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Biomedical subjects

R E Appen

Publications and source records attributed to R E Appen.

25 records · Page 2Linked to original sources

Ocular and cerebral involvement in familial lymphohistiocytosis.

A 5-month-old infant girl died of familial lymphohistiocytosis. The central nervous system showed widespread perivascular infiltration of the cerebral pia and arachnoid, the cerebral white matter and deep gray matter, the cerebellum, and brain stem by lymphocytes, benign appearing histiocytes, and macrophages with erythro-and lymphophagocytosis. The eyes had mild infiltration of the anterior uveal tract, moderate involvement of the inner retina, and marked infiltration of the optic nerves by identical cells.

Brain↗

Office treatment of eye injury. 2. Injury from sharp instruments or blunt trauma.

Eye injuries caused by sharp instruments range from superficial scratches of the corneal epithelium to serious lacerations of the globe of the eye. Scratches, conjunctival lacerations, and some eyelid lacerations can be dealth with by the primary physician in the office, but damage to the globe requires immediate referral to an ophthalmologist. Among possible results of blunt trauma to the area of the eye are ecchymosis, hyphema, blow-out fracture, subluxation or dislocation of the lens, or retinal detachment. Most of thes require thoroguh ophthalmologic examination and specialized treatment. The primary physician may be the first to examine a patient with serious head injury. For future reference the status of each eye should be carefully documented as soon as possible after injury.

Craniocerebral Trauma↗

Traumatic injuries: office treatment of eye injury. 1. Injury due to foreign materials.

Patients with eye injuries caused by foreign materials are often seen by the primary physician. The causative agents may be foreign objects, noxious liquids or vapors, ultraviolet irradiation, or contact lenses. Injuries caused by foreign bodies that do not penetrate the outer coats of the eye can be treated by the nonspecialist; the intraocular presence of an object requires prompt referral to an ophthalmologist. Ultraviolet light irradiation and contact lenses worn for a prolonged period cause a great deal of pain to the eye but injury is not serious and the eye heals well. Injury from chemicals may be moderate or severe; if pain and functional impairment persist after copious irrigation of the eye with sterile saline solution, the patient should be referred to an ophthalmologist.

Contact Lenses↗

Posterior uveitis and primary cerebral reticulum cell sarcoma.

Primary cerebral reticulum cell sarcoma appeared as unexplained posterior uveitis. A retrospective review of 19 cases of cerebral reticulum cell sarcoma seen at Massachusetts General Hospital has not confirmed the previously described high incidence of ocular involvement in patients with this tumor. The presence of posterior uveitis remote from a definite cerebral mass should suggest the possible diagnosis of primary cerebral reticulum cell sarcoma.

Brain↗

Central retinal artery occlusion.

Data regarding the etiology and subsequent course of 54 patients with an occlusion of the central retinal artery included the following: of 44 patients over 40 years of age at the time of the central retinal artery occlusion, eight (18%) had cerebrovascular accidents, but only two patients (5%) had a stroke clearly related to the vessels involving the affected central retinal artery. Five patients (11%) had occlusive disease of the ipsilateral internal carotid artery; two of these had cerebral involvement later or simultaneously. Ten of the older patients had cardiac valvular disease and presumed embolic occlusion of the central retinal artery. Associated medical disorders were common. Of the ten patients under 40 years of age, six occlusions were secondary to atrial myxoma, mitral insufficiency with Marfan's syndrome, polycythemia, hypercoagluopathy, hypertension, and orbital compression. Four had no apparent etiology at onset and were in good health many years later.

Adolescent↗

MR imaging of primary trochlear nerve neoplasms.

We present the clinical, anatomic, and MR imaging findings in six patients with seven primary trochlear nerve neoplasms, as well as the MR and clinical criteria that serve to establish the diagnosis of these rare cranial nerve neoplasms. Three patients had a history of neurofibromatosis and five patients had clinical evidence of a trochlear nerve palsy. Six of seven neoplasms produced localized, fusiform enlargement of the proximal cisternal segments of the trochlear nerves. The lesions that were visible on noncontrast MR scans (T1-, T2-, and proton density-weighted) had signal intensities that were virtually identical to normal brain parenchyma. All lesions showed intense, homogeneous enhancement on contrast-enhanced scans. Contrast-enhanced imaging was necessary for the detection of five of seven lesions and greatly increased the value of the MR study in all six patients.

Adult↗