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Biomedical subjects

A C Chandler

Publications and source records attributed to A C Chandler.

9 recordsLinked to original sources
PubMed1993

Ocular and ocular adnexal injuries treated by United States military ophthalmologists during Operations Desert Shield and Desert Storm.

BACKGROUND: Ocular and ocular adnexal injuries, both combat-related and accidental, are common during wartime. In a combat setting, the eye is particularly vulnerable to serious injury from tiny flying particles that might minimally affect other parts of the body. The purpose of this study is to examine the incidence of serious ocular and ocular adnexal injuries that occurred during Operations Desert Shield and Desert Storm. METHODS: The authors retrospectively reviewed serious ocular and ocular adnexal injuries treated by United States Army and Navy ophthalmologists that occurred during Operations Desert Shield and Desert Storm. Only those injuries that resulted in, or would have resulted in, hospital admission because of the ocular or ocular adnexal injury alone are presented. RESULTS: During Desert Shield, 20 patients (23 eyes) suffered serious ocular or ocular adnexal injuries compared with 160 patients (198 eyes) in Desert Storm. During Desert Storm, 78% of all serious injuries were caused by blast fragmentation from munitions. More than one third of the 98 globe lacerations reported in this article were 10 mm or less in size. Of 35 enucleations performed during Desert Storm, 94% were the result of munitions fragments. CONCLUSIONS: During Operation Desert Storm, fragmentation wounds from munitions were the most common cause of ocular and ocular adnexal morbidity. The authors' findings indicate that polycarbonate ballistic protective eyewear could have prevented many of the ocular injuries that they report.

Adolescent↗
PubMed1989

Inhibition of human immunodeficiency virus 1 protease in vitro: rational design of substrate analogue inhibitors.

Inhibitors of the protease from human immunodeficiency virus 1 (HIV-1) were designed, synthesized, and kinetically characterized. Analogues of a heptapeptide substrate of HIV-1 protease with sequence similar to the p17-p24 cleavage site in the natural substrate, Pr55gag, were synthesized in which the scissile dipeptide bond was replaced with bonds from six categories of stable mimics of an aspartic proteolysis transition state or intermediate. These mimics included an analogue of statine, hydroxyethylene isosteres, two categories of phosphinic acids, a reduced amide isostere, and an alpha,alpha-difluoroketone. The resulting peptide analogues were linear competitive inhibitors of purified recombinant HIV-1 protease with inhibition constants ranging from 18 nM to 40 microM depending on the type of inhibitor. A truncated inhibitor, an analogue of a hexapeptide, retained full inhibitory potency. The most potent inhibitors, containing the hydroxyethylene isostere, effectively blocked the proteolytic processing of a recombinant form of Pr55gag by HIV-1 protease in a cell-free assay.

Amino Acid Sequence↗
PubMed1984

Surgical treatment for malignant exophthalmos of endocrine origin.

Endocrine exophthalmos is a poorly understood disease process thought to be related to a dysfunction of the thyroid-pituitary axis. Initial therapy for symptomatic endocrine exophthalmos is medical. Failure to respond to medical management is heralded by progressive exophthalmos, exposure keratitis, and decreasing visual acuity. The pathophysiologic processes involved and an historical review of the various surgical procedures used are discussed. The results of 28 patients surgically decompressed by a transantral transethmoid approach are presented. Preservation or improvement in visual acuities were observed in all but one patient. Diplopia was generally not improved and may be worsened in some patients.

Adult↗
PubMed1975

Modifications of the conjunctivodacryocystostomy procedure.

I modified the conjunctivodacryocystostomy procedure in 36 patients (43 eyes) by directly threading the pre-flanged PE-190 polyethylene tubing over a No. 3 or 4 Bowman probe into and through the nasolacrimal duct, contrary to the original intranasal maneuvers. This simplified the procedure but caused minor amenable complications such as shortening the tubing postoperatively. In eight of 43 eyes, replacement or shortening the tubing was easily done in the office over a handleless Bowman probe. In three of the 43 eyes, polyethylene tubing was occasionally plugged, requiring cleansing or replacement. Of the 43 tubes inserted, 42 are still in place and functioning.

Adolescent↗
PubMed1975

Cataract surgery: review of 500 consecutive cases.

We believe that most cataract extraction procedures may be good in competent hands, but that complicated techniques do not necessarily give the best results. With inexperienced residents, or the occasional surgeon, a safe, simple method needs to be used until the skill of the operating surgeon may warrant more advanced techniques. A simple cataract procedure consisting of local anesthesia, limbal-based conjunctival flap, 3 postplaced 7-0 mildly chromicized gut sutures, 2 peripheral iridotomies and tumbling extraction of the lens with capsule forceps (indirect acting) is described. The low incidence of complications of all types would seem to negate the current trend of complicating the procedure. Further reports will include large series of cataracts done by resident physicians rather than by the instructors to try to further justify this position.

Adult↗
PubMedDate not supplied

A developmental approach to preschool vision screening.

A developmental approach to preschool vision screening is described. The choice of acuity testing material in this test is determined by the child's capabilities, assessed prior to acuity testing. When compared with the Society for Prevention of Blindness test, this approach yields approximately half the number of untestables. Further, the acuity data from the two screening tests are quite similar, and both agree well with data from an additional screening by a pediatric ophthalmologist. Screening of preschool children usually requires a number of compromises in methods felt to be ideal for adults. Sacrifices in cost (i.e., additional personnel to assist the tester), additional effort (i.e., prior training of the children), or precision of acuity measures (i.e., cruder picture type targets for all children and use of isolated targets) are typically made to assure testability. These problems have been minimized by the Experimental method. Because of its low untestability rate and its apparently valid acuity data, this developmental vision screening test can be recommended as a cost effective approach to preschool vision screening. Previous research has shown that ratings of a child's behavior during this developmentally oriented vision screening test predict results of diagnostic cognitive tests as accurately as extensive tests designed exclusively for developmental screening. This test is then extremely cost effective when used for comprehensive preschool screening.

Child, Preschool↗