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Biomedical subjects

H MacLean

Publications and source records attributed to H MacLean.

12 recordsLinked to original sources
PubMed1998

Recurrent scleritis in lepromatous leprosy.

BACKGROUND: Recurrent immune-mediated scleritis after adequate treatment of leprosy is not well documented in the literature. We describe an Australian resident with unilateral intra-ocular lepromatous leprosy who had persistent non-infectious scleritis. METHODS: A man of Anglo-Indian ancestry initially presented with lepromatous leprosy and unilateral ocular involvement. The affected eye had an interstitial keratitis and a granulomatous anterior uveitis that responded to antileprotics and anti-inflammatory agents. Despite systemic cure with triple antileprotic therapy, he developed recurrent scleritis that required multiple scleral patch grafts for scleral thinning and, subsequently, an enucleation. Histology failed to demonstrate persistent infection, rather a chronic non-granulomatous scleritis, which was probably immune mediated. RESULTS/CONCLUSIONS: This case demonstrates an ocular complication of leprosy that is infrequently reported. Patients with ocular involvement by leprosy are at risk of developing recurrent scleritis despite systemic cure with antileprotics.

Anterior Chamber↗
PubMed1997

Long-term results of corneal wedge excision for pellucid marginal degeneration.

PURPOSE: A retrospective study reporting long-term visual and astigmatic results of patients with pellucid marginal degeneration (PMD) treated by corneal wedge excision. METHODS: The notes of 9 patients (10 eyes) treated by corneal wedge excision were reviewed. All patients had typical PMD and were treated by excision of an inferior crescent of diseased corneal tissue. The excised area measured approximately 2 mm in width and extended from the 4 o'clock to the 8 o'clock meridian. All thinned corneal tissue was removed. Normal-thickness corneal stroma was then reapposed with 10/0 nylon or 10/0 polypropylene sutures. Post-operative selective suture removal was performed until a satisfactory visual and astigmatic result was achieved. This was guided by refraction, keratometry and photo-keratoscopy results. Pre-operative best corrected visual acuity ranged from 6/12 to 6/60 with an associated mean keratometric astigmatism of +13.8 dioptres (range 8-25 dioptres, axis range 30 degrees-175 degrees). Mean follow-up was 59 months (range 14-138 months). RESULTS: Post-operatively a stable corrected visual acuity of 6/9 or better was achieved in all cases in a mean time of 5.4 months (range 3-12 months). Mean post-operative keratometric astigmatism was 1.4 dioptres (range 0.5-4 dioptres). Over the course of follow-up long-term astigmatic drift (LTAD) was noted, mean 2.1 dioptres (range 0.5-5.5 dioptres). Three patients developed mild inferior pannus related to peripherally sited sutures. One case developed apparent corneal hydrops within the corneal wound after 9 years of follow-up. CONCLUSIONS: We believe that corneal wedge excision offers an excellent surgical result for patients with PMD, although modification of the technique may be required to improve long-term astigmatic drift.

Adolescent↗
PubMed1996

Primary ocular relapse in acute lymphoblastic leukemia.

Relapse of acute lymphoblastic leukaemia (ALL) occurred in the anterior segment of four children. All cases had been treated according to the Medical Research Council's UK Acute Lymphoblastic Leukaemia trial protocol (UKALL) including 2 years of continuation chemotherapy. In three cases the diagnosis was confirmed by anterior chamber aspirate while in one case the diagnosis was presumed on clinical grounds alone. All four cases experienced isolated leukaemic relapse in the anterior segment within 2 months of stopping therapy. The months immediately following cessation of continuation chemotherapy as part of the UKALL regime appear to represent a 'high-risk' period for primary anterior segment relapse of ALL. Children with ALL presenting with uveitis should be regarded as having leukaemic relapse and anterior chamber taps with or without an iris biopsy should be considered to confirm this diagnosis. Early diagnosis and treatment of ocular leukaemic relapse is likely to give these children the best chance of ultimate cure.

Anterior Chamber↗
PubMed1993

Mikulicz syndrome and disease: 2 case reports highlighting the difference.

We present 2 case reports highlighting the essential differences between Mikulicz syndrome and Mukulicz disease. A review of the literature appears to show some confusion over the terminology and we therefore also present an historical account of the evolution of the two terms and review their relative merits and relationship with other disorders. In conclusion, we would not advocate the use of the term Mikulicz syndrome and suggest that Mikulicz disease be replaced by the title 'Benign Lymphoepithelial Lesion'.

