A Case of Ocular Toxocariasis Successfully Treated with Albendazole and Triamcinolon

We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors'' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis.     

间接眼底镜下外路手术治疗孔源性视网膜脱离对患者视力与黄斑水肿的影响

摘要 目的：探讨间接眼底镜下外路手术治疗孔源性视网膜脱离对患者视力与黄斑水肿的影响。方法：选择2018年8月到2021年9月在本院诊治的孔源性视网膜脱离患者84例作为研究对象,根据1:1随机数字表法把患者分为眼底镜组与对照组各42例,对照组采用巩膜扣带术治疗,眼底镜组给予间接眼底镜下外路手术治疗,测定患者视力与黄斑水肿情况。结果：两组术后3个月的最佳矫正视力好于术前1 d,眼底镜组好于对照组（P<0.05）。眼底镜组术后3个月的总有效率为97.6 %,高于对照组的76.2 %（P<0.05）。眼底镜组术后3个月的眼内出血、视网膜坏死、眼内炎、高眼压等并发症发生率为4.8 %,低于对照组的23.8 %（P<0.05）。两组术后3个月的视网膜下液高度低于术前1 d,眼底镜组低于对照组（P<0.05）。眼底镜组术后3个月的自理等生活质量评分较对照组高（P<0.05）。结论：间接眼底镜下外路手术治疗孔源性视网膜脱离能改善黄斑水肿提高,促进恢复患者的视力,提高总体治疗效果,减少并发症,有利于患者视网膜下液高度降低,从而提高生活质量。     

兔眼孔源性视网膜脱离手术复位后视功能以及超微结构的变化

目的对比研究兔眼视网膜脱离后选择不同时期手术复位视功能的变化情况,为临床手术时机的选择及预测术后视功能的恢复情况提供理论与实验依据。方法利用家兔制备孔源性视网膜脱离模型,成模后1 d、7 d1、4 d时经手术达解剖复位,采用多焦视网膜电流图检测复位后视网膜的功能,数据处理应用SPSS软件。制备组织病理学切片。结果多焦视网膜电流图显示1 d、7 d、14 d的RRD手术复位后P1波平均象限反应密度(QAP1,nV/deg2),P1波幅值(AP1,μV),N1波幅值(AN1,μV),P1波潜伏期(TP1,ms),N1波潜伏期(TN1,ms)各项数值差异有显著性(P<0.05)。光镜电镜显示视网膜脱离复位后组织病理学改变。结论视网膜脱离手术复位后视网膜细胞功能的恢复与脱离时间有明显的负相关性;多焦视网膜电流图对于局部视网膜功能的评价有重要意义;组织病理学研究提供了解释视功能变化的重要依据。     

抗VEGF药物联合532 激光治疗视网膜中央静脉阻塞的疗效分析

目的:探讨抗VEGF药物联合532激光治疗视网膜中央静脉阻塞的疗效。方法:选取60例患视网膜中央静脉阻塞患者,年龄38-65岁,研究组(31例)采用抗VEGF药物联合532激光治疗,对照组(29例)单纯给予激光治疗。监测患者治疗前,治疗后3个月的视力,黄斑中心凹厚度(Central macular thickness,CMT)以及治疗后3个月的治疗结果,对联合治疗与单纯激光方式的疗效进行对比。结果:治疗后3个月,研究组有效率明显高于对照组(P0.05)。与治疗前相比,研究组治疗后3个月,视力改善情况较明显(P0.05),且改善幅度大于对照组(P0.05)。对照组治疗后3个月,视力有了小幅度改善,然而与治疗前相比,差异没有统计学意义(P0.05)。治疗前,两组CMT相比,差异没有统计学意义(P0.05)。治疗后3个月,两组CMT均有明显改善,且研究组改变情况优于对照组(P0.05)。所有患者在治疗后3个月内均未严重并发症。结论:抗VEGF药物联合532激光治疗视网膜中央静脉阻塞,可以显著提高患者视力和治疗有效率,降低黄斑水肿,新生血管等并发症发生率,并且不会引起其他并发症。     

Clinical Features and Treatment of Ocular Toxoplasmosis

Ocular toxoplasmosis is a disease caused by the infection with Toxoplasma gondii through congenital or acquired routes. Once the parasite reaches the retina, it proliferates within host cells followed by rupture of the host cells and invasion into neighboring cells to make primary lesions. Sometimes the restricted parasite by the host immunity in the first scar is activated to infect another lesion nearby the scar. Blurred vision is the main complaint of ocular toxoplasmic patients and can be diagnosed by detection of antibodies or parasite DNA. Ocular toxoplasmosis needs therapy with several combinations of drugs to eliminate the parasite and accompanying inflammation; if not treated it sometimes leads to loss of vision. We describe here clinical features and currently available chemotherapy of ocular toxoplasmosis.     

