Biomedical subjects

P-Y Robert

Publications and source records attributed to P-Y Robert.

10 recordsLinked to original sources

PubMed2006

[Granulocytic sarcoma in a 90-year-old patient].

Granulocytic sarcoma rarely involves the orbit. It is the local proliferation of immature myeloid cells and occurs most often in patients suffering from myelodysplastic syndromes. We report a case of granulocytic sarcoma that revealed acute myeloid leukemia in a patient suffering from chronic myelomonocytic leukemia. At the time of diagnosis, the lesion involved the nasal fossae, the ethmoidal sinus, and the orbit, with subperiosteal tumoral infiltration toward the skin. The treatment involved surgery and radiotherapy. The patient died 3 months later of complications of the hematological disease. This observation is original for the occurrence of granulocytic sarcoma during chronic and well-known leukemia, the age of onset, and the fatal outcome in just a few weeks. In this observation, the ophthalmologist revealed the acute nature of the myelodysplastic syndrome.

Aged, 80 and over↗

PubMed2006

[Herpesviruses serologic survey of corneal allograft recipients].

AIMS: Herpesviruses are ubiquitous viruses, providing circulating antibodies in a wide range of patients. Donor-to-host transmission of Herpes simplex virus via corneal graft has been proven, leading to primary graft failure. However, the serological survey of the corneal recipient for Herpesviruses has not yet been investigated. METHODS: Circulating antibodies to HSV, VZV, CMV, and EBV were tested in 117 corneal recipients prior to surgery as well as 8 days and 3 months following surgery. Twenty-two patients had a history of corneal herpes. All patients were treated with local steroids, and no patient received systemic immunosuppressive therapy. RESULTS: No seroconversion was encountered, in particular, no CMV--patient was found CMV+ after grafting. The mean concentration of antibodies significantly decreased after grafting in a few patients. A serological profile of EBV reactivation was detected after surgery in four patients at day 8 and three more patients at 3 months. CONCLUSIONS: This study shows no significant seroconversion after grafting. However, it shows a postoperative decrease in antibody levels as well as a serological profile of EBV reactivation, possibly related to local steroids or graft immune processes.

Adult↗

PubMed2006

[Tumors of the eyelids in the elderly].

The clinical aspect of tumors of the eyelids is polymorphous; however, the most frequent are benign tumors such as papillomas, basal cell carcinoma, squamous cell carcinoma, meibomian gland carcinoma, and melanomas. An important step in the management of the malignant types is to try to establish clear margins through histopathologic techniques: the Mohs technique, the rapid fixation technique, and the frozen section method are the most frequent technical tools used today. For the most malignant tumors such as malignant melanoma and Merkel cell tumor, lymph sentinel biopsy is a recent, valuable tool, but its benefit needs to be confirmed in large series.

Aged↗

PubMed2005

[Use of mitomycin C (MMC) for dacryocystorhinostomy interventions].

Mitomycin C (MMC) has been described as having a positive effect in different types of dacryocystorhinostomy (DCR) surgery such as external DCR, endonasal and transcanalicular DCR. MMC, an antineoplastic antibiotic, acts as an alkylating agent by inhibiting DNA, RNA and protein synthesis. Topical use of MMC can modulate the scarring process, which is useful in glaucoma surgery and pterygium excision. In DCR, MMC is also useful because it reduces the scarring process and thus prevents the occlusion of the osteotomy site related to the fibroblast activity. An increase in the success rate for long-term results has been observed by different authors, resulting from a larger osteotomy size as well as a decrease in the density and cellularity of the mucosa. No complications have been seen with topical use of MMC.

Cicatrix↗

PubMed2004

[Transmission of conventional agents during outpatient care].

Outpatient care bring together in a single location a large number of patients potentially bearing conventional infectious agents (virus, bacteria, fungi, parasites). This report details the germs potentially involved. We emphasize adenovirus epidemic keratoconjunctivitis, which is particularly prevalent in ophthalmology outpatient care. We analyze the modes of contamination and the means to prevent iatrogenic infections.

Eye Infections↗

PubMed2004

[Clinical and diagnostic developments in corneal herpes].

