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Biomedical subjects

M Reim

Publications and source records attributed to M Reim.

At least 163 records · Page 9Linked to original sources
PubMed1989

[Rheologic findings in patients with Eales disease].

In a retrospective analysis of findings in 12 patients with Eales' disease significant changes in blood fluidity were established. The six female and six male patients, aged between 15 and 59, were examined in the acute and subclinical stages and when a recurrence occurred. The rheologic parameters plasma viscosity, erythrocyte rigidity, and erythrocyte aggregation were significantly increased in the acute stage and when there was a recurrence, while in the subclinical stage the rheologic values improved to normal. No correlation could be found between the severity of the clinical picture in the various phases and the rheologic values. None of the other biochemical, microbiologic, and immunologic parameters were pathologic in any stage of the disease. In particular, virus serology, protein, immune, and hemoglobin electrophoresis were normal in all patients. While the etiology of Eales' disease remains unknown, deteroration in erythrocyte rigidity appears to play a part in the pathophysiology of the disease.

Adolescent↗
PubMed1989

[Corneal endothelial damage in congenital and juvenile glaucoma].

Corneal changes are typical for infantile glaucoma. In newborns, Descemet's membrane and the stroma are still soft, and distend when intraocular pressure rises. Cell counts were performed under the reflecting microscope to determine whether the endothelium is affected when corneal diameter increases and changes occur in Descemet's membrane. The mean endothelial cell density of 20 patients with congenital or secondary juvenile glaucoma, aged between 4 and 29 years, was found to be 2780/mm2. Even though increased corneal diameter was the most common primary symptom of buphthalmos, there were no relationships between corneal diameter on the one hand and postoperative endothelial cell density, visual outcome, or postoperative pressure on the other. In children who had had corneal edema followed by ruptures of Descemet's membrane the number of endothelial cells was significantly reduced, visual outcome was worse, and there were more problems with regulation of intraocular pressure. Lower-than-average endothelial cell densities were also found in some patients with secondary glaucoma.

Adolescent↗
PubMed1989

[Enzyme activities of the retina and vitreous body following experimental implantation of a brass splinter].

Brass splinters weighing 28 mg were implanted in the center of the vitreous of rabbit eyes. After a few days the well-known infiltration and liquefaction of the vitreous body were observed, together with retinal necrosis. Cellular and lysosomal enzymes usually found only in very low concentrations in the vitreous body increased more than a hundredfold during the inflammatory process and the increasing opacification. The enzymes assayed were lactic dehydrogenase (LDH), phosphofructose aldolase (ALD), glycerinaldehyde phosphate dehydrogenase (GAPDH), malate dehydrogenase (MDH), glucose-6-phosphate dehydrogenase (G-6-PDH), glutathione reductase (GR), beta-N-acetylglucose aminidase (NAcGA), and cathepsin-D. The kinetics of enzyme reproduction in the vitreous suggested that the cellular enzymes of the energy producing metabolism might originate both from the invading leukocytes as well as from the degrading retina. It seems likely that the cathepsin-D occurring in the vitreous originates mainly from the retina, and the beta-N-acetylglucose aminidase mainly from the pigment epithelium. The pathologically increased enzyme activity might well permit diagnostic conclusions concerning the intensity and stage of destruction of the retina by brass poisoning.

Animals↗
PubMed1989

Surgical procedures in the treatment of most severe eye burns. Revival of the artificial epithelium.

Report of some clinical observations in 16 patients with severe and most severe burns of 19 eyes. Major problems were delayed regeneration of the epithelium, extensive ulceration of the sclera near the limbus, and subsequent corneal ulceration. The therapy with anti-inflammatory drugs, macromolecular hyaluronic acid, fibronectin, epidermal growth factor, free transplants of oral mucosa and conjunctiva was sometimes helpful, but could not induce stable epithelial regeneration. The major problem remained the inability of the epithelium to regenerate on the cornea. Therefore, an artificial epithelium was applied in many cases. When healthy conjunctiva touched closely the artificial epithelium at the limbus, it remained tightly attached to the corneal stroma, preserved it's structure and even prevented corneal vascularisation for many months. However, when corneo-scleral ulceration was present, the artificial epithelium failed to protect the corneal stroma from secondary ulceration and sloughed off. Therefore, new surgical procedures, a conjunctiva-Tenon flap and a Tenon plasty were introduced to cover and to cure corneoscleral ulceration. These operations formed a new limbus, attached tightly to the rim of the artificial epithelium and prevented secondary ulceration underneath. Then under the protection of the artificial epithelium and the Tenon plasty the eye could be treated topically with corticosteroids for a long time. When the inflammatory response to the burn was healed, the natural epithelium recovered and the eye became ready for successful keratoplasty.

