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Biomedical subjects

M Rosner

Publications and source records attributed to M Rosner.

108 records · Page 6Linked to original sources

Corneal abscesses in silicone and soft contact lens wearers.

Fourteen cases of corneal abscesses in wearers of contact lenses were seen in our department during the last 3 years. The hospitalization period varied from a few days to seven weeks. In one case, it was necessary to perform penetrating keratoplasty in order to restore good vision. Cultures taken from the corneal abscesses were positive in six cases. Pseudomonas was found in five cases and Enterobacter in one case. During the three years of the survey, no hard contact lens wearers with corneal abscesses were hospitalized. Wearers of silicone contact lenses comprised 21.4% of the cases with corneal abscess. This is a high percentage considering the fact that these lenses are very rare among contact lens wearers in Israel.

Abscess↗

Overlapping fifth toe: a new surgical approach.

The authors introduce a new method of correction for overlapping fifth digits. With the advent of newer types of precision power surgical instrumentation, performance of an exacting wedge osteotomy is possible on small bones. Combining an abductory wedge osteotomy with previously described soft tissue revisions can now realign a common deformity--the overlapping fifth toe.

Adult↗

Video display units and visual function.

The widespread use of visual display units (VDU) in the workplace has engendered visual complaints and concern for workers' health and safety. The detectable levels of radiation emitted from VDUs have been well below safety levels and exposure to VDUs does not appear to cause any organic damage to the eye. However, visual disturbance and eye discomfort affects many workers using VDUs, and these symptoms may be alleviated by a number of measures, including proper diagnosis of pre-existing ocular problems, use of special eyeglasses, and correct arrangement of lighting and furniture in the work area.

Cataract↗

The association between cigarette smoking and ocular diseases.

Tobacco smoke is composed of as many as 4,000 active compounds, most of them toxic on either acute or long-term exposure. Many of them are also poisonous to ocular tissues, affecting the eye mainly through ischemic or oxidative mechanisms. The list of ophthalmologic disorders associated with cigarette smoking continues to grow. Most chronic ocular diseases, with the possible exception of diabetic retinopathy and primary open-angle glaucoma, appear to be associated with smoking. Both cataract development and age-related macular degeneration, the leading causes of severe visual impairment and blindness, are directly accelerated by smoking. Other common ocular disorders, such as retinal ischemia, anterior ischemic optic neuropathy, and Graves ophthalmopathy, are also significantly linked to this harmful habit. Tobacco smoking is the direct cause of tobacco-alcohol amblyopia, a once common but now rare disease characterized by severe visual loss, which is probably a result of toxic optic nerve damage. Cigarette smoking is highly irritating to the conjunctival mucosa, also affecting the eyes of nonsmokers by passive exposure (secondhand smoking). The dangerous effects of smoking are transmitted through the placenta, and offspring of smoking mothers are prone to develop strabismus. Efforts should be directed toward augmenting the campaign against tobacco smoking by adding the increased risk of blindness to the better-known arguments against smoking. We should urge our patients to quit smoking, and we must make them keenly aware of the afflictions that can develop when smoke gets in our eyes.

Eye Diseases↗

Orbital lipogranuloma after sinus surgery.

PURPOSE: To report the treatment and histopathological findings in two cases who developed eyelid swelling, proptosis and diplopia due to orbital and lid lipogranuloma after endoscopic surgery of the maxillary and ethmoidal sinuses. METHODS: To relieve the proptosis and diplopia, debulking surgery was done on the eyelids and orbit. The tissue removed was sent for histopathological examination. RESULTS: The two patients improved after surgery. The eyelid swelling, proptosis and diplopia subsided and ocular movements became normal. Histopathologic examination disclosed an extensive lipogranuloma. CONCLUSIONS: Extensive orbital and eyelid lipogranuloma causing proptosis and diplopia is a rare complication of endoscopic sinus surgery, and can be relieved by surgical debulking.

