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Biomedical subjects

I Kremer

Publications and source records attributed to I Kremer.

At least 19 recordsLinked to original sources
PubMed2000

No association between the dopamine D3 receptor Bal I polymorphism and schizophrenia in a family-based study of a Palestinian Arab population.

Several recent meta-analyses appear to show a weak but significant effect of both forms of the gly/ser DRD3 polymorphism in conferring risk for schizophrenia. Since most studies have employed the artifact-prone case-control design, we thought it worthwhile to examine the role of this polymorphism using a robust family-based strategy in an ethnic group not previously systematically studied in psychiatric genetics, Palestinian Arabs. We failed to obtain any evidence in 129 Palestinian triads, using the haplotype relative risk (allele frequency: Pearson chi-square = 0.009, P > 0.1, df = 1, n = 258 alleles) or transmission disequilibrium test design (chi-square = 0.38, P > 0.1, n = 86 families) for association/linkage (or increased homozygosity) of the DRD3 Bal I polymorphism to schizophrenia in our sample. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:778-780, 2000.

Alleles↗
PubMed2000

Confirmation of an excess of the high enzyme activity COMT val allele in heroin addicts in a family-based haplotype relative risk study.

A previous case control study by Vandenbergh et al. [1997: Am J Med Genet 74:439-442] showed an association between the high activity catechol O-methyltransferase (COMT) polymorphism and polysubstance abuse in a group of North American subjects. In the current study we confirm these results by genotyping 38 Israeli heroin addicts and both parents using a robust family-based haplotype relative risk (HRR) strategy. There is an excess of the val COMT allele (likelihood ratio = 4.48, P = 0.03) and a trend for an excess of the val/val COMT genotype (likelihood ratio = 4.97, P = 0.08, 2 df) in the heroin addicts compared to the HRR control group. We also genotyped an additional 101 nonrelated heroin addicts and 126 control subjects using a case control design and found no significant difference in COMT val allele frequency (25.4% vs. 29.7%, likelihood ratio = 1.04, P = 0.31). A significant difference is observed in COMT allele frequency among the three principal Israeli ethnic groups (Ashkenazi Jewish, non-Ashkenazi Jewish, and Palestinian Arab) in a large group of control subjects we have so far examined (chi-square = 7.9, P = 0.019, df = 2, n = 1,422 alleles) suggesting that population stratification is responsible for our failure to observe an excess of the COMT val allele when using the case-control design.

Alleles↗
PubMed2000

Diode laser treatment of posterior retinopathy of prematurity.

AIMS: To study the efficacy of infrared diode laser for the treatment of posterior retinopathy of prematurity (ROP). METHODS: 48 eyes of 25 premature babies (mean birth weight 779 (SD 127.7) g; mean gestational age 25.5 (SD 1.47) weeks) with threshold ROP in zone I and posterior zone II were treated by the indirect infrared (810 nm) diode laser. Confluent burns were applied to the avascular retina. In 18 eyes, an additional row of laser burns was added posterior to the ridge. RESULTS: Favourable anatomical results were noted in 41 eyes (85.4%). ROP stage 5 developed in two eyes, ROP stage 4A developed in four eyes, and ROP stage 4B in one eye. Three of the eyes with stage 4A eyes were successfully buckled; the fourth was not operated on and remained demarcated by laser scars. No complications were noted. CONCLUSION: In this series, the diode laser was found to be a safe and effective treatment for posterior ROP.

Female↗
PubMed1999

The combination of topical ceftazidime and aminoglycosides in the treatment of refractory pseudomonal keratitis.

BACKGROUND: Pseudomonal keratitis is a serious and potentially blinding infection. METHODS: We treated 12 patients with culture-positive fulminant pseudomonal keratitis with a topical combination of ceftazidime ophthalmic solution (50 mg/ml) and aminoglycosides (14 mg/ml). None of these patients had responded to the standard initial therapy with topical fortified gentamicin or tobramycin (14 mg/ml) combined with cefazolin (50 mg/ml). RESULTS: Substitution of cefazolin by ceftazidime achieved a remarkable clinical improvement during the first 24-48 h of administration in all cases. The average time of healing after initiation of the combination of ceftazidime and fortified aminoglycosides was 21+/-15 days. No serious side effects accompanied ceftazidime administration. In vitro susceptibility testing showed resistance to gentamicin or tobramycin in 33% of cases (4/12) and sensitivity to ceftazidime in all cases. CONCLUSIONS: The combination of ceftazidime, in a 5% solution, and fortified aminoglycosides (1.4%) may be a useful, safe and effective topical therapy for the treatment of pseudomonal keratitis resistant to aminoglycosides.

