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Biomedical subjects

L Kessel

Publications and source records attributed to L Kessel.

At least 19 recordsLinked to original sources
PubMed2004

Lens fluorescence and metabolic control in type 1 diabetic patients: a 14 year follow up study.

BACKGROUND/AIMS: In this prospective study the authors followed the post-translational modification of the proteins of the lens of the eye by fluorometry over a period of 14 years in patients with type 1 diabetes mellitus. METHODS: Twenty patients were examined at 6 years (baseline) and 20 years (follow up) after onset of diabetes mellitus. Glycaemic levels were assessed from HbA1c measured at regular intervals from the onset of diabetes mellitus. RESULTS: Lens fluorescence at follow up was significantly related to mean HbA1c during the study period and to lens fluorescence at baseline (p<0.0001). Sixty per cent of the variation in rate of increase in lens fluorescence during the study period was statistically attributable to glycaemia levels. CONCLUSION: The results confirm that the rate of fluorophore accumulation in the lens of adult diabetic patients is increased in proportion to glycaemic control. This parameter alone is, however, not sufficient to explain the entire variation in lens fluorophore accumulation. Consequently, lens fluorescence must be influenced by other factors before initiation and during the study period, and possibly even before onset of diabetes mellitus. The underlying mechanism could be a variation in susceptibility to lens protein denaturation by glycation.

Adult↗
PubMed2002

Lens ageing as an indicator of tissue damage associated with smoking and non-enzymatic glycation--a twin study.

AIMS/HYPOTHESIS: With ageing the long-lived proteins of the human lens undergo denaturation by non-enzymatic glycation. The denaturated proteins are fluorescent, a property that can be assessed in vivo by fluorometry. Our aim was to examine the relative contribution of hereditary and environmental effects on the accumulation of fluorescent compounds in the lens. METHODS: We examined 59 monozygotic and 55 dizygotic healthy twin pairs recruited from a population-based register of twins. Lens autofluorescence was measured on the undilated eye. All subjects underwent an OGTT and information on smoking habits was obtained. The genetic and environmental effects were estimated by structural equation modelling. RESULTS: Lens autofluorescence was related to age (R(2)=53%), current glucose homeostasis (R(2)=10%) and smoking habits (R(2)=10%). After adjusting for these factors, interindividual variation in lens autofluorescence was statistically attributable to hereditary factors by approximately 28% as well as shared environment by 58% and non-shared environment by 14%. The hereditary factor seems not to be linked to a genetic predisposition to diabetes. CONCLUSION/INTERPRETATION: The correlation in lens fluorescence was greater in monozygotic twins than dizygotic twins indicating a genetically predetermined susceptibility for the accumulation of fluorophores in the lens, the relative importance of which was found to increase with age. Since fluorophore formation in the lens is attributable to non-enzymatic glycation our results support that genetic characteristics to some degree determine the susceptibility to glycation related diabetes complications and ageing processes.

Adult↗
PubMed2000

Monofocal outer retinitis associated with hand, foot, and mouth disease caused by coxsackievirus.

PURPOSE: To report symptoms and signs from an otherwise healthy man with photopsia and monofocal outer retinitis occurring 3 days after the onset of hand, foot, and mouth disease. METHOD: Case report. RESULTS: Ophthalmic examination revealed a single circumscribed area of pigment epithelial mottling in the left eye and a corresponding nonarcuate absolute scotoma. Fluorescein angiography demonstrated attenuation of the retinal pigment epithelium. Serologic tests at 1 month after the onset disclosed serum antibody to enterovirus. CONCLUSION: The close association between the cutaneous eruption and the onset of visual symptoms suggests that the retinal lesion was caused by coxsackievirus infection.

Adult↗
PubMed1999

Diabetic versus non-diabetic colour vision after cataract surgery.

