi, Craig; Toohey-Kurth, Kathy

    2010-06-01

    Proliferative growth, consistent with poxvirus infection, encapsulated plastic beak-bits and covered the dorsal portion of the upper beak and nares of adult male and female captive-raised Hungarian partridges. Three representative birds were submitted to the Wisconsin Veterinary Diagnostic Laboratory for necropsy. Lesions in the necropsied birds extended through the nares, where the plastic bit ends are designed to rest. The lesions also variably extended caudally into the oropharynx and cranially within the beak epithelium, and included palate deformity and beak necrosis. Poxvirus was diagnosed in all of the birds examined based on histopathology, electron microscopy, and polymerase chain reaction amplification and sequencing. This report is the first to describe avian pox lesions associated with the application of beak-bits and the resulting beak and oral pathology.

  18. Bilateral cleft lip nasal deformity

    OpenAIRE

    Singh Arun; Nandini R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the li...

  19. Analysis of Tobyhanna Army Depot’s Radio Frequency Identification (RFID) Pilot Program: RFID as an Asset Management Tool

    Science.gov (United States)

    2005-06-01

    Florian Lohff, Naree Tubpun, Lei Xu, and Zhisong Zhang, RFID in the Automotive Industry, Institut für Wirtschaftsinformatik Humboldt University Berlin...Xu, and Zhisong Zhang, RFID in the Automotive Industry, Institut für Wirtschaftsinformatik Humboldt University Berlin, July 2004, p. 7. 10 19 Dick... Wirtschaftsinformatik Humboldt University Berlin, July 2004. Buss, Dale. The Race to RFID. Chief Executive. New York: November 2004, Issue 203. Chase, Richard B

  20. New Hardy Spaces Associated with Some Anisotropic Herz Spaces and Their Applications

    Institute of Scientific and Technical Information of China (English)

    Yong DING; Sen Hua LAN; Shan Zhen LU

    2008-01-01

    In this paper, a class of anisotropic Herz-type Hardy spaces associated with a non-isotropic dilation on R nare introduced, and the central atomic and molecular decomposition characterizations of those spaces are established. As some applications of the decomposition theory, the authors study the interpolation problem and the boundedness of the central δ-Calderon-Zygmund operators on the anisotropic Herz-type Hardy spaces.

  1. Morfologičeskie i sintaktiko-semantičeskie modeli v imperativnom značenii

    Directory of Open Access Journals (Sweden)

    Fekete Egon

    2008-01-01

    Full Text Available (ruski V nastojaščej rabote rassmatrivajutsja: (a morfologičeskie formy imperativa v serbskom jazyke i (b drugie grammatičeskie sredstva, s pomošč'ju kotoryh možno vyrazit' imperativnye značenija (prezens, buduščee vremja, glagol'nye pričastija, infinitiv, imena suščestvitel'nye, narečija i meždometija.

  2. Three new species of Calliceratomyia Lane (Diptera: Ditomyiidae) from Neotropical Mexico.

    Science.gov (United States)

    Huerta, Heron; Amorim, Dalton De Souza

    2016-02-03

    Three new species of the ditomyiid genus Calliceratomyia Lane, so far known only from the type-species from southeastern Brazil, are described from Mexico. The new species-Calliceratomyia papaveroi sp. n., Calliceratomyia pantelhomyia sp. n. and Calliceratomyia zayolli sp. n.-are described based on adult males collected with Malaise traps in the States of Oaxaca, Chiapas and Hidalgo, Mexico. The descriptions are illustrated and the diagnosis of the genus is revised.

  3. Utility of a single nasal polymerase chain reaction assay in predicting absence of skin and environmental contamination in hospitalized patients with past methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Guerrero, Dubert M; Wagner, Matthew; Carson, Grace; Hanish, Christine; Thompson, Jody; Orr, Megan; Roth, Felix; Carson, Paul J

    2016-06-01

    We evaluated hospitalized patients with a history of methicillin-resistant Staphylococcus aureus (MRSA) for persistent colonization and need for contact precautions. Up to 3 daily cultures of nares, skin, and any present wounds were compared with a single nasal polymerase chain reaction (PCR) assay. Most patients (76.2%) were no longer colonized with MRSA. A single PCR assay was sufficient to exclude persistent colonization and environmental contamination and remove the contact precautions.

  4. Breast carcinoma metastasis to the lacrimal gland

    DEFF Research Database (Denmark)

    Nickelsen, Marie N.; Von Holstein, Sarah; Hansen, Alastair B.

    2015-01-01

    A 77-year-old female, with proptosis, reduced eye motility and diplopia which had developed over two to three months and a 69-year-old female with proptosis, oedema of the eyelid, reduced motility and ptosis, which had developed over three weeks, are presented in the present study. Computed...

  5. Botulinum Neurotoxins

    Science.gov (United States)

    2012-03-28

    and VI (Sobel, 2005) and include ocular disorders such as blurred vision, diplopia , ptosis and photophobia (Terranova et al., 1979). This is generally...Dysphagia 96 97 82 Dry mouth 83 100 93 Diplopia 90 92 39 Dysarthia 100 69 50 Upper extremity weakness 86 64 NA Lower

  6. Botulinum Toxin

    Science.gov (United States)

    2009-01-01

    atypical disease symptoms of nausea, vomiting, diplopia , dysphagia, phagodynia, and instability within 7 h of exposure (Meyer and Eddie, 1951). The man...routes of exposure include, in order of descending frequency: dysphagia, xerostomia, diplopia , dysarthria, fatigue, ptosis of the eyelids

  7. The Anti-Acetylcholine Receptor Antibody Test in Suspected Ocular Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Jung Jin Lee

    2014-01-01

    Full Text Available Aim. To estimate the clinical significance of anti-acetylcholine receptor antibody (anti-AChR-Ab levels in suspected ocular myasthenia gravis. Methods. In total, 144 patients complaining of fluctuating diplopia and ptosis were evaluated for serum levels of anti-acetylcholine receptor antibody and their medical charts were retrospectively reviewed. Subjects were classified into three groups: variable diplopia only, ptosis only, and both variable diplopia and ptosis. We investigated serum anti-AChR-Ab titer levels and performed thyroid autoantibody tests. Results. Patients’ chief complaints were diplopia (N=103, ptosis (N=12, and their concurrence (N=29. Abnormal anti-AChR-Ab was observed in 21 of 144 patients (14.1%. Between the three groups, mean age, number of seropositive patients, and mean anti-AChR-Ab level were not significantly different (P=0.224, 0.073, and 0.062, resp.. Overall, 27.5% of patients had abnormal thyroid autoantibodies. Conclusion. The sensitivity of anti-AChR-Ab was 14.1% in suspected ocular myasthenia gravis and seropositivity in myasthenia gravis patients showed a high correlation with the presence of thyroid autoantibodies.

  8. Blepharophimosis Mental Retardation Syndrome Say-Barber/Biesecker/Young-Simpson Type - New Findings With Neuroimaging

    NARCIS (Netherlands)

    K. Szakszon; E. Berényi; A. Jakab; B. Bessenyei; E. Balogh; T. Koebling; J. Szilvássy; A.C. Knegt; E. Olah

    2011-01-01

    We report on a female patient with blepharophimosis mental retardation syndrome of Say/Barber/Biesecker/Young-Simpson (SBBYS) type. Main findings in her were marked developmental delay, blepharophimosis, ptosis, cleft palate, external auditory canal stenosis, small and malformed teeth, hypothyroidis

  9. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH

    1996-01-01

    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  10. Phenotype and clinical course in a family with a new de novo Twinkle gene mutation

    DEFF Research Database (Denmark)

    Jeppesen, Tina Dysgaard; Schwartz, M.; Colding-Jorgensen, E.

    2008-01-01

    , sensory neuropathy, elevated resting plasma lactate, glucose intolerance and impaired VO2max while her sons only had mild ptosis. In accordance with the clinical presentation, abnormal morphological findings in muscle and multiple deletions and depletion of mtDNA in muscle were more pronounced...

  11. The role of apraclonidine in Horner’s syndrome: A case report

    Directory of Open Access Journals (Sweden)

    Karadžić Jelena

    2016-01-01

    Full Text Available Introduction. Horner’s syndrome is an interruption of the sympathetic nervous system at any point along its course between the hypothalamus and the orbit. Horner’s syndrome is classically presented as an ipsilateral miosis, subtle ptosis, and facial anhidrosis. Pharmacologic testing is very useful in the diagnosis of Horner’s syndrome as it could help to localize the lesioned neuron in the sympathetic pathway, suggesting an etiology. Case Outline. We present a case report of a 41-year-old woman who reported right eyelid drooping immediately after operation of sympathetic chain schwannoma. We performed apraclonidine test for the diagnosis of Horner’s syndrome, which produced mydriasis on the affected eye, while there was no significant change of the normal eye. Based on the clinical presentation of anisocoria and one-sided ptosis, and previous medical history of surgical removal of the mediastinal tumor, the patient was diagnosed with a right-sided, partial Horner’s syndrome. Conclusion. Timely recognition, exact localization of the lesioned neuron, and referral for urgent imaging studies are important for ophthalmologists in order to prevent and treat life-threatening conditions. Besides its diagnostic value in Horner’s syndrome, topical apraclonidine could correct ptosis for the sake of esthetics or when ptosis reduces the superior visual field.

  12. Painful Horner syndrome due to arteritis of the internal carotid artery

    NARCIS (Netherlands)

    Bollen, AE; Krikke, AP; de Jager, AEJ

    1998-01-01

    A 44-year-old man presented with painful Horner syndrome: severe periorbital pain, ptosis, and miosis of his right eye, with intact facial sweating. Lymphadenitis at the right side of his neck preceded the symptoms. MRI and magnetic resonance angiography showed thickening of the right internal carot

  13. Terminal 3p deletions in two families--correlation between molecular karyotype and phenotype.

    NARCIS (Netherlands)

    Pohjola, P.; Leeuw, N. de; Penttinen, M.; Kaariainen, H.

    2010-01-01

    The 3p deletion syndrome is a rare disorder caused by deletions of different sizes in the 3p25-pter region. It is characterized by growth retardation, developmental delay, mental retardation, dysmorphism, microcephaly, and ptosis. The phenotype of individuals with deletions varies from normal to sev

  14. The Aarskog syndrome.

    Science.gov (United States)

    Fryns, J P; Macken, J; Vinken, L; Igodt-Ameye, L; van den Berghe, H

    1978-06-09

    In this report a description is given of the Aarskog syndrome in six males belonging to three different families. Partial expression of the syndrome was confirmed in two of the three examined obligate female heterozygotes, who had short stature, small hands and feet, short neck, and a round face with widow's peak and, in one of them, ptosis of the eyelids.

  15. Apparently previously undescribed X-linked dominant syndrome with facial and skeletal anomalies.

    Science.gov (United States)

    Kapur, S; Swinford, A; Freimanis, A K; Lachman, R S

    1989-07-01

    We report on a syndrome of widow's peak, ptosis, skeletal abnormalities and other minor anomalies in a large family. The condition appears to be inherited in an X-linked dominant fashion. No similar cases have been found in the literature, suggesting that this is a "new" syndrome. Study of 5 generations of the family documents information on the natural history of the condition.

  16. Vincristine-Induced Cranial Neuropathy

    Directory of Open Access Journals (Sweden)

    Ahmad TALEBIAN*

    2013-12-01

    Full Text Available How to Cite This Article: Talebian A, Goudarzi RM, Mohammadzadeh M , Mirzadeh AS. Vincristine-Induced Cranial Neuropathy. Iran J Child Neurol. 2014 Winter; 8(1:66-68. Abstract Vincristine (VCR is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms’ tumor, treated by vincristine (0/067 mg/kg/day and dactinomycin (0/045 mg/kg/day after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID and pyridostigmine (3 mg/kg p.o. BID started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.

  17. Anesthesic Management for Escobar Syndrome: Case Report

    OpenAIRE

    Ayse Hande Arpaci; Fusun Bozkirli; Onur Konuk

    2011-01-01

    Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration.

  18. Anesthesic management for escobar syndrome: case report.

    Science.gov (United States)

    Arpaci, Ayse Hande; Bozkirli, Fusun; Konuk, Onur

    2011-01-01

    Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration.

  19. Botulisme hos spaedbørn

    DEFF Research Database (Denmark)

    Hoffmann, Thomas; Mølbak, Kåre; Paerregaard, Anders

    2010-01-01

    of voluntary muscles. Presenting symptoms include constipation, lethargy, mydriasis and ptosis. The diagnosis is made on the basis of clinical examination and confirmed by isolating the toxin in serum or stools. Treatment consists of supportive intensive care and treatment with antitoxins....

  20. Myotonic dystrophy (DM1) and dysphagia: the need for dysphagia management guidelines and an assessment tool

    NARCIS (Netherlands)

    LaDonna, K.A.; Koopman, W.J.H.; Venance, S.L.

    2011-01-01

    Myotonic dystrophy (DM1) is the most prevalent muscular dystrophy occurring in adulthood. DM1 is a multi-systemic disorder resulting in early-onset cataracts, cardiac rhythm problems, muscle weakness, ptosis, and cognitive and psychiatric manifestations. Dysphagia is one of the most problematic

  1. Botulisme hos spaedbørn

    DEFF Research Database (Denmark)

    Hoffmann, Thomas; Mølbak, Kåre; Paerregaard, Anders

    2010-01-01

    of voluntary muscles. Presenting symptoms include constipation, lethargy, mydriasis and ptosis. The diagnosis is made on the basis of clinical examination and confirmed by isolating the toxin in serum or stools. Treatment consists of supportive intensive care and treatment with antitoxins....

  2. Deletion of short arm of chromosome 18, Del(18p syndrome

    Directory of Open Access Journals (Sweden)

    Prashant Babaji

    2014-01-01

    Full Text Available Deletion of the short arm of chromosome 18 is a rare syndrome clinically presenting with variable mental retardation, growth retardation, low height, pectus excavatum, craniofacial malformations including long ear, ptosis, microcephaly and short neck. This case report presents with characteristic features along with rare feature of single nostril.

  3. [Labial aging. Composition and therapeutic principles].

    Science.gov (United States)

    Simon, E; Stricker, M; Duroure, F

    2002-10-01

    Labial ageing process combining relaxation, distension and ptosis is aggravated by underlying structure modification: dental and bony. If the inferior lip moves back and collapses, the superior lip will go down and widen. The authors analyse the different ageing process components (intrinsic and extrinsic) as well as therapeutic principles.

  4. OTORHINOLARYNGOLOGIC CAUSES OF CLAUDE-BERNARD-HÖRNER SYNDROME: THREE CASES REPORT

    Directory of Open Access Journals (Sweden)

    R. de la Fuente Cañibano

    2010-01-01

    Full Text Available The syndrome of Claude-Bernard-Hörner is caused by the sinpatical injury of thebranches ascending innervation of the stellate ganglion and the iris smooth muscle eyelid. His triad is the presence of ptosis, myosis and enoftalmos. It may be accompanied by anhidrosis, pupillary dilation heterocromía delayed in the congenital case.

  5. Plexiform Neurofibroma Involving the Lacrimal Gland

    DEFF Research Database (Denmark)

    Hofsli, Mikael; Gampenrieder, Nico; Heegaard, Steffen

    2017-01-01

    Background: To present a rare case of a 2-year-old girl with neurofibromatosis type 1 (NF1) who presented with ptosis of the right upper eyelid along with a tumor in the eyelid. Methods: A magnetic resonance imaging scan of the orbit revealed a solid tumor located extraconally at the site...

  6. Feasibility Study of Pharmacological Treatment to Reduce Morbidity and Mortality After Brain Injury

    Science.gov (United States)

    1990-11-12

    saline (Fig 4,6) and this endured for 1 hour. Reserpine catatonia is characterized by ptosis, and an arched back position. The ability of the animals to...achieved scores to baseline post-lesion levels (t-test, df = 9, p = .289). Therefore, in reserpinized rats, AMPH appeared to alleviate the catatonia

  7. Two further cases of Ohdo syndrome delineate the phenotypic variability of the condition

    NARCIS (Netherlands)

    White, SM; Ades, LC; Amor, D; Liebelt, J; Bankier, A; Baker, E; Wilson, M; Savarirayan, R

    Ohdo syndrome (MIM 249620) is a multiple malformation syndrome characterized by blepharophimosis, ptosis, dental hypoplasia, hearing impairment and intellectual disability. A wide range of dysmorphic features and congenital abnormalities have been described in cases reported as Ohdo and Ohdo-like

  8. Vincristine-induced cranial neuropathy.

    Science.gov (United States)

    Talebian, Ahmad; Goudarzi, Razieh Moazam; Mohammadzadeh, Mahdi; Mirzadeh, Azadeh Sadat

    2014-01-01

    Vincristine (VCR) is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms' tumor, treated by vincristine (0.067 mg/kg/day) and dactinomycin (0.045 mg/kg/day) after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID) and pyridostigmine (3 mg/kg p.o. BID) was started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.

  9. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH

    1996-01-01

    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  10. 76 FR 69642 - Flutriafol; Pesticide Tolerances

    Science.gov (United States)

    2011-11-09

    ... hypertrophy and slight increases in hemosiderin-laden Kupffer cells. It is noteworthy that with chronic... cells; 4. Centrilobular hypertrophy, and 5. Increases in alkaline phosphatase release. Slight...-stained abdominal fur, ungroomed coat, ptosis, decreased motor activity, prostration, limp muscle tone...

  11. Nipple Sparing Mastectomy: Does Breast Morphological Factor Related to Necrotic Complications?

    Directory of Open Access Journals (Sweden)

    Prakasit Chirappapha, MD

    2014-01-01

    Conclusions: Large glandular specimen increases the risk of NAC necrosis. The degree of ptosis and the distance between the sternal notch and the NAC have no significant impact on necrotic complications in NSM. To reduce the necrotic complications in large breast after NSM, reconstruction should better be performed with autologous flap or slow skin expansion using the expander technique.

  12. OTORHINOLARYNGOLOGIC CAUSES OF CLAUDE-BERNARD-HÖRNER SYNDROME: THREE CASES REPORT

    OpenAIRE

    R. de la Fuente Cañibano; A. Muñoz Herrera

    2010-01-01

    The syndrome of Claude-Bernard-Hörner is caused by the sinpatical injury of thebranches ascending innervation of the stellate ganglion and the iris smooth muscle eyelid. His triad is the presence of ptosis, myosis and enoftalmos. It may be accompanied by anhidrosis, pupillary dilation heterocromía delayed in the congenital case.

  13. Mingmu Dihuang Tang Combined with Electro-acupuncture for Treatment of Diabetic Oculomotor Paralysis in 52 Cases

    Institute of Scientific and Technical Information of China (English)

    Li Zhongtai; Wang Xinzhong

    2007-01-01

    @@ Diabetic oculomotor paralysis is a commonly and frequently encountered disease with the following clinical manifestations: ptosis of the upper eyelid,narrowing of the palpebral fissure, inability of the eyeball to move upward, inward and downward,inferolateral inclination of the eyeball, double vision,platycoria, and loss of photoreaction.

  14. [Validation of the ice pack test in ophthalmoparesis due to myasthenia gravis].

    Science.gov (United States)

    Ramirez-Antunez, Ángel G; García-Ramos, Guillermo; Estañol-Vidal, Bruno; Juárez-Flores, Alejandra

    2013-11-01

    Introduccion. La miastenia grave es una enfermedad autoinmune de la union neuromuscular que se presenta clinicamente como debilidad fluctuante de los musculos estriados, como los de la region ocular (miastenia ocular). Objetivo. Demostrar que la sensibilidad y la especificidad de la prueba de hielo son altas en el diagnostico diferencial de la oftalmoparesia y ptosis palpebral por miastenia grave y miastenia ocular. Sujetos y metodos. Estudio observacional, analitico, no aleatorizado, de una muestra de 43 sujetos, 21 con miastenia grave y 22 controles. A todos los pacientes se les aplico un guante con hielo sobre sus parpados superiores afectados durante dos minutos, despues de los cuales se evaluo el grado de mejoria de la ptosis palpebral y la oftalmoparesia. Todos tenian estudio de estimulacion nerviosa repetitiva. Resultados. Se analizaron 36 pacientes, 18 con miastenia grave u ocular y 18 controles. Todos presentaron ptosis palpebral y solo 20 de ellos oftalmoparesia. La prueba de hielo para la oftalmoparesia mostro una sensibilidad del 83%, especificidad del 100%, valor predictivo positivo (VPP) del 100% y valor predictivo negativo (VPN) del 80% en el diagnostico de la miastenia grave. Para la ptosis palpebral, se determino una sensibilidad del 89%, especificidad del 100%, VPP del 100% y VPN del 90%. Para la estimulacion nerviosa repetitiva se calculo una sensibilidad del 61%, especificidad del 83%, VPP del 79% y VPN del 68%. Conclusion. La prueba de hielo es sencilla, segura, economica, rapida y fiable para utilizarse de rutina en pacientes con sospecha de ptosis u oftalmoparesia por miastenia grave, ya que tiene una alta validez, seguridad y reproducibilidad como prueba diagnostica.

  15. Mastopexia de aumento, técnica de quinta generación Augmentation mastopexy, fifth generation technique

    Directory of Open Access Journals (Sweden)

    R. Navarro

    2008-06-01

    Full Text Available Presentamos una nueva técnica de mastopexia, más sencilla, que evita recidivas además de disminuir el riesgo de carcinoma mamario. El estudio se realiza sobre 25 pacientes femeninas de 25 a 50 años de edad, con ptosis mamaria. Con las pacientes de pie realizó el marcaje tradicional; si las mamas son pequeñas se colocan implantes en el plano submuscular, y si son grandes, en retroglandular. Para evitar recidivas se colocaron dos tirantes internos con suturas irreabsorbibles. Si el complejo resultante glándula-implante es grande y pesado, se fija un tirante de mama al periostio hemiclavicular y otro al periostio de la tercera costilla; si es pequeño o mediano, únicamente se fija a la costilla. Realizamos controles entre 1 mes y 3 años tras la intervención. Conseguimos corregir ptosis de entre 5 a 12cm., sin recidiva en ninguno de los controles, ni pseudo-ptosis postoperatoria. El ejercicio físico fue posible a los 15 días de la cirugía con el apoyo de un sujetador elástico. La cicatrización fue altamente satisfactoria. Las únicas complicaciones presentadas fueron dehiscencias parciales en 2 pacientes y sensación de ardor, tirantez y elongación de la areola en pacientes cuya ptosis excedía los 12cm y con areolas grandes. La facilidad de ejecución de la técnica y su seguridad, permiten que la cirugía sea ambulatoria. Proponemos esta técnica, que denominamos de quinta generación, que evita la cicatriz periareolar, la inframamaria, la vertical y la "T" invertida; además, elimina parte de ambos cuadrantes superiores de la mama, lo que disminuye notablemente la posibilidad de desarrollar ulteriores casos de carcinoma mamario y evita recidivas con el uso del tirante clavicular.We present a new mastopexy technique, simpler, which precludes the recidivism and reduces the risk of breast cancer. The study was based on 25 female patients between 25 to 50 years old with breast ptosis. With the patients standing up, was realized the

  16. Design and preliminary analysis of a vaginal inserter for speculum-free cervical cancer screening.

    Science.gov (United States)

    Asiedu, Mercy Nyamewaa; Agudogo, Júlia; Krieger, Marlee S; Miros, Robert; Proeschold-Bell, Rae Jean; Schmitt, John W; Ramanujam, Nimmi

    2017-01-01

    Cervical cancer screening usually requires use of a speculum to provide a clear view of the cervix. The speculum is one potential barrier to screening due to fear of pain, discomfort and embarrassment. The aim of this paper is to present and demonstrate the feasibility of a tampon-sized inserter and the POCkeT Colposcope, a miniature pen sized-colposcope, for comfortable, speculum-free and potentially self-colposcopy. We explored different designs using 3D computer-aided design (CAD) software and performed mechanical testing simulations on each. Designs were rapid prototyped and tested using a custom vaginal phantom across a range of vaginal pressures and uterine tilts to select an optimal design. Two final designs were tested with fifteen volunteers to assess cervix visualization, comfort and usability compared to the speculum and the optimal design, the curved-tip inserter, was selected for testing in volunteers. We present a vaginal inserter as an alternative to the standard speculum for use with the POCkeT Colposcope. The device has a slim tubular body with a funnel-like curved tip measuring approximately 2.5 cm in diameter. The inserter has a channel through which a 2 megapixel (MP) mini camera with LED illumination fits to enable image capture. Mechanical finite element testing simulations with an applied pressure of 15 cm H2O indicated a high factor of safety (90.9) for the inserter. Testing of the device with a custom vaginal phantom, across a range of supine vaginal pressures and uterine tilts (retroverted, anteverted and sideverted), demonstrated image capture with a visual area comparable to the speculum for a normal/axial positioned uteri and significantly better than the speculum for anteverted and sideverted uteri (pcancer screening and also enables acetic acid/Lugol's iodine application and insertion of swabs for Pap smear sample collection. This study demonstrates the feasibility of an inserter and miniature-imaging device for comfortable cervical

  17. Unilateral Blepharoptosis From Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Federico Greco

    2016-12-01

    Full Text Available Blepharoptosis is the drooping or inferior displacement of the upper eyelid. Blepharoptosis can be either congenital or acquired. Tumour metastasis is one of the acquired causes of blepharoptosis. The lungs, locoregional lymph nodes, bone and liver are the usual sites of metastases of renal cell carcinoma (RCC; however, unusual locations of RCC have also been reported. Herein, we describe a case of a 47-year-old man with unilateral ptosis and blurred vision due to metastatic RCC. We describe the different causes of blepharopstosis, the path that led to the diagnosis, and how RCC can metastasize to unusual anatomical regions such as the orbit. Symptoms such as exophthalmos, lid edema, diplopia, ptosis, cranial nerve paralysis or blurred vision may mime a benign disease; however, they could also be the symptoms of a systemic malignancy.

  18. Superior orbital fissure syndrome in herpes zoster ophthalmicus.

    LENUS (Irish Health Repository)

    Kirwan, R P

    2012-02-01

    AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report. RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was no relative afferent pupillary defect. He had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and prednisolone led to recovery of visual acuity and ocular motility in addition to resolution of his proptosis and ptosis. CONCLUSION: SOFS is a rare complication of herpes zoster infection. With the appropriate treatment and follow-up, patients may be reassured that recovery of their visual acuity and ocular motility will occur.

  19. Erbium:YAG laser as a method of deepithelization in corrective and reductive breast surgery.

    Science.gov (United States)

    Trelles, Mario A; Pardo, Lourdes; Chamorro, Juan José; Bonanad, Enrique; Allones, Inés; Buil, Carmen; Luna, Ricardo

    2005-08-01

    Deepithelization of the breast in breast ptosis surgery is important, being associated with risks which could affect the clinical outcome. The role of Er:YAG laser deepithelization was investigated. A total of 12 bilateral mammoplasties were performed, randomly assigned to 2 groups, one of experienced and one of less-experienced surgeons. Results were compared between the 2 groups of surgeons for scalpel deepithelization on one breast and the Er:YAG laser on the contralateral breast. No complications; less edema, pain, and erythema; and quicker wound healing were observed in the laser-deepithelized breasts, with a shorter operation time even for the less-experienced surgeons. The authors do not suggest that the Er:YAG laser should replace the scalpel in the hands of the expert surgeon for breast deepithelization in breast ptosis surgery, but the results of the study suggest that Er:YAG laser ablation is a safe, precise, effective and complication-free method.

  20. Unusual case of persistent Horner′s syndrome following epidural anaesthesia and caesarean section

    Directory of Open Access Journals (Sweden)

    Shubhra Goel

    2011-01-01

    Full Text Available This is a rare case of persistent Horner′s syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI/magnetic resonance angiography (MRA of head, neck, and chest were unremarkable. Medline search using terms Horner′s, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner′s syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner′s syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner′s syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.

  1. A neonate with Joubert syndrome presenting with symptoms of Horner syndrome.

    Science.gov (United States)

    Lee, Narae; Nam, Sang-Ook; Kim, Young Mi; Lee, Yun-Jin

    2016-11-01

    Joubert syndrome (JS) is characterized by the "molar tooth sign" (MTS) with cerebellar vermis agenesis, episodic hyperpnea, abnormal eye movements, and hypotonia. Ocular and oculomotor abnormalities have been observed; however, Horner syndrome (HS) has not been documented in children with JS. We present the case of a 2-month-old boy having ocular abnormalities with bilateral nystagmus, left-dominant bilateral ptosis, and unilateral miosis and enophthalmos of the left eye, which were compatible with HS. Brain magnetic resonance imaging (MRI) revealed the presence of the MTS. Neck MRI showed no definite lesion or mass around the cervical sympathetic chain. His global development was delayed. He underwent ophthalmologic surgery, and showed some improvement in his ptosis. To the best of our knowledge, the association of HS with JS has not yet been described. We suggest that early neuroimaging should be considered for neonates or young infants with diverse eye abnormalities to evaluate the underlying etiology.

  2. Prosthetic rehabilitation of an ocular defect with post-enucleation socket syndrome: A case report.

    Science.gov (United States)

    Amornvit, Pokpong; Rokaya, Dinesh; Shrestha, Binit; Srithavaj, Theerathavaj

    2014-01-01

    Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results.

  3. Prosthetic

    Directory of Open Access Journals (Sweden)

    Pokpong Amornvit

    2014-01-01

    Full Text Available Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results.

  4. A Case of Oculomotor Nerve Palsy and Choroidal Tuberculous Granuloma Associated with Tuberculous Meningoencephalitis

    Science.gov (United States)

    Moon, Sunghyuk; Chang, Woohyok

    2008-01-01

    We report a rare case of oculomotor nerve palsy and choroidal tuberculous granuloma associated with tuberculous meningoencephalitis. A 15-year-old male visited our hospital for an acute drop of the left eyelid and diplopia. He has been on anti-tuberculous drugs (isoniazid, rifampin) for 1 year for his tuberculous encephalitis. A neurological examination revealed a conscious clear patient with isolated left oculomotor nerve palsy, which manifested as ptosis, and a fundus examination revealed choroidal tuberculoma. Other anti-tuberculous drugs (pyrazinamide, ethambutol) and a steroid (dexamethasone) were added. After 3 months on this medication, ptosis of the left upper eyelid improved and the choroidal tuberculoma decreasedin size, but a right homonymous visual field defect remained. When a patient with tuberculous meningitis presents with abrupt onset oculomotor nerve palsy, rapid re-diagnosis should be undertaken and proper treatment initiated, because the prognosis is critically dependent on the timing of adequate treatment. PMID:18784452

  5. Reversible bilateral blepharoptosis following oxaliplatin infusion: a case report and literature review.

    Science.gov (United States)

    Fanetti, Giuseppe; Ferrari, Laura A M; Pietrantonio, Filippo; Buzzoni, Roberto

    2013-01-01

    Oxaliplatin, a platinum analogue employed in the treatment of colorectal cancer and various other neoplasms, is characterized by a broad range of adverse events. Peripheral neuropathy is probably the most peculiar and clinically relevant toxicity associated with its use and can be distinguished into two types: acute and chronic neurotoxicity.We report a case of acute reversible bilateral palpebral ptosis and dyspnea without bronchospasm or laryngospasm which occurred at the end of the third administration of adjuvant oxaliplatin by infusion for stage III colon cancer in a 54-year-old woman. Chlorphenamine and hydrocortisone were administered with fast resolution of dyspnea and slight improvement of ptosis. Complete resolution with no sequelae occurred in one hour. No further recurrence of blepharoptosis was described during the following days. The subsequent cycles were prescribed at reduced dosage without acute complications.

  6. Modified Frontalis Sling Procedure with Lid Crease Formation

    Directory of Open Access Journals (Sweden)

    Maryam Aletaha

    2013-01-01

    Full Text Available Purpose: To report the results of a modified frontalis sling procedure using Mersilene mesh for correction of upper lid ptosis associated with poor levator muscle function. Methods: This interventional case series included 10 patients (15 eyelids with congenital ptosis and poor levator function. All subjects underwent the upper lid sling procedure with modifications. Main outcomes were lid crease height and position. Results: Overall, 15 eyelids from ten patients including 7 male and 3 female subjects underwent surgery. After a mean period of 10.2±2.8 months, all cases had symmetrical lid crease and contour; upper lid margin to corneal reflex distance and lid fissure were both increased significantly. Conclusion: This modified frontalis sling procedure may be considered as an alternative to conventional surgery; this method provides good cosmesis and is associated with a low rate of reoperations.

  7. Tolosa-Hunt syndrome: a rare case report with uncommon imaging findings and discussion

    Directory of Open Access Journals (Sweden)

    Rajeev Ranjan

    2014-08-01

    Full Text Available A 45 year old diabetic but non hypertensive female presented with unilateral ptosis and complete external ophthalmoplegia on the left side. All the routine investigations were inconclusive. A signal void change was found in MRI study including angiogram of brain. On performing VEP (visually evoked potential, there was mild left optic pathway dysfunction (axonal and demyelinating. A probable diagnosis of Tolosa-Hunt Syndrome (THS was made and the patient was started on steroids. She responded dramatically to the therapy and was discharged on steroids. Thus the diagnosis of THS was confirmed. On follow up after one month, both her ptosis and ophthalmoplegia had resolved completely. On subsequent follow up visits, she was free of any ophthalmological symptoms and signs. [Int J Res Med Sci 2014; 2(4.000: 1795-1798

  8. Unusual case of persistent Horner's syndrome following epidural anaesthesia and caesarean section.

    Science.gov (United States)

    Goel, Shubhra; Burkat, Cat Nguyen

    2011-01-01

    This is a rare case of persistent Horner's syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) of head, neck, and chest were unremarkable. Medline search using terms Horner's, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner's syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner's syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner's syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.

