PubMed Health⌕ Search

Biomedical subjects

J Funk

Publications and source records attributed to J Funk.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Reproducibility of measurements with the Heidelberg retina tomograph in fundus elevations].

PURPOSE: The Heidelberg Retina Tomograph (HRT) was intended to evaluate the optic nerve head. It is, however, also possible to measure retinal elevations. There are no systemic data on the reproducibility of HRT measurements of retinal elevations. We now provide such data. METHODS: 117 measurements in patients with diseases which are characterized by retinal elevations were analyzed with the HRT. We measured the "volume above surface" of the retinal elevations. Each patient was analyzed three times, and the coefficient of variation was calculated. RESULTS: The coefficient of variation was between 0.55% and 40.5%. Some 42% of the coefficients of variation were between 0% and 10%, 31% between 5% and 10%, 21% between 10% and 20%, and 6% larger than 20%. CONCLUSION: The reproducibility of the HRT measurements in retinal elevations is clinically sufficient. The relation between sufficient reproducibility and accuracy is discussed.

Diabetic Retinopathy↗
PubMed1994

[Results of cyclocryocoagulation].

BACKGROUND: The success of a cyclocryocogulation is not only defined by the reduction of the intraocular pressure but also by the simplification of the therapy necessary for the regulation of the glaucoma. PATIENTS: We examined retrospectively the charts of 27 patients with glaucoma chronicum simplex (GCS) and 63 patients with various types of non-simplex glaucomas (NGCS). All underwent a cyclocryocoagulation made 51 seconds at -70 to -80 degrees C, 4 mm behind the limbus at 6 points. RESULTS: IOP was controlled (i.e. < 25 mm Hg and decreased > 20% of the preoperative value) in 69% of the cases (GCS 70%, NGCS 68%) 3-5 days after the operation. IOP decreased from 31 to 19 mm Hg on average. The effect decreased with time, more than 12 months after the operation only 36% of the eyes were still regulated. 4 eyes with persisting pain had to be enucleated. The cyclocryocoagulation never caused blindness or phthisis bulbi. Therapy with eye drops was necessary in 70% of the patients preoperatively, and in 37% postoperatively. Oral carboanhydrase inhibitors had to be used in 57% of the patients before and in 20% of the cases after the operation. CONCLUSION: Cyclocryocoagulation is considered an effective method to lower IOP and simplify drug therapy without having serious complications.

Adult↗
PubMed1994

[The Heidelberg Retina Tomograph: reproducibility and measuring errors in different pupillary widths using a model eye].

BACKGROUND: We measured the reproducibility and relative error of the Heidelberg Retina Tomograph (HRT) in a model eye with various widths of the pupil. METHODS: We put diaphragms of various diameters in front of the lens of a model eye. The volume of an artificial papilla which was inserted into the model eye was measured three times. The coefficient of variation (standard deviation/mean value) was taken as a measure of the reproducibility. The relative error was defined as the absolute value of the quotient of the difference between measured and real value. RESULTS: The relative error for diaphragms of 1.5 to 5 mm was 7% to 18.4%, for a diaphragm of 1 mm 19.8%, and for a diaphragm of 11 mm 21.3%. The coefficient of variation ranged from 0.49% to 1.95% for diaphragms of 1.5 to 11 mm diameter, and was 8.1 for a diaphragm of 1 mm diameter. CONCLUSION: The HRT is capable of measuring volumes with a reasonable accuracy. The accuracy does not depend on the width of the pupil over a wide range of pupil diameters. In cases of very small or very much dilated pupils the accuracy and reproducibility declines.

Eye, Artificial↗
PubMed1994

Dietary supplementation with very long-chain n-3 fatty acids in patients with atopic dermatitis. A double-blind, multicentre study.

