Résumé
BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.
Sujets)
Femelle , Humains , Pression sanguine , Petit-déjeuner , Fromage , Prestations des soins de santé , Régime alimentaire , Régime pauvre en sel , Prise en charge de la maladie , Jeûne , Glucose , Comportement en matière de santé , Modèles logistiques , Viande , Lait , Applications mobiles , Activité motrice , Odds ratio , Santé publique , Facteurs de risque , Ordiphone , Produits alimentaires à base de soja , Télémédecine , Triglycéride , Légumes , Tour de taille , YaourtRésumé
The principal objective of this study was to determine the importance of obesity management nutrition programs for obese male workers after performing a 10-week nutrition program and to compare changes in the obesity index, health behavior, meal intake, and blood constituents. The study subjects included 44 individuals, all without chronic disease. After the program, the weight, body mass index (BMI), body fat percentage, and waist-hip ratio (WHR) of the subjects dropped. Dietary life behavior scores increased. In particular, more than 30% increases were detected in self-control of surfeit, control of eating speed, temperance, and regular exercise items. Total caloric intake and average drinking intake dropped. Though insignificant, systolic pressure, total cholesterol, LDL-cholesterol, and sGPT all dropped as compared to the levels measured prior to the program. Fasting blood sucrose, triglyceride, g-GTP, and atherogenic index dropped significantly. HDL-cholesterol, though insignificant, increased. As the result of examining correlations between the subjects' health life behavior, caloric intake, and improvement in obesity, we noted a significant correlation between self-control of surfeit and temperance in the health life behavior item, along with significant correlations among total calorie intake, surfeit percentage, and daily average drinking intake. These results demonstrated that nutrition program for obese workers performed at the Community Health Center had the effect of reducing obesity, improving health behavior, and improving clinical levels. Thus, it is advisable that obesity management programs be achieved, linking the center of local societies' health promotion projects, community health centers, and workplaces, and various programs should be developed to maintain and continue changes in workers' behaviors, such that the positive effects of improvement in obesity could be maintained, even after the program.
Sujets)
Humains , Mâle , Tissu adipeux , Alanine transaminase , Pression sanguine , Poids , Cholestérol , Maladie chronique , Centres de santé communautaires , Consommation de boisson , Consommation alimentaire , Ration calorique , Jeûne , Comportement en matière de santé , Promotion de la santé , Repas , Obésité , Saccharose , Modération , Rapport taille-hanchesRésumé
A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient.
Sujets)
Adulte , Humains , Mâle , Migration d'un corps étranger/étiologie , Capsule du cristallin/anatomopathologie , Pose d'implant intraoculaire , Lentilles intraoculaires , Ligaments/ultrastructure , Microscopie électronique à balayage , Phacoémulsification , Réintervention , Rétinite pigmentaire/complications , VitrectomieRésumé
This study was carried out to investigate the effect of nutrition education program for diabetic patients on the glycemic control at the public health center. The study subjects, aged 61.7 +/- 9.4 years, were 93 sex- and age-matched patients with type 2 diabetes mellitus. They were divided into three groups: nutrition education & diet practice group(EDG), nutrition education-only group (EG), and the control group (CG). Height, weight, and the postprandial 2 hour blood glucose (PP2) were measured at baseline, and 4, 6 and 8 week after the diabetic nutrition education program. At baseline there were no differences in height, weight, and blood glucose levels among the three groups. Nutrition education programs, especially that with group lunch practice sessions were found to be effective in lowering the blood glucose levels in patients with NIDDM patients. At 4 week blood glucose levels were decreased by 40.6% and 19.6% in EDG and EG, respectively, which was further dropped by 50.2% and 35.1% at 8 week, as compared to the CG group. For the EDG group, the total energy intake, which was 162.3% of the prescription before the diet counselling session, was decreased to 113.6% of the prescription after the lunch visit, with most decrease coming from the reduction in carbohydrate and fat intake. Multiple stepwise regression analysis revealed that the total energy intake explained 47.9% and 57% of blood glucose changes for men and women, respectively, and that percent energy intake from protein explained 15.8% for women. These results demonstrate that the public health center nutrition education programs for diabetic patients, especially that with group lunch practice sessions are very effective for the glycemic control in patients with diabetes mellitus.