  9. Horner's syndrome in large animals.

    Science.gov (United States)

    Smith, J S; Mayhew, I G

    1977-10-01

    The sympathetic nervous innervation of the head was surgically transected in the horse, cow, sheep and goat. The site of transection was preganglionic in all 4 species and ganglionic-postganglionic in 2 additional horses. The Horner's syndrome, manifested as a result of the iatrogenic lesion, varied with the species. Ptosis was the most constant sign in all species. Unilateral sweating over the face and proximal neck, particularly at the base of the ear, was the most prominent feature in the horse. The cow revealed distension of vasculature and cutaneous heat of the pinna, and a reduced production of beads of sweat over the nostril on the affected side. The goat and sheep exhibited little more than slight ptosis of the upper eyelid of the affected side as the most prominent sign. The ophthalmologic manifestations of Horner's syndrome seen in these large animals were not readily apparent and could easily be overlooked upon clinical examination.

  10. Patients with ocular symptoms referred for electrodiagnosis: how many of them suffer from myasthenia gravis?

    Science.gov (United States)

    Zambelis, Th; Pappas, V; Kokotis, P; Zouvelou, V; Karandreas, N

    2015-12-01

    The aim of this study was the diagnosis of patients with isolated ocular manifestations (ptosis and/or diplopia) referred for electrophysiological evaluation to the electrodiagnostic laboratory of a University Neurological Department. Examination was performed either in inpatient status or in outpatient basis. We analyzed the clinical, electrophysiological and other laboratory data in 79 subjects. Myasthenia gravis (MG) was diagnosed in 38 %, 45.6 % in other diseases (Graves disease, blepharospasm, IIId cranial verve palsy, multiple sclerosis, stroke, etc.), while in 16.5 %, the cause remained unidentified. Symptoms fluctuation was significantly more frequent in the myasthenic patients, compared to patients with other diseases. The presence of both diplopia and ptosis are more likely due to MG rather than other pathology.

  11. Colonización nasal y vaginal por Staphylococcus aureus resistente a meticilina en mujeres embarazadas en Cartagena, Colombia

    Directory of Open Access Journals (Sweden)

    Oscar Correa

    2012-02-01

    Full Text Available Introduction: The host niche for Staphylococcus aureus (SA are the anterior nares; however, vaginal colonization rates between 14% and 17.1% in pregnant women have been recently reported, raising interest about the potential risk in postpartum women and in neonates from colonized mothers.Objectives: To determine the prevalence of nasal and vaginal colonization of SA and the antibiotic susceptibility of the isolates in pregnant women attending a maternity hospital in Cartagena, Colombia.Methods: Nasal and vaginal swabs were obtained from participants and subjected to microbiological and molecular assays. A post discharge follow-up was performed for up to four weeks.Results: From 100 pregnant women enrolled in the study, 34 were colonized with SA; 29 only in the nares, three only in the vagina, and two at both sites. Colonization of pregnant women with SA was more common in the nares than in the vagina or at both sites [29/34 (85.3% vs 3/34 (8.8% and 2/34 (5.9%; p<0.05]. We obtained 36 SA isolates, nine (25% of which were methicillin-resistant Staphylococcus aureus (MRSA, one was from the vagina; thus, the overall MRSA colonization rate among pregnant women was 9%. Molecular analysis showed that Panton-Valentine leukocidin (PVL genes were carried by the vaginal MRSA, seven of the nasal MRSA, and two of the Methicillinsensitive Staphylococcus aureus (MSSA isolates. Two MRSA isolates carried SCCmec type I and seven carried SCCmec type IV.Conclusions: Nasal colonization rate for SA in the study population was similar to previous reports. However, the frequency of nasal colonization of MRSA was higher while vaginal colonization of SA was lower than previouslyreported in other studies for similar populations. The MRSA isolates obtained showed a community profile.

  12. Survey of Staphylococcus isolates among hospital personnel, environment and their antibiogram with special emphasis on methicillin resistance

    Directory of Open Access Journals (Sweden)

    Shobha K

    2005-01-01

    Full Text Available The objective of this study was to find the prevalence of Staphylococcus spp. carriage among hospital personnel and hospital environment and their antibiogram with special emphasis on methicillin resistance. A total of 205 samples from hospital personnel and environment were collected from casualty, oncology and multidisciplinary cardiac unit ward of Kasturba Medical College Hospital, Manipal. Samples were collected using sterile cotton wool swabs and inoculated into brain heart infusion broth. Subcultures were done onto blood agar and MacConkey′s agar. Isolates were identified by standard methods up to species level. Antimicrobial susceptibility test was performed according to standardized disc diffusion Kirby-Bauer method. Each of the isolates was screened for methicillin resistance using oxacillin disc on Mueller Hinton agar plate followed by MIC for methicillin and cefoxitin susceptibility test by disc diffusion method. Sixty five out of 205 strains (31.7% were Staphylococcus spp. and all of them were coagulase negative. Most of the strains belonged to S.epidermidis 49.23%(32/65 followed by S. saprophyticus 26.15%(17/65. Maximum isolates of S.epidermidis were from anterior nares 28.12%(9/32 strains of S.epidermidis . Highest number of methicillin resistant coagulase negative strains (3/9, 33.33% were isolated from stethoscope of multidisciplinary cardiac unit ward followed by carriers in the anterior nares (2/9, 22.22%. Methicillin resistant coagulase negative staphylococci are prevalent in anterior nares of hospital personnel and in the hospital environment thereby providing a definite source for hospital acquired infection. All isolates were sensitive to vancomycin, ciprofloxacin and amikacin.

  13. Non-Hodgkin`s lymphoma of the sino-nasal region penetrating to the orbit and cranial cavity; Chloniak nieziarniczy zatok przynosowych wnikajacy do oczodolu i jamy czaszki

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, E.; Piotrowski, S.; Grono, L.; Zalewska-Rzezniczak, I. [Szpital Morski im. PCK, Gdynia-Redlowo (Poland)]|[Szpital Miejski im. J. Brudzinskiego, Gdynia (Poland)

    1994-12-31

    In case presented in this report non-Hodgkin`s lymphoma occupied the ethmoid and sphenoid sinuses with penetrating to the orbit and middle cranial fossa. The patient suffered from ophthalmic symptoms like ptosis, exophthalmus and diplopia. Chemotherapy in COP - pattern and MV radiotherapy in total dose 4600 cGy were applied. Full remission was achieved. The patient is alive after more than 2 years without recurrence of the disease. (author). 15 refs, 1 fig.

  14. Pituitary apoplexy presenting as myocardial infarction

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2014-01-01

    Full Text Available We describe a male patient who presented with sudden onset severe headache and right sided ptosis that was diagnosed to be secondary to pituitary apoplexy on the background of diabetes mellitus. This was complicated by left ventricular failure and acute coronary syndrome. The case highlights the importance of considering hypocortisolism/hypopituitarism as an important and rare precipitant of an acute coronary event as occurred in the case.

  15. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation

    OpenAIRE

    Min Ji Kang; Hye Bin Yim; Hyung Bin Hwang

    2016-01-01

    We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure wa...

  16. Progressive muscle weakness with respiratory insufficiency in a young patient with tetanus during magnesium sulfate infusion.

    Science.gov (United States)

    Mathew, Preethy Joseph; Muthurajan, Narayanan; Wig, Jyotsna

    2010-09-01

    Magnesium sulfate administered as an intravenous infusion is considered safe. However, there have been concerns about the neuromuscular blocking properties of magnesium that can cause respiratory insufficiency. We report a patient with mild tetanus who, after being started on magnesium infusion, developed progressive respiratory insufficiency, proximal muscle weakness and ptosis. On discontinuation of magnesium infusion, the muscular weakness improved and respiration became normal. The safety of magnesium sulfate infusion for the management of tetanus needs to be re-evaluated.

  17. Miopatia mitocondrial relato de 12 casos com estudo histoquímico do músculo esquelético

    OpenAIRE

    B. H. Kiyomoto; Gabbai,A. A.; Oliveira,A. S. B.; Schmidt, B.; Lima, J. G. C. [UNIFESP

    1991-01-01

    Twelve patients with histologically defined mitochondrial myopathy are described. There were 9 males and 3 females. The age of onset ranged from birth to 35 years with a median of 14 years. The most common clinical picture was that of ophthalmoplegia, ptosis and muscle weakness found in 10 patients. One presented with exercise intolerance due to muscular aches and pains, and the other besides his muscular weakness had mental retardation and an aggressive behavior. The clinical presentation an...

  18. A case with a rare type of trigemino-oculomotor synkinesis: clinical and blink reflex study.

    Science.gov (United States)

    Balaban, H; Yildiz, O K; Eliaçik, S; Bolayir, E; Topaktaş, S

    2010-12-01

    Several abnormal synkinetic eye movements during jaw movements may often be seen after trauma or congenitally in the Marcus Gunn jaw winking phenomenon. The most frequent type consists of unilateral ptosis and retraction of the ptotic lid upon moving the jaw. The authors describe a case with isolated simultaneous adduction of the left eye upon jaw movement. This paper presents a rare case of Marcus Gunn jaw winking with trigemino-oculomotor synkinesis.

  19. Mitochondrial depletion causes neonatal-onset leigh syndrome, myopathy, and renal tubulopathy.

    Science.gov (United States)

    Lee, Inn-Chi; Lee, Ni-Chung; Lu, Jang-Jih; Su, Pen-Hua

    2013-03-01

    The authors describe a newborn with postnatal myopathy who subsequently developed feeding difficulties, ophthalmoplegia, ptosis, encephalopathy, and seizures. She became ventilator dependent after sudden apnea. The myopathy was without ragged red fibers in the muscle biopsy. An electron transport chain study showed a markedly generalized low level of enzyme activity, particularly in complexes I, I + III, and IV. An initial electroencephalogram finding was normal; subsequent electroencephalograms showed suppression bursts. The mitochondrial copy number in skeletal muscle was 2% of normal.

  20. Early onset and severe clinical course associated with the m.5540G>A mutation in MT-TW

    Directory of Open Access Journals (Sweden)

    Jorge L. Granadillo

    2014-01-01

    Full Text Available We report a patient harboring a de novo m.5540G>A mutation affecting the MT-TW gene coding for the mitochondrial tryptophan-transfer RNA. This patient presented with atonic–myoclonic epilepsy, bilateral sensorineural hearing loss, ataxia, motor regression, ptosis, and pigmentary retinopathy. Our proband had an earlier onset and more severe phenotype than the first reported patient harboring the same mutation. We discuss her clinical presentation and compare it with the only previously published case.

  1. Apoplejía en metástasis hipofisiaria de carcinoma de células renales: Caso clínico con siete años de seguimiento

    OpenAIRE

    Quevedo L,Iván; Rodríguez Portale,José A; Rosenberg G,Helmar; Mery S,Jorge

    2000-01-01

    We report a man in whom a 15 cm. renal tumor was excised at the age of 49. The pathological examination showed a clear cell carcinoma. Five years later, he presented with headache, vomiting and unilateral palpebral ptosis. Imaging studies showed a sellar tumor with pituitary apoplexy. The tumor was excised and the pathological study disclosed a clear cell tumor, positive for vimentin, cytokeratins AE1 and AE3 and immunohistochemically negative for LH, TSH, ACTH and GH. Considering the similar...

  2. Aplicaciones del Gore-tex en Oftalmología

    Directory of Open Access Journals (Sweden)

    María Cáceres Toledo

    Full Text Available Objetivo: evaluar los resultados terapéuticos en la corrección quirúrgica de afecciones oculares, con el uso del Gore-tex y con la modificación realizada a la técnica quirúrgica convencional de la suspensión al frontal. Métodos: se realizó un estudio descriptivo prospectivo en una serie de 16 casos: 7 con ptosis, 5 con estrabismo y 4 con retracción palpebral inferior. Para la corrección de la retracción y la ptosis se utilizaron fragmentos del referido material y una sutura de Gore-tex en la corrección del estrabismo y en algunos casos con ptosis. Se colocaron 2 mm de Gore-tex por cada milímetro de retracción y de ptosis palpebral. Se corrigieron 2 dioptrías prismáticas por cada milímetro de retroinserción del músculo afectado. Resultados: fueron satisfactorios en un total de 13 casos (87 %. La mayoría de los pacientes operados con la modificación realizada a la técnica de la suspensión al frontal disminuyeron los mm de caída hasta el nivel fisiológico palpebral. Conclusiones: los resultados son satisfactorios en la mayoría de los casos operados con el uso del Gore-tex y con la técnica de suspensión al frontal modificada.

  3. Det komplekse kliniske billede ved arvelige mitokondriesygdomme

    DEFF Research Database (Denmark)

    Frederiksen, Anja Lisbeth; Nielsen, Morten Frost; Yderstræde, Knud

    2014-01-01

    Mitochondria produce cellular energy, which is of vital importance for cellular metabolism. The organelles contain their own genetic material (i.e. mitochondrial DNA (mtDNA)) with a matrilineal inheritance. Mutations in the mtDNA may cause mitochondrial disease affecting multiple organs leading...... to diabetes, hearing impairment, muscle fatigue, ptosis and stroke-like episodes in varying combinations and severity. The variable phenotypic presentations make it a challenge to recognize mitochondrial diseases and, consequently, the correct diagnosis is often delayed....

  4. Üç Yaşında Kız Hastada Bilateral Pitosiz İle İlişkili Çocukluk Çağı Alternan Hemiplejisi

    OpenAIRE

    KABAKUŞ, Nimet; Kurt, Abdullah; KURT, Ayşegül Neşe ÇITAK

    2006-01-01

    Alternating hemiplegia of childhood=Alternating hemiplegia of childhood is a rare and poorly understood clinical syndrome that has hemiplegia as the major feature. The syndrome has been linked to migraine, epilepsy and familial paroxysmal choreoathetosis. Cranial nerve dysfunctions are very rare in Alternating hemiplegia of childhood. We present a child with Alternating hemiplegia of childhood who had two attacks associated with ptosis . Flunarizine therapy was started to prevent a new attack...

  5. Imaging of Horner's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    George, A.; Haydar, A.A. [Derriford Hospital Plymouth, Derriford, Plymouth (United Kingdom); Adams, W.M. [Derriford Hospital Plymouth, Derriford, Plymouth (United Kingdom)], E-mail: william.adams@phnt.swest.nhs.uk

    2008-05-15

    Horner's syndrome, or oculosympathetic paresis, results from interruption of the sympathetic trunk innervation to the eye and presents typically with meiosis, ptosis and facial anhydrosis on the affected side.{sup 1} The pathological process ranges from benign, such as cluster headache, or life threatening, such as lung malignancy. Appropriate imaging requires an anatomical appreciation of the complex and circuitous route the neuronal pathway takes as it passes from the central nervous system to the eye.

  6. Topical timolol maleate 0.5% solution for the management of deep periocular infantile hemangiomas.

    Science.gov (United States)

    Painter, Sally L; Hildebrand, Göran Darius

    2016-04-01

    This retrospective, consecutive, clinical case series examined the use of topical timolol in the treatment of 5 children with deep, periocular infantile hemangiomas that caused astigmatism, change in head posture, or ptosis. All patients were treated with timolol maleate solution 0.5% twice daily until the lesions had regressed. All 5 children showed regression of the lesion and improvement in amblyogenic risk factors within 2 weeks.

  7. [Ophthalmological manifestations of Cornelia de Lange syndrome: Case report and review of the literature].

    Science.gov (United States)

    Avgitidou, G; Cursiefen, C; Heindl, L M

    2015-05-01

    A 2-year-old boy suffering from Cornelia de Lange syndrome, presented with mucopurulent ocular discharge and epiphora since birth. Irrigation and probing of the nasolacrimal system revealed and successfully treated bilateral nasolacrimal duct obstructions. Cornelia de Lange syndrome is characterized not only by typical facial features, visceral and urogenital anomalies but also by ophthalmological manifestations in 99% of cases. The most common ophthalmological disorders are synophrys, blepharitis, epiphora, hypertrichosis of the eyebrows and eyelashes, myopia, ptosis and nasolacrimal duct obstruction.

  8. Transient unilateral brachial plexopathy and partial Horner′s syndrome following spinal anesthesia for cesarean section

    Directory of Open Access Journals (Sweden)

    Jonathan A Anson

    2014-01-01

    Full Text Available A healthy 21-year-old primigravida presented for elective cesarean section. At 45 min after intrathecal (IT injection of bupivacaine, morphine and fentanyl she developed dysphagia, right sided facial droop, ptosis and ulnar nerve weakness. This constellation of signs and symptoms resolved 2 h later. Based on the time course and laterality of her symptoms, as well as the pharmacologic properties of spinal opioids, we believe her symptoms can be attributed to the IT administration of fentanyl.

  9. Incomplete Horner syndrome: Report of a case and description of the sympathetic nervous system anatomy involved in Horner syndrome.

    Science.gov (United States)

    Garbo, Grant M; Harmatz, Alexander J; Isaacson, Glenn

    2011-02-01

    Horner syndrome, in which ptosis, miosis, and anhidrosis occur concomitantly, can arise from injury to the sympathetic nerve pathways anywhere from the brain to the end organs. Incomplete Horner syndrome lacks the sign of anhidrosis. We present a case of incomplete Horner syndrome caused by internal carotid artery dissection and provide a road map of the cervical sympathetic nerves involved in Horner syndrome to explain its etiology. We also discuss the imaging of and therapy for internal carotid artery dissections.

  10. Surgical treatment of grade III gynaecomastia.

    OpenAIRE

    Ward, C M; Khalid, K.

    1989-01-01

    Gross enlargement of the male breast with skin redundancy and ptosis cannot be effectively managed by subcutaneous mastectomy alone. A technique is described in which the excess breast tissue and skin are excised along a design which allows the nipple-areolar complex, mounted on a vertical deepithelialised pedicle, to lie in a natural position. A horizontal scar is an unavoidable exchange for this particular operation.

  11. Congenital Horner Syndrome with Heterochromia Iridis Associated with Ipsilateral Internal Carotid Artery Hypoplasia

    OpenAIRE

    Deprez, Fabrice; Coulier, Julie; Rommel, Denis; Boschi, Antonella

    2014-01-01

    Background: Horner syndrome (HS), also known as Claude-Bernard-Horner syndrome or oculosympathetic palsy, comprises ipsilateral ptosis, miosis, and facial anhidrosis. Case Report: We report herein the case of a 67-year-old man who presented with congenital HS associated with ipsilateral hypoplasia of the internal carotid artery (ICA), as revealed by heterochromia iridis and confirmed by computed tomography (CT). Conclusions: CT evaluation of the skull base is essential to establish this diagn...

  12. Primary central nervous system lymphoma in an immunocompetent patient

    OpenAIRE

    Málaga-Zenteno, José; Médico Asistente, Servicio de Hematología, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud, Arequipa, Perú.; Mamani-Quispe, Jersson Alonso; Estudiante de Medicina Humana, Centro de Investigación y Estudios Médicos (CIEM), Universidad Católica Santa María, Arequipa, Perú. Sociedad Científica Médico Estudiantil Peruana (SOCIMEP).; Fuentes Fuentes, Mariela; Médico Asistente, Servicio de Hematología, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud, Arequipa, Perú.; Suclla-Velásquez, José Alonso; Estudiante de Medicina Humana, Centro de Investigación y Estudios Médicos (CIEM), Universidad Católica Santa María, Arequipa, Perú. Sociedad Científica Médico Estudiantil Peruana (SOCIMEP).; Meza Aragón, Julio; Médico Asistente, Servicio de Neurocirugía, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud, Arequipa, Perú.

    2012-01-01

    Primary central nervous system lymphoma (PCNSL) constitutes 2% of extranodal lymphomas and 0,3%-1,5% of all intracranial neoplasms in immunocompetent patients, being more frequent after the sixth decade of life. We report a case of a 76 year-old man with no antecedents who started his disease with march instability, difficulty to move left side of his body with brachial predominance, holocraneal headache and dizziness. He arrived at emergency with Glasgow 14 and right eyelid ptosis. He had le...

  13. Anesthesic Management for Escobar Syndrome: Case Report

    Directory of Open Access Journals (Sweden)

    Ayse Hande Arpaci

    2011-01-01

    Full Text Available Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration.

  14. Sleeping Beauty Gets an Eye Exam: A Case Report and Literature Review on Narcolepsy

    OpenAIRE

    Jenna Liechty, OD

    2014-01-01

    Background: Narcolepsy, a neurological sleep disorder that affects both adults and children, is caused by the inability of the brain to regulate sleep-wake cycles normally. The common tetrad of symptoms includes excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. Ocular symptoms such as blurred vision, diplopia, ptosis, and ocular pain have been reported. Case Report: A ten-year-old female who was diagnosed with narcolepsy at an early age prese...

  15. Isolated unilateral oculomotor nerve neuropraxia following a trivial fall in a patient with calcified posterior petroclinoid ligament

    Science.gov (United States)

    Patwardhan, Maneesha Anil

    2015-01-01

    Isolated traumatic oculomotor nerve palsy caused by a trivial fall is extremely rare. We report a case of this condition. A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall. She did not show any clinical or radiological signs of head injury. Computerized tomography revealed a calcified posterior petroclinoid ligament which has direct anatomical and pathological relation with the oculomotor nerve. PMID:25767590

  16. RESPIRATORY REHABILITATION IN ACUTE CARE OF PATIENTS WITH NEUROPARALYTIC SNAKE ENVENOMATION: CASE SERIES

    OpenAIRE

    2016-01-01

    Background: Snakebite is an environmental hazard associated with significant morbidity and mortality. Neurotoxic envenomations have the potency to cause a broad spectrum of presentations starting from ptosis and ophthalmoplegia to respiratory arrest. These patients require ventilatory assistance in addition to administration of anti-snake venom (ASV) and other supportive measures. Mechanically ventilated patients are at risk for retained secretions due to endotracheal intubation disrupting mu...

  17. Saethre-Chotzen syndrome : cranofacial anomalies caused by genetic changes in the TWIST gene

    OpenAIRE

    2004-01-01

    textabstractIn this thesis, one of the most frequently occurring and most variable craniosynostosis syndromes was investigated; Saethre-Chotzen syndrome. Craniosynostosis is the premature obliteration of cranial sutures in the developing embryo. It can also occur in the first few months of life. Saethre-Chotzen syndrome is, besides craniosynostosis, characterized by specific facial and limb abnormalities, of which the most frequently reported are ptosis, prominent crus helicis, cutaneous synd...

  18. Homozygotes for oculopharyngeal muscular dystrophy have a severe form of the disease.

    Science.gov (United States)

    Blumen, S C; Brais, B; Korczyn, A D; Medinsky, S; Chapman, J; Asherov, A; Nisipeanu, P; Codère, F; Bouchard, J P; Fardeau, M; Tomé, F M; Rouleau, G A

    1999-07-01

    Autosomal dominant oculopharyngeal muscular dystrophy (OPMD) usually begins with ptosis or dysphagia during the fifth or sixth decade of life. We studied 7 patients with OPMD symptoms starting before the age of 36 years. All were found to be homozygotes for the dominant (GCG)9 OPMD mutation. On average, disease onset was 18 years earlier than in heterozygotes, and patients had a significantly larger number of muscle nuclei containing intranuclear inclusions (INIs) (9.4 vs 4.9%).

  19. Ectopic prolactinoma in the clivus: a case report.

    Science.gov (United States)

    Narese, D; Virzì, V; Virzì, G; Narese, F; Sciortino, A; Culmone, G; Virzì, F; Maira, G

    2015-01-01

    We report the case of an ectopic pituitary adenoma in a 65-year-old man with an empty sella who initially presented with right ptosis and eyelid edema and headache. Neuroimaging studies revealed a large tumoral process at the height of the clivus, with partial destruction of surrounding bone structure. He underwent transphenoidal surgery and histopathologic examination, including immunohistochemical studies, revealed a prolactin-producing pituitary adenoma. A careful review of the literature was done.

  20. Ocular complication of malar fracture and its handling. Case report

    OpenAIRE

    2004-01-01

    Antecedents: The superior orbital fissure syndrome (SOFS) is a rare complication in patient with maxillofacial fractures, that consists of a direct compression or hematoma of the structures related to the SOFS. The characteristic clinics are: gross and persistent edema of the periorbital tissues; proptosis and subconjuntival echyimosis; ptosis and ophtalmoplegia; dilatation of the pupil; direct light, reflex absent, inderect reflex (consensual) present; loss of the accommodation reflex; loss ...

  1. Intracranial meningeal melanocytoma associated with nevus of Ota.

    Science.gov (United States)

    Pan, Hao; Wang, Handong; Fan, Youwu

    2011-11-01

    We report a rare intracranial meningeal melanocytoma associated with the nevus of Ota. The patient was 36-year-old man with a 2-week history of headache and difficulty in opening his right eye. Physical examination showed a black nevus scattered on the right-hand side of the face, right eyelid ptosis and papilledema. CT scans and MRI showed a tumor in the region of the right cavernous sinus. The tumor was subtotally resected. Histological examination confirmed the diagnosis of melanocytoma.

  2. Lymphoid proliferations in the orbit: malignant or benign?

    OpenAIRE

    van der Gaag, R.; Koornneef, L.; Heerde, P. van; Vroom, T M; Pegels, J H; Feltkamp, C.A.; Peeters, H J; Gillissen, J P; Bleeker, G M; Feltkamp, T E

    1984-01-01

    Clinical, pathological, and immunological analysis of 20 patients with ocular adnexal lymphoid disease has demonstrated several parameters which are useful for distinguishing malignant from benign lesions. Patients in the fourth or fifth decade of life presenting with an acute history of pain, oedema, epiphora, double vision, and ptosis, with a mass localised in the lacrimal gland area, are more likely to have a pseudolymphoma or a chronic inflammatory lesion than a true non-Hodgkin lymphoma ...

  3. ON THE ESTIMATIONS OF BOUNDS FOR DETERMINANT OF HADAMARD PRODUCT OF H-MATRICES

    Institute of Scientific and Technical Information of China (English)

    Yao-tang Li; Ji-cheng Li

    2001-01-01

    In this paper, some estimations of bounds for determinant of Hadamard product of H-matrices are given. The main result is the following: if A = (aij) and B = (bij) are nonsingular H-matrices of order n and IIin=1 aiibii > 0, and Aκ and Bκ,k = 1,2,... ,n,are the k × k leading principal submatrices of A and B, respectively, thenwhere Ml(Aκ) denotes the comparison matrix of Aκ.Key words: H-matrix, Determinant, Hadamard product.

  4. A new Nototriton (Caudata: Plethodontidae) from Parque Nacional Montaña de Botaderos in northeastern Honduras.

    Science.gov (United States)

    Townsend, Josiah H; Medina-flores, Melissa; Reyes-Calderón, Onán; Austin, James D

    2013-01-01

    The highlands of northeastern Honduras remain under-characterized in terms of biological diversity, as exemplified by the regularity of new amphibian and reptile taxa discoveries. Following the recent description of a new species of Nototriton from the Sierra de Agalta in northeastern Honduras, we report the discovery of a second new species of Nototriton from the nearby Parque Nacional Montaña de Botaderos. This new taxon, Nototriton mime sp. nov., is distinguished from other Nototriton by its distinctive pale brown dorsal coloration in adult males, relatively large nares, a relatively broad head, mitochondrial sequence divergence, and phylogenetic relationships, and is geographically isolated from other populations of Nototriton.

  5. Confirmation of Anopheles (Anopheles) calderoni Wilkerson, 1991 (Diptera: Culicidae) in Colombia and Ecuador Through Molecular and Morphological Correlation with Topotypic Material

    Science.gov (United States)

    2010-12-01

    nominal species from synonymy with the former. According to Wilkerson (1990, 1991), An. punctimacula is reported from Mexico to northern Colombia and...Illustrated key to the female anopheline mosquitoes of Central America and Mexico . J Am Mosq Control Assoc 6: 7-34. 1Supplementary data An. calderoni...Gómez Plata El Brasil 244 10 May1984 SEM Puerto Nare El Pescado 270 4 Oct 1983 SEM Santafe de Antioquia Paso Real 666 17 Mar 1984 SEM Bolívar Achí

  6. The Greenland ice sheet - a model for its culmination and decay during and after the last glacial maximum

    DEFF Research Database (Denmark)

    Funder, Svend Visby; Hansen, Louise

    1996-01-01

    LGM, only southern Greenland (south of lat. 69°-72°N) saw a major expansion of the ice sheet with thick cover over the present coastline and onto the shelf. In the north, outlet glaciers filled fjord basins, including the Nares Strait between Canada and Greenland, and piedmont glaciers descended from...... coastal mountains onto the coastline, but the glaciers did not cover the shelf. Break up probably began after c. 15 ka, and took place in two discrete steps. First, the shelf and major inlets were cleared of marine based ice. There was little thinning of the ice on land, and in the northern parts...

  7. Wire-guided (Seldinger technique intubation through a face mask in urgent, difficult and grossly distorted airways

    Directory of Open Access Journals (Sweden)

    Jake M Heier

    2012-01-01

    Full Text Available We report two cases of successful urgent intubation using a Seldinger technique for airway management through an anesthesia facemask, while maintaining ventilation in patients with difficult airways and grossly distorted airway anatomy. In both cases, conventional airway management techniques were predicted to be difficult or impossible, and a high likelihood for a surgical airway was present. This technique was chosen as it allows tracheal tube placement through the nares during spontaneous ventilation with the airway stented open and oxygen delivery with either continuous positive airway pressure and/or pressure support ventilation. This unhurried technique may allow intubation when other techniques are unsuitable, while maintaining control of the airway.

  8. Burn Resuscitation Decision Support System (BRDSS)

    Science.gov (United States)

    2013-09-01

    mole tha.B n-Uirimat fi:.k to the p;.tie-nl, were .attributahl: to r.t.e u:s : t int-:sf~: aOO £~:-qui!~ soirNare -cha~s. Enter P-1 ti e-nt WeigM...s~ Ofol. Se<~ e.ra’l t~. usE:T mant(al aOO sof rw;:re ctw-~*’" .,..~·E nwJ>:>.g~,diry to l(~ fir.di~ i rom It~ HF study. A~.d human fa

  9. Wire-guided (Seldinger technique) intubation through a face mask in urgent, difficult and grossly distorted airways.

    Science.gov (United States)

    Heier, Jake M; Schroeder, Kristopher M; Galgon, Richard E; Arndt, George A

    2012-07-01

    We report two cases of successful urgent intubation using a Seldinger technique for airway management through an anesthesia facemask, while maintaining ventilation in patients with difficult airways and grossly distorted airway anatomy. In both cases, conventional airway management techniques were predicted to be difficult or impossible, and a high likelihood for a surgical airway was present. This technique was chosen as it allows tracheal tube placement through the nares during spontaneous ventilation with the airway stented open and oxygen delivery with either continuous positive airway pressure and/or pressure support ventilation. This unhurried technique may allow intubation when other techniques are unsuitable, while maintaining control of the airway.

  10. The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Weiser, Mitchell C; Moucha, Calin S

    2015-09-01

    The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty.

  11. Long-Lasting Cranial Nerve III Palsy as a Presenting Feature of Chronic Inflammatory Demyelinating Polyneuropathy

    Directory of Open Access Journals (Sweden)

    Rossella Spataro

    2015-01-01

    Full Text Available We describe a patient with chronic inflammatory demyelinating polyneuropathy (CIDP in which an adduction deficit and ptosis in the left eye presented several years before the polyneuropathy. A 52-year-old man presented with a 14-year history of unremitting diplopia, adduction deficit, and ptosis in the left eye. At the age of 45 a mild bilateral foot drop and impaired sensation in the four limbs appeared, with these symptoms showing a progressive course. The diagnostic workup included EMG/ENG which demonstrated reduced conduction velocity with bilateral and symmetrical sensory and motor involvement. Cerebrospinal fluid studies revealed a cytoalbuminologic dissociation. A prolonged treatment with corticosteroids allowed a significant improvement of the limb weakness. Diplopia and ptosis remained unchanged. This unusual form of CIDP presented as a long-lasting isolated cranial nerve palsy. A diagnostic workup for CIDP should therefore be performed in those patients in which an isolated and unremitting cranial nerve palsy cannot be explained by common causes.

  12. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome

    Directory of Open Access Journals (Sweden)

    Cuneyt Kucur

    2015-01-01

    Full Text Available Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.

