A Passive Behavioral Measure of Sleep Onset in High-Alpha and Low-Alpha Subjects

Polygraph recordings were conducted with normal subjects who were not sleep-deprived lo examine the association between EFG alpha dynamics and a passive behavioral index of sleep/ wake status, and to assess the usefulness of that index in subjects who do not produce abundant wakeful alpha activity. I In- behavioral indicator of sleep unset comprised the depression of a telegraph key initialed by loss of extensor tension in the finger. Alpha abundant (high-alpha) subjects showed a strong association of alpha level (as sleep Stage Wake (w) vs. Stage I sleep) with behavioral level, and a strong association of alpha loss events with key closure events. Mean latencies between alpha loss and key closure varied from - 1.8 to 18.4 s with a median of 1.0 s. As expected, high-alpha subjects also showed significant correlations between alpha level and changes in peripheral physiological variables in the vicinity of sustained alpha losses. Compared with Stage W. Stage 1 was associated with a greater incidence of slow eye movements, lower abdominal breathing amplitude, and a higher thoracic:abdominal breathing ratio. Similar correlations were observed in both high-alpha and low-alpha subjects between these variables and the key index, supporting its potential generality as an indicator of sleep onset.     

地塞米松缓释剂在外伤性白内障人工晶状体植入术中的临床应用

目的 :观察地塞米松缓释剂前房内植入对外伤性白内障人工晶状体植入术后炎症反应、后囊混浊的预防和治疗效果。方法 :将近 2年来在我院就诊的 2 2例外伤性白内障患者随机分为两组 ,一组 (1 0例 )行白内障摘除人工晶状体植入后 ,前房内植入地塞米松缓释剂 (植入组 ) ,另一组 (1 2例 )为对照组只做白内障摘除人工晶状体植入。观察两组术后视力、前房炎症以及后发障的发生率。结果 :术后视力 :植入组 :1 0者 6例 ,0 6者 2例 ,0 3者 3例 ;对照组 :1 0者 4例 ,0 6者 2例 ,0 3者 4例 ,0 1者 2例。术后前房炎症反应和后囊混浊发生情况 :植入组明显低于对照组 ,差异有显著性 (P <0 0 5)。结论 :前房内植入地塞米松缓释剂可有效地减轻外伤性白内障人工晶状体植入术后炎症反应 ,预防后发障的发生。是一种安全有效的给药途径。     

鼻内窥镜外科技术的应用现状

鼻内窥镜不只限于诊断和治疗鼻窦炎等疾病 ,临床上已广泛应用于鼻腔手术、鼻眼相关手术、鼻颅底手术 ,即形成了鼻内窥镜外科技术。现就这一技术的应用现状作一综述     

小切口非超声乳化摘除术治疗短眼轴性白内障

目的分析短眼轴性白内障小切口非超声乳化摘除术的特点 ,探讨其并发症的预防措施。方法对行小切口非超声乳化的白内障摘除术、眼轴长度为 19 5 6 - 2 3 OOmm的白内障患者 118例 (14 3只眼 )进行回顾性分析。结果术后 1个月矫正视力≥ 1 0者 2 8只眼 (19 6 % ) ,0 5 - 0 9者 10 2只眼 (71 3% ) ,0 3- 0 4者 13只眼 (9 1% ) ;术中晶状体后囊膜破裂 8只眼 (5 6 % ) ,术后角膜可逆性水肿 38只眼 (2 6 6 % )。随访过程中眼压升高者 2只眼 (1 4 % )。结论短眼轴性白内障患者前房浅、眼前段组织空间狭小、玻璃体压力高 ,手术难度大 ;强调术前降低眼内压 ,术中规范切口 ,对硬核应用咬核或劈核技术 ,合理使用高质量粘弹剂 ,保持前房深度 ,均是顺利完成手术的关键     

