PubMed Health⌕ Search

Biomedical subjects

B Seitz

Publications and source records attributed to B Seitz.

159 records · Page 9Linked to original sources
PubMed1979

[Pharmacokinetic studies on broad spectrum antibiotic combinations of penicillin and oxacillin in normal volunteers (author's transl)].

After i.v. application of broad spectrum penicillins (ampicillin, mezlocillin, carbenicillin) alone or combined with oxacillin (concomitantly) in different dosages to normal volunteers, the course of serum levels and recovery from urine were assessed and pharmacokinetic data were calculated for a 1-compartment model, in some cases also for a 2-compartment model. The following penicillins were tested alone and combined with oxacillin; ampicillin 3 g, oxacillin 2 g and their combination; ampicillin 2 g, oxacillin 1 g and their combination; mezlocillin 3.75 g, oxacillin 1.25 g and their combination; mezlocillin 2 g, oxacillin 1 g and their combination; carbenicillin 7.5 g, oxacillin 2.5 g and their combination. Apart from one combination (oxacillin 2 g + ampicillin 3 g), all penicillin combinations exceeded the serum levels achieved after individual application at any time. In combinations, the elimination constants decreased, total clearance was lower, and half-lives increased. The distribution volumes varied. With one exception, oxacillin 2.5 g + carbenicillin 7.5 g, all the combinations yielded a higher recovery from urine than did individual administration. When administering i.v. two penicillins simultaneously, a process similar to that following administration of probenecid in association with caronamide must need be considered. It may be assumed that the prolongation and elevation of serum levels after combined administration likewise lead to higher tissue concentrations, which effect might be of clinical consequence.

Adult↗
PubMedDate not supplied

Design of computer-generated hologram with ring focus for nonmechanical corneal trephination with Er:YAG laser in penetrating keratoplasty.

PURPOSE: To calculate a beam-shaping optical element for homogeneous intensity distribution within a focal ring to be used in nonmechanical trephination with the Er:YAG laser in penetrating keratoplasty instead of a spot guiding device. METHODS: The phase distribution behind a holographic optical element (HOE) k psi(u) can be described by the addition of the hologram phase phiH(u) to the beam phase phiE(u): k psi(u) = phiH(u) + phiE(u), k = 2pi/lambda, where u denotes the coordinates inside the hologram aperture, k an integer, and lambda the laser wavelength. To avoid discontinuous wavefronts leading to speckle noise, a smooth phase function is necessary. After transforming the hologram aperture coordinates into the focal plane x in a focal distance f, psi can be retrieved from the slope equation: inverted delta psi(u) = x(u) - u/f. RESULTS: Creating a ring focus can be reduced to an essentially one-dimensional problem by separation of variables due to the symmetry condition. We calculated a computer-generated eight-level phase-only HOE with 4096 x 4096 pixels from a Gaussian-distributed 2.94 Er:YAG laser spot with a beam diameter of 10 mm and a focal distance of 100 mm. Thereby, a ring focus with an inner/outer radius of 7/8 mm can be created. To avoid Poisson's spo, the symmetry of the problem was broken by circular modulation of the phase leading to a spiral-like structure. The calculated efficiency of the HOE relating the energy within the ring to the total energy was 91%. CONCLUSION: With an HOE it is possible to redistribute the energy along the desired focal ring. The HOE design can be adapted to the intensity distribution of the impinging laser beam with its characteristic aperture shape. A circular homogeneous corneal trephination depth is possible, because the energy fluctuation from pulse to pulse does not locally affect the ablation process. A ring focus for the Er:YAG laser has the potential to render superfluous a manual beam control via micromanipulator and to allow a more rapid and more regular corneal trephination along aperture masks.

Cornea↗
PubMedDate not supplied

Impact of increased intraocular pressure on long-term corneal endothelial cell density after penetrating keratoplasty.