Burns, Chemical↗
PubMed1989

[Graphic assessment of retinal findings by computer].

Despite the increasing amount of patient data in the area of words and numbers that is being stored by computer, the graphic storage of ophthalmological findings has found only limited success. However, a sketch is much more instructive than a description in words. This paper shows that by using a suitable computer with a graphic oriented disc-operating system and a purchasable graphic and data base program, it is easily possible to generate sketches of retinal detachment on a computer screen. In the graphic program, all of the necessary symbols are already available when the program is started. The user just makes a copy of the symbols he needs to "draw" the actual fundus findings. We use the system of Meyer-Schwickerath. Afterwards, the drawing on the monitor is transferred into the data base program and stored.

Computer Graphics↗
PubMed1989

[A new treatment concept in severe caustic injuries and burns of the eye].

In severe burns of the eye the combination of surgical and drug therapy has proved to be useful. Initially, necrotic epibulbar tissues were excised. Large areas of denuded and in many cases ischemic sclera were covered with Tenon flaps, which were prepared and advanced from the parabulbar undamaged connective tissue. For several months an artificial epithelium was used to protect the denuded and to a large extent acellular corneal stroma. Subsequently, drug therapy including corticosteroids, Healon and prostaglandin synthesis inhibitors was applied to reduce the inflammatory reaction of the burned anterior eye segment. Regeneration of the conjunctival and the corneal epithelia can be improved by epidermal growth factor, autologous fibronectin and proteinase inhibitor (Trasylol). This therapy avoids some of the complications that could not be managed up to now and thus provides more favorable conditions for corneal grafts later.

Biological Dressings↗
PubMed1989

[Video fluorescence angiography for studying the hemodynamics of the eye].

The fluorescence angiogram can be recorded continuously with a video camera equipped with a low light amplifier and attached to a 3/4-inch videorecorder. The light intensities are low enough not to disturb the patient. Indocyanine and infrared light are used to examine the choroid. Conventional fundus cameras with 30 degrees or 50 degrees frames can be used. The inflow of the dye may be followed through the arterioles into the precapillary vessels. The capillaries themselves can only be seen as diffuse background fluorescence. Subsequently, the filling of the venules can be seen. The quality of the videofluorescence angiograms also allows nonperfusion areas and leakage of the fluorescein to be identified. Compared to conventional photography, angiography using the videotechnique allows to evaluate the blood flow with electronic procedures. The dilution curves obtained from the image analyzing system are not perfect because of reperfusion of the dye, but the exact time point when the fluorescein appears in the arterioles and venules can be defined and reproduced. From such measurements the arteriovenous passage time (AVP) and the speed of the dye bolus in the vessel (FBG) can be calculated. The clinical value of videofluorescence angiography evaluated with the image analyzing system has been proven in more than 1000 patients suffering from diseases of the retinal circulation. In cases with thromboses of the central retinal veins, occlusion of the central retinal arteries, stenoses of the internal carotid arteries, diabetic retinopathy and arterial hypertension, the extent of the retinal circulation disturbances could be defined by measuring the AVP and the FBG.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[The development of stereoscopic vision in the first months of life].

Dynamic random dot patterns generated on a TV screen by a special pattern generator are proven to be adequate stimuli for testing stereopsis. The registration of transient visual evoked cortical potentials (VECP) to these random dot stimuli offers objective proof of stereopsis. Using different disparities in older people a typical amplitude behaviour in the dynamic random dot stereo VECP with maximum amplitudes to medium sized disparities was found. Compared to 20 adults and 30 children with normal vision, in 26 children with negative TNO- and Titmus-tests for stereoscopic vision treated for strabismus no dynamic random dot stereo VECPs could be recorded. The development of stereoscopic vision in the first 12 months of life was investigated in five babies. First positive components in the dynamic random dot stereo VECP could be found in the 4th to 6th months of life in all children. From these results the assumption, that stereoscopic vision develops in later childhood, must be revised in favour of a much earlier period of infancy.

