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Biomedical subjects

A G Neff

Publications and source records attributed to A G Neff.

4 recordsLinked to original sources

Lacrimal gland ductal cyst abscess.

PURPOSE: To describe a case of lacrimal gland ductal cyst complicated by secondary infection. METHODS: Case report. RESULTS: A 51-year-old woman presented acutely with an enlarging, painful mass in the superotemporal fornix. Clinical examination, echography, and surgical evaluation revealed a lacrimal gland ductal cyst with abscess formation. The lacrimal gland cyst was treated with oral antibiotics in combination with incision, drainage, and marsupialization. CONCLUSIONS: Lacrimal gland ductal cysts are rare but must be considered in the differential diagnosis of lacrimal gland and upper eyelid mass lesions. Typically, lacrimal gland ductal cysts develop after chronic inflammation, infection, or trauma. We describe a patient who presented acutely with a lacrimal gland ductal cyst associated with a rare complication of abscess formation.

Abscess↗

Posterior fixation suture augmentation of full-tendon vertical rectus muscle transposition for abducens palsy.

OBJECTIVE: To evaluate the effect of augmenting full-tendon vertical rectus transpositions with posterior fixation sutures in patients with complete or near-complete lateral rectus palsy. METHODS: Transposition of the vertical recti to the lateral rectus muscle was performed in seven patients with unilateral lateral rectus palsy (the mean angle of preoperative horizontal deviation in primary gaze was 36.7 prism diopters (delta); range, 25-62delta of esotropia). A posterior fixation suture of 5.0 Mersilene (Ethicon, Somerville, NJ) was placed in sclera (14-16 mm posterior to the limbus) adjacent to the lateral rectus and incorporated 1/3 belly width of each transposed vertical rectus muscle. RESULTS: The mean angle of postoperative horizontal deviation in primary gaze was 7.1delta (range, 0-20delta). The mean change in primary-position horizontal deviation postoperatively was 41.2delta (range, 37-72delta). Four patients were able to fuse without prism in primary gaze; three patients were orthophoric and one patient had a consecutive intermittent exotropia. The remaining three patients required prism correction to neutralize the postoperative gaze deviation. All patients had improvement in abduction. Mild limitation of adduction was noted in three patients (range, -0.5 to -2.0). CONCLUSIONS: Augmenting full vertical rectus muscle transpositions with posterior fixation sutures improves the abducting effect of surgery without significant limitation of adduction.

Abducens Nerve Diseases↗

Intracameral muramyl dipeptide-induced paracellular permeability associated with decreased glutamate transporter and gamma -glutamyltranspeptidase activities.

Muramyl dipeptide (MDP) (N -acetylmuramyl- L -alanyl- D - isoglutamine) was injected intracamerally to test if MDP applied to the aqueous side of the blood-aqueous barrier would increase paracellular permeability in association with diminished uptake of glutamate. The symptoms of anterior uveitis, i.e., increase in vascular dilatation, could be detected as early as 30 min post MDP injection while aqueous protein concentration did not increase at this time suggesting an initial dissociation between the circulatory and epithelial barrier responses. However, at 45 min, the aqueous protein concentration increased 10-fold (201+/-174 to 2094+/-1835 micrograms ml-1;P<0.001) rising progressively to 20-fold above the control eye at 60 min post injection (254+/-194 vs. 5038+/-2514 micrograms ml-1;P<0.001). Epithelial cell barrier paracellular permeability increased at 45 min as evidenced by the enhanced efflux of radiolabelled L -glucose out of the aqueous (8% and 13% faster than control at 45 and 60 min post MDP injection, respectively), coinciding with the accelerated protein influx. A near 50% reduction in efflux of both radiolabelled glutamate and D -aspartate was consistent with reduced glutamate uptake by the transport system X-AG. In addition, a 24% decline in aqueous glutamate, but not aspartate, was detected in the aqueous of the MDP-treated eyes in association with a 54% decrease in iris/ciliary body gamma-glutamyltranspeptidase activity consistent with reduced de novo glutamate formation from glutamine. The aqueous of MDP injected eyes also had 6-fold and 34-fold higher prostaglandin E2and F2alphaconcentrations, respectively (P</=0.03) as well as reduced AH bicarbonate concentration. These results suggest that increased paracellular permeability is associated with diminished gamma-glutamyltranspepidase-mediated glutamate production, X-AGtransport activity, and cellular acidosis in the MDP-induced prostaglandin-mediated inflammation.

ATP-Binding Cassette Transporters↗

Giant cell arteritis update.

Giant cell arteritis (GCA) is a systemic disorder characterized by vasculitis involving medium and large arteries. GCA is an ophthalmologic and systemic emergency, because devastating consequences, such as blindness and death, can occur without treatment. With prompt recognition and appropriate treatment, complications are almost always preventable. The prognosis for recovery of vision already lost because of GCA is usually poor, underscoring the absolute necessity of immediate intervention. Knowledge of the various manifestations of GCA is essential for recognition of this disorder early enough to prevent complications. This article highlights the important points regarding diagnosis, management, and complications associated with treatment of GCA.

Biopsy↗