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Biomedical subjects

Anna Ells

Publications and source records attributed to Anna Ells.

5 recordsLinked to original sources

Hydroxyapatite orbital implant vascularization assessed by magnetic resonance imaging.

PURPOSE: To report hydroxyapatite (HA) implant enhancement patterns on magnetic resonance (MR) images at varying time intervals after implantation. METHODS: We retrospectively reviewed the records of 45 consecutive patients(from one author's practice) who underwent an MR imaging study 2 to 157 months after HA orbital implant placement. Implant fibrovascular ingrowth was assessed by analyzing the extent of implant enhancement seen on MR imaging. RESULTS Of 21 patients undergoing gadolinium-DTPA T1-weighted MR imaging 2 to 7 weeks after HA placement, 15 had enhancement limited to the implant rim (Grade I or less). Five patients had peripheral foci of enhancement (Grade II), and one patient had foci of enhancement extending to the center of the implant (Grade III). MR images obtained 9 to 15 weeks after HA insertion in all 14 patients had some degree of central enhancement (Grade III) and 11 had homogeneous enhancement throughout the implant (Grade IV or V). Seven patients in the homogeneous group were believed to have particularly intense enhancement patterns (Grade V). Of the 10 patients undergoing MR imaging from 31 to 69 weeks after surgery, 5 had Grade III enhancement and 5 had Grade IV enhancement. CONCLUSIONS: This study demonstrated consistent central HA orbital implant enhancement on MR imaging in the 9- to 15-week group and the >31-week postoperative group. HA orbital implant drilling and peg placement should be performed after central vascularization of the spherical implant has occurred. The results of this study support the principle of performing orbital implant drilling and peg placement at least 5 to 6 months after HA implant insertion.

Adolescent↗

Effective treatment of ligneous conjunctivitis with topical plasminogen.

PURPOSE: The etiology of ligneous conjunctivitis is now known to be due to an underlying type 1 plasminogen deficiency. We hereby report the clinical features of three cases and their response to topically administered plasminogen. DESIGN: Observational case series. METHODS: Two Caucasian females aged 5 years and an 18-month male of north African descent presented with a membranous conjunctivitis, which recurred after surgical excision. Case 1 presented before the association with plasminogen deficiency was known with a bilateral chronic membranous mucopurulent conjunctivitis from the age of 14 months associated with bronchiolitis and gingival hyperplasia. A diagnosis of ligneous conjunctivitis was entertained and a number of drops were instituted. At the age of 4 years plasminogen levels were ordered. Case 2 presented at the age of 4 years with a unilateral chronic membranous conjunctivitis. Plasminogen levels were requested as soon as a diagnosis of ligneous conjunctivitis was suspected. Case 3 was born with congenital hydrocephalus. Conjunctivitis was treated with antibiotics from the age of 1 month. He presented to the eye clinic at the age of 5 months when a clinical diagnosis of ligneous conjunctivitis was entertained and treated with a number of medications. Plasminogen levels were available at 9 months of age. RESULTS: The two female patients returned plasminogen levels of 0.25 U/ml and 0.3 U/ml, well below the normal level of 0.7-1.0 U/ml. Functional plasminogen levels in the male infant were not recordable with plasminogen antigen levels of 0.125 U/ml (normal range, 0.52-1.82). All cases have responded well to excision of the membranes and institution of topical plasminogen drops. There has been no recurrence with more than 12 months' follow-up. CONCLUSIONS: With the knowledge of the etiology of ligneous conjunctivitis, efforts are underway to identify the best method of delivery of plasminogen. Topical plasminogen concentrate from fresh frozen plasma holds promise as the definitive treatment for this chronic membranous conjunctivitis

Administration, Topical↗