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At least 55 records · Page 3Linked to original sources
PubMed1993

Keratometric comparison of 4.0 mm and 5.5 mm scleral tunnel cataract incisions.

Postoperative keratometric astigmatism was analyzed in 276 consecutive cases of phacoemulsification and posterior chamber lens implantation performed by one surgeon. The series was divided into two groups: one received 4.0 mm incisions and the other 5.5 mm incisions. Incision design was triplanar and required suture closure, i.e., all wounds were closed with two X-pattern 10-0 nylon sutures. Using the Cravy method, an insignificant difference in induced astigmatism was found between the groups at one day, two weeks, and one year after surgery. The average induced diopters of astigmatism for the 4.0 mm group was +0.80 +/- 0.94 at one day, +0.49 +/- 0.73 at two weeks, and -0.34 +/- 0.91 at one year; for the 5.5 mm group it was +0.69 +/- 1.07 at one day, +0.41 +/- 0.85 at two weeks, and -0.23 +/- 1.01 at one year. Two-week uncorrected visual acuity of 20/40 or better was similar for both groups. Seventy-six percent of the 4.0 mm group and 68% of the 5.5 mm group had acuities of 20/40 or better. A significant difference in the incidence of immediate postoperative hyphema was noted. The overall hyphema incidence was 9%, with a 14% and 4% incidence for 5.5 mm and 4.0 mm incisions, respectively.

Astigmatism↗
PubMed1996

Astigmatism reduction: no-stitch 4.0 mm versus sutured 12.0 mm clear corneal incisions.

PURPOSE: To compare the effect on astigmatism of phacoemulsification using a 4.0 mm, no-stitch, clear corneal incision with that of extracapsular cataract extraction (ECCE) using a 12.0 mm, sutured, clear corneal incision. SETTING: Augenklinik, Städtisches Klinikum Karlsruhe, Germany. METHODS: The study comprised 211 patients who had cataract extraction and intraocular lens implantation through a superior clear corneal incision; 108 patients had phacoemulsification with a 4.0 mm no-stitch incision, and 103 had ECCE using a 12.0 mm sutured corneal incision. The main outcome measure was amount of astigmatism preoperatively and at 1 week and 3 and 6 months postoperatively. Corresponding medians (lower and upper quartiles) were evaluated. RESULTS: Median surgically induced cylinder was 1.00 diopter (D) (range 0.56 to 1.50 D) in the 4.0 mm no-stitch incision group and 1.75 D (range 1.00 to 2.62 D) in the 12.0 mm sutured incision group. In eyes with preoperative with-the-rule astigmatism, astigmatism decreased from a median of 0.75 D (range 0.50 to 1.00 D) to 0.50 D (range 0 to 1.50 D) in the 4.0 mm incision group. The difference between preoperative and postoperative astigmatism in the 12.0 mm incision group was not statistically significant. CONCLUSION: Clear corneal cataract surgery leads to a predictable reduction in astigmatism when performed on the steeper axis with a small, no-stitch incision. Larger sutured incisions are not suitable for planned refractive changes but are still recommended in certain cases such as hard cataract and glaucoma.

Astigmatism↗
PubMed2001

Comparison of femoral head penetration rates between cementless acetabular components with 22-mm and 28-mm heads.

Between April 1993 and July 1994, the senior author (R.C.J.) performed 151 consecutive primary total hip arthroplasties using a Harris-Galante II acetabular component and a polished Iowa femoral component. In 105 hips, 22-mm head components were used, and in 46 hips, 28-mm head components were used. Femoral head penetration into the acetabular shell was measured using digital edge detection techniques. The group average penetration for the initial 2-year bedding-in period was 0.35 mm/y for the 22-mm and 0.31 mm/y for the 28-mm head components. The long-term rate of penetration into the shell was 0.11 mm/y for the 22-mm heads and 0.17 mm/y for the 28-mm heads, a significant difference (P=.029). The dislocation rate was significantly higher, however, with the 22-mm heads (P=.001). The 22-mm components showed significantly less wear but at the expense of an increase in the prevalence of dislocation.

Acetabulum↗
PubMed2003

Increase in systolic blood pressure of > or = 30 mm Hg and/or diastolic blood pressure of > or = 15 mm Hg during pregnancy: is it pathologic?

