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Biomedical subjects

W Williamson

Publications and source records attributed to W Williamson.

At least 19 recordsLinked to original sources
PubMed2006

A multicentre, retrospective study of resource utilization and costs associated with glaucoma management in France and Sweden.

PURPOSE: To assess resource utilization and costs associated with glaucoma management in France and Sweden. METHODS: A total of 267 patient records (121 in France, 146 in Sweden) with diagnoses of primary open-angle glaucoma (POAG) and ocular hypertension (OH), treated medically, were reviewed for a 2-year period (beginning during 1997-99) for relevant clinical and resource utilization data. Economic data were applied to estimate treatment costs. RESULTS: The annual cost of treating glaucoma was estimated at SEK5305 (531 euro )/patient in Sweden and 390 euro/patient in France. In both countries, medication costs comprised about half of the total costs. Surgical procedures and hospitalizations represented greater proportions of total cost in France (7.0% and 9.6%, respectively) than in Sweden (3.7% and 0.6%, respectively). CONCLUSION: Medication costs represent a high proportion of total treatment costs. These findings highlight the relative importance of medical therapy and of assessing the cost-effectiveness of medications in glaucoma.

Aged↗
PubMed2005

Comparison of carteolol plasmatic levels after repeated instillations of long-acting and regular formulations of carteolol 2% in glaucoma patients.

BACKGROUND: A new long-acting (LA) formulation of carteolol 2% instilled once daily has been shown to provide a therapeutic effect similar to that of the regular formulation of carteolol 2% instilled twice daily. This study was designed to test whether the new formulation reduces the systemic delivery of carteolol. METHODS: In this double-masked, randomised, intra-subject comparative study, 23 patients with bilateral primary open-angle glaucoma or bilateral ocular hypertension received sequentially, according to the randomised order of administration, each of the 2 following treatments: carteolol 2% LA once daily for 2 months and carteolol 2% regular twice daily for 2 months. Treatments were instilled in both eyes throughout the study period. At the end of each period of treatment, blood samples were taken immediately before the last morning instillation (residual time), then 30 min, 1 h, 2 h and 4 h after this instillation in order to measure the carteolol plasma concentrations. RESULTS: The mean values of maximal plasma concentration (C(max)), residual level and area under the curve obtained following carteolol 2% LA treatment were significantly lower than the values obtained after carteolol 2% regular treatment (mean+/-SD): C(max) (ng/ml): 1.72+/-0.85 versus 3.64+/-3.65; residual level (ng/ml): 0.70+/-0.58 versus 1.80+/-0.84; area under the curve (ng/mlxh): 5.50+/-2.66 versus 10.27+/-5.46. Regarding safety, two drug-related, non-serious adverse events were reported in the LA group: one case of moderate, superficial, punctate keratitis and one case of "bitter taste in the throat." Both treatments appeared to be well tolerated. CONCLUSIONS: The data from this study showed that the systemic delivery of carteolol is lower for the once-daily LA formulation than for the regular twice-daily formulation. Consequently, long-acting carteolol eye-drops should reduce the risk of beta-blocking systemic side effects.

Adrenergic beta-Antagonists↗
PubMed2001

[An observational, retrospective two-year cost study in primary open-angle glaucoma and ocular hypertension in newly diagnosed patients].

PURPOSE: To investigate the different treatment strategies in France and the direct costs for patients with newly diagnosed primary open-angle glaucoma or ocular hypertension who have started treatment with beta-blockers, and to estimate the total direct cost for two years of treat. MATERIAL: and methods: We analyzed 225 medical charts retrospective in eleven academically and office-based centers in France over the first two years after diagnosis. Standard costs for each resource in current medical practice were determined from the French Social Security perspective. RESULTS: The vast majority of patients (90%) had a diagnosis of primary, open-angle glaucoma or ocular hypertension in both eyes. In 60% of the patients we found a moderate or severe defect in their visual field or optic nerve. Intraocular pressure before treatment was 23.9+4.7mmHg and 17.5+4.2mmHg after two years of treatment. Over the first two years, 25% of visits led to a change in therapy (medical or surgical), involving 64% of the patients. Two-thirds of the changes occurred during the first year of treatment and in around 80% of cases for low intraocular pressure at check-up. Laser surgery or surgical intervention was performed in 25% of the patients. Total direct costs for two years were 5698F.F. The intraocular pressure before treatment was positively correlated (p<0.01) with treatment costs, while the initial intraocular pressure-lowering effects of treatment were negatively correlated with two-year costs. CONCLUSION: After two years of treatment, the mean intraocular pressure decreased from 24 to 17.5mmHg. The higher the basal intraocular pressures is, the more intensive the treatment and the higher the costs. The more efficient the treatment to decrease baseline intraocular pressure is, the earlier the costs will be reduced.

Aged↗
PubMed2001

[Histologic evaluation in rabbits of the biocompatibility of episcleral implant material: S-PTFEe (silicone core covered with expanded polytetrafluoroethylene)].

