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Biomedical subjects

M Oliver

Publications and source records attributed to M Oliver.

At least 55 records · Page 3Linked to original sources

Syringofibrocarcinoma versus squamous cell carcinoma involving syringofibroadenoma: is there a malignant counterpart of Mascaro's syringofibroadenoma?

Although a benign syringofibroadenoma has been recognized as an eccrine tumor exhibiting net-like ductal proliferation embedded in fibroma-like stroma, a malignant counterpart has not been described heretofore. An 82-year-old man with severely sun-damaged skin had a 3 cm plaque in the dorsum of his left hand. The clinical diagnosis was squamous cell carcinoma. Histologically, the lesion was a bowenoid squamous cell carcinoma, both in situ (Bowen's disease-like) and bluntly invasive, with a concurrent phase showing unequivocal and widespread ductal differentiation, local expression of carcinoembryonic antigen, and sclerotic stroma. This syringofibrocarcinoma also impinged laterally on a mature and benign syringofibroadenoma and occurred above a minute deep dermal trichoepithelioma. This report presents a probably unrecognized new malignant tumor, clearly distinct yet related to both squamous cell carcinoma and eccrine carcinoma. Because its organoid architecture and the resemblance to and impingement on syringofibroadenoma, the term syringofibrocarcinoma is proposed.

Adenoma, Sweat Gland↗

Progression of nonischemic central retinal vein occlusion.

Progression of nonischemic central retinal vein occlusion (CRVO) to ischemic CRVO occurs in up to 5-20% of patients with nonischemic CRVO. Eyes presenting with nonischemic CRVO and exhibiting an increase in intraretinal hemorrhages together with angiographic findings of aggravation of venule wall staining were assumed to be showing early signs of progression. Eight eyes of 7 patients were followed prospectively and when they exhibited signs of progression they were assigned to either follow-up or early laser treatment. Four eyes received grid and early panretinal laser photocoagulation. Three of them showed regression of retinopathy and 1 eye progressed to ischemic CRVO. The other 4 eyes did not receive early panretinal photocoagulation; 2 of them received no laser treatment at all and the other 2 received only grid laser photocoagulation. All of these 4 eyes progressed to ischemic CRVO.

Adult↗

Bilateral papilledema with retinal hemorrhages in association with cerebral venous sinus thrombosis and paroxysmal nocturnal hemoglobinuria.

PURPOSE: To report a patient with paroxysmal nocturnal hemoglobinuria who complained of transient obscurations of vision and exhibited bilateral papilledema with retinal hemorrhages. METHODS: Case report. Computed tomography did not demonstrate any abnormality but magnetic resonance imaging disclosed signs of cerebral venous sinus thrombosis. RESULTS: The patient was treated with subcutaneous low molecular weight heparin and intravenous corticosteroids. Symptoms improved within one week and ophthalmoscopic signs resolved within four months. CONCLUSION: Bilateral papilledema with extensive retinal hemorrhages may be a sign of cerebral venous sinus thrombosis, a reported devastating complication of paroxysmal nocturnal hemoglobinuria. Thus, any patient with suspected cerebral venous sinus thrombosis should undergo magnetic resonance imaging, even when results of computed tomography are normal.

Anticoagulants↗

Age-related macular degeneration after extracapsular cataract extraction with intraocular lens implantation.

PURPOSE: To evaluate the course of age-related maculopathy after cataract surgery. METHODS: Included were 47 patients with bilateral, symmetric, early age-related macular degeneration (AMD), documented by fluorescein angiography, who underwent extracapsular cataract extraction with intraocular lens implantation in one eye. The fellow eye served as the control. The patients were retrospectively reviewed or prospectively followed. RESULTS: Wet AMD developed in nine eyes (19.1%) that were treated with surgery compared with two fellow eyes (4.3%). It was detected within 3 months of surgery in four (44.4%) of the nine affected eyes and within 6 to 12 months of surgery in four other eyes (44.4%). Progression to wet AMD occurred significantly more often in men than in women (P < 0.05). Soft drusen were found as a significant ocular risk factor (P < 0.05). The final visual outcome was poor in all eyes with such progression. CONCLUSIONS: In this study, progression of AMD occurred more often in the surgical eyes compared with the fellow eyes. However, the reasons for the progression of AMD after cataract surgery are still uncertain. Further prospective studies are needed to investigate this observation.