Adult↗
PubMed1989

[Retinal hemodynamics and morphologic findings in patients with occlusion of the internal carotid artery].

Only a minor percentage of patients with occlusion of the internal carotid artery develops the clinical symptoms of ischemic ophthalmopathy. The degree of functional collateralization that mirrors the alteration in ocular perfusion seems to be of importance for its development. We employed video fluorescein angiography to determine the degree of minor retinal perfusion in 33 patients. With a picture analyzer (Microvideomat 3, Zeiss) we quantified the arm-retina time (ART), the arteriovenous passage time (AVP) and the arterial dye bolus velocity. In these patients retinal perfusion was significantly decreased compared to a normal control group. The AVP of 18 patients was more than triple the average normal value (1.45 +/- 4.0 s); 3 of these patients showed morphological signs of ischemic ophthalmopathy with extensive non-perfusion areas: they showed a change in retinal hemodynamics and a massive deficiency in vasomotor response to CO2 stimulation. After panretinal laser coagulation their retinal hemodynamics, morphological alterations and subjective complaints improved. Our results show that using video fluorescein angiography on patients suffering from occlusion of the internal carotic artery analyzing the retinal hemodynamics can help to determine whether ischemic ophthalmopathy is developing or not.

Adolescent↗
PubMed1988

Cellular invasion on the surface of intraocular lenses. In vivo cytological observations following lens implantation.

Cellular growth on intraocular lenses can be observed by using a specular microscope. We examined in vivo the cellular pattern on the surface of implanted lenses during the early postoperative period in 63 patients. In every case inflammatory cells were noted on the lens surface at some point during the observation period. These often showed a spindle-like appearance resembling fibroblasts. The density of the cell population increased during the following days but usually did not exceed 100 cells/mm2. From the end of the first week, multinucleated giant cells may appear. In one case, a patient with a severe postoperative iritis and hypopyon demonstrated an extremely pronounced and long-lasting cellular proliferation.

Cataract Extraction↗
PubMed1988

Effect of low temperatures on the metabolism of corneal cultures.

Whole pig corneas were stored in minimum essential medium at 4 degrees, 21 degrees, and 31 degrees C in closed flasks with sufficient air. When the corneal cultures were kept at 31 degrees C, the epithelial glucose remained below the levels of the stroma. At 21 degrees C the glucose levels remained constant at the initial values, and at 4 degrees C glucose accumulated in the epithelium. The concentration gradients for glucose between the stroma and epithelium were maintained in the natural direction only at 31 degrees C. At 4 degrees and 21 degrees C, the concentration gradients for glucose were reversed in direction from the epithelium to the stroma. Lactate production in the epithelium was higher in the cultures at 31 degrees C than at 21 degrees C, and it was much lower at 4 degrees C. The ATP levels and ATP/ADP ratios were highest at 21 degrees C, although at 31 degrees C the initially decreased ATP levels and ATP/ADP ratios recovered after 6 days of culture. The cultured corneas were markedly swollen. At 4 degrees C, no hydration control was seen. At 21 degrees and 31 degrees C, significantly less swelling was observed. Consequently, at the lower temperatures membrane barriers and pump functions might have been impaired.

Adenine Nucleotides↗
PubMed1988

[Pediatric neuroblastoma with early bilateral blindness].

The authors present the case history of a child with neuroblastoma and early infiltration of the orbit accompanied by bilateral blindness. The typical clinical signs developed later. The thickening of the periosteum infiltrated by the tumor in the lateral wall of the orbit was demonstrated by computerized tomography. This may be regarded as an early sign of infiltration of the orbit by the neuroblastoma. In the case reported here a severe inflammatory reaction developed in the left orbit and anterior segment during massive chemotherapy and melted the cornea.

Adrenal Gland Neoplasms↗
PubMed1988

[Video fluorescence angiography follow-up of patients with retinal stasis syndrome].

