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Biomedical subjects

J B Rubenstein

Publications and source records attributed to J B Rubenstein.

At least 19 recordsLinked to original sources

Treatment of recurrent conjunctival papillomatosis with mitomycin C.

PURPOSE: To report an effective treatment for recurrent squamous papillomas of the conjunctiva with excision and application of mitomycin C. METHOD: Case report. RESULTS: A 5-year-old African-American girl with recurrent squamous papillomas of the right bulbar and palpebral conjunctiva was treated with multiple therapies, including excision, cryotherapy, and conjunctival injection of alpha-interferon; all therapies were followed by recurrence. After treatment with excision followed by intraoperative application of mitomycin C to the involved conjunctiva, the patient had no recurrence in a 30-month period. CONCLUSIONS: Excision with application of mitomycin C was successful in managing a case of squamous papillomatosis that was resistant to traditional therapy.

Antibiotics, Antineoplastic↗

Reproducibility of corneal flap thickness in LASIK.

BACKGROUND: The purpose of the microkeratome in laser assisted in situ keratomileusis (LASIK) is to create a corneal flap of desired thickness, thus exposing the stroma. The accuracy and repeatability of intended flap thickness with the current microkeratome system has not been documented. The purpose of this study was to determine the precision and consistency of creating a corneal flap thickness of 160 microns with the Moria LSK-One microkeratome (distributed by Microtech, Inc., Doylestown, PA). PATIENTS AND METHODS: The records of 93 eyes from 67 patients who underwent LASIK were reviewed. The central corneal thickness was measured at baseline. The microkeratome using a "130" footplate was used to create an intended flap 160 microns thick, and the corneal thickness was then remeasured. RESULTS: The mean flap thickness for both eyes combined was 159 microns (S.D. = 28). There was no significant correlation between pre-flap corneal thickness or average K and the corneal flap thickness. CONCLUSION: This study provides evidence that the Moria LSK-One microkeratome creates reproducible LASIK flaps consistently near the intended 160 microns corneal flap thickness. This knowledge enables the surgeon to make a corneal flap with great confidence in the thickness of the excision. In addition, this study provides a clinical, in vivo model for testing corneal flap thickness.

Cornea↗

Granulomatous prostatitis: a hypoechoic lesion of the prostate.

Numerous benign and malignant entities can disrupt the normal prostatic parenchymal architecture producing hypoechoic lesions in the peripheral zone. We report two cases of granulomatous prostatitis mimicking carcinoma. The differential diagnosis of hypoechoic lesions and the etiologies of granulomatous prostatitis are discussed. All hypoechoic lesions in the peripheral zones of the prostate require biopsy for histologic diagnosis.

Administration, Intravesical↗

The fetal presacral pseudo-mass: a normal sonographic variant.

We examined 416 consecutive third trimester intrauterine gestations over a 4-month period and discovered 26 hypoechoic masses in the fetal presacral space (6.3% incidence). These masses varied in diameter from 15 to 30 mm (mean, 21.5 mm). All neonates were normal on follow-up examination, without evidence of any masses or neurologic deficits. The fetal rectosigmoid colon frequently is identified in the third trimester and may reach 2 to 3 cm at term. Because the prevalence of meconium-filled rectum (6.3%) exceeds that of a presacral teratoma (0.0025%), this normal anatomic variant should be considered the most common cause of a third trimester presacral "mass."

Colon, Sigmoid↗

Keratoconus and Fuchs' corneal endothelial dystrophy in a patient and her family.

A 44-year-old patient with bilateral keratoconus and bilateral Fuchs' dystrophy underwent penetrating keratoplasty. Examination of the patient's family revealed keratoconus in the patient's son and central guttata and abnormal endothelial cells in the patient's mother and daughter. Histopathologic evaluation of the corneal button demonstrated a thinned central epithelium and folds and keratocytes in Bowman's layer consistent with keratoconus. Central guttata, subepithelial bullae, and a decreased number of endothelial cells, consistent with Fuchs' endothelial dystrophy, were also seen. This case demonstrates that two distinct familial corneal diseases can occur in the same patient. Although one cannot conclude inheritance patterns based on this limited evaluation, the findings in this family support previous observations that keratoconus can be familial, and that Fuchs' corneal dystrophy has a female predilection with an autosomal-dominant inheritance pattern.

Adult↗

Transient acute tubular dysfunction in the newborn: CT findings.

We report the CT and sonographic findings of transient acute tubular disease in a newborn infant, who was dehydrated at birth. The initial CT scan demonstrated focal areas of increased attenuation within the central portions of both kidneys, and sonography showed echogenic medullary pyramids. After adequate hydration, a follow-up examination demonstrated complete spontaneous resolution.

