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Biomedical subjects

C W Spraul

Publications and source records attributed to C W Spraul.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Conjunctival pseudolymphoma in infectious mononucleosis].

BACKGROUND: The most frequent manifestation of an infection with Epstein-Barr virus is the mostly unilateral transient follicular conjunctivitis. PATIENT: A 19-year-old man was evaluated for a unilateral salmon colored subconjunctival mass that had developed over one week. Additionally, the patient had painful cervical lymph nodes and a sore throat. Blood tests demonstrated a lymphocytosis and a high titer for Epstein-Barr-Virus-IgG and -IgM which was consistent with infectious mononucleosis. A biopsy form the conjunctival mass showed a mixed cellular infiltrate including lymphocytes, plasma cells, histocytes, and cells with a prominent eosinophilic nucleolus. The lesion displayed a spontaneous regression over the following 8 weeks. CONCLUSION: Infectious mononucleosis should be considered with a conjunctival tumor which may mimic a lymphoma.

Adult↗
PubMed1999

[Sebaceous hyperplasia of the lower eyelid].

BACKGROUND PATIENT: A 61-year-old man was evaluated for a yellow tumor located at the lid margin of his lower eyelid, which had recurred for the second time after surgical excision. The patient's ocular examination was otherwise unremarkable as was the general examination with the exception of the presence of a polyp in the colon and a family history of multiple colorectal carcinomas. The eyelid tumor was excised and histologic examination showed a sebaceous hyperplasia. CONCLUSION: When one encounters a sebaceous tumor involving the eyelid the possibility of Muir-Torre syndrome should be considered. Muir-Torre syndrome is an autosomal dominant genodermatosis characterized by at least a single sebaceous gland tumor (either a hyperplasia, an adenoma, an epithelioma, or a carcinoma) and a minimum of one internal malignancy.

Colonic Polyps↗
PubMed1999

[Periphlebitis retinae, uveitis and cystoid maculopathy in a patient with multiple sclerosis].

PATIENT: A 44-year-old woman has a history of multiple sclerosis since 20 years. Besides recurrent numbness she had many instances of optic nerve neuritis which has led to a pronounced optic atrophy on her left eye. Additionally, she has developed recurrent iridocyclitis on her right eye. This was the reason why she was referred to our outpatient department for evaluation. Ophthalmic examination revealed an iridocyclitis associated with a multifocal retinal periphlebitis and severe cystoid macular edema in her right eye. CONCLUSION: Patients with multiple sclerosis develop in approximately 30% of cases retinal periphlebitis which may rarely be associated with anterior uveitis or cystoid macular edema as observed in our patient.

Adult↗
PubMed1999

[Deep penetrating nevus of the eyelid].

BACKGROUND: A 52-year-old woman was evaluated for a pigmented tumor in her right lower eyelid, which has developed over the last year. The tumor measured 3 x 4 mm. The patient's ophthalmologic and medical history was normal. Clinically, a malignant melanoma was suspected, and an excision was carried out in local anesthesia. The histopathology was suggestive for a deep penetrating nevus. CONCLUSION: Deep penetrating nevus is a variant of benign pigmented nevi with deep dermal and subcutaneous involvement. The pattern should be recognized and differentiated form malignant melanoma.

Eyelid Neoplasms↗
PubMed1999

[Prevalence of systemic and ocular diseases in age-related cataract patients].

BACKGROUND: Cataract patients often display concomitant ocular and systemic diseases which may influence the decision between general and regional anesthesia. The aim of this study was to quantify co-morbidity of these patients and assess the influence of the two types of anesthesia an the anesthesiological risk on the frequency of intra- and post-operative complications and visual outcome. METHODS: In this prospective study, in patients scheduled for cataract extraction at the University Eye Hospital and Clinic of Ulm (tertiary eye care center) all systemic and ocular diseases as well as intra- and postoperative complications were analyzed. The prevalence of the co-morbidity in our patients was compared to other studies including age-matched controls. The anesthesiological risk was quantified using the classification scheme of the American Society of Anesthesiologists (ASA). RESULTS: Eighty-eight patients with a mean age of 70.4 +/- 11.7 years were analyzed. Sixty-one% of patients displayed systemic as well as ocular co-morbidity. Only systemic or ocular comorbidity was present in 32% and 5% of patients, respectively. Two% of patients exhibited neither ocular nor systemic comorbidity. In 61% of patients the surgery was performed in regional anesthesia and in 39% in general anesthesia. The prevalence of systemic and ocular co-morbidity as found in our study was significantly higher as compared to that in the general population of the same age. Visual improvement and the frequency of intra- and postoperative complications were independent on type of anesthesia and anesthesiological risk. CONCLUSIONS: Patients who were scheduled at our institution for cataract surgery exhibited a high frequency of ocular as well as systemic co-morbidity. This can be interpreted in such a way that patients with a high level of co-morbidity are referred to tertiary eye care centers for cataract surgery.

