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Shu-Ching Kao

Publications and source records attributed to Shu-Ching Kao.

13 recordsLinked to original sources
PubMed2006

Lacrimal gland extranodal marginal zone B-cell lymphoma of MALT-type.

PURPOSE: To evaluate the clinical features and outcome of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma) in the lacrimal gland. DESIGN: Retrospective, noncomparative, observational case series in an academic referral setting. METHODS: A consecutive series of 13 histologically verified MALT lymphoma in the lacrimal gland at presentation was studied. Clinical characteristics, treatment, and prognosis were analyzed. RESULTS: Eight males and five females with a median age of 64 years and a median follow-up time of 48 months were included. All patients had no prior lymphoma and initially presented as MALT lymphoma in the lacrimal gland. Extraorbital involvement at diagnosis was noted in six patients (46.2%). Two patients had autoimmune disease, and both had Stage IV disease at presentation. Treatment consisted of surgical resection in one patient, radiotherapy in four, chemotherapy in four, and combined radiotherapy and chemotherapy in four. Complete remissions were obtained in eight patients (61.5%). Patients with bilateral disease (61.5%) had a higher rate of advanced-stage disease and a poor outcome. Recurrence was noted in two patients. At the last follow-up, eight patients were free of disease, three were alive with disease, one died of sepsis as a complication of chemotherapy, and one died of lymphoma. CONCLUSIONS: MALT lymphoma in the lacrimal gland has a high rate of extraorbital involvement and synchronous bilateral lacrimal gland involvement at presentation. The prognosis is relatively poor, especially in patients with advanced disease and bilateral involvement. Extensive staging and long-term follow-up are warranted for these patients.

Adult↗
PubMed2006

Retinoblastoma with spinal recurrence presenting as spinal cord compression.

Central nervous system (CNS) involvement is not rare in extraocular retinoblastoma, and it is not surprising to find it in view of its route of spread. However, although spinal recurrence presenting as spinal cord compression (SCC) is a form of CNS involvement, it is extremely rare. This report describes two patients with unilateral retinoblastoma with spinal recurrence presenting as SCC. The first patient developed erythematous swelling of the right foot and weakness of the bilateral lower limbs at 7 months after left enucleation. Examination revealed pitting edema of bilateral feet and muscle power of 2+ to 3+, with intact sensory function. The second patient developed weakness of the bilateral lower limbs, and defecative and urinary difficulty for 2 days at 8 months after left enucleation. Examination revealed pitting edema of bilateral feet and muscle power of 2+, with defective sensory function. Both patients received surgery and local irradiation after SCC. The first patient refused chemotherapy and survived only 4 months due to disease progression. The second patient received systemic and intrathecal chemotherapy, and survived 19.5 months without disease progression. Spinal recurrence with SCC should be suspected when leg weakness or bowel or bladder disturbance occurs in patients with retinoblastoma.

Child, Preschool↗
PubMed2006

Preseptal and orbital cellulitis: a 10-year review of hospitalized patients.

BACKGROUND: Preseptal and orbital cellulitis range in severity from minor to potentially severe complications. The purpose of this study is to describe the clinical features of patients with preseptal or orbital cellulitis in one medical center in Taiwan, and to assess the effectiveness of treatments and the complications. METHODS: Patients admitted between 1996 and 2005 to Taipei Veterans General Hospital under the diagnosis of preseptal or orbital cellulitis were retrospectively reviewed. The demographics, administrative history, past history, clinical presentations, treatments, and complications were analyzed. RESULTS: In total, 94 patients fulfilling the diagnostic criteria for preseptal or orbital cellulitis were identified (67 had preseptal cellulitis, 27 had orbital cellulitis). While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesions in children and dacryocystitis in adults were the most common in preseptal cases. Microbiologic investigations showed variable results, but the most common pathogen isolated was Staphylococcus aureus. Cultures from eye swabs and local abscesses gave the highest positive yield. Blood cultures were taken in some patients, but the positive rate was extremely low. Treatments included intravenous antibiotics alone, or intravenous antibiotics combined with surgical drainage. Only one case had permanent ocular motility impairment after removal of the orbital foreign body. CONCLUSION: Despite the past history of potential morbidity and even mortality from orbital cellulitis, early diagnosis and prompt treatment with proper antibiotics and/or surgical intervention can achieve a good prognosis.

