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Biomedical subjects

C E Margo

Publications and source records attributed to C E Margo.

At least 145 records · Page 8Linked to original sources
PubMed1983

Endodermal sinus tumor (yolk sac tumor) of the orbit.

The endodermal sinus tumor is a malignant germ cell neoplasm that usually arises in gonads, but on rare occasion occurs in extragonadal locations. Five tumors of the orbit, which by light microscopy displayed features characteristic of gonadal endodermal sinus tumor, were tested for the presence of alpha fetoprotein using paraffin-embedded tissue and an immunoperoxidase technique. Each tumor contained intracytoplasmic alpha fetoprotein. Review of the clinical histories revealed that orbital endodermal sinus tumors differ from other extragonadal endodermal sinus tumors in that they occur at a younger age and when treated aggressively can result in long-term survival. In children with rapidly progressive proptosis the distinction between endodermal sinus tumor and rhabdomyosarcoma poses diagnostic difficulties for both the clinician and the pathologist. When considering the diagnosis of endodermal sinus tumor, the use of immunohistochemical testing for alpha fetoprotein can be helpful.

Child, Preschool↗
PubMed1983

Conjunctival Rhinosporidiosis. Light and electron microscopic study.

Two cases of conjunctival rhinosporidiosis were studied by light and electron microscopy. Two distinct phases of the tissue life cycle were present: trophic and endosporulating. Young trophocytes contained a single nucleus. As the trophocyte matured chromatin was dispersed throughout the cyst. During the next phase of the life cycle, sporangial cyst walls acquired a new inner layer that appeared to give rise to endospores. Histochemical and ultrastructural features of Rhinosporidium seeberi are consistent with it being a fungus. Complete surgical excision of the lesion is the only known method to eradicate the infection.

Adolescent↗
PubMed1982

HLA and ophthalmic disease associations: a critical review and improved method for statistical analysis.

A critical review of published ophthalmic histocompatibility antigen association studies found numerous conflicting or ambiguous reports. Methodologic errors that could account for these discrepancies were categorized into 3 groups (1) arbitrary application of statistical methods to determine significance, (2) poor sampling design, and (3) variable disease definition. Multivariate analysis, not previously applied in this area provides a more powerful tool for assessing statistical significance. A computer program using this methodology for large studies is now available.

Computers↗
PubMedDate not supplied

Aniridia. A review.

Aniridia occurs as a phenotypically heterogeneous condition which may be inherited as an autosomal dominant disorder or as part of several systemic syndromes. It has been linked with the loci of chromosomes 1 and 2 and associated with the deletion of the p-13 band of chromosome 11. Aniridia may occur in a highly penetrant form in association with other ocular abnormalities with poor vision or in a more variable form with good vision. The recognition of a child with sporadic aniridia should alert physicians to the increased risk of development of Wilms' tumor.

Cataract↗
PubMedDate not supplied

The diagnostic value of fungal autofluorescence.

Many pathogenic and saprophytic fungi fluoresce under ultraviolet light. Autofluorescence usually persists even if the specimen has undergone fixation, paraffin embedding, and staining with hematoxylin and eosin. Thus, fluorescence microscopy can help to identify organisms in histopathologic sections of ocular and periocular tissue. It may reveal microorganisms that do not stain with hematoxylin and eosin, and it does not alter or adversely affect microscopic sections. We describe a case of periocular cutaneous blastomycosis which was misdiagnosed clinically and histologically as squamous cell carcinoma. Fluorescence microscopy of the initial hematoxylin and eosin stained section revealed microorganisms that were not appreciated on the first skin biopsy.

Abscess↗
PubMedDate not supplied

Special histochemical stains in ocular pathology: agnogenic myeloid metaplasia with leukemic transformation.

With the use of special immune and enzymatic histochemical techniques, ocular pathologists are able to detect and localize certain cytoplasmic antigens and proteins in tissue section. An immunoperoxidase stain and special enzyme histochemical technique were used to confirm leukemic ocular involvement in a patient who suffered from agnogenic myeloid metaplasia (AMM). Although the transformation of AMM to acute leukemia can be heralded by ocular symptoms, diffuse leukemic infiltration of the choroid may be difficult to detect clinically. Special stains to detect immature myeloid cells may be of particular importance in establishing the diagnosis of granulocytic sarcoma of the orbit in children and certain forms of leukemia having a predilection for cutaneous and conjunctival involvement in adults.

Choroid↗
PubMedDate not supplied

Advertising in ophthalmology. I. Advertising is a threat to professional autonomy.

