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1.
Zhonghua Wai Ke Za Zhi ; 60(3): 223-229, 2022 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-35078297

RESUMO

Objective: To investigate the efficacy and safety of a new cervical artificial disc prosthesis in the treatment of cervical degenerative diseases. Methods: The clinical data of 18 patients with single-level cervical degenerative diseases who underwent three dimensional printed anatomical bionic cervical disc replacement at Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University from May 2019 to July 2020 were analyzed retrospectively. There were 7 males and 11 females,aged (45±8) years old(range:28 to 58 years).The surgical segment was located at C3-4 level in 2 cases, C4-5 level in 5 cases, C5-6 level in 9 cases, and C6-7 level in 2 cases.The clinical and radiographic outcomes were recorded and compared at preoperative,postoperative times of one month and twelve months.The clinical assessments contained Japanese orthopedic association (JOA) score,neck disability index (NDI) and visual analogue scale (VAS).Imaging assessments included range of motion (ROM) of cervical spine, prosthesis subsidence and prosthesis anteroposterior migration.Repeated measurement variance analysis was used for comparison between groups,and paired t test was used for pairwise comparison. Results: All patients underwent the operation successfully and were followed up for more than 12 months.Compared with preoperative score,the JOA score,NDI and VAS were significantly improved after surgery (all P<0.01).There was no significant difference in postoperative ROM compared with 1-and 12-month preoperative ROM (t=1.570,P=0.135;t=1.744,P=0.099). The prosthesis subsidence was (0.29±0.13) mm (range: 0.18 to 0.50 mm) at 12-month postoperatively.The migration of prosthesis at 12-months postoperatively were (0.71±0.20) mm (range: 0.44 to 1.08 mm).There was no prosthesis subsidence or migration>2 mm at 12-month postoperatively. Conclusion: Three dimensional printed anatomical biomimetic cervical artificial disc replacement has a good early clinical effect in the treatment of cervical degenerative diseases, good mobility can be obtained while maintaining stability.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Substituição Total de Disco , Adulto , Biomimética , Vértebras Cervicais/cirurgia , Feminino , Seguimentos , Humanos , Disco Intervertebral/cirurgia , Degeneração do Disco Intervertebral/cirurgia , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Estudos Retrospectivos , Substituição Total de Disco/métodos , Resultado do Tratamento
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 50(2): 226-230, 2018 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-29643519

RESUMO

OBJECTIVE: To compare the differences of neutrophils chemotaxis ability in peritoneal cavity between normal rats and schizopherenic rats with cell dynamic visualization system. METHODS: In the study,18 healthy Kunming rats were randomly divided into 3 groups which were control group (n=6), 0.3 mg/kg MK-801 treatment group (n=6), 0.6 mg/kg dizocilpine maleate (MK-801) treatment group(n=6), extracted neutrophils separately, and observed the morphology and counted under a microscope. Each group of cells was divided into two parts for chemotactic experiment, called chemokine agent treatment group and no chemokine agent treatment group respectively, indicating control 1, 0.3 mg/kg MK-801 treatment 1,0.6 mg/kg MK-801 treatment 1 and control 2, 0.3 mg/kg MK-801 treatment 2,0.6 mg/kg MK-801 treatment 2. The dynamic migration of cells was recorded using the NIS-Elements software, and TAXIScan Analyzer 2 software was used to select 30 cells (n=30) in each group of cells and analyze cells migration trajectory, speed and distance, and use pair test and One-Way analysis of variance for statistical analysis. RESULTS: The number of neutrophils in control group, 0.3 mg/kg MK-801 treatment group and 0.6 mg/kg MK-801 treatment group were(1.00±0.03)×104/mL,(0.05±0.02)×104/mL,(0.32±0.01)×104/mL respectively, the differences of results were statistically significant(P<0.05).Under the effect of chemotactic agent,the directional migration capability of neutrophils in control group 1, 0.3 mg/kg MK-801 treatment group 1 and 0.6 mg/kg MK-801 treatment group 1 were(0.85±0.11) radian,(1.00±0.11) radian,(0.96±0.10) radian respectively (P<0.05); the migration velocities of neutrophils were (0.09±0.02) µm/s,(0.12±0.01) µm/s,(0.14±0.01) µm/s respectively (P<0.05);the migration distances of neutrophils were (94.26±0.02) µm,(134.61±0.01) µm,(156.19±0.01) µm respectively(P<0.05). CONCLUSION: Compared with neutrophils in peritoneal cavity of control group, the neutrophils in peritoneal cavity of schizophrenic rats have stronger chemotactic movement ability.


