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At least 721 records · Page 40Linked to original sources

Argon laser iridotomy in the treatment of patients with primary angle-closure or pupillary block glaucoma: a clinicopathologic study.

A "pulsed" argon laser was successful in 48 of 64 (75%) attempted laser iridotomies. Scanning and transmission electron microscopy performed on specimens taken at varying intervals following laser treatment revealed progressive scarring of iris tissue. The complications appear minimal at this time, but longer follow-up is required before it can be stated that laser and surgical peripheral iridectomies are comparable. However, the laser's simplicity and ease of administration appear to warrant its continued use at this time.

Argon↗

Q-switched neodymium:YAG laser iridotomy.

Twenty phakic eyes of 19 patients underwent Q-switched neodymium:YAG laser iridotomies for angle-closure glaucoma. Eleven eyes were previous argon laser failures. Penetration was achieved in each case with several shots in one session. Complications were minor and transient.

Eye Color↗

Selective conventional and xero-arteriography of the external carotid artery for control of intra-arterial chemotherapy.

The control of intra-arterial chemotherapy by selective conventional and xero-angiographic exploration of the external carotid artery is reported. With the aid of a catheter inserted into the superior thyroid, facial or super-facial temporal artery, all the main branches of the external carotid artery can be depicted. Xeroangiography in the area of the external carotid artery is a new method on which no data could be found in the literature. Anatomical variations of the vascular system and vascular lesions caused by surgery, a tumour, or intra-arterial chemotherapy are better demonstrated by xeroradiography. The bones and the soft parts are well depicted at the same time in the xeroradiographic pictures; thus the bony masses of the facial and petrous regions, together with the vessels on the bones, in the bones and in the soft parts are visible on one and the same picture.

Angiography↗

Adenoviral gene transfer of endothelial nitric oxide synthase (eNOS) to the penis improves age-related erectile dysfunction in the rat.

Nitric oxide (NO) is the principal mediator of penile erection. NO is synthesized by a variety of nitric oxide synthases (NOS). It has been demonstrated that a decrease in NOS activity, as observed in aging, is associated with a diminished erectile response. The objective of this study was to determine if adenoviral-mediated gene transfer of eNOS could reverse age-related erectile dysfunction in the rat. Two groups of animals were transfected with adenoviruses: (1) aged rats (60 weeks) with AdRSVbetagal; and (2) aged rats (60 weeks) with AdRSVeNOS. Five days after transfection, these study animals underwent cavernosal nerve stimulation (CNS) to assess erectile function and their responses were compared with young (20 weeks) control rats. Cross-sections of the rat penises transfected with AdRSVeNOS were examined after trichrome staining. Adenoviral transduction efficiency of beta-galactosidase reporter gene was measured by a galacto-light chemiluminescent reporter gene assay in cavernosal tissues of rats administered AdRSVbetagal. The transgene expression of eNOS was examined by RT-PCR in rats transfected with AdRSVbetagal and AdRSVeNOS. eNOS and iNOS protein levels were measured by Western blot analysis, and cGMP levels were assessed in cavernosal tissue by enzyme immunoassay. Adenoviral expression of the beta-galactosidase reporter gene was observed in cavernosal tissue for up to 30 days, with peak expression registered at 5 days after intracavernosal administration of AdRSVbetagal. Cross-sections of the rat penises transfected with the AdRSVeNOS revealed no pathological (morphological or histological) changes. Five days after administration of AdRSVeNOS, eNOS protein, mRNA and cGMP levels in the corpora cavernosa were significantly increased (P<0. 05), while iNOS protein levels remained unchanged (P>0.05). In conclusion, enhanced expression of eNOS employing an adenoviral vector significantly increased the erectile response to cavernosal nerve stimulation in the aged rat, similar to the response observed in younger rats. These data suggest that in vivo adenoviral gene transfer of eNOS can physiologically improve erectile function in the aged rat.

Adenoviridae↗

Minimal residual disease detection in childhood precursor-B-cell acute lymphoblastic leukemia: relation to other risk factors. A Children's Oncology Group study.

Minimal residual disease (MRD) can be detected in the marrows of children undergoing chemotherapy either by flow cytometry or polymerase chain reaction. In this study, we used four-color flow cytometry to detect MRD in 1016 children undergoing therapy on Children's Oncology Group therapeutic protocols for precursor-B-cell ALL. Compliance was excellent, with follow-up samples received at the end of induction on nearly 95% of cases; sensitivity of detection at this time point was at least 1/10,000 in more than 90% of cases. Overall, 28.6% of patients had detectable MRD at the end of induction. Patients with M3 marrows at day 8 were much more likely to be MRD positive (MRD+) than those with M2 or M1 marrows. Different genetically defined groups of patients varied in their prevalence of MRD. Specifically, almost all patients with BCR-ABL had high levels of end-of-induction MRD. Only 8.4% of patients with TEL-AML1 were MRD+>0.01% compared with 20.3% of patients with trisomies of chromosomes 4 and 10. Our results show that MRD correlates with conventional measures of slow early response. However, the high frequency of MRD positivity in favorable trisomy patients suggests that the clinical significance of MRD positivity at the end of induction may not be the same in all patient groups.

