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Biomedical subjects

K N Miller

Publications and source records attributed to K N Miller.

13 recordsLinked to original sources
PubMed1992

Papillary adenofibroma of the uterus. Report of a case involved by adenocarcinoma and review of the literature.

An unusual case of uterine papillary adenofibroma involved by an invasive well-differentiated adenocarcinoma is reported. The diagnosis was established using a hysterectomy specimen from a 68-year-old woman who was initially examined for abdominal pain and vaginal bleeding. The tumor was a broad-based polypoid mass composed of papillary projections into clefts and cysts. These papillations were covered by a variety of epithelial types and focally involved by an infiltrating adenocarcinoma. The stroma was fibrous and collagenized with variable numbers of benign fibroblasts. The papillary adenofibroma is considered to be a benign mixed tumor of Müllerian origin. Fifteen other cases of uterine adenofibroma have been reported in the literature and only one of these was focally involved by an adenocarcinoma. The clinical and histologic features of this rare disease are reviewed.

Adenocarcinoma↗
PubMed1991

A comparison of total and partial tenonectomy with trabeculectomy.

We compared the results of two methods of tenonectomy at the time of trabeculectomy. Of 49 eyes, 23 were randomly assigned to a partial tenonectomy and 26 to a total tenonectomy. There was no statistically significant difference in the success rate between the two surgical groups using an upper limit of intraocular pressure of either 18 or 21 mm Hg as the criterion for success. There was no difference in the need for postoperative medications or further surgical intervention between the two groups. Although certain advantages exist with each technique, these findings suggest that equivalent results can be anticipated with either a total or partial tenonectomy.

Female↗
PubMed1991

Early postoperative prognostic indicators following trabeculectomy.

We compared prognostic indicators manifesting within the first 2 postoperative days, with filtration status 3 months following trabeculectomy in 51 primary open-angle glaucoma patients. Patients with an avascular area in the filtering bleb 2 days after surgery had a significantly lower (P less than .05) intraocular pressure (IOP) (12.6 mm Hg) 3 months postoperatively than patients with vascular blebs (16.3 mm Hg). However, neither the height, breadth, or transparency of the filtering bleb, presence of microcysts, anterior chamber depth, nor IOP during the first 2 postoperative days were related significantly to the filtration status at 3 months.

Female↗
PubMed1990

Hemianopic offsets in the visual field of patients with glaucoma.

In 359 glaucoma patients (600 eyes), we measured the peripheral field with kinetic targets and the central 30 degrees field of vision with static testing, using the Field-master-5000 automated perimeter to evaluate the prevalence and significance of step-like visual-field defects along the vertical midline (a hemianopic offset). In all, 129 eyes of 121 patients had a hemianopic offset. In 108 eyes the offsets (involving either the peripheral or the central field or both) were associated with other glaucomatous field changes, whereas 21 eyes showed a peripheral offset as an isolated finding. Of the 8 cases of offsets found in both eyes, 7 were binasal and 1 occurred bitemporally but in separate hemifields. This study suggest that hemianopic offsets occur commonly in glaucoma patients but have limited diagnostic value because most are associated with other glaucomatous field changes. However, these findings help in distinguishing glaucomatous offsets from those caused by neurological lesions.

Glaucoma↗
PubMed1990

Evaluation of a protocol for transscleral neodymium: YAG cyclophotocoagulation in one hundred patients.

One hundred consecutive patients with intractable glaucoma underwent transscleral neodymium: YAG (Nd:YAG) cyclophotocoagulation using a standard protocol derived from a study of human autopsy eyes, and were followed prospectively for a minimum of 6 months. After the first treatment, 51 patients had a final intraocular pressure (IOP) between 7 and 20 mmHg (classified as "IOP success") and 17 more had an IOP less than 7 mmHg or more than 20 mmHg, but required no additional surgery ("qualified IOP success"). With one or more additional treatments, the totals rose to 65 IOP successes and 30 qualified IOP successes. Parameters associated with qualified success and failure were younger age and higher preoperative IOP. Forty-five patients in the cumulative IOP success and qualified IOP success groups had reduced visual acuity, although this could be attributed to other ocular problems in at least one half of the cases. Other postoperative complications included transient IOP rise in 23 patients, severe pain in 12 patients, and severe inflammation in 29 patients.

