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Dive into the research topics where Suzanne K. Freitag is active.

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Featured researches published by Suzanne K. Freitag.


Journal of Pediatric Ophthalmology & Strabismus | 1994

Traumatically Ruptured Globes in Children

Jay C Rudd; Edward A Jaeger; Suzanne K. Freitag; John B Jeffers

This retrospective study was designed to document the etiology of traumatically ruptured globes in children and to determine the prognostic value of several clinical parameters with respect to visual outcome. Forty-six children 16 years of age and under seen in the emergency room over a 2-year period were found to have full thickness penetration of the globe. Fifty-nine percent of injuries occurred during recreational activities, and 59% occurred outside of the home. Boys outnumbered girls by a 6:1 ratio. For children, initial visual acuity proved to be less valuable as a prognostic indicator with regard to final vision than has been reported in adults. Smaller corneal wounds offered better visual outcomes. Four eyes were enucleated. Ten ruptures (22%) were related to activity involving guns. Four of six BB gun injuries were the result of a ricocheted BB. Visual outcomes in gun-related injuries were particularly poor.


Scandinavian Journal of Gastroenterology | 2001

Ulcerative colitis and colorectal carcinoma: DNA-profile, laminin-5 gamma2 chain and cyclin A expression as early markers for risk assessment.

Jens K. Habermann; C. Lenander; Uwe J. Roblick; St. Krüger; D. Ludwig; A. Alaiya; Suzanne K. Freitag; L. Dümbgen; Hans-Peter Bruch; E. Stange; S. Salo; K. Tryggvason; Gert Auer; Hendrik Schimmelpenning

Background: Ulcerative colitis patients are at increased risk for developing colorectal carcinomas. Despite expensive surveillance programmes, clinical practice reflects an uncertainty in individual risk assessment. The aim of the study was to evaluate independent cellular features with possible predictive value. Methods:BACKGROUND Ulcerative colitis patients are at increased risk for developing colorectal carcinomas. Despite expensive surveillance programmes, clinical practice reflects an uncertainty in individual risk assessment. The aim of the study was to evaluate independent cellular features with possible predictive value. METHODS Two patient groups were selected: group A comprised 8 patients with ulcerative colitis-associated colorectal carcinomas, group B comprised 16 ulcerative colitis patients with risk factors (duration of disease, extent of inflammation, epithelial dysplasias). A total of 683 paraffin-embedded mucosal biopsies were retrospectively evaluated for inflammatory activity, grade of dysplasia, ploidy status, laminin-5 gamma2 chain and cyclin A expression. RESULTS Mild or moderate inflammatory activity was present in 78% of all biopsies, low- or high-grade dysplasia in 5.5%. There was no difference in inflammatory activity and dysplasia between patient groups. In group A, 75% of the biopsies exhibited aneuploid DNA distribution patterns. Group B showed mainly proliferative-diploid cell populations (85% / P = 0.006). Laminin-5 gamma2 chain was expressed in 13% of all biopsies, with a higher frequency in group A (P = 0.002). Cyclin A expression was found in 98% of all biopsies, with a higher number of immunopositive cells in group A biopsies (P = 0.014). CONCLUSIONS Combined nuclear DNA assessment, laminin-5 gamma2 chain and cyclin A expression may help to identify ulcerative colitis patients with an increased risk for cancer development.


Ocular Immunology and Inflammation | 2015

Ipilimumab-induced Ocular and Orbital Inflammation—A Case Series and Review of the Literature

Evangelia Papavasileiou; Sashank Prasad; Suzanne K. Freitag; Lucia Sobrin; Ann-Marie Lobo

Abstract Purpose: Ipilimumab, a monoclonal antibody directed against the immune protein cytotoxic T-lymphocyte antigen-4 (CTLA-4), characteristically induces side effects called “immune-related adverse events” (IRAE). Although ophthalmic involvement is rare, we report 7 cases of eye and orbit complications related to ipilimumab therapy. Methods: We performed a retrospective review of patients with metastatic melanoma who developed ipilimumab-related ocular or orbital inflammation who were seen at our institutions. Results: Seven patients were identified: 4 patients had orbital inflammation, 2 had uveitis, and 1 had peripheral ulcerative keratitis. Four patients developed inflammation after the second ipilimumab infusion, 2 after the third infusion and 1 after the first infusion. All 4 patients with orbital inflammation were treated with systemic corticosteroids. Two patients with uveitis were treated with topical steroids, but were also treated with systemic corticosteroids for other IRAE, including colitis and hypophysitis. The patient with keratitis was treated with topical corticosteroids alone with resolution of inflammation. All 7 patients discontinued ipilimumab therapy, 5 due to systemic IRAE and 2 due to tumor progression. Five of 7 patients had tumor progression on ipilimumab therapy. Conclusions: Ocular and orbital inflammation may occur in patients with metastatic melanoma receiving ipilimumab, is frequently accompanied by other IRAEs, and resolves with corticosteroid treatment, often leaving no long-term sequelae.


