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Biomedical subjects

D R Meyer

Publications and source records attributed to D R Meyer.

At least 37 records · Page 2Linked to original sources
PubMed1998

Intra- and infrahepatic agenesis of the inferior vena cava with azygos continuation accompanied by duplication of the postrenal segment.

Agenesis of one or more segments and duplication of the infrarenal segment are, individually, rare abdominal variants of the inferior vena cava (IVC). In this article, the authors report on a case in which these two anomalies occurred concurrently. Details of the embryology are presented insofar as they are necessary for an understanding of this IVC variant. Spiral computed tomography makes it possible to define the vascular morphology and to make a differentiation from lymphadenopathy. Cavography gives an overall picture of the vascular morphology.

Abnormalities, Multiple↗
PubMed1998

[Nephrolithiasis in "disk-variant" cross-over renal dystopia. Report of a case].

Renal dystopia is a frequent urogenital anomality. Renal dystopia encloses pelvic kidney or malascending kidney, but also rare anomalities like renal duplication or crossed renal dystopia. These allotopias are often diagnosed on routine examination of the urogenital system. We report a case with fused crossed renal dystopia on the left with atypical symptoms of nephrolithiasis and give a summery of the embryological origin.

Diagnosis, Differential↗
PubMed1998

Who gets custody?

Changes in the living arrangements of children have implications for social policy and children's well-being. Understanding who gets custody on divorce--mother, father, or both sharing custody--can also inform our understanding of family organization and the merits of alternative theories of marriage and divorce. We examine physical-custody outcomes among recent Wisconsin divorces in an effort to understand the factors associated with shared custody as well as mother-sole custody and father-sole custody. Although mother-sole custody remains the dominant arrangement, shared custody has increased over a nine-year period. We find that the probability of shared custody increases with parent's income. Prior marital history, parents' ages, the age and gender of children, and the legal process also have an impact on the probability of shared custody. In contrast to shared custody, the probability of father-sole custody decreases with parent's income, while the relationship with other significant factors is generally similar. The notable exception is that, unlike shared custody, we find no evidence for an increase over time in the probability of father-sole custody. We also find that when the father has a higher proportion of the couple's total income, both shared custody and father-sole custody are more likely.

Adult↗
PubMed1998

[Right-sided double inferior vena cava and common iliac vein: imaging with spiral computerized tomography].

Duplications of the inferior vena cava (IVC) are rare variants of the abdominal vessels and are normally located on both sides of the abdominal aorta. The rare case of a rightsided infrarenal duplication of the IVC with involvement of the common iliac vein is reported. Details of the embryology are presented for the understanding of this IVC variant. The spiral CT with multiplanar reconstructions makes it possible to define the vascular morphology and to differentiate it from lymphoma.

Adult↗
PubMed1997

Juvenile xanthogranuloma of the lacrimal sac fossa.

PURPOSE: Masses involving the medial canthus and lacrimal sac fossa include dacryocystoceles and, less commonly, mucoceles, hemangiomas, diverticula, and lacrimal sac neoplasms. To our knowledge, juvenile xanthogranuloma presenting as a lacrimal sac fossa mass has not been previously reported. METHODS: We examined a 2-year-old boy who had epiphora in the left eye since birth and a mass in the left lacrimal sac fossa for 6 weeks. During surgery, left lacrimal probing disclosed obstruction at the level of the common canaliculus and lacrimal sac. Exploration and excision of the mass were performed. RESULTS: Histopathologic evaluation disclosed a juvenile xanthogranuloma characterized by an inflammatory cell infiltrate with foamy histiocytes and scattered Touton-type multinucleated giant cells. CONCLUSION: Juvenile xanthogranuloma should be included in the differential diagnosis of a medial canthal and lacrimal sac fossa mass.

Child, Preschool↗
PubMed1997

Lung torsion--a rare postoperative complication. A case report.

