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Biomedical subjects

Grant W Su

Publications and source records attributed to Grant W Su.

7 recordsLinked to original sources
PubMed2006

Quantitative analysis of temporal artery contraction after biopsy for evaluation of giant cell arteritis.

BACKGROUND: Although the degree of contraction of temporal artery biopsy specimens after formalin fixation has been previously reported to range from 6% to 13%, the degree of contraction before fixation has not been previously studied. The aim of this study was to quantify the postexcision (prefixation) contraction of temporal artery biopsy specimens and to determine the relationship between contraction and the result of the biopsy. METHODS: All patients undergoing temporal artery biopsies from February 2003 through May 2004 were retrospectively reviewed. Contraction was determined by subtracting the in vivo and ex vivo lengths, then dividing the difference by the in vivo length to obtain a percentage of contraction. Statistical analysis was performed with the unpaired t test and Fisher exact test. RESULTS: We reviewed 37 negative and 7 positive biopsies for giant cell arteritis (GCA). For specimens positive for GCA, the mean contraction was 12%, whereas for negative specimens, mean contraction was 22%. There was a significant difference in the contraction between the specimens positive and negative for GCA (p = 0.009). The Fisher exact test revealed that GCA was positively associated with arterial contraction of less than 15% (p = 0.002). INTERPRETATION: The temporal artery can contract substantially after excision and before tissue fixation. GCA-positive specimens exhibit statistically less contractility than negative specimens.

Biopsy↗
PubMed2005

Primary squamous cell carcinoma arising from an epithelium-lined cyst of the lacrimal gland.

A 66-year-old man presented with a slowly enlarging, nontender left orbital mass of 2 months' duration. CT and MRI showed a left lacrimal gland mass with enhancement and internal irregularity of cystic structures. Histopathologic analysis of the biopsy specimen revealed a squamous cell carcinoma arising from an epithelium-lined cyst. The patient underwent left orbital exenteration followed by radiation treatment. No evidence of tumor recurrence was observed after a follow-up of 30 months. We believe this primary squamous cell carcinoma may have arisen either from preexisting lacrimal duct cyst (dacryops) with areas of squamous metaplasia or, less likely, from a choristomatous epithelium-lined cyst of the lacrimal gland. Although rare, this entity should be included in the differential diagnosis of cystic lesions of the lacrimal gland.

Aged↗
PubMed2004

Mucous membrane pemphigoid in a patient with chronic lymphocytic leukemia.

PURPOSE: To describe a case of mucous membrane pemphigoid (MMP) with ocular manifestations in a patient subsequently diagnosed with B-cell chronic lymphocytic leukemia (CLL). METHODS: Case report and literature review. RESULTS: A 64-year-old man presented with redness and irritation of both eyes. The patient also had blistering lesions on the roof of his mouth, trunk, and buttocks as well as bilateral conjunctival ulceration and symblepharon formation. A complete blood count performed before initiating treatment of presumed mucous membrane pemphigoid revealed a markedly increased white blood cell count (83,920) with a predominance of lymphocytes. Hematologic evaluation including immunophenotyping flow cytometry resulted in the diagnosis of B-cell chronic lymphocytic leukemia. Cyclophosphamide treatment improved his MMP and decreased the white blood cell count. CONCLUSIONS: Mucous membrane pemphigoid has been reported in association with a variety of nonhematologic malignancies. This case suggests that mucous membrane pemphigoid may also occur in B-cell CLL and supports the concept that autoantibodies play a role in the pathogenesis of this cicatricial conjunctival disease.

Conjunctival Diseases↗
PubMed2004

Current trends in managing the anophthalmic socket after primary enucleation and evisceration.

PURPOSE: To evaluate current trends in the management of the anophthalmic socket after primary enucleation and evisceration. METHODS: The active membership of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) was surveyed regarding primary enucleations and eviscerations performed between January and December 2002. Survey questions included practice demographics, orbital implant use, wrapping materials, placement of a motility peg, reasons for implant choice, and complications encountered. RESULTS: A total of 2,779 primary orbital implants were reported, comprising 1,919 (69.1%) enucleations and 860 (30.9%) eviscerations. The high-density porous polyethylene implant was used most frequently for enucleations (42.7%), followed by coralline hydroxyapatite (27.3%) and nonporous alloplastic implants (19.9%). For eviscerations, the high-density porous polyethylene implant was the most commonly used implant (42.3%), followed by hydroxyapatite (25.9%) and nonporous alloplastic implants (25.7%). The top 3 reasons for implant choice were outcome (69.3%), cost (43.6%), and experience (39.5%). Most implants were either not wrapped (59.8%) or were wrapped in donor sclera (25.2%) or polyglactin mesh (7.2%). Pegs were used in 8.1% of all implants reported. The most frequent complications encountered for unpegged implants were exposure (3.2%) and infection (0.4%). For pegged implants, the most common complications reported were pyogenic granuloma (13.7%), exposure (5.7%), and discharge (5.7%). CONCLUSIONS: In managing the anophthalmic socket, ASOPRS survey respondents preferred to use the porous polyethylene implant after primary enucleation and evisceration. Most orbital implants were not wrapped, and most surgeons preferred not to place a motility post or peg in the implant.

Anophthalmos↗
PubMed2003

Update on giant cell arteritis.

PURPOSE OF REVIEW: Giant cell arteritis (GCA) is the most common form of systemic vasculitis that causes visual loss in the elderly. This review highlights current concepts dealing with the diagnosis, treatment, and visual prognosis of patients with GCA. RECENT FINDINGS: Recent evidence suggests that recovery of visual function in patients with visual loss from GCA is poor. An algorithm has been constructed to assist clinicians in the evaluation and management of patients suspected of having GCA. SUMMARY: Despite a number of new adjunctive agents, corticosteroids remain the standard treatment in patients with GCA.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Combined inferior and medial surgical approaches and overlapping thin implants for orbital floor and medial wall fractures.

PURPOSE: To evaluate the clinical outcome of combined orbital floor and medial wall fracture repair using overlapping thin implants. METHODS: A retrospective chart review was conducted on 19 fracture repairs performed by one surgeon using thin overlapping implants inserted through transcaruncular and inferior fornix incisions. RESULTS: Nineteen combined medial wall and floor fractures were repaired in 18 patients (14 male, 4 female). The median age was 37 years (range, 13-60 years). The median trauma-to-surgery interval was 9 days (range, 1 day to 6 years). Two overlapped implants (0.2-0.4 mm) were used in 12 fracture repairs, and 3 overlapped implants (0.2-0.3 mm) were used in 7 fracture repairs. Materials included prepunched nylon foil in 18 fractures and, in one fracture, high-density polyethylene. Follow-up time ranged from 1 month to 53 months (median, 7 months). No complications occurred during the postoperative follow-up period. Clinically significant enophthalmos was not observed after treatment. CONCLUSION: The repair of combined orbital floor and medial wall fractures using thin overlapping implants inserted through transcaruncular and inferior transconjunctival incisions is a safe, effective, and cosmetically sensitive surgical technique.

Adolescent↗