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Biomedical subjects

G Grabner

Publications and source records attributed to G Grabner.

At least 19 recordsLinked to original sources
PubMed1992

[Corneal ulcer. Current analysis from specialized ambulatory care of a clinic].

A review of 115 cases of ulcerative keratitis that were diagnosed and treated at the specialized ambulatory care center for infectious eye diseases at the 2. Department of Ophthalmology over a period of eight years (January 1983-April 1991) is presented. In the analysis of the etiology nearly half (47.7%) were observed following a trauma to the epithelium, 38 (= 33.0%) were associated with contact lens wear and the third largest group (10.4%) was associated with lid problems. It is apparent that over the course of the last years the spectrum of microorganisms associated with this localized inflammation has shifted: the prevalence of Staphylococci (1983-1986 = 65%) has decreased, whereas the incidence of gram-negative rods increased (1987-1990 = 49%). In 19% Pseudomonas aeruginosa could be isolated, mostly associated with soft contact lens wear. A total of 37.5% of the staphylococci isolates were found to be resistant to gentamicin, most probably as a consequence of the widespread, indiscriminate use of this antibiotic. An updated treatment schedule is presented.

Ambulatory Care↗
PubMed1992

[Corneal sensibility following epikeratophakia].

The postoperative rate of reinnervation following corneal surgery is widely considered to be a useful indicator of the healing process. This study reports the corneal sensitivity of 14 patients following epikeratophakia for different indications (myopia, aphakia and keratoconus) after time periods ranging from 7 to 104 weeks. All transplants were clear at the time of measurement. A newly developed aesthesiometer (using a low electric current for stimulation) was employed. Nine positions on the operated eye were chosen for the measurements, five locations of the non-operated fellow eye served as controls. On the operated eye the corneal sensitivity peripheral to the trephination were significantly reduced at the 9 and 12 o'clock positions as compared to the other eye. The 3 and 6 o'clock locations showed no significant difference. On the epikeratophakia lenticule the sensitivity was significantly reduced at all points, the center showing the largest difference (p less than 0.001). No correlation with age, sex or the indication for the procedure was observed. Although there was a trend of a positive correlation between the postoperative time period and the central corneal sensitivity, the follow-up was too short to reach significant levels. The nearly complete lack of corneal sensitivity, particularly in the center of the transplant is therefore well compatible with its long-time survival, even when the lenticule has been prepared with the cryolathe and lyophilized for transportation.

Adult↗
PubMed1992

[Taenia crassiceps in the anterior chamber of the human eye. A case report].

An otherwise healthy 15-year-old girl developed an iridocyclitis in her right eye. A contractable living parasite measuring two millimeter could be detected in the anterior chamber, the other parts of the eye remained uninvolved. The patient had close contact with the young dog of the family. By using a viscoelastic substance the parasite could be removed alive without any complications. The tapeworm was found to be too young for having developed the characteristic scolex. Western-immunoblotting gave indirect evidence for infection with Taenia crassiceps, a dog's tapeworm. During an observation period of two years no evidence for any other ocular or general Taenia crassiceps infestations could be found.

Adolescent↗
PubMed1992

[Retinal lymphoma--simulating uveitis].

A rare form of malignant large-cell non-Hodgkin's lymphoma or reticulum cell sarcoma is confined to the eye and central nervous system (CNS). We report the case of a 62-year-old man, who presented with recalcitrant progressive uveitis in his right eye. Although lymphoma was suspected, the patient refused to undergo vitrectomy. Over one year he developed large blister-like solid scattered lesions of the retinal pigment epithelium (RPE) in the same eye. Repetitive neuroimaging detected no CNS involvement. After developing optic disc-swelling and discrete RPE-changes in the left eye also, the patient agreed to enucleation of his right eye. Histopathology and Immuno-histochemistry revealed malignant intraocular large cell-lymphoma invading all eye-tissues. Liquor cytology showed lymphomatous cells. Suffering from high grade malignant lymphoma with CNS ivolvement, the patient had to undergo radiation therapy of the orbits and neuroaxsis as well as intravenous and intrathecal chemotherapy. Papilledema of the left eye resolved quickly and completely, RPE-infiltrations disappeared and led to discrete punched out lesions with no scarring, the lens remained transparent over the whole observation period of 25 months. the patient has been surviving for more than 52 months after first suspicion of malignant lymphoma, he has retained full vision in his left eye until now.