Adolescent↗
PubMed2005

Ophthalmic manifestations of paranasal sinus mucoceles.

BACKGROUND: Paranasal sinus mucoceles are mucus-containing cysts caused by obstruction of the sinus orifice. Although such mucoceles originate in the paranasal sinuses, they are usually only associated with ophthalmic and not rhinologic symptoms. The purpose of this study was to demonstrate the presence of ophthalmic manifestations in patients with paranasal sinus mucoceles, and to discuss the possible mechanisms and prognosis for such manifestations. METHODS: Medical records for 41 patients with paranasal sinus mucoceles, who presented with ophthalmic complaints at our department over a 10-year period (1989-1999), were reviewed retrospectively. For analysis of the relationships between ophthalmic complaints and the affected paranasal sinuses, we considered the paranasal sinuses as anterior and posterior. RESULTS: Proptosis (n = 19), periorbital pain (7), and impairment of ocular mobility (5), were common manifestations associated with mucoceles in the anterior paranasal sinuses (25 patients), while blurred vision (n = 9) and impairment of ocular mobility (3) were frequently associated with mucoceles in the posterior paranasal sinuses (11 patients). Ophthalmic complaints resolved in 38 of 41 patients (92.7%) after operation. CONCLUSION: The clinical ophthalmic manifestations of paranasal sinus mucoceles correlated with the paranasal sinuses involved (i.e. anterior or posterior). Because of cranial nerve involvement, mucoceles in the posterior paranasal sinuses had a worse prognosis than those in the anterior paranasal sinuses.

Adolescent↗
PubMed2005

Pulsatile ocular blood flow in patients with Graves' ophthalmopathy.

PURPOSE: Graves' ophthalmopathy (GO) is a cosmetically disfiguring and vision-threatening complication of Graves' disease (GD). We investigated the clinical application of pulsatile ocular blood flow (POBF) measurement for detection of clinically active GO. METHODS: In this prospective study, the OBF tonometer (OBF Labs, Wiltshire, UK) was used to measure POBF in 83 eyes of 83 patients with GD in two groups and 42 normal control subjects. Group A comprised 35 GD patients without ophthalmopathy, and group B composed 48 GD patients with ophthalmopathy. Results were compared with controls. RESULTS: Pulse amplitude, pulse volume, and POBF were significantly lower in group B than that in group A and controls (P<0.001). After adjusting for age, sex, systolic blood pressure, diastolic blood pressure, heart rate, intraocular pressure, and axial length, multivariate linear regression analysis showed that POBF was still significantly lower in eyes with GO (772.4 (SD 279.3) microl/min) than group A (1177.3 (SD 326.3) microl/min) and controls (1255.4 (SD 295.1) microl/min) (P<0.001). CONCLUSIONS: These data show that the pulsatile ocular blood flow differences between the groups are relevant to the presence of GO. POBF measurement is a clinically useful adjunct for assessing the haemodynamic change in GO patients.

Adult↗
PubMed2004

Propecia-associated bilateral cataract.