Adolescent↗

Response of naevus of Ota to Q-switched ruby laser treatment according to lesion colour.

Lesions of naevus of Ota range in colour from light brown to blue, and even greenish-black. To develop guidelines for optimal treatment, we evaluated the number of Q-switched ruby laser treatments required to eliminate the pigmentation of such lesions classified by colour. Over a period of 6 years, we evaluated 151 Japanese patients with naevus of Ota who had been treated with the Q-switched ruby laser at a low energy level (wavelength 694.3 nm; pulse duration 28 x 10-9 s; energy fluence 5 J/cm2; spot size 6.5 mm) every 2 months. Each lesion was classified by colour as brown (n = 22), brown-violet (n = 42), violet-blue (n = 81) and blue-green (n = 6). The 22 predominantly brown lesions attained an excellent (100-95%) or good (95-75%) cosmetic result following three laser treatments in all patients who received this number of treatments. In the 42 brown-violet lesions, 25 of the 29 good or excellent results were achieved after four treatments; the 13 less successful results were in patients who had one to three treatments. In the 81 violet-blue lesions, 54 of the 65 good or excellent results were achieved after four treatments and 64 of 65 after five treatments, whereas all 16 less good results were in patients who had only one to three treatments. However, in the six blue-green lesions, six or more treatments were required to achieve a similarly favourable result. At the end of treatment, the area was virtually free of scarring, and its texture resembled that of the surrounding normal skin. We have confirmed that the use of the Q-switched ruby laser at a low energy level can eliminate the pigmentation of naevus of Ota. While the desired improvement can be obtained within 1 year, the number of treatments appears to depend on the predominant colour of the lesion.

Adolescent↗

Methylene blue soldered microvascular anastomoses in vivo.

OBJECTIVES: solders containing chromophores and proteins enhance the strength of lasered anastomoses. Methylene blue (MB) solder anastomoses in vitro are strong but no in vivo work has been reported. We used an MB solder in vivo and studied the effects of two laser powers on patency and histological appearance. DESIGN, MATERIALS AND METHODS: two groups of 15 rabbits had unilateral end-to-end carotid anastomoses (1.5-2.0 mm) formed using three stay sutures and MB solder. Group 1 anastomoses were formed at 5.7 Wcm(-1) and Group 2 at 2.8 Wcm(-1). The vessels were examined at various points by necropsy for patency and gross macroscopic appearance, with subsequent histological examination. RESULTS: group 2 showed patency of 93.3% v 0% ( p<0.001) endothelialisation of 100% v 26.6% ( p<0.001), giant cell formation 0% v 40.0% ( p<0.01), but stenosis was not significantly different (0% v 13.3% p=0.06). Group 2 showed a higher rate of intimal hyperplasia (IH) (66.6% v 20.0% p<0.05) but neither group exhibited thermal injury or aneurysm formation. CONCLUSIONS: laser soldered microvascular anastomoses were formed in vessels of 1.5-2.0 mm with a high degree of patency. A relationship appears to exist between laser power and anastomotic patency. Methylene blue fading has the potential to act as a switch against over exposure and a visual indicator of solder activation.

Anastomosis, Surgical↗

Colors, humors and evil eye: indigenous classification and treatment of childhood diarrhea in highland Guatemala.

Focal group interviews on indigenous perceptions and reported management of childhood diarrhea were conducted in 1987-88 in Guatemala as a part of a prospective epidemiological field study of chronic diarrhea. Six cognitive schemata were identified, each with specific causes, a linked progression of concepts, symptoms, signs, and diagnostic characteristics. Nearly all were related to the humoral theory of disease, including the concept of evil eye. Diarrheal disease was conceptualized in the village as a set of processes which could be either "hot" or "cold" rather than as an unchanging single-symptom entity occupying only one spot on the humoral continuum. Clarification of the temporal relationship between concepts was found to be essential to the understanding of these indigenously-defined schemata. Stool color reflecting humoral theory was the primary concept used in household-level diagnosis. Reported behavior associated with these cognitive schemata (traditional treatments, pharmaceutical and dietary management) showed remarkable constancy, and adhered for the most part to the humoral concept of equilibrium. These included the use of oral rehydration solutions (ORS) and liquids. The applied importance of humoral theory to home-based use of ORS is discussed briefly as is the indigenous definition of dehydration.

Child, Preschool↗

Effective epilation of white and blond hair using combined radiofrequency and optical energy.

