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Biomedical subjects

D M Albert

Publications and source records attributed to D M Albert.

At least 163 records · Page 9Linked to original sources
PubMed1989

Epithelial downgrowth: a 30-year clinicopathological review.

We performed a retrospective clinicopathological review of 124 patients with epithelial downgrowth seen over a 30-year-period at the Massachusetts Eye and Ear Infirmary. The purpose of this study was to determine predisposing factors in the development of epithelial downgrowth, diagnostic symptoms and signs, and the results of various types of treatments. The incidence of this condition after cataract surgery was 0.12%, decreasing to 0.08% over the latter decade. 82% of postsurgical patients with epithelial downgrowth presented to the ophthalmologist within one year following surgery, commonly complaining of decreasing visual acuity, red eye, and pain. The most common presenting signs of epithelial downgrowth were retrocorneal membrane, which was seen in 45% of patients, glaucoma in 43%, corneal oedema in 21%, and a positive Seidel test in 23%. We found that a variety of conditions predispose to epithelial downgrowth but that no one factor was present in all cases. Damage to the underlying endothelium, corneal stromal vascularisation, and stromal downgrowth appeared to be important events not emphasised in prior studies. The angle was partially or totally closed in 87% of enucleation specimens. Patients treated surgically underwent fewer enucleations than those treated medically or not treated.

Adolescent↗
PubMed1989

Uveal lymphoid infiltrates: immunohistochemical evidence for a lymphoid neoplasia.

A 67-year-old man presented with a diffuse choroidal and ciliary body infiltrate, suggesting clinically and ultrasonographically a diffuse uveal melanoma. After enucleation both morphological and immunohistochemical data were highly suggestive of a diffuse, low-grade B cell lymphoma or lymphoplasmacytic immunocytoma. The difficulties of clinical and histopathological differential diagnosis of uveal lymphoid infiltrates are emphasised. In view of the excellent life prognosis of these tumours, treatment of the patient should be directed towards the preservation of ocular function.

Aged↗
PubMed1989

Therapeutic approaches for ophthalmic problems in juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis is a disease of children which is chronic and painful, with the potential to produce permanent disability and blindness in a significant portion of cases. The treatment we provide these children may also disable them. Managing this disease process and caring for these patients is a challenging task in which therapeutic efficacy must be continually balanced against treatment morbidity. With respect to ocular disease, we must particularly recognize the difficulties parents have in treating a characteristically asymptomatic process with interventions that can produce unpleasant symptomatology. The importance of discussion of therapeutic decisions with parent and child cannot be overemphasized. Children with JRA should be carefully classified and those at greatest risk for development of ocular disease should receive frequent ophthalmologic screening exams. Early intervention and aggressive medical management of intraocular inflammation will minimize morbidity and permanent visual compromise. Patients should also be closely monitored for ocular side effects of therapies directed against articular disease. Procedures employed for treatment of cataract, glaucoma, corneal, and vitreal opacities must take into account the risk and complications of surgical intervention in the JRA patient prone to perioperative inflammation.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1989

Histology of partial thickness double composite eyelid graft.

Double composite grafting is a technique used in the repair of large (greater than 75%) eyelid defects due to tumor resection, trauma, or congenital coloboma. The procedure utilizes two partial thickness composite grafts derived from two unaffected lids. The skin defect is covered by a pedicle skin graft to provide an adequate blood supply. This is thought to be superior to revascularization occurring from the margin of the graft alone. We examined histologically the lid margins of two such grafts 2 and 9 months postoperatively. Each demonstrated scarred tarsus and absent meibomian glands. One of the two grafts had loss of cilia. The architecture of the graft tissue otherwise was preserved.

Aged↗
PubMed1988

Abnormal scleral findings in uveal effusion syndrome.

We successfully treated a patient with uveal effusion syndrome and abnormal sclera with a partial-thickness sclerectomy. Part of the sclera was immediately cultured, and the excised sclera and the cultured cells were examined by electron microscopy. The sclera demonstrated increased glycosaminoglycan-like deposits between the scleral fibers. The cultured scleral cells showed large intracellular glycogen-like deposits, which were not seen in cells cultured from two control scleras. These findings may be the result of a metabolic defect, which causes a thick, impermeable sclera in some cases of uveal effusion.

Body Fluids↗
PubMed1988

Polyarteritis nodosa and rheumatic heart disease in a dog.

A 12-year-old spayed Corgi-type dog developed an acute febrile illness about 2 weeks after excision of a subcutaneous arteriovenous fistula. The dog was moribund after 1 week of illness and was euthanatized. Necropsy disclosed uncommon lesions comparable to those of polyarteritis nodosa and rheumatic heart disease of human beings. The pathogenesis of the arterial and cardiac lesions was not established, but was consistent with that of an immune-mediated mechanism.

Animals↗
PubMed1988

Effects of gentamicin on healing of transdifferentiating conjunctival epithelium in rabbit eyes.

