Iodide mumps after intravenous urography.
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Major salivary gland agenesis is a rare disorder and only a few instances of the condition have been reported. The number of absent salivary glands and the degree of associated xerostomia vary between individuals. Salivary gland agenesis can cause profound xerostomia in children and there may be oral and upper respiratory tract sequelae, such as dental caries, candidiasis, ascending sialadenitis, laryngitis and pharyngitis. Salivary gland aplasia may be associated with other ectodermal defects, particularly abnormalities of the lacrimal apparatus. We report on the first observation of major salivary gland agenesis in South Korea. A child with xerostomia should be appropriately investigated and diagnosed, and careful attention should be paid to the prevention and treatment of sequelae.
The application of endoscopic operation in ophthalmology has gotten great progression in recent years. It has showed many advantages such as more effectiveness, reliability and less damage, complications. Ophthalmic laser endoscopic operations can be applied in the management of glaucoma, vitreoretinopathy and so on. Lacrimal endoscopy in the treatment of lacrimal apparatus disease and nasal endoscopy in the Ophthalmo-Rhinol associated surgeries also has got great development. The application of ophthalmic endoscopic operation has indicated that the period of mini-wounded surgery in ophthalmology began. In this paper, we will describe the basic principle, status of application and prospect of endoscopic operation in ophthalmology.
We describe a 3-generation family with lacrimo-auriculo-dento-digital syndrome (LADD). In addition to the well described abnormalities of ears, teeth, lacrimal apparatus and digits, the patients exhibit several previously undescribed anomalies, including minor facial anomalies (broad forehead, telecanthus, bulbous nasal tip, full jaw, ptosis and flared nostrils), involvement of the first and second toes, and congenital renal disease causing death in the neonatal period in 2 cases.
BACKGROUND: The Harderian gland is an orbital feature found in most terrestrial vertebrates. Although there have been several reports on the structure of the squamate Harderian gland, there has been little recent discussion as to its potential function. This article reviews both the recent morphological observations and their implications on the potential functions of the squamate Harderian gland. METHODS: Literature on the gross structure, histochemistry, and ultrastructure of the squamate Harderian gland and associated structures was reviewed. These observations were then used to assess morphologically the likelihood of the proposed functions. RESULTS: A high level of morphological variation was found in the squamate Harderian gland. Three functional hypotheses, including roles in orbital lubrication, digestion, and vomerolfaction, were considered. Both morphology of the squamate Harderian gland and the presence of alternate secretory sources suggest that it is unlikely to function in orbital lubrication. There is little evidence to suggest a function in digestion. Both the presence of the connecting lacrimal apparatus and the reduced intrinsic secretory capacity of the vomeronasal organ suggest that the Harderian gland may function in vomerolfaction. CONCLUSIONS: The most likely role of the squamate Harderian gland seems to be in vomerolfaction. Morphological variations observed in the Harderian gland may mirror the different degrees and mechanisms of vomerolfaction. Further studies, including comparative morphological, experimental, and microchemical analyses, are required to test this hypothesis.
In midfacial fractures the crucial area is the upper portion of the midfacial skeleton which lodges the orbits, the interorbital space with its anatomic relationship with the anterior cranial fossa, the lacrimal apparatus, the levator muscle, and the skeletal structures of the nose. Because of the severity of the injuries in a multisystem injured patient, these fractures may be neglected or receive inadequate primary treatment. In some cases the damage is so extensive that primary treatment can only accomplish part of the task. Late reconstruction is necessary, therefore, and is the subject of this paper.
The anatomic aspects of the lacrimal apparatus are reviewed in relation to tear production, discussing the concept of xerophthalmos, its etiology and tests for its diagnosis. The authors use two diagnostic tests which quantify the serous secretion (Schirmer's or Jones's tests) and demonstrate epithelium damage (fluorescein or rose Bengal dye test). In cases of presumed xerophthalmos, other tests such as determination of lactoferrin, muramidase, IgA, TISC/BUT, etc. may also be performed to confirm the diagnosis.
A 58-year-old man had a mucoepidermoid tumor of the lacrimal apparatus. Histologically the tumor exhibited clumps and nests of neoplastic cells that showed an admixture of squamous and mucussecreting cells. Histochemical stains for glycoproteins were useful in arriving at the correct diagnosis. Biologically the tumor seemed to be locally aggressive but not metastatic and should be differentiated histologically from the conventional squamous cell carcinomas, adenoid cystic carcinomas, adenocarcinomas, and adenoacanthomas. Large advanced lesions may be managed only by radical surgery, and the margins should be carefully studied for residual tumor. Frequent follow-up is recommended to detect early recurrence.