The purpose of this study was to investigate whether fish oil and/or corn oil had a beneficial effect on the clinical state of atopic dermatitis, and to evaluate the dietary intake of nutrients in this group of patients. In a double-blind, multicentre study lasting 4 months, during wintertime, 145 patients with moderate to severe atopic dermatitis were randomly assigned to receive either 6 g/day of concentrated n-3 fatty acids, or an isoenergetic amount of corn oil. As local treatment, only an emollient cream or hydrocortisone cream was allowed. The fatty acid pattern in serum phospholipids, and the dietary intake of nutrients were monitored in a subgroup of patients, and the results were compared with a group of patients with psoriasis. The overall clinical score, as evaluated by the physicians, improved during the trial by 30% in the fish oil (P < 0.001) and 24% in the corn oil group (P < 0.001). This was also consistent with the results from a selected skin area, and it was further confirmed by the total subjective clinical score reported by the patients. There were no significant differences in the clinical scores between the two groups at baseline, and at the end of the study. In the fish oil group, the amount of n-3 fatty acids in serum phospholipids was significantly increased at the end of the trial, compared with pretreatment values (P < 0.001), whereas the level of n-6 fatty acids was decreased (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Optic nerve head analyser and Heidelberg retina tomograph: accuracy and reproducibility of topographic measurements in a model eye and in volunteers.

The accuracy and reproducibility of the optic nerve head analyser (ONHA) and the Heidelberg retina tomograph (HRT) were compared and the performance of the HRT in measuring fundus elevations was evaluated. The coefficient of variation of three repeated measurements in a model eye and in volunteers and the relative error in a model eye was calculated. With ONHA measurements the pooled coefficient of variation in volunteers was 9.3% in measuring cup areas and 8.4% in measuring the cup volume. In a model eye the pooled coefficient of variation was 7.6% for the parameter 'cup area' and 9.9% for the parameter 'cup volume'. The pooled relative error in the model eye was 6.6% for the parameter 'cup area' and 5.1% for the parameter 'cup volume'. With HRT measurements in volunteers the pooled coefficient of variation of both the parameters 'volume below contour' and 'volume below surface' was 6.9%. In the model eye the pooled coefficient of variation was 2.4% for the 'volume below contour' and 4.1% for the parameter 'volume below surface'. The pooled relative error in the model eye was 11.3% for the 'volume below contour' and 11% for the 'volume below surface'. The pooled relative error in measuring retinal elevations in the model eye was 3.8%. The coefficient of variation was 3.5%. The accuracies of the HRT and ONHA were similar. However, as the ONHA 'cup volume' is unreliable in patients because of the design of the ONHA whereas the HRT volume parameters are reliable it seems reasonable to assume that the HRT is superior to the ONHA. Only the HRT is capable of quantifying retinal elevations.

Adult↗
PubMed1994

[Effect of artificial media opacities on Frisén ring perimetry and conventional light sense perimetry. A comparative study].

In this study we compare the influence of blurring by diffusor foils (Bangerter) on visual acuity and on the thresholds of ring and light sense perimetry. Light sense perimetry was performed using the G1 program of the Octopus 1-2-3 perimeter [1], and ring perimetry with the "ring" test, version 2.20 (High-Tech-Vision) designed by Frisén [4]. Ten eyes of ten healthy persons with a visual acuity of 1.25 or better were examined at six different levels corresponding to visual acuities between 1.6 and hand movements. With both perimeters sensitivity decreased with decreasing visual acuity. At good visual acuities (1.2-1.6) no changes were found in either ring perimetry or light sense perimetry. At acuity levels of 0.8 and below a more pronounced decrease in sensitivity was found with the ring perimeter than with the light sense perimeter. At the level of hand movements there were only absolute scotomas in the ring perimeter, while the Octopus 1-2-3 still detected a baseline sensitivity. Sensitivity was correlated with the logarithm of the visual acuity with both perimeters (Octopus 1-2-3: r = 0.99, P < 0.001; ring perimeter: r = 0.98, P < 0.001). The decrease in sensitivity per log-unit of visual acuity was 9.43 dB (Octopus 1-2-3) or 5.19 dB (ring perimeter). The ring perimeter, at least in its currently available version giving an absolute scotoma at mean scores > 14 dB, is obviously more sensitive to media opacities than the Octopus 1-2-3. This may be of importance in the clinical evaluation of the test results.

Adult↗
PubMed1993

Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis.

