To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).
Methods
Ninety eyes of 45 patients were randomly assigned to receive either the combination of IPL and MGX or MGX alone (control). Each eye underwent eight treatment sessions at 3-week intervals. Parameters were evaluated before and during treatment as well as at 3–11 weeks after the last treatment session. Measured parameters included the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score, noninvasive breakup time (NIBUT), fluorescein breakup time (BUT), lipid layer grade, lipid layer thickness (LLT), lid margin abnormalities, corneal and conjunctival fluorescein staining (CFS) score, meibum grade, and meiboscore.
Results
A significant improvement in lipid layer grade was apparent in the IPL-MGX group from 6 to 32 weeks after treatment onset (adjusted P?<?0.001) but was not observed in the control group. The IPL-MGX group also showed significant improvements in LLT, NIBUT, BUT, lid margin abnormalities, and meibum grade compared with the control group at 24 and 32 weeks (adjusted P?<?0.001) as well as significant improvements in the SPEED score at 32 weeks (adjusted P?=?0.044) and in CFS score at 24 (adjusted P?=?0.015) and 32 (adjusted P?=?0.006) weeks.
Conclusions
The combination of IPL and MGX improved homeostasis of the tear film and ameliorated ocular symptoms in patients with refractory MGD and is thus a promising modality for treatment of this condition. 相似文献
Purpose: We used an impedance-controlled generator with an internally cooled electrode to perform radiofrequency ablation (RFA) in ex vivo bovine livers, with a single injection of either 38.5% sodium chloride (NaCl) or 10% hydrochloric acid (HCl), to determine the relative effects of these two solutions on tissue impedance, temperature and ablation volume.
Materials and methods: We performed 10 ablations each with injections of NaCl (NaCl-RFA), HCl (HCl-RFA) or nothing (RFA-alone), with a power setting of 200 W for 15?minutes. We recorded tissue impedance before and after injection. We logged temperatures obtained from thermocouple probes positioned 5, 10, 15 and 20?mm from the internally cooled RF electrode. After ablation, we measured ablation zone longitudinal and transverse diameters, and we calculated a spherical ratio (SR) for each ablation.
Results: Mean post-injection impedance of 30.3 (standard deviation [SD] 2.5) ohms for HCl was significantly lower than that of 55.4 (SD 3.5) ohms for NaCl (p?<?.001). Mean maximum temperatures recorded at each respective distance from the RFA electrode were all highest for HCl-RFA and lowest for RFA-alone (p?<?.001). Mean longitudinal and transverse diameters after HCl-RFA (5.50 [SD 0.25] cm and 5.28 [SD 0.22] cm, respectively) were significantly larger than those after NaCl-RFA (4.24 [SD 0.35] cm and 3.55 [SD 0.43] cm, respectively) and after RFA-alone (3.60 [SD 0.10] cm and 2.70 [SD 0.13] cm, respectively) (p?<?.001). Mean SR after HCl-RFA (0.93, SD 0.02) was significantly higher than mean SR after NaCl-RFA (0.76, SD 0.06) and RFA-alone (0.72, SD 0.04) (p?<?.001).
