Biomedical subjects

Z Currie

Publications and source records attributed to Z Currie.

5 recordsLinked to original sources

PubMed2006

Adult xanthogranulomatous disease of the orbit and ocular adnexa: new immunohistochemical findings and clinical review.

BACKGROUND/AIMS: Adult xanthogranulomatous disease involving the ocular tissues is rare and poorly understood. Adult onset xanthogranuloma (AOX), adult onset asthma and periocular xanthogranuloma (AAPOX), necrobiotic xanthogranuloma (NBX), and Erdheim-Chester disease (ECD) are the four syndromes within this disorder, which is diagnosed by characteristic histopathology. Experience with eight cases prompted a multi-institutional effort to study the histopathology, immunohistochemistry, clinical findings, and systemic associations in this disorder. METHODS: 22 cases, including histopathological slides, were compiled. Published reports were identified by an English language Medline search (1966-2005) and review of reference citations. Each case in this series and the literature was classified as one of four syndromes and then analysed for age onset, sex, skin xanthoma, orbital location, immune dysfunction, internal organ and bone lesions, treatment, and outcome. The histopathology in each of these cases was reviewed by two pathologists. Immunhistochemical stains (CD3, CD4, CD8, L26) were performed in 14 cases where unstained slides were available. RESULTS: 137 cases were compiled. There was no sex or age difference between syndromes. AOX, AAPOX, NBX affect the anterior orbit, ECD tends to be diffuse and intraconal. Skin lesions are found in all the syndromes. Immune dysfunction was noted in all cases of AAPOX and NBX; 11% of NBX and all ECD patients had internal organ disease. Treatment included surgery, corticosteroids, other chemotherapeutic agents, radiotherapy, and combinations of these. No AOX or AAPOX deaths occurred; 66% of ECD patients died. All 22 cases had xanthoma cells; most had Touton giant cells. Lymphocytes were present in all cases and occurred as aggregates (mostly in AAPOX) or diffuse populations mixed with fibroblasts (mostly in ECD). Immunohistochemistry revealed the majority of these to be CD8+. Necrosis was most marked in NBX. CONCLUSION: Adult xanthogranuloma of the orbit is rare, making prospective evaluation or meta-analysis impossible. The best treatment is unknown but seems to be with multiagent chemotherapy guided by histopathological, immunohistochemical, and systemic findings.

Adolescent↗

PubMed2006

Ageing changes in the eye.

Ageing changes occur in all the structures of the eye causing varied effects. This article attempts to review the parameters of what is considered within the "normal limits" of ageing so as to be able to distinguish those conditions from true disease processes. Improving understanding of the ageing changes will help understand some of the problems that the ageing population faces.

Aging↗

PubMed2004

Ophthalmic management of facial nerve palsy.

The ophthalmologist plays a pivotal role in the evaluation and rehabilitation of patients with facial nerve palsy. It is crucial to recognize and treat the potentially life-threatening underlying causes. The immediate ophthalmic priority is to ensure adequate corneal protection. The medium to long-term management consists of treatment of epiphora, hyperkinetic disorders secondary to aberrant regeneration and poor cosmesis. Patients should be appropriately referred for general facial re-animation. This review aims to provide a guide to the management of this complex condition.

Esthetics↗

PubMed2000

Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire.

OBJECTIVES: To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving. DESIGN: Prospective study of patients and postal questionnaire to healthcare professionals. SUBJECTS: 50 patients with 6/9 vision and 50 with 6/12 vision and 100 general practitioners, 100 optometrists or opticians, and 100 ophthalmologists. SETTING: Ophthalmology outpatient clinics in Sheffield. MAIN OUTCOME MEASURES: Ability to read a number plate at 20.5 m and health professionals' advice about driving on the basis of visual acuity. RESULTS: 26% of patients with 6/9 vision failed the number plate test, and 34% with 6/12 vision passed it. Of the general practitioners advising patients with 6/9 vision, 76% said the patients could drive, 13% said they should not drive, and 11% were unsure. Of the general practitioners advising patients with 6/12 vision, 21% said the patients could drive, 54% said they should not drive, and 25% were unsure. The level of acuity at which optometrists, opticians, and ophthalmologists would advise drivers against driving ranged from 6/9(-2) (ability to read all except two letters on the 6/9 line of the Snellen chart) to less than 6/18. CONCLUSIONS: Snellen acuity is a poor predictor of an individual's ability to meet the required visual standard for driving. Patients with 6/9 vision or less should be warned that they may fail to meet this standard, but those with 6/12 vision should not be assumed to be below the standard.

Automobile Driving↗

PubMed1999

The correlation between cell surface markers and clinical features in choroidal malignant melanomas.

PURPOSE: Uveal melanoma continues to present problems when attempting to predict disease progression. This study attempts to identify markers indicative of the biological characteristics of cells isolated from samples of uveal melanoma, including adhesion (ICAM-1), immune reactivity (MHC Class I and II), cell cycle control (c-erbB-2, c-myc) and apoptosis control (bcl-2, p53) using dual parameter (DNA/MoAb) flow cytometry. METHODS: Sixty-three fresh tissue samples from choroidal melanomas were taken at enucleation. Samples were assayed for DNA content and cell cycle, the above antibodies together with positive (PHM-5) and negative (2 degrees FITC Ab) controls. The clinical parameters sex, age, tumour location, cell type, tumour volume and presence of metastases were compared with the results and analysed with the non-parametric Mann-Whitney U-t-test. RESULTS: ICAM-1 expression proved to be the most clinically relevant, being present on a higher proportion of cells in tumours > 2000 mm3 (median 38, n = 19) compared with the smaller tumours < 2000 mm3 (median 17, n = 26) (p = 0.0015). Metastatic disease was present in 11 patients and did not correlate with any of the surface markers. C-myc, c-erbB-2 and MHC Class II expression were associated with cell type, all showing greater expression in spindle cell tumours than mixed/epithelial types. CONCLUSION: These results show flow cytometry as a quick, easy method to provide a 'phenotypic profile' for these tumours, and identifies cell cycle control and adhesion molecule expression as important areas for further investigation. c-erbB-2 and bcl-2 positivity was typically seen on over 60% cells in each sample, indicating two potential targets for therapeutic intervention.

Adult↗