Sujets)
Adulte , Femelle , Humains , Mâle , Glycémie , Diabète , Diabète de type 2 , Régime alimentaire , Éducation , Ration calorique , Déjeuner , Ordonnances , Santé publiqueRésumé
This study was carried out to provide information on the effect of nutrition education program for diabetic patients at the Guri City's Public Health Center. Subjects of this study were 31 persons(male 7, female 24) who attended all courses of "2002 Diabetes Education Class". They were indicated as the 'education group'(EG). Eating and living habits of EG were investigated before the education. EG's weight and blood glucose (post prandial 2 hours, PP2) were examined as well. EG's PP2 reduction was compared with a 'control group'(CG) who didn't join any course in that class. All of the subjects were non-insulin-dependent diabetes mellitus(NIDDM) patients. EG's average age was 62.4+/-8.8. Before taking the course, EG's PP2 was 251.5+/-29.6mg/dl, and body mass index(BMI) was 26.3+/-2.3 on average. Most of them were stressed out from their daily lives and usually had no exercise. Most people of EG ate meals rapidly and liked sweet and fatty foods. After the course of training, EG's weight and BMI before the training were not decreased significantly. However, all of the EG's PP2s, which were measured 4 times(before the meal at the special lunch session, after 2 hours at this meal, after 2 weeks and 4 weeks dietary assembly), were decreased in comparison with the PP2 which was checked prior to joining the training. EG's average PP2 was more reduced than CG's one. In addition, all groups' PP2s were decreased for 8 weeks. After all, this nutritional education at the public health center was effective in glycemic control for diabetes mellitus patients. Especially, when the dietary assembly as practical training was included in the educational process, the patient's dietary intake and PP2 was improved more effectively. Therefore, this study suggests that nutrition work at public health centers is necessary for the Health Promotion Policy.
Sujets)
Adulte , Femelle , Humains , Glycémie , Diabète , Consommation alimentaire , Éducation , Promotion de la santé , Déjeuner , Repas , Santé publiqueRésumé
This study was carried out to provide information on the effect of nutrition education program for diabetic patients at the Guri City's Public Health Center. Subjects of this study were 31 persons(male 7, female 24) who attended all courses of "2002 Diabetes Education Class". They were indicated as the 'education group'(EG). Eating and living habits of EG were investigated before the education. EG's weight and blood glucose (post prandial 2 hours, PP2) were examined as well. EG's PP2 reduction was compared with a 'control group'(CG) who didn't join any course in that class. All of the subjects were non-insulin-dependent diabetes mellitus(NIDDM) patients. EG's average age was 62.4+/-8.8. Before taking the course, EG's PP2 was 251.5+/-29.6mg/dl, and body mass index(BMI) was 26.3+/-2.3 on average. Most of them were stressed out from their daily lives and usually had no exercise. Most people of EG ate meals rapidly and liked sweet and fatty foods. After the course of training, EG's weight and BMI before the training were not decreased significantly. However, all of the EG's PP2s, which were measured 4 times(before the meal at the special lunch session, after 2 hours at this meal, after 2 weeks and 4 weeks dietary assembly), were decreased in comparison with the PP2 which was checked prior to joining the training. EG's average PP2 was more reduced than CG's one. In addition, all groups' PP2s were decreased for 8 weeks. After all, this nutritional education at the public health center was effective in glycemic control for diabetes mellitus patients. Especially, when the dietary assembly as practical training was included in the educational process, the patient's dietary intake and PP2 was improved more effectively. Therefore, this study suggests that nutrition work at public health centers is necessary for the Health Promotion Policy.