BACKGROUND: In several studies dietary fish oil has been found to have beneficial effect on psoriasis, but the results are contradictory and based mainly on open studies or studies of small numbers of patients. METHODS: In a four-month double-blind, multicenter trial, we randomly assigned 145 patients with moderate-to-severe psoriasis to receive in their diet either highly purified ethyl esters of n-3 fatty acids ("fish oil"; 6 g of oil per day, containing 5 g of eicosapentaenoic and docosahexaenoic acid) or an isoenergetic amount of corn oil containing mainly n-6 fatty acids. All the patients were advised to reduce their intake of saturated fatty acids. A 48-hour dietary recall was performed, and the fatty-acid pattern in the serum phospholipids was monitored in a subgroup of patients. RESULTS: In the fish-oil group, n-3 fatty acids were increased in serum phospholipids (P < 0.001), the ratio of arachidonic acid to eicosapentaenoic acid decreased (P < 0.001), and the level of n-6 fatty acids decreased (P < 0.001). In the corn-oil group, only docosahexaenoic acid increased significantly (P < 0.05). The ratio of polyunsaturated to saturated fatty acids increased in both groups. Plasma concentrations of triacylglycerol decreased from base line in the fish-oil group (P < 0.05). The score on the Psoriasis Area and Severity Index, as evaluated by the physicians, did not change significantly during the trial in either group. This was also true of a total subjective score reported by the patients, but a selected area of skin in the corn-oil group showed a significant reduction in the clinical signs (P < 0.05). Scaling was reduced from base line in both groups (P < 0.01). The fish-oil group had less cellular infiltration (P < 0.01), and the corn-oil group had improvement in desquamation and redness (P < 0.05). There was no significant difference in clinical manifestations between the groups. Among the patients in the fish-oil group, an increase in the concentration of n-3 fatty acids in serum phospholipids was not accompanied by clinical improvement, whereas in the corn-oil group there was a significant correlation between clinical improvement and an increase in eicosapentaenoic acid and total n-3 fatty acids. CONCLUSIONS: Dietary supplementation with very-long-chain n-3 fatty acids was no better than corn-oil supplementation in treating psoriasis. Clinical improvement was not correlated with an increase in the concentration of n-3 fatty acids in serum phospholipids among the patients in the fish-oil group, whereas there was a significant correlation between clinical improvement and an increase in eicosapentaenoic acid and total n-3 fatty acids in the corn-oil group.

Adult↗
PubMed1993

[Do scars grow despite successful laser coagulation of subretinal neovascularization?].

After successful laser coagulation of subretinal neovascularization, we examined 9 patients to see if laser scar growth (which can be expected according to the literature) is accompanied by an increase in associated scotoma. We used a specially designed visual field program. Laser scars had grown by 23% 107 days after therapy and by 32% after 409 days. The changes in our patients were at the lower range of the data reported in the literature. The increase in the laser scar was statistically significant in just one patient. Mean sensitivity and two further parameters for describing visual fields, which we introduced, all hinted at an improvement in the central visual field, although the laser scars had grown. The mean sensitivity increased by 4.9% and 7.5% after 107 and 409 days, respectively.

Adult↗
PubMed1993

Pattern electroretinogram and computerized optic nerve-head analysis in glaucoma suspects.

Both the pattern electroretinogram (PERG) and computerized disc analysis have been shown to detect early stages of glaucomatous optic nerve disease. As these two methods tap different domains (PERG reflects ganglion cell function, whereas disc analysis yields morphometric measures), we set out to compare their results in the same eyes. We recorded the PERG and optic disc parameters in 114 eyes of 58 ocular hypertensive patients. In addition, 51 eyes (26 patients) were monitored over a follow-up period of more than 6 months using the optic nerve-head analyzer. We found: (1) that a reduction in PERG amplitude was significantly correlated with increasing loss of neuroretinal rim area (P < or = 0.01), (2) that 9 of 11 eyes with a significant (P < 0.1) decrease in neuroretinal rim area over time had a reduced PERG, and (3) no significant correlation between PERG and optic disc area or between PERG and rim area. Our data show a high agreement between PERG amplitude and computerized disc analysis. This encourages the hope that it will be possible to detect glaucoma damage before appreciable visual field defects ensue.

Electroretinography↗
PubMed1992

Gender differences and the interpretation of genetic instability in Alzheimer's disease.

