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Biomedical subjects

S H Goldberg

Publications and source records attributed to S H Goldberg.

At least 19 recordsLinked to original sources
PubMed1992

Traumatic intraconal hematic cyst of the orbit.

A 35-year-old man with a history of repeated previous facial injuries presented with acute onset of a right orbital mass less than 2 weeks after blunt trauma to the right eye. Orbital B-scan ultrasonography and computed tomography showed an intraconal cystic lesion. The tumor was excised via lateral orbitotomy. Pathologic evaluation demonstrated a hematic cyst containing fresh blood. The presence of hemosiderin in the cyst wall suggested recent bleeding in a preexisting orbital hemorrhagic lesion. Patients with hematic cysts of the orbit usually present with a subperiosteal mass months to years after trauma.

Adult↗
PubMed1992

Eyelid avulsion: a clinical and experimental study.

Traumatic eyelid avulsion is reported infrequently. We cared for an 18-year-old man who lost > 75% of his right upper eyelid. The tissue was recovered 10 h following the initial trauma. Successful surgical reimplantation resulted in a functional upper eyelid with extensive madarosis. An experimental study was undertaken to attempt to determine the optimal method for preservation of avulsed eyelid tissue. Experimental surgery was performed to simulate repair of eyelid avulsion. The postoperative changes in experimentally reimplanted eyelids parallel those noted in the clinical example of eyelid avulsion. This clinical example and experimental study suggested the following management principles for handling avulsed eyelid tissue: eyelid tissues should not be immersed in saline; avulsed eyelid tissues should be stored at 4 degrees C; if reimplantation time is < 6 h, storage in a cold moist environment is adequate.

Adolescent↗
PubMed1991

Blistering diseases. Diagnostic help for primary care physicians.

At presentation, the differential diagnosis of bullous disease may seem difficult. However, the diagnosis may be clarified by considering such factors as Nikolsky's sign, age of the patient at onset, and pattern and distribution of blisters. Careful review of family, recreational, occupational, and drug histories may also help to identify the cause.

Adult↗
PubMed1991

Poorly differentiated primary orbital sarcoma (presumed malignant rhabdoid tumor). Radiologic and histopathologic correlation.

A 47-year-old man presented with acquired hyperopia and gaze-evoked visual loss. Computed tomography and magnetic resonance imaging demonstrated a well-circumscribed intraconal tumor. Histopathologic studies indicated that the tumor was a poorly differentiated primary orbital sarcoma compatible with malignant fibrous histiocytoma or malignant rhabdoid tumor. To our knowledge, no case of primary orbital malignant rhabdoid tumor has been previously described in an adult.

Cell Differentiation↗
PubMed1991

Bilateral congenital ocular cysts.

This report presents an unusual case of bilateral congenital ocular cysts. These are in the spectrum of congenital cystic eye and microphthalmos with cysts. Diagnostic evaluation, including orbital B-scan ultrasonography, computed tomography and magnetic resonance imaging is described. Pathologic evaluation of the orbital cysts was consistent with congenital cystic eye. An associated microphthalmic eye was not detected with serial sectioning of both specimens. Examination of the orbit at exploration as well as pre- and post-operative MRI scans failed to demonstrate the presence of a microphthalmic eye in either orbit. Failure to detect a microphthalmic eye clinically, by diagnostic imaging studies, or serial microscopic sections of the cysts supports the diagnosis of congenital cystic eye. This child has associated mild facial clefting (median cleft lip and cleft palate) and basal cephalocele. Histopathologically documented cases of ocular abnormalities associated with basal encephalocele have not been reported. To the authors' knowledge, MRI findings of congenital ocular cysts have been reported once previously in a case of microphthalmos with cyst, however, histopathologic correlation has not been reported previously.

Cysts↗
PubMed1991

Patients' theories of pathogenesis.

Certain patients embark upon analytic treatment with well thought out theories regarding the origins of their difficulties. Although there is always some validity to such theories, they turn out to be incomplete and serve to screen painful recollections and pathogenic unconscious wishes and the defenses against them. Two cases are presented to illustrate how analysands use these theories in the service of resistance. Painstaking analytic work is required to elucidate their defensive nature. The narcissistic importance of such theories in maintaining a coherent narrative about one's life in the face of uncertainty is discussed, and technical and countertransference considerations are explored.

Adult↗
PubMed1990

Patient-related variables and restenosis after percutaneous transluminal coronary angioplasty--a report from the M-HEART Group.