玻璃体内注射他克莫司对异种移植的视网膜色素上皮细胞存活的影响

目的 观察少量、多次玻璃体内注射免疫抑制剂他克莫司（FK506）对移植到兔眼视网膜下间隙内的人视网膜色素上皮（retinal pigment epithelium, RPE）细胞存活情况的影响。 方法 采用绿色荧光蛋白（green fluorescent protein, GFP）逆转录病毒感 染人RPE细胞。将50 μl（4×10³个/μl）表达GFP的人RPE细胞悬液注射到18只白兔及1 0只灰兔双眼视网膜下间隙，手术后所有兔左眼玻璃体内注射5 μl FK506（5 μg/ μl），每周1次，连续5周，然后间周一次至20周;右眼不注射作为对照。眼球壁铺片倒置荧光 显微镜观察移植细胞的存活状态。 结果 白兔于移植后1、2、3、4 、6、10、11、14、18、20、23、24、25、33、54周，灰兔于移植后4、5、6、7、14、18、20、26周双眼视网膜下均可见表达的GFP细胞，但移植术后1~14周内玻璃体内注射了FK506的左眼视网膜下RPE-GFP细胞形态、细胞膜的完整程度均比未注射的右眼好。18周后，7只白兔和3只灰兔双眼视网膜下移植细胞的状态差异不明显。眼球切片苏木素-伊红（hematoxylin-eosin, HE）染色观察结果显示，移植术后1~6周，6只白兔和3只灰兔右眼脉络膜小血管周围可见灶性或弥散的淋巴细胞，应用了FK506的左眼淋巴细胞的浸润明显减少。 结论 移植术后早期玻璃体内使用小剂量免疫抑制剂可减轻局部炎症反应，有利于维持视网膜下间隙移植的异种细胞的存活。 （中华眼底病杂志，2003，19：333-404）     

Ophthalmologic Procedures in the Emergency Department— Part II: Routine Evaluation Procedures

The emergency physician (EP) must be familiar with performance of ophthalmologic procedures for evaluation and treatment of a multitude of eye complaints. This article is the second of three articles addressing ophthalmologic procedures potentially of use by the EP. This article reviews the indications and the techniques for the following routine procedures: visual acuity testing, pupil dilatation, topical anesthesia use, and tonometry. Criteria for consultation also are addressed.     

小切口无缝线整核取出法白内障摘除人工晶体植入术

①目的　探讨小切口无缝线白内障摘除人工晶体植入术的疗效。②方法　本组 31例 (31眼 )病人采用皱眉形巩膜隧道切口 ,弦长 6～ 7mm ,整核取出白内障 ,植入人工晶体 ,并与 2 0例 2 0眼采用大切口 (10～ 12mm)手术作疗效比较。③结果　小切口组和大切口组在术后第 2天视力≥ 0 .5者分别为 17眼、4眼 (χ2 =6 .10 5 ,P <0 .0 5 ) ;术后第 30天验光测视力≥ 0 .5者分别为 2 5眼、15眼 (χ2 =0 .2 38,P >0 .0 5 ) ,散光分别为 (1.0 3± 0 .6 8)D ,(2 .4 5± 1.6 0 )D(t=2 .778,P <0 .0 1)。④结论　小切口无缝线整核取出白内障 ,不切核 ,愈合快 ,术后散光度小 ,而且经济、易开展。     

Effects of oxcarbazepine and carbamazepine on the central nervous system: computerised analysis of saccadic and smooth-pursuit eye movements

Oxcarbazepine (OXC) is a new anti-epileptic agent structurally related to carbamazepine (CBZ). OXC seems to have a similar efficacy and a better tolerability profile than CBZ. In the present study we compared the subclinical side-effects on the CNS of OXC and CBZ using a computerised analysis of saccadic and smooth-pursuit eye movements. Six healthy male volunteers (mean age 29 yrs) participated in the study, which was conducted by a double-blind cross-over design. Each subject was given a single dose of either CBZ 400 mg or OXC 600 mg (according to the random assignment) after which the drug effects on eye movements were evaluated. One week later, the trial was repeated using the other drug. The parametrisation of both saccadic and smooth-pursuit eye movements was carried out by measuring a series of performance parameters [e.g. the maximum saccade peak velocity (MSPV) and the typical target velocity (TTV)]. OXC was found to induce a lesser degree of alteration on the values of both MSPV (p = 0.07) and TTV (p less than 0.03) than CBZ. In particular, the TTV values were virtually unaffected by OXC administration, while the effects of CBZ on both variables were particularly evident at 8 and 10 h after dosing which correspond to the time at which the plasma concentrations of CBZ and of its 10,11-epoxide reach the peak. In conclusion, our preliminary results indicate that OXC induces negligible alterations, if any, on the eye movement parameters evaluated in our study.