This is a case of a 28-yr-old man who underwent general anaesthesia for emergency repair of a right lid laceration and lacrimal apparatus. Following induction of anaesthesia and local nasal application of phenylephrine (0.25%) he developed transient elevation of blood pressure, which was treated immediately with labetalol. Subsequently the patient developed acute pulmonary oedema which responded to treatment with morphine and furosemide. The diagnosis of pulmonary oedema was confirmed by blood gas studies, chest x-ray and serial echocardiograms. Subsequent investigation revealed that he was a cocaine user, as the urine tested positive for cocaine. Considering that the patient was young and otherwise healthy and that the hypertension was transient, it is unlikely that phenylephrine was the main cause of pulmonary oedema. Cardiac morbidity was most likely precipitated by the interaction of phenylephrine-induced hypertension with a cocaine-depressed myocardium.
PURPOSE: The objectives of this investigation were to assess the weight of the combined internal orbital contents, to evaluate the ability of common internal orbital reconstruction materials to resist loads, and to determine whether these materials provide enough load resistance to support the orbital contents. MATERIALS AND METHODS: The combined exonerated internal orbital contents (globe, fat, extraocular musculature, neurovascular structures, lacrimal apparatus, and musculocutaneous lids) from 16 human orbits were weighed. Five each of 13 different internal orbital reconstruction materials (titanium mesh, bioresorbables, Marlex [CR Bard, Cranston, RI], Medpore [Porex Medical, College Park, GA], Silastic [Dow Coming, Midland, MI], dried calvarium) were evaluated for their ability to resist loads applied by Instron 85.11 mechanical testing device (Canton, MA) when used to reconstruct uniform orbital floor defects in synthetic skulls (Sawbones, Vashon Island, WA). Yield load, yield displacement, maximum load, and displacement at maximum load were measured. A comparison was then made between orbital content weight and the load-resisting capabilities of the various materials. RESULTS: The weight of the combined internal orbital contents was 42.97+/-4.05 g (range, 37.80 to 51.03 g). All of the materials tested except Marlex mesh met or exceeded the requirements for support of the combined internal orbital contents. CONCLUSION: Except in the instance of complete loss of the orbital floor, all of the materials tested should provide adequate orbital support.
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We describe a family with markedly deficient lacrimation from infancy and punctate corneal epithelial erosions. An autosomal dominant inheritance pattern is suggested. A hypoplasia of the lacrimal gland in this family was suggested by pharmacologic testing and by histopathologic examination of the lacrimal gland of the proposita. The family investigated in this report represents the first instance of hereditary congenital alacrima without associated ocular or adnexal abnormalities and apart from systemic disorders such as the Riley-Day syndrome and anhidrotic ectodermal dysplasia.
An unusual case of adenoid cystic carcinoma of the lacrimal gland occurred in an 11-year-old child. Clinical, echographic, and histopathologic characteristics, as well as the management of this usually fatal disease, are discussed. The subtle signs and symptoms of this tumor were noted at the age of 9 years. A review of the literature reveals this to be the youngest patient in whom this tumor has been reported.
The major histopathologic changes seen in the eyes of patients undergoing bone marrow transplantation involve the conjunctiva, cornea, choroid, and lacrimal gland. The major finding in the conjunctiva is keratinization. The major findings in the cornea are epithelial thinning and keratinization. Keratinization of the conjunctiva and cornea is associated with graft-v-host disease (GVHD) and may be either a primary manifestation of GVHD or be secondary to the "dry eye" syndrome that develops in patients with GVHD. Corneal epithelial thinning is probably secondary to the chemotherapy used in the preparative regimen. An unusual histiocytelike infiltrate is present in the choroid and appears to be associated with GVHD. In acute GVHD, lacrimal gland stasis occurs and is the probable cause of the dry eyes seen in these patients.
A 79-year-old man with a bloody ocular discharge and a mass above the medial canthal tendon was found to have a malignant melanoma of the lacrimal sac. Because he refused radical surgery, he was treated with radiotherapy and chemotherapy. Within a year the tumor had spread to his palate and cervical nodes. Because of the uncommon occurrence of melanoma in the lacrimal area and the fact that the microscopic appearance may resemble other malignancies, special stains are necessary for identification to implement the appropriate therapy.