OBJECTIVE: To determine whether a rise in systolic blood pressure (SBP) > or = 30 mm Hg and/or diastolic blood pressure (DBP) > or = 15 mm Hg in the absence of hypertension during pregnancy is associated with adverse pregnancy outcomes. METHOD: We conducted a retrospective, longitudinal study of 1,498 pregnant women without hypertension or proteinuria in the first trimester. The blood pressure levels measured during the first (7.8 +/- 2.3 weeks), second (20.7 +/- 1.2 weeks), and third trimesters (38.6 +/- 1.5 weeks) were analyzed. The perinatal outcome was compared between women who exhibited a rise in SBP > or = 30 mm Hg and/or DBP > or = 15 mm Hg during pregnancy (large Delta BP group) and women who did not (small Delta BP group) using one way analysis of variance, chi-square test, or Fisher's exact test. The contribution of gestational hypertension and a large Delta BP to the development of adverse pregnancy outcomes was evaluated using multivariate logistic regression analysis. RESULTS: Of 1441 women who remained normotensive (SBP < 140 mm Hg and DBP < 90 mm Hg) during pregnancy, 238 (16.5%) and 1,203 (83.5%) belonged to the large Delta BP and small Delta BP groups, respectively. There were no significant differences between the two groups in the occurrence rate of gestational proteinuria, preterm deliveries, low-birth-weight infants, or small-for-gestational age infants. A large Delta BP was not a risk factor in itself for the occurrence of gestational proteinuria or small-for-gestational age infants after controlling for the effect of gestational hypertension. CONCLUSION: A rise in SBP > or = 30 mm Hg and/or DBP > or = 15 mm Hg is not a risk factor of adverse outcome among women who remain normotensive during pregnancy.

Adult↗
PubMed1998

A comparison between the sensitivities of 3-mm and 5-mm thick serial brain MRI for detecting lesion volume changes in patients with multiple sclerosis.

In this longitudinal study the authors evaluated the sensitivity of 3-mm and 5-mm magnetic resonance imaging (MRI) of the brain in the detection of lesion load changes over time in multiple sclerosis (MS). The authors also correlated the changes detected with these two techniques with the changes in disability. Eighteen patients with MS underwent two MRI examinations of the brain--one at entrance into the study and one follow-up examination. At both sessions, images with 24 contiguous slices 5 mm thick and another with 40 contiguous axial slices 3 mm thick were consecutively acquired. On the same occasions, the patients' Expanded Disability Status Scale (EDSS) scores were rated. MR images with slices 3 mm thick showed higher lesion loads than those with slices 5 mm thick at both entrance and follow-up examinations (median, 13.4 vs 12.8 ml and 17.5 vs 17.0 ml, respectively; p < 0.0001). The correlation between MRI and EDSS changes was significant for both MRI acquisition schemes (3 mm, r = 0.64; 5 mm, r = 0.59). The data suggest that acquisition of thinner slices does not significantly increase the sensitivity of MRI of the brain in the detection of lesion load changes in MS.

Adult↗
PubMed2003

The effect of capsulorhexis size on development of posterior capsule opacification: small (4.5 to 5.0 mm) versus large (6.0 to 7.0 mm).

PURPOSE: The most common surgically related cause of reduced vision after extracapsular cataract extraction is posterior capsule opacification (PCO), which occurs in up to 50% of eyes following cataract extraction. This study examined whether small capsulorhexes of 4.5 to 5.0 mm, which lie completely on the 5.5 mm intraocular lens (IOL), and large capsulorhexes of 6.0 to 7.0 mm, which lie completely off the lens optic, are effective in preventing PCO development. METHODS: In this prospective study, 496 eyes of 367 patients underwent standardized phacoemulsification with capsulorhexis and capsular bag foldable acrylic IOL implantation. The patients were randomly assigned to receive either a small capsulorhexis of 4.5 to 5 mm to lie completely on the IOL optic or a large capsulorhexis of 6 to 7 mm to lie completely off the lens optic. Retroillumination photographs were taken at 6 months and then yearly. RESULTS: Throughout the follow-up, there was less PCO in the small capsulorhexis group than in the large capsulorhexis group. CONCLUSIONS.:Small capsulorhexes were associated with less wrinkling of the posterior capsule and less PCO than were large capsulorhexes. PCO after IOL implantation has a multifactored pathogenesis. Small (4.5 to 5.0 mm) capsulorhexis and capsular bag implantation of 5.5 mm acrylic IOL are likely to reduce the PCO incidence when compared with the 6.0 to 7.0 mm capsulorhexis. The significance of the IOL optic diameter in association with the capsulorhexis size should also be documented by further studies.

