ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe essence of the doctor-patient interaction is that of a caring relationship. Too often, our reliance upon data, statistical analysis, and outcome percentages obscure the need for subjective interpretation of each healing interaction in which we are engaged. Awareness and responsiveness, on personal and professional levels, to the intuitive and sacred aspects of the doctor-patient relationship need to be recognized as being as important as the rational and scientific aspects of treatment and management if we are to be healers in the fullest sense.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryEnhanced ingrowth of fibrovascular tissue into alloplastic orbital implants is clinically desirable. Basic fibroblast growth factor (bFGF) is an angiogenic factor that promotes proliferation of endothelial cells. Sucralfate is known to bind bFGF and render it stable by protecting it from degradation. To test the ability of bFGF to stimulate endothelial cell proliferation, porous orbital implants coated with a sustained-release and bioactively-stabilized preparation of the angiogenic peptide bFGF were studied. Hydroxyapatite (HA) and porous polyethylene (PP) implant discs (15±3 mm) were coated with sustained-release polymer polyhydroxyethylmethacrylate (hydron), sucralfate (a bFGF stabilizer), hydron plus or hydron/sucralfate plus bFGF. Discs were placed in tissue culture wells plated with 50,000 endothelial cells/well. After 5 days, cells were trypsinized and counted electronically using a Coulter counter. Statistical analysis was performed using unpaired Student's f-test. Implant discs coated with hydron/sucralfate/bFGF had significantly increased endothelial cell proliferation compared to discs coated with hydron alone or hydron/sucralfate (p< 0.05). There was no significant difference in the degree of enhanced proliferation between the HA and PP implants treated with hydron/sucralfate/bFGF (p> 0.05). Minimal proliferation occurred around discs treated with hydron alone or hydron/sucralfate. Coating both HA and PP orbital implants with the sustained-release form of sucralfate/bFGF promoted endothelial cell proliferation in vitro. The enhanced proliferation with hydron/sucralfate/bFGF warrants further exploration in an in vivo model.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThis case report describes a technique used for correction of enophthalmos secondary to progressive hemifacial atrophy (Parry-Romberg syndrome). The only previous described technique utilized an orbital floor implant, but this method was apparently only partially successful in correcting the conditions, i.e., it did not correct both the enophthalmos and the pseudoptosis that occurs secondary to intraorbital fatty atrophy. In the present technique, the periorbita was cut at two equators, the globe and anterior periorbita advanced forward, and the resulting empty spaces filled with thin slices of radiated cartilage. Both the enophthalmos and the pseudoptosis were corrected in a single operation. There were no long-term complications and the correction has been maintained 3 years postoperatively.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryNeurofibromatosis (NF) is an autosomal dominant abnormality that may effect multiple organ systems. Eyelids, orbits, and adjacent tissues may be involved with varying frequency and severity. Plexiform neurofibromas, causing mechanical ptosis and proptosis, optic nerve gliomas, and sphenoid wing dysplasia are some of the more common orbital and eyelid findings in NF. A series of 10 patients followed for up to 18 years is reported to describe features associated with NF, their clinical evolution, and their management.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryA 31-year-old woman complained of sudden diplopia and proptosis associated with a headache. Approximately 10 years earlier, she had sustained a right orbital blowout fracture during a snow machine accident that was repaired using a Supramid implant. She presented with 4 mm of right-sided proptosis by Hertel exophthalmometry, with limitation of up and down gaze. She manifested a right gaze preference with a left head turn to achieve fusion. Visual acuity was 20/20 on both sides; however, there was 20% red desaturation and a subtle afferent pupillary defect on the right side. Goldmann visual fields were full and the retinal examination was normal. A computed tomography (CT) scan of the orbits with and without contrast demonstrated a large right posterior inferior orbital mass. Once the periorbita was breached during orbitotomy, a burgundy serosanguinous material emerged. Gram staining revealed red cells without organisms. The implant had not been fixed by wires or screws. Upon removal, the implant appeared oversized, encompassing the orbital floor, medial and lateral walls. Postoperatively, the proptosis, gaze preference with face turn, afferent pupillary defect, desaturation abnormality, and diplopia resolved.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe goal of the study was to determine, using a nonhuman primate (NHP) model, the minimum duration of elevated intraocular pressure (IOP) (induced by an inflated catheter) necessary to produce significant visual system deficits. In Old World monkeys (Macaca mulatto), a catheter was placed retrobulbarly in one orbit and inflated with saline for either 180 min (10 monkeys) or 240 min (six monkeys subjects). Baseline color fundus photographs, monochromatic photography, fluorescein angiography, and IOP measurements were performed preoperatively and at either 2, 4, or 6 weeks postoperatively on both eyes of each monkey prior to killing and histological analysis. Optic neuropathy was demonstrated in eight of these NHPs. In the two most severe cases (240 min inflation condition), complete nerve fiber atrophy with central retinal artery occlusion was observed. Sector nerve fiber atrophy, extending from the temporal disc to beyond the macula, was noted in the other six monkeys, five of which were in the 180 min inflation condition. Thus, optic neuropathy, sufficient to produce visual loss, was noted following increased IOP (≥50 mm Hg) for 180 min or 240 min. These data emphasize the need for timely intervention to mitigate the potential detrimental effects of retrobulbar hemorrhage when it occurs in humans.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryWe report the use of a galea flap in the reconstruction of the orbit and the periorbital in region three representative cases. Two patients, who had communication between the orbit, paranasal sinuses, and cranium following orbital and periorbital tumor resection, required a physical barrier to partition these compartments and an immunological barrier to prevent infection. A third patient, who had a contracted socket and had been on systemic steroids chronically, required a tissue with intrinsic blood supply to sustain an implant and promote healing. The outcome in all three patients was gratifying. The surgical anatomy is reviewed, the surgical technique detailed, and potential applications and complications discussed.

ISSN:0740-9303    

出版商:OVID    

年代:1996

数据来源: OVID