1/15. Malignant glaucoma after diode laser cyclophotocoagulation.PURPOSE: To report a case of malignant glaucoma after diode laser cyclophotocoagulation. METHOD: Case report. RESULTS: A 45-year-old man with uncontrolled secondary glaucoma in his right eye after corneoscleral graft and cataract extraction underwent diode laser cyclophotocoagulation. The right eye was aphakic, with an intact posterior capsule. Two weeks later, the patient presented with blurred vision, edematous cornea, and flat anterior chamber. The posterior capsule was touching the endothelium. intraocular pressure was 20 mm Hg. Repeated Nd:YAG laser capsulotomy was effective in reversing the malignant glaucoma attack, and the anterior chamber deepened. CONCLUSION: Malignant glaucoma can occur after diode laser cyclophotocoagulation.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/15. Anhydrous ammonia burns case report and review of the literature.Chemical burns are associated with significant morbidity, especially anhydrous ammonia burns. Anhydrous ammonia is a colorless, pungent gas that is stored and transported under pressure in liquid form. A 28 year-old patient suffered 45% total body surface area of second and third degree burns as well as inhalational injury from an anhydrous ammonia explosion. Along with fluid resuscitation, the patient's body was scrubbed every 6 h with sterile water for the first 48 h to decrease the skin pH from 10 to 6-8. He subsequently underwent a total of seven wound debridements; initially with allograft and then autograft. On post burn day 45, he was discharged. The injuries associated with anhydrous ammonia burns are specific to the effects of ammonium hydroxide. Severity of symptoms and tissue damage produced is directly related to the concentration of hydroxyl ions. Liquefactive necrosis results in superficial to full-thickness tissue loss. The affinity of anhydrous ammonia and its byproducts for mucous membranes can result in hemoptysis, pharyngitis, pulmonary edema, and bronchiectasis. Ocular sequelae include iritis, glaucoma, cataracts, and retinal atrophy. The desirability of treating anhydrous ammonia burns immediately cannot be overemphasized. clothing must be removed quickly, and irrigation with water initiated at the scene and continued for the first 24 h. Resuscitative measures should be started as well as early debridement of nonviable skin. patients with significant facial or pharyngeal burns should be intubated, and the eyes irrigated until a conjunctivae sac pH below 8.5 is achieved. Although health care professionals need to be prepared to treat chemical burns, educating the public, especially those workers in the agricultural and industrial setting, should be the first line of prevention.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/15. zinc burns: a rare burn injury.A patient was presented with significant burns resulting from a workplace accident in a zinc production unit. This occurred as a result of the spontaneous combustion of zinc bleed under high pressure. The patient sustained burns to the face, body, and hands and suffered significant injury to the left cornea. Computed imaging revealed solid particles in the ethmoid sinus and also in the right nasal fossa, dissecting the right lacrimal duct. Photographic documentation is presented. This injury was potentially preventable and resulted from poor observance of safety procedures.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/15. Successful treatments of lung injury and skin burn due to hydrofluoric acid exposure.Recent growth in the electronics and chemical industries has brought about a progressive increase in the use of hydrofluoric acid (HF), along with the concomitant risk of acute poisoning among HF workers. We report severe cases of inhalation exposure and skin injury which were successfully treated by administering a 5% calcium gluconate solution with a nebulizer and applying 2.5% calcium gluconate jelly, respectively. Case 1: A 52-year old worker used HF for surface treatment after welding stainless steel, and was hospitalized with rapid onset of severe dyspnea. On admission to the critical care medical center he had widespread wheezing and crackles in his lungs. Chest radiograph showed a fine diffuse veiling over both lower pulmonary fields. Severe hypocalcemia with high concentrations of F in serum and urine were disclosed. He was immediately given 5% calcium gluconate solution by intermittent positive-pressure breathing (IPPB), utilizing a nebulizer. On the 21st hospital day, chest film and CT scan did not demonstrate any abnormality. He was discharged very much improved on the 22nd hospital day. Case 2: A 35-year old worker at an electronics factory was admitted to his local hospital with severe skin burn on his face and neck after exposure to 100% HF. Treatment began with immediate copious washing with water for 20 min. calcium gluconate 2.5% gel (HF burn jelly) was applied to the area as a first-aid measure. Persistent high concentrations of serum and urinary F were disclosed for 2 weeks. After treatment with applications of HF burn jelly, he was confirmed as being completely recovered. The present cases and a review of published data suggest that an adequate method of emergency treatment for accidental HF poisoning is necessary.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/15. Chemical burns due to blood pressure cuff sterilized with ethylene oxide.This paper reports two unusual instances of ethylene oxide burns that were caused by the blood pressure cuff sterilized with ethylene oxide. It is suggested that the mechanical compression caused by the blood pressure cuff facilitated penetration of ethylene oxide residues into tissues and contributed to the degree of tissue damage.- - - - - - - - - - ranking = 6keywords = pressure (Clic here for more details about this article) |
