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Biomedical subjects

T D France

Publications and source records attributed to T D France.

At least 19 recordsLinked to original sources
PubMed1988

Paradoxic pupillary phenomena. A review of patients with pupillary constriction to darkness.

The presence of pupillary constriction to darkness is said to be a useful indicator of retinal disease. However, it is also associated with optic nerve disease. The phenomenon has been reported in patients with congenital stationary nightblindness, congenital achromatopsia, bilateral optic neuritis, and dominant optic atrophy. We have observed this response in additional disorders, including anomalies of the optic nerve development, congenital nystagmus, and a variety of diseases affecting the retina. Notably, four of our patients with strabismus and amblyopia, but without apparent retinal or optic nerve disease, have also demonstrated this paradoxic pupil response. While the mechanism for pupillary constriction to darkness remains unclear, the finding of this response in patients without retinal or optic nerve abnormalities questions its value as a localizing sign.

Child, Preschool↗
PubMed1988

Low-contrast visual acuity cards in pediatric ophthalmology.

The usual high-contrast visual acuity chart is well known as the best indicator of central visual function. It has the limitation of only testing the high frequency, high-contrast sensitive cells in the visual system. Some conditions demonstrate a normal response on the standard visual acuity test, but abnormal results when testing visual fields or contrast-sensitivity function (CSF). A variety of diseases fall into this category (multiple sclerosis, diabetes mellitis, glaucoma, CNS tumors in the visual system, etc). The testing of CSF permits us not only to vary the size of the target (spatial frequency), but also to determine the contrast of the target first visible to the patient. Due to the time necessary to conduct the test and the important challenge of obtaining consistent subjective responses, contrast-sensitivity testing in children has been difficult. Recently, Regan has developed low-contrast visual acuity cards similar in format to those used in the Sheridan Gardiner test. Although they do not require literacy, correct responses can be immediately verified and the test can be carried out within a short period of time. These cards allow testing well within the child's limited attention span. In the future it may be possible to use this method of testing to detect CSF defects in amblyopia similar to those previously reported by Hess and others and to see how these defects are affected by standard treatment.

Age Factors↗
PubMed1988

Ocular findings in CHARGE syndrome. Six case reports and a review.

CHARGE syndrome is a group of nonrandomly occurring congenital anomalies which may present to the ophthalmologist, because coloboma is one of the major findings. In a series of 54 patients with ocular colobomata, 6 (11%) were found to meet the criteria for CHARGE syndrome. The mnemonic CHARGE stands for the major features of this syndrome: Coloboma, Heart defects, Atresia of the choanae, Retarded growth and development, Genital hypoplasia, and Ear anomalies and/or hearing loss. No specific etiology is known, but autosomal dominant, autosomal recessive, and X-linked recessive forms have been suggested by familial reports. The authors describe six patients with CHARGE syndrome, including the second reported case occurring in monozygotic twins. Other syndromes, chromosomal defects, and effects of teratogens may have similar clinical presentations. Though our prevalence may be skewed by our referral setting, the frequency of occurrence of this syndrome is certainly high enough that ophthalmologists should be familiar with it. Evaluation for associated defects should be carried out and referral for genetic evaluation undertaken when appropriate.

Abnormalities, Multiple↗
PubMed1988

Growth factor receptors and oncogene expression in prostate cells.

Specimens of benign prostatic hypertrophy (BPH) and prostate carcinoma and prostate cells in culture were assessed for their capacity to bind androgens, radioiodinated EGF, and IGF-I, and to express certain cellular protooncogenes. Prostate cell lines contained receptors for both EGF and IGF-I. Similarly, clinical samples of human diseased prostate contained receptors for both of these factors. Prostate carcinoma contained higher concentrations of EGF receptors based on DNA than did BPH, although it is accepted that BPH may not be the appropriate comparison for carcinoma. Increased EGF receptors were associated circumstantially with a decline in androgen receptors with deteriorating differentiation status and with an increase in expression of c-myc. Androgen receptor concentration correlated with increased expression of c-fos. Deteriorating differentiation status was associated with the appearance or increase in secondary sites with lower affinity for IGF-I. Whereas c-myc expression was increased in all grades of carcinoma compared to BPH, expression of c-H-ras accompanied loss of differentiation. Although those alterations are hindered by tissue heterogeneity and correlations are essentially circumstantial, they may provide clues to the progression of prostate cancer that can be validated in prostate cell lines with similar growth response capabilities.

Animals↗
PubMed1987

Persistent accommodative spasm nine years after head trauma.

Spasm of the near reflex is most often seen on a functional basis in young adults with underlying emotional problems. In particular, when convergence spasm is associated with miosis on attempted lateral gaze, a functional basis for the disorder should be suspected. Patients who experience spasm of the near reflex following trauma commonly follow a benign course with spontaneous resolution of their ocular complaints within 1-2 years. Accommodative spasm, manifested by pseudomyopia, or spasm of convergence, alone, or in combination with miosis, may be found as isolated signs of spasm of the near reflex. We report a patient who continues to demonstrate accommodative spasm 9 years after a motor vehicle accident.

Accommodation, Ocular↗
PubMed1985

The ocular features of Down's syndrome.

