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Biomedical subjects

K I Perman

Publications and source records attributed to K I Perman.

12 recordsLinked to original sources
PubMed1993

Dacryocystitis associated with malignant lymphoma of the lacrimal sac.

BACKGROUND: Tumors of the lacrimal sac are unusual, and lymphomas of the lacrimal sac are quite rare. Four patients with a history of well-differentiated, small cell lymphoma or chronic lymphocytic leukemia presented with either acute or chronic dacryocystitis and epiphora due to lymphomatous infiltration of the lacrimal sac. METHODS: All four patients underwent dacryocystorhinostomy with lacrimal sac biopsy. All tissues underwent complete histopathologic evaluation including immunohistochemical studies for cell surface markers and, in addition, were compared with previous biopsies performed for the initial diagnosis of lymphoma. FINDINGS: All biopsies demonstrated small cell well-differentiated lymphoma on histologic and immunofluorescent examination. No patient demonstrated orbital involvement on computed tomography. One patient had previously diagnosed chronic lymphocytic leukemia and one patient demonstrated diffuse lymph node involvement on postoperative systemic evaluation. All four patients underwent additional chemotherapy. No recurrence of dacryocystitis or epiphora occurred. CONCLUSION: Four patients presented with dacryocystitis secondary to lacrimal sac lymphoma. Lymphomatous lacrimal sac infiltration is an unusual cause of dacryocystitis. Biopsy of the lacrimal sac plays a diagnostically important role in dacryocystorhinostomy even in the absence of obvious tumorous involvement of the lacrimal sac mucosa.

Acute Disease↗
PubMed1993

Central nervous system herpesvirus infection in systemic lupus erythematosus: diagnosis by endoretinal biopsy.

A 31-year-old woman with systemic lupus erythematosus (SLE) developed meningoencephalitis, followed by transverse myelitis. The clinical picture was otherwise not consistent with a lupus flare. Extensive diagnostic evaluation was unrevealing. Acute visual loss ensued, associated with an unusual pattern of retinitis. Endoretinal biopsy established the diagnosis of herpesvirus infection. Reinstitution of antiviral therapy, and optic nerve sheath decompression, led to resolution of neurologic deficits and partial return of vision. Our report is the first that describes a patient with SLE with herpes meningoencephalitis, transverse myelitis, and rapidly progressive outer retinal necrosis, diagnosed antemortem by endoretinal biopsy, and successfully treated with acyclovir and optic nerve fenestration.

Acyclovir↗
PubMed1993

Systemic herpetic infection diagnosed by retinal biopsy.

We describe a patient with systemic lupus erythematosus who developed myelopathy, optic neuropathy, retinopathy, and aseptic meningitis unresponsive to immunosuppressive and antimicrobial therapy. Although cultures and brain biopsy were unrevealing, a Herpes virus was suggested by retinal biopsy. The patient recovered dramatically after institution of acyclovir therapy and optic-nerve-sheath decompression. This case demonstrates that herpetic retinitis can occur in an iatrogenically suppressed host and underscores the value of tissue diagnosis.

Adult↗
PubMed1992

Upper eyelid blepharoplasty.

BACKGROUND: The surgical removal of redundant upper eyelid skin along with the excision of prolapsed anterior orbital fat is one of the most popular elective cosmetic surgical procedures performed today. OBJECTIVE: To provide a brief overview of patient selection and upper eyelid blepharoplasty technique. CONCLUSION: Through careful patient selection and preoperative evaluation in addition to a thorough knowledge of eyelid and orbital anatomy, good outcomes from upper eyelid blepharoplasty can be obtained.

Eyelid Diseases↗
PubMed1988

Evisceration, enucleation, and exenteration.

The removal of the intraocular contents, the globe itself, or the entire orbital contents are three procedures that each present distinct pre- and postoperative problems. These procedures and the management challenges they present are discussed in this article.

