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Biomedical subjects

E Kuppens

Publications and source records attributed to E Kuppens.

4 recordsLinked to original sources

Topical timolol, corneal epithelial permeability and autofluorescence in glaucoma by fluorophotometry.

UNLABELLED: Corneal epithelial permeability and autofluorescence were measured by fluorophotometry in patients with open-angle glaucoma or ocular hypertension to quantify the epithelial function of the cornea and to evaluate its metabolic activity in 24 patients using daily timolol and 11 not using timolol. The findings were compared with those in age-matched healthy controls. Permeability values in patients using timolol were 1.9 times higher than in patients not using timolol and 2.5 times higher than in healthy controls (Mann-Whitney test P < 0.001). Values for patients not using timolol did not differ from those for healthy controls (P = 0.15). Corneal autofluorescence values in each patient group were higher than in healthy controls (P = 0.002). CONCLUSIONS: (1) open-angle glaucoma or ocular hypertension alone does not affect corneal epithelial permeability; (2) daily instillation of timolol causes impairment of the corneal epithelial barrier; (3) open-angle glaucoma or ocular hypertension are likely to induce an increase of corneal autofluorescence.

Administration, Topical↗

Topical timolol with and without benzalkonium chloride: epithelial permeability and autofluorescence of the cornea in glaucoma.

Epithelial permeability and autofluorescence of the cornea were determined by fluorophotometry in 21 patients with open-angle glaucoma or ocular hypertension using timolol medication with the preservative benzalkonium chloride (BAC) and 2 weeks after changing to timolol medication without BAC. The investigation was performed to determine whether removal of BAC would reduce toxic effects on the cornea and complaints of sensations of burning or dry eye. Corneal epithelial permeability decreased significantly after changing medication (mean decrease per patient 27%, P = 0.025). Corneal autofluorescence increased significantly after changing medication suggesting an alteration in corneal metabolism (mean increase per patient 6%, P = 0.003). Timolol without BAC was found to be as effective as timolol with BAC in reducing intraocular pressure (P = 0.4). Removal of BAC from timolol resulted in an improvement of corneal epithelial barrier function and in a reduction of complaints. The improvement was found to be proportional to the duration of the preceding BAC-containing therapy.

Administration, Topical↗

Multiple primary melanomas in a patient with familial-type DNS during clomiphene-induced pregnancy.

A 35-year old woman developed six primary cutaneous melanomas during her third pregnancy. She had received clomiphene treatment for nearly 2 years previously. She developed two more primary melanomas 15 and 21 months after giving birth. All melanomas were histologically associated with preexisting dysplastic naevi. The patient showed the characteristic phenotype of the dysplastic naevus syndrome; a cousin and an aunt were treated for malignant melanoma and the patient's brother had histologically confirmed dysplastic naevi. The course of her first two pregnancies was not complicated by the development of melanomas. We suggest that clomiphene may have played a role in the activation or progression of these 'precursor lesions' into malignant melanoma.

Adult↗

Pitfalls in laparoscopic cholecystectomy.

On the basis of literature and of 475 laparoscopic cholecystectomies of the authors, some pitfalls are reviewed. The circumstances, the mechanism and the prevention of injuries were detailed together with the connected problem of postoperative bile leakage. Among the cholangiographic pitfalls the importance of detection of congenital and acquired anomalies of the biliary tree by means of preoperative ERCP or intraoperative trans-cystic cholangiograms was emphasized. A particular study was made of 3 pictures: Mirizzi syndrome; stone impaction in Vater's papilla; no retrograde flow of the common hepatic duct on intraoperative cholangiograms. Biliodigestive fistulas were briefly commented. The problems with cystic duct stones, particularly the treatment of stones in a long, low inserted cystic duct with retroduodenal course and the closing of thick-walled or wide cystic stumps, were explained. In patients with intraoperative residual common bile duct stones and with failed preoperative catheterization of the papilla, the authors advocate their double approach technique. This combined intraoperative laparoscopic and postoperative endoscopic procedure is carried out via the same transcystic polythene catheters as used for cholangiography and external biliary drainage of the common bile duct.

Biliary Fistula↗