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Biomedical subjects

C E Rosen

Publications and source records attributed to C E Rosen.

13 recordsLinked to original sources
PubMed1995

Extreme eyelid swelling as an unusual presentation of dysthyroid orbitopathy.

We describe seven cases of dysthyroid orbitopathy initially seen as severe periocular lid swelling. Imaging techniques typically demonstrate normal extraocular muscles, although moderate muscle enlargement may occur. Patients do not respond to steroids, radiation therapy, antihistamines, or diuretics. We believe this clinical picture represents a unique population of dysthyroid orbitopathy patients who are best managed by long-term observation followed by cosmetic surgery.

Adult↗
PubMed1992

Immunohistochemical evidence for C3bi involvement in Graves ophthalmopathy.

PURPOSE: To determine by immunohistochemical methods if components of the complement system are present in Graves ophthalmopathy extraocular and periocular tissues compared with non-Graves ophthalmopathy ocular tissues, and, if so, whether a qualitative difference exists. METHODS: Orbital muscle, periorbital muscle, and adipose tissue from 10 Graves ophthalmopathy patients were studied with in situ assays using monoclonal antibodies for C3bi and C5b-9 (the terminal attack complex) complement components. Extraocular muscle, periocular muscle, and adipose tissue from 12 patients treated for unrelated orbital disorders were used as controls. RESULTS: All nine Graves extraocular and periocular muscle tissues exhibited C3bi positive staining in an intense, localized oval- to spindle-shaped reaction that appeared to represent cells on a diffuse staining background of the endomysial and perimysial connective tissues with no staining of the muscle fibers themselves. Some reactivity was seen in 6 of the 12 control muscles, but this was much less intense than that of Graves ocular muscle tissue. Only two Graves muscle samples stained minimally with the monoclonal antibody for the C5b-9 terminal attack complex while none of the control muscle samples demonstrated reactivity. Orbital fat from Graves and control patients did not demonstrate any reactivity for C3bi or C5b-9. CONCLUSION: C3bi and not C5b-9 (the terminal attack complex) is present in Graves ophthalmopathy extraocular and periocular tissues in a qualitatively greater way than in control non-Graves ophthalmopathy ocular tissue. Consequently, C3bi may contribute to the pathophysiology of Graves ophthalmopathy.

Adult↗
PubMed1992

Immunohistochemical evidence for IgA1 involvement in Graves ophthalmopathy.

Orbital muscle, adipose tissues, and periorbital muscle from 11 patients with Graves ophthalmopathy were studied with in situ assays using monoclonal antibodies for IgA1, IgA2, IgM, and IgG. Tissue biopsies were taken from varied extraocular muscles and orbital sites. All cases were from patients with severe disease or disease of long duration. Control specimens of extraocular muscle tissues were obtained from nine patients treated for unrelated orbital disorders. Only connective tissue associated with the extraorbital muscles and periorbital muscles showed any reactivity. Of the muscle tissue obtained from patients with Graves disease all exhibited IgA1 positive staining of the endomysium and perimysium, without staining of the muscle fibers themselves. Parallel sections of orbital muscles reacted with anti-IgA2 or anti-IgM antibody failed to demonstrate staining. Control extraocular muscle tissue did not stain with anti-IgM and one control muscle of seven reacted minimally with anti-IgA2. Some reactivity with anti-IgA1 was seen in four of the seven control muscles but this was qualitatively much less than that of muscle tissue from patients with Graves disease. Monoclonal anti-IgG did not stain tissue from the six Graves specimens and three control specimens tested.

Adipose Tissue↗
PubMed1991

Visual recovery in patients with optic neuritis and visual loss to no light perception.

We reviewed the records of 151 patients with optic neuritis examined over an eight-year period. Of these patients, 12 developed visual acuity of no light perception during the first episode of optic neuritis in the affected eye. Eight of the 12 patients recovered visual acuity of 20/40 or better. Of these, five patients had visual acuity of 20/20 or better, one had visual acuity of 20/25, one had visual acuity of 20/30, and one had visual acuity of 20/40. Four of the 12 patients recovered peripheral visual fields but had dense central scotomas and visual acuity of less than 20/400. Dyschromatopsia persisted after visual recovery in 11 of 12 patients.

Adolescent↗
PubMed1991

Neuroblastoma presenting as acute lymphoblastic leukemia but correctly diagnosed after orbital fine-needle aspiration biopsy.

A 3 1/2-year-old girl with a diagnosis of common acute lymphoblastic leukemia antigen (CALLA)-positive acute lymphoblastic leukemia was noted to be hypertensive and developed a tonic-clonic seizure. Computed tomography scan of the head revealed a right orbital mass. Orbital fine needle aspiration biopsy demonstrated rosette-like arrangements of cells with fibrillar cytoplasmic processes suggesting neuroblastoma. The tumor cells were antineuron-specific enolase positive. The cytologic findings suggested neuroblastoma, a diagnosis confirmed on subsequent work-up. The difficulty in distinguishing neuroblastoma from acute lymphoblastic leukemia in the pediatric patient is discussed in terms of clinical and cytologic features.

Biopsy, Needle↗
PubMed1985

Surface membrane expression by human blood leukocytes and platelets of decay-accelerating factor, a regulatory protein of the complement system.

