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Biomedical subjects

W Lieb

Publications and source records attributed to W Lieb.

At least 37 records · Page 2Linked to original sources
PubMed1995

Role of octreoscan and correlation with MR imaging in Graves' ophthalmopathy.

Since the identification of somatostatin receptors on lymphocytes, orbital infiltration with mononuclear cells in Graves' ophthalmopathy has provided a rationale for receptor imaging with the radiolabeled somatostatin analog Octreotide. In 40 patients with Graves' ophthalmopathy and 10 controls, 110 MBq indium-Octreotide were administered i.v., and scans were performed at 4 and 24 h after injection. An uptake ratio between the orbits and the brain was determined. In 20 ophthalmophathy patients, magnetic resonance imaging (MRI) of the orbits was performed and the T2 relaxation time was measured within the rectus muscles. Compared to controls (4 h Octreotide uptake: median 6.0 counts/pixel/MBq, orbit/brain ratio 5.6), ophthalmopathy patients showed a 2- to 3-fold increased uptake (15.8 counts/pixel/MBq vs controls p = 0.0032; ratio 12.6, vs controls p = 0.003). When considering patients with active disease only, a higher uptake was registered (16.8 counts/pixel/MBq vs controls p 0.0048, ratio 15.6 vs controls p = 0.0006). Untreated patients showed a markedly higher uptake (23 counts/pixel/MBq) compared to patients receiving steroid therapy (12.6, p = 0.001). MRI of the orbit revealed a correlation between T2 relaxation time of the eye muscles and orbital uptake of Octreotide (p < 0.001).

Adult↗
PubMed1995

Photoreactive flow changes in the posterior cerebral artery in control subjects and patients with occipital lobe infarction.

BACKGROUND AND PURPOSE: Photoreactive flow changes of the posterior cerebral artery (PCA) in control subjects and patients with unilateral occipital lobe infarction were investigated to study the hypothesis that occipital lobe infarction of varying extent leads to a reduced visually activated flow increase in the ipsilateral PCA. METHODS: Maximum mean flow velocity (MFV) of the PCA was investigated by transcranial Doppler sonography after photic stimulation of the retina. RESULTS: In 25 control subjects MFV was increased by 30.6 +/- 9.7%. In 13 patients with unilateral occipital lobe infarction the ipsilateral MFV increase was significantly lower than in control subjects. Nine patients with homonymous hemianopsia showed an ipsilateral MFV increase of 3.4 +/- 4.1% (P < .001) and four patients with incomplete occipital lobe infarction and homonymous quadrantanopsia had an MFV increase of 16.0 +/- 12.8% (P < .05). CONCLUSIONS: We conclude that photoreactive flow changes of the PCA represent a noninvasive and reliable measure of functional impairment due to occipital infarction.

Blood Flow Velocity↗
PubMed1995

[The Müller-ectomy in endocrine orbitopathy].

Thyroid ophthalmopathy frequently causes significant upper- and lower-eyelid retraction. This is not only cosmetically disfiguring, but also causes the cornea to be exposed so that a lid-correcting procedure becomes necessary. We used the Mueller ectomy technique with mechanical disinsertion of the levator muscle of the upper eyelid, as described by Putterman et al. in 1972, and operated on ten patients with thyroid ophthalmopathy. By means of the Mueller ectomy and mechanical disinsertion of the levator muscle of the upper eyelid, the eyelid was lowered by 5.0 mm compared with the preoperative findings (measured as the distance between the edge of the upper eyelid and the center of the pupil). In 3 cases the postoperative result was a temporal upper eyelid flare that required operative correction in one case; in one case a ptosis resulted postoperatively. Transconjunctival Mueller ectomy with mechanical disinsertion of the levator muscle of the upper eyelid gives good cosmetic and functional results in patients with significant upper-eyelid retraction. The transconjunctival approach avoids external scar formation and leaves the external lid structures intact so that a revision can be performed by an external lid incision.

Adult↗
PubMed1994

Pterional/Lateral approach to orbital tumors.

The purpose of this article is to detail our experience with an approach to primary pathologic conditions involving the orbit. In 27 patients these included tumors of the lacrimal gland, lymphangiomas, neurinomas, meningiomas, and various cysts of the orbit. Access to these lesions was gained by a lateral pterional approach with osteoclastic or osteoplastic removal of the lateral bony wall/roof of the orbit, and by entering adnexal contents following elevation of the lateral rectus muscle. This approach allowed for complete tumor removal in all patients. The specifics of this approach will be discussed and associated orbital complications will be detailed.

Journal Article↗
PubMed1994

[Color duplex ultrasound findings in patients with endocrine orbitopathy].