The neuronal degeneration and death which characterize Alzheimer's disease (AD) may stem from a constitutive genetic instability related to DNA repair deficits. To test this hypothesis, we treated peripheral blood lymphocytes from persons with AD, age-matched controls, and young controls with two drugs that induce chromosome breakage. Bleomycin, a radiomimetic antineoplastic drug, causes single- and double-stranded DNA breaks through the generation of activated oxygen radicals. Methyl methane-sulfonate (MMS) is a monofunctional alkylating agent that binds covalently to DNA. Cells were grown in culture for 72 h, with drug treatments for 4 h (bleomycin) or 24 h (MMS) prior to harvest. Fifty cells per subject per drug were scored for chromosome breakage. Breakage rates for both drugs in AD women were significantly higher than those in age-matched control women. This was not the case in men, due to the very high induced breakage rates seen in the age-matched normal control men. Because the induced breakage rates in AD women and AD men are equivalent, it seems likely that an independent factor may be contributing to genetic instability in the normal control men. Our findings indicate that the interpretation of the response of AD lymphocyte chromosomes to DNA-damaging chemicals can be strongly confounded by the effects of gender ratio in the control population sampled. These findings have important implications for the design of future studies of Alzheimer's disease, as well as for the assessment of health risks in unaffected elderly populations.

Adult↗
PubMed1992

[Surgical aspiration of secondary cataract. Success quotas and complications].

Cataracta secundaria ("Elschnig pearls") following extracapsular cataract extraction with IOL implantation can be treated by Neodymium-YAG laser capsulotomy or by surgical peeling. The major benefit of the peeling technique is the preservation of an intact posterior capsule. We retrospectively reviewed the peeling procedures (n = 224, mean age: 67 years) performed in our hospital from 1987 to 1990. The results were as follows: (1) In almost all cases (214/224) visual acuity was improved by the operation (mean improvement 0.16-->0.54); (2) major complications were: rupture of the posterior capsule in 9% (20 eyes), mostly (11 cases = 5%) associated with vitreous prolapse; retinal detachment in 1% (2 cases, one with, one without preceding rupture of the posterior capsule); persistnt corneal edema caused by endothelial decompensation in 1 case; (3) recurrence of cataracta secundaria after the first peeling was observed in 26%. Surgical peeling of cataracta secundaria improves visual acuity to about the same extent as Neodymium-YAG laser capsulotomy. It is not without risk, however, and complications occur, including retinal detachment. The possibility that a secondary cataract can reform must be taken into account.

Aged↗
PubMed1991

Early detection of glaucoma by longitudinal monitoring of the optic disc structure.

Computerized disc analysis (optic nerve-head analyzer, Rodenstock) and automated perimetry (Octopus 2000R, program G1) were used for the longitudinal monitoring of 25 subjects with elevated intraocular pressure (47 eyes). The mean follow-up time was 17.9 months (range, 12-30 months). The average number of disc examinations per eye during the follow-up period was 4.4 (range, 3-7). A progressive decrease in neuroretinal rim area was observed in 8 of 47 eyes. This continuous decrease is nonphysiological and must be interpreted as a valid sign of ongoing glaucomatous damage. It apparently precedes visual field defects, as all eyes showing continuous loss of neuroretinal rim area have had normal visual fields up to the present. Of the remaining 47 eyes, 21 showed a slight increase or no change in neuroretinal rim area. These eyes obviously did not suffer from progressive glaucomatous nerve-head damage during the follow-up period. A total of 18 eyes showed either considerable fluctuations or only a slight decrease in neuroretinal rim area; no decision can yet be made as to whether or not these eyes actually suffered glaucomatous damage.

Adolescent↗
PubMed1991

[Early detection of glaucoma damage with the Optic Nerve Head Analyzer. A case report].

We present a first case report demonstrating that the Optic Nerve Head Analyzer offers a potential chance to establish glaucomatous damage of the optic disc prior to the appearance of clinically detectable visual field defects. Computerized analysis of the optic disc of a female patient with unilateral irido-corneo-endothelial syndrome revealed a marked loss of neuroretinal rim within sixteen month of follow-up on the affected eye. The neuroretinal rim of her healthy eye was unchanged during this period. Identification and documentation of this ongoing disc damage by means of conventional techniques such as disc photography or nerve fiber layer photography were much more uncertain. Up to now no visual field loss was detectable by computerized perimetry (Octopus G1). This clinical case supports our previous conclusion from theoretical studies: For early diagnosis of glaucoma by means of computerized disc analysis with the Optic Nerve Head Analyzer follow-up measurements of the disc structure are more valid than single examinations.