6/15. Development of a newly designed double-fixed Seoul-type keratoprosthesis.OBJECTIVE: To develop a newly designed double-fixed keratoprosthesis (Seoul-type keratoprosthesis [S-KPro]) and to assess its mechanical stability and biocompatibility. methods: Twenty-five rabbits were divided into 4 groups by fixation technique, amniotic membrane (AM) implantation, and skirt material. The eyes were studied with the use of slitlamp, light, and electron microscopy. Stress testing was performed. In addition, 2 human subjects underwent S-KPro implantation. Best-corrected visual acuity was checked, and ophthalmic examination was performed. RESULTS: The average retention period of the group receiving double-fixated polyurethane-S-KPro with AM was longer (>24 weeks) than that of the others. Fibroblast invasions were found in polyurethane pores but not in polytetrafluoroethylene (Gore-Tex) pores on light microscopy. The minimal pressure that induced aqueous leakage was greater than 250 mm Hg in all of the tested eyes. Two human subjects have maintained a good postoperative condition for 18 and 8 months. CONCLUSIONS: The double-fixation technique of applied S-KPro and AM appears to be helpful in improving the stability of the keratoprosthesis. Polyurethane with relatively large pore size (40 microm) may be used successfully as a material for the keratoprosthesis skirt. CLINICAL RELEVANCE: Our results may be important for improving the clinical outcome of keratoprosthesis.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/15. povidone-iodine related burns.skin preparation burns associated with chemical agents are uncommon. They occur most frequently in patients placed in the lithotomic position undergoing gynaecologic or urologic operations, the burn being on the buttocks, and in those undergoing orthopaedic operations, the burn being on the extremities and under a tourniquet. The basic mechanism involves irritation coupled with maceration and pressure. If the betadine solution has not been allowed to dry and has been trapped under the body of the patient in a pooled dependent position, such as the buttocks or under a tourniquet, the solution may irritate the skin and result in a skin burn. The irritation coupled with pressure leads to a situation analogous to that seen in the development of an acute accelerated decubitus ulcer; irritation, maceration, friction and pressure compounding each other to result in a skin burn or superficial ulcer in the skin. Our experience with three illustrative patients who presented with various burns following exposure to povidone-iodine (betadine) is described below.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
8/15. Chemical burn caused by povidone-iodine alcohol solution--a case report.burns associated with chemical disinfectants for skin preparation are rare. skin irritation and maceration associated with pressure factors may contribute to its occurrence. We report a 24-year-old female with thyroid tumor who was admitted for subtotal thyroidectomy. After anesthetic induction, the patient was placed in the supine position with the trunk elevated to 20 degree. The skin over the anterior neck was sterilized with 10% povidone-iodine (PI) alcohol solution. After a 3-hour surgery, the patient complained of burning pain over the back at the recovery room. physical examination revealed a 9 x 11 cm area of skin lesion partially thickened amid on the middle of the back suggestive of chemical burn. After conservative treatment, she was discharged uneventfully 4 days later. Upon follow-up, the wound was seen to heal with minimal scarring within 3 weeks.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/15. Acute corneal calcification following chemical injury.PURPOSE: To describe the clinical and ultrastructural features of 3 cases of acute corneal calcification following accidental chemical injury. methods: Three men presented over an 18-month period with unilateral eye injuries sustained when applying an industrial fire retardant. This product is predominantly a gypsum aggregate (calcium sulfate dihydrate) plaster combined under pressure with a set-time accelerator (aluminum sulfate). In each case the tear pH was initially alkaline, and the eyes were irrigated with phosphate-buffered saline according to protocol. Within hours a dense corneal opacity had developed that showed only minor resolution over 3 years of follow-up. Two eyes required corneal graft surgery for visual rehabilitation. light and electron microscopy and energy dispersive analysis of x-rays (EDAX) was performed on excised tissue. RESULTS: light and electron microscopy showed dense mineralization of the anterior stroma with discrete crystalline deposits in the deeper stroma. EDAX of the crystals showed high emission peaks for calcium and phosphorus. CONCLUSIONS: The insolubility, elemental composition, and ultrastructural appearance suggest that the opacity was caused by calcium phosphate deposition. The absence of phosphorus from the listed components of the fire retardant suggests that the use of phosphate-buffered irrigation fluid or the subsequent use of phosphate-buffered drops may have contributed to the deposition of this insoluble crystalline deposit.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/15. Case with bromine exposure leading to respiratory insufficiency.A 21-year-old male had a chemical burn on the right forearm when he inadvertently spilled bromine during an experiment. Since he inhaled vaporized bromine and had dyspnea and pharyngalgia, he arrived at our hospital in an ambulance as an emergency patient. On arrival, he kept a clear consciousness with a pulse rate of 98, body temperature of 36.8 degrees C, blood pressure of 132/80 mmHg, respiratory rate of 25, and oxygen saturation of 100%. (10 L/min of oxygen were administered.) He had marked dry coughs. His clothes had a foreign odor with mucosal irritation. Arterial blood gas analysis and blood biochemistry were normal. Based on these findings, he was diagnosed with chemical airway damage and bulbar conjunctiva from the exposure to bromine and a chemical burn on the right forearm. His respiratory condition became worse after admission, resulting in pulmonary edema. He was endotracheally intubated and controlled with an artificial ventilator on Day 3 after his injury. He was continuously treated with steroids and sivelestat sodium hydrate, which gradually improved his respiration. He was released from the artificial ventilator and extubated on Day 7. Although dyspnea associated with body movement and hoarseness persisted after extubation, the symptoms decreased and he was discharged on Day 41. This rare case is worth attention because serious respiratory insufficiency requiring artificial ventilation due to pulmonary edema from bromine exposure has not been reported in japan.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
| | Next -> |