Lung or lobe torsion is a rare condition that must be included in the differential diagnosis when a partial or complete shadow is detected on the lung. We report a case of this rare complication after chest surgery. The bedside radiograph provided initial evidence of torsion. CT verified the diagnosis of lower lobe torsion. Prompt recognition and intervention is imperative in order to save the affected lung.

Aged↗
PubMed1997

In vitro amoebicidal activity of propamidine and pentamidine isethionate against Acanthamoeba species and toxicity to corneal tissues.

Effective chemotherapy for Acanthamoeba keratitis has been hampered because of the marked resistance of the parasites to a variety of antimicrobial agents. In view of the fact that topical Brolene (propamidine isethionate) and neosporin are currently considered to be the medical treatment of choice in Europe, we sought to determine whether pentamidine may be equally effective, because the drug is more readily available to ophthalmologists in the United States. In this study, we compared the amoebicidal activity of the Brolene (commercial product), propamidine isethionate and pentamidine isethionate (Pentam) in vitro against three different species of Acanthamoeba, and the drugs' corresponding biocompatibility with rabbit corneal epithelial and endothelial cell cultures. The results indicated that there were significant species differences in drug sensitivity. Propamidine (> 1,000 micrograms/ml) was clearly less effective than pentamidine (> 125 micrograms/ml) against A. castellanii, although equivalent potency (> 250 micrograms/ml) was observed against A. polyphaga. On the other hand, propamidine (> 31.25 micrograms/ml) was slightly more effective than pentamidine (> 62.5 micrograms/ml) against A. hatchetti. Both drugs were also relatively nontoxic after short-term contact with cell cultures, even though the highest concentration of pentamidine caused low-grade injury to the superficial epithelium and reversible membrane damage to the endothelium. Steady-state levels of propamidine at effective amoebicidal concentrations, however, were much more toxic than pentamidine, which indicated that the drug has a much lower therapeutic index. Our data suggest that pentamidine may be an effective therapeutic option because of its potency and low toxicity.

Acanthamoeba↗
PubMed1997

[Soft tissue emphysema as manifestation of perforating diverticulitis].

Pronounced soft-tissue emphysema expressing disseminated fecal abscess formation in perforated colonic diverticulitis is described. Cervical, mediastinal, and thoracic dissemination and involvement of the scrotal space and the thigh reveal the original retroperitoneal localization as well as the unusual but potential dissemination. The diagnostic methods are described.

Abdominal Abscess↗
PubMed1996

Bilateral enophthalmos associated with hydrocephalus and ventriculoperitoneal shunting.

BACKGROUND: Progressive bilateral enophthalmos in the absence of previous trauma is rare. METHODS: Three patients with progressive bilateral severe enophthalmos whose only significant medical history was that of congenital hydrocephalus were treated by ventriculoperitoneal shunt placement. RESULTS: The patients demonstrated severe bilateral enophthalmos with poor eyelid apposition to the globes resulting in superficial keratopathy. Orbital computed tomographic scans confirmed the severe enophthalmos, with apparent reduced orbital fat volume. Orbital bony anatomy appeared normal. CONCLUSIONS: Bilateral progressive enophthalmos may be associated with hydrocephalus and ventriculoperitoneal shunting. The causal mechanism remains speculative.

Adult↗
PubMed1996

Improvement in subjective visual function and quality of life outcome measures after blepharoptosis surgery.

PURPOSE: To examine patients' subjective perception of visual function and health-related quality of life as affected by blepharoptosis and the change in these perceptions after blepharoptosis surgery. METHODS: A 27-item questionnaire pertaining to vision-related activities and symptoms was used preoperatively to assess 50 consecutive patients (18 years old or older) with unilateral or bilateral acquired involutional blepharoptosis, and postoperatively six to eight weeks after blepharoptosis repair. RESULTS: Of the 24 items statistically analyzed, 16 items (67%) demonstrated significant improvement postoperatively (P < .05) among the unilateral cases and 18 items (75%) showed significant improvement postoperatively (P < .05) among the bilateral cases. The four activities that improved the most after surgery for both the unilateral and bilateral groups were the ability to perform fine manual work, hanging or reaching objects above eye level, watching television, and reading. CONCLUSIONS: Surgical repair of acquired involutional blepharoptosis resulted in significant improvement in several aspects of patients' subjective visual function and health-related quality of life. These issues are important in determining both the indications for and outcome of blepharoptosis surgery.

