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Biomedical subjects

R M Ellsworth

Publications and source records attributed to R M Ellsworth.

At least 37 records · Page 2Linked to original sources
PubMed1988

Circulating melanoma-associated antigens in ocular melanoma.

A pilot study was performed to test for melanoma-associated antigens (MAAgs) in the sera of patients with localized uveal melanoma, using monoclonal antibodies (MoAbs). Both whole sera and polyethylene glycol (PEG) 2.5% serum precipitates from 18 patients with clinically localized uveal melanoma and two patients with localized invasive conjuctival melanoma were analyzed for two human cutaneous MAAgs by an enzyme-linked immunosorbent assay (ELISA). These antigens could not be identified when whole sera were used. However, after PEG precipitation, a MoAb specific for the p210 MAAg reacted with four of 20 patient samples and none of 17 controls. A second MoAb specific for the p97a MAAg reacted with one of 20 patients and none of 17 controls. These findings indicate the existence of antigens common to both uveal and cutaneous melanoma and suggest that the refinement of assays to screen sera with a battey of MoAbs may be of value in diagnosing and/or monitoring patients with uveal melanoma. Circulating immune complexes were detected in the sera of six patients but did not correlate with any clinical features or with the presence or absence of detectable MAAgs.

Adult↗
PubMed1987

Magnetic resonance imaging in the evaluation of optic nerve gliomas.

Five patients with optic nerve gliomas were evaluated by magnetic resonance imaging (MRI). Images obtained with MRI were equal to computed tomography (CT) in evaluation of the orbital components of these tumors and superior to CT in evaluating the intracanalicular, chiasmal, and post-chiasmal extension of tumor. MRI is unimpeded by artifacts produced by surrounding bone, as encountered in CT, and also proves to be more sensitive in delineating subtle differences in fat content and hydration of neural tissues. Thus, MRI is extremely valuable in furthering our understanding of the natural and therapeutic response of optic nerve gliomas.

Adult↗
PubMed1987

Retinoblastoma with anterior chamber extension.

Anterior chamber retinoblastoma is a rare clinical entity. The authors have reviewed the records of 1500 patients with retinoblastoma to determine the incidence and prognostic ramifications. Of 30 patients with anterior chamber involvement, 15 were noted on initial examination and 15 during observation after therapy. Despite aggressive multimodality treatment, total response was never achieved and all eyes were eventually lost. Results of pathologic examination showed ciliary body invasion, which was held accountable for the poor response to therapy. Anterior chamber retinoblastoma is a poor prognostic sign which cannot be controlled effectively with current techniques and should be considered an indication for enucleation without delay.

Child↗
PubMed1987

Advanced diagnostic imaging techniques in ophthalmology.

Diagnostic imaging techniques continue to gain tremendous importance in the evaluation of ocular and orbital disease as technical developments and refinements are made. This article presents key diagnostic imaging methods, with special focus directed toward the advanced modalities important in evaluation of the traumatized eye and orbit. The text has been prepared specifically for the clinical ophthalmologist. Each of the diagnostic modalities discussed is presented in terms of its basic biophysical mechanism, indications, and advantages and disadvantages. The techniques described include simple plain film roentgenography (and its contrast-related applications: dacryocystography, orbital venography, and angiography), axial hypocycloidal tomography, computed tomography, ultrasonography, and magnetic resonance imaging.

Diagnostic Imaging↗
PubMed1987

Magnetic resonance imaging in choroidal tumors.

Magnetic resonance imaging (MRI) was performed on 13 patients with choroidal tumors to determine whether this technique could detect and portray an intraocular tumor and to investigate additional biochemical parameters of the diseased tissue. In 11 of 13 patients, the lesion was depicted, and its gross morphology was outlined with a clarity approaching that of computed tomography. We were able to apply principles derived from MRI studies in other portions of the body and identify trends in the characterization of lesions of different etiologies. The relative T1 and T2 values for each of the major pathologic categories (malignant melanoma, metastatic carcinoma, and benign choroidal lesions) are presented and discussed. In addition, MRI was clearly superior to other techniques in the detection and delineation of associated intracranial lesions.

Choroid Neoplasms↗
PubMed1986

Chromosomal abnormalities in human retinoblastoma. A review.

In part because of an association between the tumor and the constitutional chromosome 13q deletion syndrome and the finding of 13q deletions or monosomy 13 in retinoblastoma cells from individuals with normal constitutional karyotypes, chromosome 13q is postulated to contain a gene responsible for tumorigenesis in retinoblastoma. A review of the cytogenetics of retinoblastoma (incorporating an analysis of five previously unpublished cases and 77 cases from the literature) revealed recurrent abnormalities (in addition to those involving number 13, 21% of cases) that included: additional copies of 1q material (44%), isochromosome (6p) (45%), monosomy 16 (18%), marker 1p+ (13%), and homogeneously staining regions and double minutes (9%). Possible roles for these chromosome abnormalities in tumor development are discussed.

Alleles↗
PubMed1986

Ultrasonic hyperthermia and radiation in the management of intraocular malignant melanoma.

