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Biomedical subjects

K D Carter

Publications and source records attributed to K D Carter.

At least 37 records · Page 2Linked to original sources
PubMed1992

Clinical characteristics associated with orbital invasion of cutaneous basal cell and squamous cell tumors of the eyelid.

Over a six-year period, between 1984 and 1990, 622 patients with basal cell and squamous cell carcinoma of the eyelids were examined at our institution. Thirteen patients had orbital invasion at initial examination. The average age of patients at orbital invasion was 75.8 years. Ten patients were men, eight of whom had basal cell carcinoma and two of whom had squamous cell carcinoma. Most patients had an orbital mass and incomitant strabismus at initial examination. Invasive basal cell carcinoma developed in 11 patients, and squamous cell carcinoma developed in two patients. Ten patients were treated for cutaneous carcinoma at the site of invasion before examination at our institution. The average duration between onset of a cutaneous lesion and our examination for orbital invasion was 9.8 years for basal cell carcinoma and one year for squamous cell carcinoma. Radiologic and histopathologic features were reviewed. The clinical characteristics of these patients were reviewed and orbital exenteration was recommended to all 13 patients. Nine patients underwent exenteration and four refused the operation.

Aged↗
PubMed1992

Phakomatous choristoma of the orbit: a case report.

We report the case of a 3-month-old infant with a rare phakomatous choristoma of the orbit. This lesion is believed to be a congenital neoplasm of lenticular anlage. The clinical, radiological, and histopathological findings are presented.

Choristoma↗
PubMed1991

Palpebral fissure responses to topical adrenergic drugs.

We measured the magnitude and time course of the increase in palpebral fissure width in ten normal volunteers in response to direct-acting (2.5% phenylephrine, 1% apraclonidine) and indirect-acting (10% cocaine, 1% hydroxyamphetamine) topical adrenergic drugs given in one eye. The increase in the palpebral fissure width of the treated eye was compared to the width of the untreated, control eye during a period of 60 minutes after each drug was administered. The difference in fissure width (asymmetry) between the treated and untreated eyes increased significantly for all drugs during the three- to 60-minute time period after treatment. There was no significant difference in the maximum eyelid effect among the adrenergic drugs tested. The drugs exerted their maximum effect by 30 minutes in 39 of the 40 trials (97.5%). The direct-acting drugs tended to exert their effect more quickly than the indirect-acting drugs. Our results demonstrate the expected increase in palpebral fissure width in response to topical adrenergic drugs in normal eyes. This information will provide a basis for evaluating Müller's muscle and its sympathetic innervation in patients with blepharoptosis.

Administration, Topical↗
PubMed1991

The osseointegration technique for the rehabilitation of the exenterated orbit.

Osseointegrated implants can be used successfully to support maxillofacial prostheses. Six patients (aged 37 to 80 years; average age, 68 years) underwent orbital exenteration for eyelid neoplasms infiltrating into the orbit. Each patient underwent a two-stage osseointegration procedure in preparation for fitting an orbital prosthesis. In the first stage, three or four bone-anchored fixtures were placed into the bony orbital rim. Skin penetration and abutment placement were performed in the second-stage operation, performed 3 to 6 months later. Successful osseointegration was achieved in 17 (94.4%) of 18 fixtures in five nonirradiated patients. All five patients were successfully fitted with an implant-retained prosthesis. One patient who underwent irradiation lost all four fixtures that had been placed. This patient chose to wear a black patch rather than a conventional prosthesis held in with adhesive. Average follow-up was 16 months for the five patients who were successfully fitted with orbital prostheses (range, 6 to 30 months).

Adult↗
PubMed1991

Long-term efficacy of orbital decompression for compressive optic neuropathy of Graves' eye disease.

In a retrospective evaluation of the long-term effect of transantral-ethmoidal decompression for compressive optic neuropathy, the authors evaluated visual acuity, visual fields, color vision, and motility in 30 patients (52 orbits) for a median follow-up period of 2.5 years (range, 0.6 to 6.5 years). Patients with preoperative visual acuity of 20/40 or better uniformly remained in this category and demonstrated an earlier stabilization of vision than those with poorer preoperative visual acuity. Of the ten patients whose preoperative visual acuity was 20/50 to 20/100, 80% attained acuity of 20/40 or better. In patients whose visual acuity was 20/200 or less (n = 7), 57% attained an acuity of 20/40 or better. The most common visual field defect was generalized constriction, which was noted in 43 of the 52 eyes (83%). After decompression, the preoperative visual field defect had improved or completely resolved in all but one case. Dyschromatopsia, noted in 20 eyes preoperatively, cleared in 17 (85%) postoperatively. Although the study showed that surgical decompression is beneficial, some patients may require additional modalities of treatment.

Adult↗
PubMed1991

Congenital macronodular juvenile xanthogranuloma of the eyelid.

A large congenital eyelid mass prevented an infant from elevating his eyelid successfully. A small punch biopsy was initially interpreted as "consistent with a dermatofibrosarcoma protuberans." On the basis of this diagnosis, radical surgery was advised. Dermatofibrosarcoma protuberans, however, rarely affects children and seldom appears in the head and neck area. Because of the discrepancy between clinical and pathologic diagnoses, additional biopsies were performed, which disclosed the lesion to be a juvenile xanthogranuloma. The mass regressed after intralesional injections of corticosteroids. This is the first clinicopathologic description of congenital macronodular juvenile xanthogranuloma affecting the eyelids. The variability in the histologic composition of this large lesion may lead to a mistaken diagnosis of an aggressive condition that may provoke unnecessary radical surgery.

