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Biomedical subjects

L Joffe

Publications and source records attributed to L Joffe.

At least 19 recordsLinked to original sources
PubMed2004

OrthoCAD: digital models for a digital era.

This article describes the use of OrthoCAD--a digital study model capture, assessment and storage system. It is estimated that approximately 10% of orthodontists in USA and Canada now utilize digital study models, and improving technology is making it increasingly popular worldwide. The technology behind digital study models is briefly reviewed. The OrthoCAD system is described, and the advantages and disadvantages of using digital study models are highlighted.

Canada↗
PubMed2003

Invisalign: early experiences.

This article describes the Invisalign technique. It is based on the author's personal experience of over 60 cases started in the private practice setting. The technology behind Invisalign and its development is reviewed. The Invisalign clinical technique is described, and the advantages and disadvantages of using Invisalign are highlighted.

Esthetics, Dental↗
PubMed1993

Congenital scalp defects and vitreoretinal degeneration: redefining the Knobloch syndrome.

An apparently autosomal recessive syndrome of hereditary vitreoretinal degeneration (VRD) with retinal detachment, high myopia, and congenital encephalocele was described in 1971 by Knobloch and Layer [J Pediatr Ophthalmol 8:181-184]. Clinical confirmation of the presence of encephaloceles was lacking, and no neuropathologic studies were reported. We have evaluated a similarly affected family with 2 sibs with high myopia, VRD, and occipital scalp defects. Histologic examination of the scalp defects showed heterotopic neuronal tissue in both instances. The older girl has had a unilateral retinal detachment. Her other eye and both eyes of the younger sib have so far been treated successfully with prophylactic retinal cryotherapy. Both children have normal to above normal intelligence. The family reported by Knobloch and Layer [1971] and the sibship herein described appear to represent a distinct autosomal recessive trait. Analysis of the associated defects suggests an underlying defect in early cephalic neuroectodermal morphogenesis. Data from these families imply that congenital occipital scalp defects rather than true encephaloceles may, as is true in some cases of Meckel syndrome, accompany Knobloch syndrome. The presence of a congenital midline scalp defect should alert the clinician to possible underlying central nervous system and/or ocular pathology and should lead to consideration of further diagnostic evaluations and prophylactic measures.

Child↗
PubMed1992

Safety and immunogenicity of acellular pertussis vaccine combined with diphtheria and tetanus toxoids in 17- to 24-month-old children.

A double-blind, randomized, controlled trial comparing 4 lots of acellular pertussis-diphtheria tetanus toxoids vaccine (APDT) to whole cell DTP vaccine in 397 children was conducted at 7 clinical centers. Children were immunized at 17 to 24 months of age and sera were obtained pre- and postimmunization. Sera were analyzed for antibody to pertussis antigens (pertussis toxin, filamentous hemagglutinin, with a molecular weight of 69,000 (69k) outer membrane protein and agglutinogens) and to diphtheria and tetanus toxoids. Information concerning local reactions and systemic events was collected daily for 10 days postimmunization. The acellular vaccine produced significantly fewer local reactions than whole cell DTP. Parents reported that drowsiness or fretfulness occurred significantly less often in APDT vaccine recipients compared with whole cell DTP recipients. Fever greater than or equal to 38.3 degrees C occurred in 8% of APDT vaccine recipients and in 15% of whole cell DTP vaccine recipients (P = 0.06). The only significant difference in immune response to pertussis antigens between the two vaccines was for filamentous hemagglutinin (P less than 0.01) for which significantly higher antibody concentrations were found in the APDT vaccine group. We conclude that this APDT vaccine is safe and immunogenic when administered as a booster dose to 18-month-old children.

Antibodies, Bacterial↗
PubMed1992

Central retinal vein occlusion in young adults (papillophlebitis).

We performed a retrospective study of 103 cases of central retinal vein occlusion (CRVO) in young, nondiabetic adults that were followed for at least six months. Of these patients, 64% were men and 36% were women. While visual acuity was usually good, 33 eyes (32%) had a final visual acuity of 20/200 or worse, including 6 eyes (6%) with a final visual acuity of no light perception. Ocular complications included chronic cystoid macular edema, macular pigmentary changes (37%), sheathing of retinal vessels (22%), venous collaterals of the disc (33%), macular hole formation (1%), neovascularization of the disc (1%), retina (1%), and iris (19%), neovascular glaucoma (8%), and vitreous hemorrhage (7%).

Adolescent↗
PubMed1991

Cilioretinal artery occlusion in young adults with central retinal vein occlusion.