Humans↗

Acanthamoeba-contaminated hydrogel contact lenses. Susceptibility to disinfection.

Acanthamoeba keratitis has frequently been associated with contact lens use. In this study, contaminated hydrogel contact lenses of patients were subjected to disinfection by thermal hydrogen peroxide and chemical (quaternary ammonium) systems. New hydrogel contact lenses contaminated by incubation on Acanthamoeba polyphaga plates were similarly subjected to the disinfection systems described above. Thermal disinfection was universally effective in eradicating acanthamoeba, whereas hydrogen peroxide and quaternary ammonium disinfection were ineffective. Scanning electron microscope photomicrographs suggest that acanthamoeba may adhere to surfaces of hydrogel contact lenses. These findings have significant implications for soft contact lens users.

Acanthamoeba↗

Correction of hyperopia following radial keratotomy: quantification in human cadaver eyes.

Overcorrection is a significant complication following radial keratotomy (RK). This study using human cadaver eyes demonstrates that the use of interrupted sutures placed across radial incisions coincident with a 7-mm optical zone mark can induce a wide range of central corneal steepening and can therefore correct varying amounts of hyperopia following RK. A case presentation confirms the effectiveness of using interrupted sutures to steepen the cornea following RK, but it also shows that significant regression of the effect must be considered at the time of suture placement. Since placement of interrupted corneal sutures is a routine procedure, it is a very convenient technique for treating overcorrection following RK.

Adult↗

Differential gallbladder contractility in fundal adenomyomatosis: demonstration by cholecystokinin cholescintigraphy.

The cholecystokinin cholescintigraphic findings of fundal adenomyomatosis in a 29-yr-old male with severe post-prandial pain are presented. Planar cholescintigraphy demonstrated a trilobed gallbladder contour. Following the administration of 0.02 micrograms/kg of cholecystokinin at maximal gallbladder filling, fundal dyskinesia was observed. Regional gallbladder ejection fractions were: whole gallbladder, 43%; proximal two-thirds of the gallbladder, 70%; and gallbladder fundus, 32%. First harmonic Fourier phase and amplitude images demonstrated: (a) decreased fundal amplitude values, and (b) a phase shift of the pixels in the gallbladder fundus.

Adult↗

Trapezoidal astigmatic keratotomy. Quantification in human cadaver eyes.

The mechanism by which surgical procedures correct astigmatism are incompletely understood and, therefore, the results are often unpredictable. In this study, a Terry keratometer was used to analyze the effect of each component part of a 3-, 4-, and 5-mm trapezoidal astigmatic keratotomy. Semiradial incisions along the horizontal meridian produced corneal flattening along the horizontal meridian twice that of the vertical meridian, therefore inducing positive cylinder astigmatism at 90 degrees. A single pair of tangential incisions placed 5 mm apart, when added to the semiradial incisions, accounted for 100%, 87%, and 78% of the maximal effect from the 3-, 4-, and 5-mm completed trapezoidal astigmatic keratotomies, respectively. This study suggests that maximal correction of astigmatism may be attained with a single set of tangential incisions placed 5 mm apart between two sets of semiradial incisions.

Astigmatism↗

Placental changes in fetal triploidy syndrome.

The sonographic findings in fetal triploidy syndrome include intrauterine growth retardation, hydrocephalus, oligohydramnios, and hydropic changes of the placenta. Ultrasonography can establish the diagnosis only when placental findings coexist with a fetus. Although the majority of triploid conceptions abort spontaneously in the first trimester, occasionally they will progress further, but rarely to term. Six cases are presented in which the diagnosis was suspected by early ultrasound examinations, including one case in which there was an unusually large trophoblastic cyst. Determination of the karyotype is important for the management of a pregnancy with a live fetus, and has implications for genetic counseling of subsequent pregnancies.

Abnormalities, Multiple↗

Pneumatonometry through bandage contact lenses.

Bandage soft contact lenses are an effective therapy for patients with a variety of corneal diseases. These patients often require accurate measurement of the intraocular pressure, necessitating movement or removal of the contact lens for slit-lamp Goldmann applanation tonometry. Intraocular pressure was measured in 21 normal, healthy volunteers, using a pneumatonometer (Alcon). A therapeutic soft contact lens (Plano T) was then placed on the eye and the pneumatonometer was used to remeasure the intraocular pressure through the contact lens. The average intraocular pressure without the contact lens was not statistically different from the intraocular pressure with the contact lens. These data suggest that pneumatonometry is an effective way to assess the intraocular pressure in patients wearing bandage contact lenses, thus eliminating the need to manipulate the lens solely for the purpose of intraocular pressure determination.

Adolescent↗