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Biomedical subjects

A A Bialasiewicz

Publications and source records attributed to A A Bialasiewicz.

At least 19 recordsLinked to original sources
PubMed1997

[Alpha/beta and gamma/delta T-cell receptors--analysis of conjunctival tissue of patients with ocular pemphigoid].

BACKGROUND: In the conjunctiva of asymptomatic persons and patients with ocular cicatricial pemphigoid the existence and distribution of alpha/beta- and gamma/delta-T cell receptor (TCR)-positive cells has not previously been investigated. PATIENTS AND METHODS: Biopsy specimens from 20 patients with clinically diagnosed ocular cicatricial pemphigoid (OCP) were compared with 20 specimens from asymptomatic persons. Additionally, 3 specimens from patients with OCP treated with cytotoxic drugs and 8 specimens from patients who had undergone mucosal transplantation were studied. Antigen retrieval was done in deparaffinized specimens for immunohistochemical identification of alpha/beta- and gamma/delta-TCR-positive cells by monoclonal antibodies and an appropriate detection system. All steps were performed in triplicate, and negative control sera were applied. RESULTS: alpha/beta-TCR-positive cells were observed in the conjunctival epithelium and stroma of all the asymptomatic persons and in all patients with OCP. gamma/delta-TCR-positive cells were found in 4 out of 20 patients with OCP in epithelial sites, but not in asymptomatic persons. Patients with OCP who had received cytotoxic treatment exhibited neither alpha/beta- nor gamma/delta-TCR-positive cells. Staining sites of alpha/beta-TCR-positive cells changed from membrane-bound to nuclear in patients who had undergone mucosal transplantation, and were cytoplasmic rather than membrane-bound in gamma/delta-TCR positive cells. CONCLUSIONS: This study presents preliminary evidence for the existence of distinct T-cell subsets in the conjunctiva of healthy persons and of patients with OCP. Further functional studies in fresh tissue material may provide better insights into the role of defined T-cell subsets in the immunopathogenesis of autoimmune diseases of the outer eye such as OCP.

Biopsy↗
PubMed1996

Alpha/beta- and gamma/delta-T-cell-receptor-positive lymphocytes in healthy and inflamed human conjunctiva.

BACKGROUND: The possible existence and distribution patterns of alpha/beta- and gamma/delta-TCR+ cells, which are important constituents of immune surveillance and act via the CD3+ cell complex have not yet been elucidated in the healthy and inflamed conjunctiva. MATERIALS AND METHODS: Paraffin-embedded conjunctival specimens included 18 from 18 patients with ocular cicatricial pemphigoid (OCP), 20 from 20 healthy controls, 6 from 6 patients with lye burns, and 6 from 2 patients with Stevens-Johnson syndrome; all were worked up by histology and immunohistochemistry. RESULTS: alpha/beta-TCR+ cells were visualized in the conjunctival epithelium and stroma of healthy persons, OCP, lye burns and Stevens-Johnson syndrome. alpha/ beta-TCR+ cells and a small number of gamma/delta-TCR+ cells were observed in the corneal epithelium and stroma of patients who have failing corneal grafts. After ileal mucosa transplantation to the epibulbar conjunctiva, membrane staining changes to nuclear and cytoplasmic staining. Treatment with systemic cytotoxic drugs abolishes all alpha/beta-TCR+ and gamma/delta-TCR+ cells. CONCLUSIONS: alpha/beta-TCR+ cells can be found in the non-infected epithelium and stroma of the healthy and inflamed (OCP, lye burns, and Stevens-Johnson syndrome) conjunctiva, as well as in the corneal epithelium and stroma of failing corneal grafts, whereas gamma/delta-TCR+ cells are absent. A small number of gamma/delta-TCR+ cells are present in the corneal stroma and adjacent conjunctival epithelium of patients with chronic corneal graft rejection or after transplantation of gut tissue. Further investigations may establish the role, if any, of these T-cell subsets in immune surveillance of the non-infected outer eye and in corneal graft rejection.

Burns, Chemical↗
PubMed1996

[Descemetocele after Excimer laser phototherapeutic keratectomy in herpes simplex virus-induced keratitis: a clinico-pathologic correlation].

BACKGROUND: The indications for phototherapeutic keratectomy in superficial and deep corneal scars in Herpes simplex virus infections are controversial. Serious incidents after PTK have as yet not been reported. PATIENTS AND METHODS: A 62-year-old patient had suffered from recurrent central herpetic keratitis since 1948 and was treated for corneal scarring for the first time in 1992 by PTK. In 1995, epithelial defects were noted and, since medical treatment was unsuccessful, repeat PTK was performed. Two weeks after the second PTK, stromal infiltration with a subsequent corneal ulcer was followed by a descemetocele and perforation. RESULTS: The recurrence of Herpes simplex keratitis was treated with systemic acyclovir, and the corneal perforation, the posterior synechiae and the complicated cataract were managed by a triple procedure à chaud (7.0 x 7.5 mm). The inflammation calmed down, and a significant improvement of vision was noted at dismissal. Histopathology of the corneal button showed no epithelial cells, endothelial cell rarefication, loss of Bowman's layer resulting from PTK, stromal edema, a descemetocele with perforation of 1.5 mm in diameter, and immunohistochemically Herpes simplex virus in the deep stroma and pre-Descemet. CONCLUSIONS: Considering the clinical data and the histopathology we conclude that repeat excimer laser phototherapeutic keratectomy of herpetic keratitis without antiviral coverage may result in complications.

