Biomedical subjects
Stephen S Feman
Publications and source records attributed to Stephen S Feman.
Statins ameliorate endothelial barrier permeability changes in the cerebral tissue of streptozotocin-induced diabetic rats.
Statins may have favorable effects on endothelial barrier function. The effect of rosuvastatin and simvastatin therapy (10 mg/kg) for 5 weeks on blood-brain barrier (BBB), blood-retinal barrier (BRB), and cardiac muscle permeability of streptozotocin-induced diabetic rats was studied. The size-selective permeability of different vascular beds to a group of fluorescein isothiocyanate dextrans of varying molecular weights was measured. The volume of distribution of 250-, 70-, and 40-kDa dextrans in the cerebral tissue of diabetic rats were significantly increased. The volume of distribution of these dextrans in cerebral tissue was normalized by both statins. Diabetes did not significantly alter the BRB, but both statins decreased the volume of distribution of 70- and 40-kDa dextrans in the retina. The volume of distribution of 40 kDa in cardiac muscle was increased in diabetes, and this change was prevented with statin treatment. Treatment with rosuvastatin and mevalonate (150 mg/kg in drinking water for 5 weeks) did not alter the volume of distribution measurements. We concluded that 1) diabetes in rats is associated with significant changes in the BBB permeability; 2) statin treatment improves the endothelial barrier function in cerebral tissue, retina, and cardiac muscle; and 3) this statin effect could not be attributed to HMGCoA reductase inhibition.
The retinal features of acute zonal occult outer retinopathy (AZOOR).
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Endophthalmitis in patients with disseminated fungal disease.
BACKGROUND/PURPOSE: Fungal endophthalmitis caused by dissemination from extraocular fungal infections has been reported to vary between 9% and 45%. However, recent clinical experience disagrees with that. This study is an investigation of patients in an inner city teaching hospital, the risks associated with endogenous fungal endophthalmitis, and this incidence. METHODS: All ophthalmology consultations between February 1995 and August 2000 that might be associated with disseminated fungal infection were examined in a prospective manner. Patients were excluded if there was no evidence of a positive fungal culture from any site at any time. Visual symptoms were recorded along with ophthalmologic and systemic examination features. Information was gathered, including the identity of cultured organisms, the sites from which the organisms were obtained, and the patients' disposition. RESULTS: During this interval, 170 consultation requests contained the words "endophthalmitis" or "retinitis" and/or indicated concern about disseminated fungal infections. Extraocular fungal infections were found in 114 patients, but only 82 of them had evidence of systemic dissemination. Some patients had more than one organism. The following are listed in decreasing frequency of occurrence: Candida albicans, Torulopsis glabrata, Candida tropicalis, Candida parapsilosis, Candida krusei, Aspergillus niger, and others. Only two patients had evidence of chorioretinitis and progressed to fungal endophthalmitis. CONCLUSIONS: Endophthalmitis was rare among these patients with known fungal infections. Less than 2% had any related ophthalmic manifestations. Nevertheless, since treatment can save vision, evidence of intraocular infection should be sought as eagerly as before.
Severe pupil distortion following transchamber repair of a cyclodialysis cleft.
This report describes a potential complication following the repair of a traumatic cyclodialysis cleft in a pediatric patient using a novel technique. A healthy 11-year-old boy suffered a blunt traumatic tennis ball injury to his left eye. He underwent repair of a retinal dialysis with detachment shortly after the injury. Postoperatively, he developed persistent hypotony, shallow anterior chamber, and hypotony maculopathy. An occult cyclodialysis cleft was suspected. Examination under anesthesia revealed a small cyclodialysis deft. The cleft was closed by transchamber placement of prolene sutures across the cleft under direct visualization through a Tano lens. Postoperative course was complicated by severe pupillary distortion despite subsequent suture removal.