Biomedical subjects
Publications and source records attributed to P Custer.
Close interaction between the patient, surgeon, and ocularist is necessary to obtain the most ideal prosthesis. Communication between these parties will facilitate the patient's adjustment to the anophthalmic state and the maintenance of a healthy anophthalmic socket.
Two cases of orbital extension by squamous cell carcinoma along the supraorbital nerve are reported. Important clinical aspects of these cases include previous incomplete removal of squamous cell carcinoma of the forehead and altered sensation in the dermatome of the supraorbital nerve. Axial spread of carcinoma along periorbital nerves is an important avenue of local metastasis and should be suspected in all cases of periorbital squamous cell carcinoma.
A previously healthy 23-year-old white female presented with a history of horizontal diplopia prior to any other symptoms. Physical examination revealed bilateral sixth cranial nerve palsies, papilledema, right Horner's syndrome, and right hemiparesis. Cryptococcus neoformans was isolated from the cerebrospinal fluid. This is the first documented case of Horner's syndrome associated with cryptococcal meningitis.
The effects of coronary flow reduction on tracer capillary permeability surface area (PS) and distribution volumes were studied in open-chest dog preparations. A mixture of 51Cr-labeled red blood cells, 125I-labeled albumin, [14C]sucrose, and tritiated water (3H2O) was introduced into a shunt connecting the carotid and left anterior descending coronary arteries. Sampling from the coronary sinus produced a multiple indicator curve from which [14C]sucrose PS and 3H2O volumes were computed. Curves were observed in control situations and after the cannula was partially clamped. In six dogs, cardiac lymph was collected and analyzed for total protein. Paired comparison of control and flow-restricted indicator curves showed that flow reduction decreased the absolute values of PS and tracer volumes. The ratio of sucrose volume to weight of perfused tissue increased with flow reduction. The ratio of sucrose PS to weight of perfused tissue increased with moderate flow reduction and decreased with severe flow reduction. The results suggest that flow reduction has two effects which competively affect exchange: 1) flow restriction reduces surface area by capillary derecruitment, and 2) the remaining functional capillaries appear to undergo an increase in permeability to small molecules.