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Biomedical subjects

M R Levine

Publications and source records attributed to M R Levine.

At least 37 records · Page 2Linked to original sources
PubMed1993

Interactions between thermoregulation and the control of respiration in infants: possible relationship to sudden infant death.

In summary, there is evidence that developmental changes in respiratory control and in thermoregulation have effects upon each other. Theoretically, such effects could give rise to failure of the respiratory system and there is some circumstantial evidence to support the concept that on occasions such interactions may be of importance in sudden unexpected death in infancy. Future research in this area should focus on the nature of the interactions between thermoregulation and respiration, and on the effects of infection and infection-related mediators on those interactions.

Body Temperature↗
PubMed1993

Merkel cell carcinoma of the eyelid.

The Merkel cell is part of the dendritic cell population of the epidermis, and studies suggest it has a role as a slowly adapting mechanoreceptor involved with mediating the sense of touch. Merkel cells can give rise to malignant neoplasms, one tenth of which occur in the eyelid and periocular area, and manifest as painless erythematous nodules, with overlying telangiectatic blood vessels. Merkel cell carcinoma can mimic other malignant lesions, and the diagnosis can be difficult. One third of the tumors recur, and there is a high rate of metastasis. The estimated 5-year survival rate is 38%. Initial treatment should be aggressive, including surgical resection, with consideration of postoperative radiation. Merkel cell carcinoma responds to chemotherapy, but routinely recurs on cessation of treatment. Two cases are presented to illustrate the typical presentation of Merkel cell carcinoma and the importance of electron microscopy and immunohistochemical studies.

Aged↗
PubMed1993

Nasal glioma masquerading as a capillary hemangioma.

A female infant was born with a reddish-purple mass situated on the dorsum of the nose and extending onto the left medial canthal region. A presumptive diagnosis of capillary hemangioma was made, and the patient was treated with multiple intralacrimal steroids and cryotherapy without success. A diagnostic incisional biopsy was confirmatory, but erroneous, due to the lack of depth. At 9 months of age, without signs of involution, the mass was removed and a diagnosis of nasal glioma was made.

Choristoma↗
PubMed1992

Spastic entropion after cataract surgery.

Spastic entropion is an acute eyelid condition seen in patients with acute inflammatory ocular conditions. It has been reported after cataract surgery. We describe three cases of spastic entropion after cataract surgery that did not resolve after the ocular irritation subsided. All were associated with eyelid and/or cul-de-sac injection of antibiotics and corticosteroids or anesthetic solution. All had dehiscence of the capsulopalpebral fascia. Spastic entropion is an evolving stage toward permanent entropion.

Aged↗
PubMed1991

Brown tumor and secondary hyperparathyroidism.

Brown tumor is a focal, bony lesion of hyperparathyroidism that results from parathyroid hormone on bone increasing osteoclastic activity with bone resorption and trabecular fibrosis. This leads to microfractures and hemorrhage and the appearance of brown tumors, which are seen most commonly in primary hyperparathyroidism and less frequently in secondary hyperparathyroidism. Rarely do these tumors involve the orbit. We report the sixth case, to our knowledge, of orbital involvement, in a patient with chronic renal failure (secondary hyperparathyroidism) and review the literature.

Adult↗
PubMed1991

Surgical treatment of thyroid-related lid retraction: a new variation.

We describe a cutaneous approach for retraction of the upper eyelid which incorporates a levator aponeurotic/Mueller's muscle recession with maintenance of the normal orbital septum levator aponeurosis anatomy. With success defined as asymmetry between the two eyelids of 1 mm or less, with a marginal reflex distance as close to 4 mm as possible, this technique was successful in 87% of 15 consecutive patients. All patients reported improved comfort. This approach is quick and easy, bleeding is minimal, height and contour are predictable, the upper eyelid crease is preserved, and spacers are avoided, with less postoperative eyelid thickening and reaction.

Eyelid Diseases↗
PubMed1991

Adrenal suppression and growth retardation after injection of periocular capillary hemangioma with corticosteroids.

Adrenal suppression and/or growth retardation were noted in two patients after injection of periocular capillary hemangiomas with corticosteroids. Parents should be warned of these two potential complications of intralesional corticosteroid therapy. Baseline and posttreatment adrenal function should be monitored. If iatrogenic adrenal suppression occurs, supplemental systemic corticosteroids may be necessary in situations involving systemic stress such as infection or surgery.

Adrenal Cortex Hormones↗
PubMed1990

Diagnosis and treatment of complications of enucleation and orbital implant surgery.

Careful surgical technique is important in enucleation surgery. Gentle and careful handling of tissues leads to superior cosmetic results and fewer complications. Extrusion of orbital implants may occur early or late. Small extrusions may be treated with a scleral patch, and larger extrusions with an acrylic sphere wrapped in fascia lata or donor sclera. Dermis fat grafts are also satisfactory secondary implants.

Eye Enucleation↗
PubMed1990

Sclerosing syringoma.