Assuntos
Movimento Celular , Quimiotaxia , Neutrófilos/fisiologia , Esquizofrenia/imunologia , Animais , Quimiocinas , Modelos Animais de Doenças , Maleato de Dizocilpina , Camundongos , Cavidade Peritoneal , Ratos , Esquizofrenia/fisiopatologia
3.
Nanotechnology ; 28(21): 214001, 2017 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-28375138

RESUMO

The human brain is an extremely complex system of 1010-1011 neurons. To construct brain-like neuromorphic hardware, the neuron unit should be implemented effectively. Here, we report a neuron transistor based on a MoS2 flake, which has summation and threshold functions similar to biological neurons and may act as a basic neuron unit in neuromorphic hardware. The neuron transistor is composed of a floating gate and two control gates. A heavily doped silicon substrate serves as the floating gate, while the two control gates are capacitively coupled with the floating gate. The neuron transistor can be well controlled by the two control gates individually or simultaneously. The drain current can be modulated by the input voltages at the control gates. While the current response of the neuron transistor has a large dependence on the magnitude of the input signal, it shows little dependence on the frequency of the input signal. To demonstrate the potential neuromorphic application of the neuron transistor, functions including abacus-like function, AND logic and OR logic are realized in the neuron transistor.


Assuntos
Dissulfetos , Molibdênio , Neurônios , Transistores Eletrônicos , Humanos
4.
Genet Mol Res ; 14(4): 17228-34, 2015 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-26681216

RESUMO

We investigate whether three common polymorphisms in ERCC1 and ERCC2 are predictor factors for the chemotherapy response, as well as the clinic outcome of patients with gastric cancer. Between May 2011 and May 2013, 263 patients with gastric cancer who were newly diagnosed by histopathology were enrolled in our study. Genotyping of the ERCC1 rs11615 and rs3212986, and ERCC2 rs1799793 polymorphisms were conducted by the polymerase chain reaction-restriction fragment length polymorphism assay. Patients carrying the TT genotype and TT+CT genotype of ERCC1 rs11615 were associated with poorer response to chemotherapy and shorter survival times when compared with the CC genotype. In conclusion, our results suggested that the ERCC1 rs11615 polymorphism in the DNA repair pathways can be used as predictive factors to the clinical outcome of patients with gastric cancer.


Assuntos
Reparo do DNA/genética , Variação Genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/mortalidade , Idoso , Alelos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Proteínas de Ligação a DNA/genética , Endonucleases/genética , Feminino , Fluoruracila , Genótipo , Humanos , Leucovorina , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Compostos Organoplatínicos , Polimorfismo de Nucleotídeo Único , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Resultado do Tratamento , Proteína Grupo D do Xeroderma Pigmentoso/genética
5.
Opt Express ; 23(21): 27683-9, 2015 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-26480430

RESUMO

Ultraviolet photodetector with p-n heterojunction is fabricated by magnetron sputtering deposition of n-type indium gallium zinc oxide (n-IGZO) and p-type nickel oxide (p-NiO) thin films on ITO glass. The performance of the photodetector is largely affected by the conductivity of the p-NiO thin film, which can be controlled by varying the oxygen partial pressure during the deposition of the p-NiO thin film. A highly spectrum-selective ultraviolet photodetector has been achieved with the p-NiO layer with a high conductivity. The results can be explained in terms of the "optically-filtering" function of the NiO layer.

6.
J Chem Phys ; 140(4): 041106, 2014 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-25669497

RESUMO

Three spin-orbit states, 1(2)Π1/2, 2(2)Π3/2, and 2(2)Π1/2, of chloroiodine anion (ICl(-)) formed by low-energy electron attachment in the Franck-Condon region are associated with the dissociative limits of I(-) ((1)S0) and Cl ((2)P3/2) or Cl(*) ((2)P1/2) fragments. Within the adiabatic scheme, the presumptive Π-symmetry of the fragment angular distributions is dramatically changed to be the Π-Σ mixing symmetry, due to the significant spin-orbit interaction effect on the electronic state couplings of ICl(-). The present experimental approach also enables us to separate the contributions of different electronic states from the mixed states, providing a crucial method for quantitatively evaluating the configuration-interaction wavefunctions.