The decay-accelerating factor (DAF), an integral membrane protein of approximately 75,000 mol wt that regulates the stability of the C3 convertases of the classical and alternative complement pathways, was initially isolated from normal erythrocyte stroma and used to prepare a polyclonal antiserum. Previously, anti-DAF antiserum has been used to immunoprecipitate DAF from surface-labeled normal erythrocytes and to document the deficiency of DAF on the surface of erythrocytes from patients with paroxysmal nocturnal hemoglobinuria, a condition in which erythrocytes express abnormal sensitivity to complement-mediated lysis. DAF has now been demonstrated by cytofluorography with anti-DAF F(ab')2 and fluoresceinated second antibody to be present on the surface of resting polymorphonuclear leukocytes (PMN), monocytes, lymphocytes, and platelets. Populations of PMN, monocytes, and platelets each exhibited a unimodal distribution of fluorescent staining, reflecting uniform cellular expression of DAF antigen, while the lymphocyte population had a skewed pattern of staining, indicating the heterogeneous expression of DAF antigen. For platelets, the shift in mean fluorescence channel observed with cytofluorographic analysis was minimal, but the presence of surface DAF on platelets was demonstrated by specific and saturable anti-DAF F(ab')2 binding. The DAF antigen, analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of dithiothreitol-reduced anti-DAF immunoprecipitates prepared from surface-labeled, isolated populations of cells, presented a single polypeptide chain of approximately 84,000 mol wt for PMN and 75,000 to 80,000 mol wt for monocytes, T and B lymphocytes, and platelets. Thus, the complement regulatory protein, DAF, is expressed on the surface of all major types of circulating blood cells from normal donors.

Blood Platelets↗
PubMed1982

Evaluating an intervention program for the elderly.

The effectiveness of mental health group experiences on senior citizen center participants needing such services was assessed through a quasi-experiment involving 68 MH group participants and 31 comparison cases judged not in need to MH services. The evidence indicated substantial increases in social and nonsocial activity, morale, and self-satisfaction. Senior center personnel provided corroborative observations. The changes were such that by the conclusion of the group sessions the "experimentals" had come to function at a level that was indistinguishable from their comparison group. By contrast, 18 elderly needing such mental health services, but attending senior centers where services were unavailable, showed no improvement or declined over time

Aged↗
PubMed1978

Pharmacist's impact on chronic psychiatric outpatients in community mental health.

The impact of a specially trained pharmacist upon the treatment of chronic psychiatric outpatients being maintained within their communities was studied. The quantity and costs of the services provided were assessed as well as patient satisfaction and well-being. Three years of management information data from eight mental health centers were used to compare the medication monitoring services provided by pharmacists and psychiatrists. In a separate study of chronic psychiatric outpatients, patients treated exclusively by the pharmacist were compared with patients treated by other mental health professionals on measures of community adjustment and satisfaction with treatment. The pharmacist monitored the medications of about 200 chronic psychiatric patients each month. The cost of a pharmacist providing medication monitoring services was 40% of the cost of providing that service by a psychiatrist. The pharmacist's patients were found to be functioning in the community as well as or better than other patients and their reported satisfaction with treatment was at least that of other chronic psychiatric patients sampled. The psychiatric pharmacist in this study successfully monitored stabilized psychiatric patients within their communities.

Ambulatory Care↗
PubMedDate not supplied

Effectiveness of a specially trained pharmacist in a rural community mental health center.

Pharmacists having training in psychopharmacology and psychiatry are being specially trained to function in community mental health centers as a resource in psychopharmacology and to provide direct care to patients. Management information data over a 3-year period from eight rural mental health clinics indicate that these pharmacists can successfully maintain large numbers of stabilized psychiatric patients within their communities. The cost of a pharmacist's services is, conservatively, one-half that of a psychiatrist's services. A followup study of the stabilized and active aftercare outpatients in the 10-county rural area in which the 8 clinics are located revealed that those patients who received all their direct care from the pharmacist were functioning at a slightly healthier level than the other aftercare patients. The pharmacist's patients indicated that they were at least as satisfied with their care as were the aftercare patients who received care from other mental health professionals. If the results of this study can be generalized to other community mental health centers in rural areas, a pharmacist can provide services effectively when psychiatrists are inaccessible or unavailable or when funds for mental health professionals are limited.

Aftercare↗
PubMedDate not supplied

Interleukin-2 receptor beta and CD57 expression in orbital tissues from patients with chronic, stable thyroid-associated ophthalmopathy.

In order to determine whether components of the interleukin-2 receptor (IL-2R) and lymphoid cells are present in extra ocular and periocular tissues from patients with chronic, stable thyroid-associated ophthalmopathy (TAO) we studied 16 specimens of extra ocular muscle and periorbital connective tissue from 14 patients with chronic, stable, TAO using an immunohistochemical assay and a panel of murine monoclonal antibodies reactive with IL-2R alpha and beta components and lymphoid cell surface markers. As controls we studied orbital tissues from 11 patients undergoing surgery for unrelated orbital disorders. All extra ocular muscle specimens from patients with TAO exhibited IL-2R beta expression primarily on the perimysium and endomysium surrounding the ocular muscle fasciculi and fibers of which nine specimens stained intensely. The Natural Killer (NK) cell marker CD57 was the most common cell surface antigen detected, in seven of nine specimens, whose localization often corresponded to that of IL-2R beta distribution. No IL-2R alpha expression was detected in any specimen. Seven of the 11 control specimens were positive for IL-2R beta but in a less intense fashion than in TAO specimens while no CD57 staining was detected. T cell, B cell, and cells of granulocyte and monocyte lineage were only occasionally found in both TAO and control specimens. The aberrant expression of IL-2R beta and CD57 which may be representative of NK cell presence in extra ocular muscle tissues from patients with stable, chronic TAO may play a role in the pathogenesis of the ophthalmopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