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R F Meyer

Publications and source records attributed to R F Meyer.

116 records · Page 7Linked to original sources
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Clinicopathologic features of Chandler's syndrome.

The clinicopathologic features of Chandler's syndrome are elucidated based on a study of nine patients. Keratoplasty, trabeculectomy and/or iris specimens were studied by light, electron and, in six cases, specular microscopy. The prominent pathologic features were abnormalities of the endothelially-derived cells lining the posterior corneal surface, the inner surface of the trabecular meshwork, and the anterior iris surface. In all four corneal buttons, the endothelium was diffusely attenuated and focally absent, and posterior collagen layers were present. Extension of the endothelial cell layer and Descemet's membrane deposition over the trabecular meshwork were observed in two trabeculectomy specimens, and similar proliferation onto the anterior surface of the iris was evident in four iris specimens. Other abnormalities of the endothelial cells included increased intracytoplasmic filaments. These pathologic alterations are consistent with the concept of Chandler's syndrome as representing one variant of the iridocorneal endothelial (ICE) syndrome. Interestingly, although both endothelial proliferative and degenerative responses can be observed in Chandler's syndrome, their occurrence within the same eye is apparently not simultaneous.

Adult↗
PubMedDate not supplied

Morphologic characteristics of posterior polymorphous dystrophy. A study of nine corneas and review of the literature.

Based on their own study of nine corneas with clinically documented posterior polymorphous dystrophy and a review of the literature, the authors describe the morphologic features of this entity. Study by phase contrast light microscopy and transmission and scanning electron microscopy found that changes were primarily in the endothelium and consisted of endothelial cell degeneration and loss with focal fibroblastic and epithelial-like cell transformation. Secondary alterations of Descemet's membrane were seen; they consisted of abnormal lamination with deposition of abnormal collagen material, particularly in the posterior collagen layer, and formation of guttate excrescences and pits.

Adult↗
PubMedDate not supplied

Rapid and sensitive detection of foot-and-mouth disease virus in tissues by enzymatic RNA amplification of the polymerase gene.

Direct detection of foot-and-mouth disease (FMD) virus from infected bovine and porcine tissue was investigated using a modified polymerase chain reaction (PCR) technique. A high degree of conservation was found in the genomic region coding for the viral RNA polymerase among the seven FMD viral (FMDV) serotypes. An oligomeric primer pair and probe were constructed from consensus sequence data within this area. First strand cDNA was synthesized using random hexamers and Moloney MuLV reverse transcriptase. The oligomeric primers used for PCR of the random primed cDNA yielded a 454-base-pair target amplification product. The PCR product was sized by agarose gel electrophoresis and hybridized strongly with the consensus sequence oligomeric probe. The PCR product was further examined by digestion with NcoI, confirming the predicted internal restriction enzyme site. All seven serotypes of FMDV RNA were amplified in a few hours and the PCR product tested positive. The sensitivity of the enzymatic amplification for detection of FMDV was 10 TCID50 by gel electrophoresis and less than 1 TCID50 when combined with hybridization to a labeled probe. The technique was specific, as determined by examination of at least 12 other viruses, including enteroviruses and other agents of vesicular disease. In vitro enzymatic amplification of cDNA from FMDV RNA using the modified PCR technique is highly specific, rapid and at least as sensitive as presently used procedures for FMDV laboratory diagnosis.

Animals↗
PubMedDate not supplied

Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States.

