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Category:Windows softwareIatrogenic subretinal fibrosis due to inadvertent intravitreal injection of epinephrine in the management of acute angle-closure glaucoma.
To describe iatrogenic subretinal fibrosis due to inadvertent intravitreal injection of epinephrine in the management of acute angle-closure glaucoma. Case report. An 89-year-old woman with senile cataract presented to the emergency department with acute, painful, right eye fixed and staring and later, left eye blurred vision. On admission, she was noted to have fixed and staring right eye secondary to acute right eye angle-closure glaucoma, and her visual acuity was 20/50 in the right eye and 20/20 in the left eye. Acute, right eye angle-closure glaucoma was diagnosed on clinical presentation, confirmed by gonioscopy and was treated with a single peripheral iridotomy in the right eye. Immediately following treatment, an intravitreal injection of 0.3 mL of 0.3% epinephrine was performed for the right eye. The patient was discharged with glaucoma medications and follow-up 1 month later with new visual acuity of 20/40 in the right eye, IOP of 18 mmHg, and corrected visual acuity of 20/20 in the left eye. At the 1-month follow-up, there was significant subretinal fibrosis involving the fovea with scattered retinal cysts extending from 3 degrees temporal to 6 degrees nasal to the optic disc in the right eye. Subretinal fibrosis can occur following intravitreal injection of epinephrine. Onset is usually within hours to 2 weeks after the event, and progression can lead to scarring and atrophy of the retina.Interf
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[CASE OF A RETROPERITONEAL PHYSIODISC HERNATION ASSOCIATED WITH A PRESENTATION OF ASSOCIATED MULTIPLE MYELOMA].
The retroperitoneal physoid retention cyst associated with multiple myeloma (MM) is extremely rare. We report a case of a 72-year-old man with both diseases who had a large retroperitoneal cyst with a physoid appearance associated with multiple myeloma. The patient was admitted for a huge retroperitoneal mass, and underwent excision of the mass with a definite diagnosis of retroperitoneal physoid retention cyst with a myeloma cell in the cyst fluid. We discuss the differential diagnosis, clinicopathological characteristics, and the treatment of the disease..
There are now a number of approaches to determining molecular markers associated with malignant or metastatic melanoma, some of which include comparisons between primary and metastatic lesions, intra-tumoral heterogeneity and the identification of genes that are not influenced by the host environment. Identifying genes that do not change in expression when comparing primary versus metastatic lesions has the advantage of excluding genes that have already been expressed and thus would not be useful for prognosis. We found that the expression of one such gene, *TP73*, did not change and in fact was higher in the metastases as compared to the primary lesions. By contrast, we found that other genes, including *S100A4*, *NME1* and *S100A7*, were expressed at higher levels in metastases as compared to the primary tumors. This underscores the difficulty in using gene expression to identify disease specific genes. As tumor biology is a complex and heterogeneous process, with each tumor having its own unique genes, it is not surprising that some tumor types will be more gene specific than others.
Intra-tumoral heterogeneity has been described for many solid tumors, in which tumor heterogeneity may predict a drug resistance phenotype, disease progression, and malignancy \[[@R30]-[@R35]\]. The idea of intra-tumoral heterogeneity also may explain the relatively little effect that metastasis had on predicting melanoma outcome. This is because primary tumors as well as the more advanced tumors that have
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