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Biomedical subjects

M R Mandel

Publications and source records attributed to M R Mandel.

At least 19 recordsLinked to original sources
PubMed1987

Relaxing incisions with augmentation sutures for the correction of postkeratoplasty astigmatism.

We performed a prospective study of relaxing incisions with augmentation sutures in 21 patients who were unable to wear spectacles or contact lenses after penetrating keratoplasty because of high astigmatism. The mean preoperative astigmatism was 9.37 diopters (range, 4.50 to 14.50 diopters), and the mean postoperative astigmatism was 3.73 diopters (range, 0.00 to 7.00 diopters). The net decrease in astigmatism was 6.56 diopters (range, 1.00 to 11.00 diopters), which represents a 67% decrease in astigmatism. The mean vector corrected change in astigmatism was 8.40 diopters (86%). These results were compared with those of our previous study of relaxing incisions without sutures. Overall, there was a significantly greater decrease in astigmatism (67% vs 47%, P = .009) when augmentation sutures were placed 90 degrees away from the relaxing incisions. Furthermore, in patients with more than 8.50 diopters of astigmatism, relaxing incisions with sutures yielded a much greater reduction in astigmatism compared with relaxing incisions without sutures (70% with sutures vs 39% without sutures, P = .002). We recommend relaxing incisions with augmentation sutures as the initial surgical procedure in eyes with more than 8.50 diopters of astigmatism.

Astigmatism↗
PubMed1986

Anterior clear spaces in keratoconus.

Anterior clear spaces were observed prospectively at slit-lamp examination in 26 of 69 consecutive eyes (38%) with keratoconus. Two corneal buttons with this finding were examined by light and electron microscopy and revealed breaks in Bowman's layer. Anterior clear spaces should be considered in the spectrum of clinical findings in keratoconus.

Cornea↗
PubMed1986

Posterior peribulbar anesthesia: an alternative to retrobulbar anesthesia.

Posterior peribulbar anesthesia is a safe alternative to retrobulbar anesthesia for ophthalmic surgery. Because the anesthetic is deposited outside the muscle cone, the potential for intraocular or intradural injection is greatly minimized. Furthermore, intraconal hemorrhage and direct optic nerve injury is avoided. We illustrate the details of our technique for posterior peribulbar anesthesia and describe our experience in over 1,600 cases.

Anesthesia, Local↗
PubMed1985

Periorbital osteosarcoma: an unusual case report and review of the clinical and histopathological features.

We will describe a case of a rapidly growing osteoma of the orbit in a young boy presenting with orbital cellulitis. The subsequent discussion elucidates the clinical and radiographic features of osteoma and attempts to clarify the confusing terminology surrounding the histopathology of the three main types of osteoma. Patients with osteoma of the skull should be referred for appropriate gastrointestinal studies to rule out the occurrence of Gardner's syndrome.

Adolescent↗
PubMed1983

Clinical and histologic findings in opportunistic ocular infections. Part of a new syndrome of acquired immunodeficiency.

White retinal opacities and ocular inflammation may be two of the early signs of a new syndrome of acquired immunodeficiency. This syndrome primarily affects young homosexual men and is characterized by acquired cellular immunodeficiency in infections with multiple opportunistic microorganisms in addition to Kaposi's sarcoma. The apparently innocent ocular findings may be the first harbingers of this devastating syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Development and prediction of postpsychotic depression in neuroleptic-treated schizophrenics.

Data were collected during a year-long multicenter collaborative trial comparing short-acting fluphenazine hydrochloride with long-acting fluphenazine decanoate in a group of schizophrenic patients being maintained in the community. We examined the emergence and course of depressive symptomatology, operationally defined by the Hamilton Depression Scale total score. Of 211 patients, approximately 25% had depression develop within five months after discharge. Depressed patients had a more chronic psychiatric history and, contrary to the hypothesis that depression is a favorable prognostic indicator, they were more likely to relapse. There were no differences in incidence of emergent depression between the two drug treatment groups.

Adolescent↗
PubMed1979

The treatment of psychotic major depressive disorder with drugs and electroconvulsive therapy.

A retrospective chart review of 54 patients demonstrating depression with psychotic symptoms was accomplished with the use of Research Diagnostic Criteria (RDC) for diagnosis of psychotic major affective disorder. Patients received adequate trials of either tricyclic antidepressants alone, antipsychotics, the two in combination, or electroconvulsive therapy (ECT). Antidepressants alone were found to be ineffective or only partially effective in treating psychotic depression unless somatic or depressive declusions were the only psychotic symptoms. Antipsychotics alone were usually effective in providing at least a partial response, particularly with psychotic symptoms. Excellent responses of the depressive and psychotic elements were provided with ECT, ECT with antipsychotic medication, and the combination of antidepressant and antipsychotic medications. These latter treatments may be the most appropriate for depression with psychotic features.

Adult↗
PubMed1979

A comparison of two unilateral ECT electrode placements: efficacy and electrical energy considerations.

The authors compared the treatment outcomes and ECT energy requirements of 10 patients treated with the Muller unilateral placement method (secondary electrode in the frontal position) with those of 10 matched patients treated with the unilateral placement described by d'Elia (secondary electrode lateral to the vertex). Both groups showed a similar dramatic clinical improvement after ECT; however, the mean watt seconds required for the Muller method was nearly four times that for the d'Elia procedure. The treating physicians reported that the patients treated by the d'Elia method had fewer anterograde and retrograde memory disturbances and that they were alert and oriented sooner after ECT.

Aged↗
PubMed1978

Facial electromyography in the assessment of improvement in depression.

Depressed patients who showed decreases in resting corrugator muscle tension levels, as measured electromyographically, also showed improvement in clinical symptoms, as assessed by the Hamilton Psychiatric Rating Scale over a 2-week period. Patients showing good clinical improvement after 2 weeks had resting pretreatment corrugator levels higher than those showing little clinical improvement, suggesting that corrugator activity might also serve as a forecaster of subsequent change. These findings support Darwin's 1872 hypothesis concerning the role of the "grief" muscle in depression. Furthermore, psychophysiological recording of patterns of facial muscle activity may have value in the clinical assessment of depression and treatment effects.

Amitriptyline↗