Acute Disease↗
PubMed1999

Patterns of late corneal scarring after photorefractive keratectomy in high and severe myopia.

OBJECTIVE: To study the correlation between scarring 1 year after photorefractive keratectomy (PRK), final refraction, and degree of myopia. DESIGN: A retrospective, noncomparative case series. PARTICIPANTS: One hundred twenty eyes of 78 patients underwent PRK for high and severe myopia. Thirty-nine eyes had a pre-PRK spherical equivalent (SE) between -9.5 and -18.25 diopters (D) (severe myopia). Eighty-one eyes had a pre-PRK SE between -6.25 and -9.25 D (high myopia). Follow-up time ranged between 12 and 37 months with a mean of 18.2 months. INTERVENTION: Multizone PRK with the VISX 20/20 excimer laser. MAIN OUTCOME MEASURES: Corneal scarring, final best-corrected visual acuity (BCVA), and refraction. RESULTS: There were 71.7% of eyes with severe myopia and 60.5% of eyes with high myopia found to have any pattern of stromal scarring, which was classified as focal, semiannular, annular, and discoid. Discoid scars were rare (6.6%) and found in 12.8% of severe myopic eyes compared to 3.7% of high myopic eyes. Only 50% of the eyes with a discoid scar achieved final BCVA between 6/6 and 6/9 compared to 81.6% of the eyes with a clear cornea. The severe myopic eyes with a discoid scar had the highest level of final undercorrection (-5.0 D) compared to a maximum of -1.5 D in the high myopia group. The severe myopic eyes with a discoid scar had a higher number of retreatments (4 of 5) compared to the high myopia group (1 of 3). Other types of scars were less clinically significant. CONCLUSIONS: Photorefractive keratectomy was efficient in the correction of high myopia but less so in severe myopia, in which discoid scarring was more frequent and more clinically significant, being associated with significant regression. Other types of scarring were less clinically significant.

Adolescent↗
PubMed1998

Three year results of photoastigmatic refractive keratectomy for mild and atypical keratoconus.

PURPOSE: To evaluate the long-term effect of photoastigmatic refractive keratectomy (PARK) on mild keratoconus. SETTING: Laser Unit, Ein Tal Eye Center, Tel Aviv, Israel. METHODS: Eight eyes of 6 patients with stable compound myopic astigmatism and topography features of keratoconus were treated with a VISX Twenty-Twenty excimer laser. The laser beam slit width ranged between 4.8 and 5.0 mm according to the degree of cylinder. Preoperative slitlamp examination did not reveal significant thinning, ectasia, or scarring. Astigmatism ranged between -2.00 and -7.50 diopters and follow-up, between 36 and 48 months. RESULTS: In 7 of 8 eyes, uncorrected visual acuity (UCVA) before PARK ranged between 6/30 and finger counting. After PARK, it ranged between 6/9(-) and 6/15, and patients could manage in most of their daily activities without using spectacles. In 2 eyes, the final UCVA was 6/15(-) and 6/15. In 1 eye, treatment failed to improve UCVA and corneal topography revealed progression of the keratoconus. CONCLUSIONS: Photoastigmatic keratectomy was partially effective in eyes with mild stable keratoconus. However, the long-term results may be altered by progression of corneal thinning and ecstatic disease. In addition to the mild nature of the keratoconus, this is a small series and further studies are needed to confirm these results.

Adult↗
PubMed1997

The development and progression of diabetic retinopathy in type I diabetic patients: a cohort study.

