[Excessive tearing in infants and young children. Questions? Answers].
Tearing in infants and young children is a subject of controversy. A logical succession of questions and answers is helpful in developing a consensual attitude.
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Tearing in infants and young children is a subject of controversy. A logical succession of questions and answers is helpful in developing a consensual attitude.
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BACKGROUND: In clinical practice, ultrasound examination of the lacrimal drainage system is not able to represent the lacrimal canaliculi with a high quality but the high-resolution ultrasound with 20 MHz transducer is a better possibility to get images of the lacrimal canaliculi. PATIENTS AND METHODS: A total of 20 patients suffering from diseases of the lacrimal drainage system were examined ultrasonographically. Detection and localisation of the lacrimal canaliculi was made by a 20 MHz sector scanner in combination with the ultrasound diagnostic system I. After patient positioning, the high-resolution ultrasound investigation was done via immersion connection (methylcellulose). Instillation of viscoelastic substances (e.g. Healon) was necessary to detect the lacrimal canaliculi. RESULTS: In all investigated patients, the high-resolution ultrasound (transducer frequency of 20 MHz) allowed reproducible images of the lacrimal drainage system. Without viscoelastic substances, a good echographic visualisation of canaliculi structures was obtained from patients with chronic canaliculitis or dislocated punctum plugs. In chronic canaliculitis the ultrasonic images showed an ectatic canaliculus (diverticulum) and high-reflective structures (concrements). CONCLUSION: The high-resolution ultrasound (transducer frequency of 20 MHz) seems to be well suited for investigations of the lacrimal drainage system. In comparison with ultrasound biomicroscopy the resolution is lower but the depth of penetration is higher. The use of 20 MHz ultrasonic examination can be helpful in the clinical diagnostic of chronic canaliculitis.
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A report is given of a case with a mycotic process of the lacrimal sac, the course of which covers a period of 20 years until final cure. Symptoms, diagnosis and therapy are discussed.
BACKGROUND: We report a case of canaliculitis caused by Actinomyces odontolyticus in a case of dry eye with punctal plugs. CASE: A 64-year-old female with Sjögren's syndrome type of dry eye developed lacrimation, congestion in the lower palpebral conjunctiva and corneal epithelial damage in her right eye 30 months after punctal plug occlusion. After removal of the plug from lower punctum in her right eye, white material exuded from the punctum. However, even after the removal of a plug, corneal epithelial keratopathy did not get worse, implying that the granulation tissue formed by the plug completely occluded the canaliculus. Actinomices odontolyticus was cultured from the white material. One week after topical antibiotic treatment, conjunctival congestion and irritation were resolved. CONCLUSION: This report indicates the possibility of canaliculitis as a complication of punctal plug occlusion. Careful observation is necessary after punctal occlusion with punctal plugs.
Two episodes of unexpected and widely spread colonisation of Pseudomonas aeruginosa in a hospital urged us with a series of measures concerning personnel and environmental hygiene and prophylaxis. We referred on the microbiological researches made on nine stories of the hospital building in which the microorganism settled and the countermeasures were adopted. The isolates proved to have a strong resistance to the various types of disinfectant we used and it was particularly difficult to clean wash-hand-basins and some medical tests. The AA. think that carefully instructing the staff in the hospital on bacterial biology and their channel of diffusion, and on the appropriate measures to avoid and fight them, could give better results compared to those we actually obtain by simply disinfecting the environment.
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By means of a radiotracer 99mTc-pertechnetate the function of the lacrimal system was determined after dacryocystorhinostomy. The results of the examinations demonstrate that the function of the lacrimal system is more quickly normalized if the lig. canthi int. is fixed to the periosteum of the os lacrimale.
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A 41-year-old Somalian female inhabitant of The Netherlands presented with malaise and cervical lymph node swelling. Enlarged mediastinal, hilar and abdominal lymph nodes were found on CT scan. Subsequently the left lacrimal gland became swollen, accompanied by periostitis of the lateral orbit margin. Mycobacterium tuberculosis was cultured from lymph node tissue and the diagnosis of tuberculous dacryoadenitis with periostitis was made on CT images and histology. All lesions responded well to tuberculostatic treatment. Although tuberculous dacryoadenitis is a very rare manifestation of tuberculosis, it is still important to recognise this presentation, especially since the incidence of tuberculosis continues to increase in Western countries.