Sujets)
Adulte , Femelle , Humains , Glycémie , Diabète , Consommation alimentaire , Éducation , Promotion de la santé , Déjeuner , Repas , Santé publiqueRésumé
PURPOSE: To investigate the effectiveness of cyanoacrylate glue application in cases of corneal perforation or impending perforation due to refractory keratitis. METHODS: Cyanoacrylate glue was applied on 6 cases of fungal keratitis, 3 cases of herpetic keratitis, and 3 cases of bacterial keratitis from July 1998 to June 2002. 2 cases were corneal perforations and 10 were impending perforations. Cyanoacrylate glue was applied on stromal melting area including normal epithelium. When fibrovascular tissue grew beneath the glue sufficiently, glue was removed. When glue was sloughed off spontaneously or fibrovascular tissue was found to be insufficient, glue was reapplied. RESULTS: After average follow up of 25 weeks, the corneal surface was stabilized in 11 eyes except 1 case of fungal keratitis that had broad area of stromal melting(5.4mm). After use of glue, process of stromal melting was found to be discontinued. As fibrovascular tissue grew up beneath the glue, corneal surface became stable. Average diameter of stromal melting area and of glue application area was 4.0mm and 4.4mm respectively. Average duration of glue application was 17 weeks. CONCLUSIONS: Cyanoacrylate glue application appears to be an effective and convenient method in cases of corneal perforations and impending perforations associated with advanced and extensive fungal, bacterial, and herpetic keratitis with active keratolysis.
Sujets)
Adhésifs , Perforation cornéenne , Cyanoacrylates , Épithélium , Études de suivi , Congélation , Kératite , Kératite herpétiqueRésumé
BACKGROUND: It has been well known that bronchial asthma is a chronic airway inflammatory disorder. Recently, sputum specimen induced with hypertonic saline was introduced as a simple and useful noninvasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating factor (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchial asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation of changes in pulmonary function tests and symptoms. METHODS: A total 30 patients with bronchial asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second (FEV), total blood eosinophil count, and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. RESULTS: Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in FEV1 (% of predicted value) from 78.1±20.6% to 90.3±18.3% (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1±27.2% versus 29.6±21.3% (P<0.001), and ECP were 134.5±68.1 µm/L versus 41.5±42.4 µm/L (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7±12.8 pg/ml to 21.7±8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count(425.7±265.9 vs 287.7±294.7) and in the concentration of NO derivatives (70.4±44.6 µmol%/L vs 91.548.3 µmol/L) after the predinisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments of after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-0.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05). CONCLUSION: The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchial asthma. In addition, the measurement of sputum eosinophil percentages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the predinisolone treatment in bronchial asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.
Sujets)
Femelle , Humains , Mâle , Obstruction des voies aériennes , Asthme , Cytokines , Granulocytes éosinophiles , Volume expiratoire maximal par seconde , Facteur de stimulation des colonies de granulocytes et de macrophages , Inflammation , Interleukine-3 , Interleukine-5 , Monoxyde d'azote , Prednisolone , Tests de la fonction respiratoire , ExpectorationRésumé
BACKGROUND: Moxifloxacin is a newly developed drug which is more potent and safe compared to previous fluoroquinolones. This drug effectively eradicates organisms such as beta-lactamase-producing or other resistant bacteria. Moxifloxacin is known to be effective in treating respiratory infections such as Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella spp. and Mycoplasma pneumoniae. METHODS: In a multicenter, randomized, open, comparative study, the efficacy and safety of oral moxifloxacin taken 400 mg once a day and clarithromycin taken 500 mg twice daily for 7 days were compared for the treatment of Korean patients with acute exacerbations of chronic bronchitis. RESULTS: A total of 170 patients were enrolled, and they were divided into two groups:87 in the moxifloxacin group and 83 in the clarithromycin group. Of those enrolled, 76 (35 for bacteriologic efficacy) in the moxifloxacin group and 77 (31 for bacteriologic efficacy) in the clarithromycin group were included in the efficacy analysis. All were included in the safety analysis. Clinical success was noted in 70 (92.1%) of 76 moxifloxacin-treated patients and 71 (92.2%) of 77 clarithromycin-treated patients. Bacteriologic success rate seemed to be higher in moxifloxacin group (73.5%) than in clarithromycin group (54.8%), but statistically insignificant (p=0.098). Drug susceptibility among organisms initially isolated was higher in moxifloxacin group on Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae(p<0.001). Adverse events were reported by 12.8% of 86 patients receiving moxifloxacin and 21.7% of 83 patients receiveing clarithromycin. Headache (4.7% vs 4.8%, moxiflosacin group vs clarithromycin group, respectively) and indigestion (2.3% vs 6.0%, moxifloxacin group vs clarithromycin group, respectively) were the most frequent side effects in the two groups. CONCLUSION: This study demonstrated that for the treatment of acute exacerbations of chronic bronchitis a 7-days course of moxifloxacin 400 mg od was clinically equivalent and microbiologically superior to clarithromycin 500 mg bid.