Age Factors↗
PubMed1999

[Ocular bacteriosis in a patient with aplastic anemia].

BACKGROUND: For more than a century it has been recognized that bacteria may infect the eye by way of the blood stream. Until fifty years ago, eyes so afflicted nearly always were blinded and a majority of the victims died from overwhelming sepsis. Although effective antibiotics are available today the prognosis is still guarded. CASE REPORT: A 39-year-old physician died 6 years after he was diagnosed for idiopathic aplastic anemia. He had developed pseudomonas aeruginosa bacteremia and later a therapy refractive pneumonia caused by aspergillus which had led to respiratory failure. The patient had experienced a marked loss of visual acuity in his left eye ten days before he died. Ophthalmic examination at that point displayed signs of endophthalmitis, hyphaema, and heterochromic irises. The eyes were obtained postmortem and histologic examination of the left eye displayed numerous bacilli forming cuffs around blood vessels and a sheet between the necrotic retinal pigment epithelium and Bruch's membrane. No inflammatory response to the bacilli was present. The bacilli could be demonstrated with a Giemsa stain and could also be identified with electron microscopic examination. DISCUSSION: The histologic results in our patient displayed numerous bacilli without inflammatory reaction which was a result of the aplastic state. Therefore, this disease was classified as "ocular bacteriosis". The blood-ocular barrier undergoes direct assault with intraocular inflammation and the impermeability to blood-borne antibiotics is lost. However, with the lack of an inflammatory reaction the permeability to antibiotics may be too low and the achieved concentration insufficient.

Adult↗
PubMed1999

[Eccrine spiradenoma of the eyelid].

PATIENT: A 60-year-old woman was evaluated for a nodular tumor in her right upper eyelid, which has developed over the last four years. The tumor measured 10 x 8 mm and was ulcerated. The patient's ophthalmologic und medical history was normal. Clinically, a basal cell carcinoma was suspected, and an excision was carried out under local anaesthesia. The histopathology was suggestive for an eccrine spiradenoma. CONCLUSION: Eccrine spiradenomas rarely involve the eyelids. This tumor represents a benign, usually painful, sweat gland tumor. The possibility of sweat gland tumor should be kept in mind in the diagnosis of eyelid tumors. The complete excision is the only therapeutic option.

Adenoma, Sweat Gland↗
PubMed1999

Effect of thalidomide, octreotide, and prednisolone on the migration and proliferation of RPE cells in vitro.

PURPOSE: The retinal pigment epithelium (RPE) is involved in the pathogenesis of age-related macular degeneration. The purpose of this study was to assess the effect of thalidomide, octreotide, and prednisolone on the proliferation and migration of bovine RPE cells in vitro. METHODS: The migration assay was performed in double-chamber-wells separated by a membrane filter with 8 microm pores. Cells were allowed to migrate vertically for 7 hr, afterwards the cells on both filtersides were fixed, stained, and the migrated cells were counted. To examine RPE proliferation, bovine RPE cells were seeded subconfluently followed by an incubation with octreotide, thalidomide or prednisolone in a concentration gradient for 24 hr. Stimulation or inhibition of DNA synthesis was measured by [(3)H]-thymidine incorporation. Statistical analysis was performed with the paired student's t-test. RESULTS: Statistically significant (p < 0.05) inhibition of RPE cell proliferation was measured for thalidomide at a concentration of 10-50 microg/ml, for octreotide at a concentration of 5 x 10(-4) and 5 x 10(-5) M, and for prednisolone at a concentration of 250 and 500 microg/ml as compared to the negative control. RPE cell migration was significantly (p < 0.05) inhibited by thalidomide at a concentration of 10 microg/ml, by octreotide at a concentration of 5 x 10(-5) M, and also by prednisolone at a concentration of 500 microg/ml as compared to the negative control. CONCLUSIONS: Although the main effect of thalidomide, octreotide, and prednisolone when treating patients with choroidal neovascular membranes is probably related to the inhibition of angiogenesis it should be kept in mind that these substances may additionally inhibit RPE proliferation and migration.

Animals↗
PubMed1998

[Characteristics of drusen and changes in Bruch's membrane in eyes with age-related macular degeneration. Histological study].