PURPOSE: Besides immunological graft rejection, persistently increased intraocular pressure (IOP) is among the most important causes for graft failure after penetrating keratoplasty (PK). The purpose of this study was to assess the longitudinal development of IOP after PK and to investigate possible correlations with corneal endothelial cell density. METHODS: This longitudinal prospective study included 209 eyes after PK with a complete follow-up at 3 months, 6 months, before first suture removal (16 +/- 5 months) and after complete suture removal (21 +/- 5 months). At each examination, IOP was measured by Goldmann applanation tonometry. Endothelial cell density was assessed by specular microscopy (EM 1100, Tomey). The indications for PK were 48% keratoconus, 34% Fuchs' dystrophy, 5.4% stromal dystrophies, 8.6% secondary bullous keratopathy and 4% corneal scars. An iridotomy was performed routinely during PK. The postoperative treatment with topical steroids was standardized. RESULTS: Preoperatively, the mean IOP was 13.6 +/- 2.9 mm Hg with increased IOP (>21 mm Hg) in 2.0% of eyes. After 3 months, the incidence of increased IOP (24.5 +/- 4.6 mm Hg) was highest (6.7%) and decreased thereafter to 3.0% after complete suture removal. No patients showed IOP higher than 30 mm Hg. A persistently increased IOP for more than 3 months was seen in 2% of patients. At 3 months postoperatively, the mean endothelial cell density was 1,977 +/- 496/mm(2) and did not decrease significantly (p > 0.05) until 6 months (1,771 +/- 507 cells/mm(2)). At the end of the follow-up period, the mean endothelial cell density was significantly reduced (1,347 +/- 501 cells/mm(2)). There was no significant correlation between IOP and mean endothelial cell density at any postoperative examination stage (p > 0.24). Patients with persistently increased IOP for more than 3 months did not have significantly different endothelial cell densities in comparison with those without increased IOP. CONCLUSION: From 6 months after PK, the incidence of increased IOP was not higher than the preoperative level. Mild to moderate temporary IOP elevations after PK do not seem to affect the endothelial cell density of the graft until complete suture removal. Further long-term studies are necessary to assess the clinical relevance of these observations.

Cell Count↗
PubMedDate not supplied

In vitro effects of mitomycin-C on human keratocytes.

BACKGROUND: The purpose of the present study is to quantify the in vitro antiproliferative and cytotoxic effects of mitomycin-C on human keratocytes for their potential to modulate corneal stromal wound healing. METHODS: Cultured human keratocytes were exposed to various concentrations of mitomycin-C for periods of 5 minutes and 1 hour. Keratocyte proliferation and viability were assessed by phase-contrast microscopy, 3H-thymidine uptake, and electronic cell counting. RESULTS: Cytotoxic changes and inhibition of keratocyte proliferation exhibited after exposure to mitomycin-C were both dose- and time-dependent. The lowest concentrations to significantly (> 50%) inhibit keratocyte proliferation after 5-minute exposures were 0.05 mg/ml (P < .005) and after 1-hour exposures were 0.005 mg/ml (P < .001). At 5 minutes, ID50 was 0.038 mg/ml and LD50 was much higher than the greatest concentration tested (0.5 mg/ml). Mitomycin-C's median inhibitory dose (ID50) and median lethal dose (LD50) after 1 hour of exposure differed by a magnitude of 50 (0.0048 vs. 0.28 mg/ml). CONCLUSIONS: Mitomycin-C has antiproliferative effects at concentrations below those cytotoxic to human keratocytes. If used after photorefractive keratectomy, the drug should be administered at antiproliferative rather than cytotoxic concentrations.

Antibiotics, Antineoplastic↗
PubMedDate not supplied

Evaluation of corneal flap dimensions and cut quality using a manually guided microkeratome.

BACKGROUND: To evaluate reproducibility of corneal flap dimensions and cut quality with repeated blade use with a manually guided microkeratome in pig eyes. METHODS: Corneal flaps were created using a manually guided microkeratome (Model One, Moria) with an intended 130-microns cut depth in 130 enucleated pig eyes. Flap thickness was calculated by pachymetry and diameter was estimated by means of applanation lenses compared to planimetry. Histology and scanning electron microscopy of samples and blades were performed to evaluate the keratectomy surface and blade cutting edge after repeated use of the blades. RESULTS: Mean flap central thickness was 135 microns (SD, 37 microns). The mean diameter of 8.4 mm (SD, 0.4 mm) correlated significantly (P < .001) to the intended diameter (r = .79). Mean difference from the intended diameter was 0.8 mm (SD, 0.3 mm; range, 0.04 to 1.4 mm). Scanning electron microscopy showed even and smooth cuts with chatter lines at the keratectomy edge using new blades. After repeated blade use, increasing cut irregularity, folds, and tissue remnants on the corneal bed surface, and nicks and tissue remnants at the cutting edge of the blades were observed. CONCLUSION: Reproducible flap dimensions were obtained using the Moria One microkeratome on pig eyes. The cut surface was regular and smooth with a new blade, but surface quality deteriorated considerably after repeated use of the same blade.

Animals↗
PubMedDate not supplied

Evaluation of corneal flap dimensions and cut quality using the Automated Corneal Shaper microkeratome.