Forty-four patients were examined by video-fluorescein angiography. With the onset of the first symptoms a significant decrease in retinal blood flow was determined by prolonged arteriovenous passage time (AVP) and diminution of mean dye bolus velocity (MDV). No correlation could be found between the extent of impeded retinal perfusion in the acute phase and the severity of the clinical appearance. In 35 of the 44 patients a favorable clinical course was observed. An initially markedly reduced retinal perfusion improved under treatment by isovolemic or hypervolemic hemodilution, fibrinolysis, and panretinal laser coagulation, and remained stationary during the further course of time. Complete normalization of the AVP and the MDV could not be found in any of these patients. Sixteen percent of the patients with retinal stasis syndrome developed hemorrhagic central venous thrombosis. In the authors' opinion videoangiographic follow-up of patients with retinal stasis syndrome is essential for early detection of further-reduced retinal perfusion. It may thus be possible to prevent the transition to hemorrhagic central retinal vein occlusion in these cases by early treatment.

Adult↗
PubMed1988

[A classification of intraocular bacteriologic findings following lens implantation].

Findings in seven patients with intraoperative bacterial invasions are reported. These invasions were classified in three stages of severity: (1) According to the literature it may be assumed that clinically undetectable invasion occurs in more than 10% of all operations. The bacteria detected in one case may have been a secondary finding in an electron-microscopic study. (2) A benign endophthalmitis caused by Staphylococcus epidermidis was found in three patients. The symptoms initially prompted the incorrect diagnosis "toxic lens syndrome". Cells resembling leukocytes were detected on the lenses by light microscopy. Following explantation of the lens and the posterior capsule, patients' vision slowly recovered to an average of 0.8. (3) Of three patients with fulminant panophthalmitis caused by Enterococci and/or Staphylococcus epidermidis, only one patient re-attained 0.5 vision, after two weeks; in the second case vision remained restricted to "hand movements", and in the third the eye had to be enucleated.

Aged↗
PubMed1988

Organ culture of pig cornea: biochemical analyses of mid-term-stored corneal tissue.

Freshly prepared pig corneas were cultured at 22 degrees C in TC 199 medium supplemented with HEPES buffer, antibiotics and 10% sterile pig blood serum. The cultures were maintained in a closed system up to 30 days. The hydration as measured by wet and dry weights increased from 80 to 94% after 2 weeks of storage. Glucose decreased slowly and continuously during the culture time by 0.32 mmol in 30 days. This was equivalent to 11 mumol/day, 0.46 mumol/h and finally 0.264 mumol/h/cm2. Lactate increased in the culture accordingly by 0.34 mumol/h/cm2. In the corneal epithelium of the cultured tissues the glucose levels--normally at about 5 mumol/g--equilibrated with those of the medium during the first 10 days; later the epithelial glucose levels increased up to 20-30 mumol/g. The glycogen content of the epithelium remained constant for the first 10 days of storage. The ATP/ADP ratios in the corneal epithelium initially decreased but later recovered to values of about 12. The pO2 in the culture system decreased from 156 to 120 mm Hg, which is equivalent to an oxygen consumption of 7.41 microliters O2/h/cm2. The CO2 production initiating from a level of 16.6 mm Hg was 4.88 microliters/h/cm2. The data showed that the cornea was viable in this culture system for 30 days.

Animals↗
PubMed1988

Effect of epidermal growth factor in severe experimental alkali burns.

Ten rabbits with the right eye burnt by 1 N NaOH were treated 5 times daily with epidermal growth factor (EGF) eyedrops or placebo. The epithelium seemed to heal better under EGF treatment than with placebo. Also, ulceration and secondary calcification of the cornea were reduced in the EGF-treated group. The vascularisation was slightly diminished by EGF. The lactate dehydrogenase and N-acetylglucose aminidase activities and the lactate and glucose levels in the corneae were not different between the EGF and the placebo groups. The results showed that there was a beneficial effect of EGF in these experiments with most severe eye burn disease. But the improved regeneration of the epithelium seemed to be counteracted and partly abolished by the severe inflammatory reaction in these eyes.

Animals↗
PubMed1988

Clinical application of epiderm growth factor in patients with most severe eye burns.

20 eyes of 11 patients suffering from most severe eye burns of grade 4 or worse were treated in addition to various other drugs with epiderm growth factor (EGF) or placebo in a double-blind test. Among 10 eyes treated with EGF, 6 achieved complete regeneration of the corneal epithelium, and 1 additional case, of the conjunctival epithelium. Among the eyes receiving placebo, only 3 out of 10 healed; all of them were also treated with fibronectin. Although in these very difficult cases EGF could not be investigated as a single therapy, and various other undefined factors may have been effective, in the extended course of the disease the period of EGF treatment was marked by a significant better regeneration of the epithelium.

Burns, Chemical↗