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Biomedical subjects

Seymour Brownstein

Publications and source records attributed to Seymour Brownstein.

At least 19 recordsLinked to original sources
PubMed2006

Corneal myxoma arising in a patient with repeated phototherapeutic keratectomies.

PURPOSE: We report the clinical and pathologic findings of a corneal myxoma that was diagnosed in a cornea that had undergone phototherapeutic keratectomy (PTK). METHODS: A corneal myxoma was identified in a full-thickness keratoplasty specimen obtained from a 51-year-old man with a history of a forceps injury to his right eye at birth. The patient had presented with corneal edema and bullous keratopathy, which was treated on 3 occasions with PTK, resulting in progressive, persistent milky-white clouding of the cornea. This represents the eighth case of corneal myxoma in the reviewed literature and the first described after PTK. Thorough histopathologic and ultrastructural analyses were conducted. RESULTS: The histochemical, immunohistochemical, and electron microscopic findings were consistent with previously reported corneal myxomas. Most of the reported myxomas arising in the cornea presented with a history of prior corneal disease or injury and showed absence or disruption of Bowman layer histopathologically, as was found in our patient. CONCLUSION: The pathogenesis of corneal myxomas involves a reactive process that requires an antecedent affliction, in contrast to the neoplastic mesenchymal histogenesis of myxomas characterized in other parts of the body.

Corneal Diseases↗
PubMed2004

Asymptomatic lacrimal ductule dacryolithiasis with embedded cilia.

We describe a case of a 32-year-old man who presented with a visually apparent but otherwise asymptomatic mass in the right lateral fornix. Computerized tomography demonstrated the mass adjacent to the lacrimal gland. The mass was surgically removed, and histopathologic examination was consistent with a dacryolith of the lacrimal ductule. There were several cilia isolated from the dacryolith. This entity should be considered in the differential diagnosis of patients presenting with a localized mass in the region of the lacrimal gland.

Adult↗
PubMed2004

Clinicopathologic analysis of 15 explanted hydroxyapatite implants.

PURPOSE: To report the clinical findings, treatment, outcomes, and histopathologic findings in patients with suspected orbital implant infection requiring implant removal. METHODS: Retrospective, observational case series of 14 patients (15 hydroxyapatite orbital implants) undergoing implant removal from September 1994 through December 2002. Patient age, type of surgery, implant type, symptoms, treatment, histopathology of implant, and follow-up course were analyzed. RESULTS: Of the 14 patients, 7 were female and 7 were male. The mean age at explantation was 42 years. The most common symptoms were discharge and socket tenderness. The most common signs were conjunctival inflammation (edema, hyperemia), discharge, and recurrent pyogenic granuloma. Clinical evidence of infection was documented in 13 patients. Histopathologic assessment of the 15 explanted implants showed acute inflammation and necrosis (abscess) with identification of microorganisms (5 patients), acute inflammation and necrosis without identification of microorganisms (4 patients), chronic inflammation with identification of microorganisms (1 patient), chronic inflammation without identification of microorganisms (3 patients), and a predominant foreign body granulomatous response without identification of microorganisms (2 patients). Osseous metaplasia was seen in 10 implants. Prompt resolution of symptoms and signs occurred in all but one case. CONCLUSIONS: The clinical course of porous orbital implant infection may be prolonged, and the early symptom of recurrent discharge, a common problem for implant recipients, may delay diagnosis. Implant infection should be suspected when there is persistent conjunctival inflammation and discharge after implant placement despite antibiotic therapy, discomfort on implant palpation, and recurrent pyogenic granuloma (indicative of implant exposure). Implant removal is usually required in these cases. If orbital pain (not necessarily related to implant palpation) is the main complaint, without signs of conjunctival inflammation and with or without discharge, one should consider other reasons for the symptoms.

Adolescent↗
PubMed2003

Proposed pathogenesis for the delayed postoperative opacification of the hydroview hydrogel intraocular lens.

