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Biomedical subjects

J Murube

Publications and source records attributed to J Murube.

At least 19 recordsLinked to original sources
PubMed2002

[Impression cytology contribution to differential diagnosis of Sjögren syndrome in the ophthalmological clinic].

PURPOSE: First, to assess the use of impression cytology, clinical and laboratory tests in the daily clinic for the early diagnosis of Primary Sjögren Syndrome (SS1), and second, to establish morphological differences between SS1, keratoconjunctivitis sicca (KCS) and healthy controls using impression cytology. MATERIAL AND METHOD: The study comprised 35 patients suffering from primary Sjögren syndrome, same number of patients with keratoconjunctivitis sicca and normal healthy subjects. All groups underwent clinical tests (Schirmer's test, break-up time, and bengal rose staining), laboratory tests (tear protein pattern, tear osmolarity and serum immunoglobulin readings), and impression cytology on different areas of the conjunctiva and cornea. RESULTS: All patients presented one or more subjective symptoms of ocular irritation although seeming normal at naked eye. Two patients with Sjögren's syndrome showed total corneal keratinization. Clinical and laboratory tests did not show significant differences between Sjögren's syndrome patients group and keratoconjunctivitis group. Serum tests of antibodies and immunoglobulins did present diagnostic values. Impression cytology showed significant differences between Sjögren syndrome patients compared to the rest of groups with regard to epithelial and goblet cells. CONCLUSIONS: Impression cytology consists in a hystopathological test and it is considered the only ophtalmological test that offers a differential diagnosis in Sjögren's syndrome and should be included in a classification criteria. Inpression cytology presents significant differences between Sjögren syndrome and keratoconjunctivitis sicca.

Adult↗
PubMed2001

[Histopathological and immunohistochemical study of the ocular cicatricial pemphigoid].

OBJECTIVE: To study the relationship between the histopathological alterations and the clinical severity grade in the first phases of the ocular cicatricial pemphigoid to facilitate early diagnosis of the disease and initiate treatment as early as possible. MATERIAL AND METHODS: We have studied 10 patients with different clinical grades of severity (3 patients with grade I; 4 patients with grade II; 2 patients with grade III, and 1 patient with grade IV). For these patients, full ophthalmologic examinations were performed [clinical, laboratory tests, impression cytology, ultrastructural study, study of direct (IFd) and indirect immunofluorescence (IFi). RESULTS: The different techniques used have enabled us to observe the diminution of goblet cells, the initiation of subepithelial bullae, separation of epithelial basement membrane, increase and disorganization of collagen fibers, increase in the number of desmosomes, decrease in the number of hemidesmosones, increase in the intraepithelial fibrillar materials and the presence of immunoglobulin deposits and complement in the basement membrane of these patients in the early phases of the disease. CONCLUSION: The techniques used in this study have enabled us to make an earlier diagnosis of the disease, since it manifests the eye dryness immediately and the posterior biopsy can confirm the differential diagnosis.

Eye Diseases↗
PubMed2001

[Comparison of 2 lacrimal punctal occlusion methods].

PURPOSE: To study and compare two methods for canalicular occlusion: Cautery and Punctal Patch. METHOD: The study included fourty patients divided in two groups of 20 patients. The end point was 4 occluded puncti. The first group underwent deep cauterization resulting in occlusion of the full vertical aspect of the canaliculus. The second group underwent punctal patch technique for canalicular occlusion. Differential parameters were the following: time of intervention, ease of use, risks and precision. In the post operatory, discomfort, subjective and objective improvement in ocular surface as well as long term result of each technique was analysed. RESULTS: Time of intervention was longer for punctal patch compared to cautery. Both methods exhibited similar ease of use and improvement in ocular surface. Precision was high in punctal patch technique showing complete and final occlusion and no punctum needed reopening, while cautery technique presented 20% rate of reopening intervention. Postoperatory discomfort and irritation were remarkably evident with punctal technique, while minimal in cautery technique. CONCLUSION: Survival analysis after one year follow up, showed a higher rate of advantages for punctal patch technique over cautery technique.

Aged↗
PubMed1999

Audible pops during cyclodiode procedures.