Adrenal Cortex Hormones↗
PubMed1991

Long-term follow-up of severely injured eyes following globe rupture.

There is little information concerning the outcome of severely traumatized eyes, with little visual potential, which are not removed. We studied 50 eyes, which had suffered severe globe rupture, had visual acuities of no better than hand motion, and were not removed within 2 weeks of injury. Seventeen (34%) of the 50 eyes were later removed. Of the 17, nine had become painful. The other 33 eyes, which were not removed, remained comfortable over a mean follow-up of 66 months (12-161 months). Thirty (70%) of 43 eyes, which had follow-up of at least two months, became phthisical. There were no cases of sympathetic ophthalmia. These results suggest that the majority of severely-injured eyes become phthisical, but do not require removal for pain.

Adolescent↗
PubMed1990

Intraorbital wood. Detection by magnetic resonance imaging.

The authors present two cases in which intraorbital wooden foreign bodies remained undetected after initial ophthalmologic examination and radiologic investigation which included plain orbital x-rays, orbital computed tomography (CT) scans, and, in one case, orbital ultrasound. In each case, subsequent magnetic resonance imaging (MRI) showed a well-delineated low-intensity lesion suggestive of a retained foreign body. Investigation of a case of suspected wooden foreign body in the orbit should include an MRI scan if there is no contraindication, and no foreign body has been defined on CT scan, ultrasound, or plain orbital films.

Adolescent↗
PubMed1990

Histoplasma capsulatum endophthalmitis after cataract extraction.

A 60-year-old white man from an area endemic for Histoplasma capsulatum presented with a vitreous wick, hypopyon iritis, and dense vitreitis 2 months after removal of an anterior chamber intraocular lens (IOL) for chronic iritis. A diagnostic vitrectomy was performed and H. capsulatum was cultured and identified 2 weeks later. Despite intravitreal and intravenous amphotericin as well as repeat vitrectomies, the inflammation worsened and the eye was removed. Results of histopathologic examination showed Histoplasma organisms along the vitreous wick, over the surface of the iris and ciliary body, and over the retina. No organisms were found in the choroid. Dalen-Fuchs-type nodules similar to those of sarcoid also were noted, but there was no evidence of granulomatous inflammation in the uvea. Because of his unilateral disease with Histoplasma in the vitreous wick, negative serology, and an absence of systemic infection, the authors believe that this patient had a previously unreported form of ocular Histoplasma, exogenous postoperative Histoplasma endophthalmitis.

Cataract Extraction↗
PubMed1989

Short-term desensitization of prostaglandin F2 alpha receptors increases cyclic AMP formation and reduces inositol phosphates accumulation and contraction in the bovine iris sphincter.

The effect of short-term prostaglandin (PG) desensitization on PGF2 alpha receptor-mediated inositol phosphates accumulation, 1,2-diacylglycerol production, measured as phosphatidic acid (PA), myosin light chain (MLC) phosphorylation, cAMP formation and contraction was investigated in bovine iris sphincter smooth muscle. We have found that incubation of the sphincter with 25 microM PGF2 alpha for 45 min leads to: (a) significant loss in sensitivity of the tissue to PGF2 alpha receptor-stimulated inositol phosphates accumulation, PA production, MLC phosphorylation and contraction, and (b) significant increase in both basal and PGF2 alpha-stimulated cAMP formation. These changes are probably not due to reduction in phospholipid synthesis because there were no detectable differences in basal phospholipid labeling, either from 3H-inositol or from 32P, between normal and desensitized muscles. Preincubation of the sphincter in the absence of PGF2 alpha for 45 min did not lead to alterations in the biochemical-pharmacological responsiveness of the control muscle to PGF2 alpha. Our results suggest that desensitization of PG receptors in the iris sphincter occurs by a receptor-specific process. The PG receptor mediating contraction (IP3-Ca2+) is selectively susceptible to desensitization, in contrast with the receptor mediating smooth muscle relaxation (cAMP). These findings add further support to the developing hypothesis that there are functional and biochemical reciprocal interactions between the IP3-Ca2+ and cAMP messenger systems in the iris of the mammalian eye.

Animals↗
PubMed1988

Size variation of the lacrimal punctum in adults.

This is the first reported study on accurate computerized measurements of lacrimal punctal size in normal adults. There was a wide variation found between patients. The lower lid puncta were consistently noted to be larger than those of the upper lids. This is clinically significant in dry-eye patients who may need to be treated with punctal plugs of various sizes.

Adult↗
PubMed1988

Massive bilateral retinal vascular occlusion secondary to thrombotic thrombocytopenic purpura.

An 18-year-old woman developed sudden diffuse bilateral retinal vascular occlusive disease secondary to thrombotic thrombocytopenic purpura. This microangiopathic disease resulted in massive bilateral capillary closure and severe visual loss. Visual loss occurred while responding to therapy for this immune-mediated disease. This report is the first description of extensive retinal vascular occlusion in thrombotic thrombocytopenic purpura.

Adolescent↗