7.
Br J Cancer ; 107(6): 925-30, 2012 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-22878372

RESUMO

BACKGROUND: Paracentesis for malignant ascites is usually performed as an in-patient procedure, with a median length of stay (LoS) of 3-5 days, with intermittent clamping of the drain due to a perceived risk of hypotension. In this study, we assessed the safety of free drainage and the feasibility and cost-effectiveness of daycase paracentesis. METHOD: Ovarian cancer admissions at Hammersmith Hospital between July and October 2009 were audited (Stage 1). A total of 21 patients (Stage 2) subsequently underwent paracentesis with free drainage of ascites without intermittent clamping (October 2010-January 2011). Finally, 13 patients (19 paracenteses, Stage 3), were drained as a daycase (May-December 2011). RESULTS: Of 67 patients (Stage 1), 22% of admissions and 18% of bed-days were for paracentesis, with a median LoS of 4 days. In all, 81% of patients (Stage 2) drained completely without hypotension. Of four patients with hypotension, none was tachycardic or symptomatic. Daycase paracentesis achieved complete ascites drainage without complications, or the need for in-patient admission in 94.7% of cases (Stage 3), and cost £954 compared with £1473 for in-patient drainage. CONCLUSIONS: Free drainage of malignant ascites is safe. Daycase paracentesis is feasible, cost-effective and reduces hospital admissions, and potentially represents the standard of care for patients with malignant ascites.


Assuntos
Procedimentos Cirúrgicos Ambulatórios , Ascite/cirurgia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/economia , Paracentese/efeitos adversos , Paracentese/economia , Adulto , Idoso , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Procedimentos Cirúrgicos Ambulatórios/economia , Ascite/diagnóstico por imagem , Ascite/economia , Ascite/etiologia , Análise Custo-Benefício , Gerenciamento Clínico , Estudos de Viabilidade , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Londres , Prontuários Médicos , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Paracentese/métodos , Segurança do Paciente , Radiografia , Estudos Retrospectivos , Resultado do Tratamento , Reino Unido
9.
Clin Med (Lond) ; 9(5): 426-30, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19886100

RESUMO

It is a concern that increasing pressure to diagnose, treat and discharge patients rapidly is leading to unacceptably high readmission rates. Readmissions were studied over a two-month period. Patients were identified through the hospital coding system, and electronic discharge summaries provided details of each admission. In total, 69 readmissions were identified, representing 4.34% of medical admissions. Readmitted patients were older than those with single admissions (median age 75 and 71 years, respectively; p < 0.05). Initial length of stay was greater in those patients who would go on to be readmitted (median six days; single admission, two days; p < 0.0001). Seventy-one per cent of readmissions were deemed avoidable, with discharge before conclusive therapy being the leading factor implicated (56%). Readmission is more likely in older patients with complex care needs. Rapid throughput of patients is not associated with readmission. The majority of readmissions can potentially be avoided with judicious medical care.


Assuntos
Serviços Médicos de Emergência , Erros Médicos , Readmissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Nível de Saúde , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
10.
Eur J Ophthalmol ; 17(5): 804-11, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17932859

RESUMO

PURPOSE: To present the radiologic findings in scleral buckle infections and in the early postoperative period after scleral buckling. METHODS: Retrospective multicenter orbital computed tomography (CT) study of 14 patients and brain magnetic resonance (MR) in one patient with scleral buckle infections, some with the referring diagnosis of endophthalmitis, proliferative vitreoretinopathy, orbital cellulitis, or unilateral headache. The control population consisted of early postoperative prospective CT study of 38 consecutive patients with scleral buckle without clinical infection. RESULTS: Diffuse scleral thickening and preseptal soft tissue swelling were noted in acute scleral buckle infections. Scleral thickening decreased radiologically following prompt antibiotic therapy in five patients with acute infections. Silicone sponge had low attenuation without infection and high attenuation with infection. In chronically infected scleral buckle, the sclera was thickened around the buckle, with scleral melt under the buckle. MR showed increased signal intensity in the preseptal region in one patient with chronic fungal infection. In the controls, two had thickening of the sclera without soft tissue swelling. CONCLUSIONS: CT or MR can assist in the early diagnosis and management of scleral buckle infections.


