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Biomedical subjects

R A Dailey

Publications and source records attributed to R A Dailey.

At least 19 recordsLinked to original sources
PubMed2000

Surgical debulking of eyelid and anterior orbital plexiform neurofibromas by means of the carbon dioxide laser.

PURPOSE: To present the carbon dioxide laser as an effective tool for surgical debulking of eyelid and orbital neurofibromas. METHOD: Two patients with neurofibromatosis underwent surgical debulking of their eyelid and orbital plexiform neurofibromas by means of the carbon dioxide laser. RESULTS: Acceptable cosmetic results were obtained with the removal of eyelid and orbital neurofibromas with improved hemostasis and minimal destruction of surrounding tissue when compared with conventional methods of removal. CONCLUSIONS: The carbon dioxide laser may allow significant improvement in the removal of plexiform neurofibromas.

Adult↗
PubMed2000

Secondary fractures of Le Fort I osteotomy.

PURPOSE: To report the ophthalmic complications of Le Fort I osteotomy for the correction of dentofacial deformities and to determine the maximal compressive loads applied during pterygomaxillary separation in a cadaver model. METHODS: Two cases of ophthalmic complications arising after Le Fort I osteotomy are reported. Le Fort I osteotomy was performed on five cadavers. The maximal compressive load applied during pterygomaxillary separation was recorded with a 10 kN (3,000 lbf) load cell of a MTS Mini-Bionix servo-hydraulic machine (MTS, Eden Prairie, MN, U.S.A.). A paired t test was used to compare forces applied to the right and left sides. Computed tomography scans of each specimen were obtained after Le Fort I osteotomy to document secondary fractures. The skulls were subsequently stained with 1% fuschin red to highlight secondary fractures. RESULTS: Maximum compressive loads during pterygomaxillary separation ranged from 22 N (5.0 lbf) to 162 N (36.5 lbf), with an average of 106 N (23.8 lbf) (SD 47.6 N [10.7 lbf]). Forces applied on the first operative side were significantly greater than forces applied on the second operative side (p = 0.0034). Secondary fractures were found in three specimens by computed tomography and in two specimens by 1% fuschin red. All secondary fractures occurred on the second operative side. CONCLUSION: Secondary fractures in the Le Fort I osteotomy procedures occurred on the side opposite the greater maximal compressive load and on the second operative side.

Adult↗
PubMed2000

Complications of laser resurfacing and their management.

PURPOSE: To describe complications associated with laser resurfacing along with specific treatment recommendations. METHODS: The authors' experiences with laser resurfacing complications are discussed in conjunction with a review of published reports. Current preoperative and postoperative regimens are also presented. RESULTS: Postoperative erythema occurs in all patients and is considered a transient side effect, not a complication. Postinflammatory hyperpigmentation, hypopigmentation, scarring, wound infections, milia, ectropion, pain, acneiform eruptions, pruritus, and contact dermatitis are reported by multiple authors. Specific interventions combined with the passage of time allow most of these complications to resolve, leaving the patient with an acceptable final result. CONCLUSIONS: Although laser resurfacing is a safe and effective method of facial rejuvenation, the cosmetic surgeon must be aware of the various complications that may be encountered. Prompt recognition of complications and appropriate management provide the best opportunity for an acceptable aesthetic outcome.

Anti-Bacterial Agents↗
PubMed2000

Ability of induced corpora lutea to maintain pregnancy in beef cows.

Experiments were conducted in beef cows without a primary CL, in which pregnancy had been maintained with exogenous progestogen. In preliminary trials, replacement CL induced ipsilateral to the embryo and after, rather than before, d 36 of pregnancy, maintained more pregnancies after withdrawal of exogenous progestogen (13/13 vs 2/6; P < 0.05). In Exp. 1, in cows with replacement CL induced by treatment with hCG on d 28 of pregnancy, treatment with flunixin meglumine on d 31 through 37 did not increase maintenance of pregnancy. Experiment 2 was conducted to evaluate directly the effects of concentrations of PGF2alpha and estradiol-17beta during d 31 through 35 of pregnancy on maintenance of pregnancy by replacement CL induced between d 28 and 31. In cows that maintained pregnancy while progestogen was provided, maintenance of pregnancy after withdrawal of exogenous progestogen tended to be greater with high (5/5) than with low (2/6; P < 0.10) concentrations of PGF2alpha and greater with low (6/7) than with high (2/6; P = 0.10) concentrations of estradiol-17beta. Secretion of progesterone by replacement CL was greater (P < 0.05) in cows with high than in those with low concentrations of PGF2, during d 31 through 35. Prostaglandin F2alpha may facilitate attachment of the bovine embryo (d 30 to 40) in a manner similar to that reported for implantation in other species. Cows that did not form CL in response to hCG on d 28 to 31 responded well when retreated after d 36. Again, maintenance of pregnancy was greater when replacement CL were induced after (9/9) rather than before d 36 (8/16; P < 0.05).

