Biomedical subjects
Publications and source records attributed to J I Katz.
We report a case of perforation of ileal conduit during endoscopy, a rare complication of a procedure done infrequently in most institutions. We present one method of treatment.
The slow-release artificial tear (SRAT) is a biodegradable, cellulosic polymer without preservative which is inserted beneath the tarsus of the lower lid, and which provides continuous lubrication and tear film stability to the eye. The SR-AT has been shown to reduce both subjective symptoms and objective signs in patients with keratitis sicca, and is a valuable adjunct to therapy in patients with this disease.
A 17-year-old girl developed a viral encephalitis that was followed by massive exudative retinal detachments in both eyes. A diagnosis of herpes simplex encephalitis and retinitis was made as a result of finding rising herpes simplex viral titers. An examination of the patient's cell-mediated immune system showed it to be grossly intact.
We successfully used autogenous periosteum to reinforce the weakened sclera of two patients with necrotizing scleritis. One of these patients previously had an onlay scleral graft made from homologous banked sclera, which had subsequently melted. Autogenous periosteum is suggested as an alternative to banked sclera for scleral reinforcement.
A 2,000-g infant boy had many features of the Smith-Lemli-Opitz syndrome (prenatal growth deficiency and developmental retardation, microcephaly with unusual facies, hypospadias, and feeding difficulties) as well as sclerocornea. The association of this rare eye finding with this rare congenital syndrome is unique. Successful penetrating keratoplasty was performed in one eye at 8 months of age.
Methacrylate surfaces adhere to corneal endothelial cell membranes and appear to tear off the cell membranes as they separate. This adhesion appears to cause much of the massive cell damage seen at the time of intraocular lens insertion even in the hands of several groups of very experienced implant surgeons. The damage appears correlated with the incidence of endothelial touch, and may be avoidable both by avoiding contact, even for a brief period, between the endothelium and the intraocular lens during insertion, and by increasing the safety of such lenses through a hydrophilic protective coating which would give a surface similar to human lens epithelium or soft contact lens material which does not damage the endothelium. It is possible that similar damage also plays a role in causing abdominal adhesions through contact with rubber gloves, as well as venous thromboses and urethral strictures.
Clinical specular microscopy has indicated that human cell healing occurs by spreading, there is a limited healing reserve, and premature cell loss is the equivalent of a "premature aging" that may lead to later decompensation. This instrument has been useful in studying healing and cell damage from surgery, drugs, and special procedures such as intraocular lens insertion. It pointed out extensive cell loss at the time of intraocular lens insertion, and subsequent studies have indicated that at least part of this cell loss may be due to the methacrylate surface of the lens. Laboratory studies suggest that coating that surface can prevent this component of cell loss. The magnitude of benefits to be found from such coating requires further clinical study.
We herein report a case of primary malignant melanoma of the female urethra, summarize the histopathology, review the available literature and discuss the treatment. Although a definitive regimen for the treatment of this virulent malignancy has not been established a 10-year-survival has been obtained by surgical extirpation preceded by preoperative radiotherapy.
Previous studies have shown that approximately 40 per cent of the corneal endothelial cells can be lost at the time of intraocular lens insertion. Momentary contact between the methacrylate surface and the endothelial cells causes an adhesion between these surfaces and results in extensive cell damage upon separation of the surfaces. This type of damage appears to be due to a biophysical interaction between these surfaces and may be avoidable by altering the surface of the lens.