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Biomedical subjects

A S Berger

Publications and source records attributed to A S Berger.

16 recordsLinked to original sources
PubMed1992

Clinical experience with the surgical removal of subfoveal neovascular membranes. Short-term postoperative results.

BACKGROUND: Severe visual loss occurs in the presumed ocular histoplasmosis syndrome (POHS) and in age-related macular degeneration (ARMD) from subfoveal neovascularization. Although laser photocoagulation has recently been recommended for this complication in ARMD, treatment is inevitably associated with a loss of central vision. In an attempt to restore and/or preserve central vision, the authors undertook surgical removal of subfoveal neovascular membranes in these diseases. METHODS: Patients with POHS and ARMD with reduced Snellen visual acuity to 20/80 or less were selected if there was angiographic evidence of a neovascular membrane beneath the fovea. Modern vitreoretinal techniques were used to remove the subfoveal neovascular complex. RESULTS: The authors' first 15 patients with POHS and 19 patients with ARMD were followed for an average of 4 months postoperatively. Snellen visual acuity improved by 2 lines or more in 8 of 15 (53%) cases of POHS. Although similar improvements in Snellen visual acuity were not observed in cases of ARMD, 14 of 19 (74%) cases showed either slight improvement or stabilization of their vision postoperatively. Complications included recurrent neovascularization in 2 of 15 (13%) and 3 of 19 (16%) eyes with POHS and ARMD, respectively. No retinal detachment or preretinal proliferation was observed. CONCLUSIONS: These results suggest that subfoveal neovascularization can be successfully removed with preservation of foveal vision in POHS and stabilization in ARMD, at least for the short term. Visual improvement was observed in POHS even after 6 months of decreased vision. Finally, visual prognosis is most dependent on the integrity of the subfoveal RPE after removal of the membrane.

Adolescent↗
PubMed1990

Syphilitic disc edema and periphlebitis.

This photo essay shows the retinal findings in a patient with presumed syphilitic disc edema and periphlebitis. Resolution of these findings after treatment with penicillin is documented by improvement in visual acuity from 20/50 to 20/25 in the right eye and from 20/200 to 2/20 in the left eye. Photographic documentation of the resolution of retinal findings, including disc edema and periphlebitis, is presented.

Fluorescein Angiography↗
PubMed1989

Acquired disruptions of the incudostapedial articulation: diagnosis with CT.

To determine the best technique for diagnosing incudostapedial joint disruption with computed tomography (CT), the authors reviewed 15 surgically proved cases. In each case, the articulation was depicted on axial but not coronal images. Disruption was due to inflammation in ten cases and trauma in five. Axial high-resolution CT is valuable in the diagnosis of traumatic and inflammatory disruption of the incudostapedial joint.

Adult↗
PubMed1987

Computed tomography for parotid neoplasia: a new look.

Sixty-five mass lesions of parotid origin were evaluated using thin-section high-resolution computed tomography to ascertain histologic specificity. All patients were studied after infusion of intravenous contrast media. Factors judged included the extent of glandular involvement, invasion of adjacent soft tissues, degree of postcontrast computed tomography density (relative to muscle), and the presence of calcification.

Adenolymphoma↗
PubMed1987

Ossicular erosions in the dry ear: CT diagnosis.

Erosions of the ossicular chain that occurred as a complication of noncholesteatomatous chronic otitis media were studied with computed tomography (CT) in 55 patients. The incus (particularly the long and lenticular processes) was the ossicle most commonly involved (50 cases). Coronal and axial CT sections were complementary in the diagnosis of these erosions. Fibrous replacement of the incudostapedial articulation was diagnosed in four cases on axial CT scans when an unusually wide joint was present.

Ear Diseases↗
PubMed1987

Synthetic ossicular replacements: normal and abnormal CT appearance.

Twenty-two patients with synthetic ossicular replacements were studied with computed tomography (CT). Twelve patients had total ossicular replacement prostheses (TORPs), and ten patients had partial ossicular replacement prostheses (PORPs). Good results were achieved in 12 patients (eight with TORPs and four with PORPs). Four of these prostheses were clearly visible on CT scans, six were discernible, and two were not identified. In the ten patients with unsatisfactory surgical results, CT was performed before surgical revision. It disclosed subluxation of the prosthesis in four patients and fibrous tissue fixation in four. In two patients the CT scan appeared normal; surgery disclosed lateralization of the graft with a nonfunctioning interface.

Ear Ossicles↗
PubMed1986

Computed tomography of the disarticulated incus.

