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Biomedical subjects

G K Lang

Publications and source records attributed to G K Lang.

At least 127 records · Page 7Linked to original sources

[Chromosome mutagenicity of a 193 nm Excimer laser].

Considering the fundamental role somatic mutations play in carcinogenesis, inducing mutations by any form of therapy should be avoided as far as possible. The mutagenicity of UV irradiation in the wavelength range of 248 to 310 nm is well established. The data on shorter wavelengths, e.g. 193 nm, however, are so far not clear-cut. Therefore, the potential chromosome-damaging effect of a 193 nm excimer laser was examined in the present study. Cultures of primary human fibroblasts and the Chinese hamster cell line CHO were the object of examinations. The in situ preparation technique used allowed detection of a locally limited clastogenic (chromosome damaging) effect in the neighborhood of the irradiated area. A slight increase in the frequency of chromosome aberrations could be observed in the area close to the laser-exposed field, which was attributed to the fluorescence generated by the laser under the given experimental conditions. Quantitative comparison with the data obtained from experiments with 254 nm irradiation from a UV lamp or exposure to 248 nm excimer laser-pulse irradiation, however, made the former activity appear somewhat insignificant. If one considers the practical aspects of the new laser surgery, the chromosome-damaging effect of the 193 nm pulse laser seems to be negligible.

Animals↗

[Pseudokeratoconus in trisomy 21 and posterior polymorphous corneal dystrophy].

The authors examined three members of a family with an autosomal dominant trait of posterior polymorphous corneal dystrophy of varying expressivity. The 67-year-old white mother had a visual acuity of 20/30, with only discrete irregularities at the level of Descemet's membrane. The daughter developed bullous keratopathy with polymorphous ring-shaped opacities in the central area of Descemet's membrane early, in her 34th year. The 25-year-old son, who also had Down's syndrome, presented with the clinical symptoms of acute keratoconus. Light microscopy revealed a thickened, multilaminated Descemet's membrane with vesicles, breaks, and dislocation of endothelial cells into the deep stroma. Transmission electron microscopy showed a normal anterior, ribbonlike portion of Descemet's membrane and a fibroblastic differentiation of the corneal endothelial cells.

Adult↗

[Fulminant gas gangrene panophthalmia following perforating scleral injury].

A 13-year-old boy developed Clostridium perfringens panophthalmitis due to a penetrating scleral injury. The characteristic symptoms were unusually severe periocular pain, lid edema, decreased motility and protrusion of the eye, severe conjunctival chemosis, pus covering the conjunctiva and cornea, green-brown hypopyon, gas bubbles in the anterior chamber, and amaurosis within 60 hours. In view of the patient's ocular status and impaired general condition enucleation was unavoidable. The results of laboratory workups are reported in addition to the clinical and ophthalmologic findings.

Adolescent↗

Clinical observations of six cases of laser injury to the eye.

During the last decade, five patients with laser injuries were examined at the University of Munich Eye Clinic, in addition to one laser-injury patient at the University of Erlangen Eye Clinic. From a review of these cases, it is possible to gain an insight into factors that led to the eye injuries and to predict the clinical sequelae of laser retinal injury. A possible means of treatment, using an ophthalmic Q-switched Nd:YAG laser, is suggested for some types of retinal injury involving vitreal hemorrhage.

Accidents, Occupational↗

[Configuration of corneal incisions with the excimer laser: an experimental study].

The potential applications of an ophthalmic excimer laser at 193 nm include its use as a precise trephine in keratoplasty procedures. In a series of 20 human autopsy and 40 pig cadaver eyes the histological and ultrastructural results of donor and recipient trephination and full-thickness corneal grafting using new mask systems were evaluated. In comparison with other beam delivery systems the "open mask system" allows the performance of excimer laser trephinations with reproducible wound configuration and geometry, with easy handling and high reliability. This technique enables the surgeon to surmount the mechanical limitations of cutting direction and makes non-circular trephinations possible.

Animals↗

Excimer laser keratoplasty. Part 2: Elliptical keratoplasty.

An excimer laser at 193 nm was used with a new "open mask system" to perform elliptical noncontact and nonthermal keratoplasties and corneal grafts in human cadaver eyes (Part 1 of this article, Ophthalmic Surg 1989; 20:262-267). By light microscopy the corneas showed sharp, unbeveled cut margins with nearly perfect apposition of the inner wound aspects. An elliptical shape may be better than a circular one, since the former closely approximates the cornea's normal elliptical outline, making it easier to fit corresponding areas of corneal graft to bed. Also, it provides a wider area of Bowman's membrane for anchoring sutures and relatively less volume of donor antigenic tissue.

