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Biomedical subjects

J J Dutton

Publications and source records attributed to J J Dutton.

At least 55 records · Page 3Linked to original sources
PubMed1986

Orbital complications of paranasal sinus surgery.

Despite the low complication rate from surgery of the paranasal sinuses, orbital injury may be seen in up to 3% of all procedures. These complications include orbital edema, orbital hemorrhage, enophthalmos, extraocular muscle injury, and nasolacrimal duct obstruction. The most devastating complication is blindness, usually resulting from optic nerve compression with central retinal artery occlusion, or direct injury to the nerve itself. Early recognition of orbital injury during sinus surgery and appropriate intervention may prevent later, more serious ophthalmic complications.

Adult↗
PubMed1985

Idiopathic inflammatory perioptic neuritis simulating optic nerve sheath meningioma.

Between 1976 and 1982, we examined 13 patients with clinical and radiographic findings consistent with optic nerve sheath meningioma. All patients had visual loss, evidence of optic nerve dysfunction, centrocecal visual field defects, and echographic and computed tomographic evidence of optic nerve or sheath enlargement. All underwent surgery for biopsy or excision of their presumed tumors. However, adequate histologic sampling of all lesions failed to demonstrate meningioma in four patients; two of these four showed inflammatory infiltration of the dural sheath, whereas the other two showed only edematous or dense fibrous tissue. There was no evidence of other systemic disease in any of these cases. We conclude that optic nerve or sheath enlargement, probably induced by an idiopathic inflammatory perioptic neuritis, may simulate a sheath meningioma. Proper diagnosis requires biopsy confirmation.

Adult↗
PubMed1985

Surgical management of floppy eyelid syndrome.

Four patients (five eyes) with the classic findings of floppy eyelid syndrome all had chronic irritative symptoms, with papillary conjunctivitis, and a soft, rubbery, floppy, and easily everted upper eyelid. All affected eyes were treated surgically by a full-thickness eyelid shortening procedure which produced immediate relief of symptoms. Histopathologic study of the resected eyelids showed only an inflammatory infiltrate in the conjunctiva, but failed to identify specific cause for the lax tarsus.

Blepharitis↗
PubMed1985

Treatment of blepharospasm with botulinum toxin.

In 43 patients (81 eyes) with blepharospasm resistant to other forms of therapy, 149 outpatient injections of botulinum A toxin were given into the orbicularis oculi muscle. Subsequent follow-up periods ranged from ten to 210 days. Orbicularis oculi spasm, eyelid forced closure, and eyebrow spasm all decreased substantially over the first ten days following the initial injection. Patients with essential blepharospasm, hemifacial spasm, or previous surgery all responded in a similar fashion. This beneficial effect was transient, however, and additional treatment was required for sustained relief. Twenty-five patients received multiple injections with a mean interval of 65 days. Results of second and third injections were similar to the first in rapidity of onset and duration of effect. Complications were local, mild, and transient, and no systemic side effects were noted.

Adult↗
PubMed1985

A respiratory epithelial choristomatous cyst of the orbit.

A 23-year-old woman presented with a 19-year history of unilateral, intermittently painful, slowly progressive proptosis. Clinical examination disclosed decreased orbital resiliency and choroidal folds in the posterior pole. Orbital echography revealed an acoustically empty cystic lesion superotemporally. Computerized tomography demonstrated bony molding of the adjacent lateral orbital wall. At operation, a discrete, well-encapsulated mass was found adherent to the periorbita behind the lacrimal gland and extending into the muscle cone. There was no connection with the bony orbit. Histological examination disclosed the well-encapsulated cyst to be lined by pseudostratified ciliated columnar epithelium with goblet cells and filled with mucoid debris. We postulate that the cyst arose from respiratory epithelium sequestered during the intrauterine development of the paranasal sinuses.

Adult↗
PubMed1984

Hematoporphyrin photoradiation therapy for intraocular and orbital malignant melanoma.

