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Biomedical subjects

A H Friedman

Publications and source records attributed to A H Friedman.

At least 163 records · Page 9Linked to original sources
PubMed1984

Dorsal root entry zone lesions for the treatment of postherpetic neuralgia.

These investigators attempted to diminish postherpetic neuralgia in 17 patients by making dorsal root entry zone (DREZ) lesions. They describe the clinical syndrome of pain after herpes zoster, the incidence of which increases with age, and discuss its pathology. They briefly review the medical and surgical treatment of postherpetic neuralgia. The results and complications of the DREZ procedure are reported.

Electrocoagulation↗
PubMed1984

Subarachnoid hemorrhage from intracranial dissecting aneurysm.

Rupture of an intracranial dissecting aneurysm is a rare but dangerous event. The authors' experience with 14 cases of these lesions on the vertebrobasilar circulation suggests that these aneurysms have typical angiographic silhouettes and that, at least in the vertebral artery, they are treatable by proximal arterial occlusion.

Adult↗
PubMed1984

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia.

Post-herpetic pain was treated in 12 patients using dorsal root entry zone ( DREZ ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

Adult↗
PubMed1984

Failed aneurysm surgery. Reoperation in 115 cases.

Failure to obliterate intracranial aneurysms completely during initial surgery still occurs in spite of recent technical advances. Of the 115 reoperations reported in this series, 89% of the aneurysms were obliterated, and 84% of the patients had a satisfactory outcome. Twelve patients had poor results, three (2.6%) of whom were in poor condition before reoperation.

Cerebral Angiography↗
PubMed1984

The retinal lesions of the acquired immune deficiency syndrome.

AIDS is a reliably diagnosed disease that is indicative of an underlying cellular immunodeficiency with no other cause for the disorder. To date over 2000 cases have been reported in North America and Europe and the number is rising. Patients fulfilling the definition for AIDS have included male homosexuals, IV drug abusers of both sexes, people from Haiti, heterosexual partners of AIDS patients, hemophiliacs, and some patients who fit no particular pattern. The etiology has been attributed to factors acting singly or in synergy namely that repeated exposure to CMV, semen, or other antigens results in progressive cellular immunodeficiency, or alternatively, a novel virus has an etiologic role. The epidemiology of the syndrome suggests a horizontally transmissible agent. The spectrum of opportunistic infections observed in AIDS patients is well documented. A higher incidence of KS as well as squamous carcinoma of the oral cavity, cloacogenic carcinoma of the rectum, primary lymphomas of the brain, and systemic Burkitt's-like lymphoma has been noted. Seventy-one patients with AIDS were examined and followed during the course of their disease. Forty-one patients had definite retinal lesions at the time of examination. The most common intraretinal finding was CMV retinitis which displayed the typical white, crumbly areas of retinal necrosis and hemorrhage. Optic nerve involvement was quite common. The development of retinitis was a harbinger of eventual death as it was a progressive and a nontreatable disorder, lasting about 6 months. The second most common retinal finding was cotton wool spots, the lesions were usually present during the course of PCP and were due to microvascular damage in the retina from circulating immune complexes. No organisms were demonstrated in the retina. One AIDS patient who had been an IV drug abuser developed fungal retinitis due to Candida albicans. The patient eventually died from Candida sepsis. One patient had acquired toxoplasmosis retinochoroiditis. Examination revealed a large active intraretinal focus of infection. No other retinal lesion was noted. The patient, a homosexual, died from a toxoplasmosis brain abscess. The patient with AIDS is in a continuing struggle for survival against a myriad assortment of opportunistic infectious agents. Careful initial ophthalmological examination and long-term follow-up are mandatory.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Drug reservoirs in topical therapy.

The nictitating membrane, corneal epithelium, and corneal stroma were investigated as drug reservoirs. A hydrophilic drug, D,L-epinephrine HCl, or a lipophilic drug, chloramphenicol, was applied topically to rabbit eyes. Tissue levels of radioactive drug-plus-metabolites and unmetabolized epinephrine were assayed up to 24 hrs later. On a per-mg-tissue basis, concentrations of epinephrine-plus-metabolites in the stroma-endothelium were similar to or higher than those in the epithelium. The percentages of radioactivity representing unmetabolized epinephrine in the stroma-endothelium were found to be similar to or higher than those in the epithelium. On a per-mg-tissue basis, concentrations of chloramphenicol-plus-metabolites were significantly higher in the epithelium than in the stroma-endothelium during the first 130 min after drug application. While the physical properties of these drugs determined whether a higher concentration was found in the epithelium or stroma-endothelium, the ninefold greater mass of the stroma-endothelium made it the major drug reservoir on a per-whole-tissue basis. The presence or absence of a nictitating membrane had little effect on the level of either drug in the epithelium, stromal-endothelium, or aqueous humor.

Animals↗
PubMed1983

Head injuries. Initial evaluation and management.

