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Biomedical subjects

M L Lewis

Publications and source records attributed to M L Lewis.

At least 91 records · Page 5Linked to original sources
PubMed1982

The acute retinal necrosis syndrome. Part 1: Clinical manifestations.

The acute retinal necrosis syndrome is characterized by necrotizing retinitis, vitritis, and retinal vasculitis occurring in otherwise healthy patients. Experience with 11 cases and the review of 30 additional cases in the literature are presented. In this series, 50% of the affected eyes developed retinal detachments, and 64% had a final visual acuity of less than 20/200. The natural history, diagnosis, postulated etiology, and suggestions for management will be discussed.

Acute Disease↗
PubMed1981

The use of objectively scorable House-Tree-Person indicators to establish child abuse.

Conducted a study to determine whether the House-Tree-Person Test might be used as a means to identify physically abused children. Protocols of 32 abused children, 32 nonabused but disturbed children, and 45 apparently very well-adjusted children were examined for the presence of 15 objectively scorable items that emerged as good potential discriminators from a pilot study of 60 children. Results of several statistical analyses indicated (a) that items taken individually discriminate strongly between abused and well-adjusted children, but not between abused and nonabused but disturbed children; and (b) that items used collectively, specifically a 6-item test that comprised the 6 most discriminating individual items, discriminate reasonably well between abused children and both of the other two groups. Based on these results, this 6-item test is proposed for use by child care professionals in attempting to identify abused children.

Child↗
PubMed1980

Follow-up study of presumed ocular histoplasmosis syndrome.

One hundred and sixty-two patients with presumed ocular histoplasmosis syndrome were evaluated. New macular scars not present on initial angiogram developed in 9% of eyes. The risk of developing a symptomatic macular lesion in eyes with asymptomatic macular scars was 23%. In eyes with peripapillary scarring, 3.8% developed a peripapillary neovascular membrane. Follow-up was 5.5 years. When the neovascular membrane was touching or outside the foveal avascular zone, the difference between photocoagulated and control eyes was not statistically significant. When only adequately photocoagulated eyes (20) were compared with control eyes (40), the difference was statistically significant (P = 0.04).

Adolescent↗
PubMed1980

Coexisting central serous choroidopathy and retinitis pigmentosa.

A 30-year-old woman with funduscopic and electrophysiologic findings of retinitis pigmentosa had in addition several asymptomatic serous detachments of the retinal pigment epithelium. She later had a typical serous detachment of the sensory retina which was recurrent, and finally required argon laser therapy.

Adult↗
PubMed1978

Iris fluorescein angiography in diabetic vitrectomy patients.

Preoperative iris fluorescein angiograms (IFA) and ophthalmic records of 34 diabetic patients who underwent vitrectomy were reviewed. Of 2 patients without clinically apparent rubeosis, 23 showed evidence of iris microvascular abnormalities or rubeosis on IFA. Patients with rubeosis (Grades III and IV) on IFA had a 63% incidence of postoperative neovascular glaucoma, thus isolating them as a high risk group. The visual outcome of patients developing neovascular glaucoma was poor.

Diabetic Retinopathy↗
PubMed1978

Sympathetic uveitis after trauma and vitrectomy.

A case is describes in which the earliest clinical manifestations of sympathetic uveitis that occurred after trauma and pars plana vitrectomy were confined primarily to the retina, retinal pigment epithelium, and choroid posteriorly, and resembled focal lesions of acute posterior multifocal placoid pigment epitheliopathy. Similar focal lesions were noted on gross examination of the enucleated inciting eye. Histopathological examination revealed that these lesions were caused by focal choroidal granulomas and overlying Dalen-Fuchs nodules. Sympathetic ophthalmia was also noted in four other patients in whom the condition developed after trauma and vitrectomy.

Adult↗
PubMed1978

Idiopathic serous detachment of the retinal pigment epithelium.

Twenty-one patients under age 55 had idiopathic serous detachments of the retinal pigment epithelium (rpe) one-fifth disc diameter or larger in size. In the absence of other choroidal diseases, such as senile mascular degeneration, presumed ocular histoplasmosis syndrome, or anglioid streaks, serous RPE detachments have a good prognosis and probably are a variant of idiopathic central serous choroidopathy. The presence of associated subretinal fluid involving the macula was the factor that had the most effect on visual acuity. Serous detachments of the RPE should be distinguished from multiple vitelliform lesions (a variant of vitelliform dystrophy).

Adult↗
PubMed1978

Behavior of the human pulmonary circulation during head-up tilt.

Pulmonary blood volume (PBV), flow, and pressures were measured in 15 cardiopulmonary normal subjects, while supine and at 60 degrees head-up passive tilt. PBV, cardiac index (CI), right ventricular diastolic volume (VDVR), and mean pulmonary arterial (Ppa), venous (Pv), and mean right atrial (Pra) pressures all decreased during the first 4 min of tilting, with little subsequent change thereafter, to 30 min. Relative changes of CI, PBV, and VDVR were of similar magnitude (25--30%; mean Ppa and Pv fell 3.2 and 2.3 Torr, respectively. From measurements of thoracic dimensions and changes in intravascular pressures, we calculate that 11% of the pulmonary vascular bed falls into zone I condition, 34% goes from zone III to zone II, and 55% remains in zone III condition during tilt. A highly significant correlation exists between PBV and CI (P less than 0.001), with no significant change in pulmonary mean transit time during tilt. Significant correlations also exist between PBV and Pra (P less than 0.001), Pv (P less than 0.01), and Ppa (P less than 0.05). We conclude that outflow pressure plays a significant role in determining PBV during head-up tilt, but the major determinant is venous return to the right heart.

Adult↗
PubMed1976

Pathophysiological response of the blood coagulation system in acute glomerulonephritis.

A new procedure, plasma fibrinogen chromatography, has been utilized, together with other blood coagulation assays, to quantify fibrin formation in 43 children with acute poststreptococcal glomerulonephritis (AGN) from the time of hospitalization until recovery. During the prediuretic phase of AGN, significant evidence for substantial increase in fibrin formation (intravascular coagulation) included gross increase in plasma high molecular weight fibrinogen complexes (HMWFC), the development of either hypo- or hyperfibrinogenemia and gross depression of coagulation factor XIII concentration and of alpha2-macroglobulin concentration. During the diuretic phase of the disease, these abnormalities regressed and evidence of enhanced plasma fibrinolytic activity, documented by an increase in fibrinogen first derivative, was detected. Concomitantly, urinary excretion of fibrin(ogen) degradation products (FDP) underwent substantial increase. With disease recovery, which occurred in all children, urinary FDP excretion ceased and all coagulation findings normalized.

Acute Disease↗
PubMed1975

Laser iridotomy for aphakic pupillary block.

In six patients with aphakic pupillary block, argon laser produced full-thickness iridotomies that succeeded in restoring anterior chamber and intraocular pressure to normal. In one case, it was shown that location of iridotomy is important in determining whether or not iridotomy will succeed in relieving aphakic pupillary block. In two cases, pupillary block had resulted in shallowing of the anterior chamber without pressure elevation. Cases reported here show that continuous laser energy, such as from an argon laser, can produce a full-thickness opening, in contrast to the short duration pulse of the ruby, which will destroy only pigmented structures without producing a full-thickness iris opening. This need to produce some degree of spread of damage to unpigmented tissue elements in order to achieve and iris opening is a problem in phakic patients where injury to the lens must be avoided.

Aged↗