scholarly journals The Bubble Eye Sign: Understanding the Radiological Imaging of Gas inside the Orbit

2021 ◽  
Author(s):  
Sunny C. L. Au ◽  
Callie K. L. Ko
Keyword(s):  
Orbital Fracture ◽  
X Ray ◽  
Orbital Emphysema ◽  
Intraocular Gas ◽  
Intravitreal Gas ◽  
Attending Physician ◽  
Scleral Shell ◽  
Unnecessary Radiation ◽  
Tomography Scan ◽  
Tamponade Effect

AbstractGas, appears as radiolucent on X-ray, is normally absent in the orbit. However, intraocular surgeries occasionally utilize retained intraocular gas for tamponade effect. Intravitreal gas persists after retinal surgery, being confounded by the scleral shell of the operated eye, outlines the shape of the eyeball, and gives the characteristic bubble appearance on skull X-ray. This is different from orbital emphysema caused by orbital fracture when gas is located outside the globe but confined by the orbit, giving a crescent or concave shape over the superior orbit usually. Falls is common after intraocular retinal surgeries due to change of usual stereopsis, prolonged prone posturing, and other systemic comorbidities. By identifying the “Bubble Eye sign” described, attending physician should alert the presence of intravitreal gas, most commonly iatrogenic. Further ophthalmological history taking and examinations are thus indicated, instead of exposing patients to unnecessary radiation under computed tomography scan for orbital fracture investigation.

scholarly journals Opacification of hydrophilic intraocular lenses associated with vitrectomy and injection of intraocular gas

2018 ◽  
Vol 3 (1) ◽  
pp. e000157 ◽  
Author(s):  
Arie L Marcovich ◽  
Tamer Tandogan ◽  
Mor Bareket ◽  
Eva Eting ◽  
Ifat Kaplan-Ashiri ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Gas Injection ◽  
Intraocular Lenses ◽  
Calcium Deposition ◽  
Alizarin Red ◽  
Iol Implantation ◽  
X Ray ◽  
Intraocular Gas ◽  
Pars Plana ◽  
Intravitreal Gas

ObjectiveTo report 11 cases of intraocular lens (IOL) opacification after pars plana vitrectomy (PPV) involving intravitreal gas injection.Methods and analysisEleven cases of hydrophilic IOLs that opacified following PPV with intravitreal gas injection are described. Eight IOLs were explanted and analysed by light microscopy and scanning electron microscopy. Staining with alizarin red and von Kossa stains, as well as energy dispersive X-ray spectroscopy (EDX) were performed. Three IOLs were not explanted. The surgeons attached the clinical data.ResultsThe IOLs were hydrophilic acrylic produced by six manufacturers. Six patients underwent primarily phacoemulsification with IOL implantation. PPV with intravitreal gas injection was performed 3 months–6 years afterwards. The other five patients underwent combined phacoemulsification with IOL implantation and PPV with intravitreal gas injection. IOL opacification was recorded 1 month –6 years after PPV. In eight patients, the IOLs were explanted 1 month–9 years after opacification was noticed. In three patients, the opacified IOL was not explanted. IOLs had opacified mainly anteriorly at the pupillary entrance or capsulorhexis opening. Light microscopy demonstrated granular surface deposits on the IOLs that stained positive for calcium by alizarin red and von Kossa stains. EDX analysis of the deposits detected calcium and phosphorus.ConclusionsHydrophilic acrylic IOLs can opacify due to calcium deposition after PPV and intravitreal gas injection and may require IOL explantation. A hydrophobic IOL may be preferred when a simultaneous phacoemulsification and vitrectomy with intravitreal gas is performed.

Effects of X-Ray Exposure on Some CMI Regulatory Cytokines in Technicians Serum Samples

2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Weam S Al-Hamadany
Keyword(s):  
Clinical Status ◽  
Cell Mediated Immunity ◽  
Normal Range ◽  
Serum Samples ◽  
X Ray ◽  
Immunosuppressive Factor ◽  
Elisa Technique ◽  
Immunological Process ◽  
Field Workers ◽  
Tomography Scan