Eye, Artificial↗
PubMed1987

Autogenous bone in orbital reconstruction.

Autogenous bone grafts play a major role in facial and orbital reconstruction following trauma. We discuss harvesting rib, iliac, and calvarial bone grafts for such cases, and point out the controversies in the use of alloplastic versus autogenous grafting materials.

Bone Transplantation↗
PubMed1986

The use of botulinum toxin in the medical management of benign essential blepharospasm.

Twenty-eight patients with mild or moderate cases of benign essential blepharospasm were treated with botulinum toxin Type A. Average follow-up was six months. The injection technique used on these patients is illustrated. The treatment was effective in virtually all patients treated, although transient; the mean interval of relief of spasm was approximately two and one-half months. Potential side effects include ptosis and epiphora. Botulinum toxin as an initial treatment or as an adjunct in postsurgical residual blepharospasm shows promise in this preliminary study.

Adult↗
PubMed1985

Psammomatoid (juvenile) ossifying fibroma of the orbit.

The clinical and pathologic features in 21 cases of a distinctive solitary fibro-osseous lesion affecting the orbit distinguished histologically by the dominance of numerous small round "psammoma-like" ossicles embedded in a cellular benign spindle cell stroma were studied. The patients were predominantly young, and 19 of the lesions were centered on the orbital plate of the frontal bone or ethmoid. A clinical course of slowly progressive symptoms over several years was typical but not uniform. The most common clinical diagnosis was fibrous dysplasia and mucocele. At least nine patients underwent two or more surgical operations; one patient had six recurrences over a 15-year period. There were no known deaths from the tumor, but its potentially massive size can result in considerable morbidity and cosmetic deformity. Although previously referred to as active juvenile ossifying fibroma, the term psammomatoid ossifying fibroma for this lesion is more descriptive and has historical precedence.

Adolescent↗
PubMed1985

Autogenous auricular cartilage grafting for lower eyelid retraction.

The authors discuss the surgical correction of lower eyelid retraction in dysthyroid, socket, and blepharoplasty patients. Sixty-three patients underwent a lateral canthal tightening combined with a vertical lengthening of the posterior lamella using autogenous posterior auricular cartilage. The average follow-up was for 2 years. We propose this combined procedure as the surgery of choice in the treatment of lower eyelid retraction seen in these three groups of patients.

Cartilage↗
PubMed1984

Argon laser trabeculoplasty in progressive low-tension glaucoma.

Twenty-two phakic eyes with progressive low-tension glaucoma had a 360-degree argon laser trabeculoplasty (ALT). Seven of these eyes had diurnal curves performed pre- and two months postlaser treatment to measure the effect of ALT on diurnal pressure variation. Sixteen of the 22 eyes (73%) were clinical successes with a 4.9 mm Hg decrease at 12 months in the successful group. However there was a decreasing pressure lowering effect with time with a mean follow-up of 21.6 months. The diurnal curve data showed a 6.2 mm Hg decrease between the mean pressure pretreatment and two months postlaser treatment. The mean peak pressure posttreatment was 13.29 mm Hg, a 6.17 mm Hg decrease from the prelaser mean peak pressure. The finding of 24-hour pressure control and a reduction in the mean peak pressure confirms the usefulness of ALT in progressive low-tension glaucoma and we recommend that it be utilized as the step in between maximally tolerated medical therapy and filtering surgery.

Circadian Rhythm↗
PubMed1980

Bilateral clinical anophthalmia: drugs as potential factors.

This case of bilateral clinical anophthalmia presents a host of interrelated drug reactions and potential teratogenic factors. While none of the drugs ingested by the mother has a high teratogenic potential, drug interactions, toxic potentiation, and unknown incompatibilities cannot be excluded. Although a single etiologic agent is not incriminated, the drugs ingested during pregnancy and their toxic effects and interactions are discussed. Use of drugs during pregnancy should be limited to those clinically indicated.

Abnormalities, Drug-Induced↗