We examined the effects of commercially prepared gentamicin, a wide-spectrum topical antibiotic, on the healing of epithelial defects of the rabbit cornea. Abrasions were created by: (1) removing the corneal epithelium and 3 mm of the conjunctival epithelium (Group 1); and (2) producing the same initial trauma and subsequently removing the central 8 mm of epithelium 28 days after initial healing (Group 2). The complete healing of the large corneal and conjunctival epithelial defects was not delayed when gentamicin solution was used four times a day (Group 1). When the healed epithelium was reinjured while transdifferentiating from conjunctival to corneal epithelium (day 28, Group 2), treatment with the gentamicin solution and its vehicle, both containing benzalkonium chloride, delayed epithelial healing significantly compared with treatment with saline (P less than .01).

Administration, Topical↗
PubMed1988

Melanoma arising de novo over a 16-month period.

Choroidal melanoma is widely regarded as a slow-growing tumor. We report herein the first documented case, to our knowledge, of a choroidal melanoma present in an eye in which examination 16 months earlier disclosed no tumor. On gross examination following enucleation, the largest tumor diameter at the base was 19 mm and the height was 11 mm. The implications as to the growth rate and the precursor lesions of choroidal melanomas are discussed.

Aged↗
PubMed1988

Vitamin D and retinoblastoma. The presence of receptors and inhibition of growth in vitro.

The vitamin D receptor has been found in several human organs not involved in calcium metabolism and in several malignant neoplasms found in humans. The role of the receptor in these tissues is unclear. There is, however, a relationship between the presence and quantity of the vitamin D receptor in a malignant cell line and the antineoplastic effect of vitamin D on that cell line. We found that Y-79 retinoblastoma cells have receptors specific for calcitriol (1,25-dihydroxycholecalciferol). Scatchard analysis of the receptor data shows a quantity of 56,000 receptors per retinoblastoma cell. These receptors have a dissociation constant of 1.18 nmol/L. Retinoblastoma cells treated with 10(-9) mol/L of calcitriol for nine days had 15% less cell growth than the control cells. Further studies of the effect of vitamin D on retinoblastoma may warrant its inclusion in chemotherapeutic protocols for the treatment of this childhood affliction.

Calcitriol↗
PubMed1988

Verhoeff's query: is vitamin D effective against retinoblastoma?

In 1966, Verhoeff suggested that retinoblastomas might be sensitive to vitamin D because they sometimes undergo calcification and spontaneous regression. In recent years, the antineoplastic effect of vitamin D has been established in vitro and in vivo. This study presents evidence that vitamin D2 inhibits the growth of the human retinoblastoma cell line (Y-79) grown in athymic mice. In mice treated with ergocalciferol, the subcutaneous retinoblastomas were smaller and showed increased tumor necrosis and calcification. Unfortunately, the vitamin D caused significant toxic reactions. Further studies that reduce the toxicity of vitamin D will be needed before its use in children with retinoblastomas can be advocated. To our knowledge, this is the first demonstration of the activity of ergocalciferol against a tumor in vivo and it suggests that ergocalciferol or one of its derivatives may be an effective chemotherapeutic agent against retinoblastomas in humans.

Animals↗
PubMed1988

Further studies of the effect of vitamin D on retinoblastoma. Inhibition with 1,25-dihydroxycholecalciferol.

We present evidence that calcitriol (1,25-dihydroxycholecalciferol) decreases tumor takes and tumor growth of subcutaneous retinoblastomas in athymic mice. Histopathologic studies showed that the calcitriol also induced necrosis of the retinoblastomas. The calcitriol, however, did not induce tumor calcification. Unfortunately, the dose of calcitriol used in this experiment caused significant toxic effects. If the toxicity of vitamin D can be alleviated without compromising its antineoplastic effect, vitamin D may be a useful chemotherapeutic agent against retinoblastoma.

Animals↗
PubMed1988

Optic neuropathy in chronic lymphocytic leukemia.

Ophthalmic and neurologic involvement in chronic lymphocytic leukemia is uncommon, and if it does occur, it is usually only late in the course of the disease. We report three cases in which progressive visual loss from optic nerve infiltration was an early clinical manifestation of chronic lymphocytic leukemia. Progressive optic atrophy with loss of acuity and visual field occurred in all cases, preceded in one patient by transient visual obscurations and disc edema. Surface marker studies of cerebrospinal fluid lymphocytes were useful in differentiating leukemic optic nerve infiltration from other causes of optic nerve damage. Optic nerve irradiation gave considerable clinical improvement in all three cases.

Aged↗
PubMed1988

Intraocular neurilemmoma arising from the posterior ciliary nerve in neurofibromatosis. Pathologic findings.

A classic neurilemmoma was found in the eye of a 31-year-old man with known neurofibromatosis. The pathologic features of this rare intraocular tumor were examined histologically, immunohistochemically, and ultrastructurally. Contiguity of the neurilemmoma with its nerve of origin, the long posterior ciliary nerve, was clearly demonstrated. Expansion of the nerve by proliferating Schwann's cells was present.

Adult↗