Chemotherapy, Adjuvant↗
PubMed1992

Do HLA antigens play a role in intermediate uveitis?

A total of 52 nonrelated Caucasian patients (21 male, 31 female, age at onset of the disease: 7-74 years, average: 31.6 years) suffering from intermediate uveitis were tissue typed for 56 different HLA-A, -B, -C and -DR-antigens. No significant association between any specific HLA-antigen and the disease, both when comparing the total patient group with a large, healthy control population, or any of the different subgroups (male vs. female, early vs. late onset, mild vs. severe course) could be demonstrated.

Adolescent↗
PubMed1992

Ulcerative blepharitis in atopic patients--is Candida species the causative agent?

A total of 50 patients suffering both from atopic skin disease and different clinical forms of blepharitis have been included in this study. Microbiological investigations (for bacteria and fungi) of the lid margins were performed in all cases. In 21 (42%) of the patients an ulcerative blepharitis which heavily involved the follicles of the lashes was diagnosed. The remaining 29 cases presented with blepharitis of the squamous type. The cultures revealed that 19 of the 21 patients with ulcerative blepharitis were found to grow Candida species, whereas fungi could not be detected in any of the other cases of blepharitis. The frequencies of concomitant bacterial organisms found in the cultures were similar in both groups. As atopic patients are known to exhibit a defect in their cell-mediated immunity and possibly also a defective IgA antibody response it is a widely accepted assumption that these immunological changes are contributing factors to the development of a localised inflammation of the lids which is initiated by a variety of micro-organisms. We postulate that when Candida species happen to coincide with severe inflammation in atopic patients a blepharitis of the ulcerative type will develop or deteriorate thereby implying that these microorganisms may play an important role in the development or deterioration of this severe chronic inflammation. It is therefore advisable to perform repeated scrapings and cultures in every case of recalcitrant blepharitis.

Adult↗
PubMed1992

Circulating ICAM-1 levels in serum of uveitis patients.

Intercellular Adhesion Molecule-1 (ICAM-1) is a cytokine-inducible adhesion molecule expressed on cells of multiple lineages at sites of inflammation. Recently a truncated form of ICAM-1 has been discovered to be circulating in serum. This study reports on circulating serum (cICAM-1) levels in 132 uveitis patients (HLA-B 27 pos. acute anterior uveitis (AAU); HLA-B27 neg. anterior uveitis (AU); intermediate uveitis (IU); heterochromic cyclitis Fuchs (HCF); sarcoidosis; Toxoplasmosis). Measurement of circulating ICAM-1 serum levels was performed using a monoclonal antibody based ELISA, with healthy blood donors serving as the control group. Applying multiple variance analysis and the Student Newmann-Keuls test we found a statistically significant elevation of serum cICAM-1 level in the HLA-B 27 neg. AU group (n:31), in the IU group (n:25) and in patients with sarcoidosis (n:18). Serum levels of HLA-B27 pos. AAU patients, patients with HCF and patients suffering from ocular toxoplasmosis did not differ significantly from levels of the control group.

Acute Disease↗
PubMed1992

Penetration of norfloxacin into the aqueous humor of the human eye.

Forty six patients received a topical application of a 0.3% norfloxacin (Zoroxin; MSD, Austria) solution into the lower fornix at different time intervals and frequencies before undergoing planned extracapsular cataract extraction. Aqueous humor was sampled at the beginning of surgery and assayed for the level of the antibiotic with high performance liquid chromatography. The highest aqueous humor level observed 30 min after the administration of the last drop in four patients who received five drops of norfloxacin into the lower fornix was 660.25 +/- 378.2 ng/ml. These concentrations are above the minimum inhibitory concentration of norfloxacin for 90% (MIC90) of most of the gram-negative microorganisms, but below the MIC90 of most of the staphylococci (coagulase negative Staph. and Staphylococcus aureus range between 0.25-1 mg/ml).

Administration, Topical↗
PubMed1992

Retinal pigment epithelial cells in post mortem HLA typing of corneal donors.

