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491.

Purpose

This study was conducted to investigate the effects of an experimental bacterial keratitis model on the corneal collagen cross-linking treatment (CXL), and also to compare topical antibiotic treatment with the combined treatment.

Methods

The study involved 40 young adult female Sprague Dawley rats, which had a 2?mm scraped defect of the central corneal epithelium in both eyes. The rats were divided into two equal groups. The first group was inoculated in both eyes with standard Pseudomonas Aeruginosa (PA) from a strain suspension prepared from 0.05?ml (Group 1), and the second group was inoculated with standard Methicillin Resistance Staphylococcus Aureus (MRSA) strains from a suspension prepared from 0.05?ml (Group 2). Group 1 was divided into four sub-groups: Group 1A was treated by collagen cross-linking (CXL), Group 1C was treated with topical tobramycin drops CXL and also treated by collagen cross-linking (CXL), Group 1D was treated with topical tobramycin drops, and Group 1B was left untreated in order to create a control group. Similarly, Group 2 was also divided into four sub-groups: Group 2A was treated by CXL, Group 2C was treated with topical 5% fortified vancomycin drops CXL and also treated by CXL, Group 2D was treated with topical 5% fortified vancomycin drops, and Group 2B was left untreated in order to create a control group. CXL was performed on the third day following the inoculation and topical drop therapy. Biomicroscopy and microbiologic assessments were performed on the third and seventh days following the inoculation of microorganisms.

Results

In the treatment, which compared baselines in all groups before treatment, the diameter of keratitis infiltrations, corneal clouding, and corneal swab samples were obtained from the reduction in reproduction. The results were statistically significant (p?<?0.01). Keratitis infiltration groups were conducted on the seventh day for Groups 1C and 1D according to Group 1B, whilst Groups 2A, 2C and 2D were conducted according to Group 2B, which showed a significant statistical reduction (p?<?0.01). On the seventh day, focal groups were conducted in corneal clouding Group 1D according to Group 1B and in Groups 2A, 2C and 2D according to Group 2B, which revealed a significant statistical reduction (p?<?0.01). On the seventh day, reproduction in culture was obtained from corneal swab samples in Groups 1C and 1D according to Group 1B; in Groups 1C and 1D according to Group 1A; in Groups 2A, 2C and 2D according to Group 2B; and in Group 2C according to Group 2A, where a significant statistical reduction was observed (p?<?0.01).

Conclusions

The clinical and microbiological efficacy of the CXL treatment is evaluated in our study. In accordance with the conclusion reached an effective reduction in the density and severity of (infection), occurred as a result of CXL treatment, CXL treatment combined with topical antibiotic treatment and topical antibiotic treatment of Pseudomonas Aeruginosa (PA) and Metisilin Rezistant Staphylococcus Aureus (MRSA) keratitis infections. From these results, it is shown that topical antibiotics and CXL potentiate each other’s effects in the treatment of resistant bacterial keratitis.  相似文献   
492.
493.
A 59 year-old man was admitted as his left antecubital arterio-venous fistula was thrombosed, and hemodialysis could not be succeeded for the last two sessions. It was a brachio-basilic fistula without transposition, which also required thrombectomy 8 months ago, and had been created 18 months before. He had multiple catheter insertions during the period of 6 years. Following the failed catheter insertions from both jugular and femoral veins, an ultrasound-guided venography via the left popliteal vein demonstrated the intact left popliteal and femoral vein with well-developed collaterals at the level of occluded left iliac vein. A temporary hemodialysis catheter was placed through the popliteal vein with an antegrade manner under ultrasound guidance in prone position, which effectively worked during hemodialysis sessions afterwards. Transposition of basilic vein was performed. Following the wound recovery, arterialized basilic vein has started to be used effectively for hemodialysis, and the popliteal catheter was displaced.  相似文献   
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