[The efficiency of continuous hemofiltration/hemodialysis for acute respiratory failure complicated with acute renal failure].

Continuous hemofiltration/hemodialysis (CHF/CHD) have emerged as effective modalities in the management of acute renal failure. More recently, these therapies have received attention for non-renal application such as adult respiratory distress syndrome (ARDS) and multiple organ failure. To assess the potential benefits of CHF/CHD in the management of severe impairment of pulmonary gas exchange, we evaluated a series of clinical variables in a group of patients with acute respiratory failure complicated with acute renal failure. In 9 of 15 patients, pulmonary gas exchange was improved. Intrapulmonary shunt (Qs/Qt) and pulmonary vascular resistance were also improved during the therapies. The beneficial effects of the modalities seems to be induced by effective removal of extravascular lung water. However, the fact that the same effects were also observed in a few patients with zero or positive fluid balance may indicate the possibility of elimination of circulating middle-molecular pulmonary toxic mediators. We concluded CHF/CHD are recommendable methods for the management of acutely ill patients with respiratory failure.

[Intraocular lens implantation after glaucoma filtering surgery--time course of changes in intraocular pressure control and filtering blebs].

Cataract extraction and intraocular lens (IOL) implantation were carried out in 45 glaucomatous eyes that had undergone glaucoma filtering surgery. Of these, 37 eyes had primary glaucoma, 2 eyes capsular glaucoma, and 6 eyes secondary glaucoma. The visual acuity after IOL implantation was 0.5 or more in 29 eyes (64%) but in 10 eyes (22%) acuity was 0.1 or less because of advanced optic nerve head damage. To analyze affects of IOL implantation on intraocular pressure (IOP) control and functioning of the filtration bleb in 39 eyes of primary or capsular glaucoma, a life-table analysis with the Kaplan-Meier method was performed. The probability that IOP control does not worsen at 2 years was 43 +/- 7% (SE) in 21 eyes without pre-operative ocular hypotensive medication, 56 +/- 16% in 18 eyes with pre-operative ocular hypotensive medication, 47 +/- 12% in 26 eyes where functioning filtering bleb existed pre-operatively. The probability that the filtering bleb survives 2 years post-operatively was 44 +/- 11%. The present results imply that intensive management of post-operative inflammation and careful IOP follow up are imperative in eyes in which IOL implantation was indicated after undergoing filtration surgery.