Biomedical subjects
Publications and source records attributed to Anthony Maloof.
Mucinous carcinoma of skin (MCS) is an uncommon adnexal tumor of disputed differentiation. In 1995, Rahilly et al. reported a case of MCS with neuroendocrine differentiation (E-MCS). Since that report, seven additional cases have been published. Here, we report on a case of E-MCS and discuss the differential diagnoses.
A 54-year-old man presented with a painful left proptosis and a soft tissue mass at the inferolateral aspect of the left orbit with bone involvement. There was no clinical or investigational evidence of systemic disease. Both light microscopy and immunohistochemistry were required for the diagnosis of Ewing sarcoma. After failure of chemotherapy alone, management included extensive surgical excision and postoperative adjuvant radiotherapy and chemotherapy. Despite intervention, the patient died of widespread metastatic disease 17 months after initial presentation. Although rare, Ewing sarcoma should be included in the differential diagnosis of uniform round cell orbital tumors in adults.
PURPOSE: To report the reliability in detecting age-related maculopathy (ARM) lesions before cataract surgery and postoperative visual acuity (VA) in cataract surgery patients with ARM. METHODS: Medical records of surgical patients in a large public hospital, west of Sydney, were reviewed retrospectively. Detection of ARM lesions was compared before and after surgery to determine sensitivity and specificity of preoperative diagnoses. Postoperative VA was assessed 4 weeks after surgery. RESULTS: Data were available for 721/784 eyes (92.0%) of 656 patients aged 60 years or older. ARM lesions were detected in 98 eyes (13.6%) before and 92 eyes (12.8%) after surgery. Sensitivities for detecting late ARM lesions, soft drusen and retinal pigment epithelium abnormalities preoperatively were 100%, 94% and 69%, respectively. Corresponding specificities were 100%, 100% and 77%, respectively. Postoperative VA achieved or remained 6/12 or better in 81.6% of eyes. CONCLUSION: A high sensitivity and specificity in detecting late ARM lesions and soft drusen preoperatively, and a good postoperative VA outcome is achievable in patients with preoperative early ARM lesions.
PURPOSE: To investigate the effect of distilled deionized water (DDW) on lens epithelial cells (LECs) attached to the lens capsule. SETTING: Wound Healing Research Laboratory, Center for Vision Research, Westmead Hospital, Sydney, NSW, Australia. METHODS: Anterior capsulotomy specimens taken during routine cataract surgery were divided in half. One half was immersed in DDW and the other half in culture medium (control) for 1 to 5 minutes and photographed at intervals by phase-contrast microscopy. In further experiments, the capsules were exposed to DDW for 1 or 2 minutes and placed in culture for 1 week to determine whether LECs survive treatment and are capable of repopulating the lens capsule. RESULTS: Distilled-deionized water induced marked swelling of the cytoplasm within 60 seconds of treatment. At 120 seconds, there was disruption of the plasma membranes, with few intact cells remaining. In the control capsules, confluent monolayers of LECs covered the entire capsule surface with a halo of LECs growing on the surrounding plastic well. Viable LECs were observed in 1 of 3 capsules treated for 1 minute with DDW. These did not reach confluence or grow off the capsule onto the surrounding well. No viable LECs were seen on capsules exposed to DDW for 2 minutes. CONCLUSIONS: Short exposure of LECs to DDW induced extensive and rapid cell lysis. Distilled-deonized water may be a useful agent for instillation in the capsular bag during sealed-capsule irrigation to prevent posterior capsule opacification.
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BACKGROUND: This study aimed to assess the frequency of major systemic and ocular comorbidities among cataract surgical patients attending a large general public hospital. METHODS: Consecutive patients aged 60+ years who had undergone cataract surgery at Westmead Hospital from July 2001 to December 2002 were included. Preoperative information was obtained from patient medical records. RESULTS: A total of 773 cataract surgical procedures were performed during the 18-month period, including 668 (86.4%) aged 60+ years. Complete data were available for 653 eyes (97.8%); 62.2% were women. The mean age at surgery was 74.6 (+/- 7.2) years. Frequent systemic comorbidities included: angina (20.2%), previous myocardial infarct (15.0%), diabetes (27.5%) and hypertension (56.3%); 12.5% were current smokers. Major preoperative ocular comorbidities included age-related maculopathy (12.6%), diabetic retinopathy (9.0%) and glaucoma (10.6%). Preoperatively, 21.7% of this group had severe visual impairment (visual acuity [VA] <6/60), 30.6% had moderate impairment (VA <6/24 ->or=6/60) and 30.6% had mild impairment (VA <6/12 ->or=6/24); 28.5% had presenting VA >or=6/12. CONCLUSION: The data indicate a high frequency of comorbid systemic and ocular diseases among cataract surgical patients.
We present a sealed-capsule irrigation technique and a disposable instrument that facilitate selective targeting of lens epithelial cells after phacoemulsification.
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We describe the technique of sealed capsule irrigation, which aims to reduce posterior capsule opacification and better control lens epithelial cell activity.