Adolescent↗

Evaluation of superior rectus muscle attachment following hang-back recession in rabbit eyes.

PURPOSE: The hang-back suture technique has been advocated to decrease the risk of scleral perforation during strabismus surgery. In this study, we evaluated the muscle insertion site in rabbits 4 weeks after a hang-back recession was performed. METHODS: Twenty-five eyes of 13 rabbits underwent hang-back recessions of between 5 and 8 mm of the superior rectus muscle. Four weeks later, the attachment sites were examined. RESULTS: Four weeks following the surgery, 14 muscles (n=25, 56%) were anteriorly displaced. In the 5 mm recession group, one muscle was anteriorly displaced (n=7, 14.3%). In the 6 mm recession group, 50% of the muscles recessed were displaced anteriorly (n=8). The 7 mm hang-back recession group demonstrated forward displacement in five muscles operated (n=6, 83%) and in the 8 mm recession group, all four muscles (100%) were anteriorly displaced. The magnitude of displacement was positively correlated to the amount of the hang-back recession performed (Pearson correlation p<0.001). CONCLUSIONS: Anterior displacement of muscles using the hang-back technique in the rabbit eye is unacceptably high and occurred in 56% of the cases. A positive, statistically significant correlation exists between the amount of recession performed and the number of muscles displaced from their new insertion. Therefore, when performing large recessions using the hang-back technique displacement should be anticipated.

Animals↗

Myopia and stature: findings in a population of 106,926 males.

We conducted a nation-wide study of the relationship of myopia with height, weight and body-mass index in order to confirm observations that myopic persons are taller than non-myopes. From a review of the data of 106,926, consecutive male military recruits aged 17 to 19 years, we found that myopia is associated neither with higher stature nor with greater weight. Persons with severe myopia were slightly shorter (172.8 +/- 7.1 cm) and weighed less (62.6 +/- 11.0 kg) than those with mild myopia (173.3 +/- 6.9 cm and 63.8 +/- 10.5 kg respectively), while the non-myopes were taller (173.7 +/- 6.7 cm) and heavier (63.9 +/- 10.2 kg) than the myopes (p = 0.0001). The mean body-mass index was only slightly smaller among the myopes (21.1 +/- 3.1 kg/m2) than among the non-myopes (21.2 +/- 2.9 kg/m2, p = 0.0001).

Adolescent↗

Transvaginal sonographic diagnosis of cataract in a fetus.

Transvaginal ultrasonography is a relatively new technique for visualizing the orbits in a fetus of 4 to 5 cm. At fifteen weeks of gestation it is possible to recognize the lenses and the hyaloid arteries in the eyes, to diagnose structural malformations such as anophthalmos, microphthalmos, buphthalmos and moderate to severe cataract. In most cases cataracts were associated with intracranial defects. We describe a case where the sonographic diagnosis of fetal cataract was confirmed by histopathological examination. A 27-year-old woman had a routine transvaginal sonography at 15 weeks' normal gestation. Microphthalmos without a hyaloid artery and disorganization of the anterior chamber and lens consistent with cataract were demonstrated in the fetal left eye. In accordance with the parents' decision, the pregnancy was terminated a week later. Autopsy of the fetus was done and serial sections of the left eye were studied by light microscopy. Histopathological examination verified the sonographic diagnosis of fetal cataract in a microphthalmic eye. Associated findings included malformation of the anterior segment and retinal dysplasia.

Abortion, Induced↗

Epidemiology of retinal detachment in childhood and adolescence.

The prevalence of retinal detachment during childhood and adolescence was studied in 45,000 recruits aged 17 to 19 years. History of retinal detachment was found in 13 cases (0.028%); 61.5% of these had traumatic retinal detachment, and 23.1% had high myopia without history of trauma. The age-related annual incidence of retinal detachment in patients aged ten to 19 years was calculated to be 2.9 per 100,000. The prevalence among the males was 3.7 per 10,000 and among the females 1.6 per 10,000. The difference between the sexes was not statistically significant.

