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Biomedical subjects

J L George

Publications and source records attributed to J L George.

At least 19 recordsLinked to original sources
PubMed2002

[Ocular involvement during primary central nervous system lymphoma].

PURPOSE: The aim of our study was to assess and to characterize the ocular involvement in patients with primary central nervous system lymphoma. POPULATION AND METHODS: We conducted a prospective study between August 1995 and December 1998 on a cohort of consecutive patients affected by primary central nervous system lymphoma and who underwent a systematic ophthalmological examination before treatment. RESULTS: The study population comprised 24 patients (mean age, 57 years; 16 women and 8 men). Among these patients, 6 had ocular involvement (2 patients with ocular signs revealing the cerebral process, 2 evidenced at the time of the initial ocular examination, and 1 as the disease evolved). Ocular involvement was vitritis in all cases, anterior uveitis in 1 patient, obliterant vasculitis in 1 patient and yellowish subretinal lesions in 1 patient. In 1 case, a vitrectomy led to adequate diagnosis of the disease. CONCLUSION: Our study shows a 25% incidence of ocular involvement in patients with primary central nervous system lymphoma, with posterior uveitis as the most common manifestation. Because of the relatively high incidence of ocular involvement, a systematic ophthalmological examination of this subset of patients should be mandatory.

Adult↗
PubMed2001

[A full thickness macular hole as an uncommon complication of Behçet disease].

The authors report the occurrence of an unusual complication of Behçet's disease: a full thickness macular hole caused by retinal vasculitis resulting in a definite functional impairment. A review of the different ocular complications is provided, stressing the unusual location on the posterior segment and the potential seriousness of these complications.

Adrenal Cortex Hormones↗
PubMed2001

[Clinical course and prognosis of diplopias after orbital bony wall decompression for thyroid related orbitopathy].

INTRODUCTION: The aim of this study was to assess how oculomotor complications progress after orbital bony decompression for dysthyroid orbitopathy and to assess the residual risk of consecutive diplopia. MATERIAL AND METHODS: The medial orbital wall and floor were decompressed by a transpalpebral approach in 77 patients (117 orbits). Indications for decompression were optic neuropathy in 22 patients, exposure of the cornea in 1 patient, and cosmetic rehabilitation in 54 patients. Occurrence of oculomotor disorder after surgery was noted and the clinical course after a one-year follow-up was studied. RESULTS: Diplopia was observed in 34 patients (44%): 18 of these patients were treated by external orbital radiotherapy before surgery. Diplopia decreased spontaneously over a period ranging from 15 days to 2 months or was treated by adequate prism in 22 cases. A higher degree of diplopia (12 to 30 diopters) was noted in 12 cases, requiring surgical care that was successful in all cases. This progress was especially observed in patients with optic neuropathy or in patients who had been previously treated with external orbital radiotherapy. CONCLUSION: Prognosis of diplopia after bony wall decompression for thyroid-related orbitopathy can be favorable with spontaneous reduction, prism, or surgical treatment. Precise information should be given to the patients before surgery.

Adult↗
PubMed2001

[Gyrate atrophy and craniopharyngioma: a case report].

We report the case of a 13-year-old girl who developed a craniopharyngioma and a gyrate atrophy. No genetic link between these two diseases has ever been reported. This case recalls the characteristic features of gyrate atrophy.

Adolescent↗
PubMed2000

[Exploration of visual memory by functional MRI].

PURPOSE: The aim of our study was to evidence the location of the cortical area triggered by visual memory tasks by he mean of functional magnetic resonance imaging examination (fMRI). METHODS: Twelve healthy volunteers underwent fMRI examination on a 1.5 Tesla magnet with echoplanar imaging sequence during figurative and non-figurative memory tasks. An area was considered to be activated if at least 10 contiguous voxels activation was noted. Activated areas were defined for both tasks and the brain mapping was realized according to Talairach atlas. RESULTS: For all examinations a bilateral activity was evidenced (area 17 and 18). In addition, a frontal activation was also noted in 83% of the cases for both tasks. However, frontal activation was bilateral in 9/10 cases for the figurative task and 6/10 cases for the non-figurative task. CONCLUSION: FMRI was able to evidence activation of cerebral areas during visual memory tasks in all our study cases. Frontal activation was not discriminative of figurative or non figurative memory. This might be probably explain by inappropriate non-figurative tests. FMRI should allow a better knowledge of memory mechanisms as well as an enhancement of functional cerebral mapping before surgery.

Adult↗
PubMed2000

[Melkersson-Rosenthal syndrome: anatomo-clinical and evolutive concepts].

PURPOSE: To inform ophthalmologists about the Melkersson-Rosenthal Syndrome. A new clinical classification is suggested. METHODS: Commented observation and review of the litterature. RESULTS: The presented case is characterized by an exclusive involvement of orbital sphere, due to inflammation of palpebral and orbital fat. CONCLUSION: Melkersson-Rosenthal Syndrome can be divided into type 1 characterized by perioral lesions and type 2 characterized by periocular lesions, with preferential involvement of fat and evolution towards fibrosis.