Animals↗
PubMed1999

Bilateral proptosis: an unusual presentation of fibrous dysplasia.

Fibrous dysplasia is a benign, developmental bone disorder of unknown aetiology. With involvement of the facial bones, indications for surgical intervention include cosmetic deformity and/or progressive neurological dysfunction. We present the case of a 36-year-old female with bilateral orbital lesions whose initial presentation was that of progressive proptosis and visual loss. She underwent bilateral pterional craniotomies with gross total resection of her tumours. Review of the literature reveals several cases of unilateral orbital fibrous dysplasia. This appears to be the first reported case of distinct, bilateral orbital fibrous dysplasia.

Adult↗
PubMed1999

Transconjunctival frontalis suspension: a clinical evaluation.

PURPOSE: To determine the effectiveness of transconjunctival frontalis suspension in patients with blepharoptosis and poor levator function (eyelid excursion less then 5 mm). METHODS: The medical records of 29 patients (50 ptotic eyelids) were reviewed. RESULTS: Four patients (eight eyelids) had blepharophimosis syndrome, ten patients (27 eyelids) had congenital ptosis, seven patients (14 eyelids) had myogenic ptosis, and one patient (one eyelid) had neurogenic ptosis. Surgical results were good and complications were minimal during follow-up intervals ranging from six months to seven years. CONCLUSIONS: Transconjunctival frontalis suspension is technically simpler than traditional external frontalis suspension and yields satisfactory functional and cosmetic results in patients with poor levator function.

Adolescent↗
PubMed1999

Levator aponeurosis disinsertion in congenital entropion of the upper eyelid.

PURPOSE: To present a patient with congenital entropion of the upper eyelid caused by levator aponeurosis disinsertion. METHODS: Case report. RESULTS: Surgical correction of the levator aponeurosis disinsertion corrected the upper eyelid entropion. CONCLUSIONS: Congenital upper eyelid entropion may be caused by levator aponeurosis disinsertion and treated effectively by repairing the anatomic defect.

Entropion↗
PubMed1998

Concentrations of tissue-type plasminogen activator and relaxin in normal and induced-cystic follicles of gilts.

Manipulation of one ovary in prepubertal gilts treated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) results in cysts on the manipulated ovary and corpora lutea (CL) on the non-manipulated (control) ovary. Because tissue-type plasminogen activator (tPA) might play a role in follicular rupture and because relaxin might increase tPA production, concentrations of tPA and relaxin in manipulated and control follicles were measured at different stages of development. Prepubertal gilts were treated with 1000 IU PMSG followed by 750 IU hCG at 72 hr later. Follicles on one ovary in each gilt were manipulated at laparotomy 48 hr after PMSG administration. Gilts were ovariectomized at 72, 90, 108, 114, 144, and 216 hr after PMSG. Concentrations of tPA and relaxin were determined for follicular fluid from follicles dissected free of ovarian stroma and snap frozen in liquid nitrogen and media from follicles cultured for 48 hr. Relaxin did not differ between treatment groups (manipulated and control) at any time (P > 0.05); whereas, tPA was greater in control follicles at 114 hr after PMSG than in manipulated follicles (P < 0.01). The effect of pyrilamine, a histamine-1 receptor antagonist, on tPA concentrations was determined in manipulated and control follicles collected at 3, 12, 24, 42, and 66 hr after manipulation. Concentrations of tPA were similar in control and manipulated follicles for gilts treated with pyrilamine, but again control follicles had greater (P < 0.05) tPA concentrations at 114 hr after PMSG. Thus, tPA seems to be involved in ovulation, and blockage of ovulation and subsequent cyst formation results from inadequate tPA activity in manipulated follicles.

Animals↗
PubMed1998

Histopathologic changes of the eyelid skin following trichloroacetic acid chemical peel.

