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Biomedical subjects

Eli L Chang

Publications and source records attributed to Eli L Chang.

16 recordsLinked to original sources
PubMed2006

Thyroid orbitopathy.

Explore the source record for details and available documents.

Decompression, Surgical↗
PubMed2005

Simplified repair of zygomatic fractures through a transconjunctival approach.

OBJECTIVE: To describe a simplified technique of zygomatic fracture repair. DESIGN: Retrospective, noncomparative case series with description of a surgical technique. PARTICIPANTS: Twenty consecutive patients with zygomatic fractures undergoing repair with the described technique. INTERVENTION: Fracture repair was accomplished with a technique that used a T-bar screw for reduction through a transconjunctival approach. MAIN OUTCOME MEASURE: Successful fracture reduction. RESULTS: Twenty patients with zygomatic fractures underwent successful reduction with the simplified technique. No complications were observed. CONCLUSIONS: The use of the T-bar through a transconjunctival approach is a simplified and effective technique for zygomatic fracture repair.

Adolescent↗
PubMed2005

Botulinum toxin for palliative treatment of epiphora in a patient with canalicular obstruction.

OBJECTIVE: To describe the use of botulinum toxin injection of the lacrimal gland for palliative treatment of epiphora secondary to canalicular obstruction from docetaxel therapy. DESIGN: Case report. INTERVENTION: A 50-year-old female with bilateral canalicular obstruction secondary to docetaxel therapy received botulinum toxin injections (5 units each) into the lacrimal glands of both eyes. RESULTS: Symptomatic epiphora of the affected eyes was reduced after 2 weeks. No side effects were observed. CONCLUSIONS: Botulinum toxin injection of the lacrimal gland is an effective palliative treatment for epiphora secondary to canalicular obstruction from docetaxel therapy.

Antineoplastic Agents, Phytogenic↗
PubMed2005

Acquired lower eyelid epiblepharon in patients with thyroid eye disease.

PURPOSE: To describe a series of patients with acquired epiblepharon secondary to thyroid-related orbitopathy. METHODS: Retrospective case series of 9 patients with thyroid-related orbitopathy who had epiblepharon. RESULTS: Seven patients had epiblepharon in both lower eyelids and 2 patients had it in one lower eyelid. Six of the 9 patients were Asian. Each patient had punctate keratopathy. Epiblepharon resolved in all but one patient after treating coexisting manifestations of thyroid-related orbitopathy. One patient required epiblepharon repair. CONCLUSIONS: We describe a new finding of acquired epiblepharon in the setting of thyroid-related orbitopathy. The majority of patients have spontaneous resolution of the epiblepharon after other surgical procedures for thyroid-related orbitopathy.

Adult↗
PubMed2005

Hertel curve: orbital volume increment and proptosis in a cadaver model.

PURPOSE: This study examined the relation between effective orbital volume increment and proptosis induced by an inflatable orbital implant in a human cadaver orbit. METHODS: A 25-ml inflatable latex balloon was inserted between the periorbita and orbital floor in 15 human cadavers. Hertel measurements were taken for each milliliter over a total 7-ml volume increment. Five trials per orbit for 15 cadavers resulted in 525 data points. RESULTS: Average exophthalmos per milliliter of volume increment was plotted over 7 ml, using 1-ml volume increments. The resultant curve, which was termed a Hertel curve, was linear over 7 ml (R > 99%) and had a slope of 0.62 mm per milliliter of volume increment. CONCLUSIONS: An inflatable orbital implant is an effective tool for introducing a specified amount of volume in the cadaver orbit. The predictable relation between proptosis and volume increment (Hertel curve) may be a useful tool for surgeons in planning the size of an implant required to surgically correct enophthalmos.

Blepharoptosis↗
PubMed2004

Update on orbital trauma.

PURPOSE OF REVIEW: To evaluate the recent developments in the evaluation and treatment of orbital trauma from April 2003 to March 2004. The scope of orbital trauma included a MEDLINE search under the keywords of zygoma and orbital fracture, and traumatic optic neuropathy. RECENT FINDINGS: Preoperative volume assessment with computed tomography of orbital fractures can help surgical planning of volume replacement. Ultrasonography can visualize anterior orbital fractures, including rim and zygoma trauma. Orbital trauma has a high incidence of concurrent ocular trauma. Fractures in the presence of the oculocardiac reflex, persistence nausea/vomiting, or entrapped soft tissue require urgent repair. Endoscopic-assisted repair of orbital fractures offers an alternative approach to orbital fracture repair. SUMMARY: Advances in ultrasonography and computed tomography allow better visualization of orbital fractures for better preoperative evaluation and intraoperative repair. Progress in endoscopic techniques offers alternatives in orbital fracture repair. New materials allow for options in orbital reconstruction. Unfortunately, few advances in the management of traumatic optic neuropathy were found in this review.

Humans↗
PubMed2003

Transcaruncular orbital decompression for management of compressive optic neuropathy in thyroid-related orbitopathy.

This study was conducted to assess the outcome of transcaruncular orbital decompression to treat compressive optic neuropathy in thyroid-related orbitopathy. It involved a retrospective, noncomparative case series of 18 eyes of 10 consecutive patients with documented vision loss secondary to thyroid-related orbitopathy. Bony decompression of the orbital apex was performed via a transcaruncular approach. Main outcome measures were visual acuity, color vision, presence of diplopia, and reduction of exophthalmos. Of 18 eyes, 16 (89 percent) had improved visual acuity after the operation. One eye had no improvement and one had worsening of vision in the setting of diabetic retinopathy. Color vision was improved in 12 eyes (67 percent). Five of the patients did not have diplopia before the operation; none of these patients developed double vision after intervention. Exophthalmos was decreased by an average of 2.6 mm. The authors conclude that transcaruncular orbital decompression for compressive optic neuropathy in thyroid-related orbitopathy is successful in restoring visual function. Compared with other approaches used for decompression surgery, the transcaruncular approach offers direct access to the medial wall and orbital apex without a cutaneous incision or disruption of the medial canthus. In addition, this approach allows a controlled, graded removal of the ethmoidal air cells and reduced recovery time.