Complete incus disarticulation may be a complication of trauma, chronic otitis, or prosthetic stapedectomy. Purposeful incus disarticulation (with incus interposition) is used as a method of ossicular reconstruction. CT has been a valuable diagnostic tool for preoperative location of the incus in the former disorders and for determination of the status of the ossiculoplasty in the latter.

Ear Ossicles↗
PubMed1986

Stapes prosthesis: evaluation with CT.

We used computed tomography (CT) to evaluate 44 patients who had undergone stapedectomy with insertion of a prosthesis. Several patients had poor surgical results, including recurrent conductive hearing loss, vertigo, and sensorineural hearing loss. Conductive hearing loss occurring immediately after the procedure was most often caused by anatomic limitations or surgical technique. Causes of delayed or recurrent conductive hearing loss included reparative granuloma formation, incus necrosis (at the attachment of the wire), prosthesis subluxation (most often posterior), and regrowth of otosclerosis, which occasionally is further complicated by incus dislocation. We found that CT is often diagnostic when these complications occur. Immediate sensorineural hearing loss or vertigo can be self-limited if caused by serous labyrinthitis. When delayed, these symptoms may be due to perilymph fistula. If caused by the latter, CT may not yield abnormal findings unless subluxation of the prosthesis into the vestibule has occurred.

Adult↗
PubMed1985

The vestibular aqueduct syndrome: computed tomographic appearance.

We have recently examined three young patients with congenital unilateral profound sensorineural hearing loss. On computed tomography the only abnormality discovered was a remarkably enlarged vestibular aqueduct on the abnormal side. The vestibular aqueduct syndrome is an important cause of congenital hearing loss. Although this finding has been well illustrated with conventional multidirectional tomography, there has been little emphasis on the computed tomographic appearance.

Adult↗
PubMed1985

Fenestral and cochlear otosclerosis: computed tomographic evaluation.

Computed tomography has replaced conventional multidirectional tomography in the imaging of patients with the presumed diagnosis of otosclerosis. In addition to obliterative disease, which was easily diagnosed with multidirectional tomography, anterior and posterior foci of varying sizes can now also be visualized preoperatively. Active cochlear otosclerosis (otospongiosis) is diagnosed in the presence of foci of demineralization in the otic capsule. Diagnosis of these entities has been of great interest to our referring otologic surgeons.

Adult↗
PubMed1982

The frontalis nerve in the temporal brow lift.

Brow elevations via the indirect temporal lift approach was carried out on a series of 26 cadaver half heads. The purpose of the dissection was to identify the course and depth of plane of the frontalis branch of the facial nerve. Of particular interest was the area superolateral to the brow. Histologic sections were taken along the course of the nerve to determine its exact depth. It was determined that the nerve lay in the superficial musculoaponeurotic system layer of superficial fascia lying above the level of the temporalis fascia. Utilizing this information, a method of dissection in the temporal lift operation is described that safely avoids the frontalis branch of the facial nerve.

Cadaver↗
PubMedDate not supplied

MR imaging of parotid mass lesions: attempts at histopathologic differentiation.

Thirty-four parotid lesions were examined with magnetic resonance imaging. The lesions were studied for a number of factors including size, T1 signal (relative to muscle), T2 signal (relative to CSF), homogeneity, associated adenopathy, associated abnormality of the deep cervical fascia, infiltration of subcutaneous fat, and seventh nerve involvement. Lesions histologically diagnosed as pleomorphic adenoma (benign mixed cell tumor) were predominantly homogeneous as well as smoothly marginated. Those diagnosed as papillary cystadenoma lymphomatosum (Warthin tumor), although equally well marginated, were strikingly heterogeneous, often with areas of hemorrhage. Malignancies and inflammatory masses were both associated with cervical lymphadenopathy; however, inflammatory masses demonstrated fascial thickening of the deep cervical fascia and infiltration of subcutaneous fat ("dirty" fat).

Adenolymphoma↗
PubMedDate not supplied

Clinical experience with a new device that will simplify insulin injections.

In order to test clinically a newly developed, simple, and convenient device for giving multiple injections of short-acting insulin (Actrapid HM, Novo, Bagsvaerd, Denmark), 16 type I diabetic patients previously stabilized on intensified conventional therapy regimens participated in a randomized crossover study for a period of 6 wk. The patients used conventional syringes for injections of short-acting insulin during one period and the new device during the other. Conventional syringes were used for injections of basal insulin during both periods. Metabolic control was assessed by twice-weekly blood glucose profiles, HbA1c, and the frequency of hypoglycemic reactions; no significant differences were found during the two treatment periods. No infections at the injection sites were seen. Patients' evaluation of the new device was very positive.

Adult↗