The use of trichloroacetic acid (TCA) as a periorbital and eyelid peel for skin rejuvenation is gaining significant acceptance among oculoplastic surgeons, dermatologists, and other surgery groups. In spite of the current enthusiasm, there remain potentially serious complications resulting from any periorbital peel. Cases of cicatricial ectropion have been reported in phenol-peeled patients, and lower eyelid ectropion has reportedly occurred in patients undergoing deep eyelid peel in conjunction with a blepharoplasty (1,2). To avoid this complication, it is necessary to better understand the depth of the wound produced by different strengths and combinations of peeling agents applied to living eyelid tissue and, more important, to determine the concentrations of TCA that are likely to lead to cicatricial ectropion when applied in a consistent fashion. We chose upper-eyelid skin because it is easier to obtain for histopathologic study than lower-eyelid skin and, in our experience, is more sensitive to hypertrophic changes after chemical peeling or carbon dioxide laser resurfacing. We applied TCA to the preseptal skin of 10 patients 48 h before standard upper-eyelid blepharoplasty. The acid was applied to produce a "frost," using varying concentrations of acid, ranging from 20 to 50%. The treated skin removed at the time of blepharoplasty was reviewed in a masked fashion by a dermatopathologist to determine the depth of necrosis. We found that superficial peels with necrosis involving 30% of the epidermis were produced by the lowest-concentration combination of TCA applied (20% followed by 0%). As the strength increased, so did the depth of peel. The combination of 50% followed by a second application of 50% produced the deepest peel, with necrosis into the papillary dermis. This finding would indicate that the chance of developing cicatricial ectropion with any of the tested combinations of TCA should be very remote.

Administration, Topical↗
PubMed1998

A modified surgical technique in the treatment of facial nerve palsies.

The ophthalmic complications associated with facial nerve palsy present a challenging problem to the treating ophthalmologist. Over the last hundred years, a wide variety of techniques have been used to rehabilitate patients with facial nerve palsy. Each of these techniques is associated with unique complications. We describe a significantly modified surgical technique for the rehabilitation of patients with facial nerve palsy that has not, to our knowledge, previously appeared in the literature.

Facial Paralysis↗
PubMed1998

Nodular sclerosing Hodgkin disease with primary manifestation in the orbit.

Hodgkin disease with primary manifestation in the orbit is extremely rare, and even when suspected can be very difficult to diagnose. Its clinical and histological presentation can be nearly impossible to differentiate from that of a benign inflammatory process, and it is necessary to utilize immunohistochemical techniques to confirm the diagnosis. This article focuses on a case of nodular sclerosing Hodgkin disease with initial manifestation in the orbit. A comparison of the clinical, histological, and immunohistochemical presentations associated with both Hodgkin disease and benign inflammation is discussed. A brief review of the immunohistochemistry specific for Hodgkin disease is also provided.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Infection of a porous polyethylene orbital implant with Capnocytophaga.

A 68-year-old woman experienced an infection of a porous polyethylene orbital implant caused by Capnocytophaga after a dental procedure. The infection was unresponsive to both topical and oral antibiotics and required removal of the porous polyethylene orbital implant. Capnocytophaga is a capnophilic, gram-negative bacillus. Capnocytophaga is a normal commensal of the mouth and is responsible for both gingivitis and periodontal disease. Capnocytophaga is a rare cause of ocular infections. This is the first reported patient with an infection of a porous polyethylene orbital implant caused by Capnocytophaga. The authors believe infected integrated orbital implants must be removed because neither topical or systemic therapy provide effective treatment.

Aged↗
PubMed1998

LeFort I orbitotomy: a new approach to the inferonasal orbital apex.

Numerous approaches to the orbit have been elegantly described in the literature. One area of the orbit that remains difficult to approach with standard techniques is the inferonasal apex. We describe a new surgical procedure we have termed the LeFort I orbitotomy. The technique involves creation of a LeFort I osteotomy to separate the maxilla from the zygoma and nose bilaterally. The posterior inferomedial orbital bone is then removed and the periorbita opened. This approach allows a more direct, less tangential view to this area of the orbit than does a Caldwell-Luc approach. Wider access for tumor manipulation is gained than would be possible with a transnasal endoscopic approach. An illustrative case report is presented.

Antineoplastic Agents, Hormonal↗
PubMed1997

Relationships of hormonal patterns and fertility to occurrence of two or three waves of ovarian follicles, before and after breeding, in beef cows and heifers.