Adult↗
PubMed1991

[Detection of progressive glaucomatous papilla changes before onset of visual field defects].

Computerized disc analysis was used for the longitudinal monitoring of patients with moderate intraocular pressure elevation. 44 patients (80 eyes) were monitored for at least 18 months; 25 patients (47 eyes) were monitored for at least 12 months; 15 patients (25 eyes) were monitored for at least 18 months. On average, one computerized disc analysis was performed every 4 months. Eight eyes showed a progressive decrease in their neuroretinal rim area. Seven of them were monitored for more than 18 months, one was monitored for 15 months. In all cases, the progressive decrease in neuroretinal rim area was significant, p less than or equal to .1. It is non-physiological and has to be interpreted as a serious sign of ongoing glaucoma damage. In addition, it obviously precedes the onset of visual field defects. Seven out of 8 eyes with progressive decrease in their neuroretinal rim area have normal visual fields up to now. In one case a progressive decrease in neuroretinal rim area was found at first and small visual field defects developed subsequently.

Adult↗
PubMed1991

[Improved reproducibility of computer-assisted structural analysis of the optic papilla].

Longitudinal monitoring of the optic disc structure by means of automated nervehead analysis (Optic Nerve Head Analyzer, ONHA) can facilitate the diagnosis of ongoing glaucoma. Until recently, however, longitudinal disc monitoring was complicated by considerable fluctuations of the results measured with the Optic Nerve Head Analyzer. Since March/1990 there is a new software version of the equipment (ONHA-plus). The determination of disc parameters using ONHA-plus proved to be significantly more reliable than the determination using the former ONHA: the mean fluctuation of the neuroretinal rim area measured on 18 normal eyes was 0.07 mm2 (ONHA-plus) compared to 0.094 mm2 (ONHA); the variation coefficient dropped from 7.9% (ONHA) to 4.6% (ONHA-plus). A further improvement of the reproducibility can be obtained by double examinations, because the mean examination time using ONHA-plus is about half as long as the examination time using ONHA. Moreover, ONHA-plus enables the recognition and elimination of unreliable results caused by poor image quality. Due to this increased reliability the ONHA-plus system is a considerably improved equipment for the clinical monitoring of glaucoma patients.

Glaucoma↗
PubMed1991

[Group G streptococci as pathogens of postoperative endophthalmitis].

We report an exceptional case of fulminant endophthalmitis after uncomplicated extracapsular cataract extraction with posterior chamber lens implantation. The first unusual finding was the causative organisms, group G streptococci. These organisms are commonly found as normal flora of the skin, pharynx and gastrointestinal tract. They are also well known as pathogens of neonatal sepsis, otitis media and pneumonia, but there are only three case reports describing a streptococcus G endophthalmitis. The second unusual finding was the delayed onset of the fulminant endophthalmitis, occurring later than 9 days after surgery. A retrospective analysis of 17 additional cases showed that endophthalmitis occurred either during the first 5 days after surgery or later than 35 days after surgery. If endophthalmitis developed shortly after surgery it progressed rapidly and with intense inflammation. The other cases showed more chronic inflammatory reaction. From the latter finding we conclude that long postoperative monitoring remains necessary even if at first no signs of intraocular inflammation are detectable.

Aged↗
PubMed1991

[Spontaneous bilateral lens resorption in a case of Hallermann-Streiff syndrome].

The Hallermann-Streiff-syndrome was first described in 1948 by Hallermann and in 1950 by Streiff. The most common features are dyscephalia, cataract, microphthalmia, dental anomalies, hypotrichosis, cutaneous atrophy, and nanism. Anomalies of the eye include cataract, microphthalmia, nystagm, strabism, blue sclera, fundus anomalies and combined anomalies of all segments of the eye. The frequency of cataract is about 90%. Spontaneous resorption of the lens is described in about 8%. We present a five year old girl showing the typical dyscephalia of the Hallermann-Streiff-syndrome (bird face). Her lenses were replaced by opaque membranes. These membranes presumably were remnants of the posterior lens capsule.

Aphakia↗