Search PubMed⌕ Search

Biomedical subjects

R Folberg

Publications and source records attributed to R Folberg.

At least 109 records · Page 6Linked to original sources
PubMed1987

Disseminated aspergillosis in a patient with ocular reticulum cell sarcoma.

A 75-year-old healthy woman developed uveitis and chorioretinal infiltrates OD compatible with reticulum cell sarcoma. She was admitted to hospital 18 months later with somnolence and confusion. Examination revealed diffuse white matter hypodensity on computed tomography and a persistent cerebrospinal fluid pleocytosis. At necropsy reticulum cell sarcoma was found in the right globe and Aspergillus fumigatus was present in almost every other organ, including the brain.

Aged↗
PubMed1986

A clinically useful method for combining gross and microscopic measurements to select high-risk patients after enucleation for ciliochoroidal melanoma.

An objective and reproducible method was devised for estimating the malignant potential of ciliochoroidal melanomas after enucleation. This method requires only a single, routine microslide from which nucleolar area and largest tumor dimension are measured. Previous studies have shown these measurements to be reproducible and highly correlated with mortality. To demonstrate a practical method for clinical application of these measurements, a Cox statistical model was derived from 200 cases supplied by the Armed Forces Institute of Pathology. The resulting model, when applied to 340 cases with known outcome from two independent laboratories, allowed subdivision of patients into groups that suffered a six-fold difference in mortality. These results suggest that a central registry, by applying this method to histologic slides from around the world, could provide information useful for the clinical management of patients enucleated for ciliochoroidal melanoma.

Actuarial Analysis↗
PubMed1986

Topical fluorouracil. II. Postoperative administration in an animal model of glaucoma filtering surgery.

Unilateral posterior lip sclerectomies were performed in ten owl monkeys. Five milligrams of fluorouracil was injected subconjunctivally in each operated eye immediately after surgery. Three drops (approximately 2.4 mg/drop) of fluorouracil were instilled ten minutes apart in each operated eye twice daily on postoperative days 1 through 7 and once daily on postoperative days 8 through 15, 17, 19, and 21. One monkey died on the seventh postoperative day; its death could not be attributed to systemic fluorouracil toxicity. All of the operated eyes had filtering blebs after the full course of fluorouracil, but seven also had corneal epithelial defects. By the seventh postoperative week, two of the operated eyes manifested moderately severe corneal opacification. Ten weeks postoperatively, the electroretinographic a- and b-wave amplitudes averaged 17% and 12% less, respectively, in the seven operated eyes without clinically significant corneal opacification than in the unoperated fellow eyes. Only two eyes had blebs after the 12th postoperative week. Histopathologic examination was performed on five eyes, of which only two revealed patent sclerostomies. Although topical fluorouracil appears to delay bleb scarring, the corneal findings suggest that it may be more toxic than subconjunctival fluorouracil.

Administration, Topical↗
PubMed1986

Wound healing after filtering surgery in owl monkeys.

We performed posterior lip sclerectomies in 29 owl monkey eyes to determine the natural history of wound healing after filtering surgery without adjunctive antimetabolite therapy. We noted three phases of wound healing during clinical and histologic examination: early healing (days 2 to 6), intermediate healing (days 7 to 9), and late healing (days 10 to 14). In the early healing phase, all limbal fistulas except one remained open gonioscopically, but by day 6, fibroblasts had proliferated along the walls of the opening. Proliferation and migration of fibroblasts continued during the intermediate healing phase to completely occlude four and to partially occlude two of the ten fistulas in the eyes studied during this time. In the late healing phase, the limbal fistula was completely closed by granulation tissue in four of five eyes and was slitlike open in one eye. In this model of filtering surgery, wound healing at the sclerectomy site with obliteration of the limbal opening by proliferating fibroblasts occurred within the first 14 postoperative days. We believe that the short-term effects of newer treatments designed to alter wound healing after filtering surgery may be assessed in this model, which is characterized by predictable and prompt wound healing.

Animals↗
PubMed1986

The gross examination of eyes removed for choroidal and ciliary body melanomas.

Because the traditional gross examination technique used by most ophthalmic pathologists requires cutting into the eye without directly visualizing the tumor, pathologists cannot be certain that the slides generated reflect the areas or dimensions of clinical concern. An alternate laboratory technique permits the pathologist to examine the tumor from the clinician's perspective. If the tumor is confined to the posterior pole, the anterior segment is removed first; if the tumor extends anterior to the equator, the calotte opposite the tumor apex is removed permitting direct observation of the tumor. Sections of the tumor can be obtained corresponding to the largest tumor dimensions and other areas of clinical interest to obtain precise clinicopathologic correlations. All portions of the eye not involved by tumor are also studied to complete the examination.

