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Biomedical subjects

J H Calhoun

Publications and source records attributed to J H Calhoun.

At least 109 records · Page 6Linked to original sources
PubMed1982

Ophthalmic manifestations of the Hermansky-Pudlak syndrome (oculocutaneous albinism and hemorrhagic diathesis).

We report the association of oculocutaneous albinism and defective platelet function, the Hermansky-Pudlak syndrome, in two young Puerto Rican patients, a 17-year-old boy and a 9-year-old girl. Wide variation in pigmentation may obscure the diagnosis of albinism. Puerto Rican albinos are at increased risk of inheriting this autosomal recessive syndrome. Although usually mild, bleeding in affected patients can be life-threatening, especially after aspirin administration. Albino patients should be questioned about a history of bleeding and referred for hematologic consultation.

Adolescent↗
PubMed1981

Nonspecific enhancement of host defenses against infection: experimental evidence of a new order of efficacy and safety.

Enhancement of nonspecific host defenses against bacterial challenge has been a long-standing goal often thwarted by variable efficacy, inconsistent bioassay, and paradoxic immunosuppression. Muramyl dipeptide provides enhanced survival after intravenous challenge with less than 8 x 10(3) Klebsiella, as well as improved local control of infection at sites of intramuscular bacterial injection, with and without a surgical foreign body. No depression of host response was seen over wide ranges of doses and intervals. Muramyl dipeptide provides a new order of efficacy and safety and warrants continued careful assessment.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1977

Cutting-aspiration instruments.

Cutting-aspiration instruments are discussed in relation to design and principles of action. Experience with the Roto-extractor in over 100 cases is reviewed. Large pupillary openings were achieved in nearly all cases. No vitreous was attached to the wound postoperatively. Retinal detachment has not occurred to date in nontraumatic lenticular opacities.

Adolescent↗
PubMed1975

The roto-extractor in pediatric ophthalmology.

The Roto-Extractor, designed by Nicholas Douvas, M.D., was used by the authors in 66 eyes for cataracts, secondary membranes, and persistent hyperplastic primary vitreous. The average age of the patients with congenital cataracts was 2.4 years, for traumatic cataracts 16.4 years. The pupil wal cleared well in 63 of these eyes. There was no vitreous to the wound in any of the eyes. Unplanned iridectomies and prolonged inflammation were the major complications.

Adolescent↗
PubMedDate not supplied

Infantile endogenous Candida endophthalmitis presenting as a cataract.

The most common pathogen to cause endogenous endophthalmitis is the fungus Candida albicans. Most cases involve adults who are either immunosuppressed or have a history of repeated or prolonged extracorporeal access to their circulatory system. Endogenous Candida endophthalmitis can occur in infants as well, particularly when prematurity, broad spectrum antibiotic therapy, or prior surgery are present as predisposing factors. We report the clinical and histopathological findings of an infant who developed a unilateral, sectoral lens opacity four months after undergoing treatment for disseminated candidiasis. The diagnosis of localized intralenticular fungal abscess with associated endophthalmitis was made via histopathologic examination of the aspirated lens material. Treatment with systemic antifungal agents successfully preserved the eye. In addition, we review and summarize the previously reported cases of Candida endophthalmitis in patients under one year of age.

Amphotericin B↗
PubMedDate not supplied

Treatment options for infected knee arthroplasties.

Twenty-four total knee arthroplasty infections in 23 patients treated over a 9-year period at the University of Texas Medical Branch at Galveston were retrospectively reviewed. Staphylococcus epidermidis was isolated from 11 of 24 and Staphylococcus aureus from eight of 24 knees, respectively. Eleven infections were polymicrobic. Control of infection was obtained in 13 of 13 patients treated initially with resection arthroplasty, and 11 of these were ambulatory at follow-up. Infection was controlled in three of 10 knees treated initially with debridement, and six of these nine patients were ambulatory at follow-up. One patient was initially treated with amputation. Four of four patients treated by resection arthroplasty and then by reimplantation were ambulatory without signs of infection at follow-up. Resection arthroplasty reliably controls infection but produces a painful unstable joint that requires brace support or subsequent surgery for pain-free ambulation. Reimplantation in selected patients offers the best chance for pain-free ambulation.

Adult↗
PubMedDate not supplied

A new rationale for the management of large angle esotropia.