PURPOSE: To evaluate flap dimensions and cut deterioration with repeated blade use in an automated microkeratome. METHODS: The Automated Corneal Shaper (Chiron-Adatomed, Munich, Germany), 160-microm plate attached, was used to make a corneal flap in 90 pig cadaver eyes, reusing blades up to five times. Flap diameter was measured by planimetry and thickness was calculated by ultrasound pachymetry. Scanning electron microscopy of stromal beds and blade cutting edges was performed to assess cut deterioration after repeated blade use. RESULTS: Mean flap central thickness was 125 +/- 32 microm. Mean vertical flap diameter was 7.6 +/- 0.4 mm. No correlation was found between thickness and diameter (r = 0.15, P = .45). Progressive thinning of the flap was observed in the direction of the flap hinge. Smooth cuts (using new blades) with periodic chatter lines at the keratectomy edge and in the stromal bed were observed with scanning electron microscopy. Increasing tissue remnants on the stromal bed and decreasing cut quality occurred with repeated blade use. Blades showed larger tissue remnants, nicks, and even folds on the cutting edge proportional to the number of times blades were used. CONCLUSION: Satisfactory cut quality and reproducibility were obtained after a single use of stainless steel blades in the Automated Corneal Shaper microkeratome. Cut quality was degraded dramatically by repeated use of blades.

Animals↗
PubMedDate not supplied

Intraocular lens power calculation in eyes after corneal refractive surgery.

PURPOSE: The purpose of this review article is to discuss the major reasons for postoperative hyperopia after cataract surgery following radial keratotomy (RK) and photorefractive keratectomy (PRK) and to illustrate potential methods for improvement of intraocular lens (IOL) power prediction after keratorefractive surgery based on exemplary model calculations. METHODS: We previously performed model calculations in eyes after PRK for myopia (-1.50 to -8.00 D, mean -5.40 +/- 1.90 D) using keratometry readings as measured by the Zeiss keratometer and the TMS-1 topography unit and as calculated using the "clinical history method" (spherical equivalent refraction change) and change in anterior surface keratometry readings. RESULTS: We found that after PRK, mean measured keratometry readings were significantly greater than respective calculated values considering the preoperative to postoperative change of anterior corneal surface (P < .001), which itself was significantly greater than calculated keratometry readings considering the preoperative to postoperative change of spherical equivalent refraction (P < .001). IOL power underestimation correlated significantly with the difference between preoperative and postoperative spherical equivalent refraction (P = .001). CONCLUSIONS: For correct assessment of keratometric readings to be entered into more than one modern third-generation IOL power calculation formula (but not a regression formula), the clinical history method should be applied whenever refraction and keratometric diopters before the keratorefractive procedure are available to the cataract surgeon. If preoperative keratometric diopters and refraction are not known, average central power on the postoperative videokeratograph may be used after RK, but refined calculation of keratometric diopters from radius of anterior and posterior corneal surface should be used after PRK and/or LASIK.

Cataract Extraction↗
PubMedDate not supplied

[Ambulatory care of psychiatrically changed elderly patients].

Based on an empirical study in Berlin, we will attempt to answer the question of whether centers for ambulant health and social services provide adequate care for old people who are mentally disturbed. It is shown that this special group of patients already amounts to more than 40% of the services' clients. Although the client is usually referred to the center because of physical illness, psychological problems will have to be taken into consideration by the nurse. This is already happening in part, and it is possible to discriminate special psychogeriatric categories of care. As a rule, however, the quality and quantity of care given are not sufficient. In a pilot study, positive effects have been achieved by recruiting specialized staff. Additionally, cooperation with other services, concerning the psychological problems of the patient, should be improved.

Aged↗
PubMedDate not supplied

Changes of the corneal endothelium after ultraviolet-B exposure in previously photokeratectomized eyes.

The photorefractive effect of excimer lasers is based on an interaction between the 193-nm ultraviolet-C laser beam and the stromal chromophore molecules. Recently, in some patients an increase of subepithelial haze and a regression of refractive effect has been observed following suntanning (UV-B exposure). The aim of the study was to find out the possible endothelial damage caused by photoablation with increasing depth and the effect of subsequent UV-B exposure on previously photokeratactomized eyes. Altogether 12 chinchilla rabbits were treated. Four animals received a -5.0 D PRK; four animals a -15.0 D PRK and four animals a -30.0 D PRK treatment. The endothelial average number, size and variation were determined two weeks post-PRK. Three weeks following PRK, a half of the animals received a 1 J/cm2 ultraviolet-B radiation in a constant dermatological UV-chamber. The endothelial morphology was measured the same way with automated specular microscopy two weeks after UV-B irradiation. After PRK treatment there was no statistically demonstrable change in endothelial morphology. On the other hand, after UV-B radiation all eyes showed a decrease in endothelial number and an increase in size and variation. The ratio of hexagonality decreased, and endothelial rosette formation appeared. The early morphological changes resembled the physiological aging changes. Conditions (deep stromal photoablation, cumulative effect of suntanning or solarium treatments) may exaggerate the physiological aging processes leading to subsequent pleomorphism, polymegatism and cell loss. This may accelerate corneal dysfunction.

Animals↗