As part of a randomized prospective study designed to investigate the restenosis process after percutaneous transluminal coronary angioplasty (PTCA), the relation between patient-related variables and restenosis rate was examined. A total of 722 patients had successful PTCA. Angiographic follow-up was scheduled for 6 +/- 2 months after the procedure and achieved in 510 patients (71%), yielding 598 lesions for analysis. The overall restenosis rate was 40%. The rate was higher in patients undergoing early restudy for a clinical event than in those undergoing routinely scheduled follow-up restudy (71 vs 22%, p less than 0.0001). Age, sex, cigarette smoking history, diabetes mellitus and history of previous myocardial infarction were not associated with restenosis rate. Angina duration and severity before PTCA were also unrelated to restenosis rate. In summary, these variables, many of which have been previously implicated in restenosis, were not found to be predictors of restenosis. The decision to perform PTCA in individual patients should not be negatively influenced by the presence of these factors.

Adult↗
PubMed1990

Orbital varix thrombosis.

Venous disease of the orbit is a rare occurrence which can become manifest in a variety of ways including an arteriovenous aneurysm or fistula, a cavernous sinus or superior ophthalmic vein thrombosis, and an orbital varix, with and without thrombosis. Three patients had proptosis due to orbital varix thrombosis. The onset, degree of pain, and presence of diplopia were all variable. In two of three patients, computed tomographic (CT) scans showed lesions reminiscent of cavernous hemangiomas. The clinical, radiographic, surgical, and histopathologic features of this entity are described and discussed and a hypothesis is proposed to explain the pathophysiology of orbital varix thrombosis.

Adult↗
PubMed1990

Hereditary hemorrhagic telangiectasia.

A patient with hereditary hemorrhagic telangiectasia and bloody tears is described. This case report serves to familiarize the ophthalmic plastic and reconstructive surgeon with the differential diagnosis of bloody tears. Conjunctival, oral mucosal and cutaneous findings are documented, and the systemic and ocular manifestations of hereditary hemorrhagic telangiectasia are discussed.

Aged↗
PubMed1990

Esotropia following bilateral lateral orbital decompressions for Graves' disease.

A 48-year-old woman with mild Graves' orbitopathy underwent bilateral lateral orbital decompressions through preauricular hairline incisions by a general plastic surgeon. Immediately postoperatively she developed marked left orbital and eyelid edema and incapacitating diplopia due to a large angle esotropia and severe bilateral abduction deficits. Examination 13 months later revealed normal visual acuities and a 90 prism diopter esotropia. She underwent complex strabismus surgery with resultant orthophoria in primary and down gaze. Four years later, a thin section computed tomographic scan revealed severe attenuation of both lateral rectus muscles with incarceration of the muscle bellies into the lateral osteotomy sites. This case demonstrates a rare, but avoidable, complication of orbital surgery for Graves' disease.

Esotropia↗
PubMed1990

Strabismus caused by melanoma metastatic to an extraocular muscle.

Nonocular melanoma rarely metastasizes to the orbit. We report the case of a melanoma presumably arising from an axillary lymph node sinus that metastasized to the left medial rectus muscle causing proptosis, diplopia, and reduced saccadic velocity measurements. Clinical, radiographic, and histopathologic data are presented and discussed.

Adult↗
PubMed1989

Primary orbital neuroblastoma.

A 35-year-old man had a primary neuroblastoma of the left orbit. Histopathologically, the tumor was composed of uniform small round cells containing argyrophilic granules arranged in nests and cords with pseudorosettes, Homer-Wright rosettes, and a fine fibrillary background matrix. Immunohistochemical staining for chromogranin was positive. Electron microscopy showed small (108- to 173-nm) dense core granules. Eight years after surgery and radiation therapy the patient was free of local recurrence and metastases. To our knowledge, primary orbital neuroblastoma has been reported only once previously. Neuroblastoma, which occurs most frequently in children and has an incidence in the United States of 500 cases annually, is a distinctly unusual tumor in adults.

Adult↗
PubMed1989

Orbital tumors in children.

There are many reviews of pediatric orbital tumors in the literature. Most of the series originated from the tumor registries of large pathology referral centers, whereas others are from large medical institutions and pediatric hospitals. The distribution of types of tumors reported in each series are unavoidably biased by the nature of the evaluating facility. The findings were also affected by the geographic location of the clinical facility. We present an analysis of 141 orbital tumors in children and review 9 other series (totaling 1,229 cases) for an aggregate total of 1,370 cases. Our clinically based series had an incidence of malignant lesions of 10.6%, much lower than the 24% incidence among the combined referral center/pediatric hospital studies. Cystic orbital and vasculogenic tumors were the most common, comprising 58% of our cases and 40% of orbital tumors in children among the combined series.

Adolescent↗