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F V Buffam

Publications and source records attributed to F V Buffam.

10 recordsLinked to original sources
PubMed2006

Adult xanthogranulomatous disease of the orbit and ocular adnexa: new immunohistochemical findings and clinical review.

BACKGROUND/AIMS: Adult xanthogranulomatous disease involving the ocular tissues is rare and poorly understood. Adult onset xanthogranuloma (AOX), adult onset asthma and periocular xanthogranuloma (AAPOX), necrobiotic xanthogranuloma (NBX), and Erdheim-Chester disease (ECD) are the four syndromes within this disorder, which is diagnosed by characteristic histopathology. Experience with eight cases prompted a multi-institutional effort to study the histopathology, immunohistochemistry, clinical findings, and systemic associations in this disorder. METHODS: 22 cases, including histopathological slides, were compiled. Published reports were identified by an English language Medline search (1966-2005) and review of reference citations. Each case in this series and the literature was classified as one of four syndromes and then analysed for age onset, sex, skin xanthoma, orbital location, immune dysfunction, internal organ and bone lesions, treatment, and outcome. The histopathology in each of these cases was reviewed by two pathologists. Immunhistochemical stains (CD3, CD4, CD8, L26) were performed in 14 cases where unstained slides were available. RESULTS: 137 cases were compiled. There was no sex or age difference between syndromes. AOX, AAPOX, NBX affect the anterior orbit, ECD tends to be diffuse and intraconal. Skin lesions are found in all the syndromes. Immune dysfunction was noted in all cases of AAPOX and NBX; 11% of NBX and all ECD patients had internal organ disease. Treatment included surgery, corticosteroids, other chemotherapeutic agents, radiotherapy, and combinations of these. No AOX or AAPOX deaths occurred; 66% of ECD patients died. All 22 cases had xanthoma cells; most had Touton giant cells. Lymphocytes were present in all cases and occurred as aggregates (mostly in AAPOX) or diffuse populations mixed with fibroblasts (mostly in ECD). Immunohistochemistry revealed the majority of these to be CD8+. Necrosis was most marked in NBX. CONCLUSION: Adult xanthogranuloma of the orbit is rare, making prospective evaluation or meta-analysis impossible. The best treatment is unknown but seems to be with multiagent chemotherapy guided by histopathological, immunohistochemical, and systemic findings.

Adolescent↗
PubMed1993

Lacrimal sac, conjunctival, and nasal culture results in dacryocystorhinostomy patients.

Chronic dacryocystitis is commonly seen in patients requiring a dacryocystorhinostomy (DCR). The infection may be primary, or may be secondary to an anatomical abnormality that has led to tear flow stasis. It is possible that many cases of primary acquired nasolacrimal duct obstruction are in fact secondary to unrecognized low-grade dacryocystitis. The intent of this study was to determine what organisms grow in the lacrimal sac of patients requiring DCR. It also investigated whether or not there was a correlation between organisms cultured from the sac and from the conjunctiva and/or the nose. The results of the study indicate that there is not a clinically significant correlation. The level of obstruction does not affect whether similar organisms were cultured from the three sites.

Bacteria↗
PubMed1990

Prevention of radiation-induced stenosis of the nasolacrimal duct.

Epiphora is a recognized complication of radiotherapy of medial canthal tumours. We reviewed the records of 36 patients who underwent prophylactic nasolacrimal duct intubation with silicone tubing before superficial x-ray beam therapy and 42 patients who did not undergo intubation before radiotherapy. The mean length of follow-up was 3.4 years in the intubated group and 7.2 years in the nonintubated group. A total of 31% of the patients in the nonintubated group reported chronic epiphora during the follow-up period, compared with 6% in the intubated group (p less than 0.003).

Adult↗
PubMed1989

Dacryocystography: comparison of water-soluble and oil-based contrast agents.

Dacryocystography has been widely used in the assessment of the nasolacrimal duct system, particularly in patients with epiphora. Our study was undertaken to evaluate image quality and level of patient discomfort during examinations with water-soluble contrast agents (iohexol [Omnipaque 240], iopamidol [Isovue 200 and 300], and 52.7% diatrizoate meglumine and 26.9% iodipamide meglumine [Sinografin]) compared with the iodized oil-based contrast agent Lipiodol. Fifty-five dacryocystograms were obtained from 41 consecutive patients. The procedure was performed first with a water-soluble contrast agent, then repeated with Lipiodol. A distention technique was used with conventional radiography. Patients were asked to evaluate their level of discomfort (none, mild, moderate, severe). The images were evaluated separately by two radiologists, blinded to which water-soluble agent was employed, and the images were graded on a five-point scale. Images obtained with Lipiodol were significantly better than those with other agents (P less than .02), and image quality deteriorated as iodine concentration decreased. Use of Isovue 300 and Sinografin produced significantly more patient discomfort (P less than .03) than the use of other agents. The authors conclude that, in most instances, Lipiodol is the contrast agent of choice with regard to both highest level of patient comfort and greatest conventional radiographic image quality among the agents compared.

Contrast Media↗
PubMed1977

Surgical treatment of eyelid neurofibromas.

The classical surgical treatment of eyelid neurofibromas has been careful dissection of the tumor with preservation of much of the surrounding abnormal lid tissues. The reported outcome has been uniformly unfavorable. These tumors infiltrate extensively and are impossible to dissect out completely. However, the lateral location of lid neurofibromas allows "en bloc" resection of most of the tumor including the adjacent involved lid tissues. Levator function in these cases is potentially good and the lid will elevate well if the levator aponeurosis is joined to the tarsus laterally at the time of surgery. The four cases presented here indicate that this procedure is technically easier and may produce more acceptable results than other forms of treatment.

Adolescent↗
PubMed1977

The use of the "lateral canthal sling" in ectropion repair.

We describe the use of the "lateral canthal sling" in the treatment of non-cicatrical "senile" ectropion of the lower lid. Combined with a resection of the lower retractors and the hypertrophied palpebral conjunctiva we consider it the treatment of choice for repairing non-cicatrical "marginal" ectropion. We offer a theory of the pathogenesis of the latter.

Ectropion↗
PubMed1976

Acute dacryocystic retention.

Acute dacryocystic retention is a disease of adults under 50 years old due to a noninfective foreign body blocking the nasolacrimal duct. It is characterized by the sudden onset of severe unilateral facial pain without significant localized swelling or erythema. Palpation of the involved lacrimal sac reveals slight induration and marked tenderness. Percutaneous aspiration of lacrimal sac contents, followed by probing of the nasolacrimal duct, is usually curative.

Acute Disease↗
PubMed1976

Technique of combined lid and medial canthus reconstruction.

Standard lid reconstruction techniques (sliding flaps or tarsoconjunctival grafts) may be combined with the Laissez-Faire treatment of large medial canthal defects. Using this methods, satisfactory results were achieved in three cases in which it was necessary to excise both a large portion of an eyelid and the adjacent medial canthus.

Aged↗