Biomedical subjects
P Gain
Publications and source records attributed to P Gain.
Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases.
AIMS: To evaluate the clinical features as well as the visual and anatomical outcome in eyes with magnetic posterior segment foreign bodies, to identify prognostic factors after removal using an electromagnet. METHODS: The records of 40 patients with posterior segment foreign bodies were retrospectively reviewed for 6 years (1989-94). Post-traumatic cataracts and secondary retinal detachments were treated using conventional surgical techniques. Pars plana vitrectomy was used only for late complications. The mean follow up was 30 months (6-71). Clinical factors were studied using univariate analysis. RESULTS: The most common findings before treatment of these 40 eyes were lens wound, hyphaema, vitreous haemorrhage, and retinal impairment. The foreign body was in the vitreous (85%) or minimally embedded in the retina (15%). Initial visual acuity was worse or equal to 20/40 in 70% of the cases. Subsequent to surgical treatment, a cataract was reported in 60% of the patients. Postoperative complications included retinal detachment (15%) and phthysis (5%). The prognosis was worse in cases with intraocular foreign body of largest diameter > or = 3 mm, an initial visual acuity less than 20/200, or the presence of post-traumatic retinal detachment. Presence of initial intravitreous haemorrhage, hyphaema, or intraocular tissue prolapse did not appear to affect the prognosis. CONCLUSION: The long term visual acuity results indicated that wound repair associated with conventional magnet extraction in an emergency is a viable treatment for posterior segment magnetic foreign bodies in this selected group. At the time of diagnosis, size of foreign body (< 3 mm) and initial visual acuity > or = 20/200 were predictors of good visual outcome after primary magnetic extraction.
[Ocular manifestations of retinoids].
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[Human papillomavirus 6/11 in conjunctival papilloma].
INTRODUCTION: Human papilloma virus is highly prevalent, but rarely localized in the conjunctiva. CASE REPORT: A 19-year-old man with no past history of skin or mucosal disease consulted for tumefaction of the conjunctiva. Exeresis revealed a viral papilloma. In situ hybridization was positive for human papilloma virus 6/11. DISCUSSION: Conjunctival lesions of human papilloma virus are often located in the caroncula as in our patient. The papillomatous aspect of the tumour may suggest squamous cell carcinoma (sometimes induced by human papillomavirus 16/18). Contamination may be manual or occur at birth via the maternal genital mucosa. Treatment usually is based on wide exeresis with cryo-application although spontaneous regression is possible.
[Myxoma of the left atrium: a cause of retinal artery embolism not to be ignored. Apropos of a case].
We report a case of retinal artery obstruction in a 56-year-old woman which proved to be a first symptom of a left atrial myxoma. The patient also had an inflammatory syndrome and a transient embolism of the cerebellum and the left leg. Two dimensional echocardiography showed an atrial mass compatible with myxoma. This diagnosis was confirmed by histological analysis of the surgically-removed tumour.
[Myxoma of the left atrium with neurologic manifestations: 8 cases].
A cohort of 8 patients with myxoma of the left atria and neurological manifestations is reported. Cerebral ischaemia, sometimes responsible for epileptic seizures, led to the discover of the myxoma (5 cases) or recurrence after exeresis (1 case) with imaging evidence of cerebral infarction in 5 cases. The first manifestation was a retinal embolism and temporary ischaemia in 1 case and pulmonary embolism with regressive cerebral ischaemia in another case with bilateral myxoma. Some clinical particularities should be underlined including exercise-induced neurological defect (3 cases), systemic embolism associated with cerebral infarction (3 cases), migraine headache as the initial manifestation (1 case) preceding by a pseudolupic syndrome suggesting the possibility of cerebral vasculitis or infectious endocarditis (1 case). The prognosis depends on the risk of recurrent atrial tumour formation (1 case). Metastases are rare. Multiple cerebral aneurysms (3 cases) did not lead to haemorrhagic complications.
[Iris tuberculosis. A propos of a case diagnosed by iridectomy].
Ocular tuberculosis is currently rare in developed countries. We report a case of tuberculous nodular anterior uveitis which revealed primary tuberculosis in a 2-year old girl. This diagnosis was established on microscopic examination of a surgical iridectomy specimen. Thus, a metastatic retinoblastoma was eliminated. The subsequent clinical investigations showed that the girl's father had active pulmonary tuberculosis.
Shedding of GD2 ganglioside in patients with retinoblastoma.
Retinoblastoma is a rare tumor of the young child with an intraocular localization that leads to certain problems of diagnosis. With the aim of defining a biochemical marker--which is still lacking for this disease--the gangliosides of a pool of fresh retinoblastoma tumors were analyzed. The ganglioside pattern was shown to have GM3, GM2, GM1, GD3, GD2, GD1b and GT1b as the major components. The occurrence of a high concentration of GD2 in the tumors led us to investigate the possibility of changes in the level of GD2 in the sera of retinoblastoma patients, using quantitative immunostaining with GD2-specific mouse monoclonal antibodies (MAbs). In 9 out of 10 tumor-bearing patients, the serum level of GD2 ganglioside was significantly higher than the average value found in normal individuals. A 2-year follow-up of patients showed that successful treatment resulted in a rapid decrease in the serum level of GD2 down to the normal range, from which a subsequent elevation was seen only in relapsing patients. Although the clinical study needs further development, the results obtained to date suggest that GD2 is shed in the serum of tumor-bearing patients and that the level of GD2 could be a potential serum marker of human retinoblastoma.
[Current diagnostic technics of retinoblastoma (cytology of the vitreous body and marker)].
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