  13. Neuroblastoma in a Case with Congenital Horner’s Syndrome

    Directory of Open Access Journals (Sweden)

    Hüseyin Mayalı

    2014-08-01

    Full Text Available Miosis, ptosis, and ipsilateral facial anhidrosis are normally present in Horner’s syndrome. Pathologies which show central, preganglionic and postganglionic residence in sympathetic chain are present in its etiology. A 3-month-old girl baby was admitted to our clinic for ptosis in the left eye. Heterochromia, ptosis in the left eye, myosis and, ipsilateral anhidrosis were detected in her examination. In view of these findings, it seemed possible that her disease could be congenital Horner’s syndrome. Brachial plexus injury due to birth trauma plays a major role in the etiology of congenital Horner’s syndrome. There was not any birth trauma history in our patient. The patient was diagnosed to have neuroblastoma as a result of etiologic tests. In conclusion, Horner’s syndrome can be the presenting sign of childhood neuroblastoma. Therefore, it is advisable to examine the oculosympathetic system in detail in order to leave out any underlying serious disorder. (Turk J Ophthalmol 2014; 44: 325-6

  14. Clinical Use of GalaFLEX in Facial and Breast Cosmetic Plastic Surgery.

    Science.gov (United States)

    Adams, William P; Toriumi, Dean M; Van Natta, Bruce W

    2016-11-01

    Resolution of ptosis is a key step to the success of many plastic surgery procedures. Ptosis is a manifestation of tissue stretch. Tissue stretch can occur as a result of the natural aging process or health of the patient, or tissue may stretch under added weight or volume, such as when implants are placed. Surgical rejuvenation of ptotic tissues is very effective and results in marked changes in the patient profile yet the tissue that resulted in the need for the procedure first place has not improved and ptosis can recur. Recent developments in long-term resorbable porous materials have provided surgeons with the opportunity to experiment with tissue reinforcement in plastic surgery procedures. These new materials have a low profile, rapid tissue integration, and a long-term strength retention profile. Long-term resorbable scaffolds such as poly-4-hydroxybutyrate (P4HB) natural scaffold (GalaFLEX scaffold, Galatea Surgical, Inc., Lexington, MA) have shown promise for a host of plastic surgery indications. This article presents clinical experience with GalaFLEX for soft tissue reinforcement in three different clinical applications; including the reinforcement of the superficial muscular aponeurotic system (SMAS) in minimally invasive facelift, reinforcement of the skin envelope in mastopexy, and reinforcement of the breast capsule (pocket) in revisional breast surgery. Soft tissue reinforcement has been shown to provide increased mechanical strength as well as improved maintenance of postoperative results. 5 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  15. Periorbital muscle atrophy associated with topical bimatoprost therapy

    Directory of Open Access Journals (Sweden)

    Wang PX

    2014-01-01

    Full Text Available Priscilla Xinhui Wang, Victor Teck Chang Koh, Jin Fong ChengDepartment of Ophthalmology, National University Health System, SingaporeAbstract: Topical Bimatoprost is a common and popular prostaglandin analog used as an ocular hypotensive agent in the treatment of glaucoma. Side effects include ocular hyperaemia, ocular pruritus, and periocular and iris pigmentary changes. Perioribital lipodystrophy is another well-documented outcome associated with chronic use of topical bimatoprost, which results in periorbital hallowing, upper eyelid sulcus deepening, eyelid retraction and enophthalmos. We report an unusual case of periocular muscle atrophy and weakness from unilateral topical bimatoprost use. Our patient had primary angle closure and experienced a right upper eyelid ptosis 2 months after she started to use topical bimatoprost in that eye. Clinical measurements of her eyelids clearly showed reduction in the function of her right levator muscle, suggesting that effects of topical bimatoprost may not be limited to periorbital fat. She was advised to stop topical bimatoprost and right ptosis correction surgery with levator muscle advancement was performed successfully. Ophthalmologists and patients should be aware of this potential rare side effect of topical bimatoprost, as it may be potentially disfiguring, especially with monocular use. However, its exact mechanism of action needs to be clarified further.Keywords: prostaglandin analog, levator, muscle atrophy, muscle weakness, ptosis, side effects

  16. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome.

    Science.gov (United States)

    Kucur, Cuneyt; Ozbay, Isa; Oghan, Fatih; Yildirim, Nadir; Zeybek Sivas, Zuhal; Canbaz Kabay, Sibel

    2015-01-01

    Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.

  17. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome

    Science.gov (United States)

    Ozbay, Isa; Yildirim, Nadir; Zeybek Sivas, Zuhal; Canbaz Kabay, Sibel

    2015-01-01

    Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic. PMID:26064747

  18. Frontalis sling surgery: do we really need the Wright needle?

    Directory of Open Access Journals (Sweden)

    Eduardo Damous Fontenele Feijó

    2016-04-01

    Full Text Available ABSTRACT Purpose: The aim of this study is to describe a variation in technique of the frontalis sling surgery with silicone rods and its results, using an alternative needle with similar effectiveness to the Wright needle at a reduced cost. Methods: This was a prospective, interventional, noncomparative study of patients with severe ptosis who underwent surgical correction using a simple and modified frontalis sling surgery technique. Patients were included in this study from January 2012 to January 2014. 23 surgeries were performed on 15 patients. The minimum "follow-up" was 12 months. Results: Most patients had congenital ptosis (86% and the average preoperative margin reflex distance 1 (MRD1 was -1.1 mm (range -3 to 0 mm. 1 week post-operation, this was 2.7 mm ( 1.8 to 3.8 mm, 1.8 mm after 1 month and 1.7 mm (1 to 2.5 mm after one year. The satisfaction rate was 80% (12 patients. Among the dissatisfied patients, one had extrusion and infection with subsequent explantation of the wire, one had asymmetry greater than 2 mm and one had persistent lagophthalmos and punctate keratitis, with subsequent explantation of silicone. Conclusion: The use of silicone rods with tarsal fixation using an alternative needle was effective in the treatment of severe ptosis with few complication rates, a low rate of dissatisfaction and good stability of the results in the follow-up period.

  19. Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center

    Science.gov (United States)

    Bailey, Steven H.; Guenther, Dax; Constantine, Fadi

    2016-01-01

    Summary: Gynecomastia is a benign proliferation of male breast glandular tissue. Gynecomastia can affect men at any stage of life. Traditional treatment options involved excisional surgeries with periareolar or T-shaped scars, which can leave more visible scars on the chest. The technique presented represents a technique used by the senior author, which relies on ultrasonic liposuction and pull-through technique to remove breast tissue. A retrospective chart review was performed, including all patients who were treated, from 2000 to 2013 by the senior author, for gynecomastia. A deidentified database was created to record patient characteristics, including age, height, weight, ptosis, stage of gynecomastia, and gynecomastia classification. Surgical approaches, complications, and revisions were also recorded. Our experience includes 75 patients with all grades of gynecomastia from 2000 to 2013. These cases span the evolution of our technique to include direct pull-through excision with ultrasound-assisted liposuction. The distribution of the grades I, II, III, and IV ptosis was 30.6%, 36 %, 22.6%, and 10.6% respectively. There were no complications in this series. Only one patient with grade III ptosis required revision surgery. This technique provides a safe and aesthetically pleasing way to treat gynecomastia with a low need for revision. PMID:27482482

  20. Sudoriferous cyst of the orbit of adult origin after trauma

    Directory of Open Access Journals (Sweden)

    Mehta Anjali

    2008-01-01

    Full Text Available A rare case of sudoriferous cyst of the orbit occurring in an adult, who had facial trauma, is reported. Several factors suggest its adult onset. The only other case reported in an adult is of presumed childhood origin. Very few congenital cases have been reported. A 65-year-old lady presented with recent onset of left-sided ptosis and a painless mass below the left supraorbital margin. The patient had traumatic ptosis after a road traffic accident 13 years ago. The ptosis was surgically repaired, which resulted in symmetrical palpebral apertures. Computed tomographic scan revealed a well-defined cystic mass in the anterior orbit. The mass was removed in toto by anterior orbitotomy. Histopathological examination revealed a single cyst lined by double-layered cuboidal epithelium in some areas and transitional epithelium at others. A periodic acid Schiff (PAS positive, diastase-resistant glycocalyx lined the inner epithelium. Apical snouting suggested an apocrine nature. This confirmed a diagnosis of sudoriferous cyst.

  1. Uniparental disomy (UPD) for fra(X) in a 47,XXY male

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    Torfs, C.P.; Christianson, R.E.; Amos, J.A.; Huang, X.L.; Kang, X.Z. [Center for Human Genetics Boston Univ. School of Medicine, Boston, MA (United States)] [and others

    1994-09-01

    We report a 4-year-old hyperactive, mentally retarded male with 47,XXY and UPD for fra(X). Speech and motor delay were first noted at age 15 months. He has no dysmorphic features, normal ears, hyperextensible joints, small testes, and no history of seizures. His mother has prominent lowest ears, a long midface, anteverted nostrils, hyperextensible joints, malocclusion, and had learning problems in school. Routine chromosome analysis revealed the proband to be 47,XXY. Parental chromosomes were normal in number. The proband was fra(X) positive [30/160 cells, 18%]. No cells had two expressed fra(X)s; however, this may be a function of the low level of expression and the number of cells scored. Maternal cells were also fra(X) positive [19/205, 9.2%]. Southern analysis demonstrated the mother to be heterozygous for a methylated, full mutation (>220 repeats); her normal FMR-1 gene was disproportionately unmethylated. The proband had two fully expanded and methylated FMR-1 genes, one the same size as the maternal gene and the other >620 repeats. RFLP analysis revealed a maternal meiotic II error, the result of which was UPD of the X chromosome.

  2. Unusual Turner syndrome mosaic with a triple x cell line (47,X/49,XXX) in a western lowland gorilla (Gorilla gorilla gorilla).

    Science.gov (United States)

    Bradford, Carol M; Tupa, Lynn; Wiese, Debbie; Hurley, Timothy J; Zimmerman, Ralph

    2013-12-01

    A 29-yr-old female western lowland gorilla (Gorilla gorilla gorilla) was evaluated for low fertility and a midterm abortion. Laboratory testing included karyotyping, which revealed an unusual mosaicism for Turner syndrome with Triple X (47,X/49,XXX). This appears to be the first report of Turner syndrome in a great ape. In humans, Turner syndrome occurs in approximately 1 in 3,000 females, with half of those monosomic for the X chromosome. A small proportion is mosaic for a triple X cell line (3-4%). In humans, Turner syndrome is associated with characteristic phenotype including short stature, obesity, a broad chest with widely spaced nipples, webbing of the neck, and anteverted ears. This individual gorilla is significantly shorter in stature than conspecifics and is obese despite normal caloric intake. Individuals with Turner syndrome should also be screened for common health issues, including congenital heart defects, obesity, kidney abnormalities, hypertension, hypothyroidism, and diabetes mellitus. Animals with decreased fertility, multiple miscarriages, fetal losses, unusual phenotypes, or a combination of these symptoms should be evaluated for genetic abnormalities.

  3. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center.

    Science.gov (United States)

    Peters, Christopher L; Erickson, Jill A; Hines, Jerod L

    2006-09-01

    Most reports on the results of the Bernese periacetabular osteotomy for the treatment of developmental dysplasia of the hip have been by the originators of the procedure. In 1997, we began to use this osteotomy without direct training from the originators of the procedure. Seventy-three patients (eighty-three hips) underwent a Bernese periacetabular osteotomy between 1997 and 2003 and were followed prospectively with use of the Harris hip score to assess clinical results and with use of anteroposterior pelvic and false-profile lateral plain radiographs to assess radiographic results. The three-dimensional position of the acetabulum was recorded preoperatively and postoperatively. The mean duration of follow-up was forty-six months. The average Harris hip score improved from 54 to 87 points (p Bernese periacetabular osteotomy have been encouraging, with a 92% survival rate at thirty-six months. The occurrence of complications demonstrates a substantial learning curve. Recognition of the true preoperative acetabular version and reorientation of the acetabulum into an appropriately anteverted position have become important factors in surgical decision-making. Therapeutic Level IV.

  4. Fracture of a titanium sleeve-encased third-generation ceramic liner in a modern THA.

    Science.gov (United States)

    Chotai, Pranit N; Su, Edwin P

    2011-10-01

    Due to their excellent tribology, ceramics are increasingly used for total hip arthroplasty (THA) in young patients. Fracture rates for contemporary ceramics range from 0% to 0.004%. Recently, ceramic liners are encased in a titanium sleeve to further decrease the chances of fracture. We encountered 1 case of a metal-encased acetabular liner fracture in a ceramic-on-ceramic articulation in a series of 764 hips. Our literature review revealed no reports of metal-encased ceramic liner fracture. A 60-year-old woman presented 27 months after a bilateral ceramic-on-ceramic THA. She reported mechanical grinding and clicking from the left hip on extension. There was no history of trauma or fall. Examination revealed a nonantalgic gait and audible-palpable crepitations on the left hip. Range of motion of the left hip was intact with no subluxation. Radiographs revealed fractured ceramic insert and an excessively anteverted socket on the left side. Intraoperative findings revealed gross impingement in the form of indentation of the metal femoral neck against the elevated metal rim encasing the liner. Revision THA was performed using an uncemented polyethylene liner while retaining the well-fixed cup and stem. The Harris Hip Score at 4.5-year follow-up was 100, with no evidence of osteolysis or polyethylene wear.

  5. Unilateral nystagmus in an infant with acrocallosal syndrome.

    Science.gov (United States)

    Erbagci, Ibrahim; Erbagci, Hulya; Erbagci, Zulal; Sivasli, Ercan; Bekir, Necdet

    2004-10-01

    Acrocallosal syndrome (ACS), is an extremely rare disorder characterized by the absence of corpus callosum (CC), macrocephaly, hypertelorism, pre- and postaxial polydactyly and severe motor and mental retardation. There are only 3 reports of ACS associated with ocular findings, including optic atrophy, esotropia and anophthalmus. We report on the first known Turkish case of ACS associated with unilateral nystagmus in addition to several neurologic abnormalities such as absence of the adhesio interthalamica and many others. A physically and mentally underdeveloped one year-old girl was evaluated for macrocephaly, polydactyly and left-sided nystagmus, which was not recognized until the fourth month. Magnetic resonance imaging revealed external hydrocephaly, triventricular hydrocephaly, midline brain abnormalities including partial agenesis of the CC, cavum septi pellucidi, cavum vergae, and absence of the adhesio interthalamica. The following anomalies were also noted; high arched palate, short nose with broad nasal bridge and anteverted nostrils, macrocephaly, frontal bossing, open and down turned angles of the mouth, hypertelorism, postaxial polydactyly of the left foot, hypertrichiasis, and hypertrichosis. On the basis of these findings, a diagnosis of ACS was made. In addition to neuroimaging, systemic research is needed in all patients presenting with asymmetric nystagmus as such a nystagmus may be associated with various external developmental abnormalities in addition to central nervous system involvement. Our case indicates that asymmetric nystagmus and midline brain abnormalities may also be included in the diagnostic criteria of ACS.

  6. Pearls for perfecting the mastoid interpolation flap.

    Science.gov (United States)

    Justiniano, Hilda; Eisen, Daniel B

    2009-06-15

    Helical rim ear defects can present a reconstructive challenge to the Mohs surgeon. Multiple options exist including wedge excision, helical rim advancement flaps, bilobed flap, and grafts, to name a few. Wedge excision of the ear may result in a noticeable anteverted, smaller ear, and disrupts auricular cartilage with the possibility of chondritis and excess pain. Helical rim advancements can result in anteversion of the ear and a smaller lobule. Mastoid interpolation flaps, which are also called retroauricular to auricular flaps, can be a useful alternative in patients who are willing to return for a second procedure. They are easy to perform and can result in a highly aesthetic reconstruction in which the ear size and form are maintained. The donor skin comes from an area that is hidden from view and heals with minimal complications. We present our suggestions for performing these reconstructions. Ways to optimize results, potential pitfalls, and postoperative care instructions are discussed. Step by step videos are included with this manuscript.

  7. Craniotubular dysplasia with severe postnatal growth retardation, mental retardation, ectodermal dysplasia, and loose skin: Lenz-Majewski-like syndrome.

    Science.gov (United States)

    Nishimura, G; Harigaya, A; Kuwashima, M; Kuwashima, S

    1997-07-11

    The heterogeneous group of craniotubular dysplasias is characterized by modeling errors of the craniofacial and tubular bones. Some conditions in this category cause not only skeletal abnormalities but also a variety of mesoectodermal dysplasias, as exemplified in Lenz-Majewski syndrome (MIM 151050), which comprises craniodiaphyseal dysplasia, failure to thrive, mental retardation, proximal symphalangism, enamel hypoplasia, and loose skin. We report on a boy with a hitherto unknown multisystem disorder, including skeletal changes that were regarded as a form of craniotubular dysplasia. The patient had a large head, exophthalmos, a broad nasal root, anteverted nostrils, large auricles, thick lips, micrognathia, severe postnatal growth retardation with emaciation, severe mental retardation, sparse hair growth, enamel hypoplasia, and thin, loose skin with hyperlaxity. Skeletal changes consisted of thickened calvaria, sclerosis of the skull base and facial bones, thick ribs, and metaphyseal undermodeling of the tubular bones. In addition, generalized osteopenia was evident. The present disorder overlaps phenotypically with Lenz-Majewski syndrome; nevertheless, the absence of diaphyseal hyperostosis and proximal symphalangism in the present patient was not consistent with Lenz-Majewski syndrome.

  8. Report on 3 patients with 12p duplication including GRIN2B.

    Science.gov (United States)

    Poirsier, Celine; Landais, Emilie; Bednarek, Nathalie; Nobecourt, Jean-Marie; Khoury, Maroun; Schmidt, Pascal; Morville, Patrice; Gruson, Nadine; Clomes, Sandrine; Michel, Nicole; Riot, Anita; Manjeongean, Christelle; Gaillard, Dominique; Doco-Fenzy, Martine

    2014-04-01

    The duplication of the short arm (p) of chromosome 12 is a rare chromosomal abnormality, and most reported cases result from malsegregation of a balanced parental translocation associated with other chromosomal imbalances. Of the reported cases, only 15 involve a pure and complete 12p duplication and only 10 involve a pure and partial duplication overlapping the 12p12.3p13.1 region, including a single instance of an inherited duplication in two related individuals. Here, we report three new patients with a pure 12p duplication, detected by conventional cytogenetic studies and characterized by array-comparative genomic hybridization (array-CGH) and fluorescence in situ hybridization (FISH). The first patient was a child carrying a de novo inverted duplication of the short arm of chromosome 12. His phenotype was similar to that of the "trisomy 12p syndrome", characterized by developmental delays and craniofacial abnormalities including a high forehead, a short nose with anteverted nostrils and an everted lower lip. The second and third patients were a mother and son with a direct 12p12.3p13.1 duplication, exhibiting a milder phenotype characterized by moderate developmental delays, dysmorphic facial features, behavioral problems and obesity. The present data, including the rarity of the familial cases, should contribute to our knowledge of the genotype/phenotype correlation in trisomy 12p patients.

  9. Vincristine-Induced Cranial Neuropathy

    Directory of Open Access Journals (Sweden)

    Ahmad TALEBIAN*

    2014-01-01

    Full Text Available How to Cite This Article: Talebian A, Goudarzi RM, Mohammadzadeh M , Mirzadeh AS. Vincristine-Induced Cranial Neuropathy. Iran J Child Neurol. 2014 Winter; 8(1:66-68. AbstractVincristine (VCR is a vinca alkaloid that is used for treatment of many malignancies.The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms’ tumor, treated by vincristine (0/067 mg/kg/day and dactinomycin (0/045 mg/kg/day after surgery. Three weeks after treatment, he presented with bilateral ptosis.Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis.Treatment with pyridoxine (150 mg/m2 p.o. BID and pyridostigmine (3 mg/kg p.o. BID started as neuroprotective agents, and after 7 days the problem disappeared.The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later. References:Toopchizade V, Hosseini M, et al. Electrophysiological signs of neuropathy caused by vincristine. Medical Journal of Tabriz University of Medical Sciences. 2010 Autumn;31(3; 19-25.Gursel E.S. Vincristine-Induced Unilateral Ptosis in a Child. Pediatr Neurol 2009; 41:461-463.Ngamphaiboon N, Sweeney R, Wetzler M, Wang ES. Pyridoxine treatment of vincristine-induced cranial polyneuropathy in an adult patient with acute lymphocytic leukemia: Case report and review of the literature. Leuk Res. 2010 Aug;34(8:e194-6.Lash SC, Williams CP, Marsh CS, Crithchley C, Hodgkins PR, Mackie EJ. Acute Sixth-Nerve Palsy After Vincristine Therapy. Journal of AAPOS 2004 Feb;8(1: 67-8.Bay A, Yilmaz C, Yilmaz N, Oner AF. Vincristine induced cranial polyneuropathy. Indian J Pediatr. 2006 Jun;73(6:531-3.Tuxen M K, Hansen SW. Complication of treatment, Neurotoxicity secondary to antineoplastic

  10. [Secretory eosinophilia and obstructive rhinitis].

    Science.gov (United States)

    Rouvier, P; Mondain, M; Elkhoury, J

    1992-01-01

    Detecting eosinophilia in the nasal secretions of patients complaining of nasal obstruction makes it possible to identify a group of high risk patients. Hosty use of surgery in these patients carries a high risk of iatrogenic complications and little potential for improvement. The 2 most frequently used methods of obtaining cytologic specimens (swabbing versus washing) were compared in 37 patients with obstructive rhinitis (early stage polyposis and nonallergic rhinitis with eosinophilia syndrome, NARES). Swabbing gave reliable results. Eosinophilia was negligible in a group of 25 control subjects. The mean eosinophil count was 2.5% and only 1 patient had a positive cystogram. The 220 patients which nasal obstruction were classed in 5 groups according to the severity of clinical signs and symptoms. The mean eosinophil count and the percentage of patients with positive cystogram increased with increased severity of the clinical syndrome. 28 patients had uncomplicated obstructive rhinitis, 10 had NARES, 43 had allergic rhinitis, 52 had chronic obstructive rhinitis, and 87 had nasosinal polyposis. The respective mean eosinophil counts were 6.42%, 10.3%, 13.8% 16.8% and 31.4%. The percentage of patients with positive cytograms was respectively, 10.8%, 20%, 23.3%, 28.8% and 54%.

  11. The Relation Between Ocular/Nasal Bacterial Distribution, Staphylococcus aureus Colonization and Ocular and Nasal Involvement in Atopic Dermatitis Patients - Original Article

    Directory of Open Access Journals (Sweden)

    Berna Şanlı Erdoğan

    2008-12-01

    Full Text Available Objective: It was aimed to determine bacteria distribution and S.aureus colonization in nares, fornix and eyelid margin of patients with atopic dermatitis (AD compared to controls and to investigate it’s relationship with skin and eye involvement. Methods: Patients dermatological and opthalmologic examinations were done. The standart tear break-up time and Schirmer tests were performed. Samples were taken from fornix, eyelid margin and nares for bacterial culture. Results: Tweenty seven patients and 28 controls were included. There was no difference between the patients with and without eye involvement with respect to dry eye (p>0.05. The bacteria was more frequently isolated in patients (85.2% than controls (60.7%, however S.aureus colonization (51.9%, 50.0% respectively didn’t differ in both groups (p=0.042, p>0.05. The disease severity was positively correlated with S.aureus colonization (p=0.031. There was no difference between the patients with and without eye involvement with respect to S.aureus colonization and presence of bacteria (p>0.05. No bacteria was isolated from patients whom tear function analyses were performed. Conclusions: It wasn’t established an increased percent of S.aureus colonization in AD patients compared with controls. There was no association between dry eye and eye involvement. No comment could be remarked about the possible relation between dry eye and bacterial colonization.

  12. Successful application of a simple specimen transport method for the conduct of respiratory virus surveillance in remote Indigenous communities in Australia.

    Science.gov (United States)

    O'Grady, Kerry-Ann F; Torzillo, Paul J; Rockett, Rebecca J; Whiley, David M; Nissen, Michael D; Sloots, Theo P; Lambert, Stephen B

    2011-06-01

    Surveillance programs and research for acute respiratory infections in remote Aboriginal communities are complicated by difficulties in the storage and transport of frozen samples to urban laboratories for testing. This study assessed the sensitivity of a simple method for transporting respiratory samples from a remote setting for viral PCR compared with frozen specimens. We sampled every individual who presented to a remote Aboriginal community clinic in a non-epidemic respiratory season. Two anterior nasal swabs were collected from each participant. The left nare specimen was mailed to the laboratory via routine postal services. The right nare specimen was transported frozen. Testing for 16 viruses was undertaken using real-time multiplex PCR. A total of 140 participants were enrolled who contributed 150 study visits. Respiratory illnesses accounted for 10% of the reasons for presentation. Sixty-one viruses were identified in 50 (33.3%) presentations for 40 (28.6%) individuals; bocavirus and rhinovirus were the most common viruses identified (14.0% and 12.6% of episodes respectively). The sensitivity for any virus detected in mailed specimens was 67.2% (95%CI 55.4, 78.9) compared to 65.6% (95%CI 53.7, 77.5) for frozen specimens. The mailing of unfrozen nasal specimens from remote communities does not compromise the viability of the specimen for viral studies. © 2011 Blackwell Publishing Ltd.

  13. Characterization of nasal and blood culture isolates of methicillin-resistant Staphylococcus aureus from patients in United States Hospitals.

    Science.gov (United States)

    Tenover, Fred C; Tickler, Isabella A; Goering, Richard V; Kreiswirth, Barry N; Mediavilla, José R; Persing, David H

    2012-03-01

    A total of 299 nares and 194 blood isolates of methicillin-resistant Staphylococcus aureus (MRSA), each recovered from a unique patient, were collected from 23 U.S. hospitals from May 2009 to March 2010. All isolates underwent spa and staphylococcal cassette chromosome mec element (SCCmec) typing and antimicrobial susceptibility testing; a subset of 84 isolates was typed by pulsed-field gel electrophoresis (PFGE) using SmaI. Seventy-six spa types were observed among the isolates. Overall, for nasal isolates, spa type t002-SCCmec type II (USA100) was the most common strain type (37% of isolates), while among blood isolates, spa type t008-SCCmec type IV (USA300) was the most common (39%). However, the proportion of all USA100 and USA300 isolates varied by United States census region. Nasal isolates were more resistant to tobramycin and clindamycin than blood isolates (55.9% and 48.8% of isolates versus 36.6% and 39.7%, respectively; for both, P United States, were observed along with several unusual PFGE types, including CMRSA9, EMRSA15, and the PFGE profile associated with sequence type 239 (ST239) isolates. Typing data from this convenience sample suggest that in U.S. hospitalized patients, USA100 isolates of multiple spa types, while still common in the nares, have been replaced by USA300 isolates as the predominant MRSA strain type in positive blood cultures.

  14. Concordance of nasal and diabetic foot ulcer staphylococcal colonization

    Science.gov (United States)

    Haleem, Ambar; Schultz, Jonathan S.; Heilmann, Kristopher P.; Dohrn, Cassie L.; Diekema, Daniel J.; Gardner, Sue E.

    2014-01-01

    Background Nasal carriage of Staphylococcus aureus (SA) is an important risk factor for surgical site infections. The goal of this study was to investigate the concordance between nasal and diabetic foot ulcer (DFU) SA carriage. Methods 79 subjects with DFUs were assessed for nasal and DFU colonization with SA, including Methicillin-resistant-SA (MRSA). Results Twenty-five (31.6%) subjects had nares colonization with SA; 29 (36.7%) had DFU colonization with SA. Seven (8.8%) subjects had nares colonization with MRSA and 7 (8.8%) had DFU colonization with MRSA. Ulcer duration was associated with MRSA presence (p=0.01). Sensitivity and specificity of positive nasal SA colonization with positive DFU colonization were 41 and 74%. Conclusions We found substantial discordance between SA strains colonizing DFU and the nasal cavity. The poor positive predictive values for SA isolation in a DFU based on nasal carriage suggests SA colonization of a DFU by endogenous SA strains cannot be assumed. PMID:24560808

  15. Staphylococcus aureus colonization related to severity of hand eczema.

    Science.gov (United States)

    Mernelius, S; Carlsson, E; Henricson, J; Löfgren, S; Lindgren, P-E; Ehricht, R; Monecke, S; Matussek, A; Anderson, C D

    2016-08-01

    Knowledge on Staphylococcus aureus colonization rates and epidemiology in hand eczema is limited. The aim of this study was to clarify some of these issues. Samples were collected by the "glove juice" method from the hands of 59 patients with chronic hand eczema and 24 healthy individuals. Swab samples were taken from anterior nares and throat from 43 of the 59 patients and all healthy individuals. S. aureus were spa typed and analysed by DNA-microarray-based genotyping. The extent of the eczema was evaluated by the hand eczema extent score (HEES). The colonization rate was higher on the hands of hand eczema patients (69 %) compared to healthy individuals (21 %, p eczema (HEES ≥ 13) had a significantly higher S. aureus density on their hands compared to those with milder eczema (HEES = 1 to 12, p = 0.004). There was no difference between patients and healthy individuals regarding colonization rates in anterior nares or throat. spa typing and DNA-microarray-based genotyping indicated certain types more prone to colonize eczematous skin. Simultaneous colonization, in one individual, with S. aureus of different types, was identified in 60-85 % of the study subjects. The colonization rate and density indicate a need for effective treatment of eczema and may have an impact on infection control in healthcare.

  16. Nasal carriage of Staphylococcus schleiferi from healthy dogs and dogs with otitis, pyoderma or both.

    Science.gov (United States)

    May, Elizabeth R; Kinyon, Joann M; Noxon, James O

    2012-12-07

    In veterinary medicine, Staphylococcus schleiferi was previously assumed to be an inhabitant of carnivore skin, however, more recently, it has been repeatedly documented in the literature as both an inhabitant and as a pathogen. In order to determine the frequency of nasal carriage, and the methicillin susceptibility pattern of S. schleiferi from healthy dogs as well as dogs with otitis and/or pyoderma, a prospective study including 24 dogs with healthy ears and skin, 27 dogs with healthy ears and pyoderma, 15 dogs with otitis without pyoderma and 20 dogs with both otitis and pyoderma was performed. Specimens were obtained and cultured and isolates were identified as S. schleiferi based on growth and biochemical characteristics. S. schleiferi was isolated from the nares of 1 healthy dog, 3 dogs with recurrent pyoderma, 2 dogs with recurrent otitis, and 1 dog with both recurrent otitis and pyoderma. One of the S. schleiferi isolates was methicillin resistant. Nasal carriage of S. schleiferi does occur in healthy dogs as well as dogs with otitis and pyoderma. Methicillin resistant and sensitive S. schleiferi can be found in the nares of dogs with diseased ears and skin. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Teste do gelo no diagnóstico de miastenia gravis Ice pack test in the diagnosis of myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Nilson Lopes da Fonseca Junior

    2010-04-01

    Full Text Available OBJETIVO: Demonstrar a sensibilidade e especificidade do teste do gelo no diagnóstico diferencial de ptose palpebral por miastenia gravis. MÉTODOS: Estudo prospectivo tipo ensaio clínico com grupo controle. Foi realizado o teste do gelo em pacientes portadores de ptose palpebral. Os pacientes foram divididos em 2 grupos, sendo o grupo I constituído por pacientes com miastenia gravis e o grupo II (controle formado por pacientes portadores de ptose congênita, miogênica não-miastênica ou aponeurótica. RESULTADOS: Todos os pacientes do grupo I tiveram aumento da fenda palpebral de, no mínimo, 3 mm após a aplicação do gelo. Nenhum paciente do grupo II apresentou incremento da fenda palpebral após o teste. CONCLUSÃO: O teste do gelo mostrou-se específico para detecção de ptose palpebral de causa miastênica.PURPOSE: To demonstrate the sensitivity and the specificity of the ice test in the differential diagnosis of ptosis in myasthenia gravis. METHODS: Prospective trial with a control group. The patients were instructed to hold a frozen ice pack on the closed ptotic eyelid. They were divided into 2 groups, with group I consisting of patients with myasthenia gravis and group II (control consisting of patients with congenital, non-myasthenic myogenic or aponeurotic ptosis. RESULTS: All patients in group I had increased palpebral fissure for at least 3 mm after the application of ice pack. No patient in group II showed increased palpebral fissure after the ice test. CONCLUSION: Ice test proved to be specific for the detection of myasthenic ptosis.

  18. Mamoplastia de aumento dinámica con control de vectores

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    R.A. Vallarta-Rodríguez

    2014-12-01

    Full Text Available La mamoplastia de aumento debe ser una cirugía segura, predecible, duradera, que mantenga la forma natural de las mamas, preserve la sensibilidad del complejo areola-pezón, no altere la lactancia, con mínima reacción al implante colocado, y que no interfiera con los estudios imagenológicos. Cuando las mamas presentan alguna deformidad asociada tipo ptosis, mamas tuberosas, etc, el emplear una combinación de técnicas brinda un mejor resultado final en comparación con el empleo de un procedimiento de aumento puro. Presentamos la técnica quirúrgica que empleamos desde el 2003 que a nuestro juicio cumple con todos estos objetivos y puede utilizarse para aumento mamario en pacientes con ptosis leve o moderada. Describimos la técnica con detalle y discutimos las indicaciones y ventajas de incorporar estos refinamientos técnicos a la mamoplastia de aumento convencional. Recogemos 230 casos en los que se realizó mamoplastia de aumento multiplanar con disección muscular ampliada en bloque, optimizando vectores independientes para reposicionar el complejo areola-pezón en su posición ideal en casos de ptosis asociada. Agregamos puntos de anclaje percutáneos en 98 pacientes para conseguir este efecto. No hemos tenido complicaciones mayores, más allá de pequeñas dehiscencias superficiales de las heridas en 18 casos que se corrigieron con tratamiento expectante sin dejar secuelas. Con esta técnica intentamos aportar una opción más al cirujano plástico para ofrecer un resultado natural y duradero a las pacientes que se someten a mamoplastia de aumento.

  19. Clinical and electrodiagnostic findings in cyhalothrine poisoning

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    Keivan Basiri

    2016-01-01

    Full Text Available Acute onset bulbar symptoms with respiratory failure and descending paralysis may occur in several neuromuscular disorders including variants of Guillain-Barre syndrome (GBS, diphtheria, botulism and toxins. We present a 51-year-old man who presented with complains of ptosis and dyspnea following pyrethroids spraying in an enclosed area for eradication of flea. Within 5-6 days of admission limb weakness, dysphagia, dysarthria, blurred vision, diplopia, tremor and respiratory distress added to previous symptoms. Temporal profile of events after exposure, development of similar symptoms in patient's son, electrodiagnostic findings and exclusion of other etiologies confirms intoxication etiology. We reviewed the literature and provide an extensive electrodiagnostic overview.

  20. Noonan syndrome: a clinical and genetic study of 31 patients

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    Bertola Débora Romeo

    1999-01-01

    Full Text Available Noonan syndrome is a multiple congenital anomaly syndrome, inherited in an autosomal dominant pattern. We studied 31 patients (18 males and 13 females affected by this disorder regarding their clinical and genetic characteristics. The most frequent clinical findings were short stature (71%; craniofacial dysmorphisms, especially hypertelorism, ptosis, downslanting of the palpebral fissures; short or webbed neck (87%; cardiac anomalies (65%, and fetal pads in fingers and toes (70%. After studying the probands' first-degree relatives, we made the diagnosis of Noonan syndrome in more than one family member in three families. Therefore, the majority of our cases were sporadic.

