Biomedical subjects

D A Palay

Publications and source records attributed to D A Palay.

6 recordsLinked to original sources

PubMed1992

Acquired heterochromia with horner syndrome in two adults.

BACKGROUND: Heterochromia iridis, asymmetry of iris pigmentation, has been well described with congenital Horner syndrome. Acquired heterochromia associated with lesions in the ocular sympathetic pathways in adulthood, however, is rare. METHODS: Two cases are reported in which sympathectomy in adults resulted in ipsilateral Horner syndrome with heterochromia. In each case, pharmacologic testing with cocaine and hydroxyamphetamine was performed. RESULTS: In both cases, sympathectomy occurred at the level of the second order neuron, but hydroxyamphetamine testing suggested at least partial third order neuron involvement. CONCLUSION: Acquired heterochromia can occur in adults. The partial response to hydroxyamphetamine in the two cases presented may reflect trans-synaptic degeneration of the postganglionic neuron. A reduction in trophic influences on iris melanocytes may have contributed to the observed heterochromia.

Aged↗

PubMed1992

Penetrating keratoplasty in patients with rheumatoid arthritis.

The authors reviewed in a retrospective manner 47 penetrating keratoplasties performed on 23 eyes of 21 patients with rheumatoid arthritis. The indications for the first penetrating keratoplasty were corneal melt in 19 eyes (83%), infectious keratitis in 2 eyes (9%), and corneal scarring after ulceration in 2 eyes (9%). Twelve of the 23 eyes required 24 repeat penetrating keratoplasties. Seventeen of the 23 eyes (74%) had clear grafts at the last follow-up visit, a median of 13.7 months after the last penetrating keratoplasty. The final best corrected visual acuity was greater than or equal to 20/60 in 4 eyes (17%), 20/70 to 20/100 in 1 eye (4%), 20/200 to 20/400 in 7 eyes (30%), counting fingers in 4 eyes (17%), hand motions in 2 eyes (9%), and light perception in 4 eyes (17%). One eye (4%) was enucleated. Anatomic success (absence of phthisis bulbi, enucleation, or conjunctival flap) was achieved in 20 eyes (87%). The survival probability for the 21 patients was only 48% 5 years after the first penetrating keratoplasty. The authors conclude that penetrating keratoplasty is often anatomically successful in patients with rheumatoid arthritis; however, the prognosis is poor for both vision and survival of the patient.

Adult↗

PubMed1991

Corneal disease.

Explore the source record for details and available documents.

Adult↗

PubMed1991

Decrease in the risk of bilateral acute retinal necrosis by acyclovir therapy.

We reviewed the course of 54 patients who had unilateral acute retinal necrosis at initial examination. Thirty-one patients were treated with acyclovir, whereas 23 were not. Of the 31 patients treated with acyclovir, 27 (87.1%) had fellow eyes that remained disease-free throughout a median follow-up of 12 months. Of the 23 patients not treated with acyclovir, seven (30.4%) had fellow eyes that remained disease-free throughout a median follow-up of 11 months. Survival analysis indicated that the fellow eyes of the group of patients treated with acyclovir were more likely to remain disease-free than the fellow eyes of the group not treated with acyclovir (P = .0013). Two years after initial onset, the proportion of fellow eyes that remained disease-free was 75.3% for the group treated with acyclovir and 35.1% for the group not treated with acyclovir. These results suggest that acyclovir treatment reduces the risk of involvement of the fellow eye in patients with acute retinal necrosis.

Acyclovir↗

PubMed1990

The effect of external ocular compression on intraocular pressure following retrobulbar anesthesia.

Thirty consecutive patients scheduled for cataract surgery were randomized to external compression with the Honan intraocular pressure (IOP) reducer or digital pressure. The average increase in IOP after retrobulbar injection of 4 ml of anesthetic was 6.20 mm Hg. This increase was followed by a rapid decline in IOP within the first 2 1/2 minutes, averaging 1.20 mm Hg +/- 0.70 below baseline level for the Honan group and 1.00 mm Hg +/- 0.96 below baseline level for the digital group. From 5 to 10 minutes after injection there was a more gradual decline in IOP that averaged 0.35 mm Hg/min in the Honan group and 0.36 mm Hg/min in the digital group. After 10 minutes of external compression the IOP was 5.73 mm Hg +/- 0.96 below baseline level in the Honan group and 4.67 mm Hg +/- 0.64 below baseline level in the digital group. No statistical difference between the IOP measurements of the two groups was observed at 2 1/2 minutes at 5 minutes, or at 10 minutes.

Anesthesia, Local↗

PubMed1986

Cyclosporine inhibits macrophage-mediated antigen presentation.

The influence of cyclosporine on antigen-specific, macrophage-dependent T cell activation was analyzed in vitro. Murine T cell activation by antigens derived from Listeria monocytogenes was monitored by the production of interleukin 2. Pretreatment (2 hr, 37 degrees C) of macrophages with cyclosporine resulted in a cell population with a markedly diminished capacity to support the activation of T lymphocytes. When cyclosporine-pretreated macrophages were added to cultures of untreated T cells and antigen, the dose of cyclosporine that produced 50% inhibition (ID50) was 1.5 micrograms/ml, and if antigen was present during the drug pretreatment, the ID50 was 0.6 micrograms/ml. Pretreatment of T cells also inhibited their subsequent activation by antigen and untreated macrophages, but a higher dose of cyclosporine was required to produce similar inhibition (ID50 = 4.4 micrograms/ml). Additional experiments focused on the mechanism of inhibition of antigen presentation when macrophages were pretreated with the drug. The addition of interleukin 1 or indomethacin to the cultures did not alter the inhibitory effect of cyclosporine. Under conditions that produced greater than 90% inhibition of antigen presentation, macrophage surface Ia expression was not altered, and the uptake and catabolism of radiolabeled antigen remained normal. Thus, cyclosporine had profound effects on antigen presentation that appear to be unrelated to decreases in interleukin 1 production, increases in prostaglandin production, decreases in Ia expression, or changes in antigen uptake and catabolism.

Animals↗