Aged↗
PubMed1982

Production of monoclonal antibodies against MM antigen: the serologic identification of MM antigen with Ly-6.2 alloantigen.

Monoclonal antibodies against MM46, an ascitic mouse mammary tumor of C3H/H2, were produced by fusing mouse myeloma cell line NS-1 with spleen cells from a (BALB/c X C3H/HeN)F1 mice hyperimmunized with MM46, an MM antigen-positive tumor. Eight antibodies showed cytotoxicity against MM46, but not against MM48, an MM antigen-negative ascitic mammary tumor, and one hybridoma produced an agglutinating antibody. One of the cytotoxic monoclonal antibodies, 3-3-C, was selected, and the strain distribution and the tissue distribution of MM antigen were studied. The results demonstrated that MM antigen had a strain distribution identical to Ly-6.2 antigen, and a similar tissue distribution. Therefore, the characterization of MM antigen and Ly-6.2 antigen was investigated. Ly-6.2 antibody was shown to be cytotoxic for MM46, but not for MM48, in accordance with 3-3-C. Genetic segregation analysis of MM and Ly-6.2 antigens in 33 backcross mice demonstrated complete concordance between these two antigens. In addition, MM antigen phenotype of an Ly-6.2 congenic strain, C3H.B6-Ly-6b, was studied, and it was found to be positive in contrast to C3H/HeN. Furthermore, cross-absorption studies revealed that both MM46 cells and C3H.B6-Ly-6b lymph node cells could absorb cytotoxic activities of 3-3-C and monoclonal anti-Ly-6.2 antibody. The results so far obtained suggested strongly that these two loci controlling expression of MM and Ly-6.2 antigens were identical or very closely linked.

Absorption↗
PubMed1994

Long term clinical results with 19 mm or 21 mm standard aortic St. Jude Medical prosthesis.

Comparison of long term clinical results after aortic valve replacement with 19 mm or 21 mm vs. 23 mm or larger bileaflet prostheses has not yet been reported. Between December 1979 and September 1993, 80 consecutive patients who underwent isolated aortic valve replacement at Niigata University using a standard St. Jude Medical valve were assigned to small size group (19 mm and 21 mm, n = 34) or to large size group (23 mm or larger, n = 46). In the small size group, patient's age was older, body surface area smaller, female patients and calcified aortic stenosis were dominant (all p < 0.01). The left ventricular systolic dimension was shorter (p < 0.001), while the cardiothoracic ratio was similar to that of the large size group. All patients received warfarin treatment, and target thrombotest level was 15 to 25% (equivalent to INR 1.6 to 2.1). Actuarial survival rates including hospital death in the small size group (94% at fifth postoperative year) were comparable to those in the large size group. Cerebrovascular event occurred in two patients with the small size prosthesis (1.3%/pty) and three with larger prosthesis (0.9%/pty). Major hemorrhagic complication was not observed in either group. No significant difference was noticed in the proportion free from valve-related morbidity. In the patients with aortic stenosis (n = 41), the left ventricular posterior wall thickness decreased from 15 mm preoperatively to 11 mm late post surgery in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

Characterization of the MM.1 human multiple myeloma (MM) cell lines: a model system to elucidate the characteristics, behavior, and signaling of steroid-sensitive and -resistant MM cells.