The D Trisomy Syndrome: A Case Report with a Description of Ocular Pathology

A male infant with trisomy of one of the 13-15, or D, group of autosomes is described. The infant survived for only a few hours and had the following congenital abnormalities: defect of the scalp and underlying vertex of the skull, hemangioma, microphthalmia, cleft palate, ulnar deviation of forearms and wrists with flexion deformity of the fingers, polydactyly of the feet, interauricular septal defect, cryptorchidism and polycystic kidneys. Retinal dysplasia was the major abnormality in the microphthalmic eye.The congenital anomalies caused by D trisomy are sufficiently characteristic for the chromosomal error to be suspected in a newborn infant. A chromosome analysis is advisable for confirmation of the diagnosis.     

A Case of Ocular Angiostrongyliasis with Molecular Identification of the Species in Vietnam

A 23-year-old female residing in a village of Cao Bang Province, North Vietnam, visited the Hospital of Hanoi Medical University in July 2013. She felt dim eyes and a bulge-sticking pain in her left eye for some days before visiting the hospital. In the hospital, a clinical examination, an eye endoscopy, and an operation were carried out. A nematode specimen was collected from the eye of this patient. The body of this worm was thin and long and measured 22.0×0.3 mm. It was morphologically suggested as an immature female worm of Angiostrongylus cantonensis. By a molecular method using 18S rRNA gene, this nematode was confirmed as A. cantonensis. This is the first molecular study for identification of A. cantonensis in Vietnam.     

EEG Biofeedback for Treatment of Psychogenic Non-Epileptic Seizures (PNES) in Multiple Sclerosis: A Case Report

Applied Psychophysiology and Biofeedback - The objective of the present study was to evaluate the effectiveness of EEG biofeedback for treatment of psychogenic non-epileptic seizures (PNES) in a...     

A Delay Differential Model for Pandemic Influenza with Antiviral Treatment

The use of antiviral drugs has been recognized as the primary public health strategy for mitigating the severity of a new influenza pandemic strain. However, the success of this strategy requires the prompt onset of therapy within 48 hours of the appearance of clinical symptoms. This requirement may be captured by a compartmental model that monitors the density of infected individuals in terms of the time elapsed since the onset of symptoms. We show that such a model can be expressed by a system of delay differential equations with both discrete and distributed delays. The model is analyzed to derive the criterion for disease control based on two critical factors: (i) the profile of treatment rate; and (ii) the level of treatment as a function of time lag in commencing therapy. Numerical results are also obtained to illustrate the feasible region of disease control. Our findings show that due to uncertainty in the attack rate of a pandemic strain, initiating therapy immediately upon diagnosis can significantly increase the likelihood of disease control and substantially reduce the required community-level of treatment. This suggests that reliable diagnostic methods for influenza cases should be rapidly implemented within an antiviral treatment strategy.     

特发性声门下狭窄临床诊治附4例报道

目的:探讨特发性声门下型喉狭窄的发病机制及临床诊治方法。方法:对我科2012年5月-2014年1月收治的4例特发性声门下型喉狭窄患者的临床资料进行回顾性研究,在基本相同的手术方式、不同的术后用药下进行长期随访,电子喉镜下观察患者术前、后及随访2年的病灶区情况并进行相关统计学分析。结果:4例特发性声门下型喉狭窄患者多因呼吸困难就诊,均采用气管切开术及支撑喉镜下热器械切除病变,旷置创面的手术方式,术后短期内气道狭窄均得到解决、呼吸困难症状均得到缓解;配合小剂量激素中长期治疗效果尚可,患者声门下病灶无明显复发,气道症状能得到控制,其中2例患者治愈,1例患者因拒绝激素治疗术后未予激素治疗中期观察有效,1例患者术中术后未予激素治疗,术后短期复发,后经激素治疗治愈。结论:特发性声门下型喉狭窄是后天性声门下狭窄的非瘢痕性的特殊类型,为独特的喉狭窄炎症性疾病,病因不明或为某些因素引起了非特异的增生性炎症,表现为炎性细胞的浸润及淋巴组织增生。治疗上,手术能明显缓解其症状,但单纯手术治疗中长期效果不佳,极易复发;配合中长期小剂量激素治疗对病灶控制有重要的作用。     