Choroid Neoplasms↗
PubMed1985

Fine-needle aspirates of uveal melanomas and prognosis.

The computer-assisted measurement of the standard deviation of the nucleolar area from pathologic slides of uveal melanomas correlates strongly with prognosis, but the eye must be removed and examined histologically. Because it is possible to perform fine-needle aspiration biopsies of intraocular tumors, we designed a study to determine if a fine-needle aspiration biopsy sample yields the same prognostic information as the enucleation specimen. In comparing the standard deviation of the nucleolar area measured from a fine-needle aspiration biopsy sample obtained from 53 freshly enucleated eyes with the standard deviation of the nucleolar area measured from the matched enucleation specimen, we found only a modest correlation (r = 0.57) between the two measurements. A t-test of matched pairs indicated a significant difference between the two measurements (P less than .01). The fine-needle aspiration biopsy technique does not yield the same prognostic information as the larger enucleation specimen because fine-needle aspiration biopsy material may not be representative of the tumor.

Biopsy, Needle↗
PubMed1985

Diagnosis and management of Acanthamoeba keratitis.

Diagnosis and management of Acanthamoeba chronic ulcerative keratitis is difficult. Two cases of Acanthamoeba keratitis at Wills Eye Hospital were diagnosed within several months of each other during 1983. Corneal transplantation was necessary for diagnosis and therapy in these cases. Another two cases were diagnosed when histopathologic specimens from penetrating keratoplasties done between 1974 and 1983 were reviewed retrospectively. There has been no evidence of recurrent disease in any of our cases during follow-up periods averaging two years (range, 12 to 40 months). The diagnosis of Acanthamoeba keratitis must be considered in cases of chronic progressive corneal ulceration unresponsive to medical therapy.

Adolescent↗
PubMed1985

An antimelanoma monoclonal antibody and the histopathology of uveal melanomas.

Monoclonal antibody ME491 identifies a cutaneous melanoma-associated antigen in formaldehyde-fixed, paraffin-embedded tissues. This antibody was applied to tissue sections from 79 cases of formaldehyde-fixed, paraffin-embedded uveal melanomas. Sixty-nine (87.3%) of the 79 cases showed staining by monoclonal antibody ME491, thus demonstrating an antigen shared by cutaneous and uveal melanomas. No relationship between the staining pattern and the patient outcome was detected. Twelve (85.7%) of the 14 cases in which balloon cells were present stained with the antibody. The antibody stained the long posterior ciliary nerve in 12 (38.7%) of 31 cases in which the nerve was present in tissue sections. The antibody cross reacted with the retinal pigment epithelium (16.5% of cases) and a variety of normal nonocular tissues.

Antibodies, Monoclonal↗
PubMed1985

Metastatic uveal melanoma. Hepatic metastasis identified by hybridoma-secreted monoclonal antibody MAb8-1H.

Monoclonal antibody MAb8-1H, which defines an ocular melanoma-associated antigen retained in fixed tissue, was used to demonstrate metastatic melanoma cells in liver biopsy specimens from five patients with primary choroidal melanoma. In all cases, the monoclonal antibody bound to tumor cells and not to normal hepatocytes. In one case, a well-delineated focus of tumor cells bound to MAb8-1H; in two cases, MAb8-1H appeared to delineate individual tumor cells that were difficult to categorize by conventional staining techniques. The liver biopsy specimens were almost completely replaced by tumor cells in the remaining two cases. This monoclonal antibody may be applicable to the diagnosis of metastatic uveal melanoma and to delineate micrometastasis.

Antibodies, Monoclonal↗
PubMed1985

Retinal S antigen and retinoblastoma. A monoclonal antibody histopathologic study.

Using monoclonal antibody MAbA9-C6, which defines an epitope of retinal S antigen retained in fixed-tissue sections, we investigated S-antigen immunoreactivity in human fetal eyes from different gestational periods and 19 cases of retinoblastoma. S-antigen immunoreactivity was first observed in the outermost portion of the neuroblastic cell layer in the retina of a human fetus at 18 weeks' gestation, a stage preceding photoreceptor differentiation, and at all later stages examined thereafter. All adult eyes containing normal photoreceptors bound MAbA9-C6. In retinoblastomas, several different patterns of S-antigen immunoreactivity were recognized. In seven cases, S-antigen immunoreactivity appeared to be associated with normal photoreceptor elements incorporated into the growing tumor. S-antigen immunoreactivity was associated with fleurettes within the retinoblastoma in three cases and Flexner-Wintersteiner rosettes in seven cases. In 11 cases, S-antigen immunoreactivity was associated with isolated tumor cells. Our results show that S antigen may be a useful marker in the study of the embryologic development of the human retina and antigenic expression and modulation in retinoblastomas.

