Fibrin Reaction after Extracapsular Cataract Extraction: A Statistical Evaluation

As part of a retrospective sudy, 1056 eyes of 940 patients who had undergone extracapsular cataract surgery and posterior chamber IOL implantation were studied using statistical methods (chi-squared test). We studied the presence of fibrin reaction in three subgroups: diabetics without retinopathy (102 eyes), previously operated for primary open angle glaucoma “POAG” (78 eyes) and exfoliation syndrome without glaucoma (43 eyes). The results were compared for these three groups and for a group of normal individuals. The incidence of fibrin reaction was 13.7% in the diabetics, 44.8% in the group of previously operated POAG and 27.9% in the group of exfoliation syndrome without glaucoma. All the groups studied had this complication much more often than the controls (p < 0.0001). The incidence among previously operated eyes for POAG was higher than in diabetic eyes without retinopathy (p < 0.0005) and in exfoliation syndrome without glaucoma eyes (0.05 < p < 0.1). Fibrin reaction was more common in exfoliation syndrome without glaucoma than in diabetic eyes without retinopathy (p < 0.05).

HEAVY METALS IN URBAN PARK SOILS FROM ATHENS, GREECE

Urban geochemistry is a scientific discipline which is growing in the recent years mainly because of the environmental impact caused by urbanization. The present study aims to determine the concentrations of potentially harmful elements (PHEs) on surface soils (0-10cm) in Athens parks. Soil sampling was carried out in public park areas within the Athens urban area. Twenty surface soil (0-10cm) samples were collected and the <100μm grain size fraction was analyzed by Flame Atomic Absorption Spectroscopy for Pb, Zn, Ni, Cu, Mn andCr after a strong acid dissolution and partial extraction by 1M HCl. The organic soil matter content was determined by a combustion method. Two different inter-correlated groups of elements were identified, one including Pb, Zn, Cu showing the anthropogenic signature on urban soil and another including Cr, Ni and Mn showing geogenic origin. The mobility of the heavy metals determined in the present study follows the decreasing order: Pb> Mn >Ni≈ Cu≈ Zn> Cr. The data indicate that park areas seem to be important sinks of anthropogenic elements in urban soils.

Glaucoma risk assessment using a non-linear multivariable regression method

The present research investigates the relationship between the central corneal thickness (CCT), Heidelberg Retina Tomograph II (HRTII) structural measurements and intraocular pressure (IOP) using an innovative non-linear multivariable regression method in order to define the risk factors in future glaucoma development and patient management. The method is implemented to data from ninety-three open angle glaucoma eyes. The results show that in established glaucoma, CCT is significantly associated with HRTII structural measurements (maximum contour depression, cup volume inferotemporally) and IOP. They are also compared to those obtained from the application of standard linear regression methods, improving the coefficient determination R(2) by 35%, exhibiting thus the performance of the proposed methodology.

Omega- and Omega+ production in central Pb + Pb collisions at 40 and 158A GeV

Results are presented on Omega production in central Pb+Pb collisions at 40 and 158A GeV beam energy. For the first time in heavy ion reactions, rapidity distributions and total yields were measured for the sum Omega(-) + Omega(+) at 40A GeV and for Omega(-) and Omega(+) separately at 158A GeV. The yields are strongly underpredicted by the string-hadronic UrQMD model but agree better with predictions from hadron gas models.

System-size dependence of strangeness production in nucleus-nucleus collisions at squareroot[sNN]=17.3 GeV

Emission of pi+/-, K+/-, phi, and Lambda was measured in near-central C+C and Si+Si collisions at 158 AGeV beam energy. Together with earlier data for p+p, S+S, and Pb+Pb, the system-size dependence of relative strangeness production in nucleus-nucleus collisions is obtained. Its fast rise and the saturation observed at about 60 participating nucleons can be understood as the onset of the formation of coherent systems of increasing size.

Lambda and lambda production in central Pb-Pb collisions at 40, 80, and 158A GeV

Production of Lambda and Antilambda hyperons was measured in central Pb-Pb collisions at 40, 80, and 158A GeV beam energy on a fixed target. Transverse mass spectra and rapidity distributions are given for all three energies. The Lambda/pi ratio at midrapidity and in full phase space shows a pronounced maximum between the highest BNL Alternating Gradient Synchrotron and 40A GeV CERN Super Proton Synchrotron energies, whereas the Lambda/pi ratio exhibits a monotonic increase.

