[Diagnostic value of distance thermometry of the anterior surface of the eye in epibulbar and intraocular neoplasms].
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The fine needle aspiration biopsy was performed in 91 patients including 57 cases of retrobulbar tumors done under CT control. All aspirates were cytologically examined. In 21 cases immunocytochemical examination was performed in order to distinguish poorly differentiated neoplasms. In 19 cases malignant lymphoma was distinguished from pseudolymphoma. Cytological diagnosis was confirmed by histopathological examination in 77 cases /84%/. One result was false positive, 3-false negative. The value of immunocytochemical methods in differential diagnosis of poorly differentiated neoplasms was stressed.
In localized orbitotemporal neurofibromatosis, the treatment depends very much on the type and severity of the orbital involvement and on the functional state of the eye. The condition can be conveniently divided into three groups, each requiring different treatment: (1) orbital soft-tissue involvement with a seeing eye, (2) orbital soft-tissue and significant bony involvement with a seeing eye, and (3) orbital soft-tissue and significant bony involvement with a blind or absent eye. A total of 24 patients with a maximum of 12 years recurrence-free follow-up are presented.
A major drawback of conventional impression techniques used for customizing facial prostheses is the fact that pressure applied deforms soft tissue, thus reducing accuracy and causing patient discomfort. A possible solution is the use of optical 3-D coordinate measuring techniques, such as the fringe projection technique, which enables precise and contact-free recording of facial surfaces. The application of this method is demonstrated on a patient who lost his left eye and part of the jaw bone during surgery for cancer. 3-D CAD software that supports the construction of a facial prosthesis from the data obtained has been developed. For this purpose, spline functions are used to define border curves, and the intact half of the face is used as a model for the prosthetic surface. The resulting digital data are used to construct first a model made of synthetic resin, and then a final wax model with the aid of rapid prototyping techniques.
Despite progress in maxillofacial cancer surgery, most patients present disfiguration of their faces. External prostheses are a pleasing alternative to camouflaging maxillofacial mutilations after tumor ablation. Established indications for external prosthesis are: 1. the patient refusing soft-tissue reconstruction, 2. patient's multimorbidity, and, 3. the impossibility of fully reconstructing a specific maxillofacial defect. Consequently, the benefits of applying external prosthesis include the simple camouflage of an unsightly tumor defect, the ease in supervising any possible local tumor growth beneath the external prosthesis as well as helping to prevent patient's isolation. Thus, external prostheses are a good option in the rehabilitation of maxillofacial surgery patients.
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We investigated the diagnostic efficacy of the i.v. administration of a sonography (US) contrast agent to study eye and orbit tumors at different stages. We administered Levovist (Schering), an air microbubble stabilized by fatty acid, which is specific for angiographic indications. Baseline color Doppler US was performed on 24 selected patients and tumor vascularization patterns were classified into three classes. Color Doppler signal enhancement was assessed after contrast agent administration and the signal-to-noise ratio (SNR) was improved in 70% of cases, which helped identify vascular patterns and improved flowmetric accuracy. The Doppler effect was also improved and vascular signal was always enhanced. The SNR was improved also by the postcontrast detection of small vessels missed on baseline scans. Doppler signal enhancement was proportional to precontrast vascularization and depended on tumor size, with poor results in lesions < 5 mm. In contrast, vascular signal spots with increased postcontrast echogenicity sometimes caused excessive noise affecting the results. No correlation was found between signal enhancement and lesion histotype or between signal and lesion site. Treated lesions exhibited poorer contrast agent enhancement. The examination technique must be accurate and the various parameters set optimally, especially the velocity scale, gain and filtration; the unit must feature adequate recording capabilities (mm/s). To conclude, we believe that the routine use of i.v. US contrast agents will play a major role in improving diagnostic imaging in oculistics also thanks to the lack of untoward reactions and to the ease of contrast agent preparation.