Ten patients, all younger than 50 years of age, had a temporal cilioretinal artery occlusion associated with a nonischemic central retinal vein occlusion. On fluorescein angiography, the cilioretinal artery eventually filled in all but one eye. The cilioretinal artery showed pulsations on fluorescein angiography in five eyes. The central retinal vein occlusion eventually resolved and the fundus assumed a normal appearance in all nine of the followed cases. Eight of nine eyes that underwent follow-up examination had final visual acuity of 20/30 or better. The occlusion of the central retinal vein produces an elevation of intraluminal capillary pressure because the central retinal artery continues to pump blood into the retina. Because the perfusion pressure of the cilioretinal artery is lower than the central retinal artery, it becomes relatively occluded. The prognosis for these patients is generally good unless the entire parafoveal capillary net is affected by the cilioretinal artery that is occluded.

Adult↗
PubMed1990

Phase II study of fenretinide (N-[4-hydroxyphenyl]retinamide) in advanced breast cancer and melanoma.

Retinoids, the natural and synthetic analogs of vitamin A, are growth-inhibiting and differentiation-inducing agents and show clinical promise as chemopreventive and antineoplastic agents. Fenretinide, a new synthetic retinoid, has antitumor activity in certain in vitro and in vivo model systems and was relatively nontoxic in phase I trials. Based on these data, we designed a phase II study of Fenretinide involving 31 patients with advanced breast cancer [15] and melanoma [16], two cancers shown to be responsive to this agent in preclinical models. Fenretinide was inactive in patients with advanced disease. Toxicity was mild, and reversible. Mucocutaneous side effects occurred in 16 (52%) patients. Nyctalopia developed in three patients one of whom developed decreased B-wave amplitude of the scotopic electroretinogram. The minimal toxicity and significant activity in preclinical studies make this an attractive agent for future breast cancer chemoprevention studies.

Adult↗
PubMed1990

Antigenic recognition by intravenous gamma-globulin of selected bacteria isolated from throats of patients with Kawasaki syndrome.

Kawasaki syndrome (KS) or mucocutaneous lymph node syndrome is an acute febrile exanthematous illness of unknown etiology. Therapy with intravenous gamma-globulin (IVGG) results in rapid defervescence, disappearance of signs and symptoms of inflammation and prevention of coronary artery aneurysms. We hypothesized that IVGG might neutralize a bacterial toxin produced by a staphylococcus or streptococcus present in the nasopharynx. We further speculated that this toxin might be detectable in serum or urine of patients. The goal of this work was to identify microbial antigens in different materials taken from patients with a clinical diagnosis of KS. We tested 23 aerobic bacterial isolates from throat cultures from 15 patients with KS, acute serum from 121 patients and 38 acute urine specimens from patients with KS. The patients ranged in age from 1 to 6 years. Specimens were tested in a standard system of counterimmunoelectrophoresis and reacted against IVGG prepared in a 25% solution. Ten of 23 aerobic bacteria (43.5%) isolated from throat cultures demonstrated a precipitation reaction with IVGG. Counterimmunoelectrophoresis testing of IVGG against acute serum and acute urine specimens was uniformly negative. IVGG contains precipitating antibody against a limited number of aerobic throat organisms. It is possible that antigenic products of one of these bacteria may be involved in the pathogenesis of KS.

Antigens, Bacterial↗
PubMed1989

A subsidized perinatal care program in a rural Colorado county.

A large number of medically indigent women in rural areas currently receive little or no prenatal care, raising major concerns regarding perinatal health. In Colorado, subsidized prenatal and labor/delivery programs have been instituted to address this problem. This article describes the implementation of two programs in one rural county. In these rural programs, private physicians, health department personnel, and social work staff at the local hospital collaborate to provide financial assistance, comprehensive health education, and quality medical care for eligible pregnant women. The identified benefits and barriers unique to the provision of quality perinatal care in rural settings are discussed.

Colorado↗
PubMed1985

Recurrences and bilaterality in the multiple evanescent white-dot syndrome.

Multiple evanescent white-dot syndrome recurred in two men (23 and 44 years of age, respectively). One patient had a recurrence in the previously affected eye three years after the initial visual loss; the other patient had two recurrences in the contralateral eye, each separated by two years. Two additional patients (a 28-year-old woman and a 21-year-old man) had bilateral but asymmetric acute involvement. Computerized visual study showed a loss of retinal sensitivity in both eyes, correlating poorly with the clinically observed lesions. Results of electro-oculography were abnormal in the patients with bilateral involvement; results of electro-retinography were abnormal only in the more severely involved eye. Systemic investigation in the two bilateral cases was unrevealing. None of the four patients had experienced a preceding influenza-like illness and all had complete recovery of vision within four to six weeks.

