PURPOSE: Acute hydrops develops when Descemet's membrane and the endothelium of the ectatic cornea separates to allow aqueous humor to enter the stroma. The current study was done to determine if ...penetrating keratoplasty (PK) in keratoconus patients with resolved hydrops has a poor prognosis. METHODS: A retrospective chart review of 35 eyes of 35 patients with keratoconus who underwent PK after the resolution of acute hydrops (Group 1) and of 74 eyes of 69 patients who had PK without a previous history of acute hydrops (Group 2) was performed. The chi-square test was used for statistical analysis. RESULTS: The mean age in Group 1 was 21.1±11.0 years. The mean age in Group 2 was 23.2±14.4 years. Vernal keratoconjunctivitis was present in 11 patients in Group 1 (31%) and in 12 (17.4%) patients in Group 2. Loose sutures were present in two patients (6%) in Group 1; both resulted in loose suture-related corneal neovascularization. Loose sutures developed in five patients (7%) in Group 2. In Group 1, three patients (9%) had microbial keratitis. Microbial keratitis was seen in five patients (7%) in Group 2. Two patients (6%) in Group 1 developed late endothelial graft failure. In Group 2, one eye (1%) developed early and one eye (1%) late epithelial graft rejection; five eyes (7%) developed late endothelial graft rejection. There was no statistically significant difference between the two groups with respect to the incidence of graft rejection. At the last examination, 34 eyes in Group 1 had clear grafts; in the second group, graft clarity was achieved in 71 eyes. CONCLUSION: Penetrating keratoplasty in hydrops is successful in terms of graft clarity and visual outcome in patients with keratoconus after the resolution of hydrops. The patients should have preoperative and postoperative anti-allergic treatment and close follow-up for possible complications.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
72.
Primary carcinoma of the subglottic larynx Erdamar, Burak; Süoğlu, Yusufhan; Emin, A Haluk H ...
Kulak burun boğaz ihtisas dergisi,
2002 May-Jun, Letnik:
9, Številka:
3
Journal Article
Primary carcinoma of the subglottic larynx is very rare. This study was designed to evaluate patients who were treated for primary carcinoma of the subglottic larynx.
The study included 15 patients ...(14 men, 1 woman; mean age 62.8 years; range 45 to 95 years) with primary subglottic carcinoma. Correlations of different clinical parameters with three-year survival rate and Kaplan-Meier survival analysis were investigated.
On presentation, two patients (14%) had T1, five patients (33%) had T2, three patients (20%) had T3, and five patients (33%) had T4 tumors. The overall three-year survival rate was 73.4% (11/15). The median survival calculated by the Kaplan-Meier method was 45 months. No significant differences were found between the survival rates of patients with and without extralaryngeal extension.
Although primary subglottic cancer is locally aggressive with high tendency to extend to the extralaryngeal compartment at the time of diagnosis, high survival rates can be expected when appropriate treatment modalities are selected.
We report a patient with postkeratoplasty glaucoma that developed a large, filtering bleb following trabeculectomy with intraoperative antimetabolite treatment. The hypotony and the bleb were managed ...using argon laser photocoagulation. A 26-year-old female patient underwent penetrating keratoplasty in the left eye for keratoconus. Postoperatively, her elevated intraocular pressure could not be controlled medically, and the patient underwent a trabeculectomy with intraoperative antimetabolite application. Two months later, hypotony maculopathy, optic disc edema, and choroidal folds developed, and her vision dropped. Steroid treatment and soft contact lenses did not help. Photocoagulation was applied twice to the surface of the bleb and the surrounding area. After the photocoagulation therapy, the patient's vision improved, intraocular pressure increased, and the optic disc edema and macular folds had resolved. Argon laser photocoagulation applied to a large filtering bleb associated with hypotony maculopathy is a useful treatment for bleb remodeling and elevating intraocular pressure.
