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Biomedical subjects

H Beckman

Publications and source records attributed to H Beckman.

At least 37 records · Page 2Linked to original sources

Argon laser treatment of an eyelid margin capillary hemangioma.

When capillary hemangiomas do not resolve spontaneously, treatment may be indicated. Various forms of therapy have been employed. These include excisional surgery, cryotherapy, sclerosing solutions, embolization, external beam irradiation, steroids, and the argon laser. We report the use of a standard ophthalmic argon laser combined with curettage on a noninvoluting eyelid margin hemangioma found on a 29-year-old man. Details of the surgical technique are provided and postoperative results documented. We believe this to be the first case of a lid margin hemangioma successfully treated in this manner. The technique offers these advantages: (1) Selective absorption of the laser energy by the blood-filled tissue allows microablation of the lesion under ideal hemostatic conditions with minimal loss of normal lid tissue. (2) Oculoplastic lid repair is obviated since minimal normal tissue is removed. (3) The procedure can be performed under local anesthesia on an outpatient basis.

Adult↗

Evaluation of blood pressure during early alcohol withdrawal.

Ninety-five patients undergoing early alcohol withdrawal were observed for a five-day period in a non-hospital facility to evaluate the natural history of blood pressure change during this period. Patients under 30 years old developed a significant increase in systolic pressure on the second abstinent day, decreasing a mean of 10 mm Hg by the fourth abstinent day. With increasing age there was a progressively smaller rise in systolic pressure. Multivariate analysis showed a history of hypertension, delirium tremens, seizures, initial pulse, race, and sex not to be predictive of blood pressure change. Diastolic pressure was unaffected. Etiology of this difference requires further study. There were no hypertensive complications in this group. Patients undergoing early withdrawal need not be treated for changes in blood pressure without evidence of end organ damage or severe hypertension.

Adolescent↗

Carbon dioxide laser surgery of the eye and adnexa.

A carbon dioxide laser which functions in both rapid superpulsed and continuous wave mode for use in ophthalmic surgery is described. Rapid superpulsed mode was found more effective in the creation of trabeculectomy-like procedures in glaucomatous human eyes with satisfactory results in 12 of 14 eyes treated. Continuous wave energy was found to be superior when full thickness eye wall resection was performed. The carbon dioxide laser was found to be effective in hemostatic resection and ablation of skin lesions about the eye. Rapid superpulse was found to be more effective when puckering and tissue loss were to be minimized, while continuous wave was found to be effective when shrinkage of tissue, as in the performance of a Ziegler cautery type repair for ectropion, was preferred. Rapid superpulse was found to be more controllable in experimental phacovaporization in cats with anterior capsulotomy being easily performed. Continuous wave was found to be a more efficacious modality for corneal shrinkage although attempts at present to create permanent corneal alterations have been fruitless.

Animals↗

Antibiotic-host defence interactions in vitro and in vivo.

A markedly depressed chemotaxis was detected with an agarose gel technique when human leucocytes were incubated with fusidic acid and rifampicin in clinically obtainable concentrations. At high concentrations of newer well absorbed tetracyclines there was a definite depression and a less pronounced inhibition was detected for classical tetracycline. The incorporation of 14C-leucine into a trichloroacetic-acid insoluble form by human neutrophils was markedly depressed by the same antibiotics and it is suggested that some antibiotics acting by inhibition of protein synthesis also affect chemotaxis of human neutrophils. At therapeutic concentrations fusidic acid and rifampicin had a pronounced inhibiting effect on the incorporation of 3H-thymidine by human T-lymphocytes stimulated by PHA and B-lymphocytes by S. aurens, Cowan I. At concentrations above the therapeutic level inhibition was detected for doxycycline, erythromycin, clindamycin and nitrofurantoin. No apparent inhibition of neither chemotaxis by human neutrophils nor thymidine incorporation by lymphocytes could be detected for penicillins, cephalosporins, nalidixic acid, sulfamethoxazole and trimethoprim. Due to high albumin binding for some of the tested antibiotics and other factors involved, experiments were performed to test whether depression also takes place in vivo. The cellular immunity in mice was registered by monitoring the survival of transplanted heart grafts and the humoral immunity by quantitating plaque-forming cells and by titration of antibodies after immunization with sheep erythrocytes. Fusidic acid (500 mg/kg/day) and rifampicin (20 mg/kg/day, human therapeutic dose) had a highly significant effect (P less than 0.001) on the rejection of heart grafts and plaque-forming cells while the effect o serum antibodies was of low significance (P less than 0.02--P less than 0.01). The effect of doxycycline (2.5 mg/kg/day) and fusidic acid (25 mg/kg/day) at human therapeutic dose on immunity in mice was slight but significant (P less than 0.02). The relevance of experiments in mice to the situation in man is discussed. The migration of neutrophils into a skin chamber was shown to be dramatically reduced in eight healthy volunteers during a standard regimen of doxycycline.

Animals↗

Anterior segment metastases from an ovarian choriocarcinoma.

A 28-year old woman with ovarian choriocarcinoma developed a uveitis in her left eye. Subsequently, a mass was observed in the anterior segment of that eye together with a subconjunctival mass that appeared to extend from it. Biopsy of the subconjunctival nodule showed two different cell types consistent with the cytotrophoblastic and syncytiotrophoblastic elements typical and choriocarcinoma. No abnormalities of the posterior segment were found on careful examination. Treatment consisted of systemic chemotherapy with a variety of therapeutic agents, argon laser photocoagulation of tumor seedings in the anterior chamber angle, radiation to the eye, and finally, subconjunctival injections of methotrexate. The eye became blind and painful and was enucleated. Histopathologic examination revealed residual tumor cells in the anterior segment indicating treatment changes, but there were no abnormalities posteriorly. Choriocarcinoma metastatic to the eye has been reported infrequently, and this is the first case in which anterior segment metastases have been observed and the effects of treatment thoroughly documented.

Adult↗

Carbon dioxide laser scleral dissection and filtering procedure for glaucoma.

A comparison of eye bank eyes using continuous wave or rapid superpulsed carbon dioxide laser energy indicated that rapid superpulsed was the superior modality for scleral dissection, because there is less charring and puckering of tissue. The results of filtering procedures in five glaucomatous eyes by using rapid superpulsed carbon dioxide energy to perform the scleral dissection revealed the possible advantages of performing the procedure this way might be: (1) the technical ease by which the microdissection is performed under direct microscopic observation with the absence of blood or instruments in the field; (2) the safety factor of never having penetrated into the anterior chamber with a sharp instrument; (3) the possible advantage of the inhibition of healing at the wound margin because of coagulation of tissue at the wound edge by the laser beam; and (4) the bacteriocidal effect of thermal cutting.

Carbon Dioxide↗

Healing of continuous-wave and rapid superpulsed, carbon dioxide, laser-induced bone defects.

With rabbits as the experimental model, a comparative study was done to assess the healing of bone in response to osteotomy by rapid superpulsed and continuous-wave carbon dioxide lasers. The laser was capable of easily incising bone; the rapid superpulsed mode required less energy to do so than did the continuous-wave mode. When the narrow zone of tissue necrosis adjacent to the laser osteotomy was debrided, it was found that healing was similar for each laser mode. Healing occurred in orderly progression from deposition of trabecular bone to formation of lamellar bone.

Animals↗