To describe the course and risk factors for development and progression of retinopathy, we studied a cohort of 333 Israeli Jewish patients with Type 1 (insulin-dependent) diabetes mellitus. The median age at diagnosis was 9.5 (range 0.04-26.2) years and the median duration of follow-up was 14 (range 1.6-30) years. Evaluation of both retinae was performed yearly since referral and HbA1 values were tested every 3 months since 1978. During a follow-up of 4070 patient-years, 162 patients developed non-proliferative retinopathy. The median retinopathy-free interval was 14.9 years and after 30 years all patients were affected. Pre-pubertal duration of diabetes was relevant. Independent and significant risk factors for early onset of non-proliferative retinopathy were: poor cumulative glycaemic control (median retinopathy-free interval in the 1st vs 4th quartiles of mean HbA1 values over all years: 18.0 vs 12.5 years, p = 0.0001); onset of diabetes during or after puberty (median retinopathy-free interval in patients with onset of diabetes before, during or after pubescence: 16.3, 13.2 and 14.0 years, respectively, p = 0.0001); and non-Ashkenazi Jewish origin (median retinopathy-free interval 15.8 years in Ashkenazi vs 14.0 in non-Ashkenazi patients, p = 0.0004). Of 162 patients with non-proliferative retinopathy, progression to proliferative retinopathy occurred in 37, during 707 patient-years. The first event of proliferative retinopathy was diagnosed within the 1st year after non-proliferative retinopathy evolved, and at 6.3 years since onset of non-proliferative retinopathy 75% of the patients were still free of proliferative changes. Risk factors significantly and independently associated with an early progression to the proliferative stage were: poor glycaemic control in the last 3 years prior to the development of proliferative retinopathy and non-Ashkenazi Jewish origin. All patients in the 4th quartile of HbA1 values were affected by proliferative retinopathy within 11.6 years after onset of non-proliferative retinopathy.

Adolescent↗
PubMed1997

Candida tropicalis multifocal endophthalmitis as the only initial manifestation of pacemaker endocarditis.

PURPOSE: To document a case of Candida tropicalis endophthalmitis as the only manifestation of pacemaker endocarditis. METHODS: We examined a 75-year-old man with diabetes mellitus who was initially examined for bilateral multifocal endophthalmitis complicating endocarditis 2 years after a permanent pacemaker for sick sinus syndrome was implanted. RESULTS: Transesophageal echocardiography showed a large vegetation with a 3-cm diameter attached to the pacing electrode in the right ventricle. Six consecutive blood cultures grew C tropicalis. CONCLUSIONS: Ocular involvement, including multifocal endophthalmitis, may occur as the only manifestation of C tropicalis endocarditis, complicating an intravenous permanent pacemaker.

Aged↗
PubMed1997

Sulfur hexafluoride injection for Descemet's membrane detachment in cataract surgery.

Extensive Descemet's membrane detachment persisted after small incision cataract surgery in three patients. Unfolding and repositioning of Descemet's membrane by sodium hyaluronate (Healon) were followed by injection of sulfur hexafluoride 20% gas mixed with air to fill the anterior chamber. Initially, the gas bubble filled most of the anterior chamber; it disappeared over 7 to 9 days. Descemet's membrane remained attached, and the corneal edema cleared.

Aged↗
PubMed1997

Excimer phototherapeutic keratectomy for corneal subepithelial cryoglobulin deposits.

A 64-year-old man with a history of cryoglobulinemia and repeated scraping of immunoglobulin deposits from both superficial corneas presented with gradual decrease in vision and progressive hyperopia caused by circumferential redeposition of the cryoglobulins in his corneas. He had debridment of the deposits combined with phototherapeutic keratectomy to smooth the corneal surface. Visual acuity and reading capacity markedly improved, and hyperopia regressed by 5.75 diopters (D) in the right eye and 5.25 D in the left. Follow-up was 3 years.

Corneal Diseases↗
PubMed1997

Combined PRK and PTK in myopic patients with recurrent corneal erosion.

AIM: To study the results of combined photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) in myopic patients with recalcitrant recurrent corneal erosion. METHODS: PRK was performed in 16 eyes with the Visx 20/20 excimer laser at a central 6.0 mm zone, following total epithelial scraping. Subsequently, confluent 3.0 mm zones of PTK were ablated at a depth of 6.0 microns, surrounding the zone of PRK. The follow up period ranged from 26 to 42 months. RESULTS: Complete alleviation of symptoms was demonstrated and there was no recurrence of corneal erosion. Visual acuity (VA) improved slowly following treatment, with a final uncorrected VA ranging between 6/9 and 6/12. A final myopic spherical equivalent < or = -1.0 D was found in 14 out of 16 eyes. CONCLUSIONS: A combination of PRK and PTK is effective in the alleviation of symptoms and prevention of recurrences of corneal erosion. It is suggested that recalcitrant recurrent corneal erosion is a diffuse disease, although it often manifests as a local problem, and therefore extensive excimer laser ablation is required to prevent recurrence and to alleviate symptoms completely.

Adult↗