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Biomedical subjects

J I Perlman

Publications and source records attributed to J I Perlman.

14 recordsLinked to original sources
PubMed1999

A collaborative regional ocular anesthesia training program: successes and failures.

STUDY OBJECTIVE: To describe a collaborative effort of the departments of ophthalmology and anesthesiology to teach anesthesiology residents regional ocular anesthesia; to detect any differences in positive or negative outcomes after blocks performed by anesthesiology residents versus blocks performed by ophthalmology residents. DESIGN: Prospective descriptive, study. SETTING: Outpatient surgery in a university-affiliated veterans affairs hospital. PATIENTS: 614 patients requiring elective ocular surgery. INTERVENTIONS: Outcomes from patients who underwent regional anesthesia performed by ophthalmology residents were compared to outcomes from patients who received anesthesia from anesthesiology residents. MEASUREMENTS AND MAIN RESULTS: A detailed description of the collaborative teaching program in ocular anesthesia is presented. Ophthalmology residents performed the majority of regional ocular blocks (87% vs. 13%). There was no statistical difference in the incidence of negative outcomes, such as retrobulbar hemorrhage, between ophthalmology residents and anesthesiology residents (3/534 vs. 1/80) or in the incidence of successful blocks (90% for ophthalmology residents vs. 88% for anesthesiology residents). CONCLUSIONS: Regional ocular anesthetic techniques can be safely and successfully taught to residents in anesthesiology.

Ambulatory Surgical Procedures↗
PubMed1998

Unilateral Blastomyces dermatitidis endophthalmitis and orbital cellulitis. A case report and literature review.

PURPOSE: The authors report the clinical, cytologic, and histopathologic findings of a unique presentation of concomitant unilateral endophthalmitis and orbital cellulitis secondary to Blastomyces dermatitidis. DESIGN: Case report. METHODS: A 29-year-old healthy woman with a history of pulmonary tuberculosis presented with a painful right eye and rapidly decreasing vision. Fundus examination showed a diffuse elevated choroidal lesion at the posterior pole. With an otherwise unremarkable systemic work-up, the patient was treated with systemic antibiotics and corticosteroids for a presumed diagnosis of choroidal tuberculous granuloma. After an initial response to the treatment, the patient's condition deteriorated rapidly with visual acuity decreasing from 20/25 to no light perception in 3 months. Ipsilateral proptosis developed with magnetic resonance imaging showing a poorly defined orbital mass. Surgical enucleation and an orbital biopsy were performed. RESULTS: Histopathologic examination of the orbital specimen and an intact enucleated globe showed a diffuse necrotizing granulomatous process with the presence of numerous yeasts consistent with B. dermatitidis. This subsequently was confirmed by positive culture of B. dermatitidis from the orbital specimen. CONCLUSIONS: This is a unique case of concurrent unilateral endophthalmitis and orbital cellulitis secondary to B. dermatitidis. Intraocular dissemination of blastomycosis should be suspected in the differential diagnosis of endophthalmitis in patients with previous or active pulmonary lesions of equivocal nature. Early diagnosis and prompt treatment with antifungal medications are essential.

Adult↗
PubMed1998

Subretinal semiconductor microphotodiode array.

BACKGROUND AND OBJECTIVE: To examine the function of a semiconductor microphotodiode array (SMA) surgically implanted in the subretinal space. MATERIALS AND METHODS: Positive-intrinsic layer-negative (PiN) or negative-intrinsic layer-positive (NiP) SMAs were surgically placed into the subretinal space of rabbits through a pars plana incision and a posterior retinotomy. The implants required no external connections for power and were sensitive to light over the visible and infrared (IR) spectrum; IR stimuli were used to isolate implant-mediated responses from the activity of native photoreceptors. A stimulator ophthalmoscope was used to superimpose IR stimuli on the implant and adjacent retinal areas, and responses were recorded during the postoperative recovery period. SMA responses were also evaluated in vitro. The animals were given lethal anesthetic overdoses, and the retinas were examined histologically. RESULTS: The in vitro implant response consisted of an electrical spike, followed by a small-amplitude DC offset that followed the time course of the IR stimulation, and an overshoot at the stimulus offset. The SMAs placed in the subretinal space retained a stable position and continued to function throughout the postoperative period. The SMA responses recorded in vivo included additional slow-wave components that were absent from the in vitro recordings. These responses reverted to the in vitro configuration following the death of the animal. There was a significant loss of retinal cells in areas overlying the implant, and the retina appeared normal away from the implant and surgical site. CONCLUSION: SMAs can be successfully implanted into the subretinal space and will generate current in response to light stimulation during an extended period of time.