From October 4 to November 2, 2001, the first 10 confirmed cases of inhalational anthrax caused by intentional release of Bacillus anthracis were identified in the United States. Epidemiologic investigation indicated that the outbreak, in the District of Columbia, Florida, New Jersey, and New York, resulted from intentional delivery of B. anthracis spores through mailed letters or packages. We describe the clinical presentation and course of these cases of bioterrorism-related inhalational anthrax. The median age of patients was 56 years (range 43 to 73 years), 70% were male, and except for one, all were known or believed to have processed, handled, or received letters containing B. anthracis spores. The median incubation period from the time of exposure to onset of symptoms, when known (n=6), was 4 days (range 4 to 6 days). Symptoms at initial presentation included fever or chills (n=10), sweats (n=7), fatigue or malaise (n=10), minimal or nonproductive cough (n=9), dyspnea (n=8), and nausea or vomiting (n=9). The median white blood cell count was 9.8 X 10(3)/mm(3) (range 7.5 to 13.3), often with increased neutrophils and band forms. Nine patients had elevated serum transaminase levels, and six were hypoxic. All 10 patients had abnormal chest X-rays; abnormalities included infiltrates (n=7), pleural effusion (n=8), and mediastinal widening (seven patients). Computed tomography of the chest was performed on eight patients, and mediastinal lymphadenopathy was present in seven. With multidrug antibiotic regimens and supportive care, survival of patients (60%) was markedly higher (<15%) than previously reported.

Adult↗
PubMedDate not supplied

Techniques of posterior chamber lens implantation without capsular support during penetrating keratoplasty: a review.

Posterior chamber intraocular lenses have numerous advantages over iris-supported lenses and many types of anterior chamber lenses; therefore, the implantation of sutured posterior chamber lenses in the absence of a lens capsule during penetrating keratoplasty has become more common. Suture fixation of the lens implant may be achieved by either 1) sewing the optic or haptics to the iris, or 2) sewing the haptics in the ciliary sulcus using transscleral sutures. In the case of the iris-suture technique, the implant acquires its stability mainly from the fixation sutures, but to some degree, placement of the haptics in the ciliary sulcus may enhance stability. In the case of the scleral fixation technique, implant stability is derived from placement of the haptics in the ciliary sulcus and the transsscleral sutures. Several variations upon these two basic suture fixation techniques currently exist, each with its own putative advantages and disadvantages. The different methods are schematically reviewed with diagrams and the comparative benefits and deficits are discussed.

Humans↗
PubMedDate not supplied

A randomized trial of topical corticosteroids in epithelial healing after keratoplasty.

A prospective randomized trial evaluating the effect of topical 1% prednisolone acetate on epithelial defects after keratoplasty in 39 patients (18 in the untreated group and 21 in the treated group) failed to reveal any significant differences in healing between the two groups (p less than 0.16 to p less than 0.54 on post-operative days 1-5). The mean time needed for complete healing was 1.94 days in the untreated group and 2.81 days in the steroid treated group (p less than 0.09). Patients given subconjunctival methylprednisolone sodium succinate had larger initial defects (mean 33.5 mm2) than those not given subconjunctival steroids (mean 16.1 mm2), but the time for complete epithelial healing did not differ significantly (2.75 days vs. 1.91 days; p less than 0.14). As clinically used post-keratoplasty topical steroids do not appear to significantly delay epithelial healing in most patients.

Administration, Topical↗
PubMedDate not supplied

Prognosis for penetrating keratoplasty in iridocorneal endothelial syndrome.

BACKGROUND: Iridocorneal endothelial syndrome is characterized by the proliferation and spreading of an abnormal corneal endothelial membrane across the iridocorneal angle and iris surface, resulting in iridocorneal adhesions, glaucoma, pupillary distortion, varying degrees of iris atrophy, and occasionally corneal decomposition with edema. These changes may possibly affect the long-term prognosis of penetrating keratoplasty in an adverse fashion. METHODS: We reviewed the clinical course of 12 consecutive eyes (12 patients) which underwent penetrating keratoplasty for corneal edema associated with the iridocorneal endothelial syndrome (mean postoperative follow up = 30 months). RESULTS: The grafts remained clear in 10 patients (83%) and the visual acuity was 20/40 or better in nine patients (75%). The endothelial cell losses averaged 13% at 6 months and 17% at 1 year after surgery. Simultaneous extracapsular cataract extraction and posterior chamber lens implantation at the time of keratoplasty posed no measurable compromise to the overall postoperative prognosis. Causes of poor visual acuity after surgery included glaucoma and graft failure (immune and nonimmune). CONCLUSIONS: The prognosis of penetrating keratoplasty in the iridocorneal endothelial syndrome appears to be very favorable in the majority of eyes.

Adult↗