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31.
We describe a technique for performing deep lamellar keratoplasty using viscoelastic dissection. Deep lamellar dissections of the cornea using viscoelastic substances (sodium hyaluronate) were performed on 4 eyes of 4 patients. One patient with keratoconus and another with corneal scarring underwent lamellar keratoplasty using the technique as the sole procedure for visual rehabilitation. Two patients (2 eyes) with opaque corneas underwent deep lamellar dissection with removal of stromal tissue to allow visualization of the anterior segment structures prior to penetrating keratoplasty, thereby facilitating separation of iridocorneal adhesions as the Descemet membrane was incised. Deep lamellar dissection was performed without complications related to the procedure in all 4 eyes. The 2 lamellar grafts cleared completely, and both eyes achieved excellent visual acuity with spectacle correction. In the other 2 eyes, deep lamellar dissection provided clear visualization of anterior segment structures during incision of the Descemet membrane. Deep lamellar dissection using viscoelastic substances is a useful technique during lamellar keratoplasty. 相似文献
32.
PURPOSE: To prospectively examine the effect of photorefractive keratectomy with a 6-mm ablation zone on best-spectacle-corrected visual performance. METHODS: A prospective study was conducted of 164 eyes of 164 patients with an average (+/-SD) of -4.02 +/- 1.74 diopters (range, -0.63 to -8.38 diopters spherical equivalent). Best-spectacle-corrected high-contrast and low-contrast visual acuity (18% Weber contrast) was measured with both natural and dilated pupils. Patients were tested preoperatively and at 3, 6, and 12 months after photorefractive keratectomy. Photorefractive keratectomy was performed with an argon fluoride excimer laser. Fifty-five eyes of 55 patients also underwent astigmatic keratotomy. RESULTS: Twelve months after photorefractive keratectomy, best-spectacle-corrected high-contrast visual acuity with natural pupils showed no significant change from preoperative values; mean (+/-SD) change was 0.004 +/- 0.10 logMAR (t = 0.45, P = .65). Best-spectacle-corrected low-contrast visual acuity with natural pupils was significantly reduced compared to baseline; mean (+/-SD) change was 0.04 +/- 0.13 logMAR (t = 3.3, P = .001). The low-contrast loss was larger (1.5 lines) with dilated pupils; mean (+/-SD) change was 0.13 +/- 0.15 logMAR (t = 9.31, P < .001). Greater losses in dilated low-contrast visual acuity were associated with concurrent astigmatic ketatotomy (t = 2.28, P = .025) and corneal haze of grade 1 or greater (t = 2.71, P = .005). CONCLUSIONS: Reductions in visual performance occur after photorefractive keratectomy with a 6-mm zone. These changes are greatest for low-contrast visual acuity with dilated pupils. Corneal haze and concurrent astigmatic keratotomy are associated with greater losses in low-contrast visual acuity. Best-spectacle-corrected low-contrast visual acuity is a sensitive measure for evaluating visual performance after refractive surgery. 相似文献
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35.
The vasa vasorum and angioplasty 总被引:2,自引:0,他引:2
Cragg AH; Einzig S; Rysavy JA; Castaneda-Zuniga WR; Borgwardt B; Amplatz K 《Radiology》1983,148(1):75-80
Interruption of flow in the vasa vasorum may lead to medial necrosis and aneurysm formation. The purpose of this study was to determine whether angioplasty produces significant alterations in the morphology or blood flow of the vasa vasorum of the dilated artery. The morphology of the canine vasa vasorum was studied before and after angioplasty; in a separate experiment vessel wall blood flow (VWBF) in canine carotid arteries was measured after angioplasty to determine whether physiologic regulation of the blood flow was disrupted by arterial dilation. No morphologic changes could be demonstrated in the vasa vasorum of the dilated artery; however, VWBF was increased by 1194 +/- 215% (mean +/- standard error, p less than 0.01) between 90 and 120 minutes after angioplasty. VWBF in the adjacent nondilated arterial segment was also increased (720 +/- 177% between 10-30 minutes, p less than 0.01) but returned toward normal after 60 minutes. Adenosine caused a "paradoxical" decrease in VWBF (p less than 0.05) of the dilated arterial segment while causing increased VWBF (p less than 0.05) in the thoracic aorta. Angioplasty appears to produce persistent hyperemia in the dilated arterial wall. A paradoxical response to adenosine suggests that vasa vasorum in the dilated arterial segment are maximally vasodilated. This may be due to mechanical disruption of vasomotor tone or to release of vasoactive substances. 相似文献
36.
A potential conflict exists between the recent growth of unionization in the health care industry and management efforts to increase productivity. One method of managing this conflict is to link employee rewards to employee productivity through productivity bargaining. 相似文献
37.
Benzodiazepine hypnotics increase NREM sleep and alter its EEG by reducing delta (0.3–3 Hz) and increasing sigma (12–15 Hz) and beta (15–23 Hz) activity. We tested whether the nonbenzodiazepine hypnotic, zolpidem (10 mg), produced the same pattern of sleep and EEG changes as two “classical” benzodiazepines, triazolam (0.25 mg) and temazepam (30 mg). Sleep EEG of 16 subjects was analyzed with period amplitude analysis for 3 nights during drug administration or placebo. The effects of zolpidem were in the same direction but generally of smaller magnitude than those of the classical benzodiazepines. These differences are more likely the result of non-equivalent dosages than different pharmacologic actions. Period amplitude analysis showed that the decreased delta activity resulted mainly from a decrease in wave amplitude. In contrast, the increased sigma and beta activity were produced by increased wave incidence. Delta suppression increased with repeated drug administration but sigma and beta stimulation did not. While these findings have little relevance for the clinical choice of hypnotics they may hold important implications for the brain mechanisms involved in hypnotic tolerance and withdrawal delirium. 相似文献
38.