Multiple myeloma (MM) is a clonal B-lymphocyte malignancy, which is characterized by the accumulation of terminally differentiated antibody-producing cells in the bone marrow. Because current treatments offer only a median survival of 3 years, investigators continue to search for novel therapeutic strategies to combat the disease. Rational drug design is enhanced by understanding MM cell proliferation and key signaling pathways employed. In addition, a model system for preclinical evaluation of novel therapeutics is critical. Our laboratory has developed MM cell lines to study drug action and resistance, cell proliferation, and apoptosis. These cell lines are widely used in MM research. From a single MM patient, three separate cell lines were established that parallel the progression of the disease. These three cell lines, designated MM1.S, MM1.R(E), and MM1.R(L), can be distinguished on the basis of their sensitivity to steroid hormones such as glucocorticoids (GCs). Utilization of these cell lines to study the etiology of MM, effects of chemotherapeutic agents, and development of clinical resistance, will provide us with vital information for the evolution of new and more efficacious therapeutics. The aim of this review is to summarize the morphological, biochemical, and growth characteristics of these cells, and to review the results from investigations of the MM.1 signaling pathways. This information will enhance the study, treatment, and eventual eradication of MM.

Apoptosis↗
PubMed2000

Procedural results and late clinical outcomes after percutaneous interventions using long (> or = 25 mm) versus short (< 20 mm) stents.

OBJECTIVES: To evaluate clinical outcomes after the use of long coronary stents. BACKGROUND: The use of long slotted-tube stents has been recently approved in the U.S. to treat long lesions or dissections. Procedural success and long-term outcomes of long versus short stents have not been established. METHODS: We evaluated procedural success, major in-hospital complications, target lesion revascularization and long-term (one year) clinical outcomes in 1,226 consecutive patients (1,259 native coronary lesions) who underwent a single vessel intervention using a single long (> or =25 mm, 116 patients) or short (<20 mm, 1,110 patients) tubular-slotted stent. RESULTS: Patients treated with long stents had more diffuse (>10 mm length) lesions (63% vs. 28%, p = 0.001). The mean stent length was 28 +/- 5 mm versus 15 +/- 2 mm for long versus short stent groups (p = 0.001). Overall procedural success was similar in the long versus short stent groups (96% vs. 98%, p = 0.08). However, major in-hospital complications tended to occur more frequently in patients treated with longer stents (3.4% vs. 1.0%, p = 0.04). The rate of periprocedural non-Q-wave myocardial infarction (MI) (creatine kinase-MB > or =5 times normal) was notably higher after long stent implantation (23% vs. 11%, p = 0.001). Target lesion revascularization at one year was 14.5% vs. 13.8% (p = 0.69), and target vessel revascularization rate was 19.6% vs. 17.3% (p = 0.41) in the long versus short stent group, respectively. There was no difference in one year mortality (2.5% vs. 3.5%, p = 0.49) or Q-wave MI (2.7% vs. 1.2%, p = 0.48), and the overall cardiac event-free survival was similar for the two groups (81%). CONCLUSIONS: The use of single coronary long (> or =25 mm) versus short (<20 mm) stents is associated with: 1) somewhat increased major procedural complications, 2) significantly higher frequency of periprocedural non-Q-wave MIs, and 3) equivalent repeat revascularization risk and cardiac event-free survival out-of-hospital up to one year.

Blood Vessel Prosthesis Implantation↗
PubMed1993

Experimental evaluation of posterior capsule opacification and intraocular lens decentration: comparison of intraocular lenses of 12.5 mm and 14.0 mm diameter.

Most posterior chamber intraocular lenses (IOLs) in common use today measure 13.5 mm to 14.0 mm in diameter. Some investigators recommend using smaller lenses (e.g., 12.0 mm to 12.5 mm). To investigate the effect of smaller lenses, experimental phacoemulsification procedures were performed in 16 eyes of white rabbits using two intraocular lens sizes: 14.0 mm and 12.5 mm. Each lens was evaluated for its effects on posterior capsule opacification and optic decentration, two of the most common complications of modern cataract surgery and intraocular lens implantation. The 12.5 mm lens showed a slightly smaller amount of decentration than the larger lens and a comparable amount of posterior capsule opacification.

Animals↗
PubMed2004

Gamma knife radiosurgery for trigeminal neuralgia: comparing the use of a 4-mm versus concentric 4- and 8-mm collimators.