UNLABELLED: Color Doppler imaging makes it possible for the first time to assess the blood flow velocity of orbital vessels. Especially in Graves disease, with its increase of orbital contents, this technique allows detection of changes in the perfusion of retrobulbar arteries and veins. We examined 23 patients (19 female, 4 male, average age 47.9 years) with thyroid ophthalmopathy using color Doppler imaging. Central retinal artery and vein, posterior ciliary arteries, vortex veins, superior orbital vein and ophthalmic artery were located and their Doppler spectra analysed. Results were compared with observations recorded in a control group consisting of 105 healthy volunteers. The thicknesses of extraocular muscles were measured echographically. RESULTS: There was no significant difference in blood flow velocity in central retinal artery and vein, posterior ciliary arteries and vortex veins between patients with Graves disease and the control group. The maximal blood flow velocity in superior orbital vein was significantly decreased (P = 0.01 on right eye, P = 0.04 on left eye). There was a slight correlation between reduced venous outflow in the superior orbital vein and the severity of the disease (r = 0.52 on right eye, r = 0.5 on left eye). CONCLUSION: Color Doppler imaging is a new, noninvasive technique that could be used to examine patients with thyroid ophthalmopathy. Reduced venous outflow may contribute to exophthalmus by creating perivenous edema and consequent swelling of orbital fat.

Adult↗
PubMed1993

Optic nerve sheath decompression may improve blood flow in anterior ischemic optic neuropathy.

PURPOSE: The purposes of this study are to evaluate the retrobulbar circulation in progressive nonarteritic ischemic optic neuropathy (NAION) and to assess changes in blood flow after optic nerve sheath decompression (ONSD). METHODS: Twenty-five patients with progressive NAION were studied using color Doppler imaging (CDI) before and after ONSD. Blood flow velocities and vascular resistance were calculated for the ophthalmic artery, central retinal artery, and posterior ciliary arteries in each eye. Contralateral eyes served as the control group. RESULTS: Preoperatively, the study group demonstrated significantly lower blood flow velocities in the central retinal artery (P < 0.002) and posterior ciliary arteries (P < 0.02) when compared with the contralateral control group. Postoperatively, there was a significant increase in blood flow velocity in the ophthalmic artery (P < 0.04) and the central retinal artery (P < 0.05) as well as a significant decrease in vascular resistance in the posterior ciliary arteries (P < 0.02) in the study group. There were no significant changes in blood flow velocity or vascular resistance in the contralateral control group. Long-term follow-up on eight patients suggests a persistence of this trend. Seventeen of the 25 operated eyes demonstrated a postoperative improvement in visual function, defined as a gain of two lines or more in Snellen visual acuity or at least 20 degrees of visual field expansion. CONCLUSIONS: These data demonstrate that eyes with acute NAION have impaired blood flow when compared with the contralateral control group. Furthermore, they suggest that ONSD may improve blood flow to the ischemic optic nerve halting the progression of visual loss and in some cases improving visual function.

Adult↗
PubMed1993

[Color duplex ultrasound measurement of lymph node perfusion: a contribution to diagnosis of cervical metastasis].

The objective of this study was to find additional sonomorphological criteria for determining the status of enlarged lymph nodes. By using colour-coded duplex sonography the perfusion of 63 lymph nodes in the neck was analysed. The status was confirmed either histologically or clinically (29 metastases from squamous cell carcinomas and 34 acute or chronic inflammatory nodal diseases). A quantitative evaluation of the pulsatility measured in 51 lymph nodes by computing the Pourcelot-Ratio and the Mean Pulsatility Index yielded significant differences between the two groups. By definition of a limiting value of the Pourcelot-Ratio (0.75) for the prediction of benignity, the specificity and the accuracy in screening for metastases were improved as compared to clinical examination and B-mode sonography. Additional criteria of dignity were found by qualitative evaluation of nodal perfusion patterns (presence and distribution of perfusion, partial loss of perfusion). The use of colour-coded duplex sonography in nodal disease of the neck provides an improvement of early and noninvasive diagnosis of regional metastatic involvement.

Blood Flow Velocity↗
PubMed1990

Microphthalmos with colobomatous orbital cyst: clinical, histological, immunohistological, and electronmicroscopic findings.

A case of unilateral microphthalmos with orbital cyst is presented. This rare and severe malformation is a non-hereditary disorder. Pathologically it represents a failure in the closure of the embryonic fissure at the 7-14 mm stage of gestation. Staining for neurofilaments permitted the identification of rudimentary optic nerve fibers within the gliomatous cyst wall. Special stains for glial fibrillary acidic protein as well as scanning and transmission electron microscopy were used to characterise the neuroglial cell lining of the cyst wall, and to show microvilli on its inner surface.