Cicatrix↗
PubMed1996

[Rhegmatogenous retinal detachment in atrophia gyrata: pars plana vitrectomy with silicone oil instillation].

BACKGROUND: Gyrate atrophy is a form of choroidal dystrophia characterized by a genetic defect of the mitochondrial matrix enzyme ornithine ketoacidoaminotransferase on chromosome 10. Apart from rare myopathic problems, cases of choroidal, iridal atrophy, complicated subcapsular cataract, optic atrophy, macular edema, reticular retinoschisis, vasculitis and perivasculitis could be observed so far. To our knowledge, rheumatogenous retinal detachment has been described before. We present a 34-year-old female subject with a retinal detachment of the right eye over 3 quadrants with 3 small round foramina in the area 10 to 11 o'clock. PATIENTS: Concentric defects of the visual field had been known since the age of 4; the patient was slightly myopic. At the age of 31, the patient had undergone cataract extraction with implantation of posterior chamber lenses in both eyes. The ophthalmological examination revealed large areas of choroidal atrophia in both eyes. A determination of visual acuity resulted in hand movements in the right eye and 0.1 in the left eye. The ERG was extinguished. RESULTS: The retina could be fully reattached by pars plana vitrectomy and instillation of silicone oil. At the same time, we performed an excision of secondary cataract. On demission, the visual acuity of the right eye was finger counting. Because a brother of the patient had also suffering from a progressive choroidal atrophy since his childhood, an autosomal recessive disease was suspected. The only abnormality detected was strongly elevated plasma levels of ornithin (7.5 to 14 mg/dl, compared to levels of 0.6 to 2.0 in controls). Urinary excretion of ornithin was also strongly increased. DISCUSSION: To our knowledge there was no previous description of a case of atrophia gyrata in association with rhegmatogenous retinal detachment after intraocular surgery. As the pigment epithelium is missing, intraoperative endolaser-coagulation would be useless. For this reason, and since a tendency for reattachment is lacking consistent with one of the characteristics of this disease, the only approach to this case is intraocular tamponade with silicone oil.

Adult↗
PubMed1995

Plasma sterilization of selected ophthalmic instruments for combined intraocular surgery.

Plasma sterilization is a nontoxic fast procedure for thermolabile and thermostable microsurgical instruments. We report data on the microbicidal effectiveness for daily routine surgical instruments like steel scissors, trephination devices, microstripper and Vitro-Cat as well as irrigation/aspiration instruments. When these instruments were cleaned from blood and saline, and when H2O2 intensifiers (adapters) were applied where necessary plasma sterilization proved to be a microbiologically safe procedure with legally adequate reduction factors of > 6 log.

Bacillus↗
PubMed1995

[Subretinal manifestations as the chief findings in parasitic diseases in germany].

The most frequent intraocular manifestations of parasitoses in Germany and world-wide are retinochoroidal lesions of Toxoplasma gondii; worms are less frequent. In reports of four cases it is shown that demographic data, biomicroscopical hallmarks and the fecal wet-mounts are the most important parameters for a presumptive diagnosis, if no intraocular material can be isolated. The patients in this series lack systemic features and changes in the blood differential, probably due to the adequate alimentary state and lack of reinfestations.

Adult↗
PubMed1994

[Intraocular inflammation 1993 (endophthalmitis)].

Despite several recently published optimistic reports on successful therapeutic regimens of postoperative endophthalmitis caused by coagulase-negative staphylococci this intraocular disease still represents a preeminent danger for ocular vision and the integrity of the globe. In this survey critical analyses of studies concerning infectious as well as the non-infectious intraocular inflammations have been reviewed. The demand for an initiation of "metastudies" seems appropriate in order to evaluate the many controversial data collections concerning the incidence, diagnosis and results of therapeutic interventions of postoperative endophthalmitis.

Endophthalmitis↗
PubMed1994

[Ocular chlamydia infections in Munsterland. A clinical study of 409 patients].

We evaluated demographic data, McCoy cell cultures from conjunctival smears and chlamydia-specific IgG and IgA serum antibody titers in 409 patients (194 men and 212 women) suffering from (kerato)conjunctivitis of presumed bacterial etiology in 1988-1992. Overall, 105 patients were positive in culture and/or serology tests (78 in McCoy cell cultures, 45 in serology tests). In 33 patients (31%) corneal involvement was epithelial (5), subepithelial (13), phlyctenular (7) and/or took the form of pannus vasculosus (12). The incidence and severity of corneal signs correlated with the duration of the (kerato)conjunctivitis. Nasolacrimal duct complications were documented in 16 patients with a duration of illness exceeding 6 months. Some 33% of cases were recorded in May and June, a further 26% from November to January. The age groups primarily affected were: females 20-30 years (25%), males 30-40 years (25%). The highest number of new cases was registered in 1990.