PURPOSE: To study the tolerance of a silicone band wrapped with expanded polytetrafluoroethylene (e-PTFE) in "fauve de Bourgogne" rabbits. METHODS: A 5.7mmx3.2mm band of S-PTFE (silicone-polytetrafluoroethylene, France Chirurgie Instruments) was used. A tight seal was produced between the two materials by silicone gluing. Eight eyes were implanted episclerally and fixed with Mersilene 5-0. One silicone band was used on a control eye. RESULTS: Three eyes were removed at 4 weeks, one at 8 weeks and four at 12 weeks. No extrusion was observed except for the silicone band rejected 2 weeks after implantation. On histopathologic examination, PTFE colonisation was present in all eyes with fibroblast, inflammatory cells, and neovascularization. CONCLUSION: The S-PTFE implant was colonized and well tolerated in rabbit eyes. Advantages of silicone band (quality, stability of indentation) are combined to the tolerance of PTFE.

Animals↗
PubMed2000

Corneal myxoma associated with keratoconus and Down's syndrome.

PURPOSE: Primary myxoma of the cornea is extremely rare. Until now, only four primary corneal myxomas were reported in the literature, whereas secondary involvement of the cornea by conjunctival and limbal tumors is much more common. METHODS: We report an additional case in a 26-year-old woman with keratoconus and Down's syndrome. Excision of the corneal mass was performed by penetrating keratoplasty. Histochemical, immunohistochemistry, and ultrastructural studies were used to obtain a definitive diagnosis. RESULTS: The tumor exhibited the characteristic histologic features of myxoma. The tumor cells showed immunoreactivity for vimentin but not for S-100 protein, epithelial membrane antigen, CAM 5.2, HHF-35, or muscle-specific actin. Ultrastructural features were fibroblast-like or stellate cells with cytoplasm containing abundant, rough reticulum and dilated cisternae. No recurrence was observed 36 months after penetrating keratoplasty. CONCLUSION: This is only the fifth report of such an occurrence. Although the coexistence of myxoma in Down's syndrome with keratoconus is described here for the first time, the differential diagnosis of apparently evident acute hydrops on clinical inspection should not rule out the possibility of a corneal myxoma. Histologic analysis should therefore be performed.

Adult↗
PubMed2000

Myxoid liposarcoma of the supraclavicular fossa.

Liposarcomas generally originate most often in the extremities or retroperitoneum, less frequently in the head and neck, and rarely in the thorax. We describe a particularly rare presentation of myxoid liposarcoma originating in the supraclavicular fossa. The mass was resected and has not recurred. We searched our pathology database for other soft-tissue tumors of the supraclavicular fossa and found no other case of sarcoma originating in this site. In addition, we performed a literature review of thoracic and neck liposarcomas to identify similar cases and discuss their clinical course.

Aged↗
PubMed1995

[Indications of penetrating keratoplasty from a histopathological study of 1129 corneal buttons (from 1982 to 1991)].

PURPOSE: To analyze the indications or the penetrating keratoplasties which were conducted in the Bordeaux University Hospital over the 1982-1991 period and to compare these findings with those of previously published studies. METHODS: The histopathological study of 1129 corneal buttons was analyzed according to conventional methods in the Histopathology Department Pellegrin Hospital. RESULTS: The main indications for penetrating keratoplasty were (in decreasing order of frequency): pseudophakic or aphakic corneal oedema (28.7%), keratoconus (12.1%), regrafts (11.1%), and corneal scars (10.7%). Less frequent indications for penetrating keratoplasty included Fuchs' endothelial dystrophy (7.8%); corneal trauma (7.3%) and herpes (7.2%). Ophthalmological conditions requiring penetrating keratoplasty fall into six groups of unequal size: 1) corneal oedema (28.7%); 2) keratitis (26%); 3) dystrophies (23.2%); 4) graft failures (11.1%); 5) trauma and chemical burns (8%) and 6) miscellaneous (2.9%). CONCLUSION: The authors emphasize the importance of studying histologically the corneal buttons after penetrating keratoplasty. Corneal oedema after cataract surgery is shown, based on the data presented, to be the main indication for penetrating keratoplasty.

Adolescent↗
PubMed1995

[Floppy eyelid syndrome. Apropos of 4 cases and review of the literature].

Often unrecognized, Floppy eyelid syndrome is an impairment of the eyelid statics with marked conjunctival signs. Over-weight middle aged men are principally concerned. Excessive eyelid laxity in the Floppy eyelid syndrome is responsible for a night ectropion of the upper lid, creating the clinical manifestations. We report four cases of Floppy eyelid syndrome to illustrate our work and discuss the clinical and therapeutic aspects.

Aged↗
PubMed1995

[Trabeculectomy with mitomycin C. Study apropos of 30 cases].