Adult↗
PubMed2003

Isolation and characterization of cultured human conjunctival goblet cells.

PURPOSE: To isolate and characterize goblet cells from normal human conjunctival tissue to determine whether epidermal growth factor (EGF) receptors are present and whether EGF can influence goblet cell proliferation. METHODS: Goblet cells were isolated from explant cultures established from normal conjunctival tissue harvested from patients during periocular surgery. The cells were grown in RPMI culture medium supplemented with 10% fetal bovine serum and characterized using morphology, histochemistry, indirect immunofluorescence microscopy, molecular biology, and biochemistry. Proliferation was determined with a MTT proliferation assay after exposing goblet cells, which had been serum deprived for 48 hours, to increasing concentrations of epidermal growth factor (EGF; 0-80 ng/mL) for 24 hours. RESULTS: Goblet cells were isolated from conjunctival explants by scraping nongoblet cells from the culture dish. Human goblet cells exhibited positive reactivity with alcian blue-periodic acid Schiff (PAS) reagent, goblet cell-specific cytokeratin-7, HPA lectin, and MUC5AC, but negative reactivity to the stratified squamous epithelial cell marker, cytokeratin-4. The mRNA for MUC5AC was detected using RT-PCR. The presence of the EGF receptors EGFR, ErbB2, and ErbB3 was confirmed through Western blot analysis of cell lysates. EGF elicited a concentration-dependent increase in goblet cell proliferation of 160% +/- 0.5%, 188% +/- 0.45%, 293% +/- 1.3%, and 220% +/- 0.5% of control values with 10, 20, 40, and 80 ng/mL EGF, respectively. CONCLUSIONS: Human goblet cells that retain characteristics of goblet cells in vivo can be cultured. EGF receptors are present in human goblet cells, and EGF stimulates their proliferation.

Adult↗
PubMed2003

Activation of mitogen-activated protein kinase by cholinergic agonists and EGF in human compared with rat cultured conjunctival goblet cells.

PURPOSE: To compare activation of the p42/p44 mitogen-activated protein kinase (MAPK) by cholinergic agonists and epidermal growth factor (EGF) in cultured human and rat goblet cells. METHOD: . Conjunctiva was removed from either humans during ocular surgery or male Sprague-Dawley rats and cultured in RPMI medium. These cells were incubated with the cholinergic agonist carbachol (10(-4) M) or EGF (10(-8) M) for various times. Before stimulation, cells were incubated with the EGF receptor (EGFR) inhibitor, AG1478 (10(-7) M) or the muscarinic M(3) receptor inhibitor, 4-diphenylacetoxy-N-(2-chloroethyl)-piperidine hydrochloride (4-DAMP; 10(-5) M) for 10 minutes. Proteins were analyzed by Western blot analysis, using antibodies specific to phosphorylated (activated) p42/44-MAPK or total p42-MAPK. Immunoreactive bands were quantified, and data were expressed as percentage of increase over basal. RESULTS: Carbachol (10(-4) M) increased MAPK activity in human and rat cultured goblet cells in a time-dependent manner, increasing pMAPK with a maximum at 10 minutes. EGF (10(-8) M) activated MAPK in human and rat goblet cells in a time-dependent manner with a maximum at 5 minutes. Carbachol- and EGF-induced activation of pMAPK was completely inhibited by AG1478 in cultured conjunctival goblet cells from both species. Carbachol-induced MAPK activity was also completely inhibited by 4-DAMP in both species. CONCLUSIONS: In human and rat cultured conjunctival goblet cells, cholinergic agonists and EGF activate MAPK with a similar time dependency, this activation is receptor mediated, and cholinergic agonists transactivate the EGF receptor. Thus, rat cultured conjunctival goblet cells can be used as a model to study human conjunctival goblet cells.

Adult↗
PubMed2002

Bilateral multifocal hemangiomas of the orbit in the blue rubber bleb nevus syndrome.

PURPOSE: To report the clinical findings and surgical treatment of multifocal, bilateral orbital hemangiomas in a patient with the blue rubber bleb nevus syndrome, a rare vascular disorder characterized by distinctive cutaneous and visceral hemangiomas. DESIGN: Interventional case report. METHODS: Review of clinical findings, radiologic studies, and treatment of the patient. RESULTS: A 36-year-old female with multifocal, bilateral orbital lesions was seen with severe proptosis and decreased visual acuity of the left eye. Surgical debulking of multiple cavernous hemangiomas of the orbit resulted in decreased proptosis and an improvement in visual acuity. Subsequent histopathologic analysis and the results of a systemic workup revealing multiple, distinctive, cutaneous and visceral lesions were found to be consistent with the blue rubber bleb nevus syndrome. CONCLUSIONS: Although hemangiomas of the orbit are relatively common occurrences, multifocal, bilateral lesions may exist in the setting of underlying systemic hemangiomatosis. Bilateral or multifocal hemangiomas associated with cutaneous or visceral lesions should alert the clinician to the possibility of a number of syndromes that may have life-threatening consequences.

Adult↗