A 43-year-old man presented suffering from decreasing vision in both eyes for 3 months. The patient's visual acuity was 6/20 (non-corrected) in the right eye and 6/10 (-1.75/-1.00 x 91) in the left. Ocular examination of both eyes revealed anterior subcapsular opacities of both lenses with the right eye being more severe than the left. He had been taking finasteride (Propecia; Merck, Sharp and Dohme) at 1 mg/day for 3 years to treat early stage of androgenic alopecia. It was highly suspected that finasteride was associated with the anterior subcapsular opacity on the lens, and the patient therefore discontinued use of finasteride. He underwent uneventful cataract extraction surgery and intraocular lens implantation of the right eye. One month after cataract surgery in the right eye, the best-corrected visual acuity was right 6/6 (-1.25) and left 6/10 (-2.00/-0.50 x 100). To the best of the authors' knowledge, this is the first reported case of Propecia-associated cataract.

Adult↗
PubMed2003

Localized amyloidosis of the cornea secondary to trichiasis: clinical course and pathogenesis.

PURPOSE: To present four cases of localized corneal amyloidosis secondary to trichiasis and to discuss its pathogenesis. METHODS: Medical and pathologic records of four patients with corneal amyloidosis secondary to trichiasis were reviewed retrospectively. Two patients underwent trichiasis surgery and then lamellar keratectomy. One patient underwent trichiasis surgery only, and one patient received keratectomy only. The excised specimens were examined by light and electron microscopy. In two cases, they were stained with antibodies against kappa and lambda immunoglobulin light chains. All patients were followed for evidence of progression or recurrence of the lesions. RESULTS: Three cases presented with blurring of vision and a progressively enlarging vascularized unilateral corneal mass. One case had normal vision and a smaller, nonvascularized mass. All four cases had a history of trichiasis. After trichiasis surgery but before corneal surgery, two patients were followed for 24 and 18 months, respectively, and showed no progression of the corneal lesions. The patient who did not undergo trichiasis surgery had a recurrence of the corneal lesion after lamellar keratectomy. Pathologic examination confirmed amyloid deposition in all three excised specimens with almost no inflammatory cells. Immunohistochemical stains were negative. CONCLUSION: The close correlation between trichiasis surgery and the clinical course of corneal amyloidosis provides further evidence for their association. The pathologic findings in this study do not confirm that the amyloid deposits are light chain proteins (AL).

Adolescent↗
PubMed2002

Efficacy of probing the nasolacrimal duct with adjunctive Mitomycin-C for epiphora in adults.

PURPOSE: To investigate the efficacy and safety of adjunctive low-dose mitomycin-C during lacrimal probing for adults with blocked nasolacrimal ducts. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: From January 1998 to December 2000, a total of 32 adult patients (36 eyes) seen with epiphora caused by primary nasolacrimal duct obstruction was treated and evaluated. INTERVENTION: Lacrimal probing with adjunctive mitomycin-C (0.2 mg/ml). MAIN OUTCOME MEASURES: Objective evaluation of patency with irrigation, as well as patients' subjective assessment of improvement. RESULTS: For 32 of the treated eyes (89%), the nasolacrimal duct remained open 9 months after treatment. Repeat procedure was successful for two of the remaining four eyes with recurrent obstruction during follow-up, yielding an overall patency rate of 94%. Patient satisfaction was assessed after 9 months and indicated that the epiphora was at least mildly improved for 30 (83%) of the treated eyes. Watering was completely absent for nine eyes (25%), rated as moderately improved for 17 (47%), and mildly improved for 4 (11%). No complications were encountered over the 9-month follow-up period. CONCLUSIONS: Our experience suggests good long-term results for probing with adjunctive, topical Mitomycin-C for cases of adult epiphora caused by obstruction of the nasolacrimal duct followed by repeat procedure if necessary. It can be recommended as a simple, effective, and minimally invasive technique, with no significant complications resulting from low-dose use in our study.

Aged↗
PubMed2002

Corneal ulcer of the side port after phacoemulsification induced by Acinetobacter baumannii.