Seventy-two patients(ninety-one eyes) with epiphore due to obstruction of the nasolacrimal duct underwent nasolacrimal stent of our own disign. The period postoperative follow-up was 6 to 20(mean 14.5) months. Seventy-six eyes demonstrated obvious resolution of epiphore, twelve eyes had partial resolution, and three eyes had no resolution. The success rate were 96.7%. The common complications included occluded stent and a slightly blood-stanied nasal discharge. The placement of the nasolacrimal stent is a safe simple and effective method for treatment of epiphore due to obstruction of the nasolacrimal duct.
PURPOSE: International Society of Dacryology held the IV International Congress in Stockholm on June 1996. I was warmly invited as a guest of honor beforehand to deliver a lecture on a special topic of "Dacryology in China" there, so that the world might understand the dacryology in China, and thus the international growth of dacryology as a discipline would be promoted. METHODS: In China tear lab research and clinical research of LG are nearly empty except a few papers published. We had studied 3 items on LS for 28 years before 1979, and put our attention mainly on dacryology since 1979 by 3 stages: (1) collecting literatures (1979-81); (2) lab research (1981-84) and (3) clinical research, put DE as the key point by 4 steps: DE diagnosis (1984-86); DE treatment (1987-91); DE Condition Judgement (1989-92) & DE cause & mechanism (1991-95). RESULTS: In the past 44 years, esp. from 1979 on, in a planned way, we have systematically researched the dacryology with main results below: created new word "Leiyexue" in Chinese & its English words, dacryology & lacrimology by adding-ology to dacrya & lacrima; made LS consisted of reflex LG & LP, and basic LG besides; found out the normal & abnormal data of tear and serum LF & its iron bindingcapacity; MDH, LDH & isoenzymes; beta 2 m; MDA & antioxidants; trace elements, prostaglandins, intramuscular gentamicin passing the blood-tear barrier; bacteria, fungi, anaerobe, virus & parasite; Ig, T cell & subsets, Langerhan cell, HLA antigen; in cidence (KCS, 0.3-3%, trancomatous DE 0.003%); the parallel correlations between DE graded by rb, BUT & Slt; and in SS, lymphocytes infiltration in LG; Lab G & conjunctiva; LF (< 100 mg%) & beta 2 m (> 1.7 mg%); and testosterone receptors in LG; negated presence of tear Beta-lysim; set up a series of models for researching & a complete set of measures to diagnose, grade, judge and treat DE, deviced new operations. AT & prescription for DE; proved SS being autoimmune & EB virus, its one cause. CONCLUSIONS: This relatively, overall & systematical research of dacryology already have been widely applied to practice with over 100 papers published. It indicates that LS & its disease as a scientific discipline under the term of dacryology to grow up is entirely possible and extremely needful.
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OBJECTIVE: To analyze a series of patients with lacrimal duct obstruction treated with polyurethane stents. MATERIAL AND METHODS: We studied 125 cases of lacrimal duct obstruction corresponding to 115 patients, of whom 30 were males (26.08%) and 85 females (73.91%). The obstruction involved the right side in 51 cases (40.8%) and the left side in 74 (59.2%). Mean age was 65 +/- 14.64 years. Symptoms included chronic epiphora in 65 patients (52%), acute lacrimal sac inflammation in 33 (26.4%), mucocele in 6 (4.8%) and recurrent conjunctivitis in 4 (3.2%). Seventeen patients came to us diagnosed with lacrimal duct obstruction. Time of follow up was one year. RESULTS: Stents were successfully implanted in 120 cases (96%). Surgical complications included pain in 5.83%, eyelid inflammation in 5%, nasal bleeding in 0.83% and false duct in 0.83%. Functional success was achieved in 82 patients (68.3%), and surgical failure occurred in 38 patients (31.7%). Mean time of stent failure was 178 days. In these cases, inner granulation tissue was found in 63.15% of the cases and mucoid material in 36.85%. The most common postoperative complication was mucocele formation, which ocurred in 7.5% of the patients. CONCLUSIONS: In our experience, polyurethane stent implantation is a good alternative for treating nasolacrimal obstruction, but not as effective as endonasal or external dacryocystorhinostomy.
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