PURPOSE: This study was conducted to determine the incidence of intraocular uveal microexplosions ("pops") during contact diode laser transscleral cyclophotocoagulation (cyclodiode) and to analyze the influence of pop occurrence on results and postoperative complications. METHODS: Cyclodiode treatment (1.5-2 W x 2 seconds over 270 degrees) was performed in 43 consecutive patients (43 eyes) with uncontrolled glaucoma who had not undergone previous ciliary ablation. Mean duration of follow-up evaluation was 12.7 months (range, 9-18 months). These eyes included 31 seeing eyes, in which intraocular pressure (IOP) reduction was indicated to preserve visual acuity (therapeutic group) and 12 blind eyes, in which IOP reduction was advisable to relieve pain (palliative group). Success was defined as a final IOP > or = 5 mmHg and < or = 21 mmHg in seeing eyes, and as the resolution of pain in blind eyes. Potential factors evaluated for intraoperative pop occurrence included patient age, gender, iris color, glaucoma diagnosis, preoperative IOP, and number of previous surgical procedures used to treat glaucoma. RESULTS: In the group receiving therapeutic treatment, mean +/- standard deviation (SD) IOP was 41.8 +/- 12.7 mmHg before surgery and 19.2 +/- 8.3 mmHg after surgery; the success rate in this group was 83.9%. In the group receiving palliative treatment, mean IOP was 55.4 +/- 13.7 mmHg before surgery and 21.1 +/- 13.4 mmHg after surgery; success rate was 83.3% in this group. Intraoperative microdisruptions occurred in 48.8% of the cases during the first laser application; 67.5% of these occurred in the superior half of the eye. No significant difference in rate of intraoperative pop was observed between patients after one cyclodiode session and those eyes that underwent additional sessions. Mean baseline IOP was significantly higher in patients with intraoperative occurrence of pops. An audible pop was more common in the group undergoing palliative treatment. Intraoperative occurrence of pops was associated with a greater severity of postoperative iridocyclitis. All patients with postoperative hyphema also had pops during surgery. No significant difference in the success rate was found between patients in whom intraoperative pops did and did not occur. CONCLUSION: Choroidal vaporization is significantly more common in patients with higher baseline IOP. Occurrence of pops also is associated with more severe postoperative inflammation and with a greater risk of postoperative hyphema.

Aged↗
PubMed1997

Horner syndrome as an isolated manifestation of an intrapetrous internal carotid artery dissection.

PURPOSE: To describe the atypical localization and unusual clinical manifestation of an internal carotid artery dissection. METHODS: We examined a 43-year-old woman who had sudden onset of left ptosis and miosis with vague dysesthesia around her eye. RESULTS: Her examination showed an intrapetrous carotid artery dissection. CONCLUSIONS: The intrapetrous segment is an extremely rare localization for an internal carotid artery dissection. The differential diagnosis of acute Horner syndrome should include carotid dissection, which is usually accompanied by other neurologic manifestations.

Adult↗
PubMed1995

Ophthalmological tests in patients with keratoconjunctivitis sicca with and without association of primary Sjögren's syndrome.

We compared clinical, laboratory and histological tests in patients with keratoconjuctivities sicca with and without association of primary Sjögren's syndrome. Rosa bengal staining, osmolarity and impression cytology had high specificity and sensitivity for a correct diagnosis of keratoconjunctivitis sicca with and without primary Sjögren's syndrome. Schirmer and breakup time (BUT) tests were not quite as specific or sensitive. Impression cytology was the only ocular test that showed significant differences between the two pathological groups.

Adult↗
PubMed1994

Amylase in mare lacrimale in patients with submandibular salivary gland transplantation to the lacrimal basin.

Six patients with dry eyes of different etiologies underwent transplants of 1.0 to 1.6 ml of submandibular salivary gland tissue, five of them to one eye and one to both eyes. In the four cases in which the transplants survived, the amylase activity in tear fluid sampled from the cisterna lacrimalis (temporal canthal meniscus) had a mean value of 5,147 U/l in contrast with the mean value 943 U/l of the fellow control eyes. In the two eyes in which the transplants failed to survive, the average value was 635 U/l. The small sample size does not enable calculation of statistical significance to the results but suggests that salivary amylase determinations in tear fluid would facilitate assessment of the functional status of the transplanted salivary tissue.

Aged↗
PubMed1994

Previous ocular compression increases intraocular penetration of systemic drugs.

Intraocular drug penetration is dependent upon the physical and chemical characteristics of the drug, the manner of drug administration and the drug's ability to pass through the blood/aqueous barrier. Most systemically administered drugs do not achieve intraocular therapeutic levels. The authors present a new method to increase the intraocular concentration of intravenously administered drugs based on the premise that ocular hypotony by ocular compression produces a temporary break in the blood/aqueous barrier during the period of hypersecretion that follows to regain normal intraocular pressure levels. Vancomycin introduced parenterally was used as the drug model. The right eye of 22 rabbits served as experimental eye, while the left eye served as control. The concentrations of vancomycin in the aqueous humor half an hour after intravenous injection of 40 mg/kg vancomycin in 50 ml of lactated Ringer's solution were as follows: 30.17 +/- 20.68 micrograms/ml in the right (hypotonized) eyes and 4.92 +/- 3.33 micrograms/ml in the left (control) eyes. The difference in drug levels between the two sets of eyes had a high statistical significance at p = 0.001.

Animals↗
PubMedDate not supplied

Treatment of dry eye by blocking the lacrimal canaliculi.

Occlusion of the lacrimal canaliculi improves the objective signs and subjective symptoms of dry eye. In this review, methods of occlusion are classified as surgical, thermal and tamponade. Surgical methods include dacryocystectomy, canalicular ligature, canalicular offset, canalicular excision, transfer of the punctum to dry dock, punctal tarsorrhaphy and punctal patch. Thermal methods include cautery, diathermy and laser burn. Tamponade methods use absorbable inserts of hydroxypropyl cellulose, gelatin, collagen and catgut, and nonabsorbable inserts of silicone (punctum plugs, canalicular plugs), polyethylene, cyanoacrylate, and others. The characteristics of all these methods are analyzed.