Coloboma↗
PubMed1990

Ciamexone in endocrine orbitopathy. A randomized double-blind, placebo-controlled study.

The influence of ciamexone on the activity and course of endocrine orbitopathy was investigated. Fifty-one patients with active orbitopathy classes II-VI were allocated randomly to two groups: over a period of six months, 26 patients received 300 mg/day ciamexone and 25 patients received placebo tablets. In both groups, prednisolone was administered in addition in the first four weeks. Ophthalmological investigations and clinical tests as well as orbit sonography were carried out before as well as one, three and six months after the beginning of therapy. Before and after treatment, computer tomography of the orbit was performed. Symptoms and signs did not show any significant improvement one and six months after therapy. No differences between the two therapy groups were observed. Detailed examination did not reveal any preferential action of the product on individual parameters. Sonography and computer tomography showed no significant alterations of the thickness of the oculomotor muscles. Thus administration of 300 mg ciamexone once a day as compared with placebo did not show any effect on the course and activity of endocrine orbitopathy.

Adjuvants, Immunologic↗
PubMed1989

[Ultrasound microscopy findings of artificial lenses].

Acoustic microscopy permits a native, nondestructive and artefact-free analysis of the surface of intraocular lenses with regard to manufacturing defects, biologic cellular and membranaceous layers, and signs of degradation. Furthermore, it enables structures below the surface to be evaluated, so that inclusions, pores, microcracks and zones of deformation can be detected. In addition to performance of a one-dimensional, relative intensity profile of the surface and the corresponding pseudo-3D image, the properties of the materials inside the intraocular lens can be characterized by computerized analysis of the reflected ultrasound energy.

Computer Graphics↗
PubMed1989

Tumoral calcinosis: seasonal biochemical studies and chemical studies of eyelid lesion.

We recently described (Arch Ophthalmol 1988; 106:725-6) the presence of unique calcific lesions in the eyelids of a young woman with a history of hyperphosphatemic tumoral calcinosis. Here we document that no immediate family members showed similar lesions and that none was hyperphosphatemic. Dental roentgenography revealed characteristic abnormalities in the patient that confirmed the clinical diagnosis of tumoral calcinosis. Seasonal biochemical studies demonstrated persistently increased concentrations of phosphorus and 1,25-dihydroxyvitamin D in her serum. A calcific eyelid excrescence removed from the patient, studied by x-ray diffraction, was found to consist of crystals of hydroxyapatite. Microprobe analysis indicated the major elements in the deposit to be Ca, P, S, and Cl, just as in the periarticular deposits found in tumoral calcinosis. The Ca concentration in the patient's tear fluid, measured by atomic absorption spectrometry, was within the range found in tears of healthy volunteers. Phosphorus was undetectable (less than 30 mumol/L) in tears of the patient and the volunteers. These findings suggest that the eyelid lesions represent a new manifestation of the pathological process that produces the characteristic periarticular calcific masses of tumoral calcinosis.

Adolescent↗
PubMed1989

Current treatment of retinoblastoma.

Based on personal experience with 324 children with retinoblastoma who were managed on the Ocular Oncology Service at Wills Eye Hospital between 1974 and 1988, the authors review their current management of this tumor, emphasize common misconceptions in management, and describe the recent research related to the genetics of retinoblastoma. It is pointed out that the optic nerve should not be clamped at the time of enucleation. Photocoagulation should only be used to treat small tumors strictly confined to the retina and it is contraindicated if there is vitreal or choroidal invasion. The tumor should not be directly photocoagulated but rather surrounded by photocoagulation to destroy its blood supply. Cryotherapy should generally be applied to small peripheral tumors and should not be attempted if there is evidence of vitreous seeding of the tumor. External beam irradiation should employ an anterior as well as a lateral portal. Carefully selected radioactive plaque therapy, when it can be used, has distinct advantages over external beam radiotherapy.

Eye Neoplasms↗
PubMed1987

Sonography and computed tomography in the diagnosis of orbitocranial malformations and tumors.

Standardized sonography and CT scanning have distinct advantages and disadvantages in the evaluation of patients with orbital diseases. Echography provides an efficient screening examination in patients presenting with signs and symptoms of orbital pathology. It allows the detection, localization, measurement and in almost 80% differentiation of orbital lesions. High resolution CT scanning gives an excellent topographic display of masses in the orbit. In visualization of intracranial causes of orbital processes and demonstration of changes in the posterior third of the orbit, in the orbital bones and the periorbital sinuses it is superior to ultrasonography.

Bone Diseases, Developmental↗