Animals↗
PubMed1997

Effect of tunicamycin on histological organization and Na, K-ATPase distribution in the adult cat retina.

Intravitreal injection of tunicamycin (TM) was evaluated as a method for inducing photoreceptor-specific degeneration in cat retina. TM (1 microg, 5-weeks duration) markedly decreased electroretinogram amplitudes. A polyclonal antibody directed against the Na, K-ATPase was used to further assess cell-specific retinal injury induced by TM. TM-treatment induced marked alterations in the differential distribution of the Na, K-ATPase within the retina. Histology confirmed photoreceptor degeneration in TM-treated retina, but further showed a severe, non-selective degradation of most retinal layers. Therefore, long-term intraocular exposure to TM results in a progressive general toxicity to the cat retina.

Adaptation, Ocular↗
PubMed1996

Disturbances in the distribution of neurotransmitters in the rat retina after ischemia.

PURPOSE: Disturbances in neurotransmitter distribution have been observed in cerebral ischemia in the pathophysiologic process of excitotoxicity. The goal of this study was to examine the effect of pressure-induced retinal ischemia on the distribution of the retinal neurotransmitters glutamate and gamma-aminobutyric acid (GABA) within the rat retina. METHODS: Animals were subjected to increased intraocular pressure of 110 mm Hg for 45 min using an intracameral hydrostatic pressure device. The distribution of glutamate and GABA immunoreactivity (IR) was determined at 0, 2, 4, 8 and 24 hrs after reperfusion by immunogold with silver intensification. RESULTS: Three phases of neurotransmitter immunoreactivity patterns were discernible following retinal ischemia. Immediately following reperfusion (Phase I), a shift of GABA-IR from inner retinal neurons to the Mueller cells and their processes was noted. In contrast, despite marked decreases in neuronal glutamate-IR, a less pronounced shift of glutamate-IR to the Muller cells was simultaneously noted. This shift of neurotransmitter IR to the Mueller cells was transient with the gradual reappearance of IR within the inner retinal neurons noted 2-8 hrs after reperfusion (Phase II). Phase III began at 8 hrs after reperfusion with progressive loss of GABA-IR noted in the inner retina; by 24 hrs, secondary loss of inner retinal glutamate-IR was evident with corresponding dropout and pyknosis of inner retinal neurons apparent. CONCLUSIONS: The distribution of glutamate-IR and GABA-IR was significantly altered following retinal ischemia. The alteration noted in Phase I suggested that the regulation of glutamate by Mueller cells was disrupted by this ischemic insult leading to glutamate excitotoxicity, and delayed neuronal cell degeneration as evidenced by the subsequent loss of inner retinal immunoreactivity in Phase III.

Animals↗
PubMed1994

Syringocystadenoma papilliferum of the eyelid.

Syringocystadenoma papilliferum is a benign adnexal tumor of the scalp and face. We treated syringocystadenoma papilliferum in a 31-year-old man who had a circumscribed cup-shaped lesion of the left upper eyelid with a central crater. On histologic examination, the epidermal edge showed hyperkeratosis and invasive acanthosis with papillary projections that filled the central crater. The deeper portions of the projections resembled ductal structures lined by an inner columnar epithelium, which demonstrated luminal apical decapitation secretions, and an outer layer of smaller cuboidal cells. The fibrovascular dermal tissue exhibited prominent plasmacytic infiltration underlying the papillary epithelium. Although rare, syringocystadenoma papilliferum should be considered in the differential diagnosis of umbilicated squamous or basal cell tumors, especially if noted in a young individual.

Adenoma, Sweat Gland↗
PubMed1994

Retrobulbar ischemic optic neuropathy associated with sickle cell disease.

A 52-year-old black man with a history of sickle cell SS disease presented with sudden loss of vision in his right eye. Examination of the right eye revealed no light perception and an amaurotic pupil, but an otherwise normal neuro-ophthalmic examination. On initial presentation, there was no evidence of an acute vascular event on funduscopy. Computed tomography failed to demonstrate pathology of the brain or orbit. Repeat fundus examination, 2 weeks later, still failed to demonstrate retinal or optic nerve disease. However, optic nerve pallor and central cupping became evident after 2 months and continued to progress in the ensuing year. Magnetic resonance imaging performed at that time did not disclose the presence of demyelinating disease, or aneurysmal dilation of the carotid or ophthalmic artery. A diagnosis of retrobulbar ischemic optic neuropathy is considered likely in this patient. The association of retrobulbar ischemic optic neuropathy and sickle cell anemia has not been previously reported.