BACKGROUND: Different types of drusen and changes in Bruch's membrane have been associated with age-related macular degeneration (AMD). METHODS: We compared 51 eyes with different stages of AMD with 40 age-matched controls using light microscopy. The degree of calcification of Bruch's membrane, fragmentation of Bruch's membrane, number of different types of drusen, and basal laminar deposit (BLD) were assessed. RESULTS: In the macular area, the presence of basal laminar deposit was most strongly associated with the presence of AMD. There was a statistically significant difference observed in the degree of calcification and fragmentation of Bruch's membrane in eyes with AMD as compared to controls. Eyes with AMD displayed significantly more soft, confluent, and large drusen as compared to controls. CONCLUSION: Calcification and fragmentation of Bruch's membrane, soft, confluent, and large drusen and BLD but not hard drusen correlated strongly with the histologic presence of AMD. Calcification and fragmentation of Bruch's membrane seem to facilitate ingrowth of choroidal neovascular membranes with consecutive development of exudative AMD.

Adult↗
PubMed1998

Reproducibility of measurements with a new slit lamp-mounted ocular blood flow tonograph.

PURPOSE: To assess the reliability of measurements of intraocular pressure (i.o.p.), pulse amplitude (PA), and pulsatile ocular blood flow (POBF) and the validity of measurements of IOP with a new ocular blood flow tonograph. METHODS: Intraocular pressure pulse was assessed with pneumatic tonometry. In this study, we used the OBF Labs ocular blood flow tonograph with two different pneumatic probes, a modified Langham probe and a newly developed probe. One ophthalmologist compared two machines, first with the modified Langham probe and secondly with the newly developed probe (40 volunteers). Additionally, two ophthalmologists performed measurements on different days and in different sequence (34 volunteers). Furthermore, results of IOP measurements performed with this tonograph were compared to those of Goldmann applanation tonometry (213 volunteers). RESULTS: Using the modified Langham probe, POBF and PA were associated with the machine used for the test. However, using the newly developed pobe, no relevant or statistically significant differences were found for any variables, and reliability coefficients were between 0.70 and 0.90. Linear regression analysis of the Goldmann applanation tonometer on the measurements of IOP with the tonograph showed a regression coefficient of 0.765. CONCLUSIONS: Results of measurements performed with this ocular blood flow tonograph and the newly developed probe are expected to be reliable and comparable.

Adolescent↗
PubMed1998

Bilateral periocular actinic granuloma in a patient with renal failure: a clinicopathologic study.

PURPOSE: We report a 50-year-old man with end-stage renal disease who has developed bilateral inner and outer canthal nodules. METHODS: The nodules were excised, fixed in 10% formalin and 2.5% glutaraldehyde, and processed for light and electron microscopy, respectively. RESULTS: Histological examination showed elastotic changes with associated granulomatous inflammation. The granulomatous reaction was centered around elastotic fibers, and some giant cells engulfed the fibers. Areas of dystrophic calcification were identified. A diagnosis of actinic granuloma was made. The differential diagnosis and histopathology of actinic granuloma, i.e. granuloma annulare, rheumatoid nodule, and necrobiotic xanthogranuloma, are discussed. CONCLUSION: This case of an actinic granuloma originating in the sun-damaged periocular skin provides further evidence that elastotic degeneration may be associated with a giant cell reaction. It is, however, unclear which antigens are responsible for initiating the granulomatous response and whether elastotic material on its own can elicit a granulomatous reaction.

Calcinosis↗
PubMed1998

[Value of optical coherence tomography in diagnosis of age-related macular degeneration. Correlation of fluorescein angiography and OCT findings].

BACKGROUND: Age-related macular degeneration (AMD) is the leading cause of blindness in industrialized countries. In this study, we used optical coherence tomography for evaluation of patients with AMD. METHODS: Optical coherence tomography imaging is analogous to ultrasound, except that reflected light instead of sound is used. The analysis of the reflected light is processed with the technique of low-coherence interferometry. In this study, 33 patients with different stages of AMD were examined with optical coherence tomography. The classification of AMD was according to the guidelines as proposed by the "International ARM Epidemiological Study group". RESULTS: With this method we were able to identify drusen, alteration of the retinal pigment epithelium, and secondary retinal changes. Other structures such as basal laminar (linear) deposits could not be identified with this method. Choroidal neovascularization was evident in the tomogram. Classic choroidal neovascular membranes presented with well-defined boundaries on optical coherence tomography and occult choroidal neovascular membranes had a less delineable structure with optical coherence tomography. CONCLUSION: Optical coherence tomography cannot replace conventional diagnostic techniques. This method provides no additional information in patients with non-exsudative AMD. In patients with choroidal neovascular membranes secondary to AMD optical coherence tomography may be able to characterize the relation of the membrane to the retinal pigment epithelium and imaging may be possible through hemorrhage. The interpretation of the optical coherence tomogram needs further studies including clinicopathologic correlation.

Aged↗
PubMed1998

[Ocular changes in primary hematologic diseases].