Assuntos
Diagnóstico por Imagem/métodos , Endoftalmite/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Celulite Orbitária/diagnóstico , Infecções Relacionadas à Prótese/diagnóstico , Recurvamento da Esclera/efeitos adversos , Vitreorretinopatia Proliferativa/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
11.
J Cell Biochem ; 91(6): 1269-79, 2004 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-15048880

RESUMO

We explored the feasibility of studying nuclear matrix protein (NMP) expressions of the hepatocytes in normal and cirrhotic rat livers with liver regeneration after partial hepatectomy. Sixteen Wistar healthy rats were studied with experimental liver regeneration and/or liver cirrhosis. Two-dimensional (2-D) gel electrophoresis was used to generate these NMP compositions from these rat liver samples. Several antibodies against cytokeratin, vimentin, actin, B23, HNF4alpha, and heat shock protein 70 were used for identification by Western blot. Totally, 41 strongly stained protein spots were characterized on the 2-D gels. Thirty-four protein spots were detected in all of these rat livers, of which, cytokeratin, vimentin, actin, HNF4alpha, and heat shock protein 70 were identified. B23 was detected in the regenerated livers. Three protein spots (s33, s34, and s35) were detectable only in NMP preparation extracted from the regenerating rat livers after hepatectomy. Another three protein spots (s36, s37, and s38) were detectable only in NMP preparation extracted from thioacetamide-induced cirrhotic rat livers. Under these conditions including experimental liver regeneration and/or liver cirrhosis, Over thirty higher abundance NMPs of hepatocytes were consistently expressed and considered as common and basic NMPs. Some of the NMPs are specific for liver regeneration and may play a critical role in cell proliferation and cell cycle, and some are specific for liver cirrhosis.


Assuntos
Hepatócitos/fisiologia , Cirrose Hepática Experimental/fisiopatologia , Regeneração Hepática/fisiologia , Proteínas Associadas à Matriz Nuclear/biossíntese , Animais , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Hepatócitos/patologia , Cirrose Hepática Experimental/induzido quimicamente , Cirrose Hepática Experimental/patologia , Masculino , Proteínas Associadas à Matriz Nuclear/genética , Ratos , Ratos Wistar , Tioacetamida/toxicidade
12.
J Cell Biochem ; 90(6): 1140-8, 2003 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-14635188

RESUMO

It has become obvious that a better understanding and potential elucidation of the nucleolar phosphoprotein B23 involving in functional interrelationship between nuclear organization and gene expression. In present study, protein B23 expression were investigated in the regenerative hepatocytes at different periods (at days 0, 1, 2, 3, 4, 7) during liver regeneration after partial hepatectomy on the rats with immunohistochemistry and Western blot analysis. Another experiment was done with immunolabeling methods and two-dimensional (2-D) gel electrophoresis for identification of B23 in the regenerating hepatocytes and HepG2 cells (hepatoblastoma cell line) after sequential extraction with detergents, nuclease, and salt. The results showed that its expression in the hepatocytes had a locative move and quantitative change during the process of liver regeneration post-operation. Its immunochemical localization in the hepatocytes during the process showed that it moved from nucleoli of the hepatocytes in the stationary stage to nucleoplasm, cytoplasm, mitotic spindles, and mitotic chromosomes of the hepatocytes in the regenerating livers. It was quantitatively increased progressively to peak level at day 3 post-operation and declined gradually to normal level at day 7. It was detected in nuclear matrix protein (NMP) composition extracted from the regenerating hepatocytes and HepG2 cells and identified with isoelectric point (pI) value of 5.1 and molecular weight of 40 kDa. These results indicated that B23 was a proliferate shuttle protein involving in cell cycle and cell proliferation associated with nuclear matrix.


Assuntos
Núcleo Celular/química , Hepatócitos/citologia , Matriz Nuclear/química , Proteínas Nucleares/metabolismo , Animais , Ciclo Celular/fisiologia , Células Cultivadas , Hepatectomia , Hepatócitos/metabolismo , Regeneração Hepática/fisiologia , Masculino , Matriz Nuclear/metabolismo , Nucleofosmina , Ratos , Ratos Wistar
13.
Anticancer Res ; 21(4A): 2553-9, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11724321

RESUMO

Anticancer agents interfere with the proliferation and survival of tumor cells by a variety of mechanisms. An important factor in the development of a cytotoxic effect by certain anticancer agents is the localization of drug-induced lesions within the cell nucleus. Drug-target interactions at the level of nuclear matrix (NM) may be critical events in the induction of cell death by some of these agents. Arsenic trioxide (As2O3) was identified as a very potent anti-leukemic agent by inducing apoptosis. The present study shows that As2O3 significantly inhibits the growth of hepatoblastoma cell line, HepG2, changes the composition of nuclear matrix proteins and reduces the expression of Hsc 70 and HNF4 in HepG2, which in turn initiate a cascade of events that compromise multiple nuclear functions and, ultimately, cell survival.