Cadaver↗

Excimer laser keratoplasty. Part 1: Basic concepts.

A commercially available ophthalmic excimer laser was used with a new "open mask system" to perform noncontact and nonthermal excimer laser keratoplasty in 20 human and 40 pig cadaver eyes. Circular penetrating corneal trephinations and corneal grafts were performed with the excimer laser set at 193 nm. Light microscopy and scanning and transmission electron microscopy of the human and pig eyes demonstrated the high quality of excimer laser trephination (smooth wound margins that were approximately parallel to the optical axis of the eye), and the superior wound configuration and geometry.

Animals↗

[Comparative studies in chronic ocular chalcosis].

Seven eyes containing a copper foreign body for a period from 8 months to 2.5 years were studied histopathologically. Foreign bodies, containing 99% copper, were in all eyes, encapsulated and located in the anterior vitreous. Characteristic features were: formation of foreign body granuloma, especially in later stages, marked fibroblastic proliferation in the vitreous with traction retinal detachment, choroidal effusion with fibrosis and foci of chronic nongranulomatous inflammation in cyclitic membranes, iris, ciliary body and sclera. Copper could be identified by rubeanic acid and rhodanine stainings in the fibrous capsule around foreign body in all eyes, in the lens capsule in one eye and in macrophages in the vitreous and retina in 2 eyes. In eyes with intravitreal haemorrhage macrophages contained also haemosiderin.

Adult↗

[Perforating keratoplasty in pseudophakia].

Between July 1980 and March 1987 the authors performed pseudophakic penetrating keratoplasty in 56 eyes with bullous keratopathy following implantation of an intraocular lens. The postoperative results in 50 eyes (47 patients) are reported in this retrospective study. Average duration of follow-up after keratoplasty was 8.1 months. The intraocular lenses were either iris-supported (31), anterior chamber lenses (12), or posterior chamber lenses (7). The interval between implantation of the lens and performance of the keratoplasty ranged from three to 451 months (average 69.9 months). It varied considerably, depending on the type of lens used. Vision after penetrating keratoplasty improved in 44 of the 50 eyes and was unchanged in three. In ten eyes, improvement in vision was limited by persistent cystoid maculopathy (CMP). Postoperative complications occurred in five eyes and traumatic wound dehiscence in two. However, none of the transplants showed any signs of rejection during the follow-up period. The prognosis for penetrating keratoplasty following intraocular lens implantation is generally good; impaired vision is due to extracorneal factors, in particular CMP.

Adult↗

[Secondary glaucomas caused by intraocular epithelial invasion. A clinico-pathologic study of 30 patients].

The clinical data of 30 eyes with intraocular epithelial invasion were correlated to the histopathological findings (15 iridocyclectomies, four diagnostic iridectomies, one corneal button, ten globes). The diffuse (46.7%) and cystic (53.3%) types occurred with equal frequency. The correlation to the clinical data makes the relationship between the type of epithelial invasion and the pathogenetic mechanism clear: the cystic type occurs more frequently after perforating injuries (nine out of 13 patients), the diffuse type after intraocular surgery (nine out of 14 patients). Sixteen patients with intraocular epithelial ingrowth had secondary glaucoma preoperatively. In this group diffuse epithelial invasion predominates: of 14 patients with the diffuse type 12 had high intraocular pressure, while this was only the case in four out of 16 patients with cystic epithelial invasion. The multifactorial genesis of secondary glaucoma in eyes with epithelial ingrowth in discussed.

Adult↗

[Continuous blood pressure monitoring in cataract operations under local anesthesia].

Clinical data of 69 patients due to undergo ECCE with PCIOL implantation were evaluated in a standardized fashion. The preliminary results show that the blood pressure measured preoperatively and intraoperatively necessitated antihypertensive therapy. The averaged systolic blood pressure in the ward was 147.2 +/- 20.4 mm Hg; before retrobulbar anesthesia 159.9 +/- 30.4 mm Hg; after retrobulbar anesthesia 172.6 +/- 24.2 mm Hg; and at the start of surgery 154.2 +/- 18.4 mm Hg. Maximum intraoperative blood pressure was 156.2 +/- 20.7 mm Hg; at the end of surgery it was 144.3 +/- 19.5 mm Hg. In 12 patients (17%), systolic blood pressure higher than 200 mm Hg was measured after retrobulbar anesthesia. Antihypertensive therapy (nifedipine, nitroglycerin) was initiated in 44 patients (64%). These data support the recommendation that blood pressure should be monitored continuously both before and during the operation in order to minimize the rate of surgical and general complications.

Aged↗