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S C Kaufman

Publications and source records attributed to S C Kaufman.

35 records · Page 2Linked to original sources
PubMed1995

Confocal microscopy of corneal graft rejection.

Corneal allografts were transplanted into inflamed and vascularized graft beds in rabbit eyes. The grafts were examined every 4 days by slit-lamp biomicroscopy and scanning confocal microscopy. Confocal images were recorded with a video camera and computer enhanced in real-time. Layers of the cornea were visualized in serial optical sections parallel to the epithelium. In the third postoperative week, signs of graft rejection were observed; slit-lamp examination revealed a circumferential line of epithelial rejection, along with cloudiness and edema. Vessels were observed growing into the graft. By confocal microscopy, infiltrating cells were seen in the graft stroma. Foci of cells were especially pronounced around the sutures. Scattered leukocyte infiltrates were prominent at capillary terminals. There was an accompanying reduction in the stromal keratocyte density in the region of the infiltrate. Additionally, various degrees of fibrosis were noted around each suture and at the host-graft interface. Confocal microscopy may provide a valuable clinical tool for determining the earliest indicators of an antigraft immune response, and as an aid in the differential diagnosis of other inflammatory conditions of the cornea.

Animals↗
PubMed1995

A new form of primary, localized, corneal amyloidosis: a case report with confocal microscopy.

We present a case of bilateral, primary, localized, corneal amyloid deposition with a unique appearance not, to our knowledge, previously described. The patient was a 73-year-old white man who complained of glare. Best corrected visual acuity was 20/25 in both eyes. Slit lamp examination revealed subepithelial/anterior stromal white-gray deposits in the peripheral cornea in both eyes. The corneal surface was smooth with no elevated areas. Superficial corneal scrapings showed focal deposits of an amorphous, glass-like material below the epithelial surface and within Bowman's membrane, which stained with Congo red. We examined the amyloid deposits using the confocal microscope to obtain high magnification images in vivo. The confocal microscopic views showed intercellular, cotton candy-like, fibrillar amyloid material scattered throughout the anterior stroma. The use of this instrument may permit clinical diagnosis of this rare disorder without the need for biopsy.

Aged↗
PubMed1994

Quantification of real-time confocal images of the human cornea.

Real-time confocal microscopy was used to obtain images of the surface cells of the cornea in vivo in human subjects and in non-human primates. The surface cells represent the barrier between the tear layer and the internal cellular environment and as such, the state of these cells is indicative of the health of the cornea. In our study, confocal microscopy of the surface cells revealed prominent, centrally located nuclei. With the use of a series of image analysis procedures, the nuclei were located automatically and distances to the nearest neighbors were determined. Comparison of these procedures in 8 human corneas and 1 non-human primate cornea showed that unaided computer analysis of the surface cells was as accurate as manual location of the cell nuclei. The distribution of nearest-neighbor distances was found to be best fitted by a gamma distribution. Simulation of a condition marked by loss of surface cells demonstrated that the alpha (shape) and beta (scale) parameters could be used to compare the distribution of nearest-neighbor distances. Thus, confocal microscopy coupled with these image analysis and statistical procedures could provide an objective, quantitative approach to monitoring the epithelial barrier under clinical and experimental conditions, for example during post-surgical or post-traumatic healing or in the evaluation of the efficacy of topical therapeutic agents.

Animals↗
PubMed1993

An adjustable double running suture technique for keratoplasty.

In a retrospective analysis, we examined 30 consecutive cases of penetrating keratoplasty in which a double running 10-0/11-0 nylon suture technique was used and the 10-0 suture was adjusted early in the postoperative period to reduce astigmatism. When the response to suture adjustment was inadequate, the presence of the 11-0 suture allowed for early (ten to 18 weeks) removal of the 10-0 suture. Rapid visual recovery (12.3 +/- 0.95 weeks; mean +/- standard error) and low levels of final astigmatism (2.66 +/- 0.24 diopters) were achieved. Visual acuity was 20/20 to 20/40 in 25 of the 28 patients (89%) who were visually rehabilitated. In these 28 patients, visual acuity remained stable for the remainder of the study. All patients had a minimum of six months' follow-up from the time of surgery; mean follow-up was 10.6 +/- 1.70 months.

Adult↗
PubMed1992

Episiotomy. To cut or not to cut?

Episiotomy is performed in over half of the hospital-based deliveries in the US, despite the dearth of scientific data demonstrating its usefulness in uncomplicated cases. After roughly 70 years of widespread use in the US, the first randomized clinical trial of episiotomy conducted in North America (and the first worldwide involving median episiotomy) found no evidence for better outcomes in deliveries assigned to "liberal" than those assigned to "restricted" use of episiotomy. These results lend support to the many health professionals and lay persons calling for further reduction in the use of this procedure.

Episiotomy↗
PubMed1991

Thyroid hormone use: trends in the United States from 1960 through 1988.

