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Biomedical subjects

R J Simmons

Publications and source records attributed to R J Simmons.

At least 91 records · Page 5Linked to original sources
PubMed1978

Progress in glaucoma.

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Anniversaries and Special Events↗
PubMed1977

Glaucoma occurring after closed vitrectomy.

Six of 20 eyes developed postoperative glaucoma within two to ten days after closed vitrectomy for vitreous hemorrhage. Intraocular pressure was greater than 40mm Hg in all six eyes, and three developed pressure greater than 60 mm Hg. Intraocular pressure in four eyes was controlled with medical antiglaucoma therapy and two eyes required anterior chamber irrigation. Six months postoperatively three of the eyes had normal pressures, one was hypotonous, and two developed increased intraocular pressure secondary to angle neovascularization. Three of the 14 eyes that did not develop glaucoma developed a cellular accumulation in the anterior chamber. The glaucoma was caused mainly by obstruction of the trabecular meshwork by degenerated red blood cells known as ghost cells. The cells may be identified by phase-contrast examination of anterior chamber aspirates. Glaucoma can be prevented through irrigation of the vitreous cavity at the time of vitrectomy ensuring that no cells and debris are left behind to migrate into the anterior chamber and obstruct the trabecular meshwork. This type of glaucoma is caused mainly by ghost cells, whereas hemolytic glaucoma is caused mainly by macrophages and red blood cell debris.

Eye Diseases↗
PubMed1976

Iris nodules in essential iris atrophy.

Seven cases are reported, believed to be the first in the literature, in which iris nodules are verified in the complete spectrum of essential iris atrophies. This feature appears late in the course of the disease as small yellow nodules that progressively increase in number and gradually become dark brown. The differential diagnosis of multiple iris nodules includes neurofibromatosis, melanomas, inflammatory nodules, and developmental anomalies such as iridocorneal dysgenesis.

Adult↗
PubMed1976

Urinary calculus during methazolamide therapy.

A 68-year-old white man with Paget's disease and open-angle glaucoma was treated with methazolamide, 50 to 100 mg three times daily. Ten months after the medication was initiated he developed ureteral colic and a calcium oxalate stone was surgically removed. Three months after the drug was reinstituted the patient passed three calcium phosphate stones. This suggested a casual relationship between methazolamide and stone formation, although renal calculi also complicate Paget's disease and acetazolamide had been administered briefly.

Acetazolamide↗
PubMed1976

Ghost cells as a cause of glaucoma.

Clinical and investigative evidence indicated a glaucoma caused mainly by degenerated red blood cells, or ghost cells. These ghost cells, with altered shape, color, and pliability, accumulated in the vitreous cavity after hemorrhage. Following disruption of the anterior hyaloid face, they passed into the anterior chamber and caused severe glaucoma. In the anterior chamber, the tiny, khakicolored cells, circulating slowly, were frequently mistaken for white blood cells. They covered the trabecular meshwork or filled the inferior angle with a pathognomonic khaki-colored layer. They were identified by phase-contrast microscopic examination of anterior chamber aspirates. The decreased pliability of these degenerated cells seemed to account for their inability to pass easily through the human trabecular meshwork and, therefore, to cause severe glaucoma.

Aged↗
PubMed1976

Combined cyclodialysis and cataract extraction.

Combined cyclodialysis and cataract extraction was performed on 78 eyes in a consecutive series of 26 years duration. This operation was performed on eyes with severe glaucoma, inadequately controlled on maximum medical therapy, and with a cataract needing extraction. Glaucoma types included open-angle, angle-closure with peripheral anterior synechias, combined open-angle and angle-closure, and secondary to uveitis. Seventy of the 78 eyes had follow-up of six months or more and the results in these 70 eyes were analyzed. In thirteen percent of the eyes in this study the postoperative intraocular pressure was the same or higher than the preoperative level, or reductions of intraocular pressure were not clinically significant. Eighty-seven percent (61 eyes) had a clinically significant lowering of intraocular pressure following the combined procedure. Thirty-nine percent (27 eyes) of the 70 eyes in this study had a tension of 0-14 mm Hg, and 44% (31 eyes) had a tension of 15-20 mm Hg. Intraocular pressure was improved significantly more often in patients over 60 years of age. Resulting intraocular pressures of 14 mm Hg or less were more likely when the cyclodialysis was performed in the lower quadrant. The results of the combined procedure were not significantly influenced by the type of glaucoma involved or by a history of previous glaucoma surgery. Bleeding was a frequent complication, but was not related to resulting intraocular pressure. Other complications were rare. We conclude that combining cyclodialysis with cataract extraction is safe and effective, and is a suitable procedure when there is need for surgery to relieve severe glaucoma, along with a need for cataract extraction.

Adolescent↗
PubMed1972

Factors influencing the microbiological assay of tobramycin.