Hyperthermia and radiation were used in combination to treat four patients with choroidal malignant melanoma. This technique uses ultrasonically induced hyperthermia synergistically with radiation to destroy tumor cells. The lower levels of radiation used should avoid the late vascular and inflammatory complications seen in conventional radiation therapy. Tumors were scanned by a computerized diagnostic ultrasound system before treatment and assigned an acoustic tissue type on the basis of a statistical comparison of their ultrasound backscatter spectrum with spectra of tumors of known pathologic status. During the follow-up period, the longest of which was 15 months, all tumors demonstrated regression patterns consistent with choroidal tumors of the same acoustic tissue types treated with conventional radiation therapy.

Aged↗
PubMed1986

Antiviral therapy with ganciclovir for cytomegalovirus retinitis and bilateral exudative retinal detachments in an immunocompromised child.

A child with bilateral cytomegalovirus (CMV) retinitis, vitritis, and exudative retinal detachments, who was in remission from stage IV neuroblastoma and status post-chemotherapy and autologous bone marrow transplantation, was treated with ganciclovir. The drug is a new acyclic nucleoside antiviral drug with potent antiCMV activity. There was bilateral retinal reattachment, clearing of vitritis and regression of retinal exudates and hemorrhages, with concomitant resolution of viral shedding in urine and blood, on ganciclovir 7.5 mg/kg per day. There was recurrence of exudative detachments, vitritis and retinitis when the dose was reduced to 2.5 mg/kg per day, and regression of these findings when the dose was again increased to 7.5 mg/kg per day. Despite continued therapy at this dose, a relapse occurred. When the dose of drug was doubled to 15 mg/kg per day, there initially was a partial therapeutic response, followed by a subsequent relapse. No further response was seen when the dose was increased to 19.5 mg/kg per day. This patient was treated with ganciclovir for a total of 192 days. No adverse reactions to ganciclovir were seen. On the last day of drug administration, there were persistent bilateral exudative retinal detachments and progressive optic nerve head involvement with optic disc pallor, despite quiescence of the retinitis.

Acyclovir↗
PubMed1986

Unilateral vs. bilateral retinoblastoma. Correlations between age at diagnosis and stage of ocular disease.

Retrospective analysis of 358 cases of retinoblastoma for correlation between age and intraocular stage at the time of diagnosis revealed: in both early and advanced stages of intraocular disease, bilateral retinoblastoma presents at an earlier age than does unilateral retinoblastoma; support for the Knudson "two-hit" hypothesis of retinoblastoma genetics, the existence of a positive family history for retinoblastoma does not guarantee an earlier age at diagnosis compared to sporadic disease; and for any age at diagnosis, unilateral or bilateral disease, Group V is the most common intraocular stage found.

Age Factors↗
PubMed1986

Radiation and chemotherapy of parameningeal rhabdomyosarcoma involving the orbit.

Eighteen patients with parameningeal rhabdomyosarcoma (RMS) involving the orbit were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) between July 1971 and October 1983. Fifteen patients were children with a mean age of 6 years and three patients were adults with a mean age of 21 years. In four patients, the primary tumor originated in the orbit, while the remaining 14 had other parameningeal primary sites. The tumors were in a very progressive local stage, with destruction of facial bones in most patients. Six patients were treated with the T2 chemotherapy protocol and 12 received the T6 protocol. The radiation treatment plan for all patients was designed to deliver between 4500 and 7200 rad delivered to the primary tumor over 4 to 16 weeks. Eleven of the 18 patients (61%) are alive and well with a median follow-up time of six years. Two patients died of therapeutic complications and five died of tumor spread with central nervous system involvement. Ocular complications included acute and chronic conjunctival, corneal, lens, and retinal changes, which were less severe than those reported in previous series.

Cataract↗
PubMed1986

Optic disc edema and Lyme disease.

A seven-year-old child developed a febrile rash, migratory arthritis, and neurologic signs. Three days earlier, the child had been bitten by a tick. An eye examination two months later revealed bilateral papilledema, although the cerebrospinal fluid pressure was 170 mm. The IgM antibody titer for the Ixodes dammini spirochete was 1:256. I dammini is the tick vector for the Borrelia spirochete that causes Lyme disease. The papilledema receded with treatment over a month's time, and bilateral pigment epithelial mottling at the fovea was present after one year.

Antibodies, Bacterial↗
PubMed1985

Magnetic resonance imaging in the evaluation of leukocoria.

Leukocoria is an important clinical sign in ophthalmology. Conditions producing this white pupillary reflex must be differentiated from retinoblastoma to insure appropriate and timely treatment. Auxiliary diagnostic testing has been helpful in securing a clinical diagnosis. A new diagnostic modality, magnetic resonance imaging, provides similar morphologic information with the additional potential for biochemical characterization. A series consisting of 14 patients presenting with leukocoria as a result of retinoblastoma and simulating conditions was examined. The magnetic resonance imaging findings are discussed.

Child↗
PubMed1985

Computed tomography of the nonrhegmatogenous retinal detachment in the pediatric patient.

Nonrhegmatogenous retinal detachments occur in the pediatric population secondary to other ocular disorders. The most important cause to identify is retinoblastoma. Computed tomography has proven to be the most reliable ancillary diagnostic test in this pediatric population. A series of eighty patients, presenting with nonrhegmatogenous retinal detachments, was examined. The role of computed tomography and characteristic clinical findings are discussed.

Child↗