Adolescent↗

Congenital cataract surgery in children with cataract as an isolated defect and in children with a systemic syndrome: a comparative study.

PURPOSE: To compare visual acuity outcome in two groups of children who underwent congenital cataract surgery. The first group is one in which an isolated cataract occurred; the second group is one in which cataract occurred in conjunction with a systemic disease. METHODS: A review of 46 charts: 36 children (50 eyes) with congenital cataract as an isolated defect, and 10 children (16 eyes) with cataract as part of a systemic disease. RESULTS: One third of the eyes with isolated cataract had postoperative visual acuity better than 6/12, although none of the patients in the syndrome group had visual acuity better than 6/12. This difference was statistically significant (p = 0.01). Of the various ocular pathologies associated with congenital cataract, only nystagmus was found to be more prevalent in the syndrome group (40%) as compared with the isolated cataract group (11%) (p = 0.05). Surgery was performed during the first 2 years of life in 54% of the eyes in the isolated cataract group, and in 87% of the eyes in the syndrome group (p = 0.01). There was no difference in the prevalence of the postoperative complications between the two groups. CONCLUSION: Children who underwent congenital cataract surgery developed poorer visual acuity if the cataract was a part of a systemic disease as compared with children without a systemic syndrome.

Abnormalities, Multiple↗

Sclerotomy using needle puncture and subconjunctival injection of mitomycin C.

OBJECTIVE: To explore the possibilty of creating a temporary sclerotomy using a 26-gauge needle and sustaining its patency by injectiong 0.1 mL of 0.1 mg/mL of mitomycin C (MMC). ANIMALS AND METHODS: Twenty-four New Zealand white rabbits were randomized into 3 groups. In the test group, puncture was performed using 26-gauge needle penetrating the anterior chamber at the limbus, and 0.1 mg/mL MMC were injected subconjunctivally. In the control group, a puncture was performed in the same fashion and in the MMC group, MMC only was injected subconjunctivally. Intraocular pressure (IOP) was measured prior to surgery and at days 1, 3, 7, 10, 14, 21, and 28. RESULTS: The mean intraocular pressure in eyes that underwent puncture with application of MMC was significantly lower than the IOP in the eye at all measurements up to and including day 21. In the puncture group, pressure was significantly lower than in the fellow eye only at day 3. No significant pressure reduction was observed at any measurement interval in eyes treated with MMC only. CONCLUSION: This simple technique of subconjunctival puncture of the limbus combined with application of MMC was effective in lowering IOP in rabbits. This may serve to attain a temporary filter in patients who need strict short-term pressure control.

Animals↗

Time course of electroretinographic recovery following argon laser photocoagulation in cats.

We wished to study in detail the time course of changes in the electroretinogram (ERG) that occur following lesioning of the cat retina by photocoagulation. The superior-temporal quadrant of one eye of 15 adult cats was photocoagulated by argon laser. The ERG was recorded at baseline and followed for up to 13 weeks postlaser. The retina was also observed ophthalmoscopically. Immediately after photocoagulation, the b-wave amplitude was markedly reduced. This was followed by a gradual recovery over the next 10 weeks. The ophthalmoscopic appearance of the lesions, however, appeared unchanged after 1 week. The ERG, which is reduced in amplitude immediately after retinal photocoagulation, shows recovery with time.

Animals↗

Comparison of fluorescence polarization immunoassay, enzyme immunoassay, and thin-layer chromatography for urine cannabinoid screening. Effects of analyte adsorption and vigorous mixing of specimen on detectability.

