Ocular ultraviolet exposure from halogen lamps.
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Biomedical subjects
Publications and source records attributed to F Daxecker.
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Christoph Scheiner was born in 1573 or 1575. In 1595 he entered into the Order of the Jesuits; he died in 1650. In 1619 his book Oculus, dealing with the optics of the eye, appeared in Innsbruck. The invention of the telescope was of utmost importance for progress in astronomical and physical research. Scheiner himself built telescopes and discovered the sunspots. As a result, an unpleasant priority dispute with Galilei ensued. From 1624 onwards, Scheiner was in Rome, where his main work Rosa Ursina was published in 1630. A part of this book deals with the physiological optics of the eye as well. Some of his discoveries and experiments are taken from these two books: determination of the radius of curvature of the cornea, discovery of the nasal exit of the optic nerve, increase in the radius of curvature of the lens in case of accommodation, Scheiner's procedure (double images with ametropia), refractive indices of various parts of the eye, Scheiner's experiment. Without any doubt, Christoph Scheiner belongs to the foremost scientists of the first half of the 17th century.
In a 67-year-old woman a dacrocystorhinostomy had to be performed because of dacryostenoses. At operation a black adrenodacryolith was found from by topical adrenalin treatment for chronic simple glaucoma. The mineralogical and histological examinations revealed that the dacryolith consisted of organic material only.
The clinical features of xerophthalmia are described in a 60-year-old patient, who was known to have alcoholic cirrhosis. In this patient, vitamin A deficiency, which presumably had been overlooked for 15 years, was confirmed by determination of the serum vitamin A level. After substitutive vitamin A therapy, superficial punctate keratitis and conjunctival xerosis disappeared completely. Although xerophthalmia has only sporadically been described in developed countries, we point out that the possibility of a vitamin A deficiency should also be considered in cases of recurrent conjunctival and corneal lesions.
An 8-year-old boy presented with a white pupillary reflex. This clinical picture suggested a diagnosis of retinoblastoma or Coats' disease. Ultrasonography did not reveal the characteristic signs often seen in retinoblastoma. However, diagnostic vitrectomy and subsequent enucleation confirmed the diagnosis 'retinoblastoma'.
A patient presented in our clinic with impairment of visual acuity due to optic disc and macular oedema. Internal examination revealed chronic lymphatic leukaemia, and the patient was treated with Leukeran and Aprednisolone according to the chemotherapeutic regimen of Knospe. Remission occurred, and the pathological findings of the fundus disappeared.
A Fortran program which can be run on IBM-compatible personal computers has been written for the differential diagnosis of ophthalmologic syndromes. The user enters the symptoms observed and the computer displays a list of syndromes in which these symptoms occur. The program at present covers 219 syndromes and 1094 symptoms, and can be expanded. Its use is expected to make differential diagnosis and the scientific clarification of syndromes easier.
Carcinomas of the cornea have not yet been described in the literature. A 50-year-old man underwent keratoplasty because of corneal dystrophy. Microscopic examination disclosed a squamous-cell carcinoma which had spread over the entire cornea and just reached the limbus.
A Fortran computer program has been written for the differential diagnosis of ophthalmic syndromes. Input for the program are the observed symptoms and the result is a list of syndromes relevant to one or more of the symptoms. The program was written for the Control Data Cyber 840 at the Computer Center of the University of Innsbruck, which is connected permanently by terminals to institutes. A second version of the program has been adapted for IBM-compatible personal computers. At present, the program includes 219 syndromes with their individual symptoms. However, it is possible to supplement or alter the list of syndromes and symptoms. The use of this computer program is expected to make the differential diagnosis easier and to simplify and improve the scientific clarification of syndromes.
A carcinoma of the cornea is rare. A 48-year-old man underwent keratoplasty because of corneal dystrophy. Micro-scopic examination showed a squamous cell carcinoma that had spread over the entire cornea and had just reached the limbus. A conjunctival biopsy was performed. Histological analysis showed conjunctival tissue that was covered with normal epithelium. No carcinoma cells were evident.
Binding proteins for retinoic acid (cellular retinoid acid binding protein, CRABP), and for vitamin A (cellular retinol binding protein, CRBP) have been demonstrated in various cell types; these binding proteins display the characteristics of receptors. In the present study CRABP and CRBP levels were measured in 9 melanomas of the choroid. CRABP was detected in 2 of the melanomas, whereas CRBP was measurable in 1 melanoma. In comparison samples of normal choroid contained CRABP and CRBP in all cases investigated.
The patient, who is now 60, had a nevus and areas of cystic changes in the conjunctiva in her right eye, which had been present from birth to the age of 59. In 1987, rapid tumor growth aroused suspicion that malignant change could be occurring and so the nevus as well as the area of the conjunctiva containing cystic changes were excised. Histological finding: conjunctival malignant melanoma, containing compressed (densely arranged) atypical cells with pleomorphic hyperchromatic nuclei and prominent nucleoli. The biopsy specimen of the conjunctiva showed a typical nevocellular nevus with large inclusion cysts of the conjunctival epithelium.
Cellular retinoic acid-binding proteins (CRABP) and cellular retinol-binding protein (CRBP) can be found in cells and nuclei. They function in the same way as receptors. CRABP and CRBP were studied in 9 cases of choroidal melanoma and in 3 of retinoblastoma. CRABP was found in 2 cases of melanoma and in 3 cases of retinoblastoma. CRBP was found in 1 melanoma.
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A 87-year-old female patient with a squamous cell carcinoma of the conjunctiva was treated with local strontium-90 irradiation (with a so-called 'Dermaplatte'). In spite of a relatively low dosage, radiotherapy was followed by a corneal ulcer with consecutive rupture of the cornea. The cause of this unexpected perforation was, besides the effect of low-dose irradiation, probably a metabolic disorder of the cornea and a disturbance of the tear film due to the carcinoma which had spread on Bowman's layer of the cornea in an exophytic manner and was accompanied by a dense lymphocytic infiltration. An exenteration was performed and, at the last examination (1 year later), no local recurrence could be detected.
Dacryoliths are uncommon and there are only a few reports in the literature. In a patient with recurrent stenosis of the lacrimal drainage system a lacrimal stone (dacryolith) was removed from the lacrimal sac during dacryocystorhinostomy. A histological and immunohistochemical examination was performed and keratin antibodies could be detected. In a chemical analysis calcium, sulfur and some phosphorus were determined as major constituents.
Binding proteins for retinoic acid (cellular retinoic acid binding protein, CRABP) have been demonstrated in various cell types, and display the characteristics of receptors. Three retinoblastomas are described. The clinical diagnosis of retinoblastoma was established by ophthalmoscopic echographic and histological examination. One part of the tumor was frozen in liquid nitrogen immediately after surgery and used for the determination of CRABP. CRABP was present in cells from all three tumors. This may indicate sensitivity of this tumor to retinoic acid or synthetic retinoic acid derivatives with biologic activity.
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