  1. Anesthetic management in a pediatric patient with Noonan syndrome, hypopituitarism and hypothyroidism: A case report

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    Abdulkadir Yektaş

    2013-06-01

    Full Text Available Noonan syndrome is a genetically transmitted autosomaldominant disorder characterized by various anatomicanomalies and pathophysiologic derangements. Associatedanomalies include hyperthelorism, ptosis, micrognathia,downward sloping palpebral fissures, low-set ears,abnormal helix of ear, deeply grooved philtrum, short and/or webbed neck, low hairline and cervical vertebral anomalies.Patients with Noonan syndrome are known to presentwith challenging airways. Tracheal intubation can bedifficult because of airway and cervical vertebral anomaliesand bag mask ventilation may be difficult because ofasymmetrical face. We present a case of anesthetic managementfor Noonan syndrome. J Clin Exp Invest 2013;4 (2: 238-241Key words: Anesthesia, general, noonan syndrome, airwaymanagement

  2. Dental team management for a patient with Klippel-Feil syndrome: case report.

    Science.gov (United States)

    de Lima, Marina de Deus Moura; Ortega, Karem Lopez; Araújo, Luis Carlos Arias; Soares, Marcelo Melo; de Magalhães, Marina Helena Cury Gallottini

    2009-01-01

    Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by a short neck, a low posterior hairline, and limited head movement. Occasionally, patients with KFS may also show signs of deafness, intellectual disability, cardiac malformation, palpebral ptosis, facial nerve paralysis, cleft palate, and scoliosis. Although some researchers have documented this syndrome, scant attention has been paid to craniomaxillofacial manifestations and dental treatment of patients with KFS. The objective of this case report was to describe the planning and execution of dental treatment for a 10-year-old male patient with KFS.

  3. The management of congenital malpositions of eyelids, eyes and orbits.

    Science.gov (United States)

    Morax, S; Hurbli, T

    1988-01-01

    Congenital malformations of the eye and its adnexa which are multiple and varied can affect the whole eyeball or any part of it, as well as the orbit, eyelids, lacrimal ducts, extra-ocular muscles and conjunctiva. A classification of these malformations is presented together with the general principles of treatment, age of operating and surgical tactics. The authors give some examples of the anatomo-clinical forms, eyelid malformations such as entropion, ectropion, ptosis, levator eyelid retraction, medial canthus malposition, congenital eyelid colobomas, and congenital orbital abnormalities (Craniofacial stenosis, orbital plagiocephalies, hypertelorism, anophthalmos, microphthalmos and cryptophthalmos).

  4. [Surgical treatment of the Marcus-Gunn syndrome. Indications and results. Apropos of 15 cases].

    Science.gov (United States)

    Morax, S; Mimoun, G

    1989-01-01

    Fifteen cases of jaw-winking blepharoptosis treated, are reported, to suggest the management of the surgical methods. The degree of the ptosis, the eyelid retraction, the surgical procedures are reviewed. Patients with a wild retraction required a levator muscle resection. Patients with a moderate or severe retraction required an unilateral levator denervation with frontalis suspension. In this case, the most satisfactory surgical results were obtained with unilateral levator denervation on the affected side compared with a bilateral frontalis suspension with fresh autogenous fascia. Then, the surgical procedure seems to depend especially on the eyelid retraction.

  5. [Oropharyngeal dysphagia associated with Chiari I malformation and syringomyelia J].

    Science.gov (United States)

    Cortés-Medina, Julio César; Cárdenas-Lara, Armando; Guerrero-Rascón, Carlos Alberto; Rodríguez-Bautista, Heber

    2014-01-01

    Dysphagia associated with neurological disease is an important clinical manifestation in the diagnosis of injury that justifies the compression of the brainstem and lower cranial nerves. To emphasize the study of dysphagia in a patient with Chiari I malformation associated with syringomyelia in the absence of primary gastroenterological symptoms. We describe the case of a 62 year-old woman with oropharyngeal dysphagia of six years of evolution, cervicobrachialgia, ptosis and facial diplexia. Magnetic resonance imaging is an essential element for establishing the etiologic diagnosis of neurogenic dysphagia.

  6. An unusual palmaris longus tendon: variation in the insertion and orientation at the level of wrist joint

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    Kumar V

    2009-11-01

    Full Text Available Palmaris longus is a muscle often used in reconstructive plastic surgery mainly in tendon transfer procedures for replacement of long flexors of the fingers. It has also been used for many other procedures including ptosis correction, lip augmentation and management of facial paralysis. Absence of palmaris longus in humans appears to be hereditary, but its genetic transmission is not clear. We report here a variant pattern of insertion of palmaris longus, and its probable significants. Any variation in the insertion of tendon of the palmaris longus is gaining importance as it is becoming very popular amongst graft material for reconstructive surgeries.

  7. Comparison of Two Methods for Upper Lid Fascia Lata Sling in Congenital Blepharoptosis: a Randomized Clinical Trial

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    Abbas Bagheri

    2008-12-01

    Full Text Available

    PURPOSE: To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. METHODS: In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function (< 4mm were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling (modified Crawford method and group B, monotriangular fascia sling (modified Fox method. RESULTS:  This study included 30 upper eyelids (15 eyelids in each surgical group of 19 patients (8 unilateral and 11 bilateral cases with congenital ptosis. Mean increase in eyelid fissure height was 2.7±2.3 mm in group A and 3.4±2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant (P < 0.001, paired t-test but intergroup difference was not (P=0.4, independent sample t-test. Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. CONCLUSION:  The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia.

  8. Trigemino-oculomotor synkinesis: Report of a rare case

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    Manjiri Joshi

    2014-01-01

    Full Text Available Trigeminal-oculomotor synkinesis also known as the Marcus Gunn jaw winking phenomenon was first described by the ophthalmologist, Marcus Gunn, in 1883. It is one of the common congenital oculofacial synkinesis, and accounts for approximately 5% of all congenital ptosis. It is characterized by the involuntary winking of eyes during jaw movement, due to an aberrant connection between the mandibular division of the trigeminal nerve and one of the divisions of the occulomotor nerve. Here we report an unusual case of the Marcus Gunn jaw winking phenomenon, which was diagnosed accidentally.

  9. Miopatia mitocondrial: relato de dois casos Mitochondrial myopathy: two case reports

    OpenAIRE

    Sara Patrícia Grebos; Tatiana Almeida; Karine Horta Barbosa; Michele Agostini Buquera; Ana Tereza Ramos Moreira

    2005-01-01

    Miopatia mitocondrial é um distúrbio genético caracterizado por oftalmoplegia externa crônica progressiva e ptose palpebral superior, apresentando-se a partir da 3ª e 4ª década de vida. Os autores revisaram a literatura e relataram 2 casos do sexo feminino com diplopia à leitura.Mitochondrial myopathy is a genetic disorder characterized by chronic progressive external ophthalmoplegia and upper eyelid, ptosis which occurs before 30 to 40 years of life. The authors reviewed the literature and r...

  10. Primary localized amyloidosis presenting as a tarsal mass: Report of two cases

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    Saurabh Kamal

    2012-01-01

    Full Text Available Amyloidosis and its ophthalmic manifestations are rare. The unusual presentation can result in diagnostic delay and increase ocular morbidity. Additionally, there are various predisposing conditions and systemic involvement can affect various organs. Hence, localized disease warrants a thorough clinical evaluation and laboratory investigation. We report two cases of primary localized amyloidosis presenting as a tarsal mass and ptosis. The diagnosis was established on histopathology. There were no predisposing conditions and no systemic involvement. The disease was probably related to the local immunocyte disorder.

  11. Brachydactylia As A Phenotypic Feature of Mitochondrial Disorder

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    Walter Strobl

    2012-12-01

    Full Text Available Mitochondrial disorders (MIDs may occasionaly go along with dysmorphism but hand deformities, as in the following case, have been only rarely reported. A 72 year old female with ptosis, hypoacusis, tremor, myopathy, diabetes mellitus, arterial hypertension, severe cardiac disease, pulmonary hypertension, gastric carcinoid, hepatopathy, generalised atherosclerosis, anemia, polyarthrosis, and hyperlipidemia, additionally presented with brachydactylia. Upon neurological work-up a MID was suspected. The family history was positive for diabetes but negative for brachydactylia or other features of a MID. MIDs may be associated with brachydactylia. Skeletal deformities may be a phenotypic manifestation of MIDs

  12. Apoplejía pituitaria con parálisis del III par craneal. Reporte de caso.

    OpenAIRE

    Pinto Valdivia, Miguel; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Ortiz Torres, Milagros; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Villena Chávez, Jaime; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.

    2012-01-01

    Se describe el caso de un varón de 65 años de edad, sin antecedentes patológicos de importancia, que acudió a emergencia del Hospital Nacional Cayetano Heredia por presentar cefalea intensa y ptosis palpebral izquierda. El examen físico mostró parálisis aislada del III par craneal izquierdo. Los análisis de laboratorio mostraron hiponatremia e hipopituitarismo y la resonancia magnética nuclear un adenoma pituitario con área...

  13. Effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation

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    Li-Li Dong

    2014-12-01

    Full Text Available AIM:To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation.METHODS: Thirty-three cases(33 eyeswith globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo. RESULTS: Thirty-one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture.CONCLUSION: It is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.

  14. Craniosynostosis suggestive of Saethre-Chotzen syndrome: clinical description of a large kindred and exclusion of candidate regions on 7p.

    Science.gov (United States)

    von Gernet, S; Schuffenhauer, S; Golla, A; Lichtner, P; Balg, S; Mühlbauer, W; Murken, J; Fairley, J; Meitinger, T

    1996-05-03

    We describe the clinical manifestations of an autosomal dominant form of craniosynostosis in a large family with eight affected relatives. Unilateral or bilateral coronal synostosis, low frontal hair line, strabismus, ptosis, and partial cutaneous syndactyly of fingers and toes are findings suggestive of the diagnosis of Saethre-Chotzen syndrome. The disease locus was excluded from the two adjacent Saethre-Chotzen candidate regions on 7p by linkage analysis with markers D7S664 and D7S507. This indicates heterogeneity of Saethre-Chotzen syndrome with a locus outside the candidate regions on 7p.

  15. Saethre-Chotzen syndrome: a clinical, EEG and neuroradiological study.

    Science.gov (United States)

    Elia, M; Musumeci, S A; Ferri, R; Greco, D; Romano, C; Del Gracco, S; Stefanini, M C

    1996-11-01

    Saethre-Chotzen syndrome is a form of acrocephalosyndactyly with autosomal dominant inheritance, characterized by craniosynostosis, facial asymmetry, palpebral ptosis, deviated nasal septum, partial cutaneous syndactyly, and various skeletal abnormalities. We studied in detail the neurological, EEG, and neuroradiological features of a group of 11 (6 male, 5 female) patients with Saethre-Chotzen syndrome. Four subjects were affected by seizures; they had paroxysmal EEG abnormalities, and gross neuroimaging revealed destructive brain lesions or malformations. Our findings suggest that CNS involvement in Saethre-Chotzen syndrome might be more severe than previously reported and support the wider use of neurophysiological and neuroimaging techniques in the study of children with this syndrome.

  16. A RARE CASE OF ADENOID CYSTIC CARCINOMA OF ETHMOID SINUS

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    Bharath

    2013-02-01

    Full Text Available ABSTRACT: Adenoid cystic carcinoma is more common in minor sa livary glands, uncommon in parotid gland and rare in paranasal sinuses. These ar e more aggressive and fatal. Such tumors of the accessory nasal sinuses causing proptosis have be en reported so rarely in ophthalmic literature. An adult aged 31 years presented with pro ptosis of right eye, nasal obstruction and bleeding from right nose. CT scan showed soft tissu e attenuation mass with destruction of bony structures and extension to right orbit. Biopsy was done through trans nasal route. A histological diagnosis of Adenoid cystic carcinoma of ethmoid sinus was made

  17. Dermatomal sensory manifestations in lateral medullary infarction.

    Science.gov (United States)

    Hongo, Hiroki; Tanaka, Yasutaka; Shimada, Yoshiaki; Tanaka, Ryota; Hattori, Nobutaka; Urabe, Takao

    2014-01-01

    A 61-year-old man who experienced a sudden onset of unstable gait followed by nuchal pain was admitted to our department. The neurologic examination revealed right-sided limb ataxia, right partial ptosis, and decreased sensation to 50% of the normal side to pinprick and temperature stimuli on the left side below the level of the T-6 dermatome. A lateral medullary infarction caused by spontaneous vertebral artery dissection was diagnosed by magnetic resonance imaging and computed tomography angiography. In conclusion, lateral medullary infarction is an important entity to consider in the differential diagnosis of dermatomal sensory manifestations.

  18. Progressive bilateral ophthalmoparesis--a case of simultaneous autoimmunity: balancing Graves' ophthalmoparesis and ocular myasthenia.

    Science.gov (United States)

    Canepa, Carlo; Venu, Maya

    2016-01-04

    A 44-year-old woman with no medical history presented with a 1-year history of horizontal diplopia, bilateral exophthalmos and progressive asymmetrical ophthalmoparesis, with no pupillary dysfunction or ptosis. Within 3 months of her initial presentation, she noticed paresis of right eye abduction, followed after 1 month with paresis of left eye abduction. Initial investigations revealed positive antiperoxidase antibodies for Graves' disease and positive AChR for myasthenia gravis. MRI of the brain showed increased intensity in bilateral inferior rectus muscles and CT of the chest showed thymic hyperplasia. Treatment with carbimazole and pyridostigmine was started, with complete resolution after 1 month.

  19. Rhinocerebral mucormycosis: Race against time for surgeons

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    G C Rajkumar

    2016-01-01

    Full Text Available Rhinocerebral mucormycosis is a rare, aggressive, and rapidly progressive life-threatening opportunistic infection affecting the immunocompromised patients. It manifests as facial swelling, cellulitis, nasal obstruction and discharge, large areas of tissue destruction and necrosis, orbital cellulitis, ptosis, proptosis, and vision loss in advanced cases. The pathognomonic feature of the disease is the presence of invasive mycelium in the tissues. A case series on four patients diagnosed with rhinocerebral mucormycosis is presented. Diabetic ketoacidosis was the common risk factor observed in all the three patients. It was concluded that early diagnosis and aggressive medical and surgical treatment are necessary for decreasing the high mortality rate of the infection.

  20. Unilateral Suppression of Brown Fat on FDG PET/CT in Horner Syndrome.

    Science.gov (United States)

    Ulaner, Gary A; Samstein, Robert; Cahlon, Oren; Weber, Wolfgang A; Rimner, Andreas

    2016-10-01

    A 29-year-old woman underwent resection of a left anterior mediastinal thymoma and pleurectomy. Postsurgical FDG PET/CT scan demonstrated FDG avidity in the right neck and upper thoracic fat but relatively absent FDG-avid fat in the left neck and upper thorax. Bilateral FDG-avid fat was also apparent in the lower chest and upper abdomen. After surgery, the patient demonstrated Horner syndrome, with left-sided ptosis, miosis, and facial anhidrosis. It is hypothesized that left-sided sympathetic nerves were compromised during surgery, leading to Horner syndrome and denervation of ipsilateral brown fat. The unilateral FDG avidity should not be mistaken for malignancy.

  1. Unilateral straight hair and congenital horner syndrome.

    Science.gov (United States)

    Wang, Frederick M; Wertenbaker, Christian; Cho, Hyung; Marmor, Maury A; Ahn-Lee, Sandra S; Bernard, Bruno A

    2012-06-01

    Congenital Horner syndrome is a rare disorder that accounts for less than 5% of all cases of Horner syndrome. Like Horner syndrome in general, it consists primarily of ptosis, miosis, and anhidrosis. Congenital Horner syndrome may manifest some special features such as iris heterochromia since the sympathetic nervous system is an essential component for the development and maintenance of eye color. We present 3 cases of unilateral straight hair in association with congenital Horner syndrome in which the patients had straight hair ipsilateral to the Horner syndrome, whereas on the contralateral side, it was curly, and we discuss possible mechanisms for this phenomenon.

  2. [Horner syndrome following combined spinal-epidural anesthesia].

    Science.gov (United States)

    Karaca, Ömer; Kumaş Solak, Sezen; Demirgan, Serdar; Bademci, Mehmet

    2016-07-01

    Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia. Among other causes of Horner syndrome are head and neck surgery, trauma, and puncture of internal jugular vein. The present case of unilateral Horner syndrome appeared in the aortobifemoral bypass after lumbar spinal- epidural anesthesia.

  3. Acquired infantile Horner syndrome and spontaneous internal carotid artery dissection: a case report and review of literature.

    Science.gov (United States)

    Pirouzian, Amir; Holz, Huck A; Ip, Kenneth C; Sudesh, Rattehalli

    2010-04-01

    Horner syndrome, a triad of ptosis, anisocoria, and anhidrosis, results from interruption in the oculosympathetic pathway. It is classically described as either congenital or acquired to depict its underlying pathophysiology and requisite work-up. We report a case of a 10-month-old infant presenting with an acute onset of left Horner syndrome secondary to a spontaneous extracranial internal carotid artery dissection. To the best of our knowledge, this is the first case report in the literature of acute onset of acquired infantile Horner syndrome in association with spontaneous carotid artery dissection confirmed with magnetic resonance angiogram.

  4. Mitochondrial neurogastrointestinal encephalomyopathy: novel pathogenic mutations in thymidine phosphorylase gene in two Italian brothers.

    Science.gov (United States)

    Libernini, Laura; Lupis, Chiara; Mastrangelo, Mario; Carrozzo, Rosalba; Santorelli, Filippo Maria; Inghilleri, Maurizio; Leuzzi, Vincenzo

    2012-08-01

    Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE, MIM 603041) is an autosomal recessive multisystem disorder occurring due to mutations in a nuclear gene coding for the enzyme thymidine phosphorylase (TYMP). Clinical features of MNGIE include gastrointestinal dysmotility, cachexia, ptosis or ophthalmoparesis, peripheral neuropathy, diffuse leukoencephalopathy, and signs of mitochondrial dysfunction in tissues. We report the clinical and molecular findings in two brothers in whom novel TYMP gene mutations (c.215-13_215delinsGCGTGA; c.1159 + 2T > A) were associated with different clinical presentations and outcomes.

  5. Local anesthesia: A feasible option for pediatric frontalis sling surgery.

    Science.gov (United States)

    William, Jerald; Abbott, Joseph; Kipioti, Athina; Reuser, Tristan

    2011-01-01

    The purpose of this study was to demonstrate the suitability of local anesthesia in the pediatric age group for oculoplastic procedures. The authors present a case of frontalis sling surgery performed under local anesthesia in a 15-year-old boy with bilateral congenital ptosis. No significant technical difficulties were encountered during the procedure. Optimal intraoperative eyelid placement was facilitated by the patient's comfort and cooperation. For some selected children, local anesthesia is a good alternative to general anesthesia to obtain the best outcome.

  6. Recurrent painful ophthalmoplegic neuropathy; A case report

    Directory of Open Access Journals (Sweden)

    Semra Saygi

    2014-08-01

    Full Text Available Recurrent painful ophthalmoplegic neuropathy, typically seen as a serious childhood migraine attack which is followed by ptosis and diplopia due to oculomotor nerve palsy. This is regarded as a form of migraine in the previous classifications but according to the latest classification of the International Headache Society has been recognized as cranial neuralgia. Due to the poor pathological and radiological findings of oculomotor nerve during attack, it is difficult to make differential diagnosis. In this manuscript we report 11-year-old female patient with ophtalmoplegic migraine. [Cukurova Med J 2014; 39(4.000: 938-941

  7. Open angle glaucoma in a case of Type IV Ehler Danlos syndrome: A rarely reported association

    OpenAIRE

    2014-01-01

    A 26-year-old male presented to us with defective vision in the left eye. He had best corrected visual acuity (BCVA) of hand movement (HM) in right eye and 6/9 in left eye. He had ptosis with ectropion in both eyes and relative afferent pupillary defect (RAPD) in right eye. Intraocular pressure (IOP) was 46 and 44 mmHg in right and left eye, respectively. Fundus showed glaucomatous optic atrophy (GOA) in right eye and cup disc ratio (CDR) of 0.75 with bipolar rim thinning in left eye. Systemi...

  8. Preliminary screening of five ethnomedicinal plants of Guatemala.

    Science.gov (United States)

    Morales, C; Gomez-Serranillos, M P; Iglesias, I; Villar, A M; Cáceres, A

    2001-01-01

    We performed the Irwin test on some different extracts of the aerial parts of Tridax procumbens L., of the leaves of Neurolaena lobata (L.) R. Br., of the bark and leaves of Byrsonima crassifolia (L.) Kunth. and Gliricidia sepium Jacq. Walp. and of the root and leaves of Petiveria alliacea L. At a dosage of 1.25 g extract/100 g dried plant, the aqueous extracts of bark and leaves of Byrsonima crassifolia (L.) Kunth. and G. sepium Jacq. Walp. showed higher activity: decrease in motor activity, back tonus, reversible parpebral ptosis. catalepsy and strong hypothermia.

  9. Autoimmune Myasthenia Gravis after Sternal Fracture

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    Jens A. Petersen

    2012-01-01

    Full Text Available We report a 54-year-old woman who suffered a commotio cerebri, whiplash injury and a chest trauma with sternal fracture due to a high-velocity car accident. Two months later, she developed unilateral ptosis and blurred vision, which worsened during the day. Multiple diagnoses were suggested, ranging from thoracic outlet syndrome towards depression. Symptoms persisted and five years later, the patient consulted a neurologist. Laboratory analysis revealed significantly elevated levels of antibodies to acetylcholine receptors, and the diagnosis of myasthenia gravis was made. Speculatively, the damage of retrosternal thymic remnants due to a sternal fracture might have precipitated the condition or exacerbated subclinical disease.

  10. Transcervical excision of thymoma and video-assisted thoracoscopic extended thymectomy (VATET) for ectopic cervical thymoma with myasthenia gravis: report of a case.

    Science.gov (United States)

    Kumazawa, Sachiko; Ishibashi, Hironori; Takahashi, Ken; Okubo, Kenichi

    2016-12-01

    Myasthenia gravis is the most common disease associated with thymoma, but it is rarely accompanied by ectopic thymoma. We describe a 47-year-old woman who presented with an ectopic cervical thymoma with myasthenia gravis. She was admitted to our neurology department with ptosis, diplopia, and mandibular muscle fatigue, and was diagnosed with myasthenia gravis. The mass was located posterior to the right lobe of thyroid gland on computed tomography and was diagnosed as ectopic thymoma on fine-needle aspiration biopsy examination. Transcervical excision of thymoma and VATET were performed. The patient has been free of neurological symptoms and has displayed no evidence of recurrent thymoma for 2 years.

  11. Familial myasthenia gravis: report of four cases

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1976-09-01

    Full Text Available Two pairs of siblings with myasthenia gravis, belonging to two different families, are reported. This is the only record of familial myasthenia during the past twenty years, in a total of 145 patients seen at the Neurological Clinic of the São Paulo Medical School. In spite of the fact that myasthenia gravis does not show hereditary characteristics, the peculiar features of the four cases justify the present report. The two pairs of siblings were born from non myasthenic nor consanguineous parents. The disease started at birth showing bilateral partial eyelid ptosis in all patients. The course of the illness has been favorable. There was no thymoma.

  12. Genetic eye research in Tasmania: a historical overview.

    Science.gov (United States)

    Mackey, David A

    2012-03-01

    Although considerable recent work on hereditary eye diseases in Tasmanian families has been published, much of this depended on a century of meticulous pedigree collection by earlier clinical researchers. This article reviews some of the historical papers and the importance they have played in gene discovery and understanding of ophthalmic genetics. Tasmanian families have contributed to the identification of genes for X-linked megalocornea, Leber's hereditary optic neuropathy, retinitis pigmentosa, congenital cataract, ptosis, keratoconus, glaucoma and myopia. The true value of the Tasmanian pedigrees will be realized with the translation of genetic discoveries into early diagnosis and treatment for these eye diseases.

  13. Ethmoidal Mucocele Presenting as Oculomotor Nerve Paralysis

    Science.gov (United States)

    Kim, Dae Woo; Sohn, Hee-Young; Jeon, Sea-Yuong; Kim, Jin-Pyeong; Ahn, Seong-Ki; Park, Jung Je; Woo, Seung Hoon

    2013-01-01

    A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's symptoms (oculomotor nerve paralysis and headache) resolved in 4 weeks. Oculomotor paralysis is a rare symptom of an ethmoidal mucocele. In this article, we report this rare case along with a literature review. PMID:23799169

  14. A case of relapsing flitting bilateral idiopathic orbital inflammation.

    LENUS (Irish Health Repository)

    Browne, Michelle Ann

    2009-12-01

    Idiopathic orbital inflammation (IOI) is defined as a benign non-infective clinical syndrome characterized by features of non-specific inflammation of the orbit without identifiable local or systemic causes. This can be called orbital myositis if the inflammation is predominantly in the orbital muscles. It is a diagnosis of exclusion based on clinical, radiological, and if necessary, histological findings. The most commons symptoms are swelling, ptosis, proptosis and painful eye movements. To our knowledge, this patient is the first with IOI to demonstrate relapsing flitting bilateral involvement of several individual extra-ocular muscles.

  15. Craniosynostosis suggestive of Saethre-Chotzen syndrome: Clinical description of a large kindred and exclusion of candidate regions on 7p

    Energy Technology Data Exchange (ETDEWEB)

    von Gernet, S.; Muehlbauer, W.; Fairley, J. [Staedtisches Krankenhaus Bogenhausen, Muenchen (Germany)] [and others

    1996-05-03

    We describe the clinical manifestations of an autosomal dominant form of craniosynostosis in a large family with eight affected relatives. Unilateral or bilateral coronal synostosis, low frontal hair line, strabismus, ptosis, and partial cutaneous syndactyly of fingers and toes are findings suggestive of the diagnosis of Saethre-Chotzen syndrome. The disease locus was excluded from the two adjacent Saethre-Chotzen candidate regions on 7p by linkage analysis with markers D7S664 and D7S507. This indicates heterogeneity of Saethre-Chotzen syndrome with a locus outside the candidate regions on 7p. 30 refs., 6 figs., 2 tabs.

  16. Síndrome MAPE, heavy eye y esclerodermia

    OpenAIRE

    Brugnoli de Pagano, Ofelia; Pagano, Gabriela

    2009-01-01

    Paciente de 60 años de edad y sexo femenino con esclerodermia y miopía alta bilateral que consulta por estrabismo y ptosis palpebral. El estrabismo consiste en esotropía progresiva con hipotropía de ojo derecho (OD) asociado a miopía alta axial con gran tamaño del globo ocular medido por ecometría ultrasónica que conjuntamente con imágenes de Resonancia Magnética Nuclear (RMN) llevan al diagnóstico de Síndrome MAPE (Miopic Acquired Progressive...

  17. Conjunctival inclusion cysts following small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Narayanappa Shylaja

    2010-01-01

    Full Text Available The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

  18. [Iris heterochromia in acquired Horner's syndrome].

    Science.gov (United States)

    Beynat, J; Soichot, P; Bidot, S; Dugas, B; Creuzot-Garcher, C; Bron, A

    2007-09-01

    Horner's syndrome (HS) is related to an interruption of the oculosympathetic nerve pathway. The classic clinical findings associated with this condition are ptosis, miosis, and enophthalmos. Heterochromia is typically described in congenital HS, but it is an uncommon finding in acquired HS. We report a case of post-traumatic HS associated with heterochromia. A literature review indicates that this type of heterochromia may be related to a reduction in the number of iris melanocytes. This mechanism may be the same in the physiological iris color modifications in adulthood.

  19. Post-thyroidectomy iatrogenic Horner's syndrome with heterochromia

    OpenAIRE

    2016-01-01

    Purpose To present a case of iatrogenic Horner's syndrome seen together with the heterochromia in the post-thyroidectomy period. Methods A 23-year-old female patient was admitted to our clinic with complaints of low vision in the eye and difference in eye color that developed over the past two years. In the left eye, myosis and minimal ptosis (∼1 mm) was detected, and the color of the iris was lighter than the right eye. Results The pre-diagnosis of left iatrogenic Horner's syndrome was final...

  20. Orbital apex syndrome due to aspergillosis: case report

    Directory of Open Access Journals (Sweden)

    Fernandes Yvens B.

    2001-01-01

    Full Text Available We report the case of a 73-year-old female who presented facial numbness and pain in the first division of the trigeminal nerve, ptosis, diplopia and visual loss on the right side for the previous four months. The neurological, radiological and histological examination demonstrated a rare case of invasive fungal aspergillosis of the central nervous system, causing orbital apex syndrome, later transformed in temporal brain abscess. She died ten months later due to respiratory and renal failure in spite of specific antimycotic therapy.

  1. A case report: indomethacin resistance hemicrania continua or a new entity?

    Science.gov (United States)

    Coşkun, Ozlem; Uçler, Serap; Ocal, Ruhsen; Inan, Levent Ertuğrul

    2014-01-01

    Hemicrania continua (HC) is a rare primary headache disorder. It presents some autonomic features (including conjunctival injection, ptosis, eyelid edema, lacrimation, nasal congestion, and rhinorrhea). Response to indomethacin treatment is the mandatory criteria for the diagnosis of HC. However, previously reported literature indicates that there are some reported cases that did not respond to indomethacin. In this case report, we present a patient who had indomethacin resistance with an associated pregabalin response. Pregabalin may be an effective treatment for hemicrania continua in some patients with indomethacin resistance.

  2. Myositic Type of Idiopathic Orbital Pseudotumor in a 4-Year-Old Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Selim Bakan

    2012-01-01

    Full Text Available Idiopathic orbital pseudotumor is a benign, noninfectious, and nonneoplastic disease with unknown cause. It is the third most common orbital disease after thyroid orbitopathy and lymphoproliferative disorder. Idiopathic orbital pseudotumor is extremely rare in pediatric age group and may cause real diagnostic problems. This paper describes a 4-year-old girl who presented with sudden ptosis in the right eye and swollen eyelid. She recovered completely with high-dose steroid therapy. We report clinical and magnetic resonance imaging findings of orbital myositis, which is a rare subtype of idiopathic orbital pseudotumor in children and needs to be differentiated from other orbital disease especially malignancy.

  3. Dynamin 2 mutations cause sporadic centronuclear myopathy with neonatal onset.

    Science.gov (United States)

    Bitoun, Marc; Bevilacqua, Jorge A; Prudhon, Bernard; Maugenre, Svetlana; Taratuto, Ana Lia; Monges, Soledad; Lubieniecki, Fabiana; Cances, Claude; Uro-Coste, Emmanuelle; Mayer, Michèle; Fardeau, Michel; Romero, Norma B; Guicheney, Pascale

    2007-12-01

    We report four heterozygous dynamin 2 (DNM2) mutations in five centronuclear myopathy patients aged 1 to 15 years. They all presented with neonatal hypotonia with weak suckling. Thereafter, their phenotype progressively improved. All patients demonstrated muscle weakness prominent in the lower limbs, and most of them also presented with facial weakness, open mouth, arched palate, ptosis, and ophthalmoparesis. Electrophysiology showed only myopathic changes, and muscle biopsies showed central nuclei and type 1 fiber hypotrophy and predominance. Our results expand the phenotypic spectrum of dynamin 2-related centronuclear myopathy from the classic mild form to the more severe neonatal phenotype.

  4. Distal spinal muscular atrophy and ophthalmoparesis. A case with selective type 2 fiber hypotrophy.

    Science.gov (United States)

    Dubrovsky, A; Taratuto, A L; Martino, R

    1981-09-01

    A patient had distal muscular atrophy involving the upper and lower extremities, ptosis of the lid, and ophthalmoparesis and cataracts. Muscle histochemistry and electromyographic examination showed lower motor neuron involvement. This case is similar to others described in the literature and designated as distal spinal muscular atrophy. The unique association with ophthalmologic signs can be considered either as a variant form of the disease or as a separate entity. Muscle biopsy showed selective type 2 muscle fiber hypotrophy in the biceps. A second biopsy specimen of the quadriceps showed type grouping with persistence of small type 2 fibers, suggesting that reinnervation capability is independent of neuronal trophic influence.

  5. Endoscopic brow lifts uber alles.

    Science.gov (United States)

    Patel, Bhupendra C K

    2006-12-01

    Innumerable approaches to the ptotic brow and forehead have been described in the past. Over the last twenty-five years, we have used all these techniques in cosmetic and reconstructive patients. We have used the endoscopic brow lift technique since 1995. While no one technique is applicable to all patients, the endoscopic brow lift, with appropriate modifications for individual patients, can be used effectively for most patients with brow ptosis. We present the nuances of this technique and show several different fixation methods we have found useful.

  6. Distrofia muscular oculofaríngea: Tratamiento quirúrgico

    OpenAIRE

    DÍAZ DE LIAÑO A,ALVARO; FERNÁNDEZ R,LORANS; YÁRNOZ I,CONCEPCIÓN; ARTIEDA S,CRISTINA; GONZÁLEZ A,GREGORIO; ARTAJONA R,ALICIA; ORTIZ H,HÉCTOR

    2009-01-01

    La distrofia muscular oculofaríngea (DMOF) es una enfermedad de carácter hereditario, que cursa con disfagia, ptosis palpebral y debilidad proximal de las extremidades. Para su valoración la realización de manometría y estudio radiológico contrastado pueden ser de gran utilidad a pesar de que el diagnóstico de seguridad se obtiene por el estudio genético del gen PABPN1 del cromosoma 14. La enfermedad se desarrolla al sufrir este gen pequeñas expansiones en el triplete (GCG)7-13. Presentamos d...

  7. Clinical and electrodiagnostic findings in cyhalothrine poisoning

    Science.gov (United States)

    Basiri, Keivan; Mohaghegh, Mohammad Reza; Teimouri, Somayyeh Sadat; Okhovat, Ali Asghar

    2016-01-01

    Acute onset bulbar symptoms with respiratory failure and descending paralysis may occur in several neuromuscular disorders including variants of Guillain-Barre syndrome (GBS), diphtheria, botulism and toxins. We present a 51-year-old man who presented with complains of ptosis and dyspnea following pyrethroids spraying in an enclosed area for eradication of flea. Within 5-6 days of admission limb weakness, dysphagia, dysarthria, blurred vision, diplopia, tremor and respiratory distress added to previous symptoms. Temporal profile of events after exposure, development of similar symptoms in patient's son, electrodiagnostic findings and exclusion of other etiologies confirms intoxication etiology. We reviewed the literature and provide an extensive electrodiagnostic overview. PMID:27099845

  8. Causas otorrinolaringológicas de síndrome de Claude-Bernard-Horner

    OpenAIRE

    Fuente Cañibano, Rebeca de la; Muñoz Herrera, Ángel María

    2010-01-01

    [ES] El síndrome de Claude-Bernard-Hörner está causado por lesión simpática de las ramas ascendentes del ganglio estrellado, que inervan el iris y el músculo liso palpebral. Su tríada característica es la presencia de ptosis, miosis y enoftalmos, pudiendo asociarse anhidrosis, dilatación pupilar retardada y heterocromía en los casos congénitos. [EN] The syndrome of Claude-Bernard-Hörner is caused by the sinpatical injury of the branches ascending innervation of the stellate...