Conclusion: Monopolar, impedance-controlled RFA, with an internally cooled electrode and a single 10% HCl injection may allow larger tumors to be treated, potentially resulting in improved patient outcomes. 相似文献
Objective: Autoimmune chronic thyroiditis (ACT) is characterized by lymphocyte infiltration in the thyroid gland and the presence of antithyroid antibodies in serum. Medical treatment does not affect antibody levels and treatment decision is not definite yet for the euthyroid patients. We aimed to evaluate cardiac autonomic function and global left ventricular performance in autoimmune euthyroid chronic thyroiditis and determine the need for medical treatment. Method: We studied 30 ACT patients and 25 healthy control subjects. Cardiac autonomic function is evaluated by heart rate recovery (HRR). Global left ventricular performance is evaluated by two‐dimensional echocardiography and pulsed‐wave tissue Doppler echocardiography. Results: There was no difference between patients and controls with respect to clinical and biochemical parameters except hemoglobin (13.67 ± 1.25 g/dL, 14.51 ± 1.35 g/dL, p:0.047) and low density lipoprotein (120.71 ± 24.91 mg/dL, 100.55 ± 14.73 mg/dL, p: 0.003). Tei index was significantly higher in ACT group (0.521 ± 0.074, 0.434 ± 0.034, P < 0.0001). E′/A′ was found to be significantly lower (1.234 ± 0.42, 1.750 ± 0.291, P < 0.0001) and E/E′ was found to be higher than the controls (8.482 ± 0.449, 6.039 ± 0.209, P < 0.0001). HRR was significantly lower than the controls (20 ± 4 BPM, 30 ± 8 BPM, P < 0.0001). Conclusion: Although left ventricular performance is found to be normal by conventional echocardiographic methods, it is found to be impaired when Tei index and tissue Doppler parameters are used. Cardiac autonomic function is also impaired in ACT patients. As a result of these cardiac changes, medical treatment may be considered earlier, even at the euthyroid stage. (Echocardiography 2011;28:15‐21) 相似文献
During magnetic resonance imaging (MRI) examinations, the average specific absorption rate (SAR) of the whole body is calculated as an index of global energy deposition in biological tissue without taking into account the presence of metallic implants or conductive materials. However, this global SAR calculation is not sufficient to ensure patient safety and a local SAR measurement should be carried out. Several measurement techniques have already been used to evaluate the local SAR, in particular electric field (E‐field) probes, but the accuracy of the measurements and the resolutions (spatial and temporal) depend strongly on the measurement method/probe. This work presents an MR‐compatible, subcentimeter probe based on an electro‐optic (EO) principle enabling a real‐time measurement of the local E‐field during MRI scans. The experiments using these probes were performed on two different MR systems (preclinical and clinical) having different static magnetic field strengths and with different volume coil geometries. The E‐field was measured with unloaded (in air) and loaded volume coils in order to assess the sensing characteristics of the optical probe. The results show an excellent linearity between the measured E‐field and the radiofrequency (RF) magnetic field in both experimental conditions. Moreover, the distribution of the E‐field throughout the volume coil was experimentally determined and was in good agreement with numerical simulations. Finally, we demonstrate through our measurements that the E‐field depends strongly on the dielectric properties of the medium. 相似文献
This study investigated the effect of low‐power, non‐thermal atmospheric pressure plasma (NT‐APP) treatments, in pulsed and conventional modes, on the adhesion of resin composite to dentin and on the durability of the bond between resin composite and dentin. A pencil‐type NT‐APP jet was applied in pulsed and conventional modes to acid‐etched dentin. The microtensile bond strength (MTBS) of resin composite to dentin was evaluated at 24 h and after thermocycling in one control group (no plasma) and in two experimental groups (pulsed plasma and conventional plasma groups) using the Scotchbond Multi‐Purpose Plus Adhesive System. Data were analyzed using two‐factor repeated‐measures anova and Weibull statistics. Fractured surfaces and the bonded interfaces were evaluated using a field‐emission scanning electron microscope. Although there were no significant differences between the plasma treatment groups, the plasma treatment improved the MTBS compared with the control group. After thermocycling, the MTBS did not decrease in the control or conventional plasma group but increased in the pulsed plasma group. Thermocycling increased the Weibull moduli of plasma‐treated groups. In conclusion, plasma treatment using NT‐APP improved the adhesion of resin composite to dentin. Using a pulsed energy source, the energy delivered to the dentin was effectively reduced without any reduction in bond strength or durability. 相似文献
This IRB‐approved (Institutional Review Board) study evaluated the efficacy of a device that combines radio frequency, infrared energy and mechanical rollers/suction (ELOS technology) to reduce skin surface irregularities in a limited treatment zone. Sixteen patients were enrolled and received two treatments per week for 4 consecutive weeks. Treatments were limited to a 20.53 cm×33.02 cm area of the posterior or lateral thigh and lasted for 15 minutes. Maximum machine settings were used for all but one individual at every treatment. Evaluations consisted of a patient questionnaire and photographic assessment of skin contour by three physicians at 3 and 6 months after the last session who were blind to the treatment each patient received. Physician evaluators determined that all patients were improved at both post‐treatment periods. The average improvement at 3 and 6 months was 62% and 50%, respectively. All patients felt they were improved. One patient described the treatment as painful and required reduced treatment parameters after the initial treatment. Bruising within the treatment area was observed in five patients following the initial sessions but this did not alter the treatment protocol and did not occur in subsequent treatments. One patient had a superficial skin burn due to poor electrode contact that did not require corrective treatment. 相似文献