PURPOSE: To report the clinical, histopathologic, ultrastructural, and elemental features of 17 opacified Hydroview (Bausch and Lomb Surgical, Rochester, New York, USA) hydrogel intraocular lenses (IOL) necessitating explantation and discuss from a clinicopathologic perspective why these lenses became opacified. Interventional case series with clinicopathologic correlation. METHODS: Seventeen hydrogel lenses were explanted from 17 different patients owing to decreased visual acuity or quality of vision an average of 29 months after uneventful phacoemulsification and IOL implantation and associated with a granular-appearing opacification superficially within the optic. Lenses were examined by light microscopy, transmission electron microscopy (TEM), and energy dispersion x-ray (EDX) spectroscopy. A control IOL was included in our study. RESULTS: All explanted lenses showed positive staining for calcium by light microscopy. Transmission electron microscopy disclosed electron-dense crystalline deposits in the superficial substance of the IOL optic. Energy dispersion x-ray spectra analyses showed the presence of calcium and phosphorus mainly in the electron-dense periphery of the deposits in all of the specimens and the presence of silicon mainly in the electron-lucent center of the deposits in the majority of the specimens. No positive staining or deposits were observed on the IOL control or in the haptics. CONCLUSIONS: Our study is the first to demonstrate that the calcium deposits are associated with silicon, which was presumably derived from the silicone gasket in the Surefold (Bausch and Lomb Surgical, Rochester, New York, USA) packaging system, manufactured specifically for this IOL. Silicon may act as a nidus for calcium deposition within the lens, which is consistent with our findings. There may be other factors involved, and this important clinical problem requires further study.

Aged↗
PubMed2003

Radiation-induced chorioretinal degeneration: a clinicopathological report of three cases.

BACKGROUND: With the shift in radiotherapy toward the posterior segment and with the use of lead screens to shield the anterior segment, posterior segment lesions have become more readily recognized. The purpose of this study is to highlight the effects of ionizing radiation on the choroid and to demonstrate how this can result in visual loss, particularly if the macula is involved. METHODS: Histopathological study of three enucleated eyes of three patients who had received ionizing radiation: a 27-year-old woman who had received radiation as a child for a hemangioma of the left side of the face, a 16-year-old girl who had received radiation at age 11 years for a malignant mesenchymoma of the right maxilla, and a 4-year-old girl who had received radiation at age 1 year for a retinoblastoma of the right eye. RESULTS: Histopathological examination of the three globes showed extensive chorioretinal degeneration, among other ocular findings. In all cases the fellow eye did not show similar chorioretinal lesions. As all three patients were relatively young, the degree of chorioretinal degeneration was considered to be secondary to radiation treatment. INTERPRETATION: Vascular damage from ionizing radiation is not limited to the retina. It can also affect the choroid in the form of chorioretinal degeneration. Since most of the intraocular circulation arises from the uveal vessels, chorioretinal degenerative lesions may be extensive and may even involve the macula.

Adult↗
PubMed2003

Topical mitomycin treatment for primary acquired melanosis of the conjunctiva.

A case of primary acquired melanosis of the conjunctiva primarily treated with topical mitomycin chemotherapy is presented. The patient underwent treatment with one 2-week course of topical mitomycin 0.02% four times daily, followed 4 weeks later by a 2-week course of topical mitomycin 0.04% four times daily, followed by a 3-month course of topical mitomycin 0.02% twice daily. Map biopsies were performed after the initial two courses of mitomycin therapy and 12 months after all courses of mitomycin treatment had been completed. Complete resolution of the conjunctival pigmentation was noted after the final course of treatment. Map biopsies performed at 12 months following completion of treatment showed normal conjunctiva histopathologically. No recurrence of pigmentation was noted in follow-up 26 months after completion of treatment. Topical mitomycin chemotherapy may be a successful primary treatment for primary acquired melanosis of the conjunctiva.

Administration, Topical↗
PubMed2002

Hydroxyapatite and calcium phosphate coatings on aluminium oxide orbital implants.