PURPOSE: Gamma knife (GK) radiosurgery for trigeminal neuralgia (TN) has been effective in 50-80% of cases when using a single 4-mm collimator and a maximum dose of 60-90 Gy. Attempting to improve the response rate by increasing the dose may lead to increased risk of facial numbness or disturbed sensation. Combined use of 4- and 8-mm collimators results in a larger target volume, which would potentially treat a larger region of the nerve without increasing the maximum dose. MATERIALS AND METHODS: One hundred-one patients suffering from medically refractory TN were evaluated. Fifty-four were treated with a single shot using a 4-mm helmet and 47 with concentrically aimed, equally weighted 4- and 8-mm helmets. 75 Gy were prescribed to the 100% isodose line (using a 4-mm helmet output factor of 0.80) in all cases. The outcome was assessed by interview or outpatient visit. RESULTS: An excellent/good response was seen in 57.8 vs. 71.4%, respectively, with a partial response of 13.3 vs. 2.3%, respectively (p > 0.05). Pain recurrence occurred in 28.6 vs. 23.2%, respectively (p > 0.05). CONCLUSION: The use of a combined concentric 4- and 8-mm collimator treatment for medically refractory TN at a maximum dose of 75 Gy does not improve outcome as compared with a single 4-mm collimator with an equivalent maximum dose.

Adult↗
PubMed1999

Is 8-mm more effective than 4-mm tip electrode catheter for ablation of typical atrial flutter?

BACKGROUND: The prospective, randomized study comparing 4- with 8-mm tip electrodes for radiofrequency linear ablation of typical atrial flutter is not available. METHODS AND RESULTS: A total of 104 consecutive patients with typical atrial flutter were randomly assigned to undergo radiofrequency linear ablation using a 4- (Group I, n=54) or 8-mm tip electrode (Group II, n=50) catheter (temperature-control model, preset 70 degrees C). If complete bidirectional isthmus block could not be achieved after 5 pulses, the ablation catheter was changed to the other type; the maximal radiofrequency pulse number was limited to <10 pulses. Complete or incomplete isthmus conduction block was assessed by activation sequence in a multielectrode Halo catheter during low lateral right atrial and proximal coronary sinus pacing. Before shifting to the other catheter type, the 8-mm electrode catheter achieved higher complete isthmus block rate (92% versus 67%, P<0.05) with fewer pulses (2+/-1 versus 3+/-1, P<0.05), shorter procedure time (24+/-15 versus 31+/-12 minutes, P<0.05), and shorter fluoroscopic time (14+/-10 versus 23+/-15 minutes, P<0.05). After 5 failed ablation pulses, 12 (67%) of 18 patients in group I attained complete isthmus block by using an 8-mm tip catheter, but none of 4 patients in group II achieved complete block by changing to a 4-mm tip catheter. CONCLUSIONS: The 8-mm tip electrodes are more effective than the standard 4-mm length electrodes in linear ablation for typical atrial flutter. This clinical benefit may be of particular value for some patients with broad and/or thick isthmus.

Aged↗
PubMed1996

Helical computed tomography at 1.5:1 pitch reconstructed at 15-mm and 7-mm intervals for examination of patients with suspected metastatic disease.

OBJECTIVE: To document the need for overlapped reconstruction when using helical computed tomography (CT) software that reconstructs 10-mm-collimation, 1.5:1-pitch images at 15-mm intervals in follow-up examination of patients with suspected metastatic disease. PATIENTS AND METHODS: Forty consecutive patients with known or suspected metastatic disease were examined with helical CT at 10-mm collimation and 1.5:1 pitch. The studies were examinations of the chest, abdomen and pelvis; the chest and abdomen; or the abdomen and pelvis. Two image sets, one prospectively reconstructed at 15-mm intervals and the other retrospectively reconstructed at 7-mm intervals, were independently reviewed by three radiologists, and the number, size and location of lesions were documented. Differences in interpretation were resolved by consensus. The lesions detected on the two sets of images were classified according to lesion size and location, and the results were analysed by multivariate analysis of variance with repeated measures. RESULTS: Images reconstructed at 7-mm intervals revealed a total of 436 lesions, 127 (41%) more than were revealed by images reconstructed at 15-mm intervals. The number of lesions less than 1 cm in diameter that were visible in the two sets of images was significantly different (p = 0.018). However, there was no significant difference between the two sets of images in terms of lesion location. CONCLUSION: Metastatic lesions may be missed by helical CT at 1.5:1 pitch if overlapped reconstruction is not performed.

Abdominal Neoplasms↗
PubMed2002

A comparison of the in vivo performance of the 19-mm St. Jude Medical Hemodynamic Plus and 21-mm standard valve.

