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Biomedical subjects

B N Lemke

Publications and source records attributed to B N Lemke.

52 records · Page 3Linked to original sources
PubMed1991

Anatomic considerations in upper eyelid retraction.

A series of anatomically correct orbital drawings are created to examine the major integrating factors that determine upper eyelid position on the eye. The principal upper eyelid force planes can be identified as (1) the eyelid vertical retractor plane slightly divergent from the orbital axis, (2) the eyelid protractor plane nearly tangent to the orbital aperture, and (3) the upper eyelid tarsalligamentous plane swinging from within the horizontal orbital rims. These forces are governed by variation in orbital size and shape, globe size and position, and the length-tension characteristics of the eyelid retractors, protractors, and lamellae. Enhanced lateral upper eyelid retraction occurs in part because the eye in primary position looks away from the orbital axis and projects more lateral sclera. When the eye gazes laterally, coincident with the orbital axis, enhanced lateral upper eyelid retraction disappears.

Exophthalmos↗
PubMed1991

Canalicular stenosis following probing for congenital nasolacrimal duct obstruction.

A canalicular stenosis was identified in 29 of 66 (44%) children and 35 of 80 (44%) lacrimal drainage systems undergoing silicone intubation for congenital nasolacrimal duct obstruction, having previously had unsuccessful probings. The stenoses were equally divided between boys and girls and between right and left sides. There was no significant difference in age at the time of probing, number of prior probings, or age at intubation between children with and without canalicular stenosis. Stenoses may be congenital or acquired as a result of faulty probing. Any child undergoing a second lacrimal procedure after a failed probing should be evaluated for evidence of a canalicular stenosis. If a stenosis is present, a silicone stent should be placed to try to salvage the canaliculus.

Child, Preschool↗
PubMed1989

A search for lymphatic drainage of the monkey orbit.

Colloid solutions of technetium Tc 99m and india ink injected into the retrobulbar space of the cynomolgus monkey outside the extraocular muscle cone were removed from the orbit by the lymphatic vessels of the conjunctiva and eyelids and were then concentrated within the lymph nodes that drained the conjunctival and eyelid areas. Colloid solutions injected into the retrobulbar space inside the extraocular muscle cone did not reach the conjunctiva and did not collect in any lymph nodes over a 24-hour period. Within the orbit, the injected colloids spread along the planes of the connective-tissue septa. No lymphatic vessels were identified within the orbits posterior to the conjunctiva. Small amounts of india ink left the posterior orbit and ultimately entered the contralateral orbit. This posterior pathway did not lead to lymphatic vessels or lymph nodes and therefore does not appear to represent a prelymphatic pathway.

Animals↗
PubMed1989

Intraoperative flash fires associated with disposable cautery.

Three cases of intraoperative flash fires associated with the use of disposable thermal cautery units are described. As opposed to similar reports in the literature, two of the three cases were not associated with an elevated oxygen concentration at the operative site. Precautions in the use of these units or the use of mono- or bipolar cautery units are recommended.

Aged↗
PubMed1989

Eyelid gas gangrene.

A case of eyelid gas gangrene caused by Clostridium hastiforme is reported. The infection followed an alkali injury that probably aided proliferation of the organism by inducing local tissue ischemia. Debridement combined with antibiotic therapy controlled the infection, and the large lid defect healed satisfactorily by secondary intention.

Adult↗
PubMed1988

The surgical relations of the levator palpebrae superioris muscle.

We conducted a cadaver study of the levator palpebrae superioris muscle to examine several areas of interest that have been reported in the current medical literature. A very strong intermuscular fascia exists between the levator and superior rectus muscles; it is unlikely that a superior rectus bridle suture could pull them apart during cataract surgery. The superior transverse ligament of Whitnall functions to check the posterior movement of the levator; it provides longitudinal support to the resected levator, but does not act as a vertical fulcrum.

Eyelids↗
PubMed1988

Epibulbar osseous choristomas with scleral involvement.

Epibulbar osseous choristomas are rare congenital collections of mature compact bone most often located in the superotemporal fornix. Most cases are not recognized preoperatively, as the lesion is usually felt to represent a dermatolipoma or epibulbar dermoid. Although most previous reports have described a loose attachment to the surrounding orbital structures, we report two cases in which intimate scleral incorporation was present. In one case, preoperative computerized tomography and echography allowed the diagnosis and probable scleral involvement to be considered preoperatively, and surgery was deferred. The embryogenesis of these lesions is uncertain, although they seem to correlate with the scleral ossicles seen in avian anatomy, and may represent abnormal activation of embryonic pluripotential mesenchymal cells.