Adipose Tissue↗
PubMed1999

Place of radiotherapy in the treatment of Graves' orbitopathy.

PURPOSE: The aim of this study is to evaluate the response of Graves' orbitopathy to irradiation, and to specify the prognostic factors allowing one to better define the indications of orbital radiotherapy. METHODS AND MATERIALS: From 1977 to 1996, 199 patients received bilateral orbital irradiation delivering 20 Gy in 10 fractions and 2 weeks for a progressive Graves' orbitopathy. 195 patients were seen between 1 and 6 months after radiotherapy. The different symptoms were studied and their response to radiation was analyzed. Factors such as age, sex, evolution of thyroid disease, history of symptoms, and previous or combined treatments were analyzed. RESULTS: The results revealed that 50 patients (26%) had a good or excellent response, 98 (50%) had a partial response, 37 (19%) were stable, 10 (5%) had a progression of disease. The signs that best responded to radiotherapy were the infiltration of soft tissues and the corneal involvement. Responses of proptosis or oculomotor disorders were more complete when these signs were not advanced at the time of treatment. Irradiation seemed to have the same efficacy when applied as first-line treatment or after failure of corticosteroids. Neither modality of treatment of hyperthyroidism nor thyroid status at the time of orbital irradiation modified the results. The best results were recorded for early or moderately advanced presentation (p = 0.05). Patients treated within a delay of 7 months after the beginning of the ophthalmopathy had better responses than patients treated later (p = 0.10). CONCLUSION: Radiation therapy was successful in Graves' orbitopathy by stopping the progression of disease in almost all cases, by improving the comfort of patients, by obtaining objective responses, and by avoiding surgical treatments particularly when signs were moderate.

Adult↗
PubMed1999

[Complications of transpalpebral osseous orbital decompressions in thyroid orbitopathies].

INTRODUCTION: Complications of bony orbital decompression (BOD) are rather unreported and often neglected. The aim of this study was to assess the risks of this surgery. MATERIAL AND METHODS: 44 patients (76 orbits) were studied. There were 19 malignant orbitopathies and 57 cosmetic rehabilitations. All side-effects and true complications were reported. A questionnaire was send to the patient and to his ophthalmologist. RESULTS: Infra-orbital hypoesthesia, oculomotor disorders, entropion, changes of lid position were the most frequent complications. A case of hypoglobus, a case of lacrimal stenosis, a case of decreased visual acuity were reported. DISCUSSION: Side-effects of BOD are frequent. Higher rates are even found in the literature. These effects tend to decrease spontaneously or can be treated by adequate medical or surgical care. Some measures are proposed to perform surgery safer. CONCLUSION: More precise information should be given to the patients before surgery and a better prevention can be afforded.

Adult↗
PubMed1999

Severity of diabetic retinopathy is linked to lipoprotein (a) in type 1 diabetic patients.

To determine the relationship between plasma Lp(a) concentration and the risk of developing diabetic retinopathy, 341 Type 1 diabetic patients underwent an annual retinal fluorescein angiography and were assigned to one of 3 groups according to the stage of their diabetic retinopathy: no retinopathy (NR), non-proliferative diabetic retinopathy (N-PDR), or proliferative diabetic retinopathy (PDR). One hundred and twenty-three Type 1 diabetic patients had no retinopathy, 188 had N-PDR and 30 had PDR. The ages of the three groups and the duration of diabetes were significantly different. Hypertension, microalbuminuria and diabetic nephropathy were more frequent in PDR than in NR or N-PDR (p < 0.0001). Plasma HbA1c was higher in PDR than in NR or N-PDR (p < 0.01). Type 1 patients who had been diabetic for at least 20 years included 30 NR, 108 N-PDR and 24 PDR. Type 1 diabetic patients with PDR had microalbuminuria and macroproteinuria more frequently than other patients (p < 0.0001 and 0.01, respectively). Type 1 diabetic patients with PDR had the highest median plasma Lp(a) and the highest frequency of Lp(a) above 30 mg/dl (p < 0.05). Multivariate analysis carried out in Type 1 diabetic patients with a duration of diabetes of at least 20 years showed that microproteinuria, HbA1c and Lp(a) accounted significantly for 21% of variance in retinal status. Lp(a) above 30 mg/dl was related to the risk of developing PDR (OR = 8.40, p < 0.05). Lipoprotein(a) appears to be associated with the severity of diabetic retinopathy in Type 1 diabetic patients, and particular attention should be paid to those with Lp(a) above 30 mg/dl and pre-proliferative retinopathy.

Adult↗
PubMed1998

Clinical and scintigraphic comparison of silicone and polyvinylpyrrolidone coated silicone perforated plugs.