  9. Miopatia mitocondrial: relato de dois casos Mitochondrial myopathy: two case reports

    Directory of Open Access Journals (Sweden)

    Sara Patrícia Grebos

    2005-10-01

    Full Text Available Miopatia mitocondrial é um distúrbio genético caracterizado por oftalmoplegia externa crônica progressiva e ptose palpebral superior, apresentando-se a partir da 3ª e 4ª década de vida. Os autores revisaram a literatura e relataram 2 casos do sexo feminino com diplopia à leitura.Mitochondrial myopathy is a genetic disorder characterized by chronic progressive external ophthalmoplegia and upper eyelid, ptosis which occurs before 30 to 40 years of life. The authors reviewed the literature and reported two cases of reading diplopia in female patients.

  10. Isotretinoin embryopathy: report of one case

    Directory of Open Access Journals (Sweden)

    Cláudia Patraquim

    2015-12-01

    Full Text Available Retinoic acid is a derivative of vitamin A.Retinoic acid embryopathy is an association of malformations caused by the teratogenic effect of retinoic acid, a drug used for the treatment of cystic acne.Isotretinoin is also known as 13-cis-retinoic acid.The risk of malformations after exposure to oral isotretinoin has been evaluated to be around 20%.Affected infants may present craniofacial, central nervous system, cardiac, and thymus abnormalities. There is also an increased risk of spontaneous abortions and premature delivery. Isotretinoin may also have effects on child behavior in about 30-60% of children exposed to it. Termination of pregnancy may be considered in cases of pregestational and/or gestational exposure to isotretinoin.The authors present the case of an infant male who was the first child of young, healthy, unrelated parents, whose mother was exposed to isotretinoin in both pregestational and gestational periods.He had a developmental delay, craniofacial abnormalities (low-set and dysplastic ears with anteverted lobules, frontal upsweep, hypertelorism, flat nasal bridge and prominent filter and apparent articular hypermobility, more obvious in his knees. Brain magnetic resonance imaging showed absence of cerebellar vermis, midbrain dysplastic configuration with thickened superior cerebellar peduncles, decreased thickness of pons-midbrain transition, right cerebellar hemisphere dysplasia, mild decrease in corpus callosum thickness, and enlarged pericerebral subarachnoid space.The features described are compatible with isotretinoin embryopathy, according to the literature.This case aims to raise awareness about the use of teratogenic drugs in women of childbearing age, especially isotretinoin, and the importance of information regarding effective contraceptive methods, with compulsory pregnancy testing.

  11. Axenfeld-Rieger anomaly and Axenfeld-Rieger syndrome: clinical, molecular-cytogenetic, and DNA array analyses of three patients with chromosomal defects at 6p25.

    Science.gov (United States)

    Tonoki, Hidefumi; Harada, Naoki; Shimokawa, Osamu; Yosozumi, Ayako; Monzaki, Kadomi; Satoh, Kohei; Kosaki, Rika; Sato, Atsushi; Matsumoto, Naomichi; Iizuka, Susumu

    2011-12-01

    Clinical phenotypes of and genetic aberrations in three unrelated Japanese patients with Axenfeld-Rieger anomalies and various accompanying malformations of systemic organs are described. GTG-banded chromosome analysis showed terminal deletions of the short arm of chromosome 6 in two patients and an inversion, inv(6)(p25q14), in the other. FISH and DNA array analyses revealed that the two patients with deletions had 5.0-5.7 Mb and 6.6 Mb 6p terminal deletions, respectively, and FOXC1 was apparently deleted in both patients. In the other patient, the inversion breakpoint at 6p25 was estimated to be in or very close to the FOXC1 locus, but DNA array analysis did not reveal a deletion around the breakpoint. Common extraocular findings in these patients included broad forehead, brachycephaly, hypertelorism, downslanting palpebral fissures, small anteverted nose, and cardiac defects. Two patients also exhibited autistic characteristics. The two patients with deletions exhibited poor muscle tone and developmental delays. Most of these extraocular findings were similar to those found in previous patients with FOXC1 mutations and distinct from those found in patients with PITX2 mutations, who frequently develop umbilical and dental anomalies. We suggest that the psychomotor retardation is a clinical manifestation associated with a deletion of multiple contiguous genes in the 6p terminus and that this phenomenon is similar to the 6p25 deletion syndrome. Understanding the relationship between genetic lesions and the spectrum of extraocular findings in patients with Axenfeld-Rieger anomalies may lead to better clinical management. Copyright © 2011 Wiley Periodicals, Inc.

  12. Herpetiform genital lesions in a heifer with mucosal disease.

    Science.gov (United States)

    Fabis, J J; Szkudlarek, L; Risatti, G R; Sura, R; Garmendia, A E; Van Kruiningen, H J

    2008-03-01

    A 14-month-old heifer with a 17-day history of unresponsive bloody diarrhea was necropsied. There were focal, pink-red erosions of the nares and hard palate; ulcers and fissures of the tongue; and multiple ulcerative lesions of the alimentary canal. Interdigital skin of both rear limbs was ulcerated and bleeding; and the margins of the vulva contained punctiform red ulcers. The gross lesions were consistent with mucosal disease. Histopathology and laboratory testing ruled out rinderpest, foot-and-mouth disease, and vesicular stomatitis, and identified bovine virus diarrhea virus to be the cause of this disease. Lesions of the vulva similar to those seen in some stages of infectious pustular vulvovaginitis were negative for bovine herpesvirus-1 and tested positive for bovine viral diarrhea virus antigen by immunohistochemistry.

  13. Information Submanifold Based on SPD Matrices and Its Applications to Sensor Networks

    Directory of Open Access Journals (Sweden)

    Hao Xu

    2017-03-01

    Full Text Available In this paper, firstly, manifoldPD(nconsisting of alln×nsymmetric positive-definite matrices is introduced based on matrix information geometry; Secondly, the geometrical structures of information submanifold ofPD(nare presented including metric, geodesic and geodesic distance; Thirdly, the information resolution with sensor networks is presented by three classical measurement models based on information submanifold; Finally, the bearing-only tracking by single sensor is introduced by the Fisher information matrix. The preliminary analysis results introduced in this paper indicate that information submanifold is able to offer consistent and more comprehensive means to understand and solve sensor network problems for targets resolution and tracking, which are not easily handled by some conventional analysis methods.

  14. Quantum Theory of Electronic Double-Slit Diffraction

    Institute of Scientific and Technical Information of China (English)

    WU Xiang-Yao; GUO Yi-Qing; ZHANG Bai-Jun; LI Hai-Bo; LU Jing-Bin; LIU Xiao-Jing; WANG Li; ZHANG Chun-Li; LIU Bing; FAN Xi-Hui

    2007-01-01

    Phenomena of electron, neutron, atomic and molecular diffraction have been studied in many experiments, and these experiments have been explained by some theoretical works. We study electronic double-slit diffraction with a quantum mechanical approach and obtain the following results: (1) When the ratio of d + a/a = n (n = 1, 2, 3,...),orders n, 2n, 3n,...are missing in diffraction pattern. (2) When the ratio of d+a/a ≠ n (n = 1, 2, 3,...), there is not missing order in diffraction pattern. (3) The slit thickness c has a large affect on the electronic diffraction pattern, which is a new quantum effect. We believe that all the predictions in our work can be tested by the electronic double slit diffraction experiment.

  15. Hydromedusae from the Arctic in 2010 during the 4th Chinese National Arctic Research Expedition (CHINARE 4)

    Institute of Scientific and Technical Information of China (English)

    WANG Chunguang; HUANG Jiaqi; XIANG Peng; WANG Yanguo; XU Zhenzu; GUO Donghui; LIN Mao

    2014-01-01

    Fifty-seven stations (48 grid stations and nine stratified stations) were sampled across the study region (67.000°-88.394°N, 152.500°-178.643°W ) during the 4th Chinese National Arctic Research Expedition (CHI-NARE 4) from July to August 2010 by the icebreaker R/V Xuelong. A total of 24 species of Hydromedusae were identified from 130 zooplankton samples, of which seven species belonged to Automedusa, eight species to Anthomedusae, four species to Leptomedudae, and three species to Siphonophora. Catablema multicir-ratum Kishinouye, 1910, Bougainvillia bitentaculata Uchida, 1925, and Euphysa japonica (Maas, 1909) were recorded for the first time in the Arctic sea. In the present paper, 18 species of Hydromedusae were described and illustrated, of which three species were described for the first time in the Arctic sea, and 15 species were described for the first time in China.

  16. The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit.

    LENUS (Irish Health Repository)

    Edmundson, S P

    2012-01-31

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.

  17. Konstruktion av startkatapult för UAV : Utvecklad för Discoverer RPAS

    OpenAIRE

    Perfect, Oscar

    2014-01-01

    Obemannade system blir allt vanligare både på den militära och kommersiella marknaden. Unmanned Aerial Vehicle, i vardagsspråk benämnt som drönare, är ett flygplan som ombord saknar en mänsklig pilot. Då utbudet och efterfrågan av obemannade farkoster ökar måste tillverkarna lägga mer fokus på att kunna erbjuda hela system, vilket innebär att vid försäljning kan ett komplett system för obemannade farkoster erbjudas. Därför är behovet av tillbehör och kringutrustning idag lika viktigt som det ...

  18. Postoperative infection of an abdominal mesh due to methicillin resistant Staphylococcus Aureus - A case report

    Directory of Open Access Journals (Sweden)

    Ashok R

    2004-01-01

    Full Text Available Methicillin resistant Stephylococcus aureus (MRSA infection has now become a major problem in hospitals. We present a case of postoperative infection MRSA where the primary source of the infection was found to be an abdominal mesh that was used to reinforce the abdominal wall. After one year of surgery, the patient developed wound dehiscence and discharge. MRSA was isolated from the wound, mesh, external nares, throat and axilla. Initially she was started on clindamycin and discharged from the hospital. After 5 months, patient came back to the hospital with infection at the same site. The patient was then treated with vancomycin and MRSA clearance. She responded to the treatment with complete healing of the wound and clearance of MRSA.

  19. 主动监测培养气管中 MRSA 预测 ICU 患者后续 MRSA 感染%Active surveillance culture of the trachea for MRSA is predictor of MRSA infections among patients in Intensive Care Unit

    Institute of Scientific and Technical Information of China (English)

    王颖

    2015-01-01

    Objective To investigate whether traditional surveillance culture of the anterior nares for methicillin-resistant staphylococcus aureus ( MRSA) shows sufficient sensitivity and predictive value compared to other sites, especially the trachea, in ICU patients.Methods A prospective observational cohort study was performed in 142 patients.Samples for MRSA detection were obtained at the time of admission, 48 h after admission, and then weekly thereafter.All subjects were routinely monitored for the development of MRSA infection during their stay in the ICU.Results MRSA colonization was detected in 65 (46%) patients over the course of the study.The sensitivity of MRSA surveillance culture was significantly higher in tracheal aspirates ( 82%, 53/65 ) than in anterior nares (47%, 30/65) ( P 0.05).The area under the curve for MRSA pneumonia was significantly higher in trachea (0.791, 95%CI 0.739 ~0.837) than anterior nares (0.649, 95% CI 0.590 ~0.705) (P=0.044).Conclusion Cultures from tracheal aspirates are more sensitive and predictive of subsequent MRSA pneumonia than cultures from the anterior nares in this population.%目的:探讨主动监测培养鼻前庭或气管耐甲氧西林金黄色葡萄球菌( methicillin-resistant staphylococcus aureus, MRSA)对于重症加强护理病房( ICU)患者后续MRSA感染的敏感度和预测价值。方法对本院ICU收治的142例患者进行前瞻性研究,在入组患者刚入院和入院48 h取MRSA标本检测,之后每周检测1次。所有受试者在ICU期间常规监测MRSA感染情况。结果研究过程中发现65例(46%)患者MRSA定植。 MRSA在气管吸出物(82%,53/65)监测培养敏感度高于鼻前庭(47%,30/65)(P<0.001)。气管中(分别为69%和93%)监测培养物预测MRSA感染和肺炎敏感度高于鼻前庭(分别为48%和50%)。预测后续MRSA感染的ROC曲线下面积值气管吸出物(0.675)高于鼻前庭(0.648),

  20. Gravity gradient for Greenland and its tectonic interpretation

    Science.gov (United States)

    Grushinsky, Andrew N.

    2013-04-01

    Gravity gradient is the indicator of the stress conditions in the lithosphere. The axis of gradient signs changing indicates the boundary of blocks exposed to different tensions. The lines of maxima and minima of gravity gradient correspondingly marked the boundary of zones of compression and expansion. Four various types of the gravity anomalies was calculated: in free air, Bouguer's, Glennie's and isostatic. And then was calculated their gradients. The preliminary analysis of gradients shows, that its qualitative behavior for all types of gravity anomalies is very closely and, therefore, conclusions about the stress conditions in the lithosphere of the considering region are definite. Range of the changing for gradients of gravity in free air anomalies - from -96.1 to 135.8 eötvös, and for gradients of gravity Bouguer's anomalies - from -122.6 to 141.9 eötvös. Range of the changing for gradients of gravity Glennie's and isostatic anomalies are substantially smaller, for gradients of gravity Glennie's anomalies - from -27.6 to 25.5 eötvös, and for gradients of gravity isostatic anomalies - from -19.2 to 21.2 eötvös. This difference in the gradient values, evidently, connects with the difference in the thoroughness and the degree of averaging of the anomalies. Analysis of gravity gradient shown the following: 1. In the western part of the researching region are distinguished three linear structures (two maxima and one minimum), which marked rift zone of the Baffin Bay and Davis Strait. This disappeared rift characterized by depressed zone, lengthened from Nares strait along the west sea coast of Greenland. In the south part of this zone localized deep fault, which northward become lesser expressed. To the north and north-east from the Nares strait lengthened to the North Pole zone of compression, blocked up existing previously rift, by which the rotation of the Greenland part of Canadian shield from its cardinal part happened. Center of this rotation

  1. A case of antibacterial-responsive mucocutaneous disease in a seven-year-old dwarf lop rabbit (Oryctolagus cuniculus) resembling mucocutaneous pyoderma of dogs.

    Science.gov (United States)

    Benato, L; Stoeckli, M R; Smith, S H; Dickson, S; Thoday, K L; Meredith, A

    2013-04-01

    A seven-year-old, ovariohysterectomised female dwarf lop rabbit (Oryctolagus cuniculus) was referred with severe swelling and erythema of the mucocutaneous junctions of the lips, nares and vulva. Bilateral, severe periocular dermatitis was also present. Heavy pure growths of a member of the Staphylococcus intermedius group were cultured from nasal and aural swabs and skin biopsies. Other possible differential diagnoses were eliminated by standard tests. The clinical features and histopathological characteristics of the biopsies were most consistent with mucocutaneous pyoderma, a dermatosis previously reported in dogs but not in rabbits. Treatment of the bacterial infection with oral marbofloxacin and topical ofloxacin eye drops together with supportive therapy resulted in resolution of the lesions. To the authors' knowledge, this is the first report of mucocutaneous bacterial pyoderma, similar to mucocutaneous pyoderma of dogs, in a rabbit. © 2013 British Small Animal Veterinary Association.

  2. Upphandlingskrav utifrån energieffektiviseringsåtgärder i byggskedet

    OpenAIRE

    Hatami, Siamak; Inekci, Siyabend

    2015-01-01

    I takt med byggbranschens ökade miljöengagemang uppmärksammas allt fler områden som är i behov av energieffektiviseringsåtgärder. De olika parterna har vid olika skeden av byggprocessen olika ansvar och förutsättningar.   Genom att ställa fler krav vid upphandlingsskedet kan beställare i samarbete med huvudentreprenörer och även aktörer längre ner i ledet skapa en grönare byggarbetsplats. Fastighets AB Brostaden som är ett fastighetsbolag i Storstockholm vill i sin roll som beställare undersö...

  3. “Glava že vsěm Biblïja”. Le citazioni bibliche nell’opera di H.S. Skovoroda (1722-1794 tra tradizione slava ecclesiastica e cultura barocca

    Directory of Open Access Journals (Sweden)

    Maria Grazia Bartolini

    2013-02-01

    Full Text Available Innumerable quotations from the Bible permeate all Skovoroda’s writings, and yet no systematic analysis of the philosopher’s biblical quotations (or of his quotations from other ecclesiastical sources has ever been made . In this article I isolate all the biblical quotations incorporated in the dialogue Beseda 1-ja narečennaja Observatorium (Sion, while pointing to their role as a crucial component of the spiritual meaning of the text. It is my contention that Skovoroda’s use of the Bible follows the rhetorical and theological patterns already outlined by R. Picchio in his seminal works on the function of “biblical thematic clues”. On the other hand, the often whimsical distribution of biblical quotations and their complicated linking with one another are to be placed in the Baroque tradition, where, as P. Lewin’s studies on Ukrainian scholastic drama have successfully demonstrated, quotations from the Bible fulfilled stylistic as well as theological functions.

  4. TREATMENT OF PULMONICOLA COCHLEOTREMA INFECTION WITH IVERMECTIN-PRAZIQUANTEL COMBINATION IN AN ANTILLEAN MANATEE (TRICHECHUS MANATUS MANATUS).

    Science.gov (United States)

    Borges, João Carlos Gomes; Jung, Larissa Molinari; Santos, Sebastião Silva Dos; Carvalho, Vitor Luz; Ramos, Rafael Antonio Nascimento; Alves, Leucio Câmara

    2017-03-01

    The aim of this study was to report the use of an oral combination of ivermectin plus praziquantel in the treatment of a Pulmonicola cochleotrema in an Antillean manatee ( Trichechus manatus manatus). A female manatee was found exhibiting respiratory changes and the presence of parasites in the nares. Based on clinical manifestations presented by the manatee, a symptomatic therapeutic protocol was employed, which included an anthelmintic treatment using a combination of ivermectin plus praziquantel. The parasites retrieved were identified as P. cochleotrema. The fourth day after the onset of the therapeutic protocol, the clinical signs declined and on the seventh day posttreatment no clinical signs were observed. This is the first time a therapeutic protocol of ivermectin plus praziquantel has been used in the treatment of P. cochleotrema in manatees.

  5. A new syndrome of 'spondylo-epi-metaphyseal dysplasia: mixed type''

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, B.G. [Department of Radiology, Al Afia Hospital, Houn, Al-Jufra (Libya)

    2003-02-01

    A new type of rare bone dysplasia is described, which shares some common features with spondylo-meta-epiphyseal dysplasia: short limb-abnormal calcification type and lethal metatropic dysplasia. Besides these features, the present case has some additional unusual features. Facial malformation was very obvious and of a different type. The nose and nares were completely flattened. Hypertrophied acetabular bones, round densities on the ilia, premature ossification of many epiphyses and carpal bones, curvilinear calcifications in some joints, fusion of the ischiopubic rami, calcification of many costal cartilages and thick sclerotic base of the skull were a few of the significant findings. On the basis of the clinical and radiological features, the condition has been named ''spondylo-epi-metaphyseal dysplasia: mixed type''. (orig.)

  6. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA among patients visiting the emergency room at a tertiary hospital in Brazil

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    Julival Ribeiro

    2005-02-01

    Full Text Available We surveyed patients seen at the emergency room at a tertiary hospital in Brazil from August to November 1997. All patients' (n = 600 anterior nares were cultured for MRSA; the results were confirmed by oxacillin disk diffusion methods and by detection of the mecA gene with PCR. Bacteria were found in 93.3% (560 of the patients and MRSA in 0.7% (n = 4. One patient had community-acquired MRSA. We concluded that MRSA is uncommon among patients visiting the emergency room. The presence of community-acquired MRSA can lead to serious medical and epidemiological issues, although initial clinical presentation may not differ from that of infections with other staphylococci. The empirical use of vancomycin for suspected community-acquired infections is seldom warranted.

  7. Oral-facial-digital syndrome with mesoaxial polysyndactyly, common AV canal, hirschsprung disease and sacral dysgenesis: Probably a transitional type between II, VI, variant of type VI or a new type

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2014-07-01

    Full Text Available We report a 4 month old male infant, the first in order of birth of healthy first cousin consanguineous parents who has many typical features of oral-facial-digital syndrome type VI (OFDS VI including hypertelorism, bilateral convergent squint, depressed nasal bridge, and wide upturned nares, low set posteriorly rotated ears, long philtrum, gum hyperplasia with notches of the alveolar borders, high arched palate, and hyperplastic oral frenula. He has mesoaxial and postaxial, polysyndactyly which is the specific feature of OFDS VI, however the cerebellum is normal on MRI brain. He has also some rare congenital anomalies including common atrioventricular canal, hirschsprung disease, and sacral dysgenesis. This patient may have a transitional type between II and VI, a variant of type VI or a new type.

  8. Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place

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    Naveen Eipe

    2013-01-01

    Full Text Available We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.

  9. Characterization of methicillin-resistant Staphylococcus aureus Sequence Type 398

    DEFF Research Database (Denmark)

    Christiansen, Mette Theilgaard

    Staphylococcus aureus is an opportunistic pathogen that colonizes the nares and skin surfaces of several animal species, including man. S. aureus can cause a wide variety of infections ranging from superficial soft tissue and skin infections to severe and deadly systemic infections. Traditionally S...... for LA-MRSA ST398 survival on porcine skin and nasal epithelium ex vivo were identified. These genes could represent targets for de-colonization, which could help prevent further spread and adaption of LA-MRSA ST398. Manuscript III describes the construction of the S. aureus VirulenceFinder database....... The database can be applied for identification of virulence genes in S. aureus using whole genome 5 sequence data. The S. aureus VirulenceFinder will be part of the tool package generated for the Centre for Genomic Epidemiology (CGE) (www.genomicepidemiology.org)....

  10. Hepatic Necrosis and Degenerative Myopathy Associated with Cassava Feeding in Pigs

    Directory of Open Access Journals (Sweden)

    Gloria Daniel-Igwe

    2014-01-01

    Full Text Available Forty-three deaths were recorded among pigs fed boiled cassava meal at a private piggery over a period of two years. There were signs of sudden death in some cases with blood exuding from the external nares, vomiting, muscular weakness and pain or reluctance to move, emaciation, and stunted growth. The necropsy lesions included skeletal and cardiac muscle degeneration and necrosis, icterus, hepatic necrosis, and oedema of the dependent parts. The deaths and clinical signs are thought to be due to a non cyanide toxic principle in cassava, possibly the coumarins (scopoletin, which is found in high levels in cassava diet even after heat treatment. Therefore, the use of proper processing technology to obtain cassava products of high quality is recommended.

  11. COMPARATIVE GROSS ANATOMICAL STUDY OF THE AXIAL SKELETIONS OF BUFF ALOES AND COWS

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    R.U. Shahid and F. Muhammad

    2001-01-01

    Full Text Available In buffalo the lateral margins of wing of atlas were curved upward and foramina transversarium was present. The 7th cervical vertebra was having 4-5 inches long spinous process, the summit of the spinous processes from 8-13th thoracic vertebrae were undivided. The cranial articular surfaces were triangular laterally in lumber vertebrae. Groove between medial and lateral crests of sacrum were deeper. Occipital bone covered all the posterior half of the dorsal surface of the skull, foramen magnum was wider and paramastoid processes were bent caudomedially. The cornual prosesses were located at a lower level, temporal crest was caudal to the corneal process. Posterior nares were wider, the posterior surface of the skull was parabolic. The infraorbital foramen was situated in a deep fossa slightly rostral and about 1.5 inches dorsal to the first premolar.

  12. Pathologic, immunohistochemical, and electron microscopic findings in naturally occurring virulent systemic feline calicivirus infection in cats.

    Science.gov (United States)

    Pesavento, P A; MacLachlan, N J; Dillard-Telm, L; Grant, C K; Hurley, K F

    2004-05-01

    Infection with feline calicivirus (FCV) is a common cause of upper respiratory and oral disease in cats. FCV infection is rarely fatal, however, virulent, systemic strains of FCV (VS-FCV) that cause alopecia, cutaneous ulcers, subcutaneous edema, and high mortality in affected cats have recently been described. Seven cats with natural VS-FCV infection all had subcutaneous edema and ulceration of the oral cavity, with variable ulceration of the pinnae, pawpads, nares, and skin. Other lesions that were present in some affected cats included bronchointerstitial pneumonia, and pancreatic, hepatic, and splenic necrosis. Viral antigen was present within endothelial and epithelial cells in affected tissues as determined by immunohistochemical staining with a monoclonal antibody to FCV. Mature intranuclear and intracytoplasmic virions in necrotic epithelial cells were identified by transmission electron microscopy. VS-FCV infection causes epithelial cell cytolysis and systemic vascular compromise in susceptible cats, leading to cutaneous ulceration, severe edema, and high mortality.

  13. Degree of free fatty acid saturation influences chocolate rejection in human assessors.

    Science.gov (United States)

    Running, Cordelia A; Hayes, John E; Ziegler, Gregory R

    2017-02-01

    In foods, free fatty acids (FFAs) traditionally have been viewed as contributing an odor, yet evidence has accumulated that FFAs also contribute a unique taste ("oleogustus"). However, minimal work has been conducted using actual foods to test the contribution of FFA to taste preferences. Here, we investigate flavor, taste, and aroma contributions of added FFA in chocolate, as some commercial manufacturers already use lipolysis of triglycerides to generate unique profiles. We hypothesized that small added concentrations of FFAs would increase preferences for chocolate, whereas higher added concentrations would decrease preferences. We also hypothesized a saturated fatty acid (stearic C18) would have a lesser effect than a monounsaturated (oleic C18:1), which would have a lesser effect than a polyunsaturated (linoleic C18:2) fatty acid. For each, paired preference tests were conducted for 10 concentrations (0.04% to 2.25%) of added FFAs compared with the control chocolate without added FFAs. Stearic acid was tested for flavor (tasting and nares open), whereas the unsaturated fatty acids were tested for both aroma (orthonasal only and no tasting) and taste (tasting with nares blocked to eliminate retronasal odor). We found no preference for any added FFA chocolate; however, rejection was observed independently for both taste and aroma of unsaturated fatty acids, with linoleic acid reaching rejection at lower concentrations than oleic acid. These data indicate that degree of unsaturation influences rejection of both FFA aroma and taste in chocolate. Thus, alterations of FFA profiles in foods should be approached cautiously to avoid shifting concentrations of unsaturated fatty acids to hedonically unacceptable levels. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Cutaneous reactive histiocytosis in dogs: a retrospective evaluation of 32 cases.

    Science.gov (United States)

    Palmeiro, Brian S; Morris, Daniel O; Goldschmidt, Michael H; Mauldin, Elizabeth A

    2007-10-01

    Thirty-two cases of canine cutaneous histiocytosis were retrospectively evaluated. Median age at onset was 4 years. Lesions included nodules and plaques affecting the head/face, trunk and limbs, and erythema, swelling and depigmentation of the nasal planum/nares. Systemic involvement was not ruled out in all cases. All dogs had complete resolution of dermatological lesions after initial treatment (median 45 days). Initial treatment included prednisone +/- antibiotics (12 of 32 dogs), prednisone and tetracycline/niacinamide (four of 32), prednisone and azathioprine (three of 32), tetracycline/niacinamide +/- vitamin E/essential fatty acids (six of 32), antibiotics +/- antihistamines (three of 32), cyclosporine and ketoconazole (one of 32), topical therapy (two of 32), and no treatment (one of 32). Seventeen dogs received maintenance therapy which consisted of tetracycline/niacinamide +/- vitamin E/essential fatty acids (12 of 17), cyclosporine/ketoconazole (two to three times a week) (two of 17), azathioprine daily (one of 17), prednisone/azathioprine (two times a week) (one of 17), and prednisone daily (one of 17). Median follow up was 25 months. Nine dogs had a recurrence of cutaneous histiocytosis (median days to recurrence 130 days), with seven of nine having more than one recurrence. At study completion, six dogs were deceased (no lesions at the time of death) and 26 of 32 were alive with no lesions. Ten of 26 dogs were on maintenance treatment (eight tetracycline/niacinamide, one azathioprine, one vitamin E). Previous dermatological disease and season had no detectable influence on recurrence. Recurrence was significantly more likely in dogs with nasal planum/nares lesions than dogs without these lesions. Tetracycline/niacinamide was an effective treatment option for dogs in this study population.

  15. Image Guided Clinical Correlation of CDH and Calve-Legg-Perthes Disease

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    Mohammad Hossein Herischi

    2011-05-01

    Full Text Available Background/Objective: Anatomic condition and"nvascularization of the femoral head leads to Calve-"nLegg-Perthes disease (avascular necrosis in children"nand primary condition of acetabulum and coverage"nof hip joint as a defect, cause CDH or congenital"ndislocation of the hip joint. Early diagnosis of these"ndiseases in clinic, confirmation by imaging (US, Xray,"nX-ray CT and MRI help better treatment and less"ncomplication or sequel."nPatients and Methods: By two decade evaluation and"ntreatment we used clinical assessments by pediatric"northopedic surgeons and radiologic examinations like"nfrog-leg, AP X-rays, ultrasound examinations, 2D"nand 3D X-ray CT and 1.5 tesla MR-machine images."nTreatments were with fixation (using cast and elizarov"nvariant fixators, surgery and controlling by imaging."nResults: Ultrasound and MRI were the best methods"nin diagnosis, image guided treatment (medical or"nsurgical and treatment controlling. Many patients"nare treated with minor complications. Complications"nare rare in CDH but some complications have been"nmentioned for CLP disease."nConclusion: Image guidance in diagnosis and treatment"nalso treatment control of pediatric CDH and CLP"ndisease give the pediatric orthopedic surgeon a good"noutcome of the disease and its treatment. Ultrasound"nand MRI using highly sophisticated probes, coils and"nprotocols with new machines gives us the best result"nin diagnosis, treatment and post-op controls.

  16. Maturation of the infant microbiome community structure and function across multiple body sites and in relation to mode of delivery.

    Science.gov (United States)

    Chu, Derrick M; Ma, Jun; Prince, Amanda L; Antony, Kathleen M; Seferovic, Maxim D; Aagaard, Kjersti M

    2017-03-01

    Human microbial communities are characterized by their taxonomic, metagenomic and metabolic diversity, which varies by distinct body sites and influences human physiology. However, when and how microbial communities within each body niche acquire unique taxonomical and functional signatures in early life remains underexplored. We thus sought to determine the taxonomic composition and potential metabolic function of the neonatal and early infant microbiota across multiple body sites and assess the effect of the mode of delivery and its potential confounders or modifiers. A cohort of pregnant women in their early third trimester (n = 81) were prospectively enrolled for longitudinal sampling through 6 weeks after delivery, and a second matched cross-sectional cohort (n = 81) was additionally recruited for sampling once at the time of delivery. Samples across multiple body sites, including stool, oral gingiva, nares, skin and vagina were collected for each maternal-infant dyad. Whole-genome shotgun sequencing and sequencing analysis of the gene encoding the 16S rRNA were performed to interrogate the composition and function of the neonatal and maternal microbiota. We found that the neonatal microbiota and its associated functional pathways were relatively homogeneous across all body sites at delivery, with the notable exception of the neonatal meconium. However, by 6 weeks after delivery, the infant microbiota structure and function had substantially expanded and diversified, with the body site serving as the primary determinant of the composition of the bacterial community and its functional capacity. Although minor variations in the neonatal (immediately at birth) microbiota community structure were associated with the cesarean mode of delivery in some body sites (oral gingiva, nares and skin; R(2) = 0.038), this was not true for neonatal stool (meconium; Mann-Whitney P > 0.05), and there was no observable difference in community function regardless of delivery mode

  17. Co-colonization and clonal diversity of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in sows.

    Science.gov (United States)

    Fetsch, Alexandra; Roesler, Uwe; Kraushaar, Britta; Friese, Anika

    2016-03-15

    Methicillin-susceptible Staphylococcus (S.) aureus (MSSA) and methicillin-resistant S. aureus (MRSA) are colonizers of skin and mucosa. In humans, MSSA and MRSA compete for colonization space in the anterior nares of pig farmers; however, it was also shown that MSSA/MRSA co-colonization is common and one clone can be found rather than differing types of MSSA and MRSA. We investigated the colonization and clonality of both, MSSA and MRSA in pigs over a longer time. Eighteen sows were nasally sampled three times every ten weeks. Additionally, environmental samples were taken. Samples were investigated for MSSA and MRSA, respectively. The spa type was defined from up to five MRSA and MSSA isolates found per sample and sampling time; selected isolates were further investigated by microarray. Three sows (16.7%) were completely negative for MSSA and MRSA. Twelve pigs (66.7%) were irregularly positive for both, MSSA and MRSA over the time, whereas seven out of them (38.9%) were simultaneously colonized. CC398 (t034, t011) MRSA and CC9 (t337, t1430, and t13816) MSSA associated spa types were exclusively found. In 44.4% (n=8) of sows up to two different types of MSSA were present at the same time and sample. Strains of the same clonal lineage showed a high genetic identity despite their origin. Highly identic clones were present in sows and their environment. As conclusion, MSSA/MRSA may not exclude each other in the anterior nares of pigs. Pigs may also carry different clones at the same time.