AIMS: To examine whether the colour vision abnormalities found in phakic patients with diabetes mellitus is preserved after removal of the lens by cataract surgery. METHODS: 21 diabetic (16 IDDM and five NIDDM) and 19 non-diabetic patients of comparable age, postoperative visual acuity, and sex distribution, all aphakic or pseudophakic following cataract surgery, had their monocular colour vision examined using the Farnsworth-Munsell 100 hue test. The fundus status of the diabetic patients ranged from no retinopathy to photocoagulation treated proliferative diabetic retinopathy. Patients with macular oedema were specifically excluded from the study. RESULTS: The error scores of both the diabetic (mean 146 (SD 94)) and the non-diabetic patients (83 (79)) did not deviate significantly from the age related normal range. The error score in the diabetic group was significantly higher than in the non-diabetic group (p=0.02) but the amplitude of the difference was small in comparison with previous studies of phakic subjects. The error scores in the diabetic group were not correlated with the degree of retinopathy (p>0.2). CONCLUSION: After cataract surgery only a minor difference exists between the colour vision scores of diabetic and non-diabetic patients. This indicates that accelerated yellowing of the lens in diabetes is the predominant cause of the colour vision anomaly found in phakic diabetic patients.

Adult↗
PubMed1990

Sick sinus syndrome cured by ... vitamin D?

I have presented the case of a 77-year-old woman with SSS who was treated unsuccessfully with antiarrhythmic drugs for 5 years. During the fifth year, she developed chronic atrial fibrillation. Two years later she started to take vitamin D for unrelated reasons, and first regained regular sinus rhythm and later stopped having episodes of atrial fibrillation. The patient has been now asymptomatic for over 2 years.

Aged↗
PubMed1986

Arthrography of the shoulder after operative repair of the torn rotator cuff.

Double-contrast shoulder arthrograms were performed in 20 patients at an average of 30 months after operative repair of a torn rotator cuff. In 18 out of 20 shoulders the contrast medium leaked into the subacromial bursa indicating a defect in the rotator cuff. Despite this, 17 patients had complete relief of pain and 15 had a full range of shoulder elevation. The results suggest that a completely watertight closure is not essential for a good functional result, and that arthrography may not be helpful in the investigation of failure of repair.

Adult↗
PubMed1983

Operative treatment of chronic ruptures of the rotator cuff of the shoulder.

The results of 63 operative repairs of chronic tears of the rotator cuff in 61 patients are reviewed retrospectively; the mean follow-up was 32.7 months. Fifty-four patients presented with symptoms of persistent pain and seven patients with gross loss of movement. All the patients had failed to respond to conservative treatment. Results were assessed in terms of relief of pain, restoration of movement, the patients' ability to return to work and whether they were satisfied with the results. Overall, a good result in terms of relief of pain was achieved in 40 shoulders. In 31 shoulders (30 with pain and one without pain) the operation included particular measures to decompress the subacromial space; 26 of the patients achieved relief of pain which was significantly better than in those patients whose operation did not include a decompression. The complications and failures are discussed. It is suggested that operative repair of the chronically torn rotator cuff of the shoulder is a worthwhile operation and that the operation should include an adequate decompression of the subacromial space.

Adult↗
PubMed1980

Disruption of the acromioclavicular joint: surgical anatomy and biological reconstruction.

The pathological anatomy of acromioclavicular joint disruption is discussed in the light of operative findings. A method of repairing the dislocated joint is described using the coraco-acromial ligament and temporary internal fixation. It has been found to be useful in those patients who present late with pain and symptoms of instability.

Acromioclavicular Joint↗
PubMed1977

The painful arc syndrome. Clinical classification as a guide to management.

Ninety-seven patients suffering from painful arc syndrome of the shoulder were studied. Local anaesthetic and radiographic contrast investigations were carried out. One-third of the patients had lesions in the posterior part of the rotator cuff which resolved after injections of local anaesthetic and steroid. One-third had anterior lesions in the subscapularis tendon: almost all resolved under the same regime but two required division of the coraco-acromial ligament. The remaining third had lesions of the supraspinatus tendon, usually associated with degeneration of the acromio-clavicular joint: most of these failed to gain relief from the local anaesthetic and steroid. Twenty-two operations were performed either by a transcromial or by a deltoid splitting approach. Excision of the outer end of the clavicle and division of the coraco-acromial ligament abolished the pain in most cases.

Acromioclavicular Joint↗
PubMed1969

Low back pain.

Explore the source record for details and available documents.

Back Pain↗