Four commercial assays for the screening of cannabinoids in urine were compared. Urine specimens from 93 selected subjects were run by fluorescence polarization immunoassay on the Abbott TDx; by enzyme multiplied immunoassay with two Syva EMIT assays; and by thin-layer chromatography with the TOXI-LAB system (Marion Laboratories). The TDx cannabinoid threshold can be set anywhere from 25 to 150 micrograms per L. Twenty-five micrograms per L was chosen for this study. The thresholds for EMIT are fixed at 20 micrograms per L for one assay and 100 micrograms per L for the other. The detection limit for TOXI-LAB, according to the manufacturer, can be anywhere from 5 to 50 micrograms/L, depending on the specimen. Urines, positive by at least one method, were further analyzed by gas chromatography with mass spectrometry (GC/MS), The detection limit for the GC/MS method was 10 micrograms per L. The results showed a few false negatives and unconfirmable positives; in general, correlation was considered acceptable. Dose-response curves comparing TDx and EMIT gave paralell results, with comparable cross-reactivity for the major metabolite, 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (delta-9-THC-COOH). A dose-response study of TOXI-LAB using delta-9-THC-COOH also gave acceptable results. Adsorption to glass was investigated using spiked urine; a 27 percent reduction in concentration was caused by this phenomenon. Foaming of spiked urine caused by vigorous mixing resulted in a reversible 89 percent apparent reduction in concentration.

Cannabinoids↗

A method of repair for Achilles tendon ruptures without cast immobilization. Preliminary report.

A new technique for the repair of Achilles tendon ruptures has been developed with a Dacron vascular graft used as a tension suture material. The suture is passed through the calcaneal tuberosity and, with two loops applying tension to the tendon at the level of the musculotendinous junction, brings the tendon ends together by creating a solid structure. Post-operative immobilization and its possible adverse sequelae are eliminated by this procedure. The technique was first tested on five dogs with severed Achilles tendons of both hind legs. One side in each animal was repaired with this suture technique; the second leg was left as an untreated control. All the animals recovered from surgery and walked almost normally on the sutured leg within less than three weeks. The dogs did not walk on the unsutured legs. In a second procedure, the control leg was repaired by the same reparative procedure. Equally good results were obtained. The technique was then used on five patients with recent and neglected Achilles tendon ruptures or lacerations. In all instances excellent surgical results were obtained and leg immobilization was virtually eliminated. Physical therapy was begun in the immediate postoperative period. The rehabilitation period was significantly reduced.

Achilles Tendon↗

Phototherapeutic keratectomy in the treatment of corneal scarring from trachoma.

Trachoma is still one of the world's major blinding diseases. Characteristically, trachoma causes deep scarring of the conjunctiva and tarsus that can result in tear deficiency, trichiasis, and entropion. Another common finding is a diffused corneal opacity that is the end stage of peripheral and central corneal infiltrates. The conventional treatment of the corneal opacities is keratoplasty, which has a guarded prognosis because of severe dryness and trichiasis. We report on our experience in treating patients with corneal trachoma with phototherapeutic keratectomy (PTK) with the excimer laser.

Aged↗

Use of the giant-pulse Nd:YAG laser for ab-externo sclerostomy in rabbits and humans.

The giant-pulse Neodymium:YAG laser, a recently developed laser source, delivers up to 200 W of peak power at pulse widths of 20 or 40 msec. The instrument can create a sclerostomy with minimal surrounding damage and, consequently, relatively little postsurgical inflammation and scarring. We tested its efficacy in performing ab-externo sclerostomy in 10 adult pigmented rabbits and in five patients with end-stage glaucoma. All of the animal eyes were hypotonus immediately after the procedure. However, the intraocular pressure increased gradually, and by the third day, returned to presurgical levels in all of the eyes. All five of the glaucoma patients treated had patent sclerostomies following the procedure. They all had early hypotony, but after 3 months, four of the five sclerostomies apparently failed. The giant-pulse Nd:YAG laser appears useful for performing sclerostomy, but modifications are needed to solve the problems of early hypotony and late closure of the fistulula.

Animals↗