  18. Cynomolgus macaque as an animal model for severe acute respiratory syndrome.

    Directory of Open Access Journals (Sweden)

    James V Lawler

    2006-05-01

    Full Text Available The emergence of severe acute respiratory syndrome (SARS in 2002 and 2003 affected global health and caused major economic disruption. Adequate animal models are required to study the underlying pathogenesis of SARS-associated coronavirus (SARS-CoV infection and to develop effective vaccines and therapeutics. We report the first findings of measurable clinical disease in nonhuman primates (NHPs infected with SARS-CoV.In order to characterize clinically relevant parameters of SARS-CoV infection in NHPs, we infected cynomolgus macaques with SARS-CoV in three groups: Group I was infected in the nares and bronchus, group II in the nares and conjunctiva, and group III intravenously. Nonhuman primates in groups I and II developed mild to moderate symptomatic illness. All NHPs demonstrated evidence of viral replication and developed neutralizing antibodies. Chest radiographs from several animals in groups I and II revealed unifocal or multifocal pneumonia that peaked between days 8 and 10 postinfection. Clinical laboratory tests were not significantly changed. Overall, inoculation by a mucosal route produced more prominent disease than did intravenous inoculation. Half of the group I animals were infected with a recombinant infectious clone SARS-CoV derived from the SARS-CoV Urbani strain. This infectious clone produced disease indistinguishable from wild-type Urbani strain.SARS-CoV infection of cynomolgus macaques did not reproduce the severe illness seen in the majority of adult human cases of SARS; however, our results suggest similarities to the milder syndrome of SARS-CoV infection characteristically seen in young children.

  19. A study of the stable boundary layer in strong gap flows in northwest Greenland using a research aircraft

    Science.gov (United States)

    Heinemann, Günther; Drüe, Clemens

    2016-04-01

    Gap flows and the stable boundary layer (SBL) were studied in northwest Greenland during the aircraft-based experiment IKAPOS (Investigation of Katabatic winds and Polynyas during Summer) in June 2010. The measurements were performed using the research aircraft POLAR 5 of Alfred Wegener Institute (AWI, Bremerhaven). Besides navigational and basic meteorological instrumentation, the aircraft was equipped with radiation and surface temperature sensors, two laser altimeters, and video and digital cameras. In order to determine turbulent heat and momentum fluxes, POLAR 5 was instrumented with a turbulence measurement system collecting data on a nose boom with a sampling rate of 100 Hz. In the area of the Nares Strait a stable, but fully turbulent boundary layer with strong winds of 15 m s-1 to 20 m s-1 was found during conditions of relatively warm synoptically induced northerly winds through the Nares Strait. Strong surface inversions were present in the lowest 100 m to 200 m. As a consequence of channeling effects a well-pronounced low-level jet (LLJ) system was documented. The channeling process is consistent with gap flow theory and can be shown to occur at the topographic gap between Greenland and Canada represented by the Smith Sound. While the flow through the gap and over the surrounding mountains leads to the lowering of isotropic surfaces and the acceleration of the flow, the strong turbulence associated with the LLJ leads to the development of an internal thermal SBL past the gap. Turbulence statistics in this fully turbulent SBL can be shown to follow the local scaling behaviour.

  20. Aleitamento materno e colonização mucocutânea pelo Staphylococcus aureus na criança com dermatite atópica Breastfeeding and mucosal and cutaneous colonization by Staphylococcus aureus in atopic children

    Directory of Open Access Journals (Sweden)

    Raissa Massaia Londero Chemello

    2011-06-01

    remains unclear whether colonization of atopic patients by Staphylococcus aureus (S. aureus through breastfeeding is relevant to the development of AD. OBJECTIVE: To examine the potential relation between breastfeeding and colonization by S. aureus in atopic patients. METHOD: Transversal study of atopic patients, aged from 4 to 24 months, both genders, receiving outpatient care and 72 mothers. Data on infant breastfeeding practices and on clinical-epidemiological profile were registered. Swabs of the infants' nares and skin (cubital fossa and swabs of the mothers' nares were collected. For univariate analysis, X2 (chi-square and Fischer Exact's test were used. RESULTS: Among breastfed children, S. aureus was isolated from 8 (25.8% infants' nares swabs and from 4 (12.9% skin swabs. Among not breastfed children, S. aureus was isolated from 10 (20.8% infants' nares swabs and from 11 (22.9% skin swabs. Sixteen mothers (22.2% had S. aureus isolated from their nares swabs. There was no significant association between breastfeeding and S. aureus colonization (child skin and/or nares. However, there was a degree of concordance for S. aureus carriage among mothers and infants. Among 72 pairs, 56 (77.8% were concordant. CONCLUSION: Breastfeeding was not associated with S. aureus muco-cutaneous colonization in atopic infants

  1. Myotonic dystrophy type 1: frequency of ophthalmologic findings

    Directory of Open Access Journals (Sweden)

    Karin Suzete Ikeda

    2016-03-01

    Full Text Available ABSTRACT The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1 patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP. Method Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P and ophthalmic protocol. Results We evaluated 42 patients aged 17 to 64 years (mean 40.7 ± 12.5, 22 of which were men. IOP (n = 41 was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48% and ptosis in 23 (54.76%. These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment.

  2. Bing and Neel Syndrome

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    S. Jennane

    2012-01-01

    Full Text Available Introduction. We report the case of a Bing and Neel syndrome revealed by an isolated left ptosis. Case Report. a 57-year-old man was followed up since October 2003 for a typical Waldenström’s macroglobulinemia. A first complete remission was obtained with chlorambucil. In August 2004, he relapsed. A second complete remission was obtained with RFC chemotherapy regimen (rituximab, fludarabine, and cyclophosphamide. In October 2009, the patient presented with an isolated left ptosis revealing a Bing and Neel syndrome. The diagnosis was suspected on MRI and confirmed by the detection in the CSF of a monoclonal IgM similar to the one found in the plasma. A quite good partial remission has been obtained after one course of RDHAP (rituximab, dexamethasone, cytarabine, and cisplatin and 3 courses of RDHOx (rituximab, dexamethasone, cytarabine, and oxaliplatin, in addition to ten intrahectal chemotherapy injections. The treatment was followed by intensification and autologous stem cell transplantation. At D58, the patient died due to a septic shock. Conclusion. BNS is a rare and potentially treatable complication of WM. It should be considered in patients with neurologic symptoms and a history of WM.

  3. Oculopharyngeal muscular dystrophy: phenotypic and genotypic studies in a Chinese population.

    Science.gov (United States)

    Shan, Jingli; Chen, Bin; Lin, Pengfei; Li, Duoling; Luo, Yuebei; Ji, Kunqian; Zheng, Jinfan; Yuan, Yun; Yan, Chuanzhu

    2014-12-01

    Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant late-onset neuromuscular degenerative disease characterized by ptosis, dysphagia, and proximal muscle weakness. The genetic basis has been identified as an abnormal (GCN) expansion encoding the polyalanine tract in exon 1 of the polyadenylate-binding protein nuclear 1 gene (PABPN1). OPMD is worldwide distributed, but has rarely been reported in East Asians. In this study, we summarized the clinical and genetic characteristics of 34 individuals from 13 unrelated families in Chinese population. In our cohort, the mean age at onset was 47.2 years. Dysphagia, rather than ptosis, was the most common initial symptom. Genetically, we identified seven genotypes in our patients, including one compound heterozygote of (GCN)11/(GCN)12. The genetic heterogeneity implies that there is no single founder effect in Chinese population, and our data also support that the (GCN)11 polymorphism may have a disease-modifying effect. Additionally, the clinical features showed homogeneity within families, which suggests that other genetic factors apart from the already known genotype also play a role in modifying the phenotype.

  4. Noncosmetic periocular therapeutic applications of botulinum toxin

    Directory of Open Access Journals (Sweden)

    Kaynak-Hekimhan Pelin

    2010-01-01

    Full Text Available Botulinum toxin blocks acetylcholine release at the neuromuscular junction. The drug which was initially found to be useful in the treatment of strabismus has been extremely effective in the treatment of variety of conditions, both cosmetic and noncosmetic. Some of the noncosmetic uses of botulinum toxin applications include treatment of spastic facial dystonias, temporary treatment of idiopathic or thyroid dysfunction-induced upper eyelid retraction, suppression of undesired hyperlacrimation, induction of temporary ptosis by chemodenervation in facial paralysis, and correction of lower eyelid spastic entropion. Additional periocular uses include control of synchronic eyelid and extraocular muscle movements after aberrant regeneration of cranial nerve palsies. Cosmetic effects of botulinum toxin were discovered accidentally during treatments of facial dystonias. Some of the emerging nonperiocular application for the drug includes treatment of hyperhidrosis, migraine, tension-type headaches, and paralytic spasticity. Some of the undesired side effects of periocular applications of botulinum toxin inlcude ecchymosis, rash, hematoma, headache, flu-like symptoms, nausea, dizziness, loss of facial expression, lower eyelid laxity, dermatochalasis, ectropion, epiphora, eyebrow and eyelid ptosis, lagophthalmos, keratitis sicca, and diplopia.

  5. Characterization of a 8q21.11 Microdeletion Syndrome Associated with Intellectual Disability and a Recognizable Phenotype

    Science.gov (United States)

    Palomares, María; Delicado, Alicia; Mansilla, Elena; de Torres, María Luisa; Vallespín, Elena; Fernandez, Luis; Martinez-Glez, Victor; García-Miñaur, Sixto; Nevado, Julián; Simarro, Fernando Santos; Ruiz-Perez, Victor L.; Lynch, Sally Ann; Sharkey, Freddie H.; Thuresson, Ann-Charlotte; Annerén, Göran; Belligni, Elga F.; Martínez-Fernández, María Luisa; Bermejo, Eva; Nowakowska, Beata; Kutkowska-Kazmierczak, Anna; Bocian, Ewa; Obersztyn, Ewa; Martínez-Frías, María Luisa; Hennekam, Raoul C.M.; Lapunzina, Pablo

    2011-01-01

    We report eight unrelated individuals with intellectual disability and overlapping submicroscopic deletions of 8q21.11 (0.66–13.55 Mb in size). The deletion was familial in one and simplex in seven individuals. The phenotype was remarkably similar and consisted of a round face with full cheeks, a high forehead, ptosis, cornea opacities, an underdeveloped alae, a short philtrum, a cupid's bow of the upper lip, down-turned corners of the mouth, micrognathia, low-set and prominent ears, and mild finger and toe anomalies (camptodactyly, syndactyly, and broadening of the first rays). Intellectual disability, hypotonia, decreased balance, sensorineural hearing loss, and unusual behavior were frequently observed. A high-resolution oligonucleotide array showed different proximal and distal breakpoints in all of the individuals. Sequencing studies in three of the individuals revealed that proximal and distal breakpoints were located in unique sequences with no apparent homology. The smallest region of overlap was a 539.7 kb interval encompassing three genes: a Zinc Finger Homeobox 4 (ZFHX4), one microRNA of unknown function, and one nonfunctional pseudogen. ZFHX4 encodes a transcription factor expressed in the adult human brain, skeletal muscle, and liver. It has been suggested as a candidate gene for congenital bilateral isolated ptosis. Our results suggest that the 8q21.11 submicroscopic deletion represents a clinically recognizable entity and that a haploinsufficient gene or genes within the minimal deletion region could underlie this syndrome. PMID:21802062

  6. Trans-orbital orbitocranial penetrating injury by pointed iron rod

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Tewari

    2015-01-01

    Full Text Available Trans-orbital orbitocranial penetrating injury (TOPI by a foreign body is an extremely rare compound head injury having a potential to cause major morbidity and mortality. Preoperative radiological imaging by CT scan is very important for operative guidance, but in remote area where CT scan is not available, the patient is generally referred to tertiary level. Here we present a case which was dealt successfully without CT scan, only on the basis of stable clinical status and X-rays. We present a case of a 35-year-old man who had an accidental injury (fall from height by rod. Immediate X-ray (anteroposterior and lateral views revealed that the pointed end of the foreign body (rod was inside the ipsilateral anterior fossa via basifrontal bone up to frontal vertex, not crossing the midline. CT scan was not available and his vitals with GCS were normal (15/15. He was operated with the help of an ophthalmic surgeon by right frontotemporal craniotomy. The patient was discharged on 10 th day without any neurological deficit except restricted right eyeball movement to superolateral and ptosis. The restricted eyeball movements recovered after third month of follow up with remnant ptosis for 2 years. This case highlights an unusual case, direct visualization and repair of brain structures with higher antibiotics can save the life even in remote areas where CT scan is still not available only on the basis of stable GCS and X-rays.

  7. Presumed Isotretinoin-Induced, Concomitant Autoimmune Thyroid Disease and Ocular Myasthenia Gravis: A Case Report

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    Huseyin Gursoy

    2012-11-01

    Full Text Available Introduction: There are many adverse effects that have been described for isotretinoin. To the best of our knowledge, this is the first report of a possible association of oral isotretinoin intake with autoimmune thyroiditis and ocular myasthenia gravis (OMG. Case Presentation: A 19-year-old Caucasian male, who had used oral isotretinoin for severe acne disease for the previous six months, was referred to our clinic. He had a three-week history of diplopia and variable bilateral ptosis. Physical examination showed moderate periorbital edema and limitations of up- and down-gaze in the left eye. Laboratory findings and thyroid ultrasound were consistent with autoimmune thyroiditis. Antithyroid therapy did not relieve the clinical symptoms. Concomitant OMG was suspected. Variable ptosis and a positive response to oral prednisolone of 40 mg/day and pyridostigmine of 360 mg/day supported the diagnosis of concomitant autoimmune thyroiditis and OMG. Conclusion: Autoimmune disorders may be triggered by oral isotretinoin treatment. Clinicians prescribing isotretinoin should be aware of the possible association between isotretinoin intake and concomitant autoimmune thyroiditis and OMG.

  8. Saethre-Chotzen syndrome: notable intrafamilial phenotypic variability in a large family with Q28X TWIST mutation.

    Science.gov (United States)

    Dollfus, Hélène; Biswas, Partha; Kumaramanickavel, Govindsamy; Stoetzel, Corinne; Quillet, Renaud; Biswas, Jyotirmay; Lajeunie, Elisabeth; Renier, Dominique; Perrin-Schmitt, Fabienne

    2002-05-01

    Saethre-Chotzen syndrome is an autosomal dominant disease characterized by craniosynostosis, ptosis, and limb and external ear abnormalities. Variable expressivity is a well-known phenomenon in this disorder. A large Indian family has been recently identified as carrying a nonsense TWIST mutation (Q28 X) in 17 members, of whom 16 were examined in detail. Only 4 (25%) of the patients showed patent craniostenosis, namely, oxycephaly. The penetrance of craniosynostosis in this family is lower than previously reported in the literature. Fifteen patients (93%) had moderate to severe ptosis. Minor limb and external ear abnormalities were present in most patients. Eyelid features were the hallmark of the disease for 12 members of the family, suggesting that mutations in TWIST may lead to a phenotype with mainly palpebral features and no craniostenosis. The clinical analysis of this large family clearly illustrates the significant variable expressivity, probably related to haploinsufficiency because of the TWIST mutation. This phenotypic variability remains unclear but could be the result of modifier genes and/or genetic background effect, as noticed previously in the transgenic twist-null heterozygous mice.

  9. Additional phenotypic features of Muenke syndrome in 2 Dutch families.

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    de Jong, Tim; Mathijssen, Irene M J; Hoogeboom, A Jeannette M

    2011-03-01

    In about 30% of the patients with syndromal craniosynostosis, a genetic mutation can be traced. For the purpose of adequate genetic counseling and treatment of these patients, the full spectrum of clinical findings for each specific mutation needs to be appreciated. The Pro250Arg mutation in the FGFR3 gene is found in patients with Muenke syndrome and is one of the most frequently encountered mutations in craniosynostosis syndromes. A number of studies on the relationship between genotype and phenotype concerning this specific mutation have been published. Two Dutch families with Muenke syndrome were screened for the reported characteristics of this syndrome and for additional features. New phenotypical findings were hypoplasia of the frontal sinus, ptosis of the upper eyelids, dysplastic elbow joints with restricted elbow motion, and mild cutaneous syndactyly. Incidentally, polydactyly, severe ankylosis of the elbow, fusion of cervical vertebrae, and epilepsy were found. Upper eyelid ptosis is thought to be pathognomonic for Saethre-Chotzen syndrome but was also observed in our series of patients with Muenke syndrome. Because Muenke and Saethre-Chotzen syndrome can have similar phenotypes, DNA analysis is needed to distinguish between these syndromes, even when a syndrome diagnosis is already made in a family member.

  10. A propósito de un caso de síndrome fetal alcohólico With regard a case of alcoholic fetal syndrome

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    Rita Mercedes Jiménez López

    2012-03-01

    Full Text Available Se presenta el caso de un varón de tres años de edad, que fue remitido a la consulta de genética por la especialista de oftalmología. Acudió a consulta por ptosis palpebral y después de la valoración exhaustiva se detectó un cuadro complejo, con multiplicidad de alteraciones oftalmológicas por lo que se decidió la remisión. Después de la investigación correspondiente, se constataron alteraciones funcionales y anatómicas, tanto durante su desarrollo prenatal como postnatal, que permitieron concluir que se trataba de un síndrome fetal alcohólico, previo diagnóstico diferencial con otras enfermedades.This is the case of a male aged three years referred to genetics consultation by an ophthalmology specialist. He came to consultation due to palpebral ptosis and after an exhaustive assessment it was detected a complicated picture with many ophthalmologic alterations thus authors decide the remission. After corresponding research, functional and anatomical alterations were confirmed during its development and in postnatal status allowed us to conclude that it was an alcoholic fetal syndrome, previous differential diagnosis with other diseases.

  11. Ocular Myasthenia Gravis, Hashimoto’s Thyroiditis, Iron Deficiency Anemia, and Reactive Hypoglycemia

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    Füsun Mayda Domaç

    2009-06-01

    Full Text Available Myasthenia gravis (MG may occur in association with other organ- specific or nonspecific autoimmune diseases. In our study, we present a patient with ocular myasthenia, Hashimoto’s thyroiditis, and iron deficiency anemia who later developed reactive hypoglycemia. A 25-year-old woman with complaints of fluctuating extraocular muscle weakness, ptosis, and diplopia was examined. MG, type I (ocular MG, was confirmed by an elevated titer of anti-acetylcholine receptor antibodies in serum (7 nmol/l, normal <0.6 and positive edrophonium test. Nerve conduction studies, needle electromyography, repetitive stimulation tests, and mediasten MRI were normal. The coexistence of Hashimoto's thyroiditis was diagnosed by the presence of a diffuse thyroid enlargement, elevated titers of anti-thyroglobulin antibodies (211.8 IU/ml, normal 0-115, thyroid peroxidase antibodies (356.4 IU/ml, normal 0-34, thyroid stimulating hormone (8.21 uIU/ml, normal 0.27-4.2, and a decreased titer of free-T4 (1.03ng/dl normal 1.8-4.6. Diplopia and ptosis have regressed with 180 mg/day pyridostigmine bromide. On her follow-up period, 8 months later, reactive hypoglycemia has been diagnosed. The coexistence of myastenia gravis, Hashimoto’s thyroiditis and reactive hypoglycemia was not found in the literature. We should take into consideration the association and the importance of recognizing and treating these pathologies in myastenia gravis. Turk Jem 2009; 13: 31-3

  12. Johann Friedrich Horner and the Repeated Discovery of Oculosympathoparesis: Whose Syndrome Is It?

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    Abbas, Ahmed; Manjila, Sunil; Singh, Mantinderpreet; Belle, Vaijayantee; Chandar, Krishan; Miller, Jonathan P

    2015-09-01

    Disruption of cranial sympathetic tone leads to the symptom complex of miosis, ptosis, and hemifacial anhidrosis. It is widely believed that this phenomenon was discovered in 1869 by the Swiss ophthalmologist Johann Friedrich Horner, and as a result, the term Horner syndrome has become synonymous with the clinical presentation. However, the syndrome that would become Horner syndrome had actually been described several times before his report. François Pourfour du Petit documented the ocular effects of sympathetic trunk lesions in animal studies in 1727. Claude Bernard identified the full clinical triad in animal studies in 1852, and as a result, the condition is sometimes called Bernard syndrome. There were also 2 previous reports of ptosis and miosis resulting from sympathetic nerve damage in humans: 1 by Edward Selleck Hare in 1838 associated with brachial plexus tumor, and the other by Silas Weir Mitchell in 1864 associated with a gunshot wound to the neck. Although Horner was the first to objectively characterize the co-occurrence of vasomotor and ocular changes in a human patient, he did not identify the etiology of the condition, discuss its relationship to the sympathetic nervous system, or reference any of the previous studies in animals or humans. It is possible that a lack of familiarity with previous investigations delayed the full appreciation of the mechanism underlying this disorder.

  13. The aesthetic jaw line: management of the aging jowl.

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    Reece, Edward M; Rohrich, Rod J

    2008-01-01

    The lower third of the face is often an afterthought in aesthetic plastic surgery. Aging across the mandibular border may be described by several mechanisms: fat atrophy and volume loss; shifting of subcutaneous fat compartments; and mandibular septum dehiscence with submandibular fat hypertrophy. Accurate diagnosis of the apparent mechanism of jaw line aging is critical to successful facial rejuvenation. Diagnosis directs the plastic surgeon as to which key anatomic components in this region to manipulate to optimize rejuvenation. The senior author's technique for facial rejuvenation across the mandibular border is described with an algorithm for facial rejuvenation of the jaw line. Several consistent patterns of facial aging are apparent and a theory of their mechanism is suggested: (1) patients with thin skin and minimal jowling resulting from fat atrophy; (2) jowl ptosis with normal skin and loss of submalar hollow and midface fullness, caused by displacement of fat compartments; and (3) cascading confluent fat over the mandible, produced by septum dehiscence. Fat atrophy is treated with fat replacement, either injectable or autologous fat. Jowl ptosis is treated with septum release and superficial musculoaponeurotic system elevation to restore jaw line definition. Confluent fat is treated by septum release, superficial musculoaponeurotic system elevation, and direct excision of fat over the mandible. Application of techniques without proper analysis and definition may lead to an operated look with a swept jaw line. Undertreatment may not achieve jaw line definition.

  14. Histological evaluation of levator palpebralis superior muscle in patients with congenital blepharoptosis

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    Sevda Söker

    2011-03-01

    Full Text Available The aim of this study was to examine levator palpebralis superior muscle histologically in patients with congenital blepharoptosis and to investigate the relationship between these findings and age, sex and degree of blefaroptosis in this patient group.Materials and methods: Levator muscle of 13 patients with congenital ptosis, who had applied to Dicle University Medical Faculty Ophthalmology Clinic and had undergone levator palpebralis superior muscle resection between january 2009-january 2010, has been examined histopathologically in Histology and Embriology Deparment. During preoperative period, ptosis amount, levator function (LF, tear functions, Bell’s phenomenon and jaw-winking phenomenon were evaluated. All patients underwent resection of levator palpebralis superior muscle. Received postoperative levator muscle was examined by light microscopy.Results: The average age of 9 (69.2% male and 4 (30.8% female cases were 10.61 ± 4.77 (4- 19 years. In histological examination, the quality and quantity of the levator muscle fibrils have been assessed. There was no relationship detected between histological features of levator palpebralis superior muscle and patient’s age and gender (p>0.05. Patients with weak levator palpebralis superior muscle were detected to have fatty degeneration histologically. The higher the levator palpebralis superior muscle function revealed decreased fatty degeneration and increased skeletal muscle fibrils.Conclusion: More ultrastructural studies in larger populations are needed to support the relationship between structure and function of levator palpebralis superior muscle in patients with congenital blepharoptosis.

  15. Herida por proyectil de arma de fuego en un niño: Presentación de un caso Gunshot wound in a child: A case report

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    Juan Carlos Quintana Díaz

    2005-08-01

    Full Text Available Se presenta la evolución de un paciente masculino de 10 años que sufrió una herida por proyectil de arma de fuego en el párpado superior izquierdo jugando con otro niño, lo que lo provocó una ptosis palpebral marcada. Se realizó estudio radiográfico preoperatorio donde se encontró el proyectil alojado en la pared orbitaria superior. Se constató una excelente evolución posoperatoria del paciente una vez intervenido quirúrgicamente.The evolution of a 10-year-old male patient who had a marked palpebral ptosis as a result of a wound made by a bullet in the left upper eyelid while playing with another child, is presented. A preoperative radiographic study was conducted and the projectile was found in the upper orbital wall. An excellent postoperative evolution was observed once the patient underwent surgery.

  16. Novel OPA1 missense mutation in a family with optic atrophy and severe widespread neurological disorder.

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    Liskova, Petra; Ulmanova, Olga; Tesina, Petr; Melsova, Hana; Diblik, Pavel; Hansikova, Hana; Tesarova, Marketa; Votruba, Marcela

    2013-05-01

    To identify the underlying molecular genetic cause in a Czech family with optic atrophy, deafness, ptosis, ophthalmoplegia, polyneuropathy and ataxia transmitted as an autosomal dominant trait. Ophthalmological and neurological examination followed by molecular genetic analyses. Seven family members were clinically affected. There was a variable but progressive visual, hearing and neurological disability across the family as a whole. The majority of subjects presented with impairment of visual function and a variable degree of ptosis and/or ophthalmoplegia from the first to the third decade of life. Deafness, neuropathy and ataxia appeared later, in the third and fourth decade. Migraine, tachycardia, intention tremor, nystagmus and cervical dystonia were observed in isolated individuals. A significant overall feature was the high level of neurological disability leading to 3 of 4 members being unable to walk or stand unaided before the age of 60 years. A novel missense mutation c.1345A>C (p.Thr449Pro) in OPA1 segregating with the disease phenotype over three generations was detected. In silico analysis supported pathogenicity of the identified sequence variant. Our work expands the spectrum of mutation in OPA1, which may lead to severe multisystem neurological disorder. The molecular genetic cause of dominant optic atrophy in the Czech population is reported for the first time. We propose that regular cardiac follow-up in patients diagnosed with dominant optic atrophy and widespread neurological disease should be considered. © 2013 The Authors. Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation.

  17. Low-level versus high-level placement of gold plates in the upper eyelid in patients with facial palsy

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    Amer, Tarek A; El-Minawi, Hisham M; El-Shazly, Malak I

    2011-01-01

    Background: Lagophthalmos is a condition that results from facial paralysis causing functional as well as esthetic problems. This condition can be treated by a range of techniques, including tarsorrhaphy, facial slings, and canthopexies. Gold plates provide a solution for temporary or permanent lagophthalmos resulting from facial paralysis. This study discusses the use of gold plates in the treatment of lagophthalmos but with the introduction of gold plates in two different positions in the upper lids. Methods: Group 1 (38 eyes) had a low level of placement (2 mm from the lid margin) of gold plates, while Group 2 (23 eyes) had a high level of placement (5 mm from the lid margin). Results: Noticeable bulge was seen in 18.4% of Group 1 eyes compared with 13% in Group 2, and migration of the plate occurred in 2.6% and 0% of eyes in Group 1 and Group 2, respectively, as well as ptosis (7.8% and 4.3%) and conjunctival perforation (0% and 4.3%). The degree of improvement of eyelid closure, keratopathy, and visual acuity were the same for both techniques. Conclusion: Placement of gold plates at a higher level could avoid some of the drawbacks of lower level placement of these plates, such as upper eyelid bulge and ptosis, especially given the thinning of the eyelids and orbicularis muscles that occurs in facial palsy. PMID:21760718

  18. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation

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    Min Ji Kang

    2016-01-01

    Full Text Available We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure was low, but within the normal range in both eyes. Because cataracts are characteristic of myotonic dystrophy, we suggested that her 14-year-old daughter, who did not have any systemic complaints, undergo ophthalmic examination. She also had mild ptosis and snowflake cataracts. Both patients underwent genetic evaluation and were diagnosed with myotonic dystrophy caused by unstable expansion of cytosine-thymine-guanine trinucleotide repeats in the dystrophia myotonica-protein kinase gene. Ophthalmologists can diagnose myotonic dystrophy based on clinical and genetic findings, before the manifestation of systemic abnormalities.

  19. Two patients with co-morbid myasthenia gravis in a Brazilian cohort of inflammatory bowel disease.

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    Gondim, Francisco de A A; de Oliveira, Gisele R; Araújo, Davi F; Souza, Marcellus Henrique Loiola Ponte; Braga, Lúcia Libanez Bessa Campelo; Thomas, Florian P

    2014-11-01

    Co-morbid auto-immune disorders may affect 0.2% of the population. We present the clinical and electrodiagnostic findings of 2 patients with inflammatory bowel disease and myasthenia gravis from a Brazilian cohort of 218 inflammatory bowel disease patients. Patient 1: A 40year-old man was diagnosed with ulcerative colitis at age 37 and underwent total colectomy 3years later. After prednisone was tapered, he experienced a clinical relapse and was diagnosed with Crohn's disease. He then developed quadriparesis, bilateral ptosis, dysphagia and dysarthria. Patient 2: A 41year-old woman (diagnosed with ulcerative colitis and primary sclerosing cholangitis at age 35) developed speech impairment and ptosis. On both patients, symptoms quickly progressed over few weeks. Myasthenia gravis was diagnosed and confirmed by abnormal repetitive nerve stimulation and elevated anti-acetylcholine receptor antibody titers. Pyridostigmine and prednisone successfully treated both patients. Myasthenia gravis prevalence over 9years was 0.9%. Myasthenia gravis clinical course was not significantly modified by inflammatory bowel disease relapses and should be suspected with new onset weakness.

  20. Breast Cancer Presents with a Paraneoplastic Neurologic Syndrome

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    Pedro Coelho Barata

    2012-11-01

    Full Text Available Background: Paraneoplastic neurologic syndromes (PNS pose quite an uncommon neurological complication, affecting less than 1% of patients with breast cancer. Nearly one third of these patients lack detectable onconeural antibodies (ONAs, and improvement in neurologic deficits with concomitant cancer treatments is achieved in less than 30% of cases. Case Presentation: A 42-year-old, premenopausal woman presented with facial paralysis on the central left side accompanied by a left tongue deviation, an upward vertical nystagmus, moderate spastic paraparesis, dystonic posturing of the left foot, lower limb hyperreflexia and bilateral extensor plantar reflex. After ruling out all other potential neurologic causes, PNS was suspected but no ONAs were found. A PET-CT scan detected increased metabolism in the right breast, as well as an ipsilateral thoracic interpectoral adenopathy. Core biopsy confirmed the presence of an infiltrating duct carcinoma. After breast surgery, the neurologic symptoms disappeared. One week later, the patient was readmitted to the hospital with a bilateral fatigable eyelid ptosis, and two weeks later, there was a noticeable improvement in eyelid ptosis, accompanied by a rapid and progressive development of lower spastic paraparesis. She started adjuvant treatment with chemotherapy with marked clinical and neurological improvement, and by the end of radiotherapy, there were no signs of neurologic impairment. Conclusion: This case study highlights the importance of a high level of vigilance for the detection of PNS, even when ONAs are not detected, as the rapid identification and treatment of the underlying tumor offers the best chance for a full recovery.

  1. Study of two patients with craniosynostosis and deletions of 11q: One with features of Saethre-Chotzen syndrome and the other with concomitant partial trisomy 4q

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    Morsey, S. [Johns Hopkins Univ. School of Medicine, Baltimore, MD (United States)]|[Kennedy-Krieger Institute, Baltimore, MD (United States); Lewanda, A.F. [Johns Hopkins Univ. School of Medicine, Baltimore, MD (United States)]|[Children`s National Medical Center, Washington, DC (United States); Reid, C.S. [Cooper Hospitsl/Univ. Medical Center, Camden, NJ (United States)

    1994-09-01

    Partial monosomy 11q is associated with metopic craniosynostosis and trigonocephaly. Prominant features in the over 30 reported cases include downslanting palpebral fissures, epicanthal folds, hypertelorism, ptosis, wide/depressed nasal bridge, low set malformed ears, downturned mouth, micro/retrognathia, digital and cardiac anomalies and psychomotor retardation. We evaluated two patients referred for abnormal head shape. The first carried a diagnosis of Saethre-Chotzen syndrome due to brachycephaly, facial asymmetry, ptosis, cupped ears, sundactyly of 2nd and 3rd digits, developmental delay, and VSD. Karyotype revealed 46,XY,del(11)(q24.1{yields}qter). No abnormality was noted of chromosome 7p, where the Saethre-Chotzen syndrome locus has been mapped. This suggests genetic heterogeneity for this condition. The second patient had no prior diagnosis. He had trigonocephaly, bilateral cryptorchidism and inguinal hernias. He also had hypotelorism, epicanthal folds, synophrys, posteriorly rotated ears, horizontal crease below his lower lip, unilateral single palmar crease, mild soft tissue syndactyly and a shawl scrotum. His karyotype of 46,XY,-11,+der(11)t(4;11)(q31.3;q25) revealed both partial 11q monosomy and partial 4q trisomy (the latter associated with cryptorchidism, horizontal chin crease and single palmar crease). Deletions of 11q appear to produce a wide spectrum of defects, which may even mimic other known craniosynostotic conditions. Study of these patients may lead to the identification of new genes involved in craniofacial morphogenesis.