Tobramycin belongs to the aminoglycoside class of antibiotics. Assay procedures were investigated to determine the most suitable methods for the assay of tobramycin in blood, urine, and pharmaceutical preparations. The agar-plate assay was the method of choice for determinations in urine and serum. The turbidimetric assay was selected for the assay of pharmaceutical preparations. An extraction technique is described that minimizes problems encountered in the estimation of tobramycin in urine. Sample diluents, pH, and molarity were important and were variable depending on assay methods. Evidence is presented to show binding of tobramycin to alpha-cellulose susceptibility discs. Iron and sodium ions demonstrated potential inhibition of tobramycin in all assay methods tested.

Aminoglycosides↗
PubMed1972

Malignant glaucoma.

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Carbonic Anhydrase Inhibitors↗
PubMedDate not supplied

Emotional adjustment of early adolescents with cystic fibrosis.

Eighty-five 12- to 15-year-old adolescents regularly attending the cystic fibrosis (CF) clinic of The Hospital for Sick Children were asked to complete the Children's Health Locus of Control and the Tennessee Self Concept Scale. Their parents were requested to complete the Child Behavior Checklist. Thirty-four males (72%) and 28 females (74%) participated in the study. This study found that adolescents with CF are able to maintain a good self concept, be socially competent, and perceive that they are in control of their health while showing an increase in behavior problems. Females rely heavily on denial and are more behaviorally compliant, whereas boys use less denial but show more behavior problems. Males appear to integrate having a physical disorder into their self concept, whereas females do not. The findings demonstrate a difference in mechanisms of coping with cystic fibrosis between male and female adolescents with CF, which may contribute to the decline in physical status in females and better survival of males.

Adolescent↗
PubMedDate not supplied

Behavioral adjustment of latency age children with cystic fibrosis.

One hundred and twenty-six 6 to 11-year-old latency age children with Cystic Fibrosis regularly attending the CF clinic of the Hospital for Sick Children were asked to complete the Piers-Harris Self-Concept Scale and the Children's Health Locus of Control. Their parents were requested to complete the Child Behavior Checklist and the Family Assessment Measure. One hundred and eight (86%) participated in the study. Twenty-three percent of the children were found to have sufficient behavior problems to indicate a significant degree of maladjustment. Latency-age CF children show an increase in problems compared to a pre-school group, suggesting that leaving the protection of the family is problematic for a child with a chronic physical disorder. Males show more behavior problems than females. Males' behavior is characterized by somatic complaint profile. In spite of difficulties, CF latency children are able to maintain good social competence and self-concept suggesting compensatory mechanisms. These mechanisms are different for males and females. Females' self-concept and social competence are supportive of each other, whereas for males, this is not the case. Similarly, female behavior is relevant to family functioning. Males and females adjust to difficulty as indicated by differences in behavior profiles.

Adaptation, Psychological↗
PubMedDate not supplied

Goniophotocoagulation for neovascular glaucoma.

A new treatment, goniophotocoagulation, for neovascularization of the anterior chamber angle has been applied with the argon laser to 21 eyes of 20 patients. Three of the eyes had neovascularization related to central retinal vein occlusion. In the other 18 eyes the neovascularization was related to diabetic retinopathy. A specific protocol has been followed since January 1973. The results so far indicate that closure of the angle and progression of the usual chain of pathologic events in neovascular glaucoma were prevented in 10 (77%) of the 13 eyes having an average follow-up of 22 months. We believe that goniophotocoagulation of the angle deserves more extensive, judicious, and carefully monitored clinical use. Our results suggest that this new technique is safe and reasonably effective in preventing progressive neovascularization of the angle, synechial closure, and severe nonvascular glaucoma.

Anterior Chamber↗
PubMedDate not supplied

Plateau iris syndrome.

Eight cases of the plateau iris syndrome are presented. The "plateau iris syndrome" should be differentiated from the "plateau iris configuration." The "configuration" refers to a preoperative condition in which gonioscopically confirmed angle-closure glaucoma occurs, but the iris plane is flat and the anterior chamber is not shallow axially. In most cases, the angle-closure glaucoma associated with the plateau iris configuration is cured by a peripheral iridectomy. "Plateau iris syndrome" refers to a postoperative condition in which a patent iridectomy has removed the relative pupillary block which is ordinarily important in causing angle closure, but gonioscopically confirmed angle closure recurs without shallowing of the anterior chamber axially. Plateau iris syndrome is rare compared to the configuration, which itself is not common. In the syndrome, angle closure usually occurs in the early postoperative period but may occur long after iridectomy when the pupil dilates spontaneously or in response to mydriatic agents. It usually occurs in a younger age group than ordinary angle-closure glaucoma. The treatment is the use of pilocarpine postoperatively as long as it is needed. This syndrome must be considered in the differential diagnosis when the intraocular pressure rises unexpectedly following an adequate peripheral iridectomy procedure for angle-closure glaucoma.

Adult↗