Ocular manifestations can be the presenting symptom of hematological diseases. Ocular changes can be found in up to 90% of the patients depending on the underlying disease. Most patients with ocular manifestations however are asymptomatic. Hematological disorders can manifest in all structures and adnexa of the eye. The most common manifestations are conjunctival pallor and hemorrhages, intraretinal hemorrhages and cotton wool spots. Retinal infiltrates, manifestations in the lids, anterior segment, optic nerve, orbit and adnexa are rare. Different ocular manifestations in anemia, leukemia, malignant Non-Hodgkin lymphoma, Hodgkin's disease, chronic myeloproliferative diseases, plasmocytoma, myelodysplastic syndromes, coagulopathies, and reticulo-histiocytic diseases are described. Not only the underlying disease but also chemotherapy, bone marrow transplantation can lead to ocular complications.

Eye Diseases↗
PubMed1998

The two-stage mutation model in retinal hemangioblastoma.

BACKGROUND: The two-stage mutation model involving successive inactivation of both alleles of a tumor suppressor gene was originally proposed by Knudson, who analyzed the age incidence curves for unilateral and bilateral retinoblastoma, and suggested that hereditary tumors arise by a single somatic event superimposed on a defective genetic background and sporadic tumors by a two-stage somatic process. In this study, the age-incidence curve of patients with retinal hemangioblastoma with and without associated von Hippel-Lindau disease were analyzed. METHODS: We reviewed the literature between 1964 and 1998 to find all reported cases of retinal hemangioblastoma and classified patients in a type A group (n = 223) when associated with von Hippel-Lindau disease and a type B group (n = 30) when not associated with von Hippel-Lindau disease. We analyzed and compared the age incidence of these two groups. RESULTS: There was a statistically significant difference between the mean age at diagnosis of retinal hemangioblastoma in the two groups, i.e., 48.4 +/- 16.6 years for type B patients and 24.9 +/- 12.0 years for type A patients (p < 0.0001). The age incidence curve for type A retinal hemangioblastoma fit a first-order equation (log S = 0.411-0.034t) with r = 0.97, indicating a single somatic mutation, whereas the age incidence curve for type B retinal hemangioblastoma fit a second-order equation (log S = 0.184-2.25 x 10(-4)t2) with r = 0.97, indicating two somatic mutations. CONCLUSIONS: Type B (sporadic) retinal hemangioblastoma may arise from two separate somatic mutations inactivating both alleles at the von Hippel-Lindau locus, whereas patients with von Hippel-Lindau disease (type A) inherit a defective allele and require only one additional somatic mutation.

Adolescent↗
PubMed1998

Retinal pigment epithelial changes associated with systemic corticosteroid treatment: report of cases and review of the literature.

PURPOSE: The aim of our study was to describe two different manifestations of retinal pigment epithelial changes associated with systemic corticosteroid treatment. METHODS: We report 4 patients who developed maculopathy during treatment with systemic corticosteroids. Additionally, the literature was reviewed for similar cases. RESULTS: Two patients showed diffuse retinal pigment epitheliopathy. Two patients developed central serous chorioretinopathy with localized changes in the retinal pigment epithelium. A review of the literature revealed 51 patients with similar changes during treatment with corticosteroids. CONCLUSION: These 4 patients provide further evidence that systemic treatment with corticosteroids may cause central serous chorioretinopathy or diffuse retinal pigment epitheliopathy. Ophthalmologic examination is recommended on a regular basis for patients treated with systemic corticosteroids.

Adult↗
PubMed1998

Influence of special-effect contact lenses (Crazy Lenses) on visual function.

PURPOSE: Special-effect contact lenses (opaque, tinted soft contact lenses that incorporate decorative images such as "cateyes," stars, or hearts to alter eye color and structure) have become increasingly popular. The purpose of this study was to investigate whether such lenses impair visual function. METHODS: A clear soft contact lens and a special-effect soft contact lens (Crazy lens,) were fit in changing sequence in nine healthy subjects. The parameters studied included: visual acuity, contrast sensitivity (with and without glare), visual field, and mesopic vision (with and without glare). RESULTS: The following parameters displayed a statistically significant difference (P < 0.05). Visual acuity was decreased to 0.9 +/- 0.23 in the Crazy lens group as compared with 1.2 +/- 0.13 in the clear lens group. Goldmann visual field displayed a significant constriction of the isopters: III/4, I/4, and I/3. Mesopic vision without glare was reduced from 1:2.5 to 1:7.4. Contrast sensitivity was significantly reduced in a photopic condition with and without glare and in a scotopic condition without glare. Furthermore, the special-effect lenses were associated with a decrease in lens wearing comfort. CONCLUSIONS: Special-effect contact lenses were associated with a reduction of many visual functions, including visual acuity and contrast sensitivity. For some wearers this may interfere with activities where excellent vision is crucial, such as driving a car.

Adult↗