The indications for keratoplasty in treating herpes keratitis are currently declining because of recent progress in diagnosis and treatment. Clinically, corneal signs may be caused by HSV reactivation or a secondary anti-HSV immune response. Corneal opacification may be acute or the expression of sequela (meta-herpetic keratitis). The virus can be detected on a corneal surface sample by direct examination or cell culture, the only way to detect an infective virus. The detection of local antibody production in the aqueous humor is an inexpensive method, indicating the local immune anti-HSV response. Detection of HSV DNA using PCR is more sensitive, but the presence of HSV DNA within corneal tIssue may be more delicate to interpret. It is now proven that HSV can be transmitted through a corneal graft from donor to recipient, but no diagnostic test currently detects potentially infective corneas in eyebanks.

Humans↗

PubMed2004

[Clinical signs of dysthyroid orbitopathy].

Dysthyroid ophthalmopathy is an inflammatory disease of the orbit, combined or not with thyroid disorders. However, pure ophthalmologic forms exist, and the diagnosis can be made by the ophthalmologist. The diagnosis is made by examining eyelid malposition, oculomotor disorders, inflammatory signs, proptosis measurement, and by the search for optic nerve pain. We discuss the NOSPECS classification, which can evaluate the severity and progression of the disease.

Exophthalmos↗

PubMed2004

[Complications of dysthyroid ophthalmopathy].

The complications of dysthyroid ophthalmopathy should be known and screened in every patient since they can worsen visual prognosis and are critical to the decision for treatment. Ocular surface alteration can result from eyelid malposition, blinking deficiency, eye dryness, and proptosis. Oculomotor disorders are detected by coordimetry or a forced duction test. Optic neuropathy can be compressive or glaucomatous. Intraocular pressure elevation can result from elevation of intraorbital pressure, indentation by an enlarged muscle, or increased backflow in episcleral veins.

Diplopia↗

PubMed2004

[Orbital fat decompression techniques].

Fat removal orbital decompression (FROD) was first described by Olivari in 1988. Through a blepharoplasty approach, fat pads from the five palpebral pockets, as well as intraconal fat, are carefully removed. The main complications are retrobulbar hemorrhage and postoperative diplopia. The best indications are patients with wide orbits without compressive optic neuropathy. FROD is an inescapable procedure in a balanced approach to surgical orbital decompression.

Blepharoplasty↗

PubMed2003

[Antiviral therapy adjustment in corneal recipients using antibody testing in the aqueous humor].

INTRODUCTION: In corneal recipients with herpes infection, acyclovir given for 1 year postoperatively prevents viral reactivation and improves graft outcome. The indication for prophylactic antiviral therapy relies on the preoperative diagnosis of herpes. However, many patients present with corneal scars featuring sequelae of herpes without a proven history of herpes. Here we report the results of a prospective study of anti-herpes simplex virus (anti-HSV) and varicella zoster virus (VZV) antibody testing in the aqueous humor at the time of corneal transplantation to refine the indication of the antiviral treatment. MATERIAL AND METHODS: The study involved 33 keratitis corneal graft recipients, 21 of whom had documented herpes keratitis. A control group was made with 11 cataract patients. An anterior chamber puncture was performed just before surgery. The micro-ELISA test was done on both aqueous humor and serum, and local anti-HSV or VZV antibody synthesis was acknowledged if the ratio of antibody concentrations was above 4. RESULTS: Local antibody synthesis to HSV was detected in 22 cases, to VZV in 9 cases, to both HSV and VZV in 6 cases, and no synthesis in 8 cases. The sensitivity of the test was 65% in patients with a documented history of herpes (14 cases out of 21). Among non-herpetic patients, the test was positive in 9 patients, who thus benefited from postoperative antiviral therapy. No viral reactivation was encountered after a minimum follow-up of 1 year. CONCLUSIONS: Antibody testing in the aqueous humor at the time of keratoplasty is a convenient, inexpensive diagnostic tool in corneal recipients. It provides useful information before prescribing a long and expensive postoperative antiviral therapy.

Acyclovir↗