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Biomedical subjects

S M Archer

Publications and source records attributed to S M Archer.

At least 19 recordsLinked to original sources
PubMed1996

Renal clear cell carcinoma appearing as a left neck mass.

Malignant clear cell tumors of the head and neck are uncommon. Primary tumors may arise from the salivary glands, thyroid gland, or parathyroid glands, while metastatic tumors most commonly arise from the lungs, kidneys, and female genital tract. Renal cell carcinoma is the third most common metastatic tumor to the bone and soft tissues of the head and neck. Despite this, there have been few reported cases of renal clear cell carcinoma metastases to the neck. Here we report a unique case of an otherwise asymptomatic young woman with a left neck mass as the first clinical sign of advanced renal clear cell carcinoma.

Adenocarcinoma, Clear Cell↗
PubMed1995

Prophylactic antibiotic drops after tympanostomy tube placement.

OBJECTIVE: To evaluate the effectiveness of prophylactic polymyxin B sulfate-neomycin sulfate-hydrocortisone drops in decreasing the incidence of posttympanostomy otorrhea. DESIGN: Prospective randomized controlled study. SETTING: University referral center. PATIENTS: Three hundred patients undergoing tympanostomy tube placement (including those undergoing tonsillectomy, adenoidectomy, or both) were randomized into three groups. INTERVENTION: The use of polymyxin B-neomycin-hydrocortisone drops. Patients in group 1 received no antibiotic drops; group 2, a single dose intraoperatively, and group 3, an intraoperative dose followed by a 5-day course. MAIN OUTCOME MEASURE: Posttympanostomy otorrhea. RESULTS: A statistically significant decrease was observed in the incidence of posttympanostomy otorrhea between the control (16.4%) and treatment groups (group 2, 8.3%; group 3, 8.1%) (P = .011). A single dose of antibiotics was effective when patients' middle ears were dry or had serous effusions. A 5-day course was indicated for those whose ears had mucoid or purulent contents. CONCLUSIONS: Antibiotic ear drops are indicated in all patients. A single dose is as effective as a 5-day course, but our data support a longer course in certain subgroups.

Child↗
PubMed1995

Surgery for obstructive sleep apnea: effects on sleep, breathing, and oxygenation.

Advances in the treatment of obstructive sleep apnea have evolved rapidly over the past two decades. Nasal continuous positive airway pressure (CPAP) devices are effective, but are neither curative nor universally well tolerated. Uvulopalatopharyngoplasty (UPPP) has been reported to have widely varying success rates; many studies of this procedure do not include data about sleep quality, oxygenation, or patient satisfaction. The role of nasal surgery in the treatment of obstructive sleep apnea in the hands of a single surgeon, specifically evaluating its effects on sleep and oxygenation parameters. Overall, 12 of 15 patients (80%) had marked improvement, reflected by oximetry and patient interview. This pilot study shows that the combined use of UPPP and nasal surgery, when indicated, for obstructive sleep apnea is an acceptable alternative in nasal CPAP-intolerant patients. Further studies with larger numbers are needed to further substantiate these findings.

Adolescent↗
PubMed1993

Children with exotropia responsive to spectacle correction of hyperopia.

A series of seven exotropic children (aged 2 to 10 years) had resolution of exotropia after spectacle correction of hyperopia. Their hyperopic correction ranged from 3.00 to 7.00 diopters. Six had intermittent exotropia, which became small-angle esophoria after spectacle correction. In one patient with apparently no fusion, spectacle correction converted constant exotropia to small esotropia in the monofixational range. In all patients, Worth 4-dot and Titmus Stereo Test results, when obtainable, indicated an improvement in binocular sensory status after correction of the hyperopia. We conclude that a trial of spectacle correction is warranted in exotropic children with severe hyperopia and in those with moderate hyperopia and a low accommodative convergence/accommodation ratio or evidence of hypoaccommodation.

Child↗
PubMed1992

Acquired flaccid larynx. A case report supporting the neurologic theory of laryngomalacia.

Congenital flaccid larynx, also known as laryngomalacia, is a common clinical entity accounting for approximately 60% of laryngeal problems in the newborn. It is a benign and relatively asymptomatic condition that patients often outgrow by 12 to 18 months of age. A variety of mechanisms have been proposed to explain laryngomalacia including cartilage immaturity and poor neuromuscular control secondary to hypomaturity or dysfunction. This entity has only recently been described as an acquired disorder. A case of an 11-year-old boy who presented with basilar artery thrombosis and a midpontine infarction is described. Inability to extubate despite spontaneous respirations prompted flexible laryngoscopy, which revealed complete supraglottic collapse with airway obstruction. The patient was successfully treated with an epiglottoplasty. This case supports the neuromuscular dysfunction theory as a cause of laryngomalacia.

Basilar Artery↗
PubMed1991

Measurement of low vision in children and infants.