Photoradiation therapy (PRT) is a new technique that is currently under investigation for the treatment of a variety of solid malignant tumors. The technique involves systemic administration of hematoporphyrin derivative (HpD), a photosensitizing compound that is preferentially retained by malignant cells and photoactivation of the neoplasm with red light (630 nm) to achieve selective destruction of cancer cells. We used HpD PRT for seven patients with malignant melanoma of the uvea and conclude that initial results of HpD PRT for uveal malignant melanoma are encouraging and justify further investigation.

Eye Neoplasms↗
PubMed1984

Orbital malignant melanoma and oculodermal melanocytosis: report of two cases and review of the literature.

Oculodermal melanocytosis is a congenital melanoblastic hamartoma affecting ocular tissues and facial skin. It is seen more commonly in oriental and black patients. Malignant degeneration, once believed to be rare in this syndrome, occurs in 4.6% of all reported cases, and is more frequent in whites. The actual incidence of malignant melanoma in this syndrome is difficult to determine as many uncomplicated cases go unreported. The most common site of malignant melanoma associated with this entity is in the choroid. Four previously described orbital tumors represent the second most frequent area of presentation. A review of the literature in this disease is discussed as well as a new case of orbital malignant melanoma associated with it. A second case of presumed orbital melanoma associated with oculodermal melanocytosis is also discussed.

Adolescent↗
PubMed1984

Combined surgery and cryotherapy for scleral invasion of epithelial malignancies.

Three patients with epithelial malignancies of the ocular adnexa, a basal cell carcinoma, a squamous cell carcinoma, and a malignant melanoma, are presented. All three had invasive tumors with scleral involvement. In an attempt to preserve the globe, treatment consisted of local surgical excision without lamellar or full thickness sclerectomy , followed by cryotherapy utilizing a double cycle freeze-thaw- refreeze technique to the underlying scleral bed and areas of suspected residual tumor. All three patients have been followed from 24 to 37 months without change in their initial visual acuity and without clinical recurrence of tumor. Although this combined surgical and cryosurgical approach cannot be advocated as a primary mode of therapy, it may offer a useful alternative to enucleation or exenteration in selected patients with ocular invasion of tumor in whom more radical surgery may be visually incapacitating or not otherwise feasible.

Aged↗
PubMed1983

Anterior ischemic optic neuropathy of the young.

Anterior ischemic optic neuropathy is a well-recognized syndrome usually occurring in an older adult population. It is unusual for these patients to experience a second attack in an eye already affected. We describe three young patients with anterior ischemic optic neuropathy who have experienced repeat attacks in one or both eyes, leaving the patients severely disabled, without evidence of other ocular or systemic disease. We believe they may represent a new, but rare, syndrome.

Adult↗
PubMed1983

Compressive optic neuropathy following use of intracranial oxidized cellulose hemostat.

A 35-year-old white male sustained head injuries in a motor vehicle accident. He underwent neurosurgical repair of a frontotemporal skull fracture and lacerated left frontal lobe; regenerated oxidized cellulose (Surgicel) was placed into the anterior cranial fossa for hemostasis. Forty-eight hours after surgery he suffered rapid deterioration of vision to no light perception from optic nerve compression. Radiologic and echographic evaluation demonstrated a subperiosteal soft tissue density in the orbital apex consistent with hematoma. At surgery for optic canal decompression, the cellulose hemostat was found in the apex of the left orbit, having migrated through orbital roof fractures, and had apparently caused the compressive optic neuropathy. Decompression resulted in return of vision to the level of counting fingers.

Adult↗
PubMed1982

Autoimmune retrobulbar optic neuritis.

Three patients, all women, ranging in age from 26 to 44 years, had acute retrobulbar neuritis and laboratory evidence of a collagen vascular disorder. These patients were treated with intravenously administered "pulse" methylprednisolone, and visual acuity recovered in three of four involved eyes. Continued oral administration of prednisone and other immunosuppressive drugs was necessary to maintain vision.