Aged↗

Prophylactic laser photocoagulation in Stickler syndrome.

The ocular manifestations in a family with Stickler syndrome and the results of laser photocoagulation as preventive treatment for retinal detachment are described. Forty-two family members with Stickler syndrome were retrospectively reviewed; 22 had ocular abnormalities, 22 had myopia and 16 had high myopia. Ten patients had developed retinal detachment and 9 of them were blind in one or both eyes because of irreparable detachment. Only 2 eyes had been operated on successfully. Ten eyes were lasered prophylactically. In eyes with extensive vitreoretinopathy laser burns were applied 360 degrees around the peripheral retina at the border between the pathological and normal retina. Eyes with isolated lesions received focal treatment around the pathological areas. Four eyes received 360 degrees laser photocoagulation and 6 eyes received focal treatment. Of the treated cases, 9 retinas remained attached for a follow-up period ranging from 1 to 15 years. One patient was lost to follow-up, and 5 years later developed retinal detachment in one eye from a new non-lasered lesion. In conclusion, in this particular family the incidence of retinal detachment was significantly higher in non-lasered eyes than in lasered eyes (p < 0.025).

Adolescent↗

Modulation of disease severity in cystic fibrosis transmembrane conductance regulator deficient mice by a secondary genetic factor.

Mice that have been made deficient for the cystic fibrosis transmembrane conductance regulator (Cftr) usually die of intestinal obstruction. We have created Cftr-deficient mice and demonstrate prolonged survival among backcross and intercross progeny with different inbred strains, suggesting that modulation of disease severity is genetically determined. A genome scan showed that the major modifier locus maps near the centromere of mouse chromosome 7. Electrophysiological studies on mice with prolonged survival show that the partial rectification of Cl- and Na+ ion transport abnormalities can be explained in part by up-regulation of a calcium-activated Cl- conductance. Identification of modifier genes in our Cftr(m1HSC)/Cftr(m1HSC) mice should provide important insight into the heterogeneous disease presentation observed among CF patients.

Animals↗

Phenotypic abnormalities in long-term surviving cystic fibrosis mice.

Mouse models for cystic fibrosis (CF) with no CFTR function (Cftr-/-) have the disadvantage that most animals die of intestinal obstruction shortly after weaning. The objective of this research was to extend the lifespan of CF mice and characterize their phenotype. Weanlings were placed on a nutrient liquid diet, and histologic and functional aspects of organs implicated in the disease were subsequently examined. Approximately 90% of Cftr-/- mice survived to 60 d, the majority beyond 100 d. Cftr-/- mice were underweight and had markedly abnormal intestinal histology. The intestinal epithelia did not respond to challenges with agents that raised intracellular cAMP, consistent with the absence of functional CFTR. No lesions or functional abnormalities were evident in the lungs. Liquid-fed Cftr-/- mice were infertile, although some males weaned to a solid diet were fertile before they died. Thus, we have succeeded in using dietary means to prolong the lives of Cftr-/- mice.

Animals↗

Recurrent choroidal detachment following combined trabeculectomy and cataract extraction.

Two patients with glaucoma who underwent uneventful trabeculectomy and extracapsular cataract extraction with posterior chamber intraocular lens implantation, experienced late and recurrent choroidal detachment. Both patients received aqueous suppressant therapy before and after surgery. Hypotony and choroidal detachment occurred 7 months and 15 months after the combined surgery. There was no shallowing of the anterior chamber or leakage from the filtering blebs, and there were no signs of inflammation. The choroidal detachment completely resolved in the two patients 4 days and 4 weeks following discontinuation of the aqueous suppressant therapy.