Ionizing radiation considered as an immunosuppressive factor upon over dose of exposure. Radiation field workers usually following a periodic checkup to monitor changes in their clinical status. Cell Mediated Immunity (CMI) has an important cytokines that regulate this specific immunological process. This study estimated the Interleukins (IL-2, IL-12 and IL-18) levels in serum samples using ELISA technique. Serum samples were collected from X-ray Technicians (Radiography, Fluoroscopy and Computed Tomography Scan Technicians) working in AL-Muthanna governorate hospitals. A total of (60) technicians and (30) control were involved in this research. Results showed significant decrease in IL-2 levels and increase in IL-18 levels in test groups (technicians) as compared with controls. While, IL-12 levels did not show a difference; all obtained values were within normal range. Overdose of X-ray exposure caused CMI suppression via disturbing the levels of critical cytokines (IL-2 and IL-18) leading to CMI loss regulation.

scholarly journals Markedly Diminished Lipolysis and Partial Restoration of Glucose Metabolism, without Changes in Fat Distribution after Extended Discontinuation of Protease Inhibitors in Severe Lipodystrophic Human Immunodeficient Virus-1-Infected Patients

2004 ◽  
Vol 89 (7) ◽  
pp. 3554-3560 ◽  
Author(s):  
Marc van der Valk ◽  
Gideon Allick ◽  
Gerrit Jan Weverling ◽  
Johannes A. Romijn ◽  
Mariette T. Ackermans ◽  
...  
Keyword(s):  
Glucose Production ◽  
Fat Distribution ◽  
Dual Energy ◽  
Glucose Disposal ◽  
Computed Tomography Scan ◽  
X Ray ◽  
Lipodystrophy Syndrome ◽  
Total Glucose ◽  
Tomography Scan ◽  
Hiv 1

Abstract Treatment for HIV-1 infection is often complicated by a lipodystrophy syndrome associated with insulin resistance and an elevated rate of lipolysis. In eight HIV-1 infected men with lipodystrophy syndrome, we studied the effects of replacement of protease inhibitor (PI) by abacavir on insulin sensitivity and lipolysis by hyperinsulinemic euglycemic clamp and on fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan. Glucose metabolism and lipolysis were assessed by tracer dilution employing [6,6-2H2]glucose and [2H5]glycerol, respectively. Data are expressed as mean ± sd or 95% confidence interval (CI), as appropriate. There were no significant changes in fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan at wk 36 and wk 96. The fasting total glucose production decreased from 16.1 ± 2.5 at study entry by 1.1 (range, −2.1 to −0.1) to 15.0 ± 1.5 μmol/kg·min after PI withdrawal at wk 36 (n = 8). In an analysis restricted to the patients on treatment at wk 96 (n = 6), the decrease was 0.9 (range, −2.1 to 0.3) μmol/kg·min. During insulin infusion, glucose oxidation (as percent of total glucose disposal) increased from 36.8 ± 12.7% by 11.0% (range, 1.3–20.8) to 47.9 ± 13.9% in the wk 36 analysis. In the analysis restricted to the patients on treatment at wk 96 (n = 6) the increase was 7.7 (−4.0 to 19.4)%. Fasting lipolysis decreased from 2.7 ± 0.6 μmol/kg·min by 0.9 (−1.6 to −0.2) to 1.8 ± 0.3 μmol/kg·min in the wk-96 analysis (n = 6). The replacement of the studied PIs by abacavir in severe lipodystrophic HIV-1-infected patients results in a marked reduction of lipolysis. In contrast, fasting glucose production and insulin-stimulated glucose oxidation improve moderately, whereas insulin-stimulated glucose disposal and fat distribution do not change.

scholarly journals Sub-Acute Intestinal Obstruction – A Rare Complication in a patient with Autosomal Dominant Polycystic Kidney Disease

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Nazish Naseer ◽  
Sonia Yaqub
Keyword(s):  
Intestinal Obstruction ◽  
Rare Complication ◽  
Acute Intestinal Obstruction ◽  
Polycystic Kidney ◽  
Radiological Findings ◽  
X Ray ◽  
Distended Abdomen ◽  
X Ray Computed ◽  
Autosomal Dominant Polycystic Kidney ◽  
Tomography Scan

associated with vomiting and constipation. On examination he was an obese, ill looking male with a distended abdomen and bilateral palpable flank masses. Gut sounds were sluggish. Small and large bowel loops were found to be dilated on abdominal x-ray. Computed tomography scan of the abdomen showed grossly enlarged kidneys occupying almost whole of the abdomen pushing small bowel loops anteriorly. Based on clinical and radiological findings a diagnosis of sub-acute intestinal obstruction was made. Patient was managed conservatively (i.e. with NG tube and rectal decompression). This case highlights intestinal obstruction as a rare complication of ADPKD.

