Biomedical subjects
Publications and source records attributed to H Savir.
In 37 patients and 143 control patients we estimated tear fluid lysozyme content by the Micrococcus lysodeikticus agar diffusion assay. We found no correlation between the titer of lysozyme in tear fluid and the rate of tear flow. Decrease in lysozyme production was found to be a sensitive indicator of the involvement of the lacrimal system in Sjögren's syndrome.
A study of the postoperative evolution of 70 eyes subjected to trabeculectomy over a 3-year period is reported. This is the operation of choice in our department in cases of chronic open-angle glaucoma and chronic angle-closure glaucoma. The study showed that in 35.7% of the operated eyes the intraocular pressure was increased on the second postoperative day and became normal within a week. This raised intraocular pressure did not influence the final result of the operation.
The effect of vitamin E on platelet aggregation was investigated in a group of 10 patients with diabetic retinopathy. Adenosine diphosphate induced platelet aggregation was inhibited in the patients' group as well as in the controls in the presence of vitamin E. An increased platelet aggregation was obtained with arachidonic acid in both groups when platelet-rich plasma was incubated prior with vitamin E. The clot retraction inhibition test parallels the findings of aggregation obtained with the platelet aggregation meter.
The case of a 40-year-old patient who underwent an unsuccessful cadaver kidney transplantation and was treated with ethambutol and isoniazid is reported. A bilateral retrobulbar neuropathy with an unusual central bitemporal hemianopic scotoma was found. Ethambutol was stopped and only small improvement of the visual acuity followed. Isoniazid was discontinued later, followed by a dramatic improvement in the visual acuity. The hazards of optic nerve toxicity due to ethambutol are known. We emphasize the potential danger in the use of ethambutol and isoniazid.
A case of massive choroidal detachment during cataract extraction is described. Some thoughts about the pathophysiology of expulsive detachment in this case are discussed (Fuchs' heterochromy cyclitis and high blood pressure). The prognosis is good without need of posterior sclerotomy but with steroid treatment for a longer period.
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Platelet aggregation in diabetic retinopathy was investigated in a group of 25 patients. An enhanced activity induced by epinephrine and arachidonic acid was found in this group as compared with the controls, whereas in adenosine diphosphate (ADP) platelet aggregation no differences were observed. Spontaneous aggregation was found in 8% of the diabetic retinopathy cases.
Three cases of exogenous mycotic infections of the eye are presented. The first is a case of keratitis in a patient suffering from glaucoma simplex who removed a foreign body from the cornea, caused by Fusarium solani, generally known as a saprophytic soil and plant inhabitant. As factors predisposing the patient to infection, trauma to the cornea like injury by a foreign body, as well as the preexisting disease of the eye, are discussed. The other case illustrates the change in the pathogenicity of an otherwise innocent fungus like Penicillium, which penetrated the sclera after injury of the eye by a broken airpiece of a drill and caused a severe endophathalmitis. The infection responded well to treatment with 5-fluorocytosine. The last case represents a rather mild well-known mycotic infection by Streptomyces somaliensis causing canaliculitis in a patient admitted for cataract surgery. Curettage of the infected canaliculus followed by iodine washout proved to be effective. The importance of the early clinical and laboratory diagnosis in order to avoid mistreatment with antibiotics and steroids and to ensure the right antimycotic treatment is stressed.
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We found distinct alterations of the clotting and fibrinolytic mechanisms in a 27-year-old man who suffered from typical bilateral vasculitis, clinically and fluoroangiographically manifest as obstruction of the central retinal veins. The partial thromboplastin time was slightly increased, a partial clot lysis occurred after one hour, the plasminogen level was markedly low, and alpha2-macroglobulin was decreased, as were factor XII and IgG. Kallikrein was absent. Similar changes, though not so pronounced, were also found in the patient's son and in his brother.
Fifteen cases of severe cranio-cerebral injuries (C.C.I.) with hemianopsia and rehabilitation problems are presented. The correlation between the side of the hemianopsia, dexterity, visual motor organization, intellectual functions and rehabilitation outcome are discussed.
Tear calcium and magnesium levels were measured in eight patients with hypercalcemia and two patients with hypocalcemia and compared to that of 72 subjects with normal serum calcium and magnesium levels. No correlation was found between tear and serum calcium and magnesium levels. Tear calcium level has no diagnostic importance.
A case of intermittent exophthalmos due to orbital venous veins in which there were associated varicose veins of the legs is described. Of note was the preservation of vision despite the long history (28 years) of the disturbance.
A case of ocular syphilis with severe ischemic retinopathy, rubeosis iridis and secondary glaucoma is described. Fluorescein angiography revealed a complete blockage of all the vessels around the macula, with dye leakage from numerous bifurcations of veins and an infiltrative mass in the macular area of both eyes. Combined treatment with steroids and penicillin brought no improvement in this condition of severe, ischemic ophthalmia.
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We describe a case of spontaneous hyphema, in which results of fluorescein angiography revealed that the condition was caused by anomalous iris vessels. A cavernous hemangloma of the ipsilateral orbit was discovered. We stress the importance of performing fluorescein angiography in all cases of spontaneous hyphema.