Ovarian follicular waves were characterized before and after breeding in 52 lactating beef cows and 16 heifers. Effects of two (2 W) or three (3 W) waves of follicular development and associated patterns of concentrations of steroids in jugular serum on pregnancy rate were examined. Animals were observed for oestrus (= day 0) twice daily and inseminated artificially at second oestrus. Follicular development was monitored by ultrasonography and jugular blood samples were collected simultaneously on alternate days from day 6 after first oestrus until ovulation after the second oestrus and from day 6 after second oestrus (insemination) until next ovulation or day 24 of pregnancy. Pregnancy was determined by ultrasonography at 25 days after insemination. From individual patterns of growth or regression of the largest follicles, more of the 59 animals with oestrous cycles of 17 to 25 days had 2 W (51, 86%) than 3 W (8, 14%) during the oestrous cycle before breeding (P < 0.01). Cycles averaged 1.1 days longer (P < 0.10) and corpora lutea regressed later (P < 0.01) in animals with 3 W vs. those with 2 W, but mean oestradiol between 7 and 2 days before second oestrus (3.7 +/- 0.3 pg ml-1) did not differ between cycles with 2 W or 3 W. Ovulatory follicles in animals with 2 W differed from those with 3 W (P < 0.05) in day of detection (12.3 +/- 0.3 vs 16.5 +/- 0.5), growth rate (1.0 +/- 0.1 vs 1.5 +/- 0.1 mm day-1), interval from detection to ovulation (9.3 +/- 0.3 vs 6.3 +/- 0.7 days) and duration of dominance (4.0 +/- 0.2 vs 2.1 +/- 0.6 days). Pregnancy rates, 82% in cows with 2 W and 100% in cows with 3 W, did not differ (P > 0.05). During the period equivalent to an oestrous cycle after breeding, 29 (49%) of the 59 animals had 2 W and 30 (51%) had 3 W. Fewer animals with 2 W than 3 W after breeding became pregnant (16/23, 70% vs 26/27, 96%; P < 0.05), but patterns of concentrations of progesterone on days 6 through 14 or mean oestradiol on day 14 (2.6 +/- 0.2 pg ml-1) did not differ. In conclusion, fewer animals had 3 W than 2 W before breeding and fertility did not differ. During the equivalent of one oestrous cycle after breeding, approximately equal numbers of animals had 2 W or 3 W and fertility was greater for animals with 3 W.

Animals↗
PubMed1997

Coordinate developmental expression of genes regulating sterol economy and cholesterol side-chain cleavage in the porcine ovary.

To investigate the coordinate developmental expression of low-density lipoprotein (LDL) receptor, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, sterol carrier protein 2 (SCP2), steroidogenic acute regulatory protein (StAR), and cytochrome P450 side-chain cleavage (P450scc) enzyme messages throughout the pig estrous cycle, RNase protection analysis was performed using homologous (partially cloned) porcine sequences. Total RNA was isolated from ovarian tissues from unstimulated prepubertal gilts and gilts stimulated with eCG (Day -3) and hCG (Day 0) to induce follicular growth and ovulation. Specific transcripts (relative to 18S rRNA) were quantified in immature ovaries, preovulatory follicles (> or = 5 mm), corpora lutea (CL), and corpora albicantia. As an index of steroidogenesis, tissue progesterone content (per microgram protein) was low in the unstimulated ovary and preovulatory follicles, and it began to increase 4 days post-hCG, peaked at 12 days, and returned to preovulatory concentrations by 20 days post-hCG. HMG-CoA reductase mRNA was expressed at low levels and did not change significantly throughout the estrous cycle. The amount of LDL receptor mRNA increased approximately 6-fold after eCG stimulation and was expressed at similar concentrations in both preovulatory follicles and functional CL. Expression of SCP2 mRNA did not differ among the four tissue types but tended to be highest in midcycle (Day 12) CL compared other stages of CL (p = 0.007). StAR mRNA expression was minimal in unstimulated ovaries, was higher in preovulatory follicles (p = 0.014), and then rose again in CL (p = 0.009 compared with unstimulated ovary). P450scc mRNA concentrations were low in unstimulated ovaries, increased in preovulatory follicles (p = 0.044), and increased further in CL (p = 0.001 compared with preovulatory follicles). P450scc and StAR mRNA levels correlated with progesterone levels (r = +0.37, p = 0.025, and r = +0.71, p < 0.001, respectively). The expression of LDL receptor, StAR, and P450scc messages showed a dramatic decline by Day 20 post-hCG (p = 0.002, p = 0.003, p = 0.006, respectively, compared with CL) corresponding with functional regression of the CL. In summary, P450scc and StAR message expression are coordinately amplified during the pig follicular and luteal phase, whereas LDL receptor message after an initial increase is expressed at constitutively high levels, thus indicating a differential regulation of ovarian sterol-metabolizing genes during the steroidogenic life of the follicle and CL.

Animals↗
PubMed1997

Visual hallucinations after enucleation.

Visual phenomena are frequently reported in patients after ocular trauma, surgery or progressive visual degeneration. In particular, hallucinations are often seen by patients following enucleation. Whereas these visions can be verbally described to the physician, they can never actually be seen. This article focuses on the case of a female artist who experienced visual hallucinations after enucleation of her dominant right eye. In addition to her verbal descriptions, she was able to express these hallucinations visually on canvas. Her case offers insight to caregivers about the nature of visual hallucinations in patients with similar experiences. A review of the general characteristics and etiologies of such visual phenomena is also included.

Aged↗