The authors evaluated a preferential looking technique (Teller acuity cards) and a set of gross behavioral indicators (visual function battery) for the ability to rank visually impaired children and infants on the basis of their visual function. Fourteen older children with a diagnosis of cicatricial retinopathy of prematurity who were capable of giving Snellen acuities and a group of 31 preverbal infants with decreased vision due to a variety of causes were tested. Teller acuity card and visual function battery findings were highly correlated with each other (and with Snellen acuities in the older group); however, the Teller acuity cards provided better discrimination in the moderately visually impaired range, whereas the visual function battery was better in the severely impaired range. It is concluded that, in children and infants, visual function over the entire spectrum of low vision can be characterized by using a combination of the Teller acuity cards and the visual function battery.

Adolescent↗
PubMed1989

Strabismus in infancy.

In order to prospectively study the development of strabismus in infancy, the ocular alignment of a large population of normal neonates was studied and follow-up examinations were obtained in a subset of these infants. The characteristic findings of congenital esotropia subsequently developed in three infants who were either orthotropic or exotropic at birth. Pathologic exotropia developed in two infants; both were exotropic at birth, but no more so than most normal neonates. In infants with congenital esotropia or pathologic exotropia, the characteristic deviation appears to develop between 2 and 4 months of age, a period during which normal infants are becoming increasingly orthotropic.

Abducens Nerve↗
PubMed1988

Stereotest artifacts and the strabismus patient.

A new use of nonstereoscopic cues in stereopsis testing is described. It consists of alternation of fixation while observing for image jump in the disparate portions of the test target. This may enable some stereoblind strabismus patients to achieve artifactually good stereotest scores and explain those patients who appear to have gross stereopsis on the Titmus test, but are unable to perform any random-dot test of stereopsis. A new stereotest is described which does not resort to a random-dot format and yet is free from lateral displacement and alternation cues.

Adult↗
PubMed1988

Hamartoma of the larynx: report of two cases and review of the literature.

Hamartomas of the larynx are rare. Signs and symptoms vary but there is generally some degree of voice change and upper airway obstruction. The pathology may be misleading and can often be confused with other benign tumors of the larynx. Management should consist of conservative excision. Partial or total laryngectomy should be reserved for lesions involving too much of the laryngeal framework. Two cases of hamartomas of the larynx are reported requiring partial laryngectomy.

Adult↗
PubMed1988

Developmental aspects of the Brückner test.

Normal infants ranging from newborn to 10 months of age were examined in order to study age-related variation in the behavior of the fundus reflexes seen in the course of performing the Brückner test. Most infants 8 months of age and older show the characteristic symmetric dimming of the fundus reflexes in both eyes occurring with central fixation. Neonates and most infants younger than 2 months of age do not show dimming of the fundus reflex with fixation, probably due to an inability to accommodate accurately. Between 2 and 8 months of age, up to 28% of infants have asymmetric dimming of the fundus reflexes in the two eyes. In contrast to older children in which this is a pathologic finding, asymmetric fundus reflexes occurring in this age range may represent a normal stage of development.

Age Factors↗
PubMed1987

Stereoscopic contours and optokinetic nystagmus in normal and stereoblind subjects.

Moving stereoscopic contours in a dynamic random-dot stereogram have been previously shown to induce optokinetic nystagmus in subjects with normal stereopsis. For this to be validated as an objective test of stereopsis, stereoblind subjects must also be shown not to develop OKN, especially since it has been shown that the optomotor system of stereoblind individuals retains sensitivity to some cyclopean stimuli. In this report we verify that stereoblind subjects do not have an optomotor response to stereoscopic contours--regardless of the alignment angle at which the stereo image pair is presented.

Depth Perception↗
PubMed1987

The effect of intravitreal botulinum toxin on rabbit visual evoked potential.

Intravitreal injections of botulinum A toxin in two doses, 1.25 and 25 units, were performed in two rabbit eyes. The fellow eyes were injected with an equal volume of saline to serve as controls. The visual evoked potential was unchanged at one and two weeks post-injection when compared to pre-injection recordings in both botulinum and saline injected eyes.

Animals↗
PubMed1986

Stereopsis in normal infants and infants with congenital esotropia.

We used electro-oculographic recordings of eye movement responses to a dynamic random-dot stereogram to assess stereopsis in normal infants and in infants with congenital esotropia. Normal infants showed an onset of stereopsis at about 4 months of age, consistent with previous reports. Four of nine infants with congenital esotropia demonstrated stereopsis when tested within two weeks of surgical alignment. No patient with congenital esotropia showed evidence of stereopsis when tested at a postoperative interval of more than two weeks.

Adult↗
PubMed1986

Vergence amplitudes with random-dot stereograms.

Random-dot stereograms were found to be capable of producing fusional vergence amplitudes in the absence of monocular contours. These vergence amplitudes are not an artefact of monocular contours provided by the target borders or test instrument and are comparable in range to vergence amplitudes measured clinically with second degree fusion targets in an amblyoscope. We conclude that diplopia of monocularly recognisable contours is not necessary for producing fusional vergence amplitudes.

Convergence, Ocular↗