Adult↗
PubMed1982

Evaluation of the suprasellar cistern by computed tomography.

The normal suprasellar cistern is a five- or six-pointed, starshaped, fluid-filled structure as demonstrated by computerized axial tomography (CAT). At various levels the normal suprasellar cistern contains the major intracranial vessels and their anastomotic channels, the optic nerves, chiasm, and infundibular stalk. The existence of lesions, either intrinsic structures of or extrinsic structures contiguous to the suprasellar cistern can be detected by their effect on the normal anatomy of the suprasellar cistern or by filling defects produced when studied with metrizamide cisternography.

Brain↗
PubMed1981

Transport and metabolism of pyridoxine in rabbit iris--ciliary body.

Isolated rabbit iris--ciliary body preparations were found to accumulate 3H-pyridoxine by a mechanism that was time- and temperature-dependent, saturable in part, but not altered by omission of oxygen or specific ions. Tissue accumulation was only partially energy-dependent, and metabolic inhibitors had only small effects. Other B6 vitamers markedly blocked accumulation. Metabolism of 3H-pyridoxine within the tissue was extensive. After 60 min incubation with 3H-pyridoxine, about 65% of the radioactivity in the iris--ciliary body was associated with phosphorylated vitamers which did not efflux from the tissue as readily as did the nonphosphorylated forms. Unaltered pyridoxine accounted for only 16% of intracellular 3H-B6, and this did not represent accumulation against a concentration gradient. A similar saturable uptake process occurred in vivo. These data were consistent with the hypothesis that pyridoxine was accumulated by facilitated diffusion with intracellular trapping of phosphorylated metabolites.

Animals↗
PubMed1980

Fluorophotometry and the blood-ocular barrier in experimental systemic hypertension.

Fluorophotometry was used to evaluate alterations in the blood-ocular barrier to fluorescein in rats with experimental hypertension. One hour after intravenous injection of fluorescein, 16.6 mg/kg, concentrations in the anterior chamber were increased from mean normotensive values of 135 micrograms/mL to 299 micrograms/mL (P = .005) in animals with severe hypertension. Fluorescein concentrations in the vitreous also were increased from 50 micrograms/mL in normotensive rats to 109 micrograms/mL (P = .005) in hypertensive animals. With increasing duration of systemic pressures above 160 mm Hg, anterior chamber fluorescein concentrations rose from base-line of 135 micrograms/mL to 210 micrograms/mL after one to four weeks of hypertension, and to 394 micrograms/mL after five to eight weeks (P = .005). Similarly, vitreous concentrations increased from baseline of 50 micrograms/mL to 76 micrgrams/mL and 136 micrograms/mL (P = .005) after the shorter and longer periods of hypertension. Control of hypertension with return of systolic pressure to below 120 mm Hg caused a reversal of the abnormal fluorescein permeability.

Animals↗
PubMed1978

Sigmoidoscopy as a periodic screening test.

Available data suggest that routine screening procedures and removal of benign adenomatous polyps in all asymptomatic patients over the age of 40 to 50 years may significantly reduce both mortality and morbidity rates for colorectal carcinoma. Such data show that sigmoidoscopy is a valuable part of any screening program and can be performed at low cost and with minimal risk to the patient. It is concluded that an adequate routine screening program can be achieved with annual stool guaiac examination and sigmoidoscopy every five years between ages 40 and 50, and every three years over the age of 50 in asymptomatic patients. All patients with a history of colonic lesions must be seen more frequently because of the higher risk of recurrence.

Adult↗
PubMedDate not supplied

Management of blow-out fractures of the orbital floor.

The management of orbital fractures has long been controversial. In some cases, surgical repair is required, and early repair is more successful than secondary reconstruction. In other cases, slow resolution of diplopia over four to six months obviates surgery. In an editorial and two separate articles, the authors elucidate indications for and results of the early vs. late surgical repair of orbital blow-out fractures.

Humans↗