In 1977 the United States Supreme Court ruled that medicine was legally a "trade" and that physicians could not be prohibited from advertising. Since then the ethics and effects of advertising by ophthalmologists have been a source of controversy among ophthalmologists and within professional organizations. What are the effects of advertising on the patient? On the professional image and autonomy of ophthalmologists? These questions are explored in separate statements by authors with differing viewpoints, and summarized in an editorial comment.

Advertising↗
PubMedDate not supplied

Zygomaticofrontal suture defect associated with orbital dermoid cyst.

The zygomaticofrontal suture is a strong joint needed for protection of the orbit. During infancy its development can be altered by local mechanical factors which prevent its complete union. The following case report of a man with a slowly growing lesion of the left orbit was found to have a large dermoid cyst communicating with the temporal fossa. Presumably, the presence of choristomatous tissue at the junction of the zygomatic and frontal bones prevented normal closure of the joint during infancy. The computed tomographic findings in this condition are pathognomonic of dermoid cyst.

Bone Diseases↗
PubMedDate not supplied

Ocular syphilis.

There has been a steady increase in the number of cases of syphilis in the United States since the middle 1980s, with a dramatic rise in incidence among heterosexual men and women and of congenital syphilis. There also have been changes in geographic distribution of cases and an association with cocaine use. The ophthalmologic manifestations of syphilis are broad. There is anecdotal evidence that the natural history of syphilitic infection is altered by coinfection with human immunodeficiency virus. The potential of coinfection with HIV makes the clinical evaluation, treatment, and assessment of therapeutic outcome of syphilitic infection more confounding and controversial. This article provides a review of the changing demographics and ophthalmic manifestations of syphilis, the current status of laboratory testing techniques, and management approaches to various types of ocular syphilis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Basal cell carcinoma of the eyelid and periocular skin.

Basal cell carcinoma is the most common human malignancy. This locally invasive tumor rarely metastasizes, but can cause considerable morbidity when on the eyelids and periocular skin. The successful management of BCC requires an awareness of its broad clinical spectrum and knowledge of the risk factors associated with therapeutic failure. The optimal therapy for basal cell carcinoma is controversial. Treatment strategy is formulated on an individual basis, taking into account tumor size, anatomic location, and growth pattern. The immune status and life expectancy of the patient also must be considered. While complete eradication of the tumor is desirable, this can be challenging since basal cell carcinomas often extend beyond their apparent clinical margins. Since prevention is preferable to treatment, the public needs to be informed that the incidence of periocular skin cancers can be reduced with the longterm use of sunscreens, sunglasses, and hats with brims.

Basal Cell Carcinoma↗
PubMedDate not supplied

Intraepithelial sebaceous neoplasia without underlying invasive carcinoma.

Two patients with intraepithelial sebaceous neoplasia of the conjunctiva and cornea without an underlying invasive carcinoma are described. This intraepithelial disease displays the same cytologic features found in the conjunctival epithelium of patients with an invasive sebaceous carcinoma. The natural history of this incipient carcinoma is unknown. Anecdotal evidence indicates that some lesions can remain in situ for prolonged periods without undergoing transformation to an invasive carcinoma. The diagnosis of intraepithelial sebaceous neoplasia of the ocular surface is established by excluding an occult invasive carcinoma with appropriate biopsies.

Aged↗
PubMedDate not supplied

Wegener's granulomatosis.

Clinical manifestations of Wegener's granulomatosis are nonspecific and indistinguishable from a variety of neoplastic, infectious, and inflammatory diseases. Ophthalmic disease is the presenting feature in nearly one sixth of patients with Wegener's granulomatosis and will ultimately develop in a majority. The discovery of antineutrophil cytoplasmic antibodies, particularly antiproteinase-3, has changed the clinical approach to evaluating patients suspected of having Wegener's granulomatosis. These antibodies are distinguished from other related autoantibodies because they produce a coarse granular pattern of cytoplasmic staining on indirect immunofluorescence with ethanol-fixed neutrophils. Treatment of Wegener's granulomatosis with oral cyclophosphamide and corticosteroids has decreased morbidity and improved survival, but side effects from long-term immunosuppressive therapy are common and sometimes serious. The effectiveness of trimethoprim-sulfamethoxazole in decreasing the number and severity of recurrences of Wegener's granulomatosis is being investigated. It remains to be determined if wide use of trimethoprim-sulfamethoxazole in limited Wegener's granulomatosis could further improve the quality of life for some patients.