To present two cases of delayed-onset postoperative endophthalmitis following trabeculectomy combined with mitomycin C for secondary glaucoma after penetrating keratoplasty. We retrospectively ...evaluated two patients with late endophthalmitis after trabeculectomy combined with intraoperative mitomycin C application. Both patients underwent trabeculectomy for uncontrolled glaucoma following penetrating keratoplasty and they developed thin-walled cystic blebs. Intraocular pressure was normal, and grafts remained clear postoperatively. Severe endophthalmitis with hypopyon developed at 3 and 7 months postoperatively. Both patients had concomitant bleb infection. They underwent vitreous sampling and intravitreal injection of vancomycin and amikacin and were given topical fortified and systemic antibiotic therapy. Intravitreal injection was repeated once in both patients. Cultures grew Streptococcus pneumonias in one and Staphylococcus aureus in the other. Although the treatment of endophthalmitis was successful in both patients, only one of them achieved useful vision (20/40). For the other patient who had been infected with S. pneumoniae, vision was light perception. Delayed-onset endophthalmitis following trabeculectomy with mitomycin C application is a severe and vision threatening complication. It seems that the development of thin cystic filtering blebs secondary to intraoperative mitomycin C application may be a predisposing factor for bleb-related late endophthalmitis.
We have developed a CDMA based residential indoor system that uses time division duplexing with dynamic channel allocation. The proposed indoor system shares the same frequency band as the outdoor ...ANSI-008 based cellular PCS network and operates within its coverage area. Due to the time division duplexing nature of the residential system, both the forward and reverse link signals are transmitted in the same frequency band in different time slots. In principle the indoor system may operate either in the PCS uplink or the PCS downlink frequency band. After extensive simulations, we conclude that underlaying such a system to the existing ANSI-008 PCS system is feasible. Addition of such a system would ultimately increase the CDMA capacity substantially.
A simulation bed to investigate the feasibility of a CDMA based indoor residential system underlay that uses time division duplexing and dynamic channel allocation is described. The indoor system in ...question shares the same frequency band as the outdoor ANSI-008 based cellular PCS network and operates within its coverage area. Due to the TDD nature of the residential system, both the forward and reverse link signals are transmitted in the same frequency band in different time slots. Dynamic channel allocation (DCA) is used to select either the PCS uplink or the PCS downlink frequency band for the indoor system operation. The developed simulation bed measures the effects of the indoor system to the outdoor system and vice versa. System capacities, outages, DCA usage rates and blockage rates are measured using the simulator. The simulation results show that underlaying such an indoor residential system to the existing ANSI-008 PCS system is feasible. In a given geographical area, addition of such a system would ultimately increase the CDMA capacity substantially.
A series of 201 private patients bronchoscoped for diagnostic or therapeutic reasons was administered the new compound diazepam (Valium) as adjunctive premedication aimed at reducing anxiety. Dosage ...was intravenous, at a level of 5 to 7.5 mg. for most patients. In appraising drug effects, the parameters of intact cough reflex, relaxation, cooperation and amnesia for the procedure were of paramount importance. Five showed poor response, seven others fair, and 189 (93.5 per cent) were rated good or excellent by all criteria.
The authors consider diazepam a promising drug for use in endoscopy. There was no serious complication and no evidence of respiratory depression or hypotension. This study was originally undertaken because of the muscle relaxing properties of diazepam discovered by other investigators. A certain amount of muscle relaxation was in fact obtained during endoscopy, facilitating the procedure. However, a more interesting effect of this drug was its amnesic action. In interrogating the patients several hours after endoscopy, the great majority remembered the administration of the topical anesthetic, but little or nothing of the following procedure.
Thus intravenous diazepam used in conjunction with preoperative sedation and topical anesthesia has removed the unpleasant effects to the patient of bronchoscopy and esophagoscopy, without producing any serious complication. It is our opinion that diazepam will prove to be valuable and helpful in endoscopy in the future.
ABSTRACT Thirty‐one patients with the diagnosis of thyroid associated eye disease were included in the study. Samples were obtained from upper and temporal bulbar conjunctiva of both eyes by ...cellulose acetate filter paper. Control group included 20 healthy individuals. In patients with thyroid associated eye disease, grade 2 or 3 squamous metaplasia was observed in 32.26% of the samples obtained from upper bulbar conjunctiva, whereas this ratio increased to 82.26% in temporal bulbar area. None of the control cases showed changes of grade 2 or more. The evaluation of cytological changes with respect to clinical findings revealed that the main factor responsible for the cytological findings was inflammatory changes of the conjunctiva, whereas interpalpebral distance and proptosis had only a partial effect.
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