Adult↗
PubMed1996

Primary infratarsal lower eyelid retractor lysis to prevent eyelid retraction after inferior rectus muscle recession.

PURPOSE: To evaluate a procedure to prevent lower eyelid retraction, which may occur after inferior rectus muscle recession surgery as a direct consequence of the intimate anatomic connections between the inferior rectus muscle and lower eyelid retractors. METHODS: We evaluated the technique of primary infratarsal lower eyelid retractor lysis on 12 eyelids of ten patients undergoing inferior rectus muscle recession of 3 mm or more. Indications for surgery included restrictive strabismus related to Graves' ophthalmopathy, orbital blowout fracture, and orbital fibrosis syndrome. RESULTS: For the 12 eyes, inferior rectus muscle recession ranged from 3 to 10 mm (mean, 5.3 mm). Postoperatively there was no significant change in mean lower eyelid position (P > .82), and no patient developed inferior scleral show. CONCLUSION: Primary infratarsal eyelid retractor lysis is an effective technique for preventing lower eyelid retraction after inferior rectus muscle recession strabismus surgery.

Aged↗
PubMed1996

Acquired lower eyelid epiblepharon.

PURPOSE: Although congenital epiblepharon is a relatively common condition, particularly in Asians, acquired lower eyelid epiblepharon is rare. METHOD: We examined an 8-year-old boy who developed unilateral lower eyelid epiblepharon after a subciliary incisional approach for repair of a zygomatico-orbital fracture. RESULTS: The patient demonstrated an overriding fold of right lower eyelid skin and loss of the lower eyelid crease. At the time of surgical repair, disruption and scarring of the lower eyelid retractors, suborbicularis fascia, and orbital septum were noted. The epiblepharon was successfully corrected by plication of the retractors and skin to the tarsus. CONCLUSION: Disruption of the anterior subcutaneous fibers of the lower eyelid retractors (that is, capsulopalpebral fascia) contributes to epiblepharon.

Child↗
PubMed1996

Site of service, anesthesia, and postoperative practice patterns for oculoplastic and orbital surgeries.

PURPOSE: Variations in physician practice patterns, particularly with reference to cost-intensive resource utilization, are increasingly being scrutinized. However, little information is currently available regarding physician practice patterns for oculoplastic surgery. METHODS: The authors surveyed members of the American Society of Ophthalmic Plastic and Reconstructive Surgery regarding their most common site of service, type of anesthesia, and first postoperative week of follow-up for 15 selected eyelid, lacrimal, and orbital procedures. RESULTS: The majority of eyelid and lacrimal surgeries are currently performed on an out-patient basis (hospital out-patient, ambulatory surgery center, or office), typically using local anesthesia, with or without sedation. Regional differences were noted. Physicians in western states showed a greater tendency toward office-based surgery for procedures such as blepharoplasty and ptosis repair. Orbital procedures were performed more frequently as a hospital inpatient surgery, under general anesthesia. Patterns of follow-up within the first postoperative week varied considerably for most procedures. Compared with admitting practices in 1987, an obvious trend toward out-patient surgery was noted. CONCLUSION: Variations in practice patterns will assume greater importance as the pressure for cost-containment increases. Total costs are affected by physician choices for site of service and type of anesthesia. This study allows surgeons who perform oculoplastic procedures to compare their practices with a national group specializing in such surgery. Further outcome-oriented studies are needed to develop practice guidelines for "preferred patterns" of care.

Anesthesia↗