BACKGROUND: In the present study we analyzed the in vivo performance of the 19-mm St. Jude Medical Hemodynamic Plus aortic prosthesis (19HP), evaluated the midterm performance of 19HP in the aortic position, and compared the implantability and hemodynamic characteristics of this valve with those of the 21-mm standard St. Jude Medical valve (21SD) in adult patients with aortic stenosis and a narrowed aortic annulus. METHODS: From February 1994 to December 1999, 60 patients who underwent isolated aortic valve replacement with either the 19HP (n = 31) or the 21SD (n = 29) were studied. Comparison between the two models included analysis of early and late mortality and morbidity. Pre- and postoperative echocardiography was performed in all patients to evaluate and compare the hemodynamic performance of both prosthetic valves. The postoperative serum lactic dehydrogenase activity was measured in both groups of patients as an indicator of hemolysis. RESULTS: The mean body surface area was 1.46 +/- 0.16 m2 in the 19HP group and 1.49 +/- 0.13 m2 in the 21SD group (p = 0.1577). Other than female dominance in the 19HP group, there was no statistically significant difference between the two groups in terms of preoperative variables (age, preoperative pressure gradients, and New York Heart Association functional class). The average postoperative peak pressure gradient was 23.3 +/- 10.5 mm Hg in the 19HP group and 27.9 +/- 9.9 mm Hg in the 21SD group (p = 0.0666). There was no hospital death in either group. Six-year follow-up was completed in both groups of patients. Late death occurred in 1 patient in the 19HP group (1.09% per patient-year). Actuarial survival at 6 years was 92.3% +/- 7.4% in the 19HP group, and 100% in the 21SD group (p = 0.33). The linearized complication rate was 1.09% per patient-year and 1.02% per patient-year for thromboembolism, and 1.09% per patient-year and 1.02% per patient-year for anticoagulant-related hemorrhage in the 19HP group and the 21SD group, respectively. Freedom from all complications at 6 years did not show any significant difference between the two groups (p = 0.54). Although left ventricular mass indices decreased significantly after aortic valve replacement in both groups (19HP group, p = 0.0002; 21SD group, p = 0.0006), there were no significant differences in the two indices between the groups after aortic valve replacement (p = 0.999). There was no significant difference in the lactic dehydrogenase level between the two groups (p = 0.4915). CONCLUSIONS: In vivo hemodynamic performance of the 19HP valve as well as the early and intermediate clinical outcome up to 6 years was satisfactory and corresponded closely to that of the 21SD valve in adult patients. The 19-mm Hemodynamic Plus model can be recommended in patients with a measured 19-mm annulus and this valve will minimize the need for the aortic annular enlargement procedure.

Aortic Valve↗
PubMed2001

Effect of optic size on posterior capsule opacification: 5.5 mm versus 6.0 mm AcrySof intraocular lenses.

PURPOSE: To determine the effect of intraocular lens (IOL) optic diameter on posterior capsule opacification (PCO) using digital retroillumination images. SETTING: Eye Department, St. Thomas' Hospital, London, United Kingdom. METHODS: In this prospective study, 60 patients with senile cataract had routine phacoemulsification by a single surgeon and received standardized medication. The patients were divided into 2 equal groups. The first group received a 5.5 mm 3-piece AcrySof IOL (MA30BM, Alcon) inserted in the bag. The second group received a 6.0 mm 3-piece AcrySof IOL (MA60BM, Alcon). Retroillumination images were obtained 1, 30, 90, 180, and 360 days postoperatively. The percentage area of PCO was calculated objectively by dedicated software at 90, 180, and 360 days. At 1 day, the degree of capsulorhexis-IOL contact was determined by inspecting the images. RESULTS: Throughout the follow-up, there was less PCO in the 6.0 mm optic group than in the 5.5 mm optic group, and the difference reached significance 1 year postoperatively (P =.0017). At 1 year, the median percentage of PCO was 1.5% (95% confidence interval [CI] 1.4-5.3) in the 6.0 mm group and 6.9% (95% CI 5.8-18.0) in the 5.5 mm group. CONCLUSIONS: A larger IOL optic diameter was associated with less PCO.

Acrylic Resins↗