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Biomedical subjects

G E Borodic

Publications and source records attributed to G E Borodic.

24 records · Page 2Linked to original sources

Dermis fat graft in eviscerated sockets.

Following evisceration, three patients who experienced extrusion of synthetic orbital implant underwent socket reconstruction using an autogenous dermis fat graft. An incision into the fundus of the existing sclera was necessary to provide for an adequate vascular bed for a composite fat graft, although the anterior ring of existing sclera with extraocular muscle attachments was not disturbed. Conjunctival reepithelialization of the dermal surface and enhancement of orbital volume occurred in each case. Furthermore, the autogenous fat graft retained the original excellent globe motility that was present before the socket reconstruction. After an average follow-up of 18 months, the volume restoration, integrity of conjunctival epithelium and fornices, and the graft viability have remained unchanged. As with alloplastic orbital implant extrusions in enucleated sockets, autogeneous dermis fat grafts can be useful in managing extrusions in previously eviscerated sockets.

Adipose Tissue↗

Peripapillary subretinal neovascularization and serous macular detachment. Association with congenital optic nerve pits.

Congenital anomalous disc changes were associated with acquired macular detachment and peripapillary choroidal neovascularization in two cases. The anomalous disc changes resembled optic nerve pits. In one case, the peripapillary choroidal neovascularization was treated with argon laser photocoagulation, with subsequent reattachment of the macula and considerable improvement in the visual acuity. Although the pathogenesis of macular detachment occurring with optic nerve pits is usually not disclosed by fluorescein angiography, leakage from choroidal neovascularization can occur with this congenital defect and may contribute to the formation of a neurosensory macular detachment. If found, choroidal neovascularization may represent a remedial cause for visual loss in a condition with an otherwise poor prognosis.

Child↗

Immunoglobulin deposition in localized conjunctival amyloidosis.

Immunofluorescent studies were performed on tarsus and tarsal conjunctiva from a 30-year-old woman with blepharoptosis secondary to localized nonfamilial amyloidosis. Both kappa and lambda light chains were identified in abundance in the resected tissue. There was no evidence of any systemic disease or of amyloid deposition elsewhere. Six months after the patient underwent surgery, there was no sign of recurrence. The antigenic determinants of the amyloid suggested that the pathogenesis of localized nonfamilial ocular amyloidosis involves the accumulation of proteins similar to immunoglobulin.

Adult↗

Botulinum A toxin for the treatment of spasmodic torticollis: dysphagia and regional toxin spread.

Chemodenervation of cervical muscles with botulinum A toxin, although useful in treating spasmodic torticollis, has been associated with dysphagia. Retrospective analysis of dose and injection site (sternomastoid vs. posterior cervical muscle groups) in 26 patients (49 injections) suggested that dysphagia was related to the quantity of toxin injected into the sternomastoid muscle: dysphagia, median 150 IU (7 injections); and no dysphagia, median 100 IU (42 injections; p = 0.026 Wilcoxon test). In a prospective study (31 injections to 24 patients), limiting the dose administered to the sternomastoid to 100 IU, substantially reduced the incidence of dysphagia (0 of 31, p = 0.27, Fisher's exact test). Denervation of human orbicularis muscle fibers, 5 weeks to 4 months after injection of botulinum A toxin for the treatment of blepharospasm, was successfully demonstrated by intense, diffuse acetylcholinesterase staining. A weight-adjusted dose similar to that given for torticollis was injected into longissimus dorsi muscle in 6 albino rabbits. Using the acetylcholinesterase stain as a marker, a diffusion gradient was noted over a distance of 30 to 45 mm from the point of injection and in contralateral muscle 15 to 25 mm from this point. Thus, denervation was demonstrated to occur within a definable area which crossed anatomic barriers, such as fascia and bone. These clinical and laboratory data suggest that dysphagia following botulinum toxin therapy results from toxin spread to pharyngeal musculature from the sternocleidomastoid injection site. Limiting of the injection dose to 100 IU or less to the sternomastoid substantially decreases the incidence of this complication.

Acetylcholinesterase↗

Botulinum a toxin for spasmodic torticollis: multiple vs single injection points per muscle.

Eighty-six injections in 49 patients with adult onset spasmodic torticollis were evaluated for efficacy with respect to single point per muscle versus multiple point per muscle injection techniques. Parameters of the syndrome assessed were pain, posture deformity, range of cervical motion, disfigurement, cervical muscle hypertrophy, activity limitation, and degree of involuntary movement. The multiple point per muscle injection strategy appeared superior to the single injection per muscle technique with respect to pain (p less than 0.002, chi-square), posture deformity (p less than 0.001), range of motion (p less than 0.001), and improvement in activity endurance (p less than 0.001). No significant differences were noted with respect to cervical muscle hypertrophy or degree of involuntary movements, although the injections were considered beneficial in both groups to these syndrome components.

Adult↗