While primary neurologic damage in the patient with head trauma may be irreversible, damage from secondary injuries can often be avoided with rapid identification and correction of factors potentially leading to such injury. In patients with severe injuries, systematic evaluation is needed, including assessment of respiratory and circulatory systems, history taking, inspection of the head, and neurologic, general, and roentgenographic examination, as well as monitoring of vital functions, continuing patient care, and administration of intravenous fluids and medications.

Blood Circulation↗
PubMed1983

Cytomegalovirus retinitis: a manifestation of the acquired immune deficiency syndrome (AIDS).

Two homosexual males with the "gay bowel syndrome' experienced an acute unilateral loss of vision. Both patients had white intraretinal lesions, which became confluent. One of the cases had a depressed cell-mediated immunity; both patients ultimately died after a prolonged illness. In one patient cytomegalovirus was cultured from a vitreous biopsy. Autopsy revealed disseminated cytomegalovirus in both patients. Widespread retinal necrosis was evident, with typical nuclear and cytoplasmic inclusions of cytomegalovirus. Electron microscopy showed herpes virus, while immunoperoxidase techniques showed cytomegalovirus. The altered cell-mediated response present in homosexual patients may be responsible for the clinical syndromes of Kaposi's sarcoma and opportunistic infection by Pneumocystis carinii, herpes simplex, or cytomegalovirus.

Acquired Immunodeficiency Syndrome↗
PubMed1983

An unusual presentation of isolated optic nerve sarcoidosis.

A 32-year old diabetic female had unilateral reduced vision (20/30) in an eye having the ophthalmoscopic appearance of papillophlebitis of the optic nerve head. After an apparently benign course, with recovery, the optic disc became edematous again and a central retinal vein occlusion blinded the eye. Thereafter, an avascular bilobed mass progressively protruded from the optic nerve head. Computerized tomography demonstrated uniform thickening of the optic nerve from the globe through the optic canal. The radiographic appearance was consistent with an optic nerve glioma or meningioma. Spinal fluid, chest x-ray, and serum angiotensin converting enzyme activity were normal. Tuberculin skin test was positive. Optic nerve biopsy demonstrated a noncaseating granuloma and a subsequent Kveim test was positive. Isolated optic nerve sarcoidosis may exist without other systemic manifestations. The appearance on computerized tomography may be similar to that of an optic nerve glioma or meningioma.

Adult↗
PubMed1983

Retinal manifestations of the acquired immune deficiency syndrome (AIDS): cytomegalovirus, candida albicans, cryptococcus, toxoplasmosis and Pneumocystis carinii.

The ocular manifestations of 34 patients with the Acquired Immune Deficiency Syndrome (AIDS), are reviewed. Cytomegalovirus retinitis was seen in 18 patients, cotton wool spots were observed in 11 patients with Pneumocystis carinii pneumonia; Fungal retinitis and Toxoplasmosis retinochoroiditis were each seen in 2 patients. A review of literature regarding AIDS is included.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Ultrastructure of the eye in fetal type II glycogenosis (Pompe's disease).

Type II glycogenosis is an autosomal recessive storage disease characterized by absence of the enzyme acid alpha-1,4-glucosidase. The eye of a 16 week fetus, aborted after diagnosis by amniocentesis, was studied by light and electron microscopy. Extensive deposits of lysosomal and cytoplasmic glycogen were present in virtually all ocular tissues examined, with the notable exception of pigment epithelia (iris and retina). The massive glycogen deposits present in this, the youngest case thus far examined histologically, emphasize the involvement of the fetus from its earliest stages and the importance of prenatal diagnosis.

Eye↗
PubMed1981

The isolated perfused frog eye: a useful preparation for the investigation of drug effects on retinal function.

The isolated frog eye perfused through its ophthalmic artery with a modified oxygenated Sickel's media responds to light stimuli of different wavelengths in a manner similar to that observed in the frog eye in vivo for periods of 9 hr and longer. Short- and long-duration field potentials from the globe (ERG) and optic nerve (ONP) can be recorded simultaneously. Drugs perfused through the eye can be shown to modify components of the ERG and ONP and to alter the flow rate of the perfusion media through the eye.

Animals↗
PubMed1981

Proton-beam irradiated epithelioid cell melanoma of the ciliary body.

A malignant ciliary body melanoma received proton-beam irradiation. After an apparent failure of the tumor to respond, the eye was enucleated. A predominantly epithelioid cell tumor appeared viable by light microscopy, and a low degree of mitotic activity persisted, despite therapy. The tumor cells, however, displayed degenerative changes ultrastructurally, presumably results of the radiotherapy. These consisted of numerous cytoskeletal filaments, lipid vacuoles, prominent phagolysosomes, and nuclear convolutions and fragmentations. The mitochondria were fewer in number in the present tumor than typically encountered in epithelioid cells. A rare leptomeric structure was discovered, probably an organizational modification of the cytoplasmic filaments. The tumor's capillaries showed radiation-induced changes in terms of thickened basement membranes and perivascular fibrin deposition. The foregoing features are indicative of cellular and metabolic injury from the radiotherapy, but these were evidently not sufficiently injurious to sterilize the tumor.

Adult↗