Assuntos
Antineoplásicos/farmacologia , Arsenicais/farmacologia , Carcinoma Hepatocelular/metabolismo , Proteínas de Ligação a DNA , Proteínas de Choque Térmico HSP70/biossíntese , Neoplasias Hepáticas/metabolismo , Matriz Nuclear/efeitos dos fármacos , Proteínas Nucleares/biossíntese , Óxidos/farmacologia , Fosfoproteínas/biossíntese , Fatores de Transcrição/biossíntese , Antígenos Nucleares , Trióxido de Arsênio , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Divisão Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Inibidores do Crescimento/farmacologia , Proteínas de Choque Térmico HSC70 , Fator 4 Nuclear de Hepatócito , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Matriz Nuclear/metabolismo , Células Tumorais Cultivadas/efeitos dos fármacos
14.
Anticancer Res ; 21(1A): 493-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11299786

RESUMO

The aims of the present study were to assess the effects of arsenic trioxide on the nuclear matrix protein profiles of mouse neuroblastoma cells. Arsenic trioxide induces apoptosis of acute promyelocytic leukemia cells. Our results demonstrated that 2 microM As2O3 could significantly inhibit the growth of Neuro-2a cells. As early as 24 hours after As2O3 treatment, we began to observe the alteration of nuclear matrix proteins and apoptosis in tumor cells by TUNEL assay but not by DNA ladder. An increase expression of Hsc in nuclear matrix proteins of 2 microM As2O3 treated cells was also noted. Our results also showed that before a mass range of apoptosis occurred, the composition of nuclear matrix proteins had altered. Hence the alteration of nuclear matrix proteins, such as increased expression of Hsc, may be a sensitive indicator for the detection of early apoptosis.


Assuntos
Antineoplásicos/farmacologia , Arsenicais/farmacologia , Neuroblastoma/química , Neuroblastoma/patologia , Matriz Nuclear/efeitos dos fármacos , Proteínas Nucleares/análise , Óxidos/farmacologia , Animais , Apoptose/efeitos dos fármacos , Trióxido de Arsênio , Divisão Celular/efeitos dos fármacos , Núcleo Celular/efeitos dos fármacos , Núcleo Celular/ultraestrutura , Fragmentação do DNA/efeitos dos fármacos , Proteínas de Choque Térmico/metabolismo , Imunoeletroforese Bidimensional , Camundongos , Neuroblastoma/ultraestrutura , Matriz Nuclear/química , Células Tumorais Cultivadas
16.
Guang Pu Xue Yu Guang Pu Fen Xi ; 21(5): 733-4, 2001 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-12945348

RESUMO

The charge transfer reaction between clotrimazolum and alizarin red was studied spectrophotometrically. The reaction was achieved with good results in water-acetone solution. The apparent molar absorptivity is 8.7 x 10(3) L.mol-1.cm-1 at 525 nm. The Beer's law was obeyed in the range of 0-100 micrograms.mL-1 of clotrimazolum. The composition of the complex is 1:1. The proposed method has been applied successfully to the determination of clotrimazolum tablets.


Assuntos
Antraquinonas/química , Antifúngicos/análise , Clotrimazol/análise , Antifúngicos/química , Clotrimazol/química , Transferência de Energia , Indicadores e Reagentes , Espectrofotometria/métodos
17.
Anticancer Res ; 20(3A): 1599-602, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10928077

RESUMO

Sixty gliomas obtained by neurosurgical resections were examined. Paraffin blocks were retrieved from pathological files of the Second Affiliated Hospital in Guangzhou Medical College. The methods of argyrophilic technique for AgNORs staining, and Image Analysis System for measurement of AgNORs were used. Six parameters, which included hcount, count, narea, agnrea, agpern and agperc were used to correlated well with histopathological grades (compared grade 2 & 3, grade 3 & 4, and grade 2 & 4, respectively). We concluded that AgNORs is useful in evaluating proliferative activity and assessing the malignancy of human gliomas. It may also be used as a target for anti-neoplastic drugs in the treatment of gliomas.