Sujets)
Humains , Bactéries , Bronchite chronique , Chlamydophila pneumoniae , Clarithromycine , Dyspepsie , Fluoroquinolones , Haemophilus influenzae , Céphalée , Klebsiella , Legionella , Moraxella catarrhalis , Mycoplasma pneumoniae , Pneumopathie à mycoplasmes , Pseudomonas aeruginosa , Infections de l'appareil respiratoire , Streptococcus pneumoniaeRésumé
The cataract extraction in traumatic cataract with corneal laceration is likely to be different from the ordinary cataract extraction in several points. We tried to know the problems of the operation, the visual outcomes and the postoperative complications in these eyes. In 25 traumatic cataract with corneal laceration, we performed cataract extraction and corneal suture at the same time in 11 eyes and at different time in 14 eyes. The intraoperative problems were difficult anterior capsulotomy, corneal opacity, difficult lens delivery etc.The major postoperative complications were anterior chamber inflammation, corneal edema, posterior capsular opacity and exudative pupillary membrane. In 23 eyes[92%], the visual acuity was increased more than 2 lines. Cataract extraction in traumatic cataract with corneal laceration was very effective surgery, and cataract extraction after primary corneal suture has done had good results in severe corneal laceration with suspicious posterior capsular rupture and non-fitted preoperative preparation.
Sujets)
Chambre antérieure du bulbe oculaire , Extraction de cataracte , Cataracte , Oedème cornéen , Opacité cornéenne , Inflammation , Lacérations , Membranes , Complications postopératoires , Rupture , Matériaux de suture , Acuité visuelleRésumé
BACKGROUND: Pulmonary complications following bonemarrow transplantation(BMT) are common and associated with a high mortality rate, We investigated the yield, safety, and impact of fiberoptic bronchoscopy(FOB) for diagnosis of postBMT pneumoniae. METHODS: From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with repiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL(bronchoalveolar lavage), TBLB(transbronchial lung biopsy), PSB(protected specimen brush). RESULTS: The characteristics of the subjects were as follows:37 males, 15 females, mean age of 31.3 years(17-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following:12 cytomegalovirus(CMV) (21.4%), 7 pneumocystis carinii(PC) (12.5%), 11 CMV with PC (19.6%), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases(23.2%), 13 died of CMV pneumoniae(n=2), PCP(n=2), mixed infection with CMV and PC(n=3), underlying GVHD(n=1), underlying leukemia progression(n=1), or respiratory failure of unknown origin(n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleedig and 1 episode temporary hypoxemia. CONCLUSION: Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
Sujets)
Femelle , Humains , Mâle , Hypoxie , Transplantation de moelle osseuse , Moelle osseuse , Bronchoscopie , Co-infection , Diagnostic , Verre , Leucémies , Poumon , Mortalité , Pneumocystis , Pneumopathie infectieuse , Insuffisance respiratoire , Fratrie , Streptococcus , Donneurs de tissus , TuberculoseRésumé
