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Biomedical subjects

P J Dolman

Publications and source records attributed to P J Dolman.

12 recordsLinked to original sources

Orbital granulomatous giant cell myositis: a case report and review.

To present a case of orbital granulomatous giant cell myositis and review the literature. We describe the case of a 51-year-old woman, with a past history of melanoma, who presented with an acutely painful orbital myositis. This evolved into a chronic relapsing process involving multiple muscles bilaterally; which demonstrated partial steroid responsiveness. Biopsy revealed a granulomatous giant cell myositis. Orbital granulomatous giant cell myositis is a rare histological entity which has an association with giant cell myocarditis and underlying malignancy.

Anti-Inflammatory Agents↗

Comparison of three modified lidocaine solutions for use in eyelid anesthesia.

PURPOSE: To compare pain on injection and the efficacy of anesthesia of three modified lidocaine solutions for use in eyelid surgery: 1) 2% lidocaine with 1:100,000 epinephrine, 2) 2% lidocaine with 1:100,000 epinephrine buffered 9:1 with 8.4% sodium bicarbonate, and 3) 2% lidocaine with 1:100,000 epinephrine diluted 1:9 with 0.9% bacteriostatic saline solution (with benzyl alcohol). METHODS: In this prospective, randomized, double-masked, controlled clinical trial, 30 consecutive patients undergoing bilateral identical eyelid surgery were randomized to one of three treatment groups. Group 1 received buffered solution on one side and stock solution on the other, group 2 received bacteriostatic saline diluted solution on one side and stock solution on the other, and group 3 received buffered solution on one side and bacteriostatic saline diluted solution on the other. Patients used a 5-point scale to rate the perceived pain on injection and the pain felt during the operative procedure. RESULTS: Comparison of mean injection pain scores showed that buffered solution was significantly less painful than unmodified solution (2.2 versus 3.1, p < 0.05), bacteriostatic saline modified solution was significantly less painful than unmodified solution (0.9 versus 3.3, p < 0.05), bacteriostatic saline modified solution was significantly less painful than buffered solution (1.2 versus 2.3, p < 0.05). Comparison of mean intraoperative pain scores demonstrated no significant difference between the solutions in any of the treatment groups. CONCLUSIONS: For local anesthesia in eyelid surgery, bacteriostatic saline modified solution provides more comfort on injection than either buffered or unmodified lidocaine-epinephrine solution and provides an adequate level of anesthesia that does not differ significantly from either the buffered or unmodified solutions.

Anesthesia, Local↗

Primary ductal adenocarcinoma of the lacrimal gland.

PURPOSE: To their knowledge, the authors report the first recognized case of ductal adenocarcinoma of the lacrimal gland (histologic equivalent of salivary duct carcinoma). Primary adenocarcinoma of the lacrimal gland is rare and has been described generically. In contrast, primary adenocarcinomas of the major and minor salivary glands are much more common and have been classified into histopathologic subtypes that have different clinical characteristics and outcomes. METHODS: A 68-year-old man presented with a 6-month history of a painless mass in the right upper outer eyelid. The authors describe the clinical, radiologic, and histopathologic features of this case and review the lacrimal gland literature. RESULTS: A modified en bloc orbitectomy was performed, and postoperative radiotherapy was administered. The patient was alive and well without evidence of tumor recurrence 10 months after surgery. CONCLUSION: The World Health Organization classification of salivary adenocarcinomas (1991) provides a framework for further insight into the presentation and biologic behavior of the less common lacrimal carcinomas.

Aged↗

Sinus histiocytosis involving the lacrimal sac and duct. A clinicopathologic case report.

A 17-year-old girl with right-sided epiphora and a lacrimal sac mass was found radiologically to have marked enlargement of her lacrimal sac and nasolacrimal duct and mucosal thickening of her right nasal turbinates and maxillary, ethmoid, and sphenoid sinuses. Biopsy specimens from all these sites showed chronic inflammatory infiltrates with a predominant population of large phagocytic histiocytes, some of which had engulfed lymphocytes and plasmacytes. The results of a systemic workup were normal. This is the first reported case, to our knowledge, of sinus histiocytosis involving the lacrimal sac and nasolacrimal duct as an extranodal focus.

Adolescent↗

Mechanisms of visual loss in severe proptosis.

Vision loss in orbital hypertension secondary to sudden space-occupying lesions is usually attributed to one of three causes: central retinal artery occlusion, direct compressive optic neuropathy, or compression of optic nerve vasculature. Accepted modes of decompressive therapy include lateral canthotomy and cantholysis; drainage of localized orbital air, hematoma, or abscess; and bony wall decompression. Five cases are presented in which orbital hypertension caused severe proptosis with traction on the optic nerve and tenting of the posterior globe. Another mechanism contributing to visual loss is proposed in these cases: ischemic optic neuropathy due to stretching of nutrient vessels. In these cases, rapid posterior decompression should theoretically be favored to reduce orbital pressure and relieve traction on the optic nerve vasculature.

Adolescent↗

A new glaucoma filter implant.

A new glaucoma filtration procedure was performed in nine rabbits in a preliminary trial. A silastic tube with an internal diameter of 0.35 mm was passed across the anterior chamber through two limbal openings, and the free ends were buried postequatorially in sub-Tenon's space. At a later date, using an Nd:YAG laser in the thermal mode, holes 0.05 to 0.30 mm in diameter were burned in the tube in the anterior chamber. This procedure significantly lowered intraocular pressure in four rabbits on two successive tries; however, a third treatment given in two cases did not further decrease the pressure.

Animals↗

Contact lens disinfection by ultraviolet light.

A 253.7-nm ultraviolet light with an intensity of 1,100 microW/cm2 was tested for its germicidal activity against contact lenses and storage solutions contaminated with various corneal pathogens. The exposure time necessary to reduce a concentration of organisms from 10(6)/ml to less than 10/ml was 30 seconds for Staphylococcus aureus, 60 seconds for Pseudomonas aeruginosa, and 84 seconds for Candida albicans. The time necessary to sterilize a suspension of 10(4)/ml Acanthamoeba polyphaga was less than three minutes with this technique. Four brands of soft contact lenses were exposed to ultraviolet light for over eight hours without changing their appearance, comfort, or refraction.

Acanthamoeba↗

Infiltrating orbital granular cell tumour: a case report and literature review.

A surgical biopsy of an infiltrative retrobulbar mass in a 44-year-old man was diagnosed as granular cell tumour. Electron microscopy and immunoperoxidase stains were used to confirm the diagnosis and to study the histogenesis of this rare soft tissue neoplasm. S-100 stain was positive, while neuron-specific enolase and myoglobin stains were negative, suggesting a non-specific neural origin for the cells. The capability of this tumour to invade surrounding tissues has seldom been described in the orbit and is demonstrated by this case.

Adult↗

Signet-ring cell lymphoma in the orbit: a case report and review.

The authors report on the first case of signet-ring cell lymphoma involving the orbit. This variant of non-Hodgkin's lymphoma contains either vacuolated or eosinophilic cytoplasmic inclusions that squeeze the nucleus to one side of the cell. In this case, the inclusions were eosinophilic and stained positively for PAS, immunoglobulin M (IgM) heavy chain and kappa light chain. Electron microscopy showed granular electron-dense material trapped within distended loops of rough endoplasmic reticulum. Twenty-two cases of signet-ring cell lymphoma previously reported elsewhere in the body are reviewed, and their clinical significance is discussed.

Cytoplasm↗