Adolescent↗
PubMed1988

Posterior ciliary-artery occlusion after subcutaneous silicone-oil injection.

Visual loss occurred after subcutaneous silicone-oil injection for cosmetic purposes. To our knowledge, this is the first instance of amaurosis caused by a subcutaneous foreign-material injection that spared the central retinal artery and affected portions of the posterior ciliary-artery distribution, including a probable cilioretinal artery. The visual-field defects produced allow a rare opportunity to view the distribution of the human posterior ciliary-artery circulation by means of this in vivo pathologic embolic process. The facial arterial anatomy pertinent to ocular embolism is also discussed.

Adult↗
PubMed1987

Orbital cellulitis with periosteal elevation.

Computerized tomography scan evidence of periosteal elevation in patients with orbital cellulitis is interpreted in the current medical literature as an indication of subperiosteal abscess. We present three such cases in which surgical drainage yielded clear fluid or granulation tissue rather than pus. A fourth case resolved on antibiotic therapy alone. Cases of periosteal elevation that resolve without surgery may represent inflammatory effusion, infections of lesser virulence, or propagation of granulation tissue rather than true abscesses. We suggest that periosteal elevation seen in patients with orbital cellulitis should represent a relative rather than an absolute indication for drainage surgery.

Abscess↗
PubMed1987

Leiomyosarcoma of the orbit. A case report and review of the literature.

Leiomyosarcoma has been rarely encountered in the orbit. Leiomyosarcoma may arise as a primary tumor in the orbit, metastasize from distant sites to the orbit, extend into the orbit from the paranasal sinuses, or appear after radiation therapy to the orbit. The 43-year-old female patient described in this paper underwent excision of a leiomyosarcoma in the subcutaneous tissue of the buttock. Seven years later, a leiomyosarcoma in the medial orbit was removed. The clinical course of this patient's disease was similar to that of other subcutaneous leiomyosarcomas documented in the literature. Gynecological history was remarkable for a leiomyoma of the uterus, an interesting association found in at least one other case in the literature. This was the third documented case of metastatic leiomyosarcoma in the orbit.

Adult↗
PubMed1986

Eyelid necrosis in an anophthalmic patient.

A 72-year-old woman with chronic lymphocytic leukemia developed periorbital swelling, erythema, and discharge involving her anophthalmic left socket in the course of pseudomonas aeruginosa septicemia. Histopathologic examination of debrided eyelid tissues revealed ischemic necrosis of the eyelid margin and deeper eyelid tissues. Underlying malignancy, disseminated systemic infection, and alteration in the vascular supply to the eyelids following enucleation may have contributed to the development of ischemic eyelid necrosis in this patient.

Aged↗
PubMed1982

The anatomy of eyebrow ptosis.

An anatomical study was performed to gain a better understanding of the pathogenesis of eyebrow ptosis. Through cadaver dissection, we sought to establish the anatomy of the normal eyebrow, to determine why the temporal part of the eyebrow becomes ptotic earlier than the medial portion, and to locate precisely the regional nerves and vessels to aid the eyebrow surgeon. a fat-pad exists beneath the eyebrow. Dense attachments on the underside of the eyebrow fat-pad secure the eyebrow to the supraorbital ridge. Because the supraorbital ridge extends only over the medial one half to two thirds of the orbit, the lateral part of the eyebrow lacks deep support and droops with the frontal skin and muscle relaxation seen in age. Vertical lateral orbicularis fibers are consistently seen in the cadaver. Because of their location, they may play a role in producing "laugh lines."

Aging↗
PubMed1981

Epiblepharon. An important and often missed diagnosis.

Epiblepharon is a common, often unrecognized cause of epiphora and ocular irritation in the child. Epiblepharon consists of an extra fold of eyelid skin and orbicularis muscle overlying an eyelid margin. Occasionally an epiblepharon can push the lashes against the sensitive corneas, especially in downgaze. This paper illustrates epiblepharon and stresses the need for eyelid margin examination in downgaze in the child with epiphora or conjunctivitis.

Child↗