Female↗
PubMed1992

Experimental transplantation with principal islets of teleost fish (Brockmann bodies). Long-term function of tilapia islet tissue in diabetic nude mice.

Certain teleost fish have macroscopically visible islets called BBs that are anatomically discrete. BBs were harvested from Oreochromis nilotica (tilapia) with microscissors, divided, and cultured overnight at 37 degrees C before transplantation into STZ-induced diabetic nude mice. Each mouse received BB fragments from 3-5 fish weighing in aggregate approximately 1.7 kg. Non-FPGs were monitored 5 days/wk. Recipients remained normoglycemic (plasma glucose < 11.1 mM) for 50 days posttransplantation. Mice bearing 50-day-old grafts had essentially normal GTTs. Left nephrectomies then were performed to remove the grafts, and plasma glucose levels in recipient mice rose to > 22.2 mM. Histological examination of graft-bearing kidneys showed viable, vascularized islet tissue containing numerous well-granulated beta-cells; examination of recipient native pancreases revealed small islets composed predominantely of non-beta-cells.

Animals↗
PubMed1991

Low frequency maintenance ganciclovir for cytomegalovirus retinitis.

45 patients on maintenance ganciclovir for treated cytomegalovirus (CMV) retinitis were reviewed retrospectively. Treatment was given at 30 mg/kg/week in 3 divided doses: Monday, Wednesday, Friday. The median time to clinical relapse was 5.4 months. This is similar to that reported with higher frequency maintenance regimens. The high degree of immunodeficiency (median CD4 count 16 cells/microliters) and poor prognosis (median survival 8.2 months) associated with CMV retinitis were confirmed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The effect of intermittent lighting on growth, feed:gain ratio, and abdominal fat content of broiler chickens of various genotypes and sex.

Intermittent lighting (IL) regimens were tested for rearing broiler chickens from 2 to 7 weeks of age. In Experiments 1 and 2, the effects of 6 cycles of light (L) and darkness (D) of 1L:3D vs. 12 cycles of .25L:1.75 D were compared on the performance of 2400 broiler chickens. Eight genotypes of 5170 mixed-sex broilers were used to compare effects of 6 cycles of 1L:3D vs. 1 cycle per day of 23.5L:.5D on broiler performance (Experiment 3). The sexes responded differently to two IL regimens in Experiment 1. Males had higher body weight, feed intake, and abdominal fat content with 1L:3D; in females, there was no difference in body weight or feed intake, but abdominal fat content was lower with 1L:3D regimen. In Experiment 2, no significant effect of lighting regimen on broiler performance was observed. In Experiment 3, most genotypes had lower feed intake and abdominal fat content for 1L:3D than for 23.5L:.5D, but response of weight gain was variable; one genotype had higher feed intake and another genotype had higher fat content with 1L:3D. It was concluded that sex and genotype should be considered in planning the use of IL techniques for broiler chickens.

Abdomen↗
PubMedDate not supplied

Regional nerve block of the upper eyelid in oculoplastic surgery.

PURPOSE: To establish the efficacy of a regional nerve block of the upper eyelid and its effect on levator motor function. METHODS: Forty-one patients underwent surgery on 54 upper eyelids by one surgeon, after administration of a regional nerve block at the supraorbital notch. The amount of pain experienced by patients due to the local anesthetic injection and surgery was determined by using visual analogue scores. The effect of the local anesthetic injection on levator function was determined by comparing the measured levator function prior to and following administration. Any complications attributable to the regional sensory nerve block were recorded. RESULTS: Ninety-two percent of patients found the injection painless, and the rest reported negligible pain. The mean pain score for the injection was 2 (SD 1.3, range 0-6). The mean pain score for the surgery was 0.3 (SD 0.6, range 0-3). No significant difference was found in levator function prior to and following the injection (pre-function: 14.4 mm, post-function: 13.4 mm, p=0.01). One patient had hematoma formation at the site of injection. CONCLUSIONS: A regional nerve block of the upper eyelid achieves effective sensory anesthesia,without compromising motor function. This helps in an accurate assessment of intraoperative height during upper lid surgery.

Adult↗