A 75-year-old man had clear corneal phacoemulsification using a temporal approach in the left eye. Two months after surgery, a focal corneal epithelial defect developed with infiltration near the lower limbus on the site of the side-port incision. The culture of corneal scrapping grew Acinetobacter baumannii, which is resistant to most ordinary antibiotics in sensitivity tests. After appropriate antibiotic treatment, the ulcer healed gradually with vessel ingrowth. Acinetobacter baumannii is usually found in nosocomial infection of immune-compromised patients in the intensive care unit. It is a rare pathogen of infectious keratitis. Our case, with its unusual infection site, may point to potential risk factors for this pathogen.

Acinetobacter↗
PubMed2002

Phthiriasis palpebrarum: an unusual blepharoconjunctivitis.

Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may easily be overlooked because of the failure of physicians to recognize Phthirus pubis. We report a case of a 30-year-old woman with persistent itching in the left eyelid which was unsuccessfully treated under the diagnosis of allergic blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with multiple red pinpoint excretions and numerous small translucent oval eggs (nits) coating the eyelashes. The patient was successfully treated with mechanical removal of all the lice and nits from the eyelashes. The specimen proved histopathologically to be the Phthirus pubis infestation. The Phthirus pubis infestation is usually associated with poor hygiene in overcrowded or undeveloped country. However, it may become a notable problem because of frequent traveling and commercial activities across the different countries.

Adult↗
PubMedDate not supplied

Transplantation of the autologous submandibular gland to the lacrimal basin in rats.

PURPOSE: In this study, we designed an animal experiment in which we transferred a part of the autologous submandibular gland without performing a microvascular anastomosis. We studied histological changes and functional effects in the transfer glands. METHOD: Thirty male adult Sprague-Dawley rats were divided into three groups. In each animal of the three groups, the right eye was the control eye and the left eye the experimental eye. Surgical removal of the extraorbital lacrimal gland from the control eyes was performed to create a condition simulating keratoconjunctivitis sicca. In the experimental eyes of group 1, in addition to the removal of the extraorbital lacrimal gland, a part of the autologous submandibular gland was transferred to the orbit and fixed to the intraorbital lacrimal gland. In the experimental eyes of group 2, in addition to the removal of the extraorbital lacrimal gland, an aseptic silicon rubber was transferred to the orbit and fixed to the intraorbital lacrimal gland. In the experimental eyes of group 3, there was no removal of the extraorbital lacrimal gland but instead a sham operation was performed. The histological changes and innervation pattern in the transferred submandibular gland of group 1 were observed. Tear secretion of each group was measured to study the functional effect. RESULTS: Three months after the transplantation, the transferred submandibular glands were similar to the unoperated submandibular glands both in histology and innervation pattern. In group 1, the tear secretion in the experimental eyes was significantly greater than that of the control eyes at 2 and 3 months following transfer. In group 2, no significant difference was noted between the experimental eyes and control eyes. In group 3, the difference in tear secretion between the experimental eyes and control eyes was significant. CONCLUSION: The result of this study revealed that although the procedure did not involve vascular anastomosis, the transfer gland showed a normal histological appearance and good reinnervation, even 3 months after the transfer. These transferred submandibular glands continued to secrete tears. This secretion continued to increase up until the end of the experimental period.

Anastomosis, Surgical↗
PubMedDate not supplied

Corneal burn: a rare complication of radiofrequency diathermy capsulotomy.

We present 2 patients with accidental corneal burns inflicted during clear cornea cataract surgery using radiofrequency diathermy for anterior capsulotomy. During the capsulotomy procedure, the anterior capsule was not opened and only a small air bubble appeared when the energy was turned on. Meanwhile the area of the corneal tunnel that contacted the shoulder of the diathermy tip became opaque and shrank with a small defect in the anterior corneal lip. Postoperatively, focal corneal shrinkage with iris incarceration into the defect of the corneal tunnel and resultant peaking pupil were noted in the 2 patients. The corneal burns resulted in temporary irregular astigmatism with mild visual acuity impairment. To our knowledge, this is the first report of a corneal burn as a complication of radiofrequency diathermy for anterior capsulotomy in clear cornea cataract surgery.

Aged↗