Adult↗
PubMed1985

Clinicopathologic correlate of a fresh eyelid pigment implantation.

An eyelid with freshly applied black eyeliner pigment was examined histologically. X-ray microanalysis of the pigment suspension from the manufacturer's vial indicated that its composition was 98% iron and 2% titanium. Transmission electron microscopic examination disclosed that particles were in the extracellular matrix; intracellular particles were not seen. By light microscopy, implant material was detected in various levels of the dermis and was found in dermal lymphatics as well as within and surrounding a hair follicle. Our study suggests that systemic exposure to the implant material is possible and offers explanations for permanent eyelash loss, which we have seen following this procedure.

Aged↗
PubMed1985

Microcomputer applications in pathology research.

In a study of over 700 cases of uveal melanoma on file in the Department of Pathology of Wills Eye Hospital, a low-cost microcomputer using commercially available software (without modification) was used to: word process and edit this manuscript, create a patient file storage and retrieval system including the ability to create subfiles, merge files, and interchange file types, plot data points in several different graphic formats, transcribe and store information from microscopic tissue sections containing intraocular melanomas, and solve complex equations including statistical analysis. The results showed that over 150 different ophthalmologists contributed specimens to this data base. The mean age of the patients studied was 57 years and the tumors were evenly distributed according to sex and laterality of the eye. This study illustrates the feasibility of using a low-cost microcomputer and commercially available software in the study of a large patient data base.

Computers↗
PubMed1985

Primary acquired melanosis of the conjunctiva.

Forty-one cases of conjunctival primary acquired melanosis (PAM) were studied to determine the frequency of progression to malignant melanoma and to establish prognostic parameters for progression to melanoma. Two subdivisions were identified: lesions with cytologically atypical melanocytes (PAM with atypia, 28 lesions, 68.3 per cent) and those lacking cytologically atypical melanocytes (PAM without atypia, 13 lesions, 31.7 per cent). None of the lesions of PAM without atypia progressed to melanoma. Thirteen of the 28 lesions of PAM with atypia (46.4 per cent) progressed to melanoma. Progression to melanoma was more frequent in the lesions of PAM with atypia if basilar hyperplasia was not the dominant histologic pattern (90 per cent progression, P = 0.02) or if any epithelioid cells were present (75 per cent progression, P = 0.02). It was not possible to determine which lesions were atypical on the basis of clinical appearance. Lesions at risk for the development of melanoma should be totally extirpated.

Biopsy↗
PubMed1985

Malignant melanoma of the conjunctiva.

One hundred thirty-one cases of conjunctival melanoma in which biopsies had been performed were studied to determine potential factors that might affect outcome in patients with these lesions. Two groups of lesions were identified: those associated with primary acquired melanosis (melanoma with PAM, 98 cases, 74.8 per cent) and those without primary acquired melanosis (melanoma without PAM, 33 cases, 25.2 per cent). The overall mortality rate in the 131 cases was 26 per cent (34 of 131); the mortality rate due to melanoma with PAM was 25.5 per cent (25 of 98), and that due to melanoma without PAM was 27.3 per cent (9 of 33). If PAM was associated with the lesion, the presence of atypical melanocytes within the epithelium (pagetoid invasion) was a sensitive indicator of subsequent metastasis. Tumor thickness may also be useful for predicting subsequent metastases. None of the histologic parameters studied proved useful for predicting outcome in patients who had melanomas without PAM. The presence or absence of nevi had no effect on prognosis.

Adolescent↗
PubMed1985

Objective assessment of the malignant potential of intraocular melanomas with standard microslides stained with hematoxylin-eosin.

A method for extracting prognostic information from the cytologic details of intraocular melanomas was developed. With computer assistance, a technician measures the nucleolar area of 200 tumor cells randomly selected from a standard paraffin-embedded microsection stained with hematoxylin-eosin, a procedure that requires approximately 40 minutes with an apparatus that costs less than +30,000. Standard deviation of nucleolar area (SDNA), computed from these measurements, provides an objective assessment of nucleolar pleomorphism. Previous studies showed that second measurements of the same microsection or of the same tumor at different levels yield SDNA values that closely approximate the original measurements. The application of this method to 540 cases from three independent laboratories yielded a correlation of SDNA with death from tumor that was high (P much less than 0.001) and consistent among cases from all three sources. Thus, SDNA provides a clinically useful cytologic measure of the malignancy of intraocular melanomas and may ultimately prove valuable in the assessment of other types of tumors.

Cell Nucleolus↗