Anemia, Sickle Cell↗
PubMed1989

Endocytosis in the rat retinal pigment epithelium.

Endocytosis in the retinal pigment epithelium (RPE) of rats was studied using horseradish peroxidase, microperoxidase and ferritin tracers. Tracer uptake was mediated by coated pits and coated vesicles. Coated pits formed at two discrete regions at the RPE plasma membrane: that portion of basal membrane directly opposing Bruch's membrane, and at the bases of the apical lamellae and villi. Two populations of coated vesicles were identified and distinguished by size, location and function. Large coated vesicles (91.8 +/- 14.7 nm in diameter) were located near the cell surface and incorporated tracer. Small coated vesicles (64.5 +/- 15.7 nm diameter) located more deeply within the cell were not tracer-labeled, and were often fused with the endoplasmic reticulum or the Golgi apparatus. Observations of the endocytic pathway in rat RPE cells are presented. Tracer was also found in organelles of the lysosomal system, e.g. the multivesicular body, but was not identified in the smooth endoplasmic reticulum or Golgi apparatus.

Animals↗
PubMed1984

Cycloheptatrienylidene analog of 11-cis retinal. Formation of pigment in photoreceptor membranes.

In biochemical and electrophysiologic studies employing the bullfrog (Rana catesbeiana) and the rat, the authors examined the interaction of opsin and an 11-cis-locked analog of retinal. In previously bleached preparations of bullfrog receptor outer segments (ROS) and isolated retinas, incubation with the aldehyde form (I) of the analog leads to the appearance of a pigment that is degraded slowly by hydroxylamine but is relatively resistant to photolysis. In the ROS preparation, the analog pigment (lambda max of difference spectrum congruent to 497 nm) also forms on incubation with NADP+ and the alcohol form (II) of the analog. In vitamin A deprived rats possessing only approximately 45% of the normal complement of rhodopsin, intraperitoneal injection of II leads within 1 day to the appearance of the analog pigment in the photoreceptors, at levels representing a major fraction of the opsin initially available for pigment formation. Formation of the analog pigment appears to have no significant effect on the sensitivity of electroretinographic b-wave responses recorded from the rat eye; furthermore, administration of II appears to suppress the sensitizing activity of all-trans retinol injected 1 day later. The data are discussed in relation to other studies examining chromophore-opsin interactions and electrophysiologic changes associated with the formation of rhodopsin in situ.

Animals↗
PubMed1982

Utilization of retinoids in the bullfrog retina.

The capacity to generate 11-cis retinal from retinoids arising naturally in the eye was examined in the retina of the bullfrog, Rana catesbeiana. Retinoids, co-suspended with phosphatidylcholine, were applied topically to the photoreceptor surface of the isolated retina after substantial bleaching of the native visual pigment. The increase in photoreceptor sensitivity associated with the formation of rhodopsin, used as an assay for the appearance of 11-cis retinal in the receptors, was analyzed by extracellular measurement of the photoreceptor potential; in separate experiments using the isolated retina or receptor outer segment preparations, the formation of rhodopsin was measured spectrophotometrically. Treatments with the 11-cis isomers of retinal and retinol induced significant increases in both the rhodopsin content and photic sensitivity of previously bleached receptors. The all-trans isomers of retinyl palmitate, retinol, and retinal, as well as the 11-cis isomer of retinyl palmitate, were inactive by both the electrophysiological and spectrophotometric criteria for the generation of rhodopsin. Treatment with any one of the "inactive" retinoids did not abolish the capacity of subsequently applied 11-cis retinal or 11-cis retinol to promote the formation of rhodopsin. The data are discussed in relation to the interconversions of retinoids ("visual cycle of vitamin A") thought to mediate the regeneration of rhodopsin in vivo after extensive bleaching.

Animals↗
PubMedDate not supplied

Oncocytic adenocarcinoma of the lacrimal sac: report of a case with paranasal sinus and orbital extension.

A 92-year-old man has had multiple recurrent oncocytic tumors involving the right paranasal sinuses and orbit. A benign oncocytoma that arose from the right lacrimal sac was initially diagnosed at age 80 years. The tumor recurred at 3 and 7 years after initial resection. There was greater histologic atypia in the first recurrent tumor, which extended into the right paranasal sinuses. The second recurrence had zones on oncocytic adenocarcinoma exhibiting prominent nuclear atypia and mitotic activity; this tumor massively invaded the right paranasal sinuses and orbit. We describe the clinical and pathologic features of this rare case.

Adenocarcinoma↗