BACKGROUND/AIM: Isolated stenosis of the lacrimal punctum is a frequent cause of epiphora. Treatment relies on surgical opening or dilatation with bi- or monocanalicular prosthesis. Recently, silicone perforated punctum plugs (PPP) were proposed. The drawback with these silicone PPP was that secretions accumulate in the central orifice blocking the spontaneous flow of tears. A modification of the surface of the PPP using polyvinylpyrrolidone (PVP) was thus proposed. The aim was to compare silicone PPP with new PVP surface treated PPP. METHODS: A prospective study was conducted of 20 patients with dilatable stenosis of the lacrimal puncta who developed epiphora. Epiphora, tolerance, implantation of the PPP, and lacrimal drainage were evaluated using scintigraphy of the lacrimal ducts. RESULTS: The raw data and statistical analysis showed evidence of a superior performance of PVP surface treated PPP. CONCLUSION: Long term evaluation of the advantages or risks of PVP plugs and comparison with microsurgical punctoplasty are warranted.

Drainage↗
PubMed1998

[Bicanaliculonasal intubation tubes covered with and without polyvinylpyrrolidone. Comparative study].

PURPOSE: To compare the efficacy and tolerance between silicone tube and treated polymer surface (PVP) tube of the bicanalicular intubation. METHODS: A randomized prospective study was performed in 50 patients (coated between March 96 and July 97) with chronic tearing. 25 classic intubations (silicone) and 25 with PVP was used. Intubations were performed for 2 months. Functional signs and objectives parameters at the medial canthus and the nasal mucous membrane were compared. RESULTS: There was no difference about functional signs between the 2 groups of patients. Objective signs (hyperemia, secretions) observed in the medial canthus and the nasal mucous membrane were less pronounced with the treated polymer surface tube. CONCLUSION: This study confirms the great potential of treated polymer surface tube.

Chronic Disease↗
PubMed1997

Anatomic study of the distal supraorbital nerve.

This investigation was designed to extend our present knowledge of the supraorbital n. (SO n.) distal to the supraorbital notch. It is based on 40 dissected hemi-faces and the position of the notch and the periosteal and frontalis cutaneous branches of the SO n. were studied. The notch was 33.05 mm from the midline on the right side and 30.70 mm on the left. The periosteal branch arises from the lateral frontalis cutaneous branch. Its ascends in an oblique direction laterally and ends in two terminal branches. The frontalis cutaneous branch, after a very short trunk, divides into two branches, medial and lateral. The medial or deep branch enters the corrugator supercilii m. between its fibers. Most frequently, it passes under the inferior fasciculus and superficial to the middle and superior ones. Leaving the corrugator m., it ascends medially into the frontalis m., supplying the median cutaneous frontalis region. The lateral or superficial branch crosses superficial to the corrugator supercilii m. to penetrate the frontalis m. in an ascending and lateral direction, supplying the lateral frontalis region. The two branches enter the frontalis m., displaying a zigzag pattern in order to adapt its length during expressive movements. They cross the frontalis region together with the SO a. and two veins supplying the nerve and the frontalis m. These anatomic data may explain some of the complications after surgery for ptosis and blepharospasm.

Aged↗
PubMed1997

[Malignant non-Hodgkin lymphoma of the central nervous system with ocular site. Value of vitrectomy for diagnosis].

Diagnosis of intraocular lymphoma is difficult and should be considered in middle-aged or older patients with a chronic uveitis. Many explorations (lumbar punctures, brain imaging and vitrectomies) may be needed before correct diagnosis is made. We report the case of a 50-year-old woman with an intraocular lymphoma for whom the diagnosis was confirmed by a vitrectomy.

Central Nervous System Neoplasms↗
PubMed1996

[Papilledema and POEMS syndrome. Apropos of a case].

The POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, Skin Changes) is often unrecognized by ophthalmologists. We report the case of a 51-year-old female suffering from a POEMS syndrome with a bilateral optic disc edema.

Female↗
PubMed1996

[Effects of external orbital radiotherapy on the oculomotor muscle in Graves disease].

PURPOSE: Orbital radiotherapy is recognised to be effective in the treatment of acute Graves' disease. The effect on the oculomotor muscles is still controversial. MATERIAL AND METHODS: To assess this effect, we conducted a prospective study on 15 patients with acute Graves' ophthalmopathy. Patients were investigated before radiotherapy, 3 months later and at long term (mean = 2 years). To study the extent of the ophthalmopathy we chose the following criteria: class IV in the NOSPECS classification system, amplitude of gaze, measurement of the thickness of oculomotor muscles (CT-scan). RESULTS: Improvement of the amplitude of gaze and reduction of the thickness of oculomotor muscles were not statistically significant. The oculomotor disorder was unchanged 3 months after radiotherapy. After a long term follow up (mean: 2 years), only 5 patients, among those who complained of diplopia before radiotherapy, had to be operated, especially large deviations. CONCLUSION: Orbital radiotherapy does not appear as a direct treatment for oculomotor disorder in active thyroid related ophthalmopathy, however favorable indirect effects may be effective due to reduction of inflammation. As it is a harmless treatment, orbital radiotherapy may be proposed as primary treatment in active thyroid related ophthalmopathy.

Adult↗