PLOS ONE | 2013

A Cross-Sectional Survey of the Association between Bilateral Topical Prostaglandin Analogue Use and Ocular Adnexal Features

Mamta Shah; Grace M. Lee; Daniel R. Lefebvre; Benjamin P. Kronberg; Stephanie Loomis; Stacey Brauner; Angela Turalba; Douglas J. Rhee; Suzanne K. Freitag; Louis R. Pasquale

We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR)  =  2.30; 95% confidence interval (CI) 1.43–3.69; p = 5.44E-04) and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR  =  2.49; 95% CI, 1.54–4.03; p =  1.98E-04) associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004%) versus prostaglandin analogue never or past users. Upper lid ptosis (OR  =  4.04; 95% CI, 2.43–6.72; p = 7.37E-08), levator dysfunction (OR =  7.51; 95% CI, 3.39–16.65; p = 6.74E-07) and lower lid retraction (OR = 2.60; 95% CI, 1.58–4.28; p = 1.72E-04) were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis represent significant side effects that could impact visual function in glaucoma patients.


British Journal of Neurosurgery | 2001

Recurrent ectopic craniopharyngioma.

Suzanne K. Freitag; Neil R. Miller; H. Brem

A 66-year-old woman developed an asymptomatic mass in the right frontal lobe 5 years after undergoing a right frontal craniotomy and removal of a craniopharyngioma. The mass progressively enlarged over the next 3 years, during which time it became multiloculated and partially cystic. Repeat craniotomy was performed 8 years after the original operation, at which time the mass was found to be an ectopic craniopharyngioma. The lesion probably resulted from seeding of tumour cells along the surgical tract at the time of the initial surgery.


Epidemiology and Infection | 2000

Serovar specific risk factors and clinical features of Salmonella enterica ssp. enterica serovar Enteritidis: a study in South-West Germany

Manfred Kist; Suzanne K. Freitag

Human salmonellosis in Germany has been an increasing problem since the 1980s, with a peak of 195,000 reported cases in 1992. During the peak years, isolates of Salmonella Enteritidis (SE) predominated by far over other salmonella serovars (NSE) (80 vs. 20%). In a comparison of the clinical characteristics of 790 persons infected with SE to 175 persons infected with NSE, watery diarrhoea (OR 1.7) and high grade (> 39 degrees C) fever (OR 1.8) were independently associated with SE infection. When comparing possible risk factors for acquiring salmonella infection among patients with SE compared to those with NSE, consumption of raw eggs (OR 4.4; P = 0.0006) was the most significant alimentary risk factor for SE infection, while travel outside Europe was negatively associated with SE infection (OR 0.08; P = 0.0001). When comparing all patients with salmonella infection, regardless of serovar, with healthy controls, consumption of raw eggs (OR 30.3; P = 0.001), of raw or undercooked eggs (OR 1.9; P = 0.003), or having puppies, kittens or turtles (OR 6.8; P = 0.002), were risk factors for salmonellosis.


Ophthalmic Plastic and Reconstructive Surgery | 2002

Helical computed tomographic dacryocystography with three-dimensional reconstruction: a new view of the lacrimal drainage system.

Suzanne K. Freitag; John J. Woog; Philip D. Kousoubris; Hugh D. Curtin

Purpose To evaluate the utility of a new diagnostic radiologic technique for anatomic evaluation of the lacrimal outflow system in patients with epiphora and to delineate anatomic variations in the lacrimal systems of patients with both patent and obstructed systems. Methods This study retrospectively reviewed clinical and radiologic data in a series of 30 patients with epiphora who underwent our radiologic protocol. Imaging included fluoroscopic dacryocystography followed by helical CT dacryocystography after injection of lacrimal system contrast. Axial CT data was three-dimensionally reconstructed and rotated for viewing of images in multiple projections. Mean axial cross-sectional areas of the lacrimal sac and duct were determined. Results Sixty lacrimal systems in 30 patients were clinically and radiologically evaluated. The average mean cross-sectional area of the lacrimal sac and duct in the setting of complete obstruction was 0.153 cm2 and was statistically significantly larger (p =0.0286) when compared with average mean cross-sectional areas in unobstructed (0.045 cm2) and partially obstructed (0.052 cm2) lacrimal systems and were associated with lacrimal system dilation proximal to the level of obstruction. The difference in average mean cross-sectional area between patients with unobstructed and partially obstructed systems was not statistically significant. A number of lacrimal system abnormalities were noted in our series, including obstructions at various levels of the lacrimal outflow system, lacrimal sac masses, sinusitis, sarcoidosis, sinus carcinoma, and failed dacryocystorhinostomy. Twenty-three lacrimal systems were believed to be radiographically normal. Radiologic findings altered surgical treatment in 10 of 30 patients in this series. Conclusions This relatively safe and well-tolerated radiologic technique provides detailed imaging of the lacrimal outflow system and surrounding structures. The information obtained from this technique may be helpful in clinical and surgical decision making.