Assuntos
Glioma/química , Proteínas Nucleares/análise , Região Organizadora do Nucléolo/metabolismo , Adolescente , Adulto , Idoso , Antígenos Nucleares , Criança , Pré-Escolar , Feminino , Glioma/diagnóstico , Glioma/patologia , Glioma/secundário , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Coloração pela Prata/métodos
18.
Ophthalmology ; 107(1): 41-6; discussion 46-7, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10647717

RESUMO

OBJECTIVE: To determine whether the sub-Tenon's parabulbar approach for local anesthesia is a safe and effective choice for posterior segment surgery. DESIGN: Prospective, noncomparative case series. PARTICIPANTS: Two hundred seventy-six consecutive patients underwent posterior segment surgery at the University of Texas Medical Branch. INTERVENTION: Two hundred patients received sub-Tenon's parabulbar anesthesia containing an 11 -ml mixture of 5-ml 2% lidocaine (Xylocaine), 5-ml 0.5% bupivacaine (Marcaine), and 1 ml of 150 hyaluronidase (Wydase) units as primary anesthesia. The method did not involve a separate transcutaneous lid nerve or subconjunctival injection. MAIN OUTCOME MEASURES: The proportion of cases receiving supplementation (significant intravenous anesthesia, intraoperative local anesthesia, or both) was estimated. Its relationship to duration of surgery and surgical procedures deemed painful was assessed. Surgery lasting 3 hours or more was considered a long duration. Both scleral buckle and cryotherapy were considered painful procedures. The proportion of cases receiving additional local anesthesia preoperatively was also evaluated. Complications associated with sub-Tenon's parabulbar injection were monitored. RESULTS: There were 101 instances of patients receiving additional anesthesia. Nineteen received additional preoperative sub-Tenon's anesthesia, 12 received intraoperative local anesthesia supplementation, and 70 received intravenous medication. Of these 70, 19 required what the authors defined as a significant amount of intravenous medication, three of whom also received intraoperative local anesthesia supplementation. Consequently, 28 of 200 patients (14%; 95% confidence interval: 9.5, 19.6) received supplementation (significant intravenous anesthesia, intraoperative local anesthesia, or both). The proportion of cases receiving supplementation was directly related to duration of surgery. Patients involved in longer cases (51.7% vs. 7.6%; P < 0.001) and those involved in more painful procedures (48.2% vs. 8.7%; P < 0.001) were more likely to receive supplementation. Adjusting for surgery duration, a greater proportion of patients undergoing painful procedures required supplementation (31.3% vs. 0.5% for surgery < 3 hours, P = 0.003; 72.7% vs. 38.9% for surgery > or = 3 hours, P = 0.13). No associated ocular or systemic complications were observed. CONCLUSIONS: The results of this large study demonstrate that a single injection of sub-Tenon's anesthesia is relatively safe and effective for achieving local anesthesia during vitrectomies, with or without other intraocular procedures, lasting less than 3 hours. Other types of posterior segment surgery may require supplementation if they are more painful procedures, such as scleral buckle or cryotherapy, or last longer than 3 hours.


Assuntos
Anestesia Local/métodos , Anestésicos Combinados/administração & dosagem , Anestésicos Locais/administração & dosagem , Doenças Retinianas/cirurgia , Vitrectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bupivacaína/administração & dosagem , Tecido Conjuntivo , Criocirurgia , Feminino , Humanos , Hialuronoglucosaminidase/administração & dosagem , Injeções , Implante de Lente Intraocular , Lidocaína/administração & dosagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Segurança , Recurvamento da Esclera
20.
Surv Ophthalmol ; 44(1): 61-72, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10466589

RESUMO

Technology to create and move multimedia medical information is creating alternatives to physically transporting patients and health care professionals. Teletechnology is a physician extender, both supplementing and reinventing traditional health care delivery systems. The potential of comprehensive teleophthalmology is compelling. This article provides a historical perspective of telemedicine, describes various teleophthalmology systems, and surveys teleophthalmology in clinical consultation, research, and education programs around the world. It also discusses basic issues in applying teleophthalmology to public health.


Assuntos
Oftalmologia , Telemedicina , História do Século XX , Humanos , Oftalmologia/economia , Oftalmologia/história , Oftalmologia/métodos , Oftalmologia/organização & administração , Telemedicina/economia , Telemedicina/história , Telemedicina/métodos , Telemedicina/organização & administração
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