UNLABELLED: Standard trabeculectomy with adjunct Mitomycin C application was performed in 30 eyes of 26 patients with refractory glaucoma to study the efficacy and safety of this technique. The results were analyzed for each aetiology and number of ocular risk factors for failure of filtering procedure and compared with those of other series, including those using 5-fluorouracil. METHODS: The surgical procedure was similar to that described by Cairns, except that a fornix-based conjunctival flap was used. A 0.4 mg/ml solution of Mitomycin C was applied at the filtration site for three minutes. The mean follow-up was 6.4 months; the thirty eyes were followed for 4 to 11 months. RESULTS: At 6 months, the intraocular pressure was less than 21 mmHg in 65.2% of cases without postoperative glaucoma medication, and the overall success rate was 86.9%. No remarkable complications occurred. CONCLUSION: Intraoperative Mitomycin C may be a helpful adjunct in achieving low final intraocular pressure after trabeculectomy in high-risk glaucoma filtering surgery, and Mitomycin C may be a viable alternative to postoperative 5-Fluorouracil. But further studies regarding late complications due to mitomycin are required.

Adolescent↗
PubMed1995

[Complication of keratoprosthesis of posterior fixation: retroprosthetic membranes. Apropos of 4 cases].

Keratoprosthesis represents the last solution for patients with bilateral corneal blindness or for monophthalm patients who cannot benefit from corneal grafts. Complications related to this technique are recalled together with an in-depth analysis of the problem of retroprosthesis membranes. The frequency of retroprosthesis membranes varies depending on the series reported, although it appears to be a more agreement on treatment and causes. Among 8 patients who underwent a KPF operation using the E. Lacombes technique, 50% of the cases had retroprosthesis membranes with an unusual thickness, vascularization and recurrent character. Emphasis was placed on early and intense intraocular inflammation.

Adult↗
PubMed1995

[Orbital dermoid cysts. Apropos of a case].

We report the case of a 53 year-old female patient with an orbital dermoid cyst. A mass effect with proptosis, hypotropia and choroidal folds was noted. Imaging aspects (radiography, ultrasonography and computed tomography) were highly suggestive of a deep orbital dermoid cyst. A fronto-temporal neuro-surgical approach allowed complete removal of the tumour. Histopathology confirmed the diagnosis of dermoid cyst. The incidence of orbital dermoid cyst falls significantly after the second decade of life thus making our clinical case original.

Dermoid Cyst↗
PubMed1994

Compared optical performances of multifocal and monofocal intraocular lenses (contrast sensitivity and dynamic visual acuity)

The functional results (contrast sensitivity and dynamic visual acuity) of 19 multifocal (3M design) and 14 all polymethylmethacrylate biconvex monofocal intraocular lenses (IOLs), 6 mm in optical diameter were compared. Best corrected visual acuity was > or = 8/10 (Monoyer chart) Parinaud 2 in all cases. Major differences of functional performance in favour of monofocal IOLs were found outside standard conditions of vision (low contrast and illumination levels). A significant difference in contrast sensitivity was found for each spatial frequency in favour of multifocal IOLs (0.0016 < p < 0.05). Mesopic vision was statistically higher in the monofocal IOL group (p = 0.0015). Moreover, dynamic visual acuity allowed accurate evaluation of the difference in performance between these two models of implant. In view of these results multifocal IOLs should be reserved for patients with normal psychosensitive adaptation; an ocular pathology that could alter contrast sensitivity or mesopic vision is a contraindication for multifocal IOLs.

Aged↗
PubMed1994

[Results of therapeutic photo-keratectomy using the Excimer laser. Apropos of 12 cases].

We report a series of 12 eyes which underwent phototherapeutic keratectomy with the Excimer laser Aesculap Meditec (model Mel 60). Mean follow up was 11 months (range 3 to 19 months). Six types of corneal pathologic lesions were treated: recurrent corneal erosions, corneal scars after herpetic keratitis, anterior stromal dystrophy, band keratopathy, mucous plaque, and scar after viral infection. Epithelium healed within the first post-operative week in 83.3% of cases. The goal of treatment was achieved in 75% of cases (100% of therapeutic success for recurrent corneal erosions and 66.6% for superficial corneal opacities). The main undesirable effects were postoperative pain, delayed reepithelialization (16.6%). One patient (8.3%) lost more than two lines of visual acuity. The results, the limits and the undesirable effects of phototherapeutic keratectomy are discussed from our experience and data found in the literature.

Adolescent↗
PubMed1994

[Vitreous hemorrhage associated with persistent hyaloid artery. Apropos of a case].

We report a case of vitreous haemorrhage from a persistent hyaloid artery that occurred to a 50 year-old patient. The case report is followed by a review of the embryologic development and a physiopathologic discussion about the origin of vitreous haemorrhage. The authors emphasize the distinction between persistent hyaloid artery and persistent hyperplastic primary vitreous.

Humans↗
PubMed1993

[Permanence of Chlamydia of different serotypes in tissues (methodology)].

Immunofluorescence detection of C. trachomatis requires trained personnel because the threshold between positive and negative reaction is not obvious. Patients antibodies must cover EB and thus prevent binding with Mab. This problems have stimulated research on Chlamydiae probes DNA hybridization technology was applied and the specificity of the detection of CT was improved. Moreover, a polymerase chain reaction amplification of a fragment of about 1,200 bp of the M.O.M.P. gene followed by restriction endonuclease digestion with selected enzymes allows differentiation of serovars. This method seems to be promising for epidemiologic studies.

Base Sequence↗