WG Mitchell H Lynn JF Bale MA Maeder SM Donfield B Garg AH Tilton JK Willis TP Bohan 《Pediatrics》1997,100(5):817-824
BACKGROUND: Boys and young men with hemophilia treated with factor infusions before 1985 had a substantial risk of acquiring the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome. This study was designed to assess the effects of HIV and hemophilia per se on neurological function in a large cohort of subjects with hemophilia, and to investigate the relationships between neurological disease and death during follow-up. METHODS: Three hundred thirty-three boys and young men (207 HIV seropositive and 126 HIV seronegative) were evaluated longitudinally in a multicenter, multidisciplinary study. Neurological history and examination were conducted at baseline and annually for 4 years. The relationship between neurological variables, HIV serostatus, CD4+ cell counts, and vital status at the conclusion of the study was examined using logistic regression models. RESULTS: The risks of nonhemophilia-associated muscle atrophy, behavior change, and gait disturbance increased with time in immune compromised HIV-seropositive subjects compared with HIV seronegative or immunologically stable HIV-seropositive subjects. The risk of behavior change in immune compromised HIV-seropositive hemophiliacs, for example, rose to 60% by year 4 versus 10% to 17% for the other study groups. Forty-five subjects (13.5%), all of whom were HIV seropositive, died by year 4. Subjects who died had had increased risks of hyperreflexia, nonhemophilia-associated muscle atrophy, and behavior change. CONCLUSIONS: These results indicate that immune compromised, HIV-seropositive hemophiliacs have high rates of neurological abnormalities over time and that neurological abnormalities were common among subjects who later died. By contrast, immunologically stable HIV-seropositive subjects did not differ from the HIV-seronegative participants. Hemophilia per se was associated with progressive abnormalities of gait, coordination, and motor function. 相似文献
39.
Steven P Treon Mark Hansen Andrew R Branagan Sigitas Verselis Christos Emmanouilides Eva Kimby Stanley R Frankel Nikolaos Touroutoglou Barry Turnbull Kenneth C Anderson David G Maloney Edward A Fox 《Journal of clinical oncology》2005,23(3):474-481
PURPOSE: Rituximab is an important therapeutic for Waldenstrom's macroglobulinemia (WM). Polymorphisms in FcgammaRIIIA (CD16) receptor expression modulate human immunoglobulin G1 binding and antibody-dependent cell-mediated cytotoxicity, and may therefore influence responses to rituximab. PATIENTS AND METHODS: Sequence analysis of the entire coding region of FcgammaRIIIA was undertaken in 58 patients with WM whose outcomes after rituximab were known. RESULTS: Variations in five codons of FcgammaRIIIA were identified. Two were commonly observed (FcgammaRIIIA-48 and FcgammaRIIIA-158) and predicted for amino acid polymorphisms at FcgammaRIIIA-48: leucine/leucine (L/L), leucine/arginine (L/R), and leucine/histidine (L/H). Polymorphisms at FcgammaRIIIA-158 were phenylalanine/phenylalanine (F/F), phenylalanine/valine (F/V), and valine/valine (V/V). A clear linkage between these polymorphisms was detected and all patients with FcgammaRIIIA-158F/F were always FcgammaRIIIA-48L/L, and patients with either FcgammaRIIIA-L/R or -L/H always expressed at least one valine at FcgammaRIIIA-158 (P < or = .001). The response trend was higher for patients with FcgammaRIIIA-48L/H (38.5%) versus -48L/R (25.0%) and LL (22.0%), and was significantly higher for patients with FcgammaRIIIA-158V/V (40.0%) and -V/F (35%) versus -158F/F (9.0%; P = .030). Responses for patients with FcgammaRIIIA-48L/L were higher when at least one valine was present at FcgammaRIIIA-158 (P = .057), thereby supporting a primary role for FcgammaRIIIA-158 polymorphisms in predicting rituximab responses. With a median follow-up of 13 months, no significant differences in the median time to progression and progression-free survival were observed when patients were grouped according to their FcgammaRIIIA-48 and -158 polymorphisms. CONCLUSION: The results of these studies therefore support a predictive role for FcgammaRIIIA-158 polymorphisms and responses to rituximab in WM. 相似文献
40.
氯地滴眼液的含量测定 总被引:4,自引:0,他引:4
目的:采用HPLC法测定氯地滴眼液中氯霉素和地塞米松磷酸钠的含量。方法:色谱分析条件:ODS柱作分析柱,流动相为甲醇/水体系,0 ̄8min使用40%甲醇,8 ̄16min使用60%甲醇,流速1ml/min,0 ̄9min240nm紫外检测,:二组分分离良好。各组各组性关系良好,平均回收率氯霉素99.8%(RSD=1.2%,n=5),地塞米松磷酸钠99.4%(RSD=0.7%,n=5),结论:该法用于氯 相似文献