Failure of Multiple Therapies in the Treatment of a Type 1 Diabetic Patient with Insulin Allergy: A Case Report

ObjectiveTo describe the clinical manifestations of insulin allergy and explain a systematic management approach.MethodsWe present the clinical, laboratory, and pathologic findings of a type 1 diabetic patient with allergy to subcutaneous insulin and briefly review the related literature.ResultsAn 18-year old woman with type 1 diabetes mellitus had an insulin allergy and developed subcutaneous nodules after insulin administration. Human and analogue insulins were used, but painful nodule formation persisted. Treatment with antihistamines, steroids, and omalizumab and insulin desensitization were ineffective. The patient required pancreatic transplant because glycemic control could not be achieved due to the insulin allergy.ConclusionsInsulin allergy is not a common condition and can be challenging in patients with type 1 diabetes. Therefore, identifying patients with true insulin allergy and applying a stepwise approach to their treatment is important. (Endocr Pract. 2011;17:91-94)     

CO2激光、LD激光联合治疗牙龈瘤46例疗效观察

目的：研究CO2激光、LD激光联合治疗牙龈瘤及保存牙体组织的临床疗效。方法：对46例口腔牙龈瘤患者发病的年龄,性别,好发部位进行分析,采用CO2激光、LD激光联合治疗机,先用CO2激光束切割肿瘤,而后CO2激光气化肿瘤波及牙齿的牙周膜,术后第二天用LD激光,每日一次,每次15分钟,连续5天照射手术创面。结果：46列牙龈瘤患者,42例一次治疗痊愈,4例复发,二次手术后无复发,手术疗效、治愈率100％。结论：CO2激光、LD激光联合切除牙龈瘤与传统的手术方法,治疗疗效机理进行了对照,其特点是保存了肿瘤波及的牙齿,不造成组织缺损,还具有手术时间短,出血少,愈合快等优点。     

一例喉真菌病病例报道并文献复习

目的:探讨喉真菌病的临床特征、诊断要点和治疗方案。方法:回顾我院收治的一例喉真菌病患者的临床病例资料,并对1992年至今国内外报道的类似病例33例进行文献复习。本研究共纳入患者34例,男性16例,女性18例,年龄14-67岁,临床表现以声嘶为主,可伴有咽痛、咽干等咽喉不适感,其中有16例患者被误诊为急性喉炎,27例患者有不同程度的抗生素和(或)糖皮质激素使用史。结果:34例患者中,13例通过病理确诊为喉真菌病。所有患者均予抗真菌药物治疗,其中有1例同时行手术治疗,均治愈。结论:喉真菌病临床罕见,症状无特异性,易误诊,但病理学检查可靠,全身或局部使用抗真菌药物疗效佳,预后良好。     

骨髓增生异常综合征合并非霍奇金淋巴瘤一例病例报道并文献复习

目的:探讨骨髓增生异常综合征合并非霍奇金淋巴瘤的发病机制、诊断及治疗,并判断其预后情况。方法:回顾我院收治的一例骨髓增生异常综合征(MDS)患者同时诊断间变大细胞淋巴瘤(ALCL)患者的临床资料,总结其诊断及治疗经过,对其预后进行评价。结果:该患者诊断间变大细胞淋巴瘤后,经化疗对症治疗病情无显著改善,且患者ALK阳性,考虑预后较差,建议造血干细胞移植。结论:骨髓增生异常综合征合并非霍奇金淋巴瘤的病例在国内外十分罕见,治疗方法目前尚需进一步研究。     

Conservative Treatment of a Nondisplaced Intertrochanteric Femur Fracture: A Case Report and Review of the Literature

