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Biomedical subjects

W T Green

Publications and source records attributed to W T Green.

At least 19 recordsLinked to original sources
PubMed1997

Intercellular adhesion molecule-1 in proliferative vitreoretinopathy.

PURPOSE: To measure vitreous levels of the soluble intercellular adhesion molecule (sICAM-1) in eyes with rhegmatogenous retinal detachment (RRD) complicated or uncomplicated by proliferative vitreoretinopathy (PVR) to investigate whether levels of this molecule related to history of previous retinal surgery or to the duration and severity of PVR. METHODS: The authors measured vitreous sICAM-1 by enzyme-linked immunosorbent assay in 28 eyes with PVR and 35 eyes with uncomplicated RRD. Vitreous from 10 eyes with macular holes and from 12 cadaveric eye donors were used as control specimens. RESULTS: Vitreous sICAM-1 levels were higher in the group with RRD complicated by PVR as a whole than in the group with RRD alone or in the control groups. In patients with no previous retinal surgery, there was no difference in vitreous sICAM-1 levels between the groups with RRD alone and RRD complicated by PVR. However, in patients who had undergone previous external surgery, those with PVR showed higher levels of vitreous sICAM-1 than those with RRD alone. In PVR, raised levels of sICAM-1 were associated preferentially with a history of previous vitrectomy as well as with a longer duration of the condition, although these levels were not related to the grade of PVR. In eyes with RRD alone, the levels of sICAM-1 were not enhanced with the duration of the detachment. Despite showing high vitreous levels of sICAM-1, patients with PVR did not exhibit increased serum levels of this adhesion molecule. CONCLUSIONS: The current observations suggest that those persons in whom PVR develops may have an impairment of the mechanisms that control the inflammatory response to retinal trauma. Persistently raised vitreous levels of sICAM-1 point to the continued operation of cytokine-mediated vascular reactions at the blood-retinal barrier.

Enzyme-Linked Immunosorbent Assay↗
PubMed1995

Comparison of pars plana vitrectomy and scleral buckling for uncomplicated rhegmatogenous retinal detachment.

Retinal detachment surgery can now achieve a final reattachment rate in over 90% of cases. The operation of choice in most cases is that of external scleral buckling with or without drainage of subretinal fluid. However, in a minority of cases these techniques are difficult to apply either when the breaks are unseen due to media opacities or when the breaks are complex, eg, posterior, large, or multiple breaks at different distances from the ora. Improvements in the technique of pars plana vitrectomy for retinal detachment now offers us an alternative method for treating these difficult cases. Pars plana vitrectomy for retinal detachments with unseen or complex breaks has a final attachment rate of over 90%, is technically easier to perform than conventional surgery, and avoids the refractive and ocular motility problems associated with complicated buckles. For these reasons and despite the high risk of nuclear sclerosis in phakic eyes, a pars plana vitrectomy may be the preferred option in selected cases of primary retinal detachment.

Humans↗
PubMed1994

Mucosal-associated lymphoid tissue lymphoma of the conjunctiva.

The recognition of mucosal-associated lymphoid tissue as a distinct entity has lead to the separate classification of tumors arising in this tissue, ie, the mucosal-associated lymphoid tissue lymphoma. Five patients with mucosal-associated lymphoid tissue lymphoma of the conjunctiva are described herein; four of the five patients had bilateral tumors. Laboratory analysis was done using microscopy, immunophenotyping, gene rearrangement analysis using both Southern blot and polymerase chain reaction techniques, and oncogene (bcl-1, bcl-2, and c-myc) rearrangement studies. Typical mucosal-associated lymphoid tissue lymphoma features were seen in all patients; three of four patients who underwent testing with immunphenotyping had light-chain restriction, four of five patients had a clone detected using Southern blot analysis, and all five patients showed clones on polymerase chain reaction analysis. No patient demonstrated oncogene rearrangement. In all patients, complete physical examinations and laboratory tests did not detect any evidence of systemic spread. After treatment, no evidence of local recurrence or dissemination was found during follow-up ranging from 2 to 3 years.

Adult↗
PubMed1994

Corneal complications of cataract surgery.

Developments in cataract surgery have stimulated a greater interest in minimizing unwanted effects of cataract surgery on the cornea. The two main areas of concern are protection of the corneal endothelium and minimizing distortion of the anterior corneal surface. Endothelial cell loss is of particular importance where there is a preexisting significantly low cell count due to ocular trauma, surgery, or dystrophy, and in situations where cataract extraction is combined with other procedures that may be prolonged or require extensive manipulation. Recent availability of heavier molecular-weight viscoelastic substances are expected to help in minimizing endothelial cell trauma in these situations. In terms of postoperative corneal astigmatism the emphasis has changed for those who are regularly performing phacoemulsification from minimizing surgically induced astigmatism to planning the procedure so that it incorporates a correction of preexisting astigmatism. This emphasis may be more significant in cases of previous anterior segment surgery or trauma.

Astigmatism↗
PubMed1994

Optic nerve sheath decompression for the treatment of visual failure in chronic raised intracranial pressure.