Adolescent↗
PubMed1994

[Syngeneic transplantation of nasal mucosa and azathioprine medication for therapy of cicatricial ocular mucous membrane pemphigoid. Study of 9 patients with 11 eyes].

Nine patients (11 eyes) with ocular cicatricial pemphigoid were treated with systemic azathioprine and a syngeneic nasal mucosa transplant from the inferior turbinate. Follow-up was 8-26 months (average 15 months). Grafting was successful in all cases. Treatment ameliorated the symptoms of pain in all patients and double vision in one. In 2 eyes in which simultaneous pannus resection had been performed, neither pannus nor corneal vascularization recurred. Late complications were recurrences with symblephara in two cases when azathioprine was stopped; in one patient with a serpiginous ulcer tectonic penetrating keratoplasty à chaud had to be performed; and in another a trophic ulcer was healed with a therapeutic contact lens.

Aged↗
PubMed1993

[Optical rehabilitation by tectonic anterior segment reconstruction].

BACKGROUND: The potential benefits of anterior segment surgery to achieve visual rehabilitation in severely compromised eyes subsequent to infectious complications in the anterior segment remain a subject of controversy. PATIENTS AND METHODS: Anterior segment reconstructive surgery was performed on twelve patients (12 eyes) with infectious adherent leukoma and extensively damaged intraocular structures. Nine patients (nine eyes) were followed up over a period of two years (20-26 months) and three over a period of nine months (8-11 months). RESULTS: Simultaneous and consecutive surgical interventions including corneal grafting, anterior chamber reconstruction and posterior chamber lens implantation combined with antimicrobial and antiviral prophylaxis as well as corticosteroid treatment resulted in visual recovery in nine eyes, and in four in a visual acuity of 0.4 or better (reading VA). CONCLUSIONS: Surgery for optic reasons due to infectious adherent leukoma does not seem to be completely unsuccessful with respect to the low complication rate despite proven retrocorneal membranes in this study.

Adult↗
PubMed1993

Coxsackievirus B3-associated panuveitis.

A 29-year-old woman suffered from headaches, diarrhoea, and high grade fever followed by a unilateral retinal vasculitis, papillitis, and chorioretinitis. Abnormal electrocardiographic findings and antibody titre dynamics strongly suggested a coxsackievirus B3 infection. With respect to prior observations on coxsackievirus B group associated uveitis this viral infection may be considered in patients with well defined extraocular manifestations and uveitis.

Adult↗
PubMed1992

[Incidence of postoperative bacterial infections after planned intraocular interventions].

Between August 1982 and August 1984 3059 intraocular operations were performed with topical prophylactic antibiotics. Results of conjunctival cultures did not influence the surgical schedule. 8179 intraocular operations were performed between September 1984 and August 1988. An intraocular operation was postponed until conjunctival cultures were negative using topical antibiotics administered at hourly intervals. The rate of postoperative intraocular infections decreased significantly (p less than 0.0001) from 21 (0.69%) of 3059 during the first to 9 (0.11%) of 8179 intraocular operations during the second observation period. In the first period 11 vitrectomies and 2 enucleations due to bacterial endophthalmitis had to be performed. In the second period 2 vitrectomies and no enucleations were necessary (p less than 0.0001). Our results indicate, that decontamination of the conjunctiva may be an import factor for the prevention of postoperative endophthalmitis following elective intraocular surgery.

Adult↗
PubMed1992

[Unilateral chronic granulomatous blepharitis as a leading symptom of Oriental cutaneous leishmaniasis in Germany. Giesma stain as rapid diagnosis and initial description of systemic therapy with gamma-interferon].

Nine months after leaving the Lebanon, a four-year-old immigrant boy presented with a 5 months history of blepharitis. The lesion remained therapy-resistant for aminoglycoside antibiotics. Six months later, the patient presented with an indolent granulomatous necrotizing purulent blepharitis and follicular conjunctivitis. Diagnosis was made by Giemsa stain and histopathology, which revealed amastigotes in macrophages consistent with the diagnosis of oriental cutaneous leishmaniasis. Therapy with systemic recombinant gamma Interferon, which is described for the first time in this disease entity, resulted in a successful primary healing of the cutaneous lesion. Self-healing epithelial keratitis was the only side-effect observed. Ophthalmologists in Germany should be aware of the differential diagnosis of oriental cutaneous Leishmaniasis in patients suffering from chronic granulomatous lid lesions of patients from countries endemic/epidemic for Leishmaniasis. Laboratory diagnosis is simple. Insights into the immunology of infection have made possible novel therapeutic avenues using gamma-Interferon being effective without serve side-effects and allowing for a good primary healing of the cutaneous lesions.

Biopsy↗