Corneas used for transplantation are typically obtained from donors up to 48 hr post mortem. By this time, standard HLA typing usually is impossible because of the lack of viable lymphocytes in spleen and peripheral blood. To increase the number of HLA-typed corneas, we developed a method in which the retinal pigment epithelial (RPE) cells of the donor eye are isolated, cultured in the presence of 1000 IU/ml interferon-gamma (IFN-gamma), and, after 4 d, are typed for HLA Class I and Class II antigens in the standard NIH cytotoxicity assay. Sixty five donors were typed simultaneously using peripheral blood lymphocytes and RPE. One hundred and sixteen out of 120 HLA-A antigens, 125/127 HLA-B, 106/108 HLA-C, and 92/100 HLA-DR antigens were identical using the same technique. Donor age, sex, cause of death, time of enucleation post mortem, and time of RPE preparation post mortem, as well as duration of culture period prior to stimulation with IFN-gamma did not correlate with the results of HLA typing. These data show that RPE cells can substitute for lymphocytes in post mortem HLA typing. Consequently, every donor with corneas suitable for transplantation can be prepared for matched transplantation.

Adolescent↗
PubMed1991

Blepharitis--a diagnostic and therapeutic challenge. A report on 407 consecutive cases.

Over the last few years the number of patients with chronic bilateral blepharitis has increased dramatically. From January 1985 until the end of 1989, a total of 407 patients with this diagnosis underwent ophthalmological and dermatological investigations at our out-patient clinic. Keratoconjunctivitis sicca (KCS) in conjunction with blepharitis occurred in 14.5% of the patient population who also suffered from acne rosacea. A comparison of the spectrum of microorganisms that have previously been isolated from affected sites with data obtained in the present study revealed that the range of microorganisms associated with this chronic localized inflammation has apparently shifted in recent years. The prevalence of Staphylococcus aureus, which was considerable in the pre-antibiotic era, has markedly decreased, although a distinct entity of staphylococcal blepharitis seems to remain, either alone or in combination with seborrheic blepharitis (62.8% of our patients). The clinical picture, microbiological findings and therapy for this condition are presented.

Adolescent↗
PubMed1991

Hydrated electron formation in nanosecond and picosecond laser flash photolysis of hematoporphyrin in aqueous solution.

Nanosecond (lambda exc = 266, 355 and 532 nm) and picosecond (lambda exc = 355 nm) laser flash photolysis of hematoporphyrin (Hp) was performed in neutral (pH 7.4) and alkaline (pH 12) aqueous solution, as well as in the presence of 0.1% Triton X-100. The dependence of the yield of photoproduced hydrated electrons (e-aq) on laser pulse energy was studied over a wide range of energies (0.2 to greater than 1000 mJ cm-2). The results show that e-aq are predominantly formed in a two-photon process at lambda exc = 266 and 355 nm. One-photon quantum yields are higher at lambda exc = 266 nm than at lambda exc = 355 nm. Both one-photon and two-photon pathways are less efficient at higher Hp concentration, reflecting the influence of Hp self-aggregation. Two-photon e-aq formation is more efficient when 30 ps pulses are used for excitation, as compared to 10 ns pulses. No e-aq could be detected at lambda exc = 532 nm. Nanosecond pulse-induced transient spectra obtained at pH 7.4 are also discussed.

Electrons↗
PubMed1991

[Complications of epikeratophakia in correction of aphakia, myopia, hyperopia and keratoconus].

Epikeratophakia for the correction of aphakia, myopia, hyperopia and keratoconus has overcome many of the objections to earlier lamellar refractive procedures (keratophakia and keratomileusis), such as the lamellar dissection of the recipients' healthy cornea over the visual axis and the need for expensive surgical equipment. It is reasonably reversible and repeatable. The complications observed in a series of 119 operations performed at the 2nd Department of Ophthalmology, University of Vienna, are discussed and compared with those reported in the literature. Serious complications, both intraoperatively and in the early and late postoperative period, that permanently threaten the patients vision are rare. Predictability and loss of effect in a significant percentage of myopic cases, caused by lack of precision during manufacturing of the lenticules and individual wound healing, makes careful patient selection mandatory.

Adult↗
PubMed1990

Serum interleukin 2-receptor levels in uveitis.