Adult↗
PubMed1982

Presumed blastomycosis endophthalmitis.

A 49-year-old outdoor laborer had an endophthalmitis in one eye and small posterior segment lesions in the other, as well as raised lesions on his skin. The diagnosis of disseminated North American blastomycosis was established by the performance of a biopsy on one of the skin lesions. The ocular inflammation slowly improved with intravenous amphotericin B therapy, and the ocular lesions, presumably caused by Blastomyces dermatitidis, were followed clinically for six months. The patient died of a hospital-acquired pneumonia caused by Staphylococcus aureus.

Amphotericin B↗
PubMed1980

Macular branch vein occlusion.

Occlusion of a small macular tributary branch vein, not involving a major arcade, can be extremely subtle and the correct diagnosis is frequently missed. Capable of adversely affecting central visual acuity, macular vein occlusion has a variable clinical presentation and course which may elude more conventional examination techniques and require fluorescein angiography to confirm or establish its presence. Recognizing the need for increased awareness of this disorder, emphasis is placed on orientation through case presentations depicting the clinical and angiographic features of this subgroup of branch retinal vein occlusions. A retrospective evaluation of the clinical data and angiographic features of 75 individuals with macular branch vein occlusion permitted evaluation of 64 patients with follow-up ranging from two months to ten years. Various forms of medical therapy were used in the management of many of these individuals, but argon laser photocoagulation was only used in 22 patients. The limitations inherent in interpreting data from uncontrolled studies are acknowledged. Our observations support the need for recognition and intensive evaluation of this special group of vein occlusions.

Adult↗
PubMed1979

The maxillary orthopedic splint.

Craniomaxillary orthopedic correction of the skeletal imbalance of Class II malocclusions is often the desired method of treatment in these cases. The ability to apply a "pure" orthopedic force to the maxillary complex has so far eluded research efforts. However, the use of a maxillary splint with a high-pull extraoral traction assembly has been shown to be most effective in reducing Class II skeletal dysplasias through a combination of dentoalveolar and basal bone changes. Force delivery to the maxillary complex in Class II skeletal jaw disharmonies is through the teeth. The philosophy behind the use of the maxillary splint is that if the force delivered to the upper jaw involved the use of all the upper teeth (and hard palate) rather than only the maxillary first molars, as in conventional extraoral orthodontic therapy, the effect on the jaws would be more orthopedic than orthodontic in nature. The advantages of the use of the maxillary splint in the younger patient with a severe Class II malocclusion are that it reduces the vulnerability of the maxillary incisors to accidental fracture, while concomitantly reducing the Class II dysplasia, thereby effectively shortening the later-stage multiband corrective time and procedures. Further advantages of the maxillary splint described are ease of construction and clinical application, which makes it an attractive appliance for use in dental clinics or institutions in which patient volume, infrequent visits, and ecomomic factors are major considerations. This preliminary report on the philosophy of treatment procedure and description of the appliance design is to be followed by a further cephalometric and clinical evaluation of results achieved with its use.

Cephalometry↗
PubMed1979

Clinical and follow-up studies of melanocytomas of the optic disc.

Forty patients with melanocytoma of the optic disc were evaluated to determine their clinical variations and behavior. Follow-up examination of 1 to 19 years was obtained in 27 patients. Of the 27 lesions, four (15%) showed a slight increase in size, and one tumor (4%) decreased in size. The remaining 22 tumors (81%) have not yet demonstrated ophthalmoscopic changes. In spite of occasional growth, the melanocytoma is a benign tumor that requires no treatment.

Adolescent↗
PubMed1979

An alternative method of gas-fluid exchange through the limbus in giant tears and other complicated retinal detachments.

An alternative method of gas-fluid exchange through the limbus in patients with giant tears and complicated retinal detachments is presented. The indications for the combined surgery of scleral buckle, vitrectomy, and gas-fluid exchange are suggested. The results of this type of surgery in 5 patients with giatn retinal tears, and in 12 patients with complicated retinal detachments, are reported. Most failures were caused by massive periretinal proliferation.

Air↗
PubMed1978

Osseous choristoma of the choroid.

A case is presented in which the diagnosis was made clinically of an osseous lesion of the choroid in an otherwise normal eye. The clinical diagnosis of an osseous choristoma was confirmed by the use of ultrasonography, orbital roentgenograms, and computerized axial tomography. Enlargement of the lesion was documented photographically during a four-month period. The causes of intraocular ossification are discussed, and the typical clinical features of osseous choristoma of the choroid are suggested.

Adolescent↗