Evidence for an exotic S= -2, Q= -2 baryon resonance in proton-proton collisions at the CERN SPS

Results of resonance searches in the Xi(-)pi(-), Xi(-)pi(+), Xi;(+)pi(-), and Xi;(+)pi(+) invariant mass spectra in proton-proton collisions at sqrt[s]=17.2 GeV are presented. Evidence is shown for the existence of a narrow Xi(-)pi(-) baryon resonance with mass of 1.862+/-0.002 GeV/c(2) and width below the detector resolution of about 0.018 GeV/c(2). The significance is estimated to be above 4.2sigma. This state is a candidate for the hypothetical exotic Xi(--)(3/2) baryon with S=-2, I=3 / 2, and a quark content of (dsdsū). At the same mass, a peak is observed in the Xi(-)pi(+) spectrum which is a candidate for the Xi(0)(3/2) member of this isospin quartet with a quark content of (dsus[-]d). The corresponding antibaryon spectra also show enhancements at the same invariant mass.

Event-by-event fluctuations of the Kaon-to-Pion ratio in central Pb+Pb collisions at 158 GeV per nucleon

We present the first measurement of fluctuations from event to event in the production of strange particles in collisions of heavy nuclei. The ratio of charged kaons to charged pions is determined for individual central Pb+Pb collisions. After accounting for the fluctuations due to detector resolution and finite number statistics we derive an upper limit on genuine nonstatistical fluctuations, which could be related to a first- or second-order QCD phase transition. Such fluctuations are shown to be very small.

[Ahmed valve in high-risk glaucoma surgery]

We used the Ahmed valve for the treatment of 142 eyes with high-risk glaucoma. The glaucoma was neovascular in 74 cases, aphakic or pseudophakic in 19 eyes and occurred after previous faliure of filtering surgery in 49 eyes. Preoperative mean IOP was 31.6+/-10.4 mmHg under topical and/or systemic treatment. The success rate (IOP<22 mmHg with only topical treatment) was 56.3% with a mean follow-up of 32.4 months. Complications were fewer and milder compared with those reported for other types of drainage implants and for other types of antiglaucoma procedures.

Risk Factors in Ocular Hypertension

The aim of the study was to determine whether certain factors are related to an increased risk of developing open-angle glaucoma. A total of 345 untreated glaucoma suspects with intraocular pressure (IOP) ≥ 21 mmHg, cup to disc ratio 0.4 or less and no visual field defects, were followed up for 6 to 8 years (mean 7.3). During the follow-up 71 patients developed established glaucoma and were compared to the remaining 274 patients. The following factors were analysed: age, family history of glaucoma, IOP, Humphrey 30-2 visual fields, optic disc appearance, myopia, exfoliation, arterial hypertension and diabetes. Analysis yielded statistically significant results regarding a number of these factors in the patients who subsequently developed open-angle glaucoma. A significant association with the subsequent development of field loss in ocular hypertension (OHT) included: heredity (p < 0.001), age ≥ 60 years (p = 0.013), axial myopia (0.001 < p < 0.01) and arterial hypertension (p = 0.05). About 20% of patients with ocular hypertension developed glaucoma over a period of seven years. Risk factors such as heredity, age, myopia and arterial hypertension, among others, must be considered in the follow-up of glaucoma suspects.

Hemivertebral excision for congenital scoliosis

We retrospectively reviewed the cases of 10 consecutive patients treated with hemivertebral excision for congenital scoliosis at The Children's Hospital, Denver, CO, between 1982 and 1992. Follow-up consisted of physical and radiographic examination and averaged 54 months (range, 4-111). Age at surgery ranged from 9 months to 10 years, 5 months (average, 3 years, 11 months). Hemivertebra levels were between T12 and L3. The average preoperative curve measured 40 degrees (range, 20-55 degrees); the average at latest follow-up was 16 degrees (range, 3-37 degrees). We found hemivertebral excision for congenital scoliosis to be a safe and effective means of treatment. Curve correction averaged 67% and seemed to be greatest in those less than 4 years of age at the time of surgery.

Intraoperative blood salvage in children and young adults undergoing spinal surgery with predeposited autologous blood: efficacy and cost effectiveness

We conducted a retrospective review of 155 spinal operations at our institution to determine the efficacy of intraoperative salvage. Addition of intraoperative salvage had little effect on the success of a preoperative autologous donation program. Only patients with operative blood loss > 2,000 ml (12% of patients) benefited from this expensive source of autologous blood. The technique tended to be most effective in children aged 16-18 years. Use of intraoperative salvage for all pediatric spinal procedures is neither necessary nor cost effective.

Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment

During the period 1970-87 we evaluated the changes of the optic disc, peripapillary area, detached macula and visual acuity in 16 cases with congenital pit of the optic nerve and macular detachment. The study revealed in 9 of the 16 cases (56%) an increase of the dimension of the pit or changes in its color, findings which were directly related to the duration of the macular detachment. Chorioretinal scarring, pigment migration, or both, were also noted mainly at the temporal margin of optic disc. In 5/16 cases we found during the follow-up an extension of macular elevation. In altogether 10 out of 16 cases the retinal elevation covered the larger portion of the mid-periphery temporally. In 7/16 cases the final visual acuity remained unchanged, in 9/16 cases deteriorated. The difference, however, in the latter 9 cases between initial and final visual acuity was negligible. During the follow-up period deterioration of the visual fields was also noted.

Autologous transfusions for orthopaedic procedures at a children's hospital

We conducted a critical review of the use of autologous transfusions in orthopaedics at a tertiary-care children's hospital. The cases of 198 children who deposited blood before an orthopaedic operation were analyzed. There were 175 children who were enrolled in the program of preoperative deposit of autologous blood who later needed transfusion of blood; 73 per cent of them received only autologous blood. Seventy patients also had intraoperative salvage. We were unable to document a proved benefit of intraoperative salvage of blood in this group of patients. Forty patients had some difficulty donating autologous blood preoperatively, but these problems were rarely serious. Major human errors occurred in thirteen patients and resulted in some patients receiving homologous transfusions while autologous blood components were still available. Fifty-five (40 per cent) of all of the transfusions were administered in clinical circumstances that failed to meet generally accepted criteria for transfusion, and fifty-four (38 per cent) of the postoperative transfusions also failed to meet these criteria. This was true of the homologous transfusions in the study as well. Although an autologous blood transfusion is a generally safe procedure, it is not without risk, and human errors can occur. In light of the potential complications, surgeons should adhere to the standard indications for transfusion when administering autologous blood.

Displaced supracondylar humeral fractures in children. A comparison of results and costs in patients treated by skeletal traction versus percutaneous pinning

Clinical outcome and treatment cost were compared in 65 children treated by either percutaneous pinning or skeletal traction for displaced supracondylar humeral fractures. Clinical outcome was evaluated by loss of elbow motion and change in carrying angle. Results of treatment were basically equivalent in the two groups and were satisfactory in 90% or more. To determine treatment cost, the authors analyzed factors that vary according to the type of therapy. Cost of treatment was lowest in those who had percutaneous pinning and subsequent pin removal in the office. Compared to this group, the cost of treatment increased by 23% in those who had percutaneous pinning and removal of the pins as a surgical procedure, by 117% in those treated by traction with the olecranon pin inserted in the emergency room, and by 142% in those treated by traction with the olecranon pin inserted in the operating room.

Central visual field changes after panretinal photocoagulation in proliferative diabetic retinopathy

This study comprises 53 eyes, divided into two groups A and B, with proliferative diabetic retinopathy which were treated with panretinal photocoagulation (PRP). Its purpose is to investigate the alterations in the central 15 degrees and 30 degrees of the visual field and in each quadrant separately. In both groups A and B, PRP covered the periphery and mid-periphery. In group A, it stopped 2 disc diameters (DD) from the upper temporal and lower margin of the fovea including the papillomacular bundle, while in group B, PRP stopped 3 DD from the upper temporal and lower margin of the fovea and 1 DD of the nasal margin of the optic disc. The investigation revealed, in group B after PRP, an improvement of the retinal sensitivity in the central 15 degrees of the visual field (p less than 0.01). In the 30 degrees of the visual field a deterioration after PRP was noted in both groups A and B, the deterioration being however much more prominent in group A. Comparing the results between groups B and A after PRP, a difference in the retinal sensitivity in favour of group B at 15 degrees and 30 degrees of the visual field was found. As regards regression of neovascularization and visual acuity, no statistically significant difference has been observed between the two groups.

Occipito-atlantal instability in children. A report of five cases and review of the literature

We are reporting the cases of five patients who had occipito-atlantal instability, a rare condition that may be due to either trauma or congenital abnormalities. In three of the patients the instability was secondary to trauma. The clinical and neurological manifestations were varied and included cardiorespiratory arrest, motor weakness, quadriplegia, torticollis, pain in the neck, vertigo, and projectile vomiting. All of the patients underwent posterior arthrodesis of the occiput to the first or second cervical vertebra. In the patients who had trauma-related instability, surgery was performed when immobilization in a cast failed to stabilize the spine; in the patients who had a congenital abnormality, arthrodesis was indicated because of persistent symptoms and the potential for catastrophe with minor trauma. Based on our experience, we recommend surgical stabilization by posterior arthrodesis when this form of instability of the cervical spine is diagnosed.