This study reports on serum interleukin 2-receptor (IL-2R) levels in uveitis patients. IL-2R is the mediator protein of interleukin 2 (IL-2), a mitogenetic cytokine of primarily immune cell interaction. Stimulated T-cells readily express IL-2R on their cell surface and release a soluble form into serum. The measurement of IL-2R serum levels was performed using a monoclonal antibody based ELISA with age and sex matched healthy blood donors serving as the control group. The increase of IL-2R serum levels in patients affected by heterochromic cyclitis Fuchs (HCF) and a small group of children with chronic anterior uveitis affected by juvenile rheumatoid arthritis (JRA) was statistically highly significant, when compared to the control group (n = 84, alpha = 0.01). Serum levels of patients with intermediate uveitis (IU), patients with HLA-B27 positive acute anterior uveitis (AAU) and patients with HLA-B27 negative AAU did not differ significantly from the controls.

Analysis of Variance↗
PubMed1990

[Uveitis. A status assessment].

Uveitis comprises a very diverse group of entities in which oxogen or endogen-derived inflammation of the uvea and retina may lead to significant visual loss and other ocular morbidity. The uniform classification of uveitis established by the International Uveitis Study Group and the definition of new entities such as acute retinal necrosis syndrome or birdshot retinochoroidopathy have led to better differential diagnosis in inflammatory uveal disease. Comparative studies carried out in many uveitis centers over the last 10 years have revealed a shift in the distribution of certain uveitis entities. New diagnostic approaches due to advances in basic immunology and detailed analysis of animal models have made a significant contribution to our ability to understand and treat ocular immune disease. Future research will be directed towards more specific treatment for uveitis based on increasing knowledge of the molecular basis for the immune response. Newly derived drugs (e.g., cyclosporin A, ganciclovir) and developed microsurgical techniques have been of benefit in the therapy of formerly intractable cases of severe uveitis.

Diagnosis, Differential↗
PubMed1989

[Theoretical occupational studies in ambulatory care at a university eye clinic].

In the present publication we report our attempts to analyze the diagnostic actions of an ophthalmologist working in the out-patient department of a major eye clinic according to the theories that have been established in applied medicine in other fields. To the best of our knowledge such a study has never been undertaken before. Using our experience from work in the field of applied general medicine it was possible to analyze both the diagnostic approach taken and the average time spent per patient that enabled the doctor to start specific treatment of the presenting symptoms. We observed that the consultation time per patient was comparatively short and that a precise diagnosis, as previously defined by us, is only rarely established. In most of the cases treatment was initiated with a "presumptive diagnosis" and the patient was subsequently followed up as long as necessary. There is no doubt as to the importance of further studies in this field for future application in general ophthalmology.

Adult↗
PubMed1989

HLA typing from human donor eyes.

A method for HLA-ABC and HLA-DR typing of human donor eyes using pigmented retinal epithelial and uveal cells cultured in the presence of human recombinant gamma-interferon is described.

Adolescent↗
PubMed1989

[Intermediate uveitis].

Intermediate uveitis is diagnosed in about 10% of the patients seen at the "Uveitis Clinic" of the Second Department of Ophthalmology of Vienna University. Forty-nine patients (with 83 eyes showing signs of the disease) were followed up for between six months and 12 years. Bilateral involvement was seen in 34 patients. The average age of the 27 female patients at the time of diagnosis was 26.2 years, that of the 22 male patients 24.6 years. All the eyes affected showed distinct vitreous opacities; 80% developed exudates overlying the pars plana and 70% showed a mild anterior chamber reaction. Posterior synechiae were found in 10% of the eyes, swelling of the optic disk in 15%, retinal vaso-proliferation in 10%, and dense intravitreal membranes in 6%. Posterior subcapsular cataract, vitreous hemorrhage, retinal detachment, band keratopathy, and atrophy of the eye were rarely seen. The complication most frequently and severely reducing central visual acuity was cystoid macular edema (30%). Whereas 31 patients did not require any treatment over the course of the observation period, it was found that oral corticosteroid therapy led to a significant improvement in vision in 14 patients (20 eyes) with CME. Only few patients required a combination of corticosteroids and Ciclosporin-A as long-term therapy. Vitrectomy and scleral buckling operations were rarely performed.

Adolescent↗