Aged↗

The course after cataract extraction, intraocular lens implantation, and trabeculectomy for patients with diabetes.

BACKGROUND AND OBJECTIVE: To evaluate the postoperative recovery of the anterior segment and the course of diabetic retinopathy following a combined procedure of an extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy in diabetic patients with glaucoma. PATIENTS AND METHODS: The records of diabetic patients with uncontrolled glaucoma and cataract, who underwent a combined procedure in one eye, were retrospectively reviewed. RESULTS: Eleven patients were included. The mean intraocular pressure and the amount of antiglaucomatous medications required to control it were both reduced postoperatively. Anterior segment complications included hyphema in 4 eyes (37%), fibrin formation in 4 eyes (37%), and posterior synechia in 3 eyes (27%). The hyphema resolved spontaneously and the fibrin disappeared following increased administration of steroids. Development of diabetic retinopathy occurred in 1 eye (9%). Cystoid macular edema without other evidence of diabetic retinopathy was observed in 1 eye (9%). CONCLUSION: The control of intraocular pressure is improved in diabetic patients who have undergone this combined procedure. The postoperative course in these diabetic patients is similar to that previously described in the general population.

Aged↗

Non-HLA-linked hemochromatosis in a Chinese woman.

A 55 year-old Chinese woman is described with severe iron overload similar in degree and distribution to that seen in hereditary hemochromatosis in the Caucasian population. Autopsy findings confirmed severe iron overload in the liver, pancreas, skin, heart, and endocrine organs. Hepatic iron concentration was 482 mumol/g with a hepatic iron index of 8.8. There was no history of thalassemia, transfusions, or alcohol abuse. Pedigree analysis revealed two HLA identical brothers that had no clinical or biochemical evidence of iron overload. This case is an unusual example of severe iron overload in a non-Caucasian kindred and may represent a non-HLA-linked form of iron overload.

Asian People↗

Factors affecting long term results of successfully treated amblyopia: initial visual acuity and type of amblyopia.

AIMS: The study aimed to assess the effect of initial visual acuity and type of amblyopia on the long term results of successfully treated amblyopia. METHODS: The visual acuity of 94 patients, who had been successfully treated for unilateral amblyopia by occlusion of the good eye and followed up to the age of 9 years, was examined 6.4 years, on average, after cessation of treatment. Patients were divided into two groups according to the depth of amblyopia before occlusion therapy was started: those with visual acuity between 20/60 and 20/100 and those with visual acuity of 20/100 or worse. RESULTS: Deterioration of visual acuity was observed in 42% of patients in the first group and in 63% of patients in the second group. Their average deterioration, as measured by the Snellen chart, was 0.58 and 1.54 lines, respectively. The results were also assessed by the division of patients into three groups according to the type of amblyopia: strabismic, strabismic anisometropic, and anisometropic. Deterioration of visual acuity occurred in 46%, 79%, and 36% of patients in these three groups, with an average deterioration on the Snellen chart of 0.70, 2.04, and 0.64 lines, respectively. CONCLUSION: It is concluded that low initial visual acuity and strabismic anisometropic amblyopia are risk factors for deterioration of visual acuity in the long term, following the successful earlier treatment of eyes with amblyopia.

Adolescent↗

Circumferential argon laser photocoagulation for prevention of retinal detachment.

Circumferential argon laser photocoagulation was administered as preventive treatment for retinal detachment in 53 eyes with extensive areas of lattice degeneration and/or retinal breaks and at least one additional high-risk factor for retinal detachment. Laser burns were applied in several continuous rows 360 degrees around the peripheral retina at the junction between the posterior border of the lesions and the unaffected retina. The retina posterior to the treated areas remained attached in 51 eyes (96.2%) during a mean follow-up period of 85.8 months (range 6 months to 18 years). The treatment did not affect visual acuity. The only complication was the appearance in 2 eyes (3.8%) of a delicate epiretinal membrane which, however, did not require surgical intervention.

Adolescent↗