A combined prospective and retrospective study of patients with Down's syndrome showed that these patients have narrowed and slanted palpebral fissures but that the fissures are of normal height. Patients with Down's syndrome also had increased prevalences (compared with control subjects) of blepharitis (23 of 53 patients or 46%), strabismus (23 of 53 patients or 43%), nystagmus (five of 53 patients or 9%), light-colored and spotted irides (46 of 53 patients or 87% and 43 of 53 patients or 81%, respectively), keratoconus (eight of 53 patients or 15%), cataracts (seven of 53 patients or 13%), severe myopia (13 of 48 patients or 27%), and astigmatism of more than 3 diopters (12 of 48 patients or 25%).

Adolescent↗
PubMed1985

The pattern evoked electroretinogram: its variability in normals and its relationship to amblyopia.

Electroretinograms evoked by pattern stimuli (contrast reversing gratings) were measured under steady state conditions in the normal and amblyopic eyes of 14 amblyopic individuals having Snellen acuities in the range 20/100 to 20/600. These ERGs were measured as a function of spatial frequency, and compared with the psychophysical threshold losses to the same stimuli. In all cases the authors compared the normal and fellow amblyopic eye's response while taking into account the variability of right-left eye comparisons of normal individuals for these psychophysical and electrophysiological tests. When factors such as optical focus, fixation alignment, and fixation stability have been individually optimized, no pattern ERG deficit was observed in a spatial frequency range where there were obvious psychophysical deficits to the same stimuli. Our results do not substantiate previous claims of a pattern ERG anomaly in many severely amblyopic eyes.

Adolescent↗
PubMed1982

Silicone intubation for obstruction of the nasolacrimal duct in children.

We performed 63 intubations with silicone tubing for nasolacrimal duct obstruction in children in whom nasolacrimal duct probings had failed. Fifty-nine (93.7%) obstructions were congenital and four (6.3%) were acquired. The average length of intubation was 4.3 months. The final results for both congenital and acquired obstructions combined were good in 52 cases (82.5%), fair in three (4.8%), and poor in eight (12.7%). Complications, with the exception of some with infection, were easily treated or minimal and did not affect the outcome significantly. We recommend silicone intubation as the procedure of choice for congenital or acquired nasolacrimal duct obstructions in children after failure of medical therapy and nasolacrimal duct probings.

Child, Preschool↗
PubMed1981

Residual vision in humans who have been monocularly deprived of pattern stimulation in early life.

Spatio-temporal sensitivity at and above threshold was investigated in a group of patients who exhibited visual loss secondary to uniocular congenital cataract which was present within the first year of life and later removed. The results fall into two general categories depending upon the severity of the visual loss and in particular upon the nature of the temporal loss. In the group exhibiting less severe amblyopia, contrast sensitivity for high and medium spatial frequencies was attenuated to a similar extent for all temporal frequencies. In the group exhibiting more severe amblyopia no form vision a was present; only temporal perception remained. In these cases a greater loss of flicker threshold sensitivity occurred at higher temporal frequencies. Supra-threshold tests revealed that movement perception was effectively normal in both of these groups. These results demonstrate that stimulus deprivation amblyopia, while different in some respects from anisometropic amblyopia is more similar to that condition than to strabismic amblyopia Previous animal results derived from monocular lid suture in cat and monkey are compared with these findings.

Adolescent↗
PubMed1980

Succinylcholine alteration of the forced duction test.

Prior to strabismus surgery, succinylcholine produces a sustained contraction of the extraocular muscles that interferes with an accurate interpretation of the forced duction test (FDT) for up to 20 minutes. Pancuronium, a nondepolarizing muscle relaxant, does not alter the FDT. Suggestions are given for management of anesthetic induction with or without muscle relaxants to facilitate intubation.

Adolescent↗
PubMed1979

Clinical applications of a computer-assisted eye model.

A computer-assisted mathematical model of ocular movement has been developed. The model is binocular in operation and allows variation of multiple parameters including: muscle insertions, innervations, length and contractures as well as passive tissue forces. The model can be used in interpretation of clinical findings, such as fourth nerve palsies with contracture of the antagonist inferior oblique.

Adult↗
PubMed1978

Electrophysiological responses in hydranencephaly.

We recorded electrophysiological responses, both electroretinograms (ERGs) and visual evoked responses (VER), at 4 and 21 months of age in a child with hydranencephaly. As expected, the ERG was normal. Despite the apparent absence of most of the cerebral cortex, a VER was present at both visits. The child's visual performance definitely improved both subjectively and electrophysiologically. The VER contained multiple early components in contrast to previous reports, where only a slow, monophasic response was detected.

Anencephaly↗
PubMed1978

Clinical and extraneural histologic diagnosis of neuronal ceroidlipofuscinosis.

Neuronal ceroid-lipofuscinosis is manifested by visual and intellectual deterioration and seizures. Autofluorescent lipopigments are found in neural and many nonneural tissues, with characteristic staining and ultrastructural properties. Presumptive diagnosis can usually be made on the basis of history, physical examination, and electrodiagnostic tests, but in the absence of a specific biochemical defect, histologic confirmation is essential. A 6-year-old boy with the clinical appearance of the juvenile form of the disease had sea-blue histiocytes in the bone marrow, and curvilinear profiles in ultrastructural inclusions in skin biopsy tissue, cultured skin fibroblasts, and bone marrow cells.

Ceroid↗