No abstract

Background and objectives: Data from several countries suggest a recent world-wide increase in the prevalence of stone disease. However, these studies have not analyzed the effect that increases in utilization of imaging modalities have had on detection of asymptomatic stones.Design, setting, participants, & measurements: A retrospective chart review of all patients who had an abdominal or retroperitoneal ultrasound in 2005 at a Department of Veterans' Affairs Medical Center was conducted. The charts of patients who had ultrasounds demonstrating kidney stones were further reviewed. Patients were classified into symptomatic and asymptomatic groups on the basis of their clinical history. Age and sex for all patients were recorded. For those patients with stones, additional data were recorded. Of all patients in the study, the percentage of those with asymptomatic stones was calculated. Taking into account uncertainty about symptomaticity in some patients, a sensitivity analysis for the presence or absence of gross and microhematuria was performed to determine a range for the percent of asymptomatic stones. Appropriate statistical tests were used to determine significance.Results: The prevalence of all kidney stones in the study group was 8.6 %. Using the sensitivity analysis, 29.8 to 45.7% of all stones were asymptomatic. Of stones found on abdominal ultrasounds, 71.4% were asymptomatic, whereas 36.8% of stones found on retroperitoneal ultrasound were asymptomatic.Conclusions: Asymptomatic stones have a relatively high prevalence on ultrasound. Epidemiologic estimates of prevalence of nephrolithiasis need to account for increases in utilization of imaging modalities and the resulting detection bias.

This alternative method improves stent retention by using the inferior turbinate as a stopper to eliminate stent prolapse. The self-linking nature obviates the need and expense of additional biomedical devices.

This study demonstrates that 2 weeks of refrigeration does not appear to significantly affect the time of onset or efficacy of botulinum toxin in the treatment of lateral periorbital rhytids.

Recent findings indicate enucleation and evisceration are performed for blind eyes with endophthalmitis and both porous and nonporous implants may be placed primarily with acceptable outcomes in these patients.

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Brachytherapy is one of the most frequent treatment modalities for choroidal melanoma. 1,2 It allows for attempted preservation of vision and a more cosmetically acceptable outcome than enucleation. Pierre and Marie Curie first discovered radioactivity in 1898. 3 Moore first reported the use of brachytherapy in 1930 with radon seeds directly implanted into a ciliochoroidal melanoma. 4 Stallard introduced the use of cobalt 60 plaques 5 and Lommatzsch Ruthenium 106 plaques. 6 Plaque radiotherapy came into more widespread use in the 1970s as an alternative to enucleation. [6][7][8][9][10][11][12][13][14] Other isotopes that have been used in the treatment of uveal melanoma include iridium 192, gold 198, palladium 103, and iodine 125. The goal of brachytherapy is local tumor control to prevent metastatic disease. 15-18 Isotope SelectionCobalt 60 is a high-energy isotope that was used more often in the past. Advantages include availability in a standard plaque form and a long halflife that allows for multiple reuses. 19 Retrospective studies showed metastatic and all-cause death rates in Co-60-treated eyes were similar to enucleated eyes. 20,21 A study of 277 patients demonstrated a 5-year local tumor control rate of approximately 88%. 22 However, because Co-60 is a highenergy gamma emitter and cannot be adequately shielded, it poses a greater risk to nonaffected ocular structures as well as the treating physician and staff. 23 For example, an 11-mm lead shield blocks only 50% of the cobalt radiation. Only 1 mm of gold is needed to block more than 99.95% of emitted radiation from either ruthenium 106 or iodine 125. 9,24-29 Given these radiation safety concerns, lower-energy isotopes have largely 51

A 10-year-old white male presented with a recurrent painful nodule of the left lateral lower eyelid margin with associated madarosis. The initial pathologic diagnosis at an outside institution was reported as chalazion. The lesion was re-excised, and histopathologic examination with immunohistochemical evaluation confirmed the diagnosis of leiomyoma. This is the first reported case of primary leiomyoma originating in the eyelid.