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Biomedical subjects

J W Karesh

Publications and source records attributed to J W Karesh.

48 records · Page 3Linked to original sources
PubMed1983

Complications of exposed monofilament sutures.

Exposed monofilament suture ends caused a variety of symptoms and signs in 18 patients. These included foreign-body sensation, pain, contact lens intolerance, giant papillary conjunctivitis, tarsal ulceration, conjunctival granuloma, corneal infiltrate, and corneal vascularization. These changes followed cataract surgery, corneal transplantation, and pars plana vitrectomy. Diagnoses in these cases were made by careful slit-lamp examination and by eversion of the upper eyelid. In every case, removal of the sutures or trimming the suture ends resulted in the immediate relief of all symptoms with complete resolution of all signs within two months.

Adult↗
PubMed1983

Factors associated with glaucoma after penetrating keratoplasty.

We conducted a retrospective analysis of 80 eyes that underwent penetrating keratoplasties to determine the factors associated with early (less than three months) and late (more than three months) postoperative increases in intraocular pressure. The patients ranged in age from 14 to 91 years (mean age, 58.5 years). The 56 patients with aphakic eyes had a mean age of 64 years and the 24 patients whose eyes had lenses had a mean age of 48 years. In the 17 eyes with preoperative glaucoma, the intraocular pressure was controlled with medication (mean intraocular pressure, 17.6 mm Hg; range, 10 to 21 mm Hg). The follow-up periods ranged from 12 to 26 months (mean, 22 months). Of the 80 eyes, 25 had early increases in intraocular pressure and 23 had late increases. Twenty eyes showed increases during both periods. Of the 17 eyes with preoperative glaucoma, 14 had early increases and 15 had late increases (P less than .001). Of the 57 aphakic eyes, 24 had early increases (P less than .001) and 21 had late increases (P less than .025). Other factors (whether vitrectomy was done, suture technique, and graft size) were not statistically significant.

Adolescent↗
PubMed1983

Ongoing prospective clinical study of radial keratotomy.

The ongoing prospective clinical study of radial keratotomy at the University of Maryland now includes 58 eyes of 33 patients. Fifty-two eyes underwent a single operation, whereas six eyes underwent two operations. Follow-up was a minimum of six months and a mean of 19 months. Preoperative vision was 20/400 or less in 74% of eyes. Postoperative vision was 20/40 or better in 48% of eyes. There was an average myopia decrease of 2.70 diopters and an average corneal flattening of 1.51 diopters. Patients with preoperative refractive errors of 5 diopters or less achieved 20/40 or better vision in 65% of eyes, as compared to only 19% in eyes with preoperative refractive errors greater than 5 diopters. This is highly significant (P less than 0.005). There was no difference in the results achieved by our first 33 eyes when compared to our second 25 eyes. The decrease in myopia did not correlate with corneal curvature, or whether 8 or 16 incisions had been used. No microperforations were seen and only one case of endothelial cell loss was observed. Glare and fluctuating vision was not a significant problem in our series.

Adolescent↗
PubMed1983

Herpes simplex virus and congenital malformations.

We have reported a case of transplacentally transmitted herpes simplex virus (HSV) infection in association with both congenital malformations and other serious abnormalities, including facial abnormalities, microcephaly, cerebral atrophy, and microscopic cranial calcifications. Before death, the infant showed marked neurologic deficits, seizures, and respiratory distress. Serum IgM and complement fixing antibodies to HSV were elevated at birth. Light and electron microscopy and immunofluorescence studies confirmed the presence of the virus.

Abnormalities, Multiple↗
PubMed1983

Pseudophakic endophthalmitis.

Two cases of pseudophakic endophthalmitis following extracapsular surgery and insertion of posterior chamber lenses were managed with removal of the lens, vitrectomy, and intravitreal antibiotics. Removal of the intraocular lens, posterior capsule, and associated inflammatory membranes was easily accomplished maintaining a clear cornea, improving fundus visualization, and eliminating a possible source of infection. The rationale and results of this approach are discussed.

Aged↗
PubMed1982

Prospective clinical study of radial keratotomy.

A prospective clinical study of radial keratotomy was conducted at the University of Maryland. Results of surgery on 33 eyes of 19 patients with a minimum follow-up of seven months and a mean of 13.8 months are reported. There were eight patients (15 eyes) who needed adequate unaided visual acuity for occupational purposes. Preoperative visual acuity was 20/400 in 79% of eyes. Postoperative visual acuity was 20/50 or better in 48% of cases. However, in patients with preoperative refractive errors of 5 diopters or less, postoperative visual acuity was 20/50 or better in 84% of cases. Average decrease in myopia was 2.5 diopters. Decrease in myopia following radial keratotomy did not correlate with corneal curvature or whether 8 or 16 incision technique was used. However, there was a very significant (P = 0.001) difference in postoperative visual acuity of patients with refractive error of 5 diopters or less, as compared to those with greater than 5 diopters of myopia. Complications included corneal scarring, vascularization, and glare. No microperforation or endothelial cell loss was observed.

Adolescent↗
PubMed1977

Inhibitory effects of urinary macromolecules on the crystallization of calcium oxalate.

Protective (inhibitory) effects of human urinary macromolecules on the crystallization of calcium oxalate were found when these urinary macromolecules were added to water or to salt solutions, which mimic human urine with respect to the concentrations of the most abundant small molecular weight species. The aspects of calcium oxalate crystallization affected by urinary macromolecules were: (i) an inhibition of nucleation (increased metastable limit), (ii) an inhibition of the crystallization rate, (iii) a decrease in the supersaturation level, and (iv) a decrease in adhesion of crystals to container surfaces.

Calcium↗
PubMedDate not supplied

Periocular granuloma annulare.

A 2-year-old boy presented with a 3-month history of nontender masses involving the right superotemporal orbit and scalp. Over the three-week period before presentation he also developed nodules on his wrist, abdomen, and buttocks. The remainder of the ocular and general physical exam was unremarkable. A biopsy of the right orbital mass demonstrated stellate areas of collagen necrosis surrounded by pallisading epithelioid histiocytes and scattered multinucleated giant cells. Special stains for connective tissue mucin were positive in the areas of necrosis. The diagnosis reached pathologically and clinically were that of pseudorheumatoid nodules and granuloma annulare syndrome respectively. These two diagnostic terms have been used independently in the ophthalmologic and dermatologic literature, despite the identical histologic and clinical behaviors seen by both medical groups. A unified nomenclature system of pseudorheumatoid nodule for the histopathology of an individual lesion and granuloma annulare for the syndrome is suggested.

Biopsy↗
PubMedDate not supplied

Orbital "blow-in" fractures: clinical and CT features.

During a 16 month period, seven patients were admitted to our trauma center with "blow-in" fractures of the orbital roof. This injury results from a significant direct blunt force applied to the supraorbital region of the frontal bone with transmission of energy to the thin orbital plate of this bone and displacement of bone fragments downward into the superior orbit. High resolution CT with multiplanar reformation and three-dimensional display proved very useful in identifying and characterizing the bone and soft tissue abnormalities found in our patients. Our experience suggests that CT demonstration of supraorbital frontal bone fractures and/or frontal lobe cerebral contusions is an indication for thin section CT of the entire orbit, even when there is no evidence of a superior orbital rim fracture. Demonstration of an orbital blow-in fracture should prompt careful clinical assessment of the globe, optic nerve, and extraocular muscles to identify and appropriately manage underlying injuries to these structures.

Adolescent↗