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Biomedical subjects

Carol M Lane

Publications and source records attributed to Carol M Lane.

4 recordsLinked to original sources

Confident complete excision of lid-margin BCCs using a marginal strip: an alternative to Mohs' surgery.

AIMS: To report a new technique of tissue preparation, using a marginal strip, after the excision of eyelid basal cell carcinomas (BCCs) and to report the long-term results of BCCs excised using this technique. METHOD: After the excision of eyelid BCC with a safety margin of 4 mm, a 1 mm strip was excised along the whole perimeter from the margin of the freshly excised specimen. This marginal strip had intact conjunctival mucosa along one edge and skin along the other. The marginal strip and the central tumour mass were then fixed immediately in formal saline and subjected to conventional histopathology. RESULTS: Of the 61 patients who completed a 5 years follow-up, the results of 28 eye-lid BCCs that were within 4 mm of the lid margin are reported. The marginal strip was clear in 22 specimens and had the presence of residual tumour in its margin in 6 specimens. These six 6 cases were further managed by observation (n = 2), by further surgical excision using marginal strip (n = 2) and by Mohs' surgery (n = 2). CONCLUSION: Marginal strip examines the entire resection margins analogous to Mohs' technique and we recommend its use in lid margin where tarsus is present throughout the specimen and >4 mm from the lid margin.

Aged↗

Adrenal suppression and failure to thrive after steroid injections for periocular hemangioma.

PURPOSE: To evaluate the effects of steroid injections for periocular capillary hemangioma on adrenal function and body composition. DESIGN: Noncomparative, interventional case series. PARTICIPANTS: Four patients with periocular hemangioma. METHODS: Four white female infants with sight-threatening periocular hemangiomata received a combination of steroid injections of triamcinolone and betamethasone. In the first 2 cases, injections were perilesional and in the other 2, intralesional. MAIN OUTCOME MEASURES: The infants were monitored by serial measurements of basal serum cortisol concentrations, responses to the Synacthen stimulation test, measurement of growth and of weight gain, and, in one case, more detailed anthropometric measures of body composition. RESULTS: Prolonged suppression of circulating serum cortisol concentrations and cortisol responses to the Synacthen stimulation test were noted in 3 cases, and marked failure to thrive was noted in all 4 cases. CONCLUSIONS: Adrenal suppression after steroid injection for periocular capillary hemangioma is a potentially life-threatening complication. Failure to thrive is also a frequent side effect of treatment. Ophthalmologists should undertake the above treatment in consultation with a pediatric endocrinologist.

Adrenal Insufficiency↗

Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience.

UNLABELLED: To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on Graves' Orbitopathy aims to overcome this and has designed a preliminary case record form (CRF) to assess Graves' orbitopathy patients. This form was used in this first multi-center study. AIM: To investigate patient characteristics and treatment strategies in 152 new consecutively referred patients with thyroid eye disease seen in nine large European referral centers. METHODS: Newly referred patients with Graves' orbitopathy were included who were seen between September and December 2000. Demographic data and a complete ophthalmological assessment were recorded. RESULTS: One-hundred and fifty-two patients (77% females) were included. Diabetes was present in 9%, and glaucoma or cataract in 14% of patients. Forty percent were current smokers, 9% also had dermopathy, and only 33% reported a positive family history of thyroid disease. Mild eye disease was seen in 40%, moderately severe eye disease was seen in 33% and severe eye disease was seen in 28% of patients. Soft tissue involvement was the most frequent abnormality (seen in 75%), proptosis > or =21 mm was found in 63%, eye motility dysfunction in 49%, keratopathy in 16% and optic nerve involvement was found in 21% of patients. According to the clinical impression, 60% had active eye disease. Immunosuppressive treatment was planned more frequently in active patients (57/86; 66%) than in inactive patients (5/57, 9%; Chi-square 46.16; P<0.02). There were no important differences among the eight centers regarding the severity and the activity of their patients. CONCLUSIONS: In view of the large number of patients recruited in only 4 months, multi-center studies in the eight EUGOGO centers appear to be feasible.

Adult↗