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Biomedical subjects

D R Jordan

Publications and source records attributed to D R Jordan.

At least 163 records · Page 9Linked to original sources
PubMed1988

The diagnosis of sarcoidosis.

The diagnosis of sarcoidosis depends on the clinical and radiologic features along with histologic evidence of epithelioid-cell granulomas on biopsy. The amount of histologic support required varies inversely with the certainty with which the pattern of clinical features is recognized. It is essential to exclude other recognized causes of granulomatous disease. On the basis of our experience and that of other workers, we believe that sarcoidosis must be considered in the differential diagnosis when optic nerve thickening is encountered on CT, MRI or echography. Chest roentgenography is the easiest way to confirm the diagnosis. However, as many as 15% of patients will have a normal x-ray film, and other tests may be needed to help confirm the diagnosis. Biopsy of the involved tissues may be the only way to make the diagnosis. Once a provisional diagnosis is made, investigation for systemic sarcoidosis should include chest roentgenography, determination of the serum ACE level, 67Ga scanning, pulmonary function studies, testing for delayed skin reactions (with tuberculin, C. albicans, Trichophyton and mumps virus) and blood studies (determination of the erythrocyte sedimentation rate and levels of immunoglobulins, albumin, calcium and alkaline phosphatase). Finally, conjunctival biopsy is simple to do and is quite useful in supporting the diagnosis if no other tissue is readily available.

Biopsy↗
PubMed1988

Optic nerve involvement as the initial manifestation of sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown cause. It may have several diverse manifestations that may be progressive yet develop slowly. Ocular disease may occur with inactive systemic disease. We describe two patients in whom optic nerve involvement was the first manifestation of sarcoidosis and clinically mimicked an optic nerve tumour. Sarcoidosis involving the optic nerve should be considered when an optic nerve tumour is suspected.

Adult↗
PubMed1988

Diffuse large-cell lymphoma of the nasolacrimal sac.

A 63-year-old woman was referred for consultation with a clinical picture of lacrimal sac obstruction. The presence of a noncompressible mass and patency on irrigation suggested a nasolacrimal sac tumour. At biopsy a frozen section was interpreted as being consistent with lymphoma. Examination of permanent histologic sections confirmed the diagnosis of diffuse large-cell lymphoma. Postoperatively, after complete investigation and staging, the isolated extranodal lymphoma was treated with radiation therapy. Non-Hodgkin's lymphoma limited to the lacrimal sac is rare. Its management is discussed.

Biopsy↗
PubMed1987

Obtaining fascia lata.

The surgical procedure for obtaining fascia lata can be easily carried out by the ophthalmic surgeon. However, anatomy related to obtaining the tissue, as outlined in standard surgical textbooks, is not entirely accurate and should be clarified. The tissue necessary for strong frontalis slings should come from a thick band of fascia lata referred to as the "iliotibial tract." If one attempts to obtain fascia lata by directing a fascia stripper along an imaginary line directed from the head of the fibula to the anterior iliac spine, as suggested in most textbooks, an inadequate specimen may be obtained. The iliotibial tract of fascia lata actually runs from the lateral tibial condyle to the iliac crest. The fascia stripper, therefore, needs to be directed along an imaginary line from the lateral tibial condyle to the iliac crest to obtain the strongest fascia lata and avoid transecting the longitudinal fibers.

Fascia Lata↗
PubMed1987

A simple procedure for adjusting eyelid position after aponeurotic ptosis surgery.

An aponeurotic approach to ptosis surgery elevates the eyelid without sacrificing the elevating and supporting structures or the tear-producing glands. With this preservation of normal anatomy, reoperation by the technique described herein for the adjustment of overcorrections or undercorrections and contour abnormalities is simple to carry out in the first three weeks after surgery and has yielded good to excellent results in 32 of 34 patients.

Adult↗
PubMed1987

A preliminary report on the Universal Implant.

Extrusion and time-consuming surgical techniques required of implantation have been the major criticisms of quasi-integrated implants such as the Iowa Implant. With these concerns in mind, the Universal Implant (Oculo-Plastik, Montreal) has been designed to offer the motility advantages seen with quasi-integrated implants and the ease of placement of a sphere. The Universal Implant incorporates most of the advantages seen in the Iowa Implant and other quasi-integrated implants. In addition, the Universal Implant (1) utilizes a faster surgical technique for implantation; (2) avoids cleaning the muscles; (3) has lower, more rounded, smaller mounds that should decrease the late extrusion rate; (4) can be used as an enucleation implant, evisceration implant, or secondary implant; and (5) has a greater girth and larger radius of the posterior surface that helps support orbital fat and tissues, resulting in a more natural superior sulcus. Considering that the Iowa Implant is presently not available, the Universal Implant should be used by those surgeons who were pleased with the former implant and should be considered as a reasonable alternative to other enucleation implants.

Equipment Design↗
PubMed1987

An acute inflammatory reaction to silicone stents.