A 21-year-old otherwise healthy male sustained a nondisplaced, intertrochanteric fracture of the left femur after being “rear-ended” by a motor vehicle while riding his bicycle. His fracture was managed with protected weight-bearing and progressive mobilization. No traction was utilized. The patient had an excellent clinical outcome at two-year follow-up, reporting modified Harris Hip Score 85, Hip Outcome Score-Activities of Daily Living 88, Hip Outcome Score-Sport Specific 89, and International Hip Outcome Tool-33 of 77.ConclusionNonsurgical treatment, consisting of restricted weight-bearing, for non-displaced intertrochanteric femur fracture in young, healthy patients can provide a successful result.Level of Evidence: V     

大剂量甲泼尼龙救治结缔组织病合并急性呼吸窘迫综合症及文献复习

目的:探讨糖皮质激素在急性呼吸窘迫综合症(ARDS)治疗中的意义及进展。方法:回顾性分析我科采用大剂量甲泼尼龙救治的1例结缔组织病合并ARDS高龄患者诊治过程,并结合文献进行复习。结果:患者采用大剂量甲泼尼龙治疗后,有效改善肺部功能,减轻肺纤维化。随访至今病情稳定。结论:在ARDS治疗过程中,激素发挥重要作用,激素剂量及疗程的应用需因病而异。     

膀胱副神经节瘤的诊治分析(附1 例病例报告并文献复习)

目的:总结膀胱副神经节瘤的诊治方法及体会,提高膀胱副神经节瘤的诊断和治疗水平。方法:报告1例膀胱嗜铬细胞瘤的临床资料并结合文献复习分析总结膀胱副神经节瘤的诊断治疗方法。结果:患者行腹腔镜下膀胱部分切除术,手术成功,术后顺利出院,随访至今无转移。结论:膀胱副神经节瘤的诊断主要依靠临床表现和实验室检查,血尿、高血压和排尿时典型发作三联征为膀胱副神经节瘤的主要症状,对于瘤体较小的患者要警惕CT检查漏诊的可能性,可行活组织检查进行确诊。腹腔镜下切除是目前治疗膀胱副神经节瘤最有效、创伤最小的方法,但术后要严格随访。     

Lucid Dreaming Treatment for Nightmares: A Series of Cases

Goal of this series of cases was to investigate lucid dreaming treatment for nightmares. Hypotheses were that lucid dreaming treatment would decrease nightmare frequency and state/trait anxiety, and improve the quality of sleep. Eight participants received a one-hour individual session, which consisted of lucid dreaming exercises and discussing possible constructive solutions for the nightmare. Nightmare frequency and sleep quality were measured by a sleep questionnaire, anxiety was measured by the Spielberger State and Trait Anxiety Inventory. At the follow-up two months later the nightmare frequency had decreased, while the sleep quality had increased slighty. There were no changes on state and trait anxiety. Lucid dreaming treatment seems to be effective in reducing nightmare frequency, although the effective factor remains unclear.     

Slow-release Drug Delivery through Elvax 40W to the Rat Retina: Implications for the Treatment of Chronic Conditions

Diseases of the retina are difficult to treat as the retina lies deep within the eye. Invasive methods of drug delivery are often needed to treat these diseases. Chronic retinal diseases such as retinal oedema or neovascularization usually require multiple intraocular injections to effectively treat the condition. However, the risks associated with these injections increase with repeated delivery of the drug. Therefore, alternative delivery methods need to be established in order to minimize the risks of reinjection. Several other investigations have developed methods to deliver drugs over extended time, through materials capable of releasing chemicals slowly into the eye. In this investigation, we outline the use of Elvax 40W, a copolymer resin, to act as a vehicle for drug delivery to the adult rat retina. The resin is made and loaded with the drug. The drug-resin complex is then implanted into the vitreous cavity, where it will slowly release the drug over time. This method was tested using 2-amino-4-phosphonobutyrate (APB), a glutamate analogue that blocks the light response of the retina. It was demonstrated that the APB was slowly released from the resin, and was able to block the retinal response by 7 days after implantation. This indicates that slow-release drug delivery using this copolymer resin is effective for treating the retina, and could be used therapeutically with further testing.