The authors reviewed the chart of 37 patients who had chestnut bur injury to the eye from September 1997 to November 1998.Their ages were ranged from 4 to 69 years old and they 33 men (89.2%)and 4 women (10.8%).They were injured by chestnut bur on cornea (33 eyes), sclera (1 eye), cornea and sclera (2 eyes), cornea and periorbital tissue (2 eyes). Chestnut burs were removed from 28 eyes at Out Patient Department (75.7%)and from 9 eyes with surgical microscope in operating room (24.3%).At OPD, simple removals without leaking were performed in 21 eyes (56.8%)and leaking occurred in 7 eyes (18.9%).Among 7 eyes (18.9%), primary repairs were performed in 2 eyes (5.4%), therapeutic contact lens were worn in 3 eyes (8.1%), chemical tissue glue was used in 1 eye (2.7%) and a pressure patch was used in 1 eye (2.7%). At operating room, simple removals were performed in 3 eyes (8.1%)and leaking occurred in 6 eyes (16.2%).Among 6 eyes (16.2%), primary repairs were performed in 4 eyes (10.8%)and therapeutic contact lens were in 2 As complications, traumatic cataract, iritis, endophthalmitis, cornealulcers and scleral granuloma were developed in 8 eyes (21.6%), 12 eyes (32.4%), 1 eye (2.7%), 1 eye (2.7%)and 3 eyes (8.1%)respectively. In conclusion, the prompt &proper management of chestnut bur injury and the importance of prevention &public information should be stressed.
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Sujet âgé , Femelle , Humains , Mâle , Adhésifs , Cataracte , Cornée , Endophtalmie , Granulome , Iritis , Blocs opératoires , SclèreRésumé
It is known that the treatment of pseudomonas aeruginosa infection associated with scleral necrosis after pterygium excision is difficult. Pseudomonas scleritis were treated with systemic and topical antibiotics, debridement, scleral homograft,and conjunctival autograft in 3 cases of 4 cases. Another 1 case was transfered to other hospital with patient`s request after short medical treatment. The interval from pterygium operation to onset of pseudomonas scleritis ranged from 2 to 17 years with an average of 10 years. In all cases with operation, the graft was stabilized after mean time of 42 days (ranged 35 to 48 days) from operation. The complications were visual disturbance, endophthalmitis, complicated cataract, exudative retinal detachment, exotropia, and posterior synechia of iris. In 1 case, a corticosteroid which was used in the early of treatment induced exacerbation of disease.Because the complications of disease were so severe,early prophylactic operation will be necessary in noninfected scleral necrosis, and when infection is suspected, it should be necessary to do culture and sensitivity test with an intensive anti-pseudomonal therapy.
Sujets)
Antibactériens , Autogreffes , Cataracte , Débridement , Endophtalmie , Exotropie , Iris , Nécrose , Pseudomonas aeruginosa , Pseudomonas , Ptérygion , Décollement de la rétine , Sclérite , TransplantsRésumé
Apraxia of lid opening is a nonparalytic motor abnormality characterized by difficulty in initiating the act of lid elevation. It has been reported in various extrapyramidal disorders(Parkinson's disease, Huntington's chorea, progressive supranuclear palsy), right middle cerebral infarction and Wilson's disease. We report a case of apraxia of opening in Wilson's disease, 34-year-old man was noted to have resting tremor and voluntary eye opening difficulty. Wilson's disease without Kayser-Fleisher ring was diagnosed by serum Cu, serum ceruloplasmin and liver biopsy. He was treated with D-penicillamine anticholinergics, amantadine, and levodopa.