Ophthalmic Plastic and Reconstructive Surgery | 2013

Radiographic patterns of orbital involvement in IgG4-related disease.

Daniel Thomas Ginat; Suzanne K. Freitag; David A. Kieff; Arthur S. Grove; Aaron Fay; Marybeth Cunnane; Gul Moonis

Purpose:Immunoglobin G4 (IgG4)-related disease is a systemic condition characterized by lymphoplasmacytic infiltrates that can involve the orbit. The purpose of this study was to identify the various patterns of orbital IgG4-related disease on imaging. Methods:Retrospective review of radiologic examinations including CT, MRI, and positron emission tomography was performed in patients with proven cases of IgG4-related disease. Results:A total of 9 patients with orbital IgG4-related disease were identified, including 9 with CT, 4 with MRI, and 4 with 18-fluorodeoxyglucose positron emission tomography. Patterns of involvement included lacrimal gland enlargement, lacrimal sac involvement, extraocular muscle thickening, preseptal involvement, orbital fat involvement, and cranial nerve involvement, many of which occurred simultaneously. Associated demineralization of the orbital wall was evident on CT in 2 cases. On T2-weighted MRI, the lesions appeared as hypointense in 2 cases, heterogeneously hypointense to isointense in 1 case, and hyperintense in 1 case. Diffuse enhancement was present in all 3 cases in which postcontrast T1-weighted sequences were available. The lesions were hypermetabolic on positron emission tomography in 3 of 4 cases. There was definite extraorbital involvement by IgG4-related disease in 3 of the 9 patients and suspected involvement in another 3 of the 9 patients. Conclusions:IgG4-related disease displays a wide variety of imaging manifestations in the orbit. Extraorbital disease is often present and can help suggest the diagnosis.


British Journal of Ophthalmology | 2016

Invasive fungal disease of the sinus and orbit: a comparison between mucormycosis and Aspergillus

Danielle Trief; Stacey T. Gray; Frederick A. Jakobiec; Marlene L. Durand; Aaron Fay; Suzanne K. Freitag; Nahyoung Grace Lee; Daniel R. Lefebvre; Eric H. Holbrook; Benjamin S. Bleier; Peter M. Sadow; Alia Rashid; Chhabra N; Michael K. Yoon

Background/aims Invasive fungal infections of the head and neck are rare life-threatening infections where prompt diagnosis and intervention is critical for survival. The aim of this study is to determine the clinical characteristics and outcomes of invasive fungal disease of the sinus and orbit, and to compare mucormycosis and Aspergillus infection. Methods A retrospective review was conducted from a single tertiary care eye and ear hospital over 20 years (1994–2014). Twenty-four patients with a confirmed pathological diagnosis of invasive fungal disease of the sinus and/or orbit were identified and their medical records were reviewed. The main outcome measures were type of fungus, location of disease, mortality and visual outcome. Results Patients with orbital involvement had a higher mortality and higher likelihood of mucormycosis infection compared with those with sinus-only disease (78.6% vs 20%, p=0.01; 86% vs 30%, p=0.01, respectively). Patients with mucormycosis had a higher mortality (71%) than patients with Aspergillus (29%); however, this was not statistically significant (p=0.16). All patients with orbital involvement and/or mucormycosis infections were immunosuppressed or had inadequately controlled diabetes, and had a cranial neuropathy or ocular motility dysfunction. All five post-transplant patients with orbital infections died, while the two transplant patients with sinus infections survived. Conclusions Patients with orbital fungal infections are more likely to be infected with mucormycosis compared with Aspergillus and have a higher mortality compared with infections sparing the orbit. History of transplant portends a dismal prognosis in orbital infections. Invasive fungal disease should be considered in any immunocompromised patient presenting with a new cranial neuropathy or ocular motility abnormality.


International Forum of Allergy & Rhinology | 2017

Compartmental endoscopic surgical anatomy of the medial intraconal orbital space

Benjamin S. Bleier; David Y. Healy; Nipun Chhabra; Suzanne K. Freitag

Surgical management of intraconal pathology represents the next frontier in endoscopic endonasal surgery. Despite this, the medial intraconal space remains a relatively unexplored region, secondary to its variable and technically demanding anatomy. The purpose of this study is to define the neurovascular structures in this region and introduce a compartmentalized approach to enhance surgical planning.

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Daniel R. Lefebvre

Massachusetts Eye and Ear Infirmary

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Nahyoung Grace Lee

Massachusetts Eye and Ear Infirmary

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Benjamin S. Bleier

Massachusetts Eye and Ear Infirmary

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Frederick A. Jakobiec

Massachusetts Eye and Ear Infirmary

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Michael K. Yoon

Massachusetts Eye and Ear Infirmary

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N. Grace Lee

Massachusetts Eye and Ear Infirmary

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Lora Rabin Dagi Glass

Massachusetts Eye and Ear Infirmary

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Anna M. Stagner

Massachusetts Eye and Ear Infirmary

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Natalie Wolkow

Massachusetts Eye and Ear Infirmary

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