Biomedical subjects
Publications and source records attributed to A Barak.
Eight children presented who suffered from pathological changes of the anterior chamber as part of Axenfeld-Rieger syndrome. All of them had associated hypermetropia. Hypermetropia in these cases may have resulted from disturbed development of the anterior segment of the eyes during fetal life.
PURPOSE: Iridocorneal endothelial (ICE) syndrome includes Chandler's syndrome, essential iris atrophy, and the Cogan Reese syndrome. The purpose of this article is to describe a rare case with two forms of the syndrome simultaneously. METHODS: A case of Cogan Reese syndrome in one eye and Chandler's syndrome in the fellow eye is reported. RESULTS: During 5 years of follow-up only slight progression, manifested in episodes of blurred vision, occurred because of corneal changes. Glaucoma did not develop. CONCLUSION: ICE syndrome is considered as unilateral, although cases of bilateral involvement of the same variant have been described. But a simultaneous presentation of two different forms might occur, as in this patient.
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An orbital cyst is a rare complication of orbital trauma and exenteration. Infections of such cysts have not been described, and are potentially dangerous unless treated immediately. The authors describe a case of delayed treatment of such an infected cyst, which resolved following surgical drainage. The potentially hazardous outcome makes knowledge of such cases important.
This study examined the effects of schematic preinterview suggestion on counselors' (a) recognition memory of the information presented by the client; (b) clinical impression rating of the client; and (c) confidence in rating clinical impression. Fifty-two Master's-level counselor-trainees were assigned randomly to two conditions of preinterview suggestion about the status of the client (i.e., depression and no depression). After subjects had received appropriate preinterview information (i.e., depression or no-depression content) and had viewed a videotaped counseling interview, information was gathered from them. The results indicated that the preinterview suggestion (a) did not affect counselor-trainees' clinical impression rating of the client; (b) did not affect confidence of rating; and (c) yielded a weak, but significant, confirmatory memory. Implications for the interview setting are discussed.
Glaucoma and emulsification are two complications of silicone oil injection that are often coexisting. This study was undertaken to determine whether removal of emulsified oil has any effect on the management of the glaucoma. A comparison of eyes with and without glaucoma with emulsified oil also was undertaken. Eighteen eyes that underwent removal of emulsified silicone oil more than 6 months after the injection of the oil were reviewed. All eyes were observed for at least 6 months after removal with attached retinas. Eleven eyes had glaucoma at the time of removal. The diagnosis of glaucoma preceded the identification of emulsification in 8 of 11 eyes (73%). Removal of the emulsified oil did not affect the intraocular pressure (IOP) in 10 of the 11 (91%) glaucomatous eyes. The IOP was reduced in one patient. In the glaucoma patients, the final visual acuity was significantly reduced compared with the best corrected visual acuity obtained during the follow-up period (P = 0.016). In the nonglaucoma eyes with emulsified oil, the visual acuity did not significantly deteriorate during follow-up. At the end of the follow-up period, optic atrophy was observed in 9 of 11 (82%) of the eyes with glaucoma compared with two of seven (28%) of eyes without glaucoma. The results suggest that removal of emulsified silicone oil failed to control the glaucoma, and could not change the aggressive nature of the glaucoma in these eyes.
We studied the effect of ethacrynic acid on intraocular pressure in eyes with advanced open-angle glaucoma. Five to 15 microliters of ethacrynic acid (3.3 to 9.8 micrograms) was injected intracamerally after retrobulbar anesthesia was achieved in five eyes of five patients with advanced glaucoma. Intraocular pressure before treatment ranged from 26 to 46 mm Hg with maximal medical treatment. A reduction in intraocular pressure from 9 to 31 mm Hg was observed in all patients three to 24 hours after treatment, and this effect lasted for three days, with a gradual return of intraocular pressure to pretreatment values one week after treatment. No acute corneal or anterior chamber side effects were observed and results of corneal endothelial cells counts were essentially unchanged two months after treatment. We suggest that ethacrynic acid may represent a new class of antiglaucoma medication. Intracameral administration of ethacrynic acid or a derivative might be contemplated in the future at the time of other ocular surgical procedures to treat short-term intraocular pressure increase.
In a prospective study, we evaluated the effect of intracameral injection of sodium hyaluronate (HA) in trabeculectomy on short- and long-term results, including the effect on the corneal endothelium. Twenty-two patients were randomly assigned into two groups: group A, consisting of 11 patients, underwent standard trabeculectomy; in group B (11 patients), additionally, HA was injected into the anterior chamber immediately following paracentesis in an attempt to minimize shallowing of the chamber after the subsequent trabeculectomy. Both groups had comparable age distributions, preoperative intraocular pressures (IOPs), preoperative endothelial cell counts, postoperative IOPs after 3 months, and glaucoma medication indices. The reduction in the number of endothelial cells after 1 month was significantly greater in group A than in group B (16.1% vs 6.7%). Also, significantly more shallow anterior chambers occurred in group A (three eyes vs one eye). However, 1 day postoperatively, the average IOP was 16.4 mm Hg in group A, as compared with 25 mm Hg in group B. Thus, although HA, injected early in trabeculectomy, appeared to protect against corneal endothelial loss and flat anterior chamber, it also seemed to be associated with early IOP spikes.
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6-Trichloromethyl-9-methylpurine (1) rearranges to 6-dichloromethyl-9-methyl-8-oxopurine (2) in aqueous mild acidic solution. The rearrangement is rationalized in terms of a reaction involving protonation, covalent hydration, prototropic equilibrium and/or a hydride transfer. An alternative mechanism involving a "positive' halogen compound and hypochlorous acid as an intermediary is also proposed. Compound 1 condenses with 4,5-diaminopyrimidine to give the purine-pyrimidine Schiff base pair 4.
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We investigated the interactions of disopyramide and quinidine with the muscarinic receptor in tissue homogenates from rat atrium, ventricle, cortex, submandibular gland, and urinary bladder by means of competition binding experiments, using the tritium-labeled antagonist N-methyl-4-piperidyl benzilate. The drugs displayed heterogeneous characteristics of binding to the muscarinic receptors in the different tissues. The binding affinity of quinidine to the muscarinic receptor in atrial tissue was five to 10 times greater than in the other tissues studied, whereas the affinity of disopyramide to the muscarinic receptor in the heart was five times lower than in the other tissues. This inverse selectivity shown by the two drugs in their binding to cardiac and to noncardiac tissues may explain the extracardiac antimuscarinic side effects of treatment with disopyramide and their absence with quinidine.
The giant-pulse Neodymium:YAG laser, a recently developed laser source, delivers up to 200 W of peak power at pulse widths of 20 or 40 msec. The instrument can create a sclerostomy with minimal surrounding damage and, consequently, relatively little postsurgical inflammation and scarring. We tested its efficacy in performing ab-externo sclerostomy in 10 adult pigmented rabbits and in five patients with end-stage glaucoma. All of the animal eyes were hypotonus immediately after the procedure. However, the intraocular pressure increased gradually, and by the third day, returned to presurgical levels in all of the eyes. All five of the glaucoma patients treated had patent sclerostomies following the procedure. They all had early hypotony, but after 3 months, four of the five sclerostomies apparently failed. The giant-pulse Nd:YAG laser appears useful for performing sclerostomy, but modifications are needed to solve the problems of early hypotony and late closure of the fistulula.