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Adulte , Humains , Amantadine , Apraxies , Biopsie , Infarctus cérébral , Céruloplasmine , Antagonistes cholinergiques , Dégénérescence hépatolenticulaire , Maladie de Huntington , Lévodopa , Foie , Pénicillamine , TremblementRésumé
Of 782 premature babies who had been examed, 105(13.4%) were found to have retinopathy of prematurity(ROP). Between normal group and ROP group, there was statistically significant difference in birth weight, gestational age, duration of oxygen therapy and maximum arterial oxygen concentration. Between the group of regression(stage 1.2 to normal) and the group of progression(stage 1.2 to prethreshold disease) there was statistically significant difference in birth weight, gestational age and the circumferential extent of avascular zone. The 35% of prethreshold ROP eyes progressed to threshold ROP and mean interval from prethreshold to threshold ROP was 3.6 weeks.
Sujets)
Poids de naissance , Âge gestationnel , Oxygène , Pronostic , Rétinopathie du prématuréRésumé
Intraocular hemorrhage is a major problem during the vitreous surgery, despite of improvements in instrumentation and operative methods. Infusion of thrombin has been reported as an efficacious method of control of intraocular hemorrhage in various vitreous surgery. In this study, 100 U/ml diluted thrombin was injected through the infusion system of Grieshaber manipulator into the vitrous cavity on the bleeding site instead of adding to the infusion solution in 10 cases of vitreous surgery including proliferative diabetic retinopathy, posttraumatic advanced proliferative vitreoretinopathy and giant retinal tear. As the result, all cases of intraocular hemorrhage were controlled within 2 min utes after the injection of thrombin, with the combined use of intraocular diathermy or elevation of intraoclar pressure. The amount of diluted thrombin which was injected in concentration of 100 U/ml, was less than 5ml. The 6 cases of postop erative complication were noted, including 2 cases of vitreous hemorrhage and 4 cases of hypopyon which were controlled within 5 days with topical steroid therapy.
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Rétinopathie diabétique , Diathermie , Hémorragie , Perforations de la rétine , Thrombine , Vitréorétinopathie proliférante , Hémorragie du vitréRésumé
Proliferative vitreoretinopathy is an abnormality in which the rhegmatogenous retinal detachment is complicated by proliferation of membrane on both surfaces of the detached retina and on the posterior surface of the detached vitreous gel. The contraction of these membranes, causing distortion and further elevation of the retina, is the most important cause of failure in retinal reattachment surgery. The author studied the ultrastructural features of preretinal and subretinal membranes which were removed during vitreous surgery in four patients with proliferative vitreoretinopathy. The results were as follows: 1. In the four preretinal membranes, five morphologically distinguishable cell types-retinal pigment epithelial cells, fibrous astrocytes, macrophages, fibrocytes and myofibroblasts-were observed, and the extracellular matrix was composed of collagen fibrils measuring 15-25nm in diameter. 2. In one subretinal membrane, retinal pigment epithelial cells, fibrous astrocytes and macrophages were observed and the major cell type was the retinal pigment epithelial cell. The diameter of the extracellular collagen fibrils was almost the same as that of the preretinal membranes. 3. In the preretinal and subretinal membranes, some of the fibrocytes and macrophages were believed to be derived from retinal pigment epithelial cells.
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Humains , Astrocytes , Collagène , Cellules épithéliales , Matrice extracellulaire , Macrophages , Membranes , Rétine , Décollement de la rétine , Rétinal , Vitréorétinopathie proliféranteRésumé
Pneumatic retinopexy is a recently described procedure to treat the uncomplicated retinal detachment. The procedure of pneumatic retinopexy is composed of cryotherapy (or laser photocoagulation), intraocular gas injection and postoperative positioning. The advantages of pneumatic retinopexy are less tissue trauma, no hospitalization and minimal complication. For these reasons it is more and more popular, but further studies are needed to assess its ultimate safety and efficacy. The authors experienced 7 cases of primary rhegmatogenous retinal detachment treated with pneumatic retinopexy, from September, 1987 to March, 1988. Four cases of the retinal detachment were successfully reattached after pneumatic retinopexy. In the other 3 cases, new retinal tear and detachment were found after pneumatic retinopexy, which were successfully repaired with the conventional scleral buckling procedure.