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

scholarly journals Laparoscopic approach for diaphragmatic hernia repair in adult: our experience of four cases

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Abhijeet Kumar ◽  
Ratish Karn ◽  
Bhawani Khanal ◽  
Suresh Prasad Sah ◽  
Rakesh Gupta
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Presentation ◽  
Clinical Investigation ◽  
Gastrointestinal Symptoms ◽  
Laparoscopic Approach ◽  
X Ray ◽  
Patch Closure ◽  
Thoracic Approach ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Diaphragmatic hernia can be congenital or acquired. Usual clinical presentation may range from asymptomatic cases to serious respiratory/gastrointestinal symptoms and occasionally atypical presentation as lumbar hernia also. The diagnosis of diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray film and computed tomography scan. Various treatment approaches, open, laparoscopic and combination, are available for this condition. However, laparoscopic approach has recently gained in popularity. Surgical repair typically involves primary or patch closure of the diaphragm through an open or endoscopic abdominal or thoracic approach. This paper reflects our experience of repair of diaphragmatic hernias to evaluate its safety, efficacy and outcomes.

scholarly journals Posttraumatic Orbital Emphysema: A Numerical Model

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Andrzej Skorek ◽  
Paweł Kłosowski ◽  
Łukasz Plichta ◽  
Dorota Raczyńska ◽  
Marcin Zmuda Trzebiatowski ◽  
...  
Keyword(s):  
Elevated Pressure ◽  
Orbital Fracture ◽  
Common Symptom ◽  
Inferior Wall ◽  
Finite Model ◽  
Upper Airways ◽  
Numeric Model ◽  
Orbital Emphysema ◽  
Orbital Wall ◽  
Resilience Modulus

Orbital emphysema is a common symptom accompanying orbital fracture. The pathomechanism is still not recognized and the usually assumed cause, elevated pressure in the upper airways connected with sneezing or coughing, does not always contribute to the occurrence of this type of fracture. Observations based on the finite model (simulating blowout type fracture) of the deformations of the inferior orbital wall after a strike in its lower rim. Authors created a computer numeric model of the orbit with specified features—thickness and resilience modulus. During simulation an evenly spread 14400 N force was applied to the nodular points in the inferior rim (the maximal value not causing cracking of the outer rim, but only ruptures in the inferior wall). The observation was made from1·10-3to1·10-2second after a strike. Right after a strike dislocations of the inferior orbital wall toward the maxillary sinus were observed. Afterwards a retrograde wave of the dislocation of the inferior wall toward the orbit was noticed. Overall dislocation amplitude reached about 6 mm. Based on a numeric model of the orbit submitted to a strike in the inferior wall an existence of a retrograde shock wave causing orbital emphysema has been found.

scholarly journals Gastric Dilation due to a Neuroleptic Agent in an Elderly Patient: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
V. Parent ◽  
L. Popitean ◽  
A. Loctin ◽  
A. Camus ◽  
P. Manckoundia
Keyword(s):  
Computerized Tomography ◽  
Drug Prescription ◽  
Symptomatic Treatment ◽  
Clinical State ◽  
Elderly Persons ◽  
X Ray ◽  
Intestinal Occlusion ◽  
General Weakness ◽  
Neuroleptic Agent ◽  
Tomography Scan

Neuroleptics may cause side effects, some of which are little known. We describe here a case of gastric dilation related to treatment with a neuroleptic in an elderly man. To our knowledge, such a case has never been reported in the literature. A 76-year-old man, living in a nursing home, was hospitalized for general weakness and abdominal pain. He had dementia with behavioral disorders treated with cyamemazine, a sedative and anxiolytic neuroleptic. Given a clinical suspicion of intestinal occlusion, an abdominopelvic computerized tomography scan was performed before the patient was admitted to our hospital. This computerized tomography scan did not show intestinal occlusion and there was no mention of gastric dilation in the computerized tomography scan report. Thus, acute gastroenteritis was suspected. The usual medications were stopped and symptomatic treatment for gastroenteritis was started. Quickly, his clinical state and biological parameters returned to normal and his usual treatment, including cyamemazine, was started again. The next day, the digestive symptoms, except for obstipation, reappeared. The abdominal X-ray showed gastric dilation without intestinal occlusion. The neuroleptic was stopped again and symptoms vanished the next day. This report underlines all of the necessary precautions and surveillance around drug prescription, especially in elderly persons.

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