OBJECTIVE: The present study examined the long-term photoepilatory effect on blond and white hair of a combined intense pulsed light (680-980 nm) device with a bipolar radiofrequency component producing electrical current at a depth of 4 mm. MATERIALS AND METHODS: Thirty-six adult women with white and blond hair (skin phenotypes I-V) were included in the study. The chin and upper lip were treated with four treatment sessions over 9-12 months with long-term follow-up performed at month 18 (6 months after the last treatment). The level of RF energy was 20 J/cm3, while optical fluences varied from 24 to 30 J/cm2. Hair counts and photographic evaluation of some sites were obtained at baseline, months 1, 3 and 5 and the final treatment session. RESULTS: An average hair removal of 48% was observed at month 18 (6 months following the final treatment session). A slightly higher photoepilatory efficiency was noted for blond hair (52%) versus white hair (44%) treatment sites. CONCLUSION: Combined radiofrequency and optical energy technology may produce effective photoepilation of blond and white hair phenotypes.

Adult↗

Ruby laser-assisted hair removal: a preliminary report of the correlation between efficacy of treatment and melanin content of hair and the growth phases of hair at a specific site.

An unpredictable response, even in patients with dark hair, often undermines successful ruby laser hair removal. A prospective clinical study was carried out to evaluate the roles of melanin content and growth phases of hair in treatment efficacy. Thirty-six volunteers with white skin and dark hair were recruited for the study, and were all treated using the Chromos 694 Depilation Ruby Laser. The overall efficacy of treatment was assessed at the end of 3 months. The efficacy of laser treatment is not due solely to the proportion of hair in the growing or static phase of the hair cycle. There is a lack of correlation between the melanin content and the overall efficacy of laser hair removal in those treated once, but patients with darker hair responded better after repeated treatments. The proportion of hair in the growth phase and the melanin content of hair do not contribute solely to the efficacy of ruby laser hair removal.

Hair↗

The life cycle of bruises in older adults.

OBJECTIVES: To summarize the occurrence, progression, and resolution of accidentally acquired bruises in a sample of adults aged 65 and older. The systematic documentation of accidentally occurring bruises in older adults could provide a foundation for comparison when considering suspicious bruising in older adults. DESIGN: Between April 2002 and August 2003, a convenience sample of 101 seniors was examined daily at home (up to 6 weeks) to document the occurrence, progression, and resolution of accidental bruises that occurred during the observation period. SETTING: Three community-based settings and two skilled nursing facilities in Orange County, California. PARTICIPANTS: One hundred one adults aged 65 and older (mean age=83). MEASUREMENTS: Age, sex, ethnicity, functional status, handedness, medical conditions, medications, cognitive status, depression, history of falls, bruise size, bruise location, initial bruise color, color change over time. RESULTS: Nearly 90% of the bruises were on the extremities. There were no bruises on the neck, ears, genitalia, buttocks, or soles of the feet. Subjects were more likely to know the cause of the bruise if the bruise was on the trunk. Contrary to the common perception that yellow coloration indicates an older bruise, 16 bruises were predominately yellow within the first 24 hours after onset. People on medications known to affect coagulation pathways and those with compromised function were more likely to have multiple bruises. CONCLUSION: Accidental bruises occur in a predictable location pattern in older adults. One cannot reliably predict the age of a bruise by its color.

Aged↗

Normal adult performance on constructional praxis training tasks.

This study used a balanced factorial design to examine the performance of normal young adults on a parquetry block assembly task that occupational therapists use to treat constructional deficits in adults. Ninety-six 18- to 34-year-old right-handed college students or college graduates (48 men and 48 women) were tested. Independent variables were subjects' sex, presence or absence of color on the model design card, and amount of detail on the model design card. Dependent variables were speed and accuracy of design construction. Results of a factorial analysis of variance with the three variables showed that the subjects' total time scores were significantly related to their sex and to the presence or absence of color and the amount of detail on the design card. Interaction effects were significant for sex by amount of detail and for color by amount of detail. The results were used to generate clinical performance criteria and graded levels of difficulty for this modality. The subjects' learning and test behaviors were examined to generate ideas for treatment and for future research.

Adolescent↗

Color coding patient medications.

"When I first met Mr. K, he had just been discharged from the hospital, where he was treated for congestive heart failure. This was his third admission this year--his physician thought he might not be taking his medications correctly. The doctor had referred him to our home care agency for instructions in taking his medications and for cardiopulmonary assessment." A home care nurse explains how she developed a simple medication coding method to ensure an elderly patient's independence--and health.

Aged↗

Laser hair removal.

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Clinical Trials as Topic↗

Peripheral argon laser iridectomy in narrow-angle glaucoma.

Gas argon laser peripheral iridectomy was attempted as an alternative to surgical peripheral iridectomy in the treatment of acute angle-closure glaucoma and the prophylactic treatment of fellow eyes. Success was achieved in eyes with a blue iris if sufficient energy was given to achieve a permanent red reflex. Reasons for failure in eyes with a heavily pigmented iris are discussed. The procedure must be greatly improved before surgical peripheral iridectomy is superseded as the treatment of choice.

Argon↗