Adolescent↗
PubMed1989

Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome.

The medical records of 93 patients with pigmentary glaucoma and 18 patients with pigment dispersion syndrome were studied with regard to factors associated with the presence and severity of secondary glaucoma within this population. Male gender, black race, severe myopia, and Krükenberg spindles were identified as possible risk factors. Men were predominant in this population 75 (67.6%); the diagnosis was made in men at an earlier age; they had a higher proportion in the glaucoma group; and they required more aggressive glaucoma therapy. There were only four black patients, but all required surgery. Patients in the glaucoma group had significantly more severe myopia and a higher incidence of Krükenberg spindles. These risk factors may help to identify which patients with the pigment dispersion syndrome require closer follow-up or the possible initiation of prophylactic therapy.

Adolescent↗
PubMed1989

An evaluation of the Tono-Pen for the measurement of diurnal intraocular pressure.

We evaluated the Oculab Tono-Pen for potential value in the measurement of diurnal intraocular pressure. Repeated recordings every ten minutes on the same eyes suggested that the instrument provides reproducible information. However, comparisons with Goldmann applanation tonometric measurements, in both single determinations and eight-hour diurnal recordings, showed considerable variation. Correction factors, using either the mean difference in paired readings from the single measurement study or individual differences from the initial set of diurnal recordings, did not eliminate this lack of correlation between measurements with the two instruments.

Circadian Rhythm↗
PubMed1989

Accuracy of topographic measurements with the Optic Nerve Head Analyzer.

We used a plastic model of the human eye to study the accuracy with which the Optic Nerve Head Analyzer estimates the surface contour and two-dimensional size of the optic nerve head. Computer-generated contour lines were similar to the actual cross-sectional contour of plastic cups as photographed by scanning electron microscopy. The magnification error of computer-measured cup diameters was inversely related to the axial length of the model. The slope of this relationship was reduced with the use of either refraction or axial length as a correction factor for magnification error. Of the two correction factors, the former provided the closest estimation of the known diameters in the phakic model, while the latter performed better in the aphakic model.

Computer Graphics↗
PubMed1989

Automated kinetic perimetry with two peripheral isopters in glaucoma.

An automated perimeter (Fieldmaster 5000) was used to measure the central 30 degrees of vision with static targets (suprathresholding with quantification of defects) and the peripheral visual field with two kinetic stimuli in 599 eyes of 362 patients with glaucoma or a suspicion of glaucoma. The purpose of the study was to compare the additional information gained by measuring the peripheral visual field with two isopters against the time required for this extra examination. The peripheral visual field supported the diagnosis made by central testing in approximately one fourth of all eyes and added additional diagnostic information in another quarter of the cases. In 7% of the total population, or 11% of eyes with abnormal fields, a normal central field was associated with a glaucomatous peripheral defect. Half of the latter eyes had corresponding glaucomatous optic disc changes. The more sensitive isopter uncovered the vast majority of the peripheral field defects. Measurement of each isopter accounted for 22% of the total testing time.

Automation↗
PubMed1989

Reproducibility of pallor measurements with the optic nerve head analyzer.

One eye each of ten healthy volunteers was tested with the Rodenstock Optic Nerve Head Analyzer on ten separate occasions. A color-coded pallor map was developed for each examination. A color transparency of each pallor map was then obtained from the television monitor of the Optic Nerve Head Analyzer, using a camera mounted on a tripod at a fixed distance from the screen. A color-coded zone within the center of the disc was chosen for each set of ten studies, and the area of this zone was measured by boundary analysis with another computerized image analyzer, the Oasys Image Processor. There was wide intrasubject variation in all ten volunteers, suggesting that the pallor map generated by the Optic Nerve Head Analyzer, when used in the manner described in this paper, is not adequate for following subtle changes in optic nerve head pallor.

Humans↗