The records of all patients undergoing optic nerve sheath decompression for visual failure in chronic raised intracranial pressure performed over a 15 year period have been reviewed. The aim was to study the visual outcome and relation to any shunting procedures. Fourteen patients (20 eyes) were identified in whom follow up information of at least one year was available. Eleven patients had benign intracranial hypertension (idiopathic intracranial hypertension) and three had dural venous sinus occlusive disease. Eight patients had unilateral surgery and six had bilateral surgery. Visual acuity and fields either improved or stabilised in 17 out of 20 eyes and three deteriorated. Of the eight patients undergoing unilateral surgery, the other eye remained stable in seven and deteriorated in one. Four patients required optic nerve sheath decompression despite previous shunting or subtemporal decompression. Five patients required shunts or subtemporal decompression after optic nerve sheath decompression because of persistent headache in three cases and for uncontrolled visual failure in two cases. No patients lost vision as a direct consequence of surgery. It is concluded that optic nerve sheath decompression is a safe and important therapeutic option in the management of chronic raised intracranial pressure complicated by visual loss. Vision can be saved after shunt failure, and in other cases may be maintained without the need for a shunt. Shunts may still be required, however, after optic nerve sheath decompression, especially for persistent headache.

Adult↗
PubMed1992

Late onset Leber's optic neuropathy: a case confused with ischaemic optic neuropathy.

A case is reported of a 63-year-old man with progressive central visual loss in one eye followed 11 months later by involvement of the fellow eye. A diagnosis of chronic ischaemic optic neuropathy was considered. However, despite a negative family history, the absence of electrocardiographic abnormalities, and minimal fundus changes a diagnosis of Leber's optic neuropathy was made on the basis of magnetic resonance imaging findings and the mitochondrial DNA mutation at base pair 11778.

DNA, Mitochondrial↗
PubMed1989

How clean is your capsule?

Proliferation of residual lens epithelial cell is believed to be the major cause of posterior capsule opacification following extracapsular cataract extraction. During surgery these cells can be visualised with appropriate illumination facilitating their mechanical removal with the McIntyre cannula. When flat preparations of the anterior capsule are examined by light microscopy, the areas 'cleaned' of cells in this way appear transparent but scanning electron microscopy reveals tufts of remaining debris which may represent points of cellular attachment to the capsule. Control of lens epithelial cell proliferation is important for the future development of cataract surgery.

Cataract↗
PubMed1981

Freeze-dried fascia lata allografts: a review of 47 cases.

Fascia lata used to connect bony structures can provide stability while maintaining mobility. Experience with reconstituted freeze-dried allogeneic fascia used in 56 patients was reviewed, including ankle, hip, and shoulder suspensions, plus ligament and tendon repairs. Follow-up was available in 47 patients with 51 fascial grafts whose ages ranged from 2 to 58 years (mean, 19.2 years). Follow-up ranged from 6 months to 16 years with a mean of 7.2 years. Results were good in 72%, fair in 20%, and poor in 8%. Allograft fascia did not stretch out with time in these cases. Preserved fascia can provide satisfactory clinical results, thus eliminating the need for collecting autogenous fascia.

Adolescent↗
PubMed1979

Congenital radio-ulnar synostosis: surgical treatment.

The results of an operative approach to the problem of radio-ulnar synostosis were assessed in thirteen patients, ten to twenty-five and one-half years after the procedure was performed. We concluded that in a patient with bilateral synostosis one hand, the one not used in writing, should be shifted to a position of 20 to 35 degrees of supination. With one hand in this position, the other may be left in considerable pronation. Often after such a shift it is not necessary to rotate the second arm. However, if the pronation is marked in the second forearm, and if function is impaired unduly by this position, surgical correction is indicated. The arm should be placed in a position of 30 to 45 degrees of pronation. In unilateral radio-unlar synostosis, the ordinarily ideal position of the radius is between 10 and 20 degrees of supination. In an adult, the patient's occupation should be considered in deciding on the rotatory positions of the forearms. We usually prefer a method of transverse osteotomy through the conjoined mass of the radius and ulna. Careful observation of the effect on the vascular status of the limb during and immediately after surgery is important.

Adolescent↗
PubMed1977

Articular cartilage repair. Behavior of rabbit chondrocytes during tissue culture and subsequent allografting.

Chondrocytes from rabbit articular cartilage were freed from their matrix by enzymatic digestion. Under appropriate conditions of culture, these cells proliferated through many generations while maintaining their chondrocytic differentiation. They produced a cartilage-like matrix which was studied by histologic, electron microscopic, and chemical techniques. Chondroid tissue from subculture on decalcified bone, allografted into the rabbit knee, repaired a large articular defect in 10 days.

Animals↗
PubMed1976

Orthopedic overview of juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis can be classified into three forms by the extent of early involvement: (1) pauciarticular, (2) polyarticular, and (3) systemic. When this disease, in which remission is common, is properly diagnosed and appropriately treated by physical therapy, occupational therapy, drug therapy, and surgical treatment, a good clinical result can usually be expected. Only 16 of 124 children had severe persistent impairment because of the disease in one recent study;18 this number may be high, since mild cases may be unrecognized or not be referred to the study clinic. However, efforts should be directed to reducing this number of severely impaired children -- in the short run by better techniques of reconstructive surgery and in the long run by a better understanding, through research into the etiology and pathogenesis of the disease adequate to prevent or significantly alter its course. The disease may be caused by a treatable occult infective agent and may respond to an approach similar to that for rheumatic fever, which no longer fills the wards of our children's hospitals as it once did.

Adolescent↗