Silicone stents are commonly used to intubate the nasolacrimal system, and are left in place for several months. They are generally well-tolerated, but are not without complications. We report an unusual inflammatory reaction associated with the presence of a silicone stent that occurred in an individual who previously rejected several silicone implants in her metatarsal joints. The possible etiology and significance of a silicone allergy are discussed.

Dacryocystitis↗
PubMed1987

Orbital cyst formation associated with Gelfilm use.

Two patients developed cystic lesions in the anterior orbit 21 and 26 months after repair of blow-out fracture with orbital floor Gelfilm implants. Both patients had associated motility disturbances. Both lesions were surgically excised and found to be cystic in nature and filled with glistening gelatinous material consistent with partially absorbed, encysted gelatin film (Gelfilm). Histologically, a fibrous capsule was present; the contents of the cyst were not pathologically identifiable since they dissolved during fixation. Postoperatively, the motility disturbances improved in each patient.

Adult↗
PubMed1987

Carbon dioxide (CO2) laser therapy for conjunctival lymphangioma.

Lymphangiomatous tissue involving the ocular adnexa may be difficult to manage because this highly vascular, unencapsulated tissue intermingles freely with normal adnexal structures. Hemostasis is difficult to obtain, and important ocular and periocular structures are damaged easily. We have successfully treated two individuals who had extensive conjunctival involvement of their lymphangioma with the carbon dioxide (CO2) laser. The CO2 laser permits a precise form of treatment with the ultimate form of hemostasis (tissue vaporization), resulting in minimal trauma, edema, and scarring, and thus offers a safe alternative to surgical excision of these lesions.

Adult↗
PubMed1987

Herniated orbital fat.

Three patients with acquired orbital fat herniation are presented. Each was felt to have a dehiscence in Tenon's capsule, allowing fat to spontaneously herniate forward. Orbital fat herniation may be confused with other lesions, such as dermolipomas. The clinical features and differential diagnosis of orbital fat prolapse are discussed.

Adipose Tissue↗
PubMed1987

Wound necrosis following dacryocystorhinostomy in patients with Wegener's granulomatosis.

Two patients with Wegener's granulomatosis underwent dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction and epiphora. Wound necrosis occurred in each individual with the formation of a nasal-cutaneous fistula. A pedicle flap was the treatment of choice in one case, while direct closure of the necrotic incision site and high-dose steroid therapy was used in the other. Both did well with complete wound healing. The tearing persisted in one and resolved in the other. Dacryocystorhinostomy should be avoided whenever possible in patients with Wegener's granulomatosis, and steroid dosage should be increased if surgery is necessary in the presence of active inflammation.

Adult↗
PubMed1986

Dyschromatopsia following cataract surgery.

The authors report on 19 individuals who experienced colour obscurations (dyschromatopsia) following cataract surgery. Although a transient blue discoloration (cyanopsia) might be expected following cataract surgery, an erythropsia (red vision) is more common. Symptoms generally begin after outdoor activity in bright sunlight, vary in duration and are recurrent. It is important to look for a history of drug use, migraine or cerebrovascular accidents.

Aged↗
PubMed1986

The slip knot for dacryocystorhinostomy flap closure.

During dacryocrystorhinostomy (DCR) surgery, anterior and/or posterior flaps are created and anastomosed with absorbable sutures. A prominent nasal bridge and recessed lacrimal crest can often make tying of the suture within a small incision difficult. We have simplified this tying process with the use of a slip knot. The knot is tied external to the incision and then slid into the operative site until the flaps are apposed.

Humans↗
PubMed1986

The potential damaging effects of light on the eye (Part I).

The electromagnetic spectrum consists of radiant energy that is classified according to specific wavelengths. Man is constantly exposed to a portion of the electromagnetic spectrum, particularly to radiation in the ultraviolet, visible and infrared regions. The tissues of the eye and skin are particularly sensitive to the non-ionizing wavelengths of radiant energy. Although both tissues possess endogenous protective mechanisms to minimize the effects of such exposure, problems still occur due to the absorption of radiation. The cornea, lens and retina have been shown to be susceptible to damage from light in the ultraviolet, visible and infrared range. Part I of this two-part article examines the structures of the eye that are most susceptible to light damage; part II, which will be published in the next issue of the Journal, focuses on eye protection.

Anterior Eye Segment↗
PubMed1986

The potential damaging effects of light on the eye (Part II).

The electromagnetic spectrum consists of radiant energy that is classified according to specific wavelengths. Man is constantly exposed to a portion of the electromagnetic spectrum, particularly to radiation in the ultraviolet, visible and infrared regions. The tissues of the eye and skin are particularly sensitive to the non-ionizing wavelengths of radiant energy. Although both tissues possess endogenous protective mechanisms to minimize the effects of such exposure, problems still occur due to the absorption of radiation. The cornea, lens and retina have been shown to be susceptible to damage from light in the ultraviolet, visible and infrared range. Part I of this two-part article, which examined the structures of the eye that are most susceptible to light damage, appeared in the October issue of the Journal; in this, the second and final part of his article, the author focuses on eye protection.

Aphakia, Postcataract↗