Thyroid hormone preparations comprised over 1% of all prescriptions filled by retail pharmacies during 1988 in the conterminous United States, i.e., the 48 contiguous states. Their large market share gives the patterns of their use substantial public health importance. This article describes prescription thyroid hormone use in the United States from 1960 through 1988, using pharmaceutical marketing research data collected from panels of retail pharmacies and office-based physicians. Although the use of natural products has declined by over 50% since 1960, about one fourth of all thyroid hormone prescriptions were for natural preparations as recently as 1988. Per capita thyroid mentions (i.e., patient-physician contacts during which a thyroid agent of any kind was recommended, prescribed, dispensed, administered, ordered to be given by a hospital, or given as a sample) doubled during this period among those over 59 years old. Per capita mentions for synthetic thyroid products increased fourfold and tenfold among men and women in this age group, respectively. Use for weight loss, despite the label's boxed warning indicating it to be ineffective and potentially dangerous, has diminished but persists. Obesity was second only to hypothyroidism among the diagnoses underlying thyroid product mentions.

Adolescent↗
PubMed1989

Factors associated with visual outcome after photocoagulation for diabetic retinopathy. Diabetic Retinopathy Study Report #13.

Six risk factors for severe visual loss despite panretinal (scatter) photocoagulation were identified by analyzing data collected during the first 5 years after randomization in the Diabetic Retinopathy Study. Proportional hazards regression revealed NVD (neovascularization on/around the optic disc) to be the most important risk factor. The risk of severe visual loss rose with increasing NVD, hemorrhages/microaneurysms, retinal elevation, proteinuria, and hyperglycemia and fell with increasing "treatment density." These results are similar to previous DRS findings on untreated eyes. The importance of "treatment density" as an independent predictor of visual outcome is a new finding and lends support to the common clinical practice of repeating photocoagulation if initial treatment does not reduce or stabilize retinal neovascularization.

Aged↗
PubMed1988

Optic disk neovascularization and retinal vessel diameter in diabetic retinopathy.

We measured retinal vessel diameter before and after panretinal photocoagulation in 59 eyes with diabetic retinopathy and moderate to severe optic disk neovascularization. Treatment significantly reduced mean arteriolar and venular diameter. The diameter of the retinal arterioles after treatment correlated significantly with the amount of regression in disk neovascularization. Eyes with large diameter vessels after treatment usually had little or no regression of proliferative retinopathy, whereas regression was more frequently seen in eyes with smaller diameter vessels after treatment.

Arterioles↗
PubMed1987

Intraocular pressure following panretinal photocoagulation for diabetic retinopathy. Diabetic Retinopathy Report No. 11.

Data collected during the first five years after randomization in the Diabetic Retinopathy Study were analyzed to determine the effect of panretinal photocoagulation on intraocular pressure (IOP). At each follow-up visit, median IOP was identical for the treated and untreated eyes. Mean IOP rose slightly in each group. The proportion of untreated eyes with IOP above 30 mm Hg at two consecutive visits was twice that of the treated eyes (2% vs 1%). These data show that panretinal photocoagulation reduces the risk of subsequent intraocular hypertension, apparently by preventing the development of neovascular glaucoma.

Argon↗
PubMed1987

Macular thickening and visual acuity. Measurement in patients with cystoid macular edema.

Cystoid macular edema (CME) is commonly associated with many ocular conditions. The presence of CME on fluorescein angiographic examination need not, however, preclude good visual acuity. The hypothesis that the degree of macular thickening is associated with visual acuity was tested. Ten consecutive stereoscopic fluorescein angiograms were graded by 13 ophthalmologists using a set of four standards. Linear regression showed a significant relationship between mean macular thickening and the visual acuity recorded at the time of angiography. However, no significant relationship could be made between the estimation of visual acuity and the amount of fluorescein staining measured in the posterior pole. Although the observation of fluorescein leakage is indispensable for documenting a breakdown in the blood-retinal barrier, the observation of retinal thickening is important for identifying the sites of edema accumulation, and may be the useful parameter to follow when trying to assess improvement or worsening of retinal edema and in cases of uveitis when the cause of poor vision may be multifactorial.

Adult↗
PubMed1986

First case report from Argentina of fatal septicemia caused by Chromobacterium violaceum.

A case of Chromobacterium violaceum fatal septicemia is reported. The microorganism was isolated from six blood cultures and two suppurated skin lesions. It is the first such case described in Argentina, and it reinforces the need for prolonged treatment and careful clinical evaluation to ensure complete remission of human infections caused by this bacterium.

Adult↗
PubMedDate not supplied

Confocal microscopy of corneal penetration by tarantula hairs.

In vivo identification of foreign bodies in the cornea may be impossible if the size and/or location precludes visualization by slit lamp biomicroscopy, which has an upper limit of magnification of 50x. These limitations became obvious when we attempted to identify the offending material in the inflamed eye of a patient who complained of foreign body sensation after contact with a pet tarantula. As a model of this clinical situation, we used a newly developed tandem scanning confocal microscope to observe and to photograph tarantula hairs as they penetrated the corneal stroma and endothelium and entered the anterior chamber in rabbit eyes. We found that, experimentally, the hairs penetrated the ocular tissues apparently without inciting inflammation or causing fibrosis. The instrument we used--a prototype with a Nipkow disk from Noran, Inc. (Middleton, Wis.) and a 25/0.8 na glycerin immersion lens (Plan-Neofluor, Zeiss)--provides magnifications of 100-500x, real-time viewing in vivo, optical sectioning, contrast control, high resolution, processing through image analysis systems, and video and hard copy output. We believe that confocal microscopy offers a new approach to the identification and localization of foreign bodies in the anterior segment, as well as to the visualization and diagnosis of ocular diseases, including bacterial, fungal, and other parasitic invasions, in the human eye.

Animals↗