  2. Atypical Findings of Guillain-Barré Syndrome in Children

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    Parvaneh KARIMZADEH

    2012-10-01

    Full Text Available ObjectiveGuillain-Barre syndrome (GBS is an immune-mediated polyneuropathy that occurs mostly after prior infection. The diagnosis of this syndrome is dependent heavily on the history and examination, although cerebrospinal fluid analysis and electrodiagnostic testing usually confirm the diagnosis. This is a retrospective study which was performed to investigate the atypical features of GBS.Materials & MethodsThirty three patients (21/63.6% males and 12/36.4% females with GBS were retrospectively studied and prospectively evaluated at the Child Neurology institute of Mofid Children Hospital of Shahid Beheshti University of Medical Sciences between May 2011 and September 2012.ResultsThe mean age was 5.4 years (range, 1.5-10.5.Twenty one patients (87.9 % had previous history of infections. Eight patients (24.2% admitted with atypical symptoms like upper limb weakness (3%, ptosis (3%, neck stiffness (3%, inability to stand (proximal weakness (9.1%, headache (3% and dysphagia (3%.According to disease process, weakness was ascending in 26 (78.8%, descending in 5 (15.2% and static in 2 (6.1% patients. Cranial nerve involvement was found in 8(24.3% children, most commonly as facial palsy in 3 (9.1%.ConclusionIn this study, 24.3% of our patients presented with atypical symptoms of GBS as upper limb weakness, ptosis, neck stiffness, inability to stand (proximal weakness, headache and dysphagia

  3. Evaluation of intralesional propranolol for periocular capillary hemangioma

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    Awadein A

    2011-08-01

    Full Text Available Ahmed Awadein, Mohamed A FakhryCairo University Faculty of Medicine, Cairo, EgyptBackground: The purpose of this study was to evaluate the use of intralesional propranolol injection in the management of periocular capillary hemangioma.Methods: A prospective study was performed in 22 consecutive patients with periocular hemangioma. Twelve patients underwent intralesional propranolol injection and ten patients underwent intralesional triamcinolone injection. The size of the lesion was measured serially every week during the first month, every 2 weeks for the second month, and then monthly for another 2 months. The refractive error and degree of ptosis if present were measured before injection and at the end of the study.Results: There was reduction in the size of hemangioma, astigmatic error, and degree of ptosis in both groups. The difference in outcome between both groups was not statistically significant. Rebound growth occurred in 25% of the propranolol group and 30% of the steroid group but responded to reinjection. No adverse effects were reported during or after intralesional propranolol injection.Conclusion: Intralesional propranolol injection is an alternative and effective method for treatment of infantile periocular hemangioma.Keywords: propranolol, intralesional, periocular capillary hemangioma

  4. Kaufman oculo-cerebro-facial syndrome in a child with small and absent terminal phalanges and absent nails.

    Science.gov (United States)

    Kariminejad, Ariana; Ajeawung, Norbert Fonya; Bozorgmehr, Bita; Dionne-Laporte, Alexandre; Molidperee, Sirinart; Najafi, Kimia; Gibbs, Richard A; Lee, Brendan H; Hennekam, Raoul C; Campeau, Philippe M

    2017-04-01

    Kaufman oculo-cerebro-facial syndrome (KOS) is caused by recessive UBE3B mutations and presents with microcephaly, ocular abnormalities, distinctive facial morphology, low cholesterol levels and intellectual disability. We describe a child with microcephaly, brachycephaly, hearing loss, ptosis, blepharophimosis, hypertelorism, cleft palate, multiple renal cysts, absent nails, small or absent terminal phalanges, absent speech and intellectual disability. Syndromes that were initially considered include DOORS syndrome, Coffin-Siris syndrome and Dubowitz syndrome. Clinical investigations coupled with karyotype analysis, array-comparative genomic hybridization, exome and Sanger sequencing were performed to characterize the condition in this child. Sanger sequencing was negative for the DOORS syndrome gene TBC1D24 but exome sequencing identified a homozygous deletion in UBE3B (NM_183415:c.3139_3141del, p.1047_1047del) located within the terminal portion of the HECT domain. This finding coupled with the presence of characteristic features such as brachycephaly, ptosis, blepharophimosis, hypertelorism, short palpebral fissures, cleft palate and developmental delay allowed us to make a diagnosis of KOS. In conclusion, our findings highlight the importance of considering KOS as a differential diagnosis for patients under evaluation for DOORS syndrome and expand the phenotype of KOS to include small or absent terminal phalanges, nails, and the presence of hallux varus and multicystic dysplastic kidneys.

  5. Non-Hodgkin lymphoma with relapses in the lacrimal glands

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    Couceiro, Rita

    2015-06-01

    Full Text Available Objective: To report an unusual case of systemic non-Hodgkin lymphoma (NHL with repeated relapse in the lacrimal glands, in spite of complete remission for several years after treatment.Methods: A 78-year-old male with small lymphocytic B cell NHL, stage IV disease (lung invasion, was submitted to surgery and chemotherapy in 2001, with complete remission of the disease. In 2003 he developed a nodular lesion in the right lacrimal fossa. Pathology results revealed a local relapse of NHL. Radiation and chemotherapy were initiated and complete remission was again achieved. In 2012 the patient developed a new nodular lesion located in the left lacrimal fossa, resulting in diplopia, ptosis and proptosis of the left eye. Orbital computerized tomography (CT, ocular ultrasound and incisional biopsy were performed.Results: Orbital CT revealed a lesion infiltrating the left lacrimal gland and encircling the globe. Biopsy results confirmed a local relapse of B cell NHL. The patient was submitted to local radiation therapy with progressive resolution of ptosis, proptosis and diplopia. Response to treatment was monitored with ocular ultrasound. Conclusions: Patients with NHL diagnosis should be immediately investigated if ophthalmic or orbital symptoms develop. NHL extension to the orbit and adnexa is infrequent (5% of NHL cases but may occur at any stage of the disease, including as a relapse site. In such cases, radiation and chemotherapy achieve good results, inducing long periods of remission.

  6. Clinical manifestation and humoral immuno-function of myasthenia gravis patients with abnormal and normal thymus gland

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    Fuhua Peng; Yongqiang Dai; Wei Qiu; Xueqiang Hu

    2006-01-01

    Differences of age of onset and modified Osserman classification of two groups. ③ The humoral immuno-functions of two groups were compared.RESULTS: All the 49 patients were involved in the final analysis of results. ① Differences of initial symptoms: Ptosis was the most common initial symptoms in both groups. Patients with ptosis of normal thymus gland were 25 (83%, 25/30). Patients with ptosis of abnormal thymus gland were 13 (68%, 13/19). Patients with normal thymus gland: dysphagia 2 (7%, 2/30), diplopia 4 (13%, 4/30), fatigue 4 (13%, 4/30), dysarthria 3, (10 %, 13/30). Patients with abnormal thymus gland: dysphagia 3 (16%, 3/19), diplopia 6 (32%, 6/19),fatigue 3 (16%, 3/19), dysarthria 2 (10%, 2/19). ② Differences of clinical manifestation of two groups: Ptosis was the most common clinical manifestation in both groups. Patients with ptosis of normal thymus gland were 29 (97%, 29/30). Patients with ptosis of abnormal thymus gland were 15 (79%, 15/19). The rates of fatigue and breathing disorder in patients with abnormal thymus gland were higher than patients with normal thymus gland. Myasthenia crisis occurred in 3 patients (16 %, 3/19) in abnormal thymus gland group, with 1 (3%, 1/30) in abnormal thymus gland group. ③ Differences of age of onset and modified Osserman classification: The rate of type Ⅰ (63%, 19/30) in patients with normal thymus gland was higher than patients (42%, 8/19) with abnormal thymus gland. The rates of type Ⅱ a, Ⅱ b and Ⅲ (58 %) in patients with abnormal thymus gland were higher than patients (37%, 8/19) with normal thymus gland. But no differences were found between two groups (P > 0.05). Patient number of onset from 20 to 29 year old in abnormal group (47%) was higher than that in normal group (20%). Comparison of two groups was x2=4.10 and P < 0.05.④ Comparison of the humoral immunol indexes of two groups: The levels of IgG, IgA, C3 and CH50 in abnormal group were higher than those in normal group. But no differences were

  7. Diagnosis and clinical characteristics of patients with non-allergic rhinitis%非变应性鼻炎的诊断及临床特征分析

    Institute of Scientific and Technical Information of China (English)

    王洪田; 张静; 尤少华; 奥彦云; 白银; 石怀银; 籍灵超; 贾婧杰; 张悦

    2014-01-01

    Objective To explore a step-by-step exclusive diagnosis and analyze the clinical characters of non-allergic rhinitis (NAR).Methods Patients with symptoms (nasal itching,sneezing,rhinorrhea,nasal congestion) were selected to take four-step exclusive diagnosis for NAR.The false NAR was eliminated and the true NAR was retained.First step was to exclude the patients who were not suitable for skin prick test (SPT,such as during pregnancy,breastfeeding,asthma,oral antihistamine medication in 7 day,severe skin diseases).The second step was to exclude the patients with positive SPT and the third step was to exclude the patients with 1 level or above of specific seroimmunoglobulin E (sIgE).The fourth step was to exclude the patients with infection rhinitis,clear abnormal nasal structure,drug-induced rhinitis,nasal neoplasm.The remained patients were finally diagnosed as NAR and who were further differential diagnosed as vasomotor rhinitis (VMR) or non-allergic rhinitis with eosinophilia syndrome (NARES) according to the eosinophilia counts in nasal secretion and venous blood.The common characters of patients with NAR were analyzed and their symptoms and quality of life were evaluated by visual analogue scale (VAS) and rhino-conjunctivitis quality of life questionnaire (RQLQ) separately.Results One thousand four hundred and thirty-seven patients were included after first step exclusion and 735 cases with negative SPT were remained after second step exclusion.Of 735 patients,302 were tested in vitro for sIgE and 93 cases with 0 level of sIgE and total IgE were remained after third step exclusion.Sixty-two patients were finally diagnosed as NAR after fourth step exclusion.The NAR diagnosis rate was 51.15% (735/1 437) with negative SPT alone and the NAR diagnosis rate was 29.06% (93/302) with combination of negative SPT and sIgE.Of 62 patients with NAR,47 patients (75.81%) were diagnosed as VMR and 15 cases (24.19%) as NARES.There were 23 males and 39 females in the 62

  8. Doble parálisis de los elevadores y su comportamiento clínico-quirúrgico en Ciudad de La Habana, Cuba Double elevador palsy and its clinical surgical behavior in the City of Havana, Cuba

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    Teresita de Jesús Méndez Sánchez

    2009-12-01

    Full Text Available OBJETIVO: Describir los resultados clínico-quirúrgicos de los pacientes con doble parálisis de los elevadores. MÉTODOS: Se realizó un estudio descriptivo retrospectivo a 16 pacientes que acudieron al servicio de oftalmología pediátrica y estrabismo del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", desde septiembre de 2004 hasta septiembre de 2006, en el que se analizaron las siguientes variables: etiología, motilidad ocular, ausencia de signo de Bell, ptosis o pseudoptosis palpebral, resultados de la técnica quirúrgica aplicada. La técnica utilizada fue la transposición completa de los rectos horizontales al recto superior. RESULTADOS: La etiología fue congénita en todos los pacientes. El 100 % de la muestra presentó hipotropía en posición primaria de mirada con marcada limitación de la elevación activa, tanto en aducción como abducción, con elevación del mentón y signo de Bell ausente. El 62,5 presentaba pseudoptosis y el 37,5 ptosis. Alcanzaron ortotropia 14 pacientes y dos quedaron con hipotropía menor de 15 dioptrías prismáticas. CONCLUSIONES: Se obtuvieron buenos resultados quirúrgicos en casi la totalidad de los pacientes.OBJECTIVE: To describe the clinical surgical outcomes of patients with double elevator palsy. METHODS: A retrospective descriptive study of 16 patients, who went to the ophthalmologic pediatric strabismus service at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September 2004 to September 2006, was carried out based on the following variables: etiology, ocular motility, lack of Bell´s sign, palpebral pstosis or pseudoptosis, and results of the applied surgical technique. The surgical method was the complete transposition of horizontal recti to upper rectus. RESULTS: There was congenital etiology in all the patients. The whole sample presented with hypotropia in the primary position of the look, with significant restriction of active elevation both in adduction and

  9. A cross-sectional survey of the association between bilateral topical prostaglandin analogue use and ocular adnexal features.

    Science.gov (United States)

    Shah, Mamta; Lee, Grace; Lefebvre, Daniel R; Kronberg, Benjamin; Loomis, Stephanie; Brauner, Stacey C; Turalba, Angela; Rhee, Douglas J; Freitag, Suzanne K; Pasquale, Louis R

    2013-01-01

    We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR) = 2.30; 95% confidence interval (CI) 1.43-3.69; p = 5.44E-04) and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR = 2.49; 95% CI, 1.54-4.03; p= 1.98E-04) associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004%) versus prostaglandin analogue never or past users. Upper lid ptosis (OR = 4.04; 95% CI, 2.43-6.72; p = 7.37E-08), levator dysfunction (OR = 7.51; 95% CI, 3.39-16.65; p = 6.74E-07) and lower lid retraction (OR = 2.60; 95% CI, 1.58-4.28; p = 1.72E-04) were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis represent

  10. A cross-sectional survey of the association between bilateral topical prostaglandin analogue use and ocular adnexal features.

    Directory of Open Access Journals (Sweden)

    Mamta Shah

    Full Text Available We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR = 2.30; 95% confidence interval (CI 1.43-3.69; p = 5.44E-04 and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR = 2.49; 95% CI, 1.54-4.03; p= 1.98E-04 associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004% versus prostaglandin analogue never or past users. Upper lid ptosis (OR = 4.04; 95% CI, 2.43-6.72; p = 7.37E-08, levator dysfunction (OR = 7.51; 95% CI, 3.39-16.65; p = 6.74E-07 and lower lid retraction (OR = 2.60; 95% CI, 1.58-4.28; p = 1.72E-04 were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis

  11. The treatment of simple shortening of levator palpebrae superioris muscle with authentic power of levator muscle in treating severe congenital blepharoptosis%术中提上睑肌肌张力评估后单纯提上睑肌缩短术的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    王鸿; 王冰; 王利华

    2011-01-01

    Objective To obtain the treatment of the shortening of levator palpebrae superioris muscle with authentic power of levator muscle in severe congenital ptosis.Methods Measure and estimate the Authentic power of levator muscle of 169 children (216 eyes)with severe congenital ptosis and treat 143 children (182 eyes) of themwith simple Shortening of levator palpebrae superioris muscle.Results The postoperative lid fissure on straight gaze in 216 eyes were over 6mm (6 ~ 9mm) and the position of the superior eyelid margin were over pupil area.The eyelid radian and an upper lid fold were good.Conclusions Children measured no power of levator muscle in severe congenital ptosis could be operated with simple Shortening of levator palpebrae superioris muscle.This procedure could be effective, less-injured and keep the most physiologic construction.%目的 探讨根据术中对提上睑肌肌张力评估采取的单纯提上睑肌缩短术对儿童重症先天性上睑下垂的疗效方法 对169例(216只眼)重症先天性上睑下垂患儿,根据术中实际提上睑肌肌张力的评估,设计手术方式及手术量,其中143例(182只眼)行单纯提上睑肌缩短术,结果 169例(216只眼)术后6个月至2年随访,上睑缘位置均在瞳孔以上,平视时睑裂6~9mm,上睑缘弧度及双重睑形成良好.结论 根据术中对患儿实际提上睑肌肌张力的评估,可选择最佳手术方式及手术量,对术前检查提上睑肌无肌力的患儿实行单纯提上睑肌缩短术,可减少手术创伤,有效改善病变,保留最佳生理解剖结构.

  12. 手术治疗先天性上睑下垂44例临床分析

    Institute of Scientific and Technical Information of China (English)

    吴媛媛

    2016-01-01

    obj ective to explore the reasonable operation of congenital ptosis method,analysis of postoperative complications, improve operation skills,to further improve the cure rate.Methods:44 cases of patients with congenital ptosis surgery were retrospec-tively analyzed,of which 26 on the eyelid muscle shortening after operation,18 routine frontal muscle flap suspension surgery.Re-sults:44 cases,follow-up time was 6 m - 1 y,26 cases on the eyelid muscle shortening,21 cases were cured,2 cases of owe affair, 3 cases of correction,the cure rate was 80%,18 underwent frontal muscle flap suspension surgery,15 cases were cured,2 cases of owe affair,1 case of correction,the cure rate was 80%.Conclusion:for patients with congenital ptosis,surgical treatment,with satis-factory effect.%目的::探讨先天性上睑下垂的合理手术方法,分析术后出现的并发症,不断提高手术技能,进一步提高治愈率。方法:对44例先天性上睑下垂患者的手术进行回顾性分析,其中26例行提上睑肌缩短术,18例行额肌瓣悬吊术。结果:44例患者,随访时间为6m-1y,26例行提上睑肌缩短术,21例治愈,2例欠矫,3例过矫,治愈率为80%,18例行额肌瓣悬吊术,15例治愈,2例欠矫,1例过矫,治愈率为80%。结论:对于先天性上睑下垂的患者,手术治疗,手术效果满意。

  13. [Long-term results of two temporalis muscle transfer procedures in correction of paralytic lagophthalmos].

    Science.gov (United States)

    Qian, Jiange; Yan, Liangbin; Zhang, Guocheng

    2004-11-01

    To compare the long-term results and possible complications of a modified temporalis muscle transfer (TMT) with the Johnson's procedure in correction of paralytic lagophthalmos. From September 1997 to March 2000, paralytic lagophthalmos due to leprosy in 92 patients were corrected with TMT. The 89 cases (127 to eyes including 51 unilateral and 38 bilateral) followed up 3 years after operation were analyzed. There were 69 males and 20 females with ages ranging from 18 to 65 years (52 years on average). The duration of lagophthalmos was 1-22 years with an average of 8.2 years. And 36 eyes were complicated with lower eyelid ectropion. Sixty-five eyes were corrected with Johnson's procedure (Johnson's TMT group), 62 with the modified TMT procedure (modified TMT group). The modifications were as follows: (1) omitting the fascial strip in the lower eyelid to avoid postoperative ectropion. (2) fixing the fascial strip of the upper eyelid to the middle or inner margin of the tarsal palate depending on the degree of the lagophthalmos to avoid possible ptosis of the upper eyelid. In Johnson's TMT group, the mean lid gap on light closure was reduced to 3.1 mm postoperatively from 7.7 mm preoperatively; and the mean lid gap on tight closure was reduced to 0.5 mm postoperatively from 6.1 mm preoperatively. The symptoms of redness (73.7%) and tearing (63.7%) disappeared or were improved postoperatively. However, ectropion and ptosis occurred in 24 eyes and 9 eyes respectively. The overall excellent and good rate was 58.5%. In the modified TMT group, the mean lid gap on light closure was reduced to 3.3 mm postoperatively from 7.5 mm preoperatively; and the mean lid gap on tight closure was reduced to 0. 6 mm postoperatively from 6. 3 mm preoperatively. The symptoms of redness (90.9%) and tearing (71.0%) disappeared or were improved postoperatively, and no ectropion or ptosis was found except one ectropion. The overall excellent and good rate was 87.1%, which was significantly

  14. Analysis and treatment of an acquired blepharoptosis after blepharoplasty%上睑成形术后继发睑下垂的诊治与预防

    Institute of Scientific and Technical Information of China (English)

    李东; 谢宏彬; 李比; 薛宏宇; 秦荣生; 李健宁

    2001-01-01

    Objective To analyze the reasons of the blepharoptosis caused after blepharoplasty in order to search the proper method to correct the problem. Methods Eighteen patients of the blepharoptosis with 20eyes were undergoing for this study. The ptosis was determined with the measurement of the function of the levator muscle. The proper surgical technique selected was performed mainly to focus on the repair of the orbital septum and the levator muscle. All of the patients were followed up from 1 week to 4 years after the operation. Results Eighteen acquired blepharoptosis patients with 20 eyes were repaired after the analyzing the reasons. The results were satisfactory in 16 eyes,improved in 3 eyes and recurrent in 1 eye. Conclusions It is necessary to evaluate the function of the injured levator muscle and analyze the surgical-induced reasons of the ptosis eye before to repair the acquired ptosis. It is also reminded of the surgeons to pay more attention in order to prevent the occurrence of the problem when they do the blepharoplasty.%目的明确睑成形术后继发上睑下垂的病因,正确选择修复方法。方法根据术前、术中上睑提肌的功能状况以及术中所见上睑的解剖关系确定修复方案,修复的关键是眶隔整形和重建上睑提肌的生理解剖结构。结果临床治疗18例,20只眼。随访时间为1周~4年。16只效果良好,3只效果较满意,1只效果欠佳。结论术前、术中上睑提肌肌力测定对评判导致上睑下垂综合因素的作用具有定量诊断意义。以此为依据制定的修复方案经临床实践证明比较合理,并提出上睑成形术后继发上睑下垂的预防措施。

  15. Objective Outcome Measurement After Upper Blepharoplasty: An Analysis of Different Operative Techniques.

    Science.gov (United States)

    Park, Ki-Soo; Park, David Dae-Hwan

    2017-02-01

    Upper blepharoplasty is indicated in Asians for double-eyelid fold creation, periorbital rejuvenation, and functional visual field improvement. This article introduces a technical classification for blepharoplasty methods and investigates approaches to evaluate its outcomes. Of 535 patients undergoing aesthetic upper blepharoplasty in our institution in 1998-2011, 136 patients who were well followed up were retrospectively reviewed and categorized into four groups according to the techniques employed. Blepharoplasty with skin excision only was indicated for upper eyelid-skin redundancy patients with prominent double eyelids (n = 20). Blepharoplasty with skin excision and nonburied suture fixation was indicated for patients with upper lid-skin redundancy and weak double eyelids (n = 15). Blepharoplasty with skin excision and buried suture fixation was indicated for patients with upper lid-skin redundancy but no double-eyelid folds (n = 46). Finally, blepharoplasty with simultaneous ptosis correction was utilized for patients with senile or subclinical ptosis requesting upper blepharoplasty (n = 55). The mean age was 48.7 years at surgery; the mean follow-up period was 6 months. Digital photographs were used to compare changes in marginal reflex distance 1 (MRD1), percentage of the area of corneal exposure (%ACE), and brow height. MRD1 increased from 1.92 to 2.84 mm in the whole patient group after upper blepharoplasty; it increased the most in blepharoplasty with simultaneous ptosis correction (1.22 mm). %ACE increased from 62.1 to 76.6% (14.5%), whereas brow height decreased from 29.4 to 26.7 mm (9.2%). Upper blepharoplasty improves palpebral fissure. Numerically measured palpebral fissure changes facilitate operation outcome measurement. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern

  16. 肱骨远段内固定物及假体设计与其解剖学参数的关系%Association of designing internal fixator and prosthesis for the distal end of humerus with the anatomical parameters

    Institute of Scientific and Technical Information of China (English)

    王友华; 马江川; 吴菊; 赵剑; 刘璠

    2007-01-01

    experiments were carried out in the Trauma Research Room, Affiliated Hospital of Nantong University from October 2005 to February 2006. Fifty-four pairs of humerus samples from adult antisepsis corpses were randomly selected (provided by the Department of Human Anatomy, Medical College of Nantong University), including 30 pairs from males and 24 pairs from females, while those with deformation and degeneration of elbow joint were excluded. METHODS: The soft tissues adhered to the humerus samples were all rejected, and the anatomical parameters of the distal end of humerus were measured with slide gaud (0.01 mm in precision, produced by Shanghai Measuring and Cutting Tool Works), calipers and goniometer. ① Measurement of angles related to the distal end of humerus: The measured parameters included the anteverted angle of the distal humerus, the lateral rotation angle of humerus trochlea,the anteverted angulation of humerus capitulum, the anteverted angulation of humerus trochlea, the condyle-shaft angle of humerus, and the internal rotation angle of the line of lateral-medial humerus epicondyle. ② Measurement of structural width and depth related to the distal end of humerus: The measured parameters included the horizontal diameter of the anterior end of humerus trochlea, the horizontal diameter of the inferior end of humerus trochlea, the sagittal diameter of humerus trochlea, the width between medial epicondyle and external epicondyle, the width between medial trochlea and lateral capitulum, the width of olecranon fossa, the depth of olecranon fossa, the width of medial epicondyle, the depth of sulcus for ulnar nerve, the width of humerus capitulum, and the sagittal diameter of humerus capitulum..MAIN OUTCOME MEASURES: Results of the angles and structural width or depth related to the distal end of the humerus.males and females in the anteverted angle of the distal humerus [(35.62±5.21)°, (96.22±5.29)°], the lateral rotation angle of humerus trochlea [(5.22±1.15)

  17. Not All Hip Dysplasias are the Same: Preoperative CT Version Study and the Need for Reverse Bernese Periacetabular Osteotomy.

    Science.gov (United States)

    Thawrani, Dinesh P; Feldman, David S; Sala, Debra A

    2017-01-01

    Dysplastic hip may present with acetabular retroversion with or without femoral retroversion. This retroversion, if not accounted for when performing a periacetabular osteotomy (PAO), will lead to anterior hip pain and early osteoarthritis. A reverse PAO involves anteverting the acetabulum while still obtaining lateral coverage. The purpose of this study was to investigate the relationship between rotational malalignment of acetabulum and femur on 2-dimensional computed tomographic (CT) scans of hips that underwent Bernese PAO and its role in the surgical decision making. This retrospective, case-control study examined and compared preoperative 2-dimensional CT scans of hips that underwent reverse PAO to the hips that underwent traditional PAO. Twelve hips underwent reverse PAO from 2005 to 2010. Twelve hips were randomly selected from a cohort of 52 hips that underwent traditional PAO during same time period. Hips that underwent reverse PAO showed crossover sign on preoperative radiographs, but not on postoperative radiographs. Crossover sign was negative preoperatively and postoperatively on hips that underwent traditional PAO. The 2 groups were similar in regards to preoperative lateral center-edge angle, acetabular index, and anterior center-edge angle on plain radiographs and showed significant improvement after surgery.On preoperative CT scans both acetabulae and femurs were retroverted in reverse PAO group. Comparison of the 2 groups demonstrated that acetabular version (16.5±4.9 degrees vs. 25.3±5.6 degrees, P=0.001), femoral version (12.8±10.4 degrees vs. 31.9±8 degrees, P<0.001), and McKibbins Instability Index (29.3±11.9 degrees vs. 57.1±9.8 degrees, P<0.001) were significantly lower for the reverse PAO than the traditional PAO group. Anterior Acetabular Sector Angle (determines anterior coverage) was significantly higher in reverse PAO group, 53.1±13.7 degrees versus 39.7±10.4 degrees (P=0.013). Retroverted acetabulae seem to be associated with

  18. Síndrome de Aarskog: hallazgos fenotípicos en una cohorte de pacientes Aarskog syndrome: phenotypic findings in a cohort of patients

    Directory of Open Access Journals (Sweden)

    Iván Hernández García

    2008-12-01

    Full Text Available Se presentan los hallazgos fenotípicos de 7 pacientes diagnosticados de síndrome de Aarskog en el servicio de Genética del Hospital Pediátrico Docente «William Soler». Las características fenotípicas que estuvieron presentes en todos los pacientes fueron el pico de viuda, las extremidades cortas y la braquidactilia. Les siguieron en orden de frecuencia (85 % la nariz pequeña, el puente nasal ancho y el filtrum largo y ancho. Otras dismorfias faciales encontradas (71 % fueron la frente amplia, las narinas antevertidas, el hipertelorismo, el cuello corto y el surco simiano. Se discute la posibilidad de que exista algún sesgo de detección debido a que el examinador presta mayor atención a la cara que a otros segmentos corporales. La criptorquidia, que distingue y da nombre al síndrome, se encontró en un porcentaje menor de individuos (60 %. En dos casos se encontró hipoplasia renal, hallazgo ocasional en la literatura consultada. En ningún caso se constató retraso mental. Las diferencias fenotípicas halladas pudieran atribuirse a las diferencias moleculares reportadas en la literatura.The phenotypic fndings of 7 patients who were diagnosed Aarskog syndrome in the Service of Genetics of «William Soler» Pediatric Teaching Hospital were presented. The phenotypic characteristics appearing in all patients were widow's peak, short extremities and brachydactilia. They were followed in order of frequency (85 % by small nose, wide nasal bridge and long and wide filtrum. Other facial dismorphies (71 % were wide forehead, anteverted narines, hypertelorism, short neck and simian crease. It is discussed the possibility that there is some bias of detection due to the fact that the examiner pays more attention to the face than to other body segments. Criptorchydia, that distinguishes and gives name to the syndrome, was found in a lower percent of individuals (60 %. Renal hypoplasia, an occasional finding in the consulted literature, was

  19. New quantitative radiographic parameters for vertical and horizontal instability in acromioclavicular joint dislocations.

    Science.gov (United States)

    Zumstein, Matthias A; Schiessl, Philippe; Ambuehl, Benedikt; Bolliger, Lilianna; Weihs, Johannes; Maurer, Martin H; Moor, Beat K; Schaer, Michael; Raniga, Sumit

    2017-05-25

    The aim of this study was to identify the most accurate and reliable quantitative radiographic parameters for assessing vertical and horizontal instability in different Rockwood grades of acromioclavicular joint (ACJ) separations. Furthermore, the effect of projectional variation on these parameters was investigated in obtaining lateral Alexander view radiographs. A Sawbone model of a scapula with clavicle was mounted on a holding device, and acromioclavicular dislocations as per the Rockwood classification system were simulated with the addition of horizontal posterior displacement. Projectional variations for each injury type were performed by tilting/rotating the Sawbone construct in the coronal, sagittal or axial plane. Radiographic imaging in the form of an anterior-posterior Zanca view and a lateral Alexander view were taken for each injury type and each projectional variation. Five newly defined radiographic parameters for assessing horizontal and vertical displacement as well as commonly used coracoclavicular distance view were measured. Reliability, validity and the effect of projectional variation were investigated for these radiographic measurements. All radiographic parameters showed excellent intra- and interobserver reliability. The validity was excellent for the acromial centre line to dorsal clavicle (AC-DC) in vertical displacement and for the glenoid centre line to posterior clavicle (GC-PC) in horizontal displacement, whilst the remaining measurements showed moderate validity. For AC-DC and GC-PC, convergent validity expressed strong correlation to the effective distance and discriminant validity demonstrated its ability to differentiate between various grades of ACJ dislocations. The effect of projectional variation increased with the degree of deviation and was maximal (3 mm) for AC-DC in 20° anteverted malpositioning and for GC-PC in 20° retroverted malpositioning. AC-DC and the GC-PC are two novel quantitative radiographic parameters of

  20. Horner's syndrome following a subtotal thyroidectomy for a benign nodular goitre.

    Science.gov (United States)

    Aslankurt, Murat; Aslan, Lokman; Colak, Mustafa; Aksoy, Adnan

    2013-06-13

    We present a case of Horner's syndrome occurring as a complication of thyroidectomy. A 42-year-old female patient presented with eyelid drop which developed immediately after thyroidectomy for goitre. Ophthalmic examination revealed eyelid ptosis, miosis and anhidrosis. Preoperative ultrasonography showed multiple isohyperechogenic solid nodules in each lobe, consistent with multinodular goitre. Therefore, the patient underwent subtotal thyroidectomy. The ophthalmic findings did not improve at the end of 6 months follow-up. Similar cases have been reported related to neck tumours or their surgery, mediastinum-located goitre and retropharyngeal abscess surgeries, but not after benign nodular goitre surgery. Several possible mechanisms have been proposed to explain this phenomenon; anatomical variations making the patient susceptible to damage to the sympathetic chain seem to be most likely in our patient.

  1. Atypical Cat-Scratch Disease in Children: Report of Seven Presentations Ranging From Hepatosplenic Disease to Horner Syndrome

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    Gilliaux

    2016-01-01

    Full Text Available Introduction Cat scratch disease (CSD is an infectious disease caused by the Gram-negative rod Bartonella henselae (BH. It usually leads to subacute loco-regional lymphadenitis occasionally associated with fever. In most of the cases, it resolves spontaneously within 4 - 6 weeks. However, CSD has also been associated with other atypical presentations. Case Presentation We reported a series of seven children with unusual symptoms of CSD. In particular, we described the case of a child with ptosis, miosis and enophtalmy, suggesting Horner syndrome, associated with cervical lymphadenitis. Cat scratch was mentioned in only one patient, while four of them mentioned a recent contact with cats. We reviewed and discussed the incidence of these atypical presentations of CSD as well as the therapeutic approaches recommended and the available diagnostic tools. Conclusions This paper highlighted the need to exclude CSD in children with unexplained symptoms such as prolonged fever, hepatosplenic lesion and osteomyelitis.

  2. Chromosome deletion of 14q32.33 detected by array comparative genomic hybridization in a patient with features of dubowitz syndrome.

    Science.gov (United States)

    Darcy, Diana C; Rosenthal, Scott; Wallerstein, Robert J

    2011-01-01

    We report a 4-year-old girl of Mexican origins with a clinical diagnosis of Dubowitz syndrome who carries a de novo terminal deletion at the 14q32.33 locus identified by array comparative genomic hybridization (aCGH). Dubowitz syndrome is a rare condition characterized by a constellation of features including growth retardation, short stature, microcephaly, micrognathia, eczema, telecanthus, blepharophimosis, ptosis, epicanthal folds, broad nasal bridge, round-tipped nose, mild to moderate developmental delay, and high-pitched hoarse voice. This syndrome is thought to be autosomal recessive; however, the etiology has not been determined. This is the first report of this deletion in association with this phenotype; it is possible that this deletion may be causal for a Dubowitz phenocopy.

  3. Chromosome Deletion of 14q32.33 Detected by Array Comparative Genomic Hybridization in a Patient with Features of Dubowitz Syndrome

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    Diana C. Darcy

    2011-01-01

    Full Text Available We report a 4-year-old girl of Mexican origins with a clinical diagnosis of Dubowitz syndrome who carries a de novo terminal deletion at the 14q32.33 locus identified by array comparative genomic hybridization (aCGH. Dubowitz syndrome is a rare condition characterized by a constellation of features including growth retardation, short stature, microcephaly, micrognathia, eczema, telecanthus, blepharophimosis, ptosis, epicanthal folds, broad nasal bridge, round-tipped nose, mild to moderate developmental delay, and high-pitched hoarse voice. This syndrome is thought to be autosomal recessive; however, the etiology has not been determined. This is the first report of this deletion in association with this phenotype; it is possible that this deletion may be causal for a Dubowitz phenocopy.