Antibodies, Antineutrophil Cytoplasmic↗
PubMedDate not supplied

The placebo effect.

Placebos have been traditionally regarded as deceptive therapies and have not been understood in the broader context of social symbols and of interpersonal factors that surround the healing process itself. Although the power of inert substances to heal is well recognized, the placebo effect also influences the outcome of conventional therapies. The role of the placebo in modern medicine is poorly defined because of a lack of a common understanding of what the placebo effect is and because of the negative connotions associated with its use. The response rate to placebo varies by illness. The natural course of disease and patient or physician bias can be misinterpreted as a placebo response. In research, the placebo effect is therapeutic noise to be removed by placebo-controlled trials. Few studies are designed to measure the placebo response rate directly. Placebos are a reminder of how little is known about mind-body interaction. The placebo effect may be one of the most versatile and underused therapeutic tools at the disposal of physicians.

Clinical Trials as Topic↗
PubMedDate not supplied

Neuroretinitis in presumed visceral larva migrans.

Neuroretinitis is a rate manifestation of toxocariasis that can occur as a late sequelae to the active disseminated phase of the disease visceral larval migrans (VLM). This case report describes a 14-year-old boy who developed VLM and concurrent neuroretinitis. During the acute illness, the patient's serum ELISA titer to Toxocara canis rose to greater than 256 and a lymph node biopsy revealed necrotizing lymphadenitis with eosinophilia. The constitutional symptoms of VLM may be mild and easily overlooked in children. Toxocariasis is an important diagnostic consideration in persons with acute neuroretinitis, since medical treatment may alter its course.

Adolescent↗
PubMedDate not supplied

Endodermal sinus tumor (yolk-sac carcinoma) of the orbit.

A 15-month-old boy with rapidly progressive proptosis had an unusual malignant germ-cell tumor of the orbit and nasopharynx identified as an endodermal sinus tumor (yolk-sac carcinoma). Endodermal sinus tumors arising in extra gonadal locations are highly malignant and generally lethal. The boy was treated with radiation and three-drug chemotherapy and has survived more than eight years.

Exophthalmos↗
PubMedDate not supplied

Sclerosing endophthalmitis in children: computed tomography with histopathologic correlation.

Three children with histopathologically diagnosed sclerosing endophthalmitis presumably secondary to Toxocara canis were studied by orbital computed tomography. The diffuse increased intraocular density present in the CT scans was indistinguishable from that observed in Coats's disease and non-calcifying retinoblastoma. Although retinoblastoma constitutes the major life-threatening cause of leukocoria in children, a number of other simulating conditions (pseudoglioma) can cause diagnostic confusion. In some cases of leukocoria it is exceedingly difficult to exclude the possibility of retinoblastoma without having to resort to enucleation. The availability of new non-invasive tests may make the distinction between retinoblastoma and pseudogliomas more easily attainable. Computed tomography (CT) has been shown to be of particular value in this regard by demonstrating intraocular calcification within retinoblastoma and rarely in lesions that stimulate it. CT may also be used to more appropriately plan therapy for children with retinoblastoma by assessing the status of the optic nerve and orbit. The exact role of CT in the evaluation of children with leukocoria, however, has not been completely established, since the computed tomographic features of several lesions that simulate retinoblastoma have not been described. The three most common causes of pseudoglioma are persistent hyperplastic primary vitreous, Coats's disease and sclerosing endophthalmitis. The latter entity when associated with a characteristic granulomatous inflammation is considered to represent the sequela of Toxocara canis infection of the eye. This report describes the computed tomographic findings in three cases of histologically diagnosed sclerosing endophthalmitis, presumably due to Toxocara canis.

Child↗
PubMedDate not supplied

Congenital aniridia: a histopathologic study of the anterior segment in children.

Seven eyes from seven children with congenital aniridia were studied histologically in order to assess the relationship between congenital and acquired abnormalities. At the time of enucleation the children ranged in age from six days to 14 years. There was no history of previous intraocular surgery in any of the children. Besides iridic and ciliary body hypoplasia three congenital abnormalities of the anterior segment were noted: anomalous development of the anterior chamber angle, incomplete cleavage of the anterior chamber angle, and attenuation of Bowman's membrane. Three acquired abnormalities of the anterior segment were identified: corneal pannus, peripheral anterior synechiae, and lenticular degeneration. The two cases showing anomalous development of the anterior chamber angle occurred in children with a partial deletion of the short arm of chromosome 11.

Adolescent↗