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The gene for pigment epithelium-derived factor (PEDF) was localized to chromosome 17 by the analysis of three independent somatic cell hybrid panels. Fluorescence in situ hybridization shows a specific hybridization signal at the terminal portion of the short arm of chromosome 17. PCR analysis of somatic cell hybrids containing specific regions of 17 was subsequently used to sublocalize PEDF to 17p13.1-pter. PEDF thus maps to a region containing a number of cancer-related loci and thus must be considered a candidate gene for these cancers. Preliminary studies with cultured human Y79 retinoblastoma cells indicate that expression of PEDF is associated with relatively undifferentiated, proliferating cells rather than their differentiated, slow-growing counterparts. This and the fact that the PEDF protein can act as a potent neurotrophic differentiating agent suggest that PEDF is linked to proliferative events that terminate in final phenotypic determination within specific cell lineages.
PURPOSE: Our previous experiments have shown that low dose angiostatin results in decreased hepatic micrometastasis in a mouse model of uveal melanoma. The purpose of these experiments is to evaluate the effect of angiostatin on in vitro migration of melanoma cells and to explore the in vivo mechanism of angiostatin in our model. METHODS: For in vitro studies, quantitative RT-PCR was used to detect VEGF and PEDF mRNA in mouse B16LS9 melanoma cells and Mel290 human uveal melanoma cells with or without supplemental 0.1 mug/ml murine or human recombinant angiostatin. A wound healing assay was used to measure cellular migration in these two groups of cells. For the in vivo mechanism, aliquots of tissue culture B16LS9 cells treated with or without 0.1 mug/ml murine angiostatin were heterotopically inoculated into the posterior compartments of the right eyes of C57BL/6 mice. Frozen hepatic tissue was prepared and stained with hematoxylin using an RNase-free technique. Hepatic micrometastatic uveal melanoma cells were obtained by laser capture microdissection (LCM). Levels of VEGF and PEDF mRNA were detected by real time RT-PCR in the hepatic micrometastases. RESULTS: After in vitro treatment of the cell lines with angiostatin, the ratio of VEGF/PEDF mRNA significantly decreased in the B16LS9 (0.88+/-0.11 [mean+/-standard deviation] versus 2.70+/-0.15 in the control group; p=0.00006) and Mel290 (0.12+/-0.02 versus 0.68+/-0.04 in the control group; p=0.00346). However, the absolute VEGF mRNA and PEDF mRNA did not significantly change (p>0.08 for both cell lines). The migration assay showed significantly decreased migration at 24 h and 48 h after angiostatin treatment for both B16LS9 (p<0.01) and Mel290 (p<0.01) cell lines. For the in vivo experiments, pretreatment with angiostatin resulted in a decreased VEGF/PEDF mRNA ratio in B16LS9 cells compared to controls (0.0274+/-0.0070 versus 0.1726+/-0.0313; p=0.0014). Additionally, there was significantly increased PEDF mRNA (2.14+/-0.12 versus 0.30+/-0.05 in the control group; p=0.00002) in the liver metastases after pretreatment with angiostatin. CONCLUSIONS: Angiostatin inhibits the migration of melanoma cells in vitro. Angiostatin significantly decreases the ratio of VEGF/PEDF mRNA level in vitro and in hepatic micrometastatic melanoma cells. Angiostatin increases PEDF mRNA in melanoma metastases.
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The frequency and the causes of extrusion of orbital implants have been investigated. Of the 294 patients in which enucleation was done, in 17 cases (5.8%) extrusion of the first implant developed; in 9 cases with second or third implantations another 5 implants have been extruded. The extrusion of implants is caused mainly by the operative technique and only rarely by intolerance reactions. For a reliable healing exact sutures of the muscles and also exact closure of the implant with plenty of covering tissue is important.
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The application of radiation therapy in the retreatment of unilateral recurrent retinoblastoma presents a very difficult dilemma in which consideration must be given to preservation of vision in the remaining eye while tumoricidal doses of irradiation are delivered. A technique is described in which a methylmetraculate eye sphere carrying a single Iodine-125 seed was used to deliver local irradiation to the orbital tissues in a patient with multiple episodes of recurrent retinoblastoma. The tissue dose at 2 mm depth was 2630 cGy while the dose to the retina of the remaining eye and to the optic chiasm was negligible.
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