Syringoma, a benign sweat gland tumor which may occur in the eyelid, commonly presents as multiple lesions in young women. We had an unusual case of a sclerosing syringoma found as a single lesion in the lower eyelid of a man.

Adenoma↗
PubMed1989

Metastatic melanoma within and to the conjunctiva.

Two patients with epibulbar juxtalimbal primary conjunctival melanomas experienced local intralymphatic metastases to the inferior cul-de-sac, and a hematogenous metastasis to the conjunctiva developed in five other patients with cutaneous melanomas. Whether reflective of a local or distant metastasis, all of the lesions histopathologically were located in the substantia propria, and were separated from the overlying epithelium by a thin mantle of collagen. There was no evidence of atypical intraepithelial melanocytic proliferation, as would be expected in association with a primary conjunctival melanoma. Two of the cutaneous metastases exhibited a binodular or multinodular appearance that correlated histopathologically with variably confluent micronodules suggestive of the origin of the clinical lesion from a shower of tumor cell emboli. Patients with local intralymphatic spread from a primary conjunctival melanoma may experience additional lesions in the conjunctival sac or eyelid skin and are at risk for regional or distant metastases. They should be examined closely several times a year. The patients with the distant metastases all had their previously diagnosed primary cutaneous tumors on the truncal skin (a similar tendency emerges from a review of previous ocular cases), typically had myriad other cutaneous lesions, and two of them had a neoplastic iridocyclitis and vitreitis. These patients tended to die of the disseminated tumors within 1 year after conjunctival metastases developed.

Adult↗
PubMed1989

Primary intraosseous hemangioma of the orbit. Report of a case and review of literature.

Orbital intraosseous hemangiomas are rare entities, with only 15 previously reported. We review these and present our own. They are benign, vascular tumors, typically found in the frontal, ethmoid, or zygomatic bones. They tend to present in the 4th or 5th decades as a mildly painful orbital rim mass. Ocular findings may be absent or severe, including blindness. These tumors have characteristic, although not always present, roentgenologic features that differentiate them. Our case is unusual in that it is the oldest patient reported, demonstrates bilateral lesions, and did not exhibit classic x-ray findings. We report imaging these lesions with magnetic resonance imaging with nonspecific results. The pathology of orbital hemangiomas is presented, with the most common being the cavernous type. Because these tumors may bleed when entered, block excision with normal margins is the treatment of choice. Radiation therapy has specific indications for nonresectable lesions. Prognosis is uniformly good, if treated.

Aged↗
PubMed1989

Gunshot wounds of the eye and orbit.

Gunshot wounds to the globe and orbit require careful evaluation and management. This article highlights five cases of penetrating gunshot injuries, each demonstrating different points to consider when managing the severely traumatized patient. Immediate and late complications are described. Missile velocities of different weapons are detailed, and the mechanism of injury is discussed. Careful preoperative evaluation is stressed as a means of avoiding complications.

Adult↗
PubMed1988

Delayed primary wound closure. Use to prevent implant extrusion following evisceration for endophthalmitis.

We used delayed primary wound closure in three cases of bacterial endophthalmitis to minimize the risk of implant extrusion following evisceration. In a fourth case, the wound was closed primarily, but wound dehiscence and implant extrusion occurred six weeks postoperatively, and reoperation was required. The advantages of delayed primary wound closure following evisceration of the globe for endophthalmitis include rapid removal of the intraocular abscess, continued drainage and mechanical débridement of the infected scleral pouch, and the development of granulation tissue resistant to bacterial growth at the wound margins prior to wound closure. These factors are important in reducing the risk of implant extrusion following evisceration of the globe for endophthalmitis.

Adult↗
PubMed1988

Frontal sinus mucopyocele in cystic fibrosis.

This report summarizes the treatment of two patients with cystic fibrosis and frontal sinus mucopyocele. The first patient, an 18-year-old boy, had a 1-year history of a proptosis of the left eye. The second patient, a 28-year-old woman, had a 3-month history of intermittent diplopia. In both cases, the frontal sinus mucocele was diagnosed by computed tomographic scans; both were successfully treated with an osteoplastic flap and fat obliteration of the frontal sinus. When a patient with cystic fibrosis presents with a history of unilateral proptosis, diplopia, or frontal headaches, a paranasal sinus mucocele should be suspected.

Adolescent↗
PubMed1988

Calcium oxalate retinopathy associated with methoxyflurane abuse.

A 34-year-old woman developed a crystalline retinopathy after 2 years of inhalational abuse of methoxyflurane. After the woman developed renal failure, a renal biopsy showed multiple birefringent crystals in the renal tubular lumens, epithelial cells, and interstitium compatible with calcium oxalate. Multiple bright yellow-white crystals were deposited throughout the retina and at the level of the retinal pigment epithelium with a retinal arterial and periarterial predilection. This is the first reported case of methoxyflurane abuse with secondary hyperoxaluria in which there was a widespread retinal distribution of crystalline deposits, especially along the retinal arteries and arterioles.

Acute Kidney Injury↗