  4. A CASE OF CHRONIC SPHENOIDITIS WITH NEUROLOGIC AND OPHTHALMOLOGIC COMPLICATIONS

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    M. Yu. Bobylova

    2012-01-01

    Full Text Available A case of chronic sphenoidal sinusitis in a girl of 9 years old is proposed; in clinical picture oculomotor dysfunction occurred (ptosis, strabismus divergent, diplopia, epiphora. The condition was masked by neurological symptoms, and so initial differential diagnosis was between 1 ocular form of myopathy (including mitochondrial diseases, 2 ocular form of myasthenia and 3 onset of multiple sclerosis. The definite diagnosis «pansinusitis» was proposed by neurologist only after attentive analysis of clinical symptoms and data of MRI, only since 1,5 year after beginning of the disease. This clinical case demonstrates the complexity of differential diagnosis of chronic sphenoidal sinusitis in children and necessity of developed clinical thinking for a doctor of every speciality

  5. Historical case: "Portrait of a one-eyed man" by Vincent Van Gogh.

    Science.gov (United States)

    Meulemans, J; Huskens, I; Piessens, P

    2014-01-01

    The post-impressionist Dutch painter Vincent Willem Van Gogh (1853-1890) painted the "Portrait of a one-eyed man" (1889) when he was admitted to the mental hospital of Saint Paul-de-Mausole. The portrait probably depicts one of Van Gogh's fellow patients who was suffering from a left-sided upper eyelid ptosis. Neurofibromatosis type I with orbitotemporal involvement has been suggested as the underlying disease process. However, from an otorhinolaryngological point of view, alternative diagnoses are possible. In this paper, the entities of giant frontal sinus osteoma and giant frontal sinus mucocoele are discussed, as well as the operative procedures available at the end of the nineteenth century to treat these lesions.

  6. Additional case of Marden-Walker syndrome: support for the autosomal-recessive inheritance adn refinement of phenotype in a surviving patient.

    Science.gov (United States)

    Orrico, A; Galli, L; Zappella, M; Orsi, A; Hayek, G

    2001-02-01

    In this report, we present a 14-year-old girl, born to consanguineous parents, who presented with severe mental retardation, hypotonia, short stature, and congenital joint contractures. The craniofacial features were scaphocephaly, thin/long and immobile face, marked hypoplasia of the midface, temporal narrowness, blepharophimosis, palpebral ptosis, and strabismus. The combination of such a distinctive craniofacial appearance and psychomotor retardation allows us to recognize a new case of the Marden-Walker syndrome. Our patient represents one of the rare cases in which consanguineous mating supports the autosomal-recessive pattern of inheritance of this condition. Furthermore, through refining the phenotype of a surviving patient, this report may contribute to a better recognition of this disorder in older affected children.

  7. Pattern Dystrophy of the Macula in a Case of Steinert Disease

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    Filipe Esteves

    2013-09-01

    Full Text Available Introduction: Myotonic dystrophies are typically associated with ocular complications like ptosis, weakness of the ocular muscle and cataracts, but also with less recognized retinal changes. Case Report: A 41-year-old female with type 1 myotonic dystrophy complained of progressive vision loss. Slit lamp examination revealed the presence of typical bilateral polychromatic cataract with posterior subcapsular component. Dilated fundus examination was remarkable for bilateral macular depigmented changes. Multimodal imaging analysis of the macula suggested the presence of a butterfly-shaped pattern dystrophy. Discussion: In cases of myotonic dystrophies it is of great relevance to analyze the presence of retinal changes that might limit the visual improvement following cataract extraction.

  8. Low voltage lead titanate/Si one-transistor ferroelectric memory with good device characteristics

    Science.gov (United States)

    Sun, C. L.; Chen, S. Y.; Liao, C. C.; Chin, Albert

    2004-11-01

    We have developed one-transistor ferroelectric memory using lead titanate (PTO) as a gate dielectric directly formed on Si without any buffer layer. The PTO/Si metal-oxide-semiconductor field-effect transistor memory has shown a large threshold voltage shift of 1.6 V at only ±4V program/erase voltages. The corresponding good interface was achieved by lowering the anneal temperature to 450 °C. Besides the sharp capacitance change of 0.17μF/Vcm2, it was also evidenced by the high mobility of 169cm2/Vs close to high-κ HfO2. In addition, long retention >1000s and endurance >1011 stress cycles in the device suggested good memory characteristics.

  9. Unusual Horner's syndrome in recurrent breast cancer: Evaluating using {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Kim, Tae Sung; Kim, Seok Ki [Dept. of Nuclear Medicine, National Cancer Center, Goyang (Korea, Republic of)

    2017-03-15

    {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a widely used imaging modality in the initial diagnosis of cancer, treatment response evaluation and detection of recurrence. Herein, we present the case of a 39-year-old female who presented right ptosis on the follow-up of breast cancer after surgery. Clinicians suspected Horner's syndrome, and the patient underwent FDG PET/CT for the evaluation of recurrence that could cause Horner's syndrome. FDG PET/CT demonstrated a focal hypermetabolic lesion in the right cervicothoracic junction area, corresponding to the preganglionic cervical sympathetic trunk. A subsequent needle biopsy was done, and the lesion was confirmed as metastatic ductal carcinoma. In this case, we could detect the exact location of the recurring lesion that caused Horner's syndrome using FDG PET/CT.

  10. A novel 30 bp deletion in the FOXL2 gene in a phenotypically normal woman with primary amenorrhoea: case report.

    Science.gov (United States)

    Gersak, Ksenija; Harris, Sarah E; Smale, Wendy J; Shelling, Andrew N

    2004-12-01

    In a Slovene patient with primary amenorrhoea without an association with blepharophimosis/ptosis/epicanthus inversus syndrome (BPES), a novel 30 bp deletion was identified in the FOXL2 gene. We report the clinical features of this woman who has spontaneously conceived and delivered two live healthy babies. The novel deletion was predicted to remove 10 out of 14 alanines (A221_A230del), from the polyalanine tract downstream of the winged helix/forkhead domain of the FOXL2 protein. The patient's parents and sister were shown not to carry this deletion. Despite seeing an anovulatory secretory pattern of FSH, follicles developed spontaneously. Persistent and consistent monitoring have practical implications for genetic and fertility counselling in the era when women with premature ovarian failure usually seek ovum donation. The role of FOXL2 in the development of infertility is still unclear, but several lines of evidence suggest that it plays a central role in follicle development.

  11. An investigation into FOXE1 polyalanine tract length in premature ovarian failure.

    Science.gov (United States)

    Watkins, Wendy J; Harris, Sarah E; Craven, Megan J; Vincent, Andrea L; Winship, Ingrid M; Gersak, Ksenija; Shelling, Andrew N

    2006-03-01

    Premature ovarian failure (POF) is a common condition affecting 1% of women worldwide. There is strong evidence for genetic involvement in POF as many cases are familial, and mutations in several genes have been associated with POF. We investigated variation in FOXE1 polyalanine tract length, following the observation that polyalanine tract deletions are seen in the closely related FOXL2 in patients with POF. In addition, polyalanine tract expansions in FOXL2 are often seen in patients with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES), a rare eyelid disorder often associated with POF. The FOXE1 polyalanine tract shows marked variation in its length between POF patients and normal controls, existing as an allele of 12, 14, 16, 17 or 19 alanine residues. We found evidence to suggest that variation in FOXE1 polyalanine tract length predisposes to POF.

  12. Blepharophimosis and bilateral Duane syndrome associated with a FOXL2 mutation.

    Science.gov (United States)

    Vincent, A L; Watkins, W J; Sloan, B H; Shelling, A N

    2005-12-01

    This case describes the novel coexistence of sporadic blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) and bilateral type I Duane syndrome in a female infant, with a FOXL2 mutation. Mutational analysis of FOXL2 demonstrated a 30-nucleotide duplication (c.672(-)701dup30) within the polyalanine tract of FOXL2. The association of BPES and Duane syndrome represents a novel phenotype which may suggest a greater pleiotropic effect of FOXL2 in development. During the period of the 4-8th week of embryonic development, the cranial nerves, their nuclei and the corresponding innervation to the extraocular muscles develop, the extraocular muscles undergo development and differentiation. This coincides with the period of time that FOXL2 is expressed strongly in the developing eyelids and the surrounding tissues. Forkhead genes are transcription factors and likely to be involved in signal transduction pathways. This case expands the spectrum of FOXL2 mutations associated with BPES.

  13. “Why do I always see double?” A misdiagnosed case of ocular myasthenia gravis for 10 years

    Science.gov (United States)

    Mohamed Yousuf, Uduman Ali; Yashodhara, B M; Thanigasalam, Thevi; Ting, Heng Siang

    2014-01-01

    A 58-year-old man presented with diplopia and partial ptosis for 10 years. It was non-progressive in nature, despite inadequate medical attention the patient received from non-specialists/general practitioners. He did not have fatigability or diurnal variation in weakness and was clinically stable without exacerbations of disease for a decade. He did not have features of Graves's disease, oculopharyngeal dystrophy, cranial nerve paralysis, polymyositis and stroke. The possibility of an atypical presentation of myasthenia gravis (MG) was considered and the patient was evaluated. Ice pack test was negative, Cogan's lid twitch (CLT) test was positive and high titres of acetylcholine receptor antibodies (AChR Ab) suggestive of MG were found. He was treated accordingly with a very good response. PMID:24792021

  14. Effects of hydroalcoholic extract of Borago officinalis on naloxone-precipitated withdrawal syndrome in morphine-dependent mice

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    Zahra Rabiei

    2016-12-01

    Full Text Available The aim of the present study was to investigate the effect of hydroalcoholic extract of Borago officinalis on morphine withdrawal syndrome in mice. Morphine-dependent group received morphine for nine days and then received naloxone via intraperitoneal injection. Control group received saline for nine days. Post-treated group received B. officinalis extract intraperitoneally (100 mg/kg on the day 10 before naloxone injection. Co-treated group received B. officinalis extract intraperitoneally (100 mg/kg and morphine for nine days and then received naloxone. Extract-treated group received extract for nine days and then received naloxone. Naloxone injection significantly increased the frequency of jumping, blinking, ptosis, defecation, paw trembling, and two-legged standing in comparison to the control group. Co-treatment and post-treatment with B. officinalis extract significantly decreased the withdrawal symptoms. In conclusion, hydroalcoholic extract of B. officinalis significantly attenuated the symptoms of morphine withdrawal syndrome.

  15. Management of respiratory failure in severe neuroparalytic snake envenomation.

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    Agrawal P

    2001-01-01

    Full Text Available Fourteen patients with severe neuroparalytic snake envenomation, resulting in acute type II respiratory failure, admitted to respiratory critical care unit for mechanical ventilation during one year period, were studied. Ventilatory requirements, amount of anti snake venom (ASV infused, period of neurological recovery and hospital survival were evaluated. All patients had severe manifestations such as ptosis, extraocular muscle paresis and limb weakness along with dyspnoea. Seven patients (50% had additional complaints of dysphagia and dysphonia. ASV was administered to all, with a median requirement of 900 ml. Mechanical ventilation was required for a median duration of 17 hours and all except one patient, who had suffered irreversible hypoxic cerebral injury prior to resuscitation, survived with complete neurological recovery. We conclude, that the timely institution of ventilatory support and anti-venom therapy in such patients, is associated with an excellent outcome.

  16. NOONAN SYNDROME – CASE REPORT

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    Milena Vujanović

    2014-06-01

    Full Text Available Noonan Syndrome is a rare, autosomal dominant disorder characterized by short stature, facial abnormalities, congenital heart defects and urogenital malformations. Ocular changes occur in 95% of patients and usually include hypertelorism, ptosis, refractive errors, strabismus, amblyopia, rarely nystagmus, colobomas, cataracts, optic nerve drusen. Case report: We present a case of a boy, 10 months old, referred by the pediatrician because of strabismus. During the general examination of the head and face, we noted that the ears were low-set, and the lower jaw was slightly smaller. Ophthalmological examination revealed hypertelorism, left eye esotropia, hyperopia, and optic disc pit. Other associated malformations were: dilatation of both pyelons, cryptorchidism, pulmonary stenosis. Genetic analysis confirmed the diagnosis of Noonan syndrome. The variety of clinical manifestations of this syndrome indicates that a multidisciplinary approach is necessary for diagnosis, treatment, and follow-up of these patients.

  17. Treatment of Amblyopia and Amblyopia Risk Factors Based on Current Evidence.

    Science.gov (United States)

    Koo, Euna B; Gilbert, Aubrey L; VanderVeen, Deborah K

    2017-01-01

    Amblyopia is a leading cause of low vision and warrants timely management during childhood. We performed a literature review of the management of amblyopia and potential risk factors for amblyopia. Literature review of the management of amblyopia and risk factors for amblyopia. Common amblyopia risk factors include anisometropic or high refractive error, strabismus, cataract, and ptosis. Often a conservative approach with spectacles is enough to prevent amblyopia. However, surgery may be necessary to clear the visual axis or align the eyes. Amblyopia risk factors should be managed early. Though amblyopia treatment is more likely to be successful at a younger age, those who are older but treatment-naïve may still respond to treatment. Promoting binocular or dichoptic experiences may be the future direction of amblyopia management.

  18. Matricaria chamomilla extract inhibits both development of morphine dependence and expression of abstinence syndrome in rats.

    Science.gov (United States)

    Gomaa, Adel; Hashem, Tahia; Mohamed, Mahmoud; Ashry, Esraa

    2003-05-01

    The effect of Matricaria chamomilla (M. chamomilla) on the development of morphine dependence and expression of abstinence was investigated in rats. The frequencies of withdrawal behavioral signs (paw tremor, rearing, teeth chattering, body shakes, ptosis, diarrhea, and urination) and weight loss induced by naloxone challenge were demonstrated in morphine-dependent rats receiving M. chamomilla extract or saline. The withdrawal behavioral manifestations and weight loss were inhibited significantly by chronic co-administration of M. chamomilla extract with morphine. Administration of a single dose of M. chamomilla before the naloxone challenge in morphine-dependent animals abolished the withdrawal behavioral manifestations. The dramatic increase of plasma cAMP induced by naloxone-precipitated abstinence was prevented by chronic co-administration of M. chamomilla extract with morphine. These results suggest that M. chamomilla extract inhibits the development of morphine dependence and expression of abstinence syndrome.

  19. Unilateral pupillary mydriasis from nebulized ipratropium bromide: A false sign of brain herniation in the intensive care unit

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    Priyanka Chaudhry

    2014-01-01

    Full Text Available Although there are many causes of anisocoria in the intensive care setting, the development of unilateral mydriasis in patients with intracranial hemorrhage or tumor is a neurological emergency, as it may herald the onset of uncal herniation. We describe two patients with a hemiparesis from neurosurgical disorder who subsequently developed a fixed and dilated pupil. The pupillary abnormality was caused by nebulized ipratropium bromide in both cases, and resolved when the medication was discontinued. Nebulized ipratropium may leak from the mask into ipsilateral eye and cause mydriasis in patients with facial weakness. This benign cause of anisocoria in the intensive care setting is distinguished from uncal herniation by the laterality of neurologic findings, and lack of mental status change, ptosis, and extraocular movement impairment.

  20. The forkhead transcription factor Foxl2 is sumoylated in both human and mouse: sumoylation affects its stability, localization, and activity.

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    Mara Marongiu

    Full Text Available The FOXL2 forkhead transcription factor is expressed in ovarian granulosa cells, and mutated FOXL2 causes the blepharophimosis, ptosis and epicanthus inversus syndrome (BPES and predisposes to premature ovarian failure. Inactivation of Foxl2 in mice demonstrated its indispensability for female gonadal sex determination and ovary development and revealed its antagonism of Sox9, the effector of male testis development. To help to define the regulatory activities of FOXL2, we looked for interacting proteins. Based on yeast two-hybrid screening, we found that FOXL2 interacts with PIAS1 and UBC9, both parts of the sumoylation machinery. We showed that human FOXL2 is sumoylated in transfected cell lines, and that endogenous mouse Foxl2 is comparably sumoylated. This modification changes its cellular localization, stability and transcriptional activity. It is intriguing that similar sumoylation and regulatory consequences have also been reported for SOX9, the male counterpart of FOXL2 in somatic gonadal tissues.

  1. Kearns-Sayre syndrome "plus": classical clinical findings and dystonia

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    MARIE SUELY K.NAGAHASHI

    1999-01-01

    Full Text Available We present a boy of eight years of age with symptoms of Kearns-Sayre syndrome (KSS characterised by ophthalmoparesis, palpebral ptosis, mitochondrial myopathy, pigmentous retinitis, associated to short stature, cerebellar signs, cardiac blockade, diabetes mellitus, elevated cerebrospinal fluid protein concentration, and focal hand and foot dystonia. The skeletal muscle biopsy demonstrated ragged red fibers, cytochrome C oxidase-negative and succinate dehydrogenase-positive fibers. The magnetic resonance imaging showed symmetrical signal alteration in tegmentum of brain stem, pallidum and thalamus. Mitochondrial DNA analysis from skeletal muscle showed a deletion in heteroplasmic condition. The association of dystonia to KSS, confirmed by molecular analysis, is first described in this case, and the importance of oxidative phosphorylation defects in the physiopathogenesis of this type of movement disorder is stressed.

  2. A novel de novo mutation of the mitochondrial tRNAlys gene mt.8340G>a associated with pure myopathy.

    Science.gov (United States)

    Jeppesen, Tina Dysgaard; Duno, Morten; Risom, Lotte; Wibrand, Flemming; Rafiq, Jabin; Krag, Thomas; Jakobsen, Johannes; Andersen, Henning; Vissing, John

    2014-02-01

    Most patients with mutations in the tRNA(lys) gene (MTTK) present with symptoms from the central nervous system (CNS). We describe a 41-year-old woman with pure myopathy associated with a novel de novo mtDNA mutation, mt.8340G>A, which was heteroplasmic in muscle (53%), blood, urine and mouth epithelial cells (<7%). No other family members, including her mother, carried the mutation. She presented with exercise intolerance from age 9, and since age 20 she experienced ptosis and reduced ocular motility. A muscle biopsy revealed ragged red fibres (10%), no COX negative fibres, and many fibres with central nuclei (30%), indicating ongoing damage and repair. The present case expands the mutational and phenotypic spectrum of diseases associated with mutations in MTTK.

  3. Surgical intervention and capsular contracture after breast augmentation

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R

    2005-01-01

    -requiring complications and capsular contracture grades III to IV among 2277 women who underwent cosmetic breast implantation from June 1999 through April 2003. During an average follow-up period of 1.6 years after implantation, 4.3% of these women (3% of implants) required secondary surgery as a result of short......-term complications. The most frequent clinical indications for surgery were displacement of the implant (38%), capsular contracture grades III to IV (16%), ptosis (13%), and hematoma (11%). Overall, the authors found that inframammary incision and subglandular placement were associated with decreased risks...... of developing complications requiring surgical intervention, whereas implants larger than 350 mL increased the risk of such complications (relative risk [RR], 2.3; 95% confidence interval [CI], 1.3-4.0). Thirty-nine Baker III to IV capsular contractures were identified, of which 22 were treated surgically...

  4. Gorlin-Chaudhry-Moss or Saethre-Chotzen syndrome?

    Science.gov (United States)

    Preis, S; Kaewel, E V; Majewski, F

    1995-05-01

    We report a 2-year-old girl with craniosynostosis, an ossification defect of the cranial vault, midface hypoplasia, low frontal hairline, anti-mongoloid slant of the palpebral fissures, ptosis of the lateral upper lids and high-arched narrow palate. There are additional findings fitting the Gorlin-Chaudhry-Moss syndrome, such as hypoplasia of the labia majora, hypoplasia of the distal phalanges of fingers and toes and conductive hearing loss, but hypertrichosis and dental anomalies are missing, which were described in the four females previously reported with the probably autosomal recessive Gorlin-Chaudhry-Moss syndrome. Since the autosomal dominant Saethre-Chotzen syndrome may show similar cranio-facial features, short fingers with non-obligatory cutaneous syndactyly, and ossification defects of the cranial vault, the Saethre-Chotzen syndrome should also be considered in our patient.

  5. Microdeletions of chromosome 7p21, including TWIST1, associated with significant microcephaly, facial dysmorphism, and short stature.

    Science.gov (United States)

    Busche, Andreas; Graul-Neumann, Luitgard M; Zweier, Christiane; Rauch, Anita; Klopocki, Eva; Horn, Denise

    2011-01-01

    Saethre-Chotzen syndrome due to TWIST1 mutations is characterized by coronal synostosis, facial dysmorphism and additional variable anomalies. Small deletions comprising the whole TWIST1 account for a small proportion of patients with Saethre-Chotzen syndrome. Here we describe 3 patients with facial dysmorphism, marked microcephaly, short stature (2/3 patients), and overlapping 7p21 microdeletions. Molecular karyotyping identified small deletions of chromosome 7p21 including TWIST1 with a size of 526 kb, 9.2 Mb, and 11.7 Mb, respectively. The clinical manifestations of these patients do not resemble the typical phenotype of Saethre-Chotzen syndrome. In the two patients with larger microdeletions, severe mental retardation and significant short stature are present. Facial dysmorphism of patient 3 includes also signs of blepharophimosis-ptosis-epicanthus inversus syndrome.

  6. Envenoming following bites by the Balkan adder Vipera berus bosniensis - first documented case series from Bulgaria.

    Science.gov (United States)

    Westerström, Alexander; Petrov, Boyan; Tzankov, Nikolay

    2010-12-01

    We report the first detailed accounts of bites by the Balkan adder, Vipera berus bosniensis from Bulgaria. Documentation of bites by this subspecies is very rare in the literature and most available accounts are from the northern limit of its distribution. V. berus bosniensis is considered to possess neurotoxic venom but little evidence has hitherto been available to support this supposition. In this case series symptoms typical of adder bites developed including oedema, nausea, dizziness, lymphangitis, vomiting, and diarrhoea together with aberrant symptoms such as diplopia and ptosis that confirm the presence of neurotoxic venom in Balkan adders. In addition, unusual and atypical symptoms of adder bites such as painless bites and muscle cramps appeared. The inadequate treatment in hospital and the remote habitats in which this species is encountered are potential sources of complication.

  7. Maximizing aesthetics in lateral-tension abdominoplasty and body lifts.

    Science.gov (United States)

    Lockwood, Ted E

    2004-10-01

    The high-lateral-tension abdominoplasty addresses the practical and theoretic faults of standard abdominoplasty design. Key features include limited direct undermining, increased lateral skin resection with highest-tension wound closure along lateral limbs, two-layer superficial fascial system repair, and significant truncal liposuction when needed. The high-lateral-tension design limits the unfavorable features of standard abdominoplasty and produces balanced natural aesthetic contours. The high-lateral-tension abdominoplasty is the foundation for treatment of more generalized relaxation problems in the circumferential trunk and thighs. For more significant thigh laxity and buttock ptosis, the lateral-tension abdominoplasty is combined with the transverse thigh/buttock lift to produce the lower body lift #2.

  8. Contiguous gene deletion neighboring TWIST1 identified in a patient with Saethre-Chotzen syndrome associated with neurodevelopmental delay: Possible contribution of HDAC9.

    Science.gov (United States)

    Shimbo, Hiroko; Oyoshi, Tatsuki; Kurosawa, Kenji

    2017-02-21

    Saethre-Chotzen syndrome (SCS) is an autosomal dominant craniosynostotic disorder characterized by coronal synostosis, facial asymmetry, ptosis, and limb abnormalities. Haploinsufficiency of TWIST1, a basic helix-loop-helix transcription factor is responsible for SCS. Here, we report a 15-month-old male patient with typical clinical features of SCS in addition to developmental delay, which is a rare complication in SCS. He showed a de novo 0.9-Mb microdeletion in 7p21, in which TWIST1, NPMIP13, FERD3L, TWISTNB, and HDAC9 were included. In comparison with previously reported patients, HDAC9 was suggested to contribute to developmental delay in SCS patients with 7p21 mirodeletions. © 2017 Japanese Teratology Society.

  9. Dopamine-independent locomotor actions of amphetamines in a novel acute mouse model of Parkinson disease.

    Directory of Open Access Journals (Sweden)

    Tatyana D Sotnikova

    2005-08-01

    Full Text Available Brain dopamine is critically involved in movement control, and its deficiency is the primary cause of motor symptoms in Parkinson disease. Here we report development of an animal model of acute severe dopamine deficiency by using mice lacking the dopamine transporter. In the absence of transporter-mediated recycling mechanisms, dopamine levels become entirely dependent on de novo synthesis. Acute pharmacological inhibition of dopamine synthesis in these mice induces transient elimination of striatal dopamine accompanied by the development of a striking behavioral phenotype manifested as severe akinesia, rigidity, tremor, and ptosis. This phenotype can be reversed by administration of the dopamine precursor, L-DOPA, or by nonselective dopamine agonists. Surprisingly, several amphetamine derivatives were also effective in reversing these behavioral abnormalities in a dopamine-independent manner. Identification of dopamine transporter- and dopamine-independent locomotor actions of amphetamines suggests a novel paradigm in the search for prospective anti-Parkinsonian drugs.

  10. Clinically and electrophysiologically diagnosed botulinum intoxication.

    Science.gov (United States)

    Kotan, Dilcan; Aygul, Recep; Ceylan, Mustafa; Yilikoglu, Yalcin

    2013-01-03

    In this case report, clinical and electrophysiological findings of 43-year-old female patient who developed Clostridium botulinum intoxication after consumption of home-made canned food are presented. Following the sudden onset of severe nausea and vomiting, diplopia, blurred vision, bilateral ptosis, weakness, speech and swallowing difficulties have developed and the patient declared that she has just tasted the canned beans after she had rinsed them several times. The case, where serological tests cannot be performed, was diagnosed clinically and treated with antitoxin immediately. During follow-up, consecutive nerve stimulation was performed and significant incremental response was observed. There was an improvement in symptoms within 2 weeks, and in 5 or 6 weeks the symptoms had disappeared completely. Electrodiagnostic studies revealed that the findings turned to normal. The case showed that immediate antitoxin treatment is life-saving even the diagnosis of botulinum intoxication is based on clinical findings.

  11. King-Denborough Syndrome: report of two Brazilian cases

    Directory of Open Access Journals (Sweden)

    Reed Umbertina Conti

    2002-01-01

    Full Text Available We report on two boys aged 2 and 6 years-old respectively with dysmorphic face, ptosis, down-slanting palpebral fissures, hypertelorism, epicanthic folds, low-set ears, malar hypoplasia, micrognathia, high-arched palate, clinodactyly, palmar simian line, pectus excavatum, winging of the scapulae, lumbar lordosis and mild thoracic scoliosis who present congenital hypotonia, slightly delayed motor development, diffuse joint hyperextensibility and mild proximal weakness. The muscle biopsy revealed minimal but identifiable changes represented by size fiber variability, type I fiber predominance and atrophy, perimysial fibrous infiltration and some disarray of the intermyofibrillary network. These cases correspond to the first Brazilian reports of the King-Denborough syndrome and our objective is increasing the awareness of this disorder as these patients are predisposed to developing malignant hyperthermia.

  12. The missed missing hole

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    Fábio Henrique de Gobbi Porto

    2012-06-01

    Full Text Available At times in clinical neurology, the identification of a subtle clinical or radiological sign can lead to prompt diagnosis of a very rare or difficult case. We report on a patient who presented with untreatable headache and unilateral ptosis. Computed tomography (CT scan of the head did not reveal any structural cause. Magnetic resonance angiogram showed absence of left internal carotid artery, which was eventually confirmed by a catheter angiography. Reviewing the case, it emerged that a feature on the initial CT scan "bone window" would have confirmed the diagnosis, had it been searched for: the underdeveloped carotid canal, which is a consequence and a marker of internal carotid artery agenesis.

  13. Horner syndrome in neurofibromatosis type 1.

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    Lee, Jang Hyun; Jeen, Yoon-Mi; Kang, Sang Gue; Tark, Min Seung; Kim, Chul Han

    2015-01-01

    The authors report a rare case of Horner syndrome in a patient with neurofibromatosis type 1 (NF-1). A 31-year-old man visited the clinic with drooping left eyelid. The physical examination revealed ptosis of the left eyelid, miotic pupil, facial anhidrosis, and several skin masses on the chest. The radiological examination of the chest demonstrated a well-defined left posterior mediastinal mass close to the vertebral bodies of the upper thoracic spine at the level of T1-T5. The masses of mediastinum and skin were totally removed. They were diagnosed as neurofibromas. Neurofibromatosis type 1 was diagnosed. To the best of my knowledge, this is a rare case of a patient with NF-1 who presented with Horner syndrome. Clinicians should be vigilant on the possibility of Horner syndrome in patients with NF-1.

  14. [Pharmacological Tests for Horner Syndrome - Case Report].

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    Skorkovská, K

    2016-01-01

    The case report presents a patient, who was examined at our department due to anisocoria that was present for more than one year. Besides the anisocoria the patient had no other pathological symptoms. The pupil on the right eye was larger than on the left eye by more than 1mm. Photoreaction was present on both eyes with a dilatation deficit on the left eye. There was also a slight ptosis on the left. The anterior and posterior eye segment was normal, only the iris of the left eye was slightly decoloured. The ophthalmological finding was pointing to Horner syndrome on the left side. The cause of the syndrome was not found. The case report discusses current problems of pharmacological pupillary tests used in Horner syndrome. Alternatives to the standard cocaine test are proposed, with respect to substances currently available in the Czech Republic.

  15. Horner syndrome as a manifestation of thyroid carcinoma: a rare association.

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    Pereira, Bernardo; Silva, Tiago; Luiz, Henrique; Manita, Isabel; Raimundo, Luísa; Portugal, Jorge

    2013-08-01

    An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies.

  16. Suppurative dacroadenitis causing ocular sicca syndrome in classic Wegener′s granulomatosis

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    Khanna Dhanita

    2011-01-01

    Full Text Available Wegener′s granulomatosis (WG is a multisystem vasculitic disorder which can commonly afflict various components of the eye. Here we describe some unusual ocular manifestations of the disease in one patient. A young male with history of upper respiratory tract symptoms including epistaxis, nasal stuffiness and maxillary sinus pain presented with bilateral lacrimal gland abscess and ptosis. Lacrimal gland biopsy revealed granulomatous vasculitis. Lung cavities, positive cytoplasmic-antineutrophil cytoplasmic antibodies and high titers of serine proteinase-3 antibodies confirmed the diagnosis of WG. The patient developed dry eyes after a month of first presentation. There was no dryness of mouth, suggesting the absence of salivary gland involvement, and antinuclear antibodies as well as antibodies against Ro and La antigens classical of primary Sjogren′s syndrome were absent. Granulomatous vasculitis of lacrimal gland leading to abscess formation and dryness of eyes has not been described in WG and reflects the aggressive nature of inflammatory process in this disease.

  17. Temporary diazepam responsive apneic attacks and congenital myasthenic syndrome.

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    Yis, Uluç; Kurul, Semra Hiz; Oztura, Ibrahim; Ozden, Omer; Akinci, Gülçin; Dirik, Eray

    2009-07-01

    Congenital myasthenic syndromes are a genetically and phenotypically heterogeneous group of hereditary disorders affecting neuromuscular junction. Mutations in the gene encoding choline acetyltransferase cause presynaptic defects. The missense mutation I336T has been identified in Turkish population, and most of the cases carrying this mutation present with exercise-induced fatigability and ptosis. Although apneic attacks occur in these cases during febrile illness in childhood, the number of reported respiratory distress episodes during infancy is scarce. Another important feature of these cases is that response to esterase inhibitors is satisfactory. We present a case of congenital myasthenic syndrome with I336T choline acetyltransferase mutation who presented with numerous attacks of respiratory distress in the infancy period. Interestingly, the patient had myopathic findings on electromyography and diazepam decreased severity of apneic attacks. There was also no improvement with esterase inhibitors.

  18. Anti-musk positive myasthenia gravis and three semiological cardinal signs

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    André P.C. Matta

    2017-01-01

    Full Text Available Myasthenia gravis (MG is a relatively uncommon disorder with an annual incidence of approximately 7 to 9 new cases per million. The prevalence is about 70 to 165 per million. The prevalence of the disease has been increasing over the past five decades. This is thought to be due to better recognition of the condition, aging of the population, and the longer life span of affected patients. MG causes weakness, predominantly in bulbar, facial, and extra-ocular muscles, often fluctuating over minutes to weeks, in the absence of wasting, sensory loss, or reflex changes. The picture of fluctuating, asymmetric external ophthalmoplegia with ptosis and weak eye closure is virtually diagnostic of myasthenia. We report an atypical MG case with three semiological cardinal signs.

  19. [CT findings of the temporal bones in Waardenburg's syndrome].

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    Irie, K; Ogata, H; Mitsudome, A

    1990-05-01

    We reported three cases of Waardenburg's syndrome and discussed CT findings of the temporal bones. Two cases of these patients were mother and daughter. Case 1, a two-year-old girl, had lateral displacement of the medial canthi, a broad nasal root, hetero-chromic iridis, left ptosis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules, short lateral semicircular canal, and absent right posterior semicircular canal. The mother had congenital deafness, heterochromia iridis, and a white forelock and showed similar abnormal CT findings of the temporal bones. Case 2, a one-year-old boy, had lateral displacement of the medial canthi, a broad nasal root, partial heterochromia iridis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules and absence of semicircular canals except the right lateral semicircular canal. These cases were diagnosed as Waardenburg's syndrome on the basis of the characteristic features.

  20. Atrioventricular block and wiry hair in Teebi hypertelorism syndrome.

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    Han, Xiao-Dong; Cox, Vicki; Slavotinek, Anne

    2006-09-15

    We report on a 4 1/2-year-old girl with clinical features of Teebi hypertelorism syndrome (THS), including a prominent forehead with a widow's peak, heavy and broad eyebrows, hypertelorism, long palpebral fissures, ptosis, a thin upper lip, a grooved chin, and a left preauricular cyst. She required a pacemaker for third degree atrioventricular (AV) block, a finding that has not been previously reported in 36 other patients with THS and for which we were unable to identify other causes. We have reviewed the previous reports of THS and note a characteristic facial appearance with hypertelorism, heavy, broad, and arched eyebrows, a thin upper lip with a long and deep philtrum, and a prominent forehead. Structural cardiac defects were present in five patients, implying that cardiac investigations are warranted in patients with a cardiac murmur and a clinical diagnosis of THS.