It is not only possible but safe to exceed the traditional 5 mm maximum recession of each medial rectus muscle to correct large angle esotropia. It is possible to grade the amount of recession to the preoperative deviation, similar to that which is done for esotropia less than 35 prism diopters. The results of this series indicate that alignment to within 10 prism diopters with one procedure is more likely by large recessions of the medial rectus than by other approaches. If a reoperation is necessary, there still remain two other untouched horizontal muscles on which to operate.

Child↗
PubMedDate not supplied

Surgery of large angle exotropia.

In summary, 22 patients have been presented who have undergone lateral rectus recessions ranging from 8 to 14 millimeters. The overall cosmetic success rate (plus or minus 15 diopters of orthophoria) was 77%. Eight of these patients had unilateral recession-resection procedures. Surgically created incomitance ranged from 3 millimeters to 6 millimeters and correlated only poorly with the amount of surgery performed. None of the patients complained of cosmetic or symptomatic effects of the lateral incomitancy induced. We have restricted surgery of the large angle exotrope to a single, two-muscle procedure, thereby decreasing patient morbidity. It is therefore our recommendation that surgery for large angle exotropia be restricted to two horizontal muscles.

Adolescent↗
PubMedDate not supplied

Development of monofixation syndrome in congenital esotropia.

Fifty patients with 8 prism diopters or less of esotropia after the last surgery were studied. Forty-nine percent of those straightened before 12 months of age and 41% of those straightened between 13-24 months developed the M.S. Only one of 22 patients straightened after the age of two developed the M.S. Although D.V.D and overaction of the inferior oblique muscles were associated findings, neither precluded the development of the M.S. Those patients without M.S. had a higher incidence of subsequent exotropia and manifest D.V.D.

Age Factors↗
PubMedDate not supplied

Development of monofixation syndrome in congenital esotropia.

Fifty patients with 8 prism diopters or less of esotropia after the last surgery were studied. Forty-nine percent of those straightened before 12 months of age and 41% of those straightened between 13-24 months developed the M.S. Only one of the 22 patients straightened after the age of two developed the M.S. Although D.V.D. and overaction of the inferior oblique muscles were associated findings, neither precluded the development of the M.S. Those patients without M.S. had a higher incidence of subsequent exotropia and manifest D.V.D.

Adolescent↗
PubMedDate not supplied

Safety evaluation of BSS plus in pediatric intraocular surgery.

An open-label study was conducted to determine the safety of a new intraocular irrigating solution, BSS Plus, when used during pediatric ophthalmic surgery. BBS Plus is a modified glutathione-bicarbonate-Ringer's solution which contains the necessary ions, buffers, and substrates for maintenance of normal cellular metabolism, function, and structural integrity when used as a perfusate during ophthalmic surgical procedures. At three centers, 30 patients undergoing lens aspiration or anterior segment reconstruction using vitrectomy instrumentation were enrolled in this study. Transient postoperative increases in intracellular pressure and internal or external ocular inflammatory signs were seen which were consistent with the trauma produced by the surgical procedure. The solution was judged to be safe when used in these surgical indications.

Adolescent↗
PubMedDate not supplied

Recurrent esotropia following early successful surgical correction of congenital esotropia.

A study was conducted using a group of congenital esotropes who had an adequate surgical alignment prior to 18 months of age, to determine how many of them would redevelop esotropia. In the group that redeveloped the condition, a high percentage of the esotropia was accommodative in nature and was therefore able to be corrected with spectacles. Both the initial refractive error and changes in refractive error were noted to be significant. This study emphasizes the importance of monitoring the refractive state continuously, especially in children with subnormal fusion.

Accommodation, Ocular↗
PubMedDate not supplied

Extended wear contact lenses in pediatric aphakia.

A 100% silicone polymer contact lens can be used successfully for extended wear in pediatric aphakia. Compared to a hydrogel extended wear contact lens, the silicone lens has several advantages. These include easier handling, a less traumatic fitting procedure for the child, fluorescein use for evaluation of the lens-cornea relationship and a lower loss rate. Bacterial and preservative contamination are minimized due to the lower water content. The silicone lens appears to be safe, having no permanent adverse effects on the cornea. It would be more advantageous if the lens could be obtained in higher plus powers; however, the available power (up to +32.00D) is appropriate in almost all cases.

Aphakia↗
PubMedDate not supplied

Prosthetic treatment of severe microphthalmos in infancy.

Four infants with blind, severely microphthalmic eyes have been treated with cosmetic scleral shells. Through periodic refitting, this method has permitted the development of symmetrical ocular appearance without the need for surgery. We recommend that this treatment be initiated in early infancy in appropriate patients.

Child↗