Electrocoagulation↗
PubMedDate not supplied

Measuring the lacunar sulci as a new indicator of shrinkage of the ocular surface.

PURPOSE: To present a new indicator that measures the sulci of the lacrimal lake of the eye according to the degrees of ocular abduction at which they vanish. This new approach will help determine the severity and progression of mucosal retraction in ocular surface diseases. METHODS: A total of 181 eyes of 94 healthy persons, 130 eyes of 65 patients with Sjogren's syndrome, and 30 eyes of 15 patients with ocular pemphigoid were examined using the slit lamp. We recorded the vanishing point of the three main lacunar sulci (plico-bulbar, plicocaruncular and dermo-caruncular) while abducting. RESULTS: In healthy persons, the average vanishing points for the first and second lacunar sulci were respectively, 53.20 +/- 12.3 and 54.50 +/- 9.8. In patients with Sjogren's syndrome, 49.53 degrees +/- 10.81 and 53.17 degrees +/- 7.28 and in patients with incipient ocular cicatricial pemphigoid, 42.69 degrees +/- 14.33 and 44.46 degrees +/- 16.85. Statistical significance was p < 0.005. CONCLUSIONS: The lacunar sulci are shallower and vanish sooner in ocular cicatricial pemphigoid and Sjogren syndrome than in normals. Investigating the vanishing point of the lacunar sulci while abducting is useful for grading the shrinkage of the conjunctiva, caruncle and medial canthus.

Adult↗
PubMedDate not supplied

Soft tissue conjunctivo-rhinostomy.

PURPOSE: To evaluate the results of implantation of a tubular prosthesis between the medial palpebral canthus and the nasal fossa, through the soft tissues of the face, in cases of irrecuperable damage of the lacrimal canaliculi. MATERIAL AND METHODS: Fifty eyes with canalicular destruction were operated, placing a silicone and Pyrex tubular prosthesis between the lacrimal caruncle and the nasal vestibulum, running almost vertically through the soft tissues of the face, without osteal perforation. RESULTS: Lacrimal flow was restored in 47 cases. There were three cases of dislocation of the prosthesis, three infections and five papillomata. CONCLUSIONS: Vertical conjunctivo-rhinostomy without osteal perforation is an easy and efficient solution for irrecuperable occluded canaliculi.

Conjunctiva↗
PubMedDate not supplied

Ultrastructural study of the conjunctiva in patients with keratoconjunctivitis sicca not associated with systemic disorders.

PURPOSE: The aim of this work was to evaluate ultrastructural alterations of the conjunctiva during the clinical course of keratoconjunctivitis sicca (KCS), and to detect its earliest and most characteristic morphological changes. METHODS: The conjunctiva was studied in biopsies from 75 patients and 10 controls. Patients were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity and impression cytology. RESULTS: The conjunctiva in these KCS patients showed progressive hyperplasia, hypertrophy and cellular flattening, with diminution of goblet cell density and microvilli. In the severe cases, the epithelial cells lost their organelles, and fibrous material increased. From the early phases of KCS, clear nuclear alterations (indentation, binucleation) were found, but pyknotic nuclei or anucleated cells were only observed in the most severe cases. From the earliest stages to the most severe cases of KCS, decreases in cell membrane interdigitations were observed parallel to increases in the number and size of desmosomes. There were also increases in the number of inflammatory cells. Alterations in blood vessels were only observed in the most severe cases. CONCLUSIONS: Morphological studies alone were able even in the earliest phases of KCS, to detect the squamous metaplasia that progresses from the surface of the epithelium to the connective tissue. This degenerative or adaptative cellular process was characterized mainly by marked proliferation of the cytoskeleton and a general loss of organelles, mitochondria being the least affected.

Biopsy↗
PubMedDate not supplied

The association of conjunctival snake-like chromatin with keratoconjunctivitis SICCA.

PURPOSE: This work describes the snake-like chromatin cells in the conjunctiva of patients with keratoconjunctivitis sicca (KCS), assessing the relationship between tear function parameters and the severity of the disease, and searching for any differential pattern that could lead to early and diagnosis help clarify the etiology of KCS. METHODS: The conjunctiva of 366 eyes from 187 patients with KCS, and 30 eyes from 15 controls, were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity, ferning tests and electrophoresis; they were then studied by impression cytology and electron microscopy. RESULTS: Snake-like chromatin cells, other nuclear changes, and a decreased number of goblet cells were found by impression cytology in different areas of the KCS conjunctiva. The presence of snake-like chromatin was significantly correlated with the severity of the disease. No nuclear changes were found in the control group. CONCLUSIONS: We assume these findings can be attributed to a natural regeneration of conjunctival cells and to resistance to a pathological reaction to KCS.

Adult↗