Biomedical subjects
Publications and source records attributed to L Vijaya.
A case of torsion of the testis in the newborn is presented. A review of the literature indicates that this condition tends to occur in babies weighing over 3,000 Gm., born of primigravida; the involved testicle is usually nontender, and frequently there is adhesion of the skin to the mass. Controversies in regard to methods of treatment are discussed.
BACKGROUND AND OBJECTIVE: This study was undertaken to compare the efficacy and safety of low-dose intraoperative application of mitomycin-C (MMC) with that of 5-fluorouracil (5-FU) in primary trabeculectomy. PATIENTS AND METHODS: A non-randomized prospective study was performed between August 1994 and November 1995. Thirty-two eyes of 16 consecutive patients who underwent trabeculectomy for uncontrolled glaucoma of various causes form the study group. The mean age was 46.8 +/- 9.9 years. The first eye received MMC (0.2, 0.4 mg/ml), fellow eye received 5-FU (50 mg/ml), for 1 minute intraoperatively. Bleb characteristics and intraocular pressure (IOP) control were analyzed. Success of surgery based on IOP control was measured by 3 different criteria: IOP less than 21 mm Hg; IOP less than 21 mm Hg with more than 30% reduction; and IOP less than 16 mm Hg with more than 30% reduction. RESULTS: Mean preoperative IOP was 31.4 +/-12.7 mm Hg in MMC group and 27.8+/- 8.8 mm Hg in 5-FU group. Mean follow-up in MMC group was 16.12 +/- 8.17 months; in 5-FU group 13.37 +/- 8.19 months. At last follow-up all 5-FU blebs were nonischemic, while 4 eyes in the MMC group showed nonischemic blebs, and 12 eyes had ischemic blebs. There was no statistically significant difference between MMC group and 5-FU group success rates with all 3 criteria. Success rates were: IOP less than 21 mm Hg; 100% in both groups; IOP less than 21 mm Hg with more than 30% reduction; MMC group 93.8%, 5-FU group 75%; less than 16 mm Hg with more than 30% reduction; MMC group 87.5%, 5-FU group 68.8%. CONCLUSIONS: Low-dose intraoperative MMC and 5-FU can provide control of IOP in primary trabeculectomy, 5-FU group showed more non-ischemic blebs.
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Dose-inhibition studies of proliferating fibroblasts grown from Tenon's capsule biopsy specimens obtained during trabeculectomy from 17 glaucoma patients were performed using varying concentrations of mitomycin C (MMC), with exposure of cells to the drug for either 5 days or 5 minutes. Surgical outcomes were determined 3 months postoperatively. Based on in vitro results, fibroblasts were classified as either MMC-"resistant" or MMC-"sensitive." Thirteen surgically successful cases were associated with 10 "sensitive" and three "resistant" fibroblasts; four surgical failures with one "sensitive" and three "resistant" fibroblasts. The in vitro studies were positively correlated with the clinical outcomes, the former correctly predicting the latter in 76.5% of the surgeries.
Ninety-three consecutive trabeculectomies in which mitomycin C (MMC) was applied intraoperatively, either at a concentration of 0.5 mg/mL for 5 minutes (n = 48) or at a concentration of 0.4 mg/mL for 3 minutes (n = 45), were reviewed to determine whether there was a significant difference between the two groups in terms of intraocular pressure (IOP) control and the incidence of complications. Preoperative and postoperative IOPs in the two groups did not differ significantly (P = .817 and .131, respectively). The 5-minute group had a higher incidence of serous choroidal detachments (P = .001). The incidence of postoperative hypotony and filtration failure with uncontrolled IOP in the two groups did not significantly differ (P = .177 and .582, respectively). Thus, intraoperative application of MMC at a concentration of 0.4 mg/mL for 3 minutes controlled postoperative IOP as effectively as MMC at a concentration of 0.5 mg/mL for 5 minutes, with a significantly lower incidence of choroidal detachments.