BACKGROUND: Hydroxyapatite and calcium phosphate have been used as bone graft substitutes as they facilitate and promote tissue ingrowth. We carried out a study to examine uncoated and coated aluminium oxide (alumina) spherical orbital implants and assess whether the coatings influence fibrovascular ingrowth. METHODS: The aluminium oxide spheres (three coated with hydroxyapatite, three coated with calcium metaphosphate and three uncoated) were manufactured at the School of Materials Engineering, Yeungnam University, Kyongsan, Kyongbuk, Korea. The implants were examined macroscopically and with scanning electron microscopy and were analysed chemically by means of x-ray powder diffraction and x-ray fluorescence spectrophotometry. Implantation of three hydroxyapatite-coated, three calcium metaphosphate-coated and three uncoated aluminium oxide spheres was done in nine adult male New Zealand albino rabbits. Implant vascularization was evaluated at 4, 8 and 12 weeks by means of histopathological sectioning. RESULTS: All three types of implant had multiple interconnected pores. The coatings increased the size of the trabeculae from 150 microm to 300 microm. As a result, the pores appeared slightly smaller but still ranged in size from 300 microm to 750 microm, compared to 400 microm to 800 microm in the uncoated implants. The coatings also increased the weight of the implants slightly. The implants were all strong mechanically. They were made up primarily of aluminium oxide. The coated implants contained significant amounts of calcium oxide (a contaminant). There was no clinical difference in the socket response between the three groups. Histopathologically, fibrovascularization occurred uniformly throughout each implant at 4, 8 and 12 weeks after implantation. INTERPRETATION: The hydroxyapatite and calcium metaphosphate coatings did not appear to facilitate or inhibit fibrovascular ingrowth at 4, 8 and 12 weeks. Longer-term studies are need to determine whether the coatings play a role in long-term acceptance and retention of the implants.

Aluminum Oxide↗
PubMed2002

Investigation of a bioresorbable orbital implant.

PURPOSE: To analyze a new bioresorbable orbital implant (open-celled polylactic acid, also known as OPLA). METHODS: The implants were examined macroscopically, with chemical analysis (Fourier transform infrared spectroscopy), and microscopically with scanning electron microscopy. Animal implantation of OPLA implants was carried out in 9 adult male New Zealand albino rabbits. Implant vascularization was evaluated by histopathologic sectioning. RESULTS: The OPLA implant is porous and lightweight but fragile. Histopathologically it stimulated primarily a multinucleated giant cell granulomatous reaction with little fibrovascular ingrowth seen at 4 and 8 weeks. By 20 and 24 weeks, the implant was replaced predominantly by necrotic debris and peripheral giant cells. CONCLUSIONS: The OPLA implant is not an acceptable alternative to other currently available orbital implants.

Absorbable Implants↗
PubMed2002

Accumulation of a black material around some titanium coupling posts.

PURPOSE: To report 5 patients with a black material accumulating in the conjunctiva around the titanium peg and sleeve systems. METHODS: Retrospective small case series. The clinical features of 5 patients were reviewed. Histopathologic analysis was performed on specimens from 3 patients. Neutron activation analysis was performed on 1 sample. RESULTS: Five asymptomatic patients with black material accumulating in the conjunctiva at the conjunctival-titanium peg interface were evaluated. All patients had a hydroxyapatite-coated titanium sleeve with a titanium peg in position. Histopathologic analysis performed on specimens from 3 patients revealed a mixed inflammatory cell infiltrate with focal areas of a black, foreign-appearing material showing birefringence under polarized light that was predominantly intracytoplasmic. This black material did not respond to bleaching, and in 2 patients, it showed positive staining for iron (Perls method). The material from one patient was evaluated by neutron activation analysis and was found to contain titanium, aluminum, and vanadium. In 18 to 48 months of follow-up, the presence of the material did not appear to be associated with any problems. CONCLUSIONS: The presence of a black substance accumulating in the conjunctiva around some titanium coupling posts is uncommon and appears to be without any